Topical treatment of psoriasis: questionnaire results on topical therapy accessibility and influence of body surface area on usage.

BACKGROUND: Topical treatment of mild to moderate psoriasis is first-line treatment and exhibits varying degrees of success across patient groups. Key factors influencing treatment success are physician topical treatment choice (high efficacy, low adverse events) and strict patient adherence. Currently, no formalized, international consensus guidelines exist to direct optimal topical treatment, although many countries have national guidelines. OBJECTIVE: To describe and analyse cross-regional variations in the use and access of psoriasis topical therapies. METHODS: The study was conducted as an observational cross-sectional study. A survey was distributed to dermatologists from the International Psoriasis Council (IPC) to assess topical therapy accessibility in 26 countries and to understand how body surface area (BSA) categories guide clinical decisions on topical use. RESULTS: Variation in the availability of tars, topical retinoids, dithranol and balneotherapy was reported. The vast majority of respondents (100% and 88.4%) used topical therapy as first-line monotherapy in situations with BSA < 3% and BSA between 3% and 10%, respectively. However, with disease severity increasing to BSA > 10%, the number of respondents who prescribe topical therapy decreased considerably. In addition, combination therapy of a topical drug and a systemic drug was frequently reported when BSA measured >10%. CONCLUSION: This physician survey provides new evidence on topical access and the influence of disease severity on topical usage in an effort to improve treatment strategies on a global level.

Maternal environmental enrichment protects neonatal brains from hypoxic-ischemic challenge by mitigating brain energetic dysfunction and modulating glial cell responses.

There is evidence that maternal milieu and changes in environmental factors during the prenatal period may exert a lasting impact on the brain health of the newborn, even in case of neonatal brain hypoxia-ischemia (HI). The present study aimed to investigate the effects of maternal environmental enrichment (EE) on HI-induced energetic and metabolic failure, along with subsequent neural cell responses in the early postnatal period. Male Wistar pups born to dams exposed to maternal EE or standard conditions (SC) were randomly divided into Sham-SC, HI-SC, Sham-EE, and HI-EE groups. Neonatal HI was induced on postnatal day (PND) 3. The Na+,K+-ATPase activity, mitochondrial function and neuroinflammatory related-proteins were assessed at 24 h and 48 h after HI. MicroPET-FDG scans were used to measure glucose uptake at three time points: 24 h post-HI, PND18, and PND24. Moreover, neuronal preservation and glial cell responses were evaluated at PND18. After HI, animals exposed to maternal EE showed an increase in Na+,K+-ATPase activity, preservation of mitochondrial potential/mass ratio, and a reduction in mitochondrial swelling. Glucose uptake was preserved in HI-EE animals from PND18 onwards. Maternal EE attenuated HI-induced cell degeneration, white matter injury, and reduced astrocyte immunofluorescence. Moreover, the HI-EE group exhibited elevated levels of IL-10 and a reduction in Iba-1 positive cells. Data suggested that the regulation of AKT/ERK1/2 signaling pathways could be involved in the effects of maternal EE. This study evidenced that antenatal environmental stimuli could promote bioenergetic and neural resilience in the offspring against early HI damage, supporting the translational value of pregnancy-focused environmental treatments.

Topical treatment of psoriasis: questionnaire results on topical therapy as long-term continuous treatment and use on specific body sites.

BACKGROUND: Currently, no formalized international consensus guidelines exist to direct optimal topical treatment including long-term treatment. OBJECTIVE: In this survey, we aim to examine if and which topicals are used in clinical practice in long-term continuous treatment of psoriasis and how topicals are used in treating specific sites of the body. METHODS: A questionnaire was distributed electronically to dermatologists from the International Psoriasis Council (IPC) representing 26 countries. RESULTS: The top three topicals used across all severities of disease were topical corticosteroids, vitamin D analogs, and potent topical corticosteroids in combination with vitamin D analogs. On locations where the skin is thin, flexural and genital psoriasis, lower potency topical corticosteroids were used, whereas on other sites, in particular in palmoplantar psoriasis, superpotent topical corticosteroids and combination vitamin D analogs/corticosteroids were used. CONCLUSIONS: It is relevant to optimize localized therapy for all severities of psoriasis reconciling disease activity (stable vs. unstable disease), localization of the lesions and the individual patient and his/her perspectives on disease control. Topical therapies are valuable treatments for classical mild disease and may have a position in some patients with more severe manifestations.

Vulvar myiasis.

Myiasis is a parasitic infestation caused by larvae of several fly species. Diagnosis and treatment are simple. This infestation is, however, rarely seen in the vulvar area. We present a short review of the disease and the case of a 19-year-old pregnant girl with vulvar myiasis and concomitant syphilis, vaginal trichomoniasis and genital candidiasis. The patient was also positive for human immunodeficiency virus.

Production and purification of beta-toxin from Clostridium perfringens type C

Empregaram-se os métodos cromatográficos de afinidade metálica e de imunoafinidade para purificação da toxina beta em sobrenadante de cultivo de Clostridium perfringens tipo C. Observaram-se, na eletroforese das primeiras frações eluidas nos dois métodos de purificação, uma banda de peso molecular aproximado de 38kDa, característica da forma monomérica de toxina beta de Clostridium perfringens tipo C, e bandas de peso moleculares superiores, referentes às suas formas oligoméricas. Maior rendimento foi obtido com a utilização do método de imunoafinidade.

Estudo prospectivo controlado comparando lomefloxacina e ampicilina mais probenecide em dose única oral no tratamento de uretrite gonocócica aguda no homem / Controlled prospective study comparing lomefloxacin and ampicilin more probenecid in a single dose in the treatment of acute gonococcal urethritis in the man

As infecçöes gonocócicas há muito constituem um fator de importância para a saúde pública, devido à sua alta prevalência na populaçäo. Torna-se, portanto, imperioso a obtençäo de tratamentos eficazes e práticos, visando a observância completa do paciente ao tratamento, a cura clínica e a interrupçäo do ciclo de transmissäo. Neste estudo comparou-se lomefloxacina e ampicilina, quanto a sua eficácia clínica, laboratorial e seus efeitos colaterais, administradas em dose única. A lomefloxacina mostrou-se superior quanto à eficácia e apresentou menos efeitos adversos em relaçäo à ampicilina.

Miíase vulvar / Vulvar myiasis

A miíase é uma infecção parasitária causada por larvas de diversos tipos de moscas. Embora o reconhecimento e tratamento sejam fáceis, constituem uma infecção pouco freqúente na região vulvar. Este estudo apresenta uma revisão a respeito da patologia por miíase e a descrição do caso de uma adolescente de 19 anos, gestante, portadora de miíase vulvar associada à tricomoníase, candidíase e sífilis, além se ser soropositiva para HIV.

Desenvolvimento de um sistema computadorizado para medida da esfericidade da córnea durante o ato cirúrgico / Development of a computerized system for corneal sphericity measure during surgicalk procedures

Neste trabalho foi desenvolvido um ceratômetro intracirúrgico computadorizado. Projeta-se um anel iluminado na córnea e, através do processamento computacional do reflexo desta imagem calcula-se a curvatura da região central, gerando mapas coloridos codificados de acordo com a dioptria.

An intra-surgical computerized keratometer was developed. By projecting an illuminated ring on the anterior surface of the cornea and processing the reflection of this image, the central curvature was calculated and colored dioptric coded maps where generated

Descriçäo da demanda de alcoolistas em um hospital psiquiátrico da rede pública do Estado de Säo Paulo, em um período de 18 meses consecutivos / Description of alcoholic lawsuit in a psiquiatric hospital of public service in Säo Paulo State, in a period of 18 months consecutives

É consenso que o alcoolismo é doença multifatorial e que qualquer programa de tratamento deve levar em conta fatores sócio-econômicos e psico-biológicos. Com o objetivo de implantar um programa de tratamento hospitalar de alcoolista coerente com o estabelecido acima em um hospital psiquiátrico da Rede Pública Estadual de Säo Paulo, entende-se que o passo inicial é o de conhecer o perfil da populaçäo de alcoolistas que procuram o Hospital "Prof.Cantídio de Moura Campos" em Botucatu, S. P