What's new in psoriasis treatment? An analysis of systematic reviews published in 2015.

This review provides a summary of key findings from 27 systematic reviews of 51 articles first published or indexed during 2015, focusing on the treatment of psoriasis and on precision medicine in psoriasis. The evidence supports weight-loss interventions by dieting and exercise for improvement in disease severity in overweight and obese patients with psoriasis. No significant increased risk of serious infections was reported for the biologic therapies adalimumab, etanercept and ustekinumab compared with appropriate comparators. Evidence could not provide reliable estimates of rare adverse events, emphasizing the need for large prospective registries. Polymorphisms in the tumour necrosis factor (TNF)-α gene may confer improved responses to TNF inhibitor (TNFI) therapy, but the studies to date lack power to detect a true association. From the limited available evidence, multidisciplinary management is both more effective and more satisfactory for patients with psoriasis and psoriatic arthritis than conventional consultations. This summary of reviews provides a succinct guide for clinicians and patients wishing to remain up to date with high-quality evidence for the treatment of psoriasis.

Racial and ethnic differences in drug treatment entry of injection drug users in Massachusetts.

This article examines patterns of drug treatment entry among 28,000 adult injection drug users (IDUs), with special attention to racial and ethnic differences. The data analyzed originates from a statewide drug-treatment database covering four years. Through the use of logistic regression analysis, the study identified significant population differences between those who used detoxification only, those who used residential treatment and those who used methadone maintenance. Latino IDUs were approximately a third less likely than Caucasian IDUs to enter residential treatment and African American IDUs were half as likely as Caucasian IDUs to enter methadone maintenance treatment. This article discusses specific programmatic and research implications including the need to determine whether differential entry rates are due to access, client awareness, cultural, referral or other factors.

Age-related change in peripheral blood T-lymphocyte subpopulations and cytomegalovirus infection in the very old: the Swedish longitudinal OCTO immune study.

Results from the previous times (Times 1-3) of the Swedish longitudinal OCTO immune study indicated that a combination of high CD8 and low CD4 percentages and poor T-cell proliferation in PBL was associated with a higher 2-year mortality in a sample of very old Swedish individuals. The combination of immune parameters was closely related to an inverted CD4/CD8 ratio. In the present study at Time 4 (T4) results are reported from the final follow-up of this longitudinal study, 8 years after it was initiated in 1989. An additional goal at this time point was to examine the immune system alterations in the very old in relation to evidence of lymphocyte activation and cytomegalovirus antibody status. In the present study immune system changes were identified that suggest a loss of T-cell homeostasis, as reflected by a decrease in the number of CD4 cells and a very significant increase in the number of CD8 cells in individuals with an inverted CD4/CD8 ratio. When considered over the duration of the OCTO study the inversion occurred in a high percentage (32%) of the individuals included in the original sample and was associated with non-survival. At T4 the changes were apparent in a number of the T-cell subsets, but particularly in the CD8+CD28-and CD57+ subsets. T-cell activation was significantly associated with the inversion of the CD4/CD8 ratio. In this very old sample the subset alterations were associated with evidence of cytomegalovirus (CMV) infection.

Changes in CD8 and CD4 lymphocyte subsets, T cell proliferation responses and non-survival in the very old: the Swedish longitudinal OCTO-immune study.

Results from a previous longitudinal study indicated that a combination of high CD8 and low CD4 percentages and poor T cell proliferation in peripheral blood lymphocytes was associated with higher mortality in a subgroup of a sample of very old Swedish individuals. The present study examined whether those results could be confirmed at a subsequent 2-year time interval by investigating if additional individuals from the same original sample had developed the immune profile associated with higher mortality. Subgroups were formed by cluster analysis and similar to our previous results, this follow-up study identified a subgroup of subjects (n = 18) with an immune profile which again included high CD8, low CD4 percentages and poor mitogen response and was associated with higher mortality. Over the 2-year period 12 additional individuals: (1) Developed this immune profile; and (2) Could be identified by changes in their CD4:CD8 ratios which progressively decreased over the study period. These results confirm our original study and indicate that in this very old sample, over a subsequent 2 year period, additional individuals moved into the cluster at risk for higher mortality.

Reduction in animal numbers required for antisera production using the subcutaneous chamber technique in rabbits.

The purpose of this study was to determine if the subcutaneous chamber technique would reduce the number of rabbits required for antisera production by enabling serial use of individual animals for multiple antigens. Rabbits were assigned to immunization protocols against two antigens in series that involved combinations of chamber implantation, Freund's adjuvant and injection of antigen either by the subcutaneous route or by direct inoculation into the chamber. Results indicate the systemic immune response to both antigens achieved similar magnitude and duration by use of either Freund's adjuvant or direct inoculation of antigen into the chamber, suggesting that chamber use may be able to replace use of Complete Freund's adjuvant for many antigens. Rabbits re-used for a second antigen were equally successful in production of significant titres in both serum and chamber fluid without evidence of either a significant inflammatory response due to the chronic presence of the implant or a decrease in the yield of antisera harvested from the chamber. These results support the advantages of chamber use as reported by others and demonstrate that the chamber technique can significantly extend the productive life of an individual animal that would otherwise be euthanized following a single use in antisera production.

Preweaning variables' influence on market traits in rabbits.

Influence of several preweaning variables on market trait determination was investigated using 338 fryer rabbits from 52 litters. Variables measured at 1, 8, and 15 d included litter size, individual kit body weight (BW), within-litter rank score for BW, and litter uniformity (coefficient of variation for BW among littermates; CV). Daily milk consumption in wk 1, 2, and 3 was used to determine average weekly dominance rank score and total weekly milk consumption. Market traits were individual average daily gain (ADG) and litter feed intake (FI) from 28 to 70 d, and 70-d BW (BW70), litter uniformity (CV70), litter size (LS70), and within-litter rank score for BW (RANK70). Market traits were analyzed separately by week involving preweaning variables and season of weaning as covariates. The week models provided the most accurate predictions of ADG, BW70, FI, and LS70 (R2 = .542, .712, .906, and .970, respectively). Prediction of CV70 and RANK70 was poor (R2 = .202 to .369). Season influenced ADG, BW70, and FI (partial R2 values of .285 to .435). Path analysis indicated that milk consumption and BW were more important in BW70 determination (28.4, 26.4, and 36.9% of total variation in wk 1, 2, and 3, respectively) than litter size (partial R2 < or = 2.0%). In wk 1, litter size plus dominance rank score primarily determined LS70 (direct and indirect contributions of 62.3 and 21.5%). Because of major seasonal influences, management should take measures to optimize feed intake and to improve doe milk yield and fryer gain performance.

Implications and management of oral diseases in children and adolescents with HIV infection.

The impact of human immunodeficiency virus (HIV) infection on children continues to be felt worldwide. Since 1981, when the first patients with HIV were recognized, to 1996, when it was estimated that more than 14 million men, women and children were infected with the virus, no other infectious disease has had such a strong impact on the medical community. With the advent of better methods of detection and better therapies we are beginning to see HIV-infected children surviving longer, and thus coming under the care of a host of affiliated medical personnel, including dentists. This article will serve as a brief update on pediatric HIV and its impact on the oral health of infected children.

Facilitation of informed consent for agency residents with developmental disabilities.

The challenges in the management and delivery of care to persons with developmental disabilities are well-recognized by the dental profession. However, these challenges are usually not recognized or appreciated by the general public.

Immune parameters in a longitudinal study of a very old population of Swedish people: a comparison between survivors and nonsurvivors.

As a part of an ongoing longitudinal investigation, this study examined relationships between survival and selected immune system parameters in a sample (n = 102) of very old individuals (86-92 years at the time of initial immune system data collection). Analyses were performed comparing initial time-point measurements from those individuals who were alive (n = 75) and those who were deceased (n = 27) two years after initial data collection. Immune system measurements consisted of determination of peripheral blood lymphocytes and lymphocyte subsets, as well as T-cell responses to activation by Concanavalin A. Cluster analysis identified a subgroup associated with nonsurvival which indicated characteristics that included: poor T-cell proliferative responses, high CD8 percentages, and low CD4 and CD19 percentages. This multivariate analysis suggested that combinations of immune system parameters predict two-year survival otherwise not apparent when single immune system parameters were evaluated in the elderly.

Age-related differences in subset composition and activation responses of intestinal intraepithelial and mesenteric lymph node lymphocytes from neonatal swine.

Interesting differences were found in the phenotypes and functional responses of intestinal intraepithelial lymphocytes (IEL) and mesenteric lymph node lymphocytes (MLN) from neonatal swine aged 15 to 47 days. IEL and MLN differed significantly in their proliferative responses to the mitogens concanavalin A (Con A) and phorbol ester with ionophore (TPA/ionomycin) and to the cytokine, interleukin 2 (IL-2). IEL did not proliferate well in response to Con A, yet they were able to initiate a high proliferative response to exogenous IL-2, suggesting previous activation. In addition, the IEL response to TPA/ionomycin was very low unless the concentration of ionomycin was increased. With increasing age of the animals, response of the IEL increased. This IEL developmental response pattern was associated with a significant age-related change in T cell phenotype from CD2-4-8- cells to CD2+4-8- cells. In contrast to IEL, proliferation of MLN to Con A and TPA at a lower ionomycin concentration was significant and not influenced by age. Unlike the IEL, MLN were unresponsive to exogenous IL-2. Similar to IEL, they produced very little IL-2 in response to Con A stimulation. Both lymphoid tissues contained 70% T cells and in the MLN more cells were CD4+ or CD4+8+ and fewer were CD4-8- compared to the IEL. These differences between IEL and MLN in neonatal swine may reflect differences not only in the state of cell activation related to the in vivo microenvironment, but also the nature of responsive cell types in each lymphoid tissue.

Cosmic dust analog simulation in a microgravity environment: the STARDUST program.

We have undertaken a project called STARDUST which is a collaboration with Italian and American investigators. The goals of this program are to study the condensation and coagulation of refractory materials from the vapor and to study the properties of the resulting grains as analogs to cosmic dust particles. To reduce thermal convective currents and to develop valuable experience in designing an experiment for the Gas-Grain Simulation Facility aboard Space Station Freedom we have built and flown a new chamber to study these processes under periods of microgravity available on NASA's KC-135 Research Aircraft. Preliminary results from flights with magnesium and zinc are discussed.

Age-related changes in immune parameters in a very old population of Swedish people: a longitudinal study.

This study used a longitudinal design to examine age-related changes in a well-defined sample of Swedish people ranging from 86 to 92 years of age at baseline. The longitudinal design encompassed three measurement occasions with 1 year intermeasurement intervals. The results were analyzed by multivariate analyses of variance (MANOVA), which is useful for comparing individuals over time. Healthy middle-aged subjects (39 years SD +/- 5.8) served as controls. The proliferative responses to Concanavalin A (Con A), a T-cell mitogen, indicated significant lower levels in responses of the old when the two groups were compared. The MANOVA revealed no significant change in mitogen responses over measurement occasions in the old sample as compared with the young. However, when cell types and lymphocyte subpopulations were examined, significant differences were found between the two age groups in many of these parameters and for some (lymphocyte percentages and numbers, CD3 numbers) the MANOVA indicated significant decreases over the measurement occasions in the very old. The results also consistently indicated significant intraindividual correlations in cell types, lymphocyte subpopulations, and mitogen responses over time.

Enzyme-linked fluorescent detection for automated multiplex DNA sequencing.

Initiatives to sequence DNA on a large scale have created a need for increased throughput and decreased costs. One scheme for increasing throughput, multiplex sequencing, involves the processing of a mixture of sequencing templates followed by sequential hybridization to reveal the individual sequence ladders on a membrane. Because multiplex sequencing has not been fully automated, and has not seemed automatable, few sequencing efforts have attempted to exploit it. We describe here a scheme for the automation of multiplex sequencing. Probe hybridized to target DNA is detected via spatially localized enzyme-linked fluorescence. Light output is high enough that imaging is possible with simple instrumentation. Direct imaging within an automated hybridization apparatus is made feasible so that the entire process will be automatic once a multiplex membrane is produced. The technique has the potential to increase severalfold the throughput of automated sequencing instruments required for sequencing the human genome.

The effects of group housing on the research use of the laboratory rabbit.

This project evaluated the influence of group housing on common aspects of research use of female laboratory rabbits (Oryctolagus cuniculus). Eight rabbits housed individually in conventional cages were compared to a second group of 8 housed as a social group in a proportionately larger enclosure. The group housing method provided increased opportunities for exercise, social contact, and a more novel environment. As a function of housing style, the 2 experimental groups were compared on humoral and delayed hypersensitivity response, feed intake, growth rate, and selected physiological parameters that are considered to reflect stress in most species. Single and group housed rabbits did not significantly differ in physiological and immunological measurements, indicating that the practical research performance (immune response, stress level, growth rates etc.) of these rabbits was not significantly affected by group housing compared with the more traditional single housing. Analysis of group social behaviour indicated that the rabbits preferred small social groups, had preferences for microenvironments within the enclosure, and exhibited behaviours that are not possible when housed singly. Group housing appeared to be a successful method for enriching the environment of female rabbits and aspects of it should be considered in the approach to housing rabbits used in research.