Skin homeostasis is impaired in hidradenitis suppurativa lesions, a comparative study.

INTRODUCTION: Hidradenitis suppurativa (HS) is a chronic skin disease whose impact on skin homeostasis has not been adequately studied at present. Knowledge about how skin function changes in these patients, and could be of interest not only to improve the topical management of the disease, but also as an objective measure of disease activity. The aim of this study was to compare skin homeostasis and the epidermal barrier function in lesional and healthy skin areas of patients with HS. METHODS: We conducted a cross-sectional study. Skin homeostasis and the epidermal barrier function of lesions were assessed in HS patients using validated tools. A healthy perilesional skin control was assigned to each lesion to compare skin homeostasis parameters. RESULTS: A total of 43 patients were included: 22 nodules, 10 abscesses and 25 draining tunnels were measured. The male-to-female ratio was 20:23, and the mean age, 35.95 years (SD, 14.82). Increased transepidermal water loss (TEWL) and erythema were found in nodules, abscesses and draining tunnel vs healthy skin. A direct association was observed between inflammatory nodules TEWL and IHS4 stage. In draining tunnels, a direct association was observed between TEWL and smoking. A trend of increasing TEWL values was observed as a function of Hurley stage. CONCLUSION: HS lesions exhibit epidermal barrier dysfunction that depends on the severity of inflammatory activity. These results could be useful to develop objective classification systems for the severity and degree of involvement of HS or help in the development of vehicles for specific drugs, antiseptics and dressings for the management of this disease.

French early nationwide idecabtagene vicleucel chimeric antigen receptor T-cell therapy experience in patients with relapsed/refractory multiple myeloma (FENIX): A real-world IFM study from the DESCAR-T registry.

Idecabtagene vicleucel (ide-cel), a chimeric antigen receptor T-cell therapy targeting B-cell maturation antigen (BCMA), received early access program (EAP) authorization in France in April 2021 for relapsed/refractory multiple myeloma (RRMM). We conducted a real-world registry-based multicentre observational study in 11 French hospitals to evaluate ide-cel outcomes. Data from 176 RRMM patients who underwent apheresis between June 2021 and November 2022 were collected from the French national DESCAR-T registry. Of these, 159 patients (90%) received ide-cel. Cytokine release syndrome occurred in 90% with 2% grade ≥3, and neurotoxicity occurred in 12% with 3% grade ≥3. Over the first 6 months, the best overall response and ≥complete response rates were 88% and 47% respectively. The median progression-free survival (PFS) from the ide-cel infusion was 12.5 months, the median overall survival (OS) was 20.8 months and the estimated OS rate at 12 months was 73.3%. Patients with extra-medullary disease (EMD) had impaired PFS (6.2 months vs. 14.8 months). On multivariable analysis, EMD and previous exposure to BCMA-targeted immunoconjugate or T-cell-redirecting GPRC5D bispecific antibody were associated with inferior PFS. Our study supports ide-cel's feasibility, safety and efficacy in real-life settings, emphasizing the importance of screening for EMD and considering prior treatments to optimize patient selection.

Estudio de la calidad de vida en pacientes con fibromialgia: impacto de un programa de educación sanitaria. Respuesta de los autores / Study of quality of life of patients with fibromyalgia: impact of a health education programme

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[Study of quality of life of patients with fibromyalgia: impact of a health education programme]. / Estudio de la calidad de vida en pacientes con fibromialgia: impacto de un programa de educación sanitaria.

OBJECTIVE: To assess the impact of a programme of health education on the quality of life and frequency of attendance of persons with fibromyalgia. DESIGN: Community clinical trial with randomised allocation. SETTING: Sant Joan Despí urban Health District (Barcelona), with a population of 13 282 inhabitants. PARTICIPANTS AND METHODS: 67 women who attended our centre for consultation and were diagnosed with fibromyalgia by the Area Rheumatologist using the criteria of the American College of Rheumatology (1990). They were distributed at random into control and intervention groups. MAIN MEASUREMENTS: Social and demographic variables (age, marital status, educational background, job situation), health variables (physical exercise taken, current treatment, symptoms evolution time) and frequency of attendance were gathered. The Nottingham Health Profile (NHP) for measuring quality of life was administered. The presence of psychological malaise was determined through the Mini International Neuropsychiatric Interview. After the intervention, which consisted of four health education sessions, the NHP was administered again and frequency of attendance was measured again. RESULTS: The most important dimension on the NHP prior to intervention was pain (78.6 points), which was not modified either by physical exercise or the disease s time of evolution. Prevalence of psychological malaise was 64.6%. After the intervention there was a significant improvement in the pain dimension (P=.003). CONCLUSIONS: Health education for people with fibromyalgia modifies their perception of quality of life and reduces their pain. In addition, this kind of activity increases understanding of illness and reduces dependence on the health services.

Estudio de la calidad de vida en pacientes con fibromialgia: impacto de un programa de educación sanitaria / Study of quality of life of patients with fibromyalgia: impact of a health education programme

Objetivo. Valorar el impacto de un programa de educación sanitaria sobre la calidad de vida y frecuentación de personas con fibromialgia. Diseño. Ensayo clínico comunitario con asignación aleatoria. Emplazamiento. Área básica urbana de Sant Joan Despí (Barcelona), con una población de 13.282 habitantes. Participantes y métodos. Sesenta y siete mujeres diagnosticadas de fibromialgia por el reumatólogo de zona según los criterios del American College of Rheumatology (1990), que consultaron en nuestro centro. Fueron distribuidas aleatoriamente en grupo control y grupo intervención.Mediciones principales. Se recogieron variables sociodemográficas (edad, estado civil, nivel de instrucción y situación laboral), sanitarias (práctica de ejercicio físico, tratamiento actual y tiempo de evolución de los síntomas) y frecuentación. Se administró el test Nottingham Health Profile (NHP) para medir la calidad de vida y se determinó la presencia de malestar psíquico mediante el Mini International Neuropsychiatric Interview. Después de la intervención, que constaba de 4 sesiones de educación sanitaria, se volvió a administrar el NHP y a medir la frecuentación. Resultados. El ítem más afectado del NHP previo a la intervención era el dolor (78,6 puntos), que no se modificaba ni por la práctica de ejercicio físico ni por el tiempo de evolución de la enfermedad. La prevalencia de malestar psíquico fue del 64,6 por ciento. Tras la intervención se objetivó una mejoría significativa del ítem dolor (p = 0,003).Conclusiones. La educación sanitaria en pacientes con fibromialgia modifica su percepción de la calidad de vida, mejorando el dolor. Por otro lado, este tipo de actividades aumentan su conocimiento de la enfermedad, disminuyendo la dependencia de los servicios sanitarios (AU)

A descriptive analysis of patient encounter data from the Fleet Hospital FIVE humanitarian relief mission in Haiti.

Fleet Hospital FIVE personnel treated more than 24,000 patients during a 1997 military operation other than war in Haiti. Sample data were analyzed for 10,215 Haitians who received humanitarian assistance care at field treatment sites and for 353 military, United Nations personnel, and Haitian nationals who were treated at the fleet hospital. Demographic data, type of encounter, diagnoses, and prescriptions were tabulated. Children aged 1 to 10 years accounted for 31% of humanitarian assistance visits. Females outnumbered males; in adults aged 21 to 30 years, the proportion was almost three to one. Most (97%) were initial encounters. Infectious and parasitic diseases, such as worms or scabies, accounted for 25% of diagnoses. At the fleet hospital, more than 80% of patients were males; these were most often older than 21 years. Injuries and aftercare procedures constituted 51.5% of diagnoses. Of 18,100 prescriptions, 57% were for anti-inflammatories, vitamins, or anti-parasitics. Implications for medical planning are described.