RESUMO
AIM: Jansen et al. conducted a randomized trial to compare the efficacy of four field treatments for actinic keratosis (AK). SETTING AND DESIGN: This was a multicentre, single-blind, randomized trial conducted in the dermatology departments of four Netherlands hospitals. Patients were not blinded. The investigator who evaluated the trial outcome was blinded. STUDY EXPOSURE: This study included adult patients with at least five AKs on the face or vertex scalp. Patients were randomized to treatment with fluorouracil 5% cream, imiquimod 5% cream, methyl aminolaevulinate photodynamic therapy (MAL-PDT) or ingenol mebutate 0·015% gel. OUTCOMES: The primary outcome was whether patients had ≥ 75% reduction in AK count 12 months after treatment. RESULTS: In total 624 patients participated. The likelihood of having ≥ 75% reduction in AK count 12 months after treatment was significantly higher (twice as high or greater) for fluorouracil than for any other therapy. Approximately 75% of patients treated with fluorouracil experienced ≥ 75% reduction in AK count at 12 months. CONCLUSIONS: Jansen et al. conclude that 1 year after treatment, fluorouracil was significantly more effective at AK reduction than imiquimod, MAL-PDT or ingenol mebutate.
Assuntos
Ceratose Actínica , Fotoquimioterapia , Adulto , Ácido Aminolevulínico , Humanos , Países Baixos , Fármacos Fotossensibilizantes , Método Simples-CegoAssuntos
Carcinoma Basocelular/epidemiologia , Neoplasias Cutâneas/epidemiologia , Idoso de 80 Anos ou mais , Biópsia , Carcinoma Basocelular/diagnóstico , Carcinoma Basocelular/patologia , Feminino , Seguimentos , Grécia , Humanos , Incidência , Estudos Longitudinais , Masculino , Fotografação , Projetos Piloto , Pele/diagnóstico por imagem , Pele/patologia , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/patologiaRESUMO
The conversion of light fields in photonic crystal fibers (PCFs) capitalizes on the dramatic enhancement of several optical nonlinearities. We present here spectrally smooth, highly broadband supercontinuum radiation in a short piece of high-nonlinearity soft-glass PCF. This supercontinuum spans several optical octaves, with a spectral range extending from 350 nm to beyond 3000 nm. The selection of an appropriate propagation-length determines the spectral quality of the supercontinuum generated. Experimentally, we clearly identify two regimes of nonlinear pulse transformation: when the fiber length is much shorter than the dispersion length, soliton propagation is not important and a symmetric supercontinuum spectrum arises from almost pure self-phase modulation. For longer fiber lengths the supercontinuum is formed by the breakup of multiple Raman-shifting solitons. In both regions very broad supercontinuum radiation is produced.
RESUMO
The 3D structures of Fim H and PapG proteins complexed with the host carbohydrate receptor demonstrate that both utilize binding-pocket asparagines for contact or stabilization with the carbohydrate. Pretreatment of whole bacteria with asparaginase resulted in decreased fimbriae-mediated attachment to urinary epithelial cells. Enzyme treatment of bacteria pre-adhered to epithelial cells removed more uropathogenic E. coli than the indigenous flora attached to them.