Isolated lip dermatitis (atopic cheilitis), successfully treated with topical tacrolimus 0.03.

BACKGROUND: Exfoliative and erosive cheilitis, may be a source of speech and chewing discomfort, but may also be an aesthetic issue for the patients affected. Such a clinical presentation may implicate a variety of inflammatory conditions, including atopic (eczematous) cheilitis. Topical and systemic agents, e.g. corticosteroids, have been used to treat inflammatory lip conditions. Topical tacrolimus has also been used in some inflammatory lip conditions. MATERIAL AND METHODS: We performed a retrospective clinical analysis of atopic cheilitis patients. RESULTS: Between 2015 and 2020, we addressed 7 (seven) patients with atopic dermatitis affecting only lips and were diagnosed as atopic-eczematous cheilitis. They were treated with 0.03 per cent topical tacrolimus ointment and responded completely. CONCLUSIONS: These cases represent an underreported atopy / eczema event;-few cases of atopic cheilitis without concomitant dermal lesions appear in the literature. We are also showing and discussing yet another application of tacrolimus in a local atopic form of inflammation affecting the lips.

Shear-induced ordering in systems with competing interactions: A machine learning study.

When short-range attractions are combined with long-range repulsions in colloidal particle systems, complex microphases can emerge. Here, we study a system of isotropic particles, which can form lamellar structures or a disordered fluid phase when temperature is varied. We show that, at equilibrium, the lamellar structure crystallizes, while out of equilibrium, the system forms a variety of structures at different shear rates and temperatures above melting. The shear-induced ordering is analyzed by means of principal component analysis and artificial neural networks, which are applied to data of reduced dimensionality. Our results reveal the possibility of inducing ordering by shear, potentially providing a feasible route to the fabrication of ordered lamellar structures from isotropic particles.

Identification of long non-coding RNAs expressed in knee and hip osteoarthritic cartilage.

OBJECTIVE: Long intergenic non-coding RNAs (lincRNAs) are emerging as key regulators in gene expression; however, little is known about the lincRNA expression changes that occur in osteoarthritis (OA). Here we aimed to define a transcriptome of lncRNAs in OA cartilage, specifically comparing the lincRNA transcriptome of knee and hip cartilage. METHOD: RNA-seq was performed on nucleic acid extracted from hip cartilage from patients undergoing joint replacement surgery because of either OA (n = 10) or because of a neck of femur fracture (NOF; n = 6). After transcript alignment, counts were performed using Salmon and differential expression for ENSEMBL lincRNAs determined using DESeq2. Hip RNA-seq lincRNA expression was compared to a knee dataset (ArrayExpress; E-MTAB-4304). ChIP-seq data from ENCODE was used to determine whether lincRNAs were associated with promoters (plncRNA) or unidirectional enhancer-like regulatory elements (elncRNAs). RESULTS: Our analysis of the hip transcriptome identified 1692 expressed Transcripts Per Million (TPM ≥1) Ensembl lincRNAs, of which 198 were significantly (FDR ≤0.05) differentially expressed in OA vs normal (NOF) cartilage. Similar analysis of knee cartilage transcriptome identified 648 Emsembl lincRNAs with 93 significantly (FDR ≤0.05) differentially expressed in intact vs damaged cartilage. In total, 1834 lincRNAs were expressed in both hip and knee cartilage, with a highly significant correlation in expression between the two cartilages. CONCLUSION: This is the first study to use RNA-seq to map and compare the lincRNA transcriptomes of hip and knee cartilage. We propose that lincRNAs expressed selectively in cartilage, or showing differential expression in OA, will play a role in cartilage homoeostasis.

On the calculation of solubilities via direct coexistence simulations: Investigation of NaCl aqueous solutions and Lennard-Jones binary mixtures.

Direct coexistence molecular dynamics simulations of NaCl solutions and Lennard-Jones binary mixtures were performed to explore the origin of reported discrepancies between solubilities obtained by direct interfacial simulations and values obtained from the chemical potentials of the crystal and solution phases. We find that the key cause of these discrepancies is the use of crystal slabs of insufficient width to eliminate finite-size effects. We observe that for NaCl crystal slabs thicker than 4 nm (in the direction perpendicular to the interface), the same solubility values are obtained from the direct coexistence and chemical potential routes, namely, 3.7 ± 0.2 molal at T = 298.15 K and p = 1 bar for the JC-SPC/E model. Such finite-size effects are absent in the Lennard-Jones system and are likely caused by surface dipoles present in the salt crystals. We confirmed that µs-long molecular dynamics runs are required to obtain reliable solubility values from direct coexistence calculations, provided that the initial solution conditions are near the equilibrium solubility values; even longer runs are needed for equilibration of significantly different concentrations. We do not observe any effects of the exposed crystal face on the solubility values or equilibration times. For both the NaCl and Lennard-Jones systems, the use of a spherical crystallite embedded in the solution leads to significantly higher apparent solubility values relative to the flat-interface direct coexistence calculations and the chemical potential values. Our results have broad implications for the determination of solubilities of molecular models of ionic systems.

Conformational transitions of weak polyacids grafted to nanoparticles.

The charge distribution on polyelectrolytes is a key factor, which controls their conformation and interactions. In weak polyelectrolytes, this distribution is determined by a number of factors, including the solvent conditions and local environment. In this work, we investigate charge distributions of chains end-grafted on a spherical nanoparticle in a salt solution, using grand canonical titration Monte Carlo simulations of a coarse-grained polymer model. In this approach, the ionization state of each polymer bead fluctuates based on the dissociation constant, pH of the solution, and interactions with other particles in the system. We determine charge and polymer conformations as functions of the pH and solvent quality. We compare the results to a fixed charge model and also investigate the role of grafting density and the effect of curvature on the film morphologies.

Grand-canonical Monte Carlo method for Donnan equilibria.

We present a method that enables the direct simulation of Donnan equilibria. The method is based on a grand-canonical Monte Carlo scheme that properly accounts for the unequal partitioning of small ions on the two sides of a semipermeable membrane, and can be used to determine the Donnan electrochemical potential, osmotic pressure, and other system properties. Positive and negative ions are considered separately in the grand-canonical moves. This violates instantaneous charge neutrality, which is usually considered a prerequisite for simulations using the Ewald sum to compute the long-range charge-charge interactions. In this work, we show that if the system is neutral only in an average sense, it is still possible to get reliable results in grand-canonical simulations of electrolytes performed with Ewald summation of electrostatic interactions. We compare our Donnan method with a theory that accounts for differential partitioning of the salt, and find excellent agreement for the electrochemical potential, the osmotic pressure, and the salt concentrations on the two sides. We also compare our method with experimental results for a system of charged colloids confined by a semipermeable membrane and to a constant-NVT simulation method, which does not account for salt partitioning. Our results for the Donnan potential are much closer to the experimental results than the constant-NVT method, highlighting the important effect of salt partitioning on the Donnan potential.

Simulations of micellization of sodium hexyl sulfate.

Micellization of the ionic surfactant sodium hexyl sulfate has been studied using atomistic explicit-solvent molecular dynamics simulations with and without excess NaCl or CaCl(2). Simulations were performed at surfactant loadings near the critical micellization concentration. Equilibrium micelle size distributions and estimates of the critical micellization concentration obtained from the simulations are in agreement with experimental data. In comparison to the sodium dodecyl sulfate surfactant, the shorter alkyl chain of sodium hexyl sulfate results in increased disorder of the micellar core and water exposure of the hydrocarbon tail groups. However, water and ions do not penetrate into the micellar core even for these weakly micellizing surfactants. Excess NaCl is observed to have a minor influence on the micelle structure but excess CaCl(2) induces drastic changes both in the structure and the dynamics of the micellar system. Furthermore, in the absence of excess salt, sodium hexyl sulfate forms predominantly spherical, disorganized aggregates but an increase in ionic strength drives an increase in aggregate size and leads to prolate aggregates.

Prognostic factors for the response to treatment in males with genital warts.

BACKGROUND: Factors predicting an unfavourable course of genital warts to treatment have not been determined. MATERIALS AND METHODS: Behavioural and baseline disease characteristics were recorded from 246 males with anogenital warts. Urethral swabs were obtained and examined using the Hybrid Capture 2 Microplate assay. Patients were treated for their anogenital warts with cryotherapy, imiquimod cream 5% or podophyllotoxin. They were followed up every 3 months for 1 year. RESULTS: Patients with a negative or low-risk initial test tended to respond earlier to treatment than those with a high/intermediate-risk human papillomavirus (HPV) or with a dual infection (P = 0.028). The response rate was unrelated (P > 0.05) to the duration, number and anatomical location of the lesions and to the patient's age and sexual orientation, and only marginally to the initial extent of the lesion (P = 0.046). However, the type of treatment predicted a favourable response (P < or = 0.001), with patients who received both imiquimod and crotherapy responding worse. Considering all factors simultaneously in logistic regression, only the type of treatment and extent of the disease were found to influence the response rate. CONCLUSION: The type of treatment and extent of the disease were the only factors found critical for patients' response.

Charge correlation effects on ionization of weak polyelectrolytes.

Ionization curves of weak polyelectrolytes were obtained as a function of the charge coupling strength from Monte Carlo simulations. In contrast to many earlier studies, the present work treats counterions explicitly, thus allowing the investigation of charge correlation effects at strong couplings. For conditions representing typical weak polyelectrolytes in water near room temperature, ionization is suppressed because of interactions between nearby dissociated groups, as also seen in prior work. A novel finding here is that, for stronger couplings, relevant for non-aqueous environments in the absence of added salt, the opposite behavior is observed-ionization is enhanced relative to the behavior of the isolated groups due to ion-counterion correlation effects. The fraction of dissociated groups as a function of position along the chain also behaves non-monotonically. Dissociation is highest near the ends of the chains for aqueous polyelectrolytes and highest at the chain middle segments for non-aqueous environments. At intermediate coupling strengths, dissociable groups appear to behave in a nearly ideal fashion, even though chain dimensions still show strong expansion effects due to ionization. These findings provide physical insights on the impact of competition between acid/base chemical equilibrium and electrostatic attractions in ionizable systems.

Phase diagrams of charged colloids from thermodynamic integration.

We present full phase diagrams (including solid phases) of spherical charged colloids, using Monte Carlo sampling and thermodynamic integration of the Helmholtz free energy. Colloids and their co- and counterions are described by the primitive model for ionic systems that consists of hard-spheres with central point charges, while the solvent is taken into account solely through its dielectric constant. Two systems are considered: (i) a size-asymmetric system of oppositely charged spheres with size ratios q = 0.3 and 0.5 and (ii) a charge- and size-asymmetric system with colloid charge Q = 10 and counterions of charge -1 in the presence of monovalent added salt. In system (i), for both size ratios, the stable solid phase is equivalent to the NaCl crystal where the oppositely charged spheres take the lattice positions of Na and Cl ions. In system (ii), the phase diagram consists of gas-liquid and fluid-solid coexistence regions. We show that added salt stabilizes the fluid phase and shrinks the fluid-solid coexistence region, in agreement with experimental and theoretical results.

Disappearance of the gas-liquid phase transition for highly charged colloids.

We calculate the full phase diagram of spherical charged colloidal particles using Monte Carlo free energy calculations. The system is described using the primitive model, consisting of explicit hard-sphere colloids and point counterions in a uniform dielectric continuum. We show that the gas-liquid critical point becomes metastable with respect to a gas-solid phase separation at colloid charges Q > or =20 times the counterion charge. Approximate free energy calculations with only one and four particles in the fluid and solid phases, respectively, are used to determine the critical line for highly charged colloids up to Q=2000. We propose the scaling law T*(c) approximately Q(1/2) for this critical temperature.

Assessment of the efficacy of cryosurgery in the treatment of granuloma faciale.

BACKGROUND: Granuloma faciale (GF) is an uncommon dermatosis of unknown pathogenesis. Multiple treatments have been proposed with varying results. We report nine cases treated successfully with cryosurgery and we review the literature. OBJECTIVES: To study the efficacy, tolerability and safety of cryosurgery techniques in the treatment of GF. METHODS: Nine immunocompetent adults with GF were treated by cryosurgery. The initiation of the therapy was preceded by a 60-day washout period in all subjects using other medication. Two different techniques were used (open-spray and contact cryo-probe). RESULTS: All patients were treated successfully. Apart from mild postinflammatory hypopigmentation in two patients that resolved within 4 months, no other adverse event was mentioned. During an average 24-month follow-up period after the integration of therapy, no recurrences were observed. CONCLUSIONS: Cryosurgery is an efficient, safe, inexpensive, easily used method for this uncommon dermatosis, which can be proposed as a treatment of first intention.

Thermodynamic properties of lattice hard-sphere models.

Thermodynamic properties of several lattice hard-sphere models were obtained from grand canonical histogram- reweighting Monte Carlo simulations. Sphere centers occupy positions on a simple cubic lattice of unit spacing and exclude neighboring sites up to a distance sigma. The nearestneighbor exclusion model, sigma = radical2, was previously found to have a second-order transition. Models with integer values of sigma = 1 or 2 do not have any transitions. Models with sigma = radical3 and sigma = 3 have weak first-order fluid-solid transitions while those with sigma = 2 radical2, 2 radical3, and 3 radical2 have strong fluid-solid transitions. Pressure, chemical potential, and density are reported for all models and compared to the results for the continuum, theoretical predictions, and prior simulations when available.

Actinic granuloma successfully treated with acitretin.

Actinic granuloma is a rare skin disorder that develops in an area of actinic elastosis. The pathogenesis of the disease is obscure but the most accepted hypothesis implicates the solar radiation as the triggering factor. Typically the disease presents in middle-aged individuals with significant past sun-exposure and involves mainly the sun-exposed skin. It manifests as asymptomatic annular patches with elevated borders and central atrophy and shows little tendency to regression. Several treatments have been tried with variable success. We present a 74-year-old male who consulted our department for annular atrophic plaques involving his forehead and nose, present for 8 months and insidiously spreading but otherwise asymptomatic. A biopsy confirmed the clinical suspicion of actinic granuloma and excluded other possibilities. Our patient was commenced on acitretin 25 mg/day and showed a remarkable improvement within a year; the lesions stopped spreading and almost disappeared.

Euthyroid sick syndrome in acute ischemic syndromes.

The purposes of this study were to assess the occurrence of euthyroid sick syndrome in patients with acute myocardial infarction (AMI) or unstable angina (UA), and the relationship with beta-blocker or thrombolytic therapy. Plasma triiodothyronine (T3), reverse T3 (rT3), free T3 (FT3), thyroxine (T4), free T4 (FT4), thyroid-stimulating hormone (TSH), thyroxine-binding globulin (TBG), and albumin (ALB) levels were determined in 95 patients (59 males, 36 females, aged 58.4+/-9) with AMI and 19 patients (13 males, 6 females aged 54.7+/-12.3) with UA for 5 consecutive days from the onset of the acute syndrome and 1 month later. Patients were divided according to beta-blocker therapy and thrombolytic therapy. There was a significant T3 decrease and rT3 increase in all patients during the first 5 days following admission (p < 0.05). FT3 and FT4 remained unchanged during the study. In patients with complicated infarctions, the rT3 increase and the T3 decrease were significantly greater compared to those with uncomplicated infarctions (p<0.03). TSH, T4, TBG, and ALB were significantly (p<0.05) decreased only in complicated infarctions. No differences were observed between patients with or without thrombolysis or patients with or without beta-blocker treatment. The apparent decrease in T3, the increase in rT3 levels and the decreased TSH and T4 levels, show clearly that the euthyroid sick syndrome (low T3) occurs not only in AMI but also in UA. In addition, these hormonal changes are not affected by beta-blocker therapy and thrombolysis does not influence the occurrence of the syndrome. The degree of T3 decrease is proportional to the severity of cardiac damage and may have a possible prognostic value.

Dipolar origin of the gas-liquid coexistence of the hard-core 1:1 electrolyte model.

We present a systematic study of the effect of the ion pairing on the gas-liquid phase transition of hard-core 1:1 electrolyte models. We study a class of dipolar dimer models that depend on a parameter R(c), the maximum separation between the ions that compose the dimer. This parameter can vary from sigma(+/-) that corresponds to the tightly tethered dipolar dimer model to R(c)--> infinity that corresponds to the Stillinger-Lovett description of the free ion system. The coexistence curve and critical point parameters are obtained as a function of R(c) by grand-canonical Monte Carlo techniques. Our results show that this dependence is smooth but nonmonotonic and converges asymptotically towards the free ion case for relatively small values of R(c). This fact allows us to describe the gas-liquid transition in the free ion model as a transition between two dimerized fluid phases. The role of the unpaired ions can be considered as a perturbation of this picture.

Precise simulation of criticality in asymmetric fluids.

Extensive grand canonical Monte Carlo simulations have been performed for the hard-core square-well fluid with interaction range b=1.5 sigma. The critical exponent for the correlation length has been estimated in an unbiased fashion as nu=0.63+/-0.03 via finite-size extrapolations of the extrema of properties measured along specially constructed, asymptotically critical loci that represent pseudosymmetry axes. The subsequent location of the critical point achieves a precision of five parts in 10(4) for Tc and about 0.3% for the critical density rhoc. The effective exponents gamma+(eff) and beta(eff) indicate Ising-type critical-point values to within 2% and 5.6%, respectively, convincingly distinguishing the universality class from the "nearby" XY and n=0 (self-avoiding walk) classes. Simulations of the heat capacity CV(T,rho) and d2psigma/dT2, where psigma is the vapor pressure below Tc, suggest a negative but small Yang-Yang anomaly, i.e., a specific-heat-like divergence in the corresponding chemical potential derivative (d2 musigma/dT2) that requires a revision of the standard asymptotic scaling description of asymmetric fluids.

Treatment of widespread cutaneous larva migrans with thiabendazole.

Cutaneous larva migrans (CLM) is a characteristic eruption that is caused by penetration and migration in the skin of nematode larvae. Both animal and human hookworms have been implicated in the pathogenesis of the condition, with Ancylostoma braziliensis and A. caninum being the most common among them. CLM is quite common in tropical areas, but, due to travelling, several cases have also been described in Europe. We present a patient with CLM who presumably contacted the disease during a holiday in Singapore. The patient was treated successfully with oral thiabendazole.