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1.
Semergen ; 2020 Feb 07.
Artigo em Espanhol | MEDLINE | ID: mdl-32044200

RESUMO

Urticaria is a common cause for patient consultations in Primary Care (PC). However, the optimal approach to managing urticaria in PC is controversial and not well-established. For this reason, there is a clear need to clarify the causes of urticaria and to develop treatment protocols to improve urticaria management in the PC setting. The present work has been developed with this objective. A group of experts in PC and dermatology, with specific expertise in treating urticaria, have reviewed the main clinical guidelines and publications on urticaria in order to develop clear, interdisciplinary recommendations on managing urticaria. In this article, consensus-based recommendations are presented that include simple, practical diagnostic, and treatment algorithms. These guidelines will help to optimise the management of patients with urticaria, increasing their quality of life and reducing the socioeconomic costs associated with this illness.

2.
Mikrochim Acta ; 187(3): 164, 2020 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-32052200

RESUMO

Gold nanostars (GNST), gold nanospheres (GNP) and carbon black (CB) are chosen as alternative nanomaterials to modify carbon screen-printed electrodes (c-SPEs). The resulting three kinds of modified c-SPEs (GNP-SPE, CB-SPE and GNSP-SPE) were electrochemically and microscopically characterized and compared with standardized c-SPEs after pretreatment with phosphate buffer by pre-anodization (pre-SPE). The results show outstanding electrochemical performance of the carbon black-modified SPEs which show low transient current, low capacitance and good porosity. A competitive chronoamperometric immunoassay for the shellfish toxin domoic acid (DA) is described. The performances of the CB-SPE, GNP-SPE and pre-SPE were compared. Hapten-functionalized magnetic beads were used to avoid individual c-SPE functionalization with antibody while enhancing the signal by creating optimum surface proximity for electron transfer reactions. This comparison shows that the CB-SPE biosensor operated best at a potential near - 50 mV (vs. Ag/AgCl) and enables DA to be determined with a detection limit that is tenfold lower compared to pre-SPE (4 vs. 0.4 ng mL-1). These results show very good agreement with HPLC data when analysing contaminated scallops, and the LOD is 0.7 mg DA kg-1 of shellfish. Graphical abstractSchematic representation of the magnetic bead-based immunoassay for the quantification of domoic acid (DA) in shellfish with nanomaterial-modified screen-printed electrodes. CB, carbon black; GNP, gold nanospheres; GNST, gold nanostars; MB, magnetic beads; DA-mAb, anti-DA monoclonal mouse antibody; HRP-pAb, horseradish conjugated polyclonal goat anti-mouse antibody; DA-BSA, bovine serum albumin conjugated DA; HQ, hydroquinone; BQ, benzoquinone.

3.
J Mol Med (Berl) ; 98(2): 161-177, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31970428

RESUMO

In this review, we highlight the role of intratumoral heterogeneity, focusing on the clinical and biological ramifications this phenomenon poses. Intratumoral heterogeneity arises through complex genetic, epigenetic, and protein modifications that drive phenotypic selection in response to environmental pressures. Functionally, heterogeneity provides tumors with significant adaptability. This ranges from mutual beneficial cooperation between cells, which nurture features such as growth and metastasis, to the narrow escape and survival of clonal cell populations that have adapted to thrive under specific conditions such as hypoxia or chemotherapy. These dynamic intercellular interplays are guided by a Darwinian selection landscape between clonal tumor cell populations and the tumor microenvironment. Understanding the involved drivers and functional consequences of such tumor heterogeneity is challenging but also promises to provide novel insight needed to confront the problem of therapeutic resistance in tumors.

4.
Eur J Endocrinol ; 182(1): 11-21, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31652416

RESUMO

Objective: The increasing prevalence of obesity is expected to promote the demand for endocrine testing. To facilitate evidence guided testing, we aimed to assess the prevalence of endocrine disorders in patients with obesity. The review was carried out as part of the Endocrine Work-up for the Obesity Guideline of the European Society of Endocrinology. Design: Systematic review and meta-analysis of the literature. Methods: A search was performed in MEDLINE, EMBASE, Web of Science and COCHRANE Library for original articles assessing the prevalence of hypothyroidism, hypercortisolism, hypogonadism (males) or hyperandrogenism (females) in patients with obesity. Data were pooled in a random-effects logistic regression model and reported with 95% confidence intervals (95% CI). Results: Sixty-eight studies were included, concerning a total of 19.996 patients with obesity. The pooled prevalence of overt (newly diagnosed or already treated) and subclinical hypothyroidism was 14.0% (95% CI: 9.7-18.9) and 14.6% (95% CI: 9.2-20.9), respectively. Pooled prevalence of hypercortisolism was 0.9% (95% CI: 0.3-1.6). Pooled prevalence of hypogonadism when measuring total testosterone or free testosterone was 42.8% (95% CI: 37.6-48.0) and 32.7% (95% CI: 23.1-43.0), respectively. Heterogeneity was high for all analyses. Conclusions: The prevalence of endocrine disorders in patients with obesity is considerable, although the underlying mechanisms are complex. Given the cross-sectional design of the studies included, no formal distinction between endocrine causes and consequences of obesity could be made.

6.
Angew Chem Int Ed Engl ; 59(2): 674-678, 2020 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-31693283

RESUMO

Small peptides containing combinations of cysteine, tyrosine, histidine, and serine residues react with octafluorocyclopentene (OFCP) to afford atypically structured macrocycles through successive vinylic substitutions. The reactions proceed rapidly in air at 0 °C and are tolerant of spectating tryptophan, asparagine, glutamine, and threonine residues. Hexapeptides of consensus sequence YXCXXC displace four fluorine atoms from OFCP to generate fluorinated macrobicyclic compounds that display dual-turn surfaces. The method provides facile access to a wide range of previously unknown heterocyclic structures.

7.
Am J Hypertens ; 33(1): 70-76, 2020 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-31877218

RESUMO

BACKGROUND: Peripheral mean arterial pressure (MAP) responses to muscle metaboreflex activation using postexercise muscle ischemia (PEMI) in type 2 diabetes patients (T2D) are contradictory. Given that aortic pulse pressure (PP) and wave reflections are better indicators of cardiac load than peripheral MAP, we evaluated aortic blood pressure (BP) and wave amplitude during PEMI. METHODS: Aortic BP and pressure wave amplitudes were measured at rest and during PEMI following isometric handgrip at 30% maximum voluntary contraction (MVC) in 16 T2D and 15 controls. Resting aortic stiffness (carotid-femoral pulse wave velocity, cfPWV) and fasting blood glucose (FBG) were measured. RESULTS: Increases in aortic MAP (Δ26 ± 2 mmHg vs. Δ17 ± 2 mmHg), PP (Δ15 ± 2 mmHg vs. Δ10 ± 1 mmHg), augmentation index (AIx) (Δ8.2 ± 1.0% vs. Δ4.5 ± 1.3%), augmented pressure (AP) (Δ11 ± 1 mmHg vs. Δ5 ± 1 mmHg), forward (Pf) (Δ9 ± 1 mmHg vs. Δ5 ± 1 mmHg), and backward pressure waves (Pb) (Δ10 ± 1 mmHg vs. Δ5 ± 1 mmHg) responses to PEMI were greater in T2D than controls (P < 0.05). Aortic PP, but not MAP, response to PEMI was correlated to Pf (r = 0.63, P < 0.001) and Pb (r = 0.82, P < 0.001) responses and cfPWV (r = 0.37, P < 0.05). CONCLUSIONS: Aortic BP and pressure wave responses to muscle metaboreflex activation are exaggerated in T2D. Aortic PP during PEMI was related to increased wave reflection, forward wave amplitude, and aortic stiffness in T2D patients.

8.
Eur J Endocrinol ; 182(1): G1-G32, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31855556

RESUMO

Obesity is an emerging condition, with a prevalence of ~20%. Although the simple measurement of BMI is likely a simplistic approach to obesity, BMI is easily calculated, and there are currently no data showing that more sophisticated methods are more useful to guide the endocrine work-up in obesity. An increased BMI leads to a number of hormonal changes. Additionally, concomitant hormonal diseases can be present in obesity and have to be properly diagnosed - which in turn might be more difficult due to alterations caused by body fatness itself. The present European Society of Endocrinology Clinical Guideline on the Endocrine Work-up in Obesity acknowledges the increased prevalence of many endocrine conditions in obesity. It is recommended to test all patients with obesity for thyroid function, given the high prevalence of hypothyroidism in obesity. For hypercortisolism, male hypogonadism and female gonadal dysfunction, hormonal testing is only recommended if case of clinical suspicion of an underlying endocrine disorder. The guideline underlines that weight loss in obesity should be emphasized as key to restoration of hormonal imbalances and that treatment and that the effect of treating endocrine disorders on weight loss is only modest.


Assuntos
Índice de Massa Corporal , Hipotireoidismo/diagnóstico , Obesidade/diagnóstico , Comorbidade , Endocrinologia , Humanos , Hipotireoidismo/epidemiologia , Obesidade/epidemiologia , Prevalência , Testes de Função Tireóidea
9.
Actas Dermosifiliogr ; 2019 Dec 18.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31864538

RESUMO

BACKGROUND: The association between dipeptidyl peptidase 4 inhibitors (DPP-4i) and bullous pemphigoid (BP) has been demonstrated in several studies. The main aim of this study was to estimate the use of DPP-4i treatment in patients diagnosed with BP in our setting. METHODS: We selected patients histologically diagnosed with BP in our department between October 2015 and October 2018 and performed a retrospective chart review to assess clinical and epidemiological data and direct immunofluorescence (DIF) patterns. RESULTS: Of the 70 patients diagnosed with BP during the study period, 50% were diabetic and 88.57% of these were being treated with a DPP-4i when diagnosed with BP. The most common DPP-4i was linagliptin (used in 18.6% of patients), followed by vildagliptin (17.1%). The median latency period between initiation of DPP-4i treatment and diagnosis of BP was 27.5 months for all treatments, 16 months for linagliptin, and 39 months for vildagliptin (log rank < 0.01). A negative DIF result was significantly more common in patients not being treated with a DPP-4i. The DIF pattern most strongly (and significantly) associated with DPP-4i treatment was linear immunoglobulin G deposits along the dermal-epidermal junction. DPP-4i treatment was withdrawn in 87% of patients and 96% of these achieved a complete response. CONCLUSIONS: DPP-4i treatment is very common in patients with BP in our setting. The latency period between start of treatment and onset of BP seems to be shorter with linagliptin than with other types of gliptins. Patients receiving DPP-4i treatment may show different DIF patterns to those not receiving treatment.

10.
Actas Dermosifiliogr ; 2019 Nov 16.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31744595

RESUMO

INTRODUCTION AND OBJECTIVE: The epidemiology of genital herpes has changed in recent years with an increase in the incidence of herpes simplex virus type 1 (HSV-1) infection. The aim of this study was to analyze the clinical and epidemiological characteristics of patients diagnosed with genital herpes. MATERIAL AND METHODS: A retrospective observational study was designed. All patients diagnosed with genital herpes between January 2016 and January 2019 in a Sexually Transmitted Infections Unit (ITS) in Valencia, Spain, were included. RESULTS: We identified 895 STI diagnoses. Of these, 126 (14%) were genital herpes; 68 (54%) of these cases were in women and 58 (46%) in men. Diagnosis was confirmed by molecular detection of HSV DNA in 110 cases (87.3%). Of these, 52 were cases of HSV-1 infection (47.3%) and 58 were HSV-2 infection (52.7%). HSV-2 was more common in men (69.5%), while HSV-1 was more common in women (59.3%). In the subgroup of women, mean age at diagnosis was 26 years for HSV-1 and 34 years for HSV-2 (P=.015). Recurrent genital herpes rates were 13% for HSV-1 and 40% for HSV-2. CONCLUSIONS: There has been an increase in the number of cases of genital herpes caused by HSV-1 in our setting, with young women in particular being affected. This has important prognostic implications because genital herpes caused by HSV-1 is less likely to recur.

11.
Hypertens Res ; 42(12): 1979-1988, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31515507

RESUMO

To examine the effects of low-intensity resistance exercise training (LIRET) and whole-body vibration training (WBVT) with an external weighted vest on arterial stiffness, wave reflection, brachial flow-mediated dilation (FMD), and physical performance in postmenopausal women. Thirty-three postmenopausal women were stratified by age, body mass index (BMI), and maximal voluntary contraction (MVC) (age, 65 ± 4 years; BMI, 23.3 ± 2.6 kg/m2; MVC, 17.4 ± 2.6 kg) and randomized into LIRET, WBVT, or a nonexercising control group for 12 weeks. Arterial stiffness, augmentation index (AIx), augmented pressure (AP), brachial FMD, gait speed and leg strength were measured at baseline and 12 weeks. WBVT induced improvements in pulse pressure amplification (PPA) (0.04 ± 0.02) compared to control (P = 0.048) and in wave reflection indices [AIx (-4.3 ± 1.4%) and AP (-2.9 ± 1.3 mmHg)] compared to LIRET (P = 0.039 and 0.048, respectively). WBVT (3.8 ± 1.4%) and LIRET (5.0 ± 1.5%) induced similar improvements in FMD compared to control (P = 0.029 and 0.008, respectively). WBVT and LIRET elicited similar increases in leg strength (P = 0.001 and 0.019, respectively), compared to no improvement in the control group. LIRET significantly increased gait speed compared to WBVT (P = 0.043). Although both WBVT and LIRET increased brachial artery FMD (systemic effect), WBVT seemed to be more efficacious in improving wave reflection and cardiac pulsatile load. Interestingly, LIRET elicited a significant improvement in gait speed. Both modalities seem effective in improving systemic endothelial function and muscle strength in postmenopausal women.

12.
J Helminthol ; 94: e89, 2019 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-31544721

RESUMO

The relationship between epilepsy and the presence of visceral larva migrans caused by Toxocara canis in Mexican children remains uncertain; however, this relationship needs to be elucidated because these parasite larvae can invade the human central nervous system. Accordingly, this study aimed to determine the frequency and specificity of anti-T. canis antibodies in the sera of children with epilepsy to determine the relationship between this parasite and epilepsy. The sera samples of 214 children were examined: 111 children diagnosed with epilepsy and 103 clinically healthy children without neurological disorders. In the sera of each group, the presence and specificity of anti-T. canis and anti-Ascaris lumbricoides antibodies, as well as the cross-reactivity between them, were assessed using enzyme-linked immunosorbent assay and Western blotting analysis. Among the children with epilepsy, 25.2% exhibited seropositivity to T. canis. Cross-reactivity against the A. lumbricoides antigen was present in 46.8% of the children with epilepsy, whereas 11.7% of the children with epilepsy and anti-T. canis antibodies did not exhibit cross-reactivity against this antigen. The Western blotting analysis of the sera from the children with epilepsy demonstrated the presence of T. canis proteins, with molecular weights of 24, 35, 55, 70, 120 and 210 kDa, and A lumbricoides proteins with molecular weights of 70, 80 and 110 kDa. Our results revealed the presence of anti-T. canis antibodies in the children with epilepsy; furthermore, cross-reactivity tests with A. lumbricoides showed the importance of the presence of anti-T. canis antibodies in revealing the relationship between this parasite and epilepsy in children.

13.
J Emerg Med ; 57(2): 207-211, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31229301

RESUMO

BACKGROUND: Transorbital ultrasound was used to diagnose acute optic neuritis (AON) at bedside in an emergency department (ED). CASE REPORT: A 59-year-old female patient presented to an ED after 7 days of progressive unilateral visual loss while she was receiving outpatient treatment for relapsing-remitting multiple sclerosis. Transorbital ultrasound revealed a disparity between the optic nerve sheath diameters of the affected and nonaffected eyes and striking optic nerve edema in the affected eye. These findings led to a diagnosis of AON and early definitive treatment. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Given an absence of reliable diagnostic criteria for AON, comorbidity with multiple sclerosis, and limitations inherent to magnetic resonance imaging, transorbital sonography may facilitate diagnosis of this condition in emergent presentations.

14.
Anal Bioanal Chem ; 411(22): 5897-5907, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31218398

RESUMO

Five different enzyme-linked immunosorbent assays (ELISAs) have been developed and applied for the detection of five representatives of important families of chemical pollutants in seawater: Irgarol 1051® (triazine biocide), sulfapyridine and chloramphenicol (antibiotics), 17ß-estradiol (hormone), and domoic acid (algae toxin). The assays were validated by high-performance liquid chromatography (HPLC) coupled with high-resolution mass spectrometry (HRMS) showing good correlation between both immunochemical and chemical techniques. A process of extraction and clean-up was added prior to the analysis based on solid-phase extraction (SPE). The multianalyte platform presented good specificity for each compound and adequate sensitivity, with limits of detection (LOD) after the SPE treatment of 0.124 ± 0.006, 0.969 ± 0.09, 0.20 ± 0.05, 1.11 ± 0.012, and 1.39 ± 0.09 ng L-1 for Irgarol 1051®, sulfapyridine, chloramphenicol, 17ß-estradiol, and domoic acid, respectively. No matrix effects were noticed in working with the seawater extracts. Afterward, seawater samples from the Mediterranean Sea (coastal area of Catalonia) were analyzed by both techniques and only one sample presented one contaminant, 17ß-estradiol, in the concentration of 0.011 ± 0.04 µg L-1.

15.
Ecol Evol ; 9(11): 6378-6388, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31236228

RESUMO

Complex interactions between protected populations may challenge the recovery of whole ecosystems. In California, white sharks (Carcharodon carcharias) mistargeting southern sea otters (Enhydra lutris nereis) are an emergent impact to sea otter recovery, inhibiting the broader ecosystem restoration sea otters might provide. Here, we integrate and analyze tracking and stranding data to compare the phenology of interactions between white sharks and their targeted prey (elephant seals, Mirounga angustirostris) with those of mistargeted prey (sea otters, humans). Pronounced seasonal peaks in shark bites to otters and humans overlap in the late boreal summer, immediately before the annual adult white shark migration to elephant seal rookeries. From 1997 to 2017, the seasonal period when sharks bite otters expanded from 2 to 8 months of the year and occurred primarily in regions where kelp cover declined. Immature and male otters, demographics most associated with range expansion, were disproportionately impacted. While sea otters are understood to play a keystone role in kelp forests, recent ecosystem shifts are revealing unprecedented bottom-up and top-down interactions. Such shifts challenge ecosystem management programs that rely on static models of species interactions.

16.
PLoS One ; 14(5): e0214642, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31067227

RESUMO

While adult white sharks (Carcharodon carcharias) are apex predators with a circumglobal distribution, juvenile white sharks (JWS) feed primarily on bottom dwelling fishes and tend to be coastally associated. Despite the assumedly easier access to juveniles compared to large, migratory adults, limited information is available on the movements, environments, and distributions of individuals during this life stage. To quantify movement and understand their distribution in the southern California Bight, JWS were captured and fitted with dorsal fin-mounted satellite transmitters (SPOT tags; n = 18). Nine individuals crossed the U.S. border into Baja California, Mexico. Individuals used shallow habitats (134.96 ± 191.1 m) close to shore (7.16 ± 5.65 km). A generalized linear model with a binomial distribution was used to predict the presence of individuals based on several environmental predictors from these areas. Juveniles were found to select shallow habitats (< 1000 m deep) close to land (< 30 km of the shoreline) in waters ranging from 14 to 24°C. Southern California was found to be suitable eight months of the year, while coastal habitats in Baja California were suitable year-round. The model predicted seasonal movement with sharks moving from southern California to Baja California during winter. Additionally, habitat distribution changed inter-annually with sharks having a more northerly distribution during years with a higher Pacific Decadal Oscillation index, suggesting sharks may forego their annual fall migrations to Baja California, Mexico, during El Niño years. Model predictions aligned with fishery-dependent catch data, with a greater number of sharks being captured during periods and/or areas of increased habitat suitability. Thus, habitat models could be useful for predicting the presence of JWS in other areas, and can be used as a tool for potentially reducing fishery interactions during seasons and locations where there is increased susceptibility of incidental catch.


Assuntos
Ecossistema , Tubarões/fisiologia , Animais , El Niño Oscilação Sul , Modelos Teóricos , Movimento/fisiologia , Estações do Ano , Tubarões/crescimento & desenvolvimento , Temperatura Ambiente
17.
Actas Dermosifiliogr ; 2019 May 24.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31133298

RESUMO

INTRODUCTION: Phototherapy involves the use of UV radiation to treat different dermatologic diseases. Its efficacy and safety have been thoroughly established in adults and some publications indicate that it is also an effective and safe treatment in pediatric patients with refractory skin diseases. MATERIAL AND METHODS: Retrospective study that included all patients under 17 years of age and 122 randomly selected adults who received phototherapy in our department between 2002 and 2017. RESULTS: Ninety-eight pediatric patients (61% girls and 39% boys) with a mean age of 10.5 years received phototherapy. The 3 most frequently treated diseases were psoriasis (48% of patients), vitiligo (17%), and atopic dermatitis (16%). Eighty-six percent of the patients received phototherapy with narrowband UV-B, whereas 7% received phototherapy with psoralen and UV-A (PUVA). No statistically significant differences were found in terms of dosage, duration, or number of sessions compared to the adult population treated with narrowband UV-B therapy or PUVA. A complete response was achieved in 35% of the pediatric patients and no differences were found with respect to the adults. Only 16% of the children showed adverse effects, mostly in the form of mild erythema. We found greater adherence to treatment in the pediatric patients than in the adult patients (P<.05). CONCLUSIONS: Narrowband UV-B therapy and PUVA appear to be safe and effective in children and can be administered using the same treatment protocols as those used in adults. Adherence to treatment is greater in children than in adult patients.

18.
Biol Lett ; 15(4): 20190085, 2019 04 26.
Artigo em Inglês | MEDLINE | ID: mdl-30940023

RESUMO

Traditional forms of marine wildlife research are often restricted to coarse telemetry or surface-based observations, limiting information on fine-scale behaviours such as predator-prey events and interactions with habitat features. We use contemporary animal-attached cameras with motion sensing dataloggers, to reveal novel behaviours by white sharks, Carcharodon carcharias, within areas of kelp forest in South Africa. All white sharks tagged in this study spent time adjacent to kelp forests, with several moving throughout densely kelp-covered areas, navigating through channels and pushing directly through stipes and fronds. We found that activity and turning rates significantly increased within kelp forest. Over 28 h of video data revealed that white shark encounters with Cape fur seals, Arctocephalus pusillus pusillus, occurred exclusively within kelp forests, with seals displaying predator evasion behaviour during those encounters. Uniquely, we reveal the use of kelp forest habitat by white sharks, previously assumed inaccessible to these large predators.


Assuntos
Kelp , Tubarões , Animais , Ecossistema , Florestas , Comportamento Predatório , África do Sul
19.
Sci Rep ; 9(1): 6153, 2019 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-30992478

RESUMO

Predatory behavior and top-down effects in marine ecosystems are well-described, however, intraguild interactions among co-occurring marine top predators remain less understood, but can have far reaching ecological implications. Killer whales and white sharks are prominent upper trophic level predators with highly-overlapping niches, yet their ecological interactions and subsequent effects have remained obscure. Using long-term electronic tagging and survey data we reveal rare and cryptic interactions between these predators at a shared foraging site, Southeast Farallon Island (SEFI). In multiple instances, brief visits from killer whales displaced white sharks from SEFI, disrupting shark feeding behavior for extended periods at this aggregation site. As a result, annual predations of pinnipeds by white sharks at SEFI were negatively correlated with close encounters with killer whales. Tagged white sharks relocated to other aggregation sites, creating detectable increases in white shark density at Ano Nuevo Island. This work highlights the importance of risk effects and intraguild relationships among top ocean predators and the value of long-term data sets revealing these consequential, albeit infrequent, ecological interactions.

20.
Actas Dermosifiliogr ; 110(7): 585-589, 2019 Sep.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31006480

RESUMO

BACKGROUND: Ixekizumab has proven efficacy and safety for the treatment of psoriasis in clinical trials. The aim of this study was to evaluate its effectiveness and safety in routine clinical practice. METHODS: Retrospective study of all patients treated with ixekizumab in 2 dermatology departments in the city of Valencia, Spain. RESULTS: Seventy-five patients (53.3% men and 46.7% women) with a mean age of 48.61 years were studied; 77.3% (n = 58) had plaque psoriasis and 22.7% (n = 17) had psoriasis predominantly affecting a specific area. The most common comorbidity was obesity (present in 48% of patients) and 40% of the overall group had not been previously treated with a biologic drug. Mean psoriasis area and severity index (PASI) fell from 9.99 at baseline to 1.5 at week 16. PASI-75 and PASI-90 (improvements of at least 75% and 90% in PASI) were independent of sex, age, baseline PASI, and the comorbidities analyzed. Responses at week 16 and 52 were significantly better in biologic-naïve patients for the overall group and the subgroup of patients with localized psoriasis. Adverse effects were reported for 25.7% of patients and the most common effect was injection-site reaction. There were no serious adverse effects. CONCLUSIONS: Our findings show that ixekizumab is both effective and safe in the treatment of psoriasis in routine clinical practice.

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