Adult-Onset Periodic Fever, Aphthous Stomatitis, Pharyngitis, and Cervical Adenitis Syndrome on the Basis of Selective IgA Deficiency.

Periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis syndrome (PFAPA) is an autoinflammatory disease that is thought to occur with the contribution of genetic and environmental factors, but its etiology has not been clearly elucidated. It is characterized by recurrent attacks with fever, pharyngitis, oral aphthous lesions, and cervical lymphadenopathy, and an increase in the level of serum acute phase reactants is observed during the attacks. Although PFAPA usually begins in childhood, adult-onset cases are also reported in the literature. In the pathogenesis of PFAPA, an increase in the expression of various inflammatory cytokines, especially interleukin-1ß (IL-1ß), is observed as a result of the increase in inflammasome activity. Selective IgA deficiency (SIgAD) is the most prevalent primary immunodeficiency. Although most SIgAD cases remain asymptomatic and remain undiagnosed, it is known that the risk of mucosal infection is generally increased in SIgAD cases. In addition, the frequency of autoinflammatory diseases is increased in SIgAD cases compared with the general population. We aim to present a case of adult-onset PFAPA and SIgAD coexistence.

Important Roles of Interleukin-36, Interleukin-37, and Interleukin-38 Cytokines in the Pathogenesis of Rosacea.

Background: Rosacea is a chronic inflammatory skin disease. Previous studies have determined that IL-36, IL-37, and IL-38 may play a role in the pathogenesis of various inflammatory diseases. Aims and Objectives: The present study aims to evaluate the relationship of these cytokines with rosacea. Materials and Methods: A total of 100 individuals, including 50 patients with rosacea and 50 healthy controls, were included in the study. IL-36, IL-37, and IL-38 levels were measured using the ELISA method by taking serum samples from all participants. Results: The mean serum levels of IL-36, IL-37, and IL-38 in the patient group were 52.17 ± 24.07 pg/ml, 18.46 ± 8.18 pg/ml, and 25.74 ± 8.36 ng/l, respectively. The mean serum levels of IL-36, IL-37, and IL-38 in the control group were 32.99 ± 19.90 pg/ml, 44.61 ± 22.27 pg/ml, and 45.61 ± 17.32 ng/l, respectively. The difference between the serum levels of IL-36, IL-37, and IL-38 in the patient and control groups was statistically significant (P < 0.001). Conclusion: Based on these findings, an increase in IL-36 and a decrease in IL-37 and IL-38 may contribute to the pathogenesis of rosacea. Future rosacea treatments could target and/or interact with these possible steps in the pathogenesis of rosacea.

How do the printing parameters of fused filament fabrication and structural voids influence the degradation of biodegradable devices?

Fused Filament Fabrication (FFF), a commonly used additive manufacturing technology, is now employed widely in biomedical fields for fabricating geometrically complex biodegradable devices. Structural voids arising from the printing process exist within the objects manufactured by FFF. This paper reveals the underlying mechanism of how the printing parameters and voids affect the degradation behaviours of devices made of biodegradable polyesters. It was found that both voids and internal architecture (layer height, for instance) affect the degradation rate by interacting with the reaction-diffusion process. Large suppression of the degradation rate was found when auto-catalytic hydrolysis and diffusion are significant. Degradation rate reduced in an approximately logarithmic manner as void size increased. The extent this effect depended on the strength of auto-catalytic hydrolysis and diffusion, void size and overall device size. The internal architecture of FFF products (regulated by printing parameters) influences the degradation rate by altering the diffusion speed of acid catalysts (regulated by diffusion path length). Both void size and internal architecture should be considered in fabricating biodegradable devices using FFF. STATEMENT OF SIGNIFICANCE: A geometric model that relates printing parameters with voids of FFF is developed to characterise the structure of FFF components. Such a model, when coupled with a degradation model, offers end-to-end simulation capability (e.g. from printing parameters to degradation rate) for predicting degradation properties. The model is validated against the in vitro degradation data obtained in this study. To our knowledge, the impact of printing parameters and voids on degradation is investigated here for the first time. It is found that both the void size and the internal architecture determined by the printing parameters play an essential role in regulating degradation behaviours.

Elevated Serum Endocan Levels in Patients with Rosacea: A New Therapeutic Target?

BACKGROUND: Rosacea is a chronic inflammatory skin disease whose etiopathogenesis is still unknown. Previous studies have shown a relationship between certain inflammatory disorders and serum endocan levels. Endocan (previously known as endothelial cell-specific molecule 1) might play a role in the pathogenesis of various inflammatory diseases. AIMS AND OBJECTIVES: Our study aimed to evaluate serum endocan levels in patients with rosacea to investigate the association of endocan with the demographic data. MATERIALS AND METHODS: The study recruited individuals aged ≥18 years who voluntarily agreed to participate in the study. The participants included 37 women (mean age: 48.29 ± 12.08 years) and 13 men (mean age: 52.23 ± 13.34 years) diagnosed with rosacea, and 37 women (mean age: 49.18 ± 16.6 years) and 13 men (mean age: 53.69 ± 11.30 years) selected as controls. Both groups were matched according to age and sex. The rosacea diagnosis was based on clinical examination findings, and serum endocan levels were measured using the method of enzyme-linked immunosorbent assay (ELISA). The statistical significance of the data was determined by the Mann-Whitney U test, and a value of P < 0.05 was considered statistically significant. RESULTS: Serum endocan levels differed significantly between the patients with rosacea and the control group (P < 0.05). CONCLUSION: Circulating endocan might be a new marker related to disease progression in patients with rosacea. Further investigation is needed to determine whether endocan levels could become a new therapeutic target in rosacea, a disease that still cannot be fully cured.

Mechanical and hydrolytic properties of thin polylactic acid films by fused filament fabrication.

Thin polymeric films are widely used as medical applications such as cell culture, stent, drug delivery and mechanical fixation. One of the most commonly used materials is polylactic acid (PLA) - a material, which is non-toxic, biodegradable and biocompatible. Fused filament fabrication (FFF) is a preferable additive manufacturing technique to manufacture polymers, where PLA is one of the most common materials. FFF is a promising technique for customised biomedical applications due to its relatively low cost and geometrical flexibility where biomedical applications are patient tailored. This study is the first to consider FFF monolayered thin films of PLA in terms of mechanical and hydrolytic properties at 37 °C in vitro degradation. Throughout degradation, the reduction in mechanical properties was examined by analysing molecular weight and thermal properties. FFF monolayered PLA underwent autocatalytic bulk degradation with no proof of significant mass loss. Young's modulus, ultimate tensile strength and molecular weight reduced by approximately 60%, 86%, and 80% after 280 days, respectively, while the degree of crystallinity increased by 143% in comparison to benchmark thin films at day 0. It was found that the decrease in mechanical properties was more sensitive to the increase in crystallinity in the early stage of the degradation, while the molecular weight was more dominant in the late stage of the degradation. This study provides practical information in terms of mechanical properties to support medical device designers in a range of potential end-use biomedical applications to achieve safe functional products over the required degradation lifetime.

Layer-dependent properties of material extruded biodegradable Polylactic Acid.

Polylactic acid (PLA) is a biodegradable, biocompatible and non-toxic biopolymer with good mechanical properties, and is commonly used for the additive manufacture of PLA-based biomedical devices. Such devices are available in a range of sizes and thicknesses, with smaller devices capable of being realised via additive manufacturing in just a few layers. Due to their thermal history and thermal degradation, the thermal, molecular weight and mechanical properties of each layer was different when the raw material was melted, and the in-course layer was deposited to the previous layer. This study investigated the effect of the number of layers on mechanical, thermal and molecular weight properties, and the relationship between them. Material extruded ISO 527-2 type 5A specimens with 1-, 2-, 3-, 4-, 5-, 7- and 10-layers were prepared with the cutting die. Results indicated that the degree of crystallinity was found to decrease from 8% to 0.5% with an increasing number of layers. This was likely due to different cooling rates, where the molecular weight was lowest for 1-layer and increased with the increasing number of layers until it almost reached that of the bulk material. Additionally, ultimate tensile strength and strain increased with an increasing number of layers, while Young's Modulus decreased due to heterogeneous material structure. Of all obtained results, there was no significant difference between 5- and 10-layer in terms of mechanical and thermal properties.