Dermoscopy of Gottron's papules and other inflammatory dermatoses involving the dorsa of the hands.

BACKGROUND: Several inflammatory dermatoses, including dermatomyositis (DM), may present as erythematous papules or plaques on the dorsal aspects of the hands over the joints. Limited skin involvement in these entities may pose a diagnostic challenge. (Video)dermoscopy is being utilized more frequently to aid in the differential diagnosis of inflammatory skin conditions. OBJECTIVE: To describe the dermoscopic findings in Gottron's papules and compare them with dermoscopic features of other dermatoses involving the dorsal aspects of the hands. METHODS: Videodermoscopic images from patients presenting with erythematous papules or plaques on the dorsal surface of the hands were retrospectively analysed for the presence of standardized dermoscopic parameters. RESULTS: Dermoscopic images from patients with DM (n = 12), psoriasis (n = 19), chronic dermatitis (n = 16), mycosis fungoides (n = 7), lichen planus (n = 5) and pityriasis rubra pilaris (n = 3) were included. Gottron's papules were characterized by pleomorphic vessels (dotted vessels accompanied by thick or thin linear vessels with branches or linear curved vessels) in 66.7% of cases, arranged in an unspecified pattern (91.7%), and accompanied by white or pink structureless areas (75.0%). Psoriatic plaques were characterized by dotted vessels arranged in a uniform pattern (94.7%). Vessels arranged in a ring pattern were nearly exclusively observed in psoriasis, while yellow structureless areas and erosions were more frequently present in chronic dermatitis. White lines, corresponding to Wickham striae, were specific for lichen planus. CONCLUSIONS: Videodermoscopy might be of value in differentiating Gottron's papules from other dermatoses involving dorsa of the hands.

Comparison of the impact of childhood psoriasis on mothers' and fathers' quality of life - does gender of a caregiver play a role?

BACKGROUND: Psoriasis is a chronic skin condition that in one third of cases starts in the first two decades of life. The disease might impact the quality of life (QoL) of the affected children and their caregivers. The issue of gender differences in the assessment of psychological burden of dermatological conditions has been the subject of few studies with contradictory results. OBJECTIVES: The aim of this study was to investigate the differences in the impact of childhood psoriasis on mothers' and fathers' well-being using Family Dermatology Life Quality Index (FDLQI). METHODS: Forty-five children with psoriasis (31 girls and 14 boys; mean age ± standard deviation (SD) 10.53 ± 3.44 years) and their parents (45 mothers and 45 fathers) were included in the study. Both parents of each child were asked to separately fill in the validated Polish version of the FDLQI questionnaire. RESULTS: Comparing the FDLQI scores, the QoL of mothers was significantly more impaired than the QoL of fathers (13.44 ± 6.46 versus 9.53 ± 6.12 points; P < 0.0001). In mothers, childhood psoriasis had a significantly greater impact in the areas of emotional distress (P = 0.007), dealing with other people's reactions (P < 0.0001), social life (P = 0.02), amount of time spent caring for the child's skin (P = 0.0001) and extra housework (P = 0.0005), compared to fathers. The FDLQI scores of both mothers and fathers were independent of the impairment of children's QoL or the severity of psoriasis, except for positive correlation between mothers' FDLQI scores and children's BSA (R = 0.31; P = 0.03). CONCLUSIONS: Differences in the impact of childhood skin diseases on mothers' and fathers' well-being should be taken into consideration while developing educational programmes for patients and their families. There is a need for further, multi-centre research that would take into account geographical and cultural differences, in order to reliably assess the impact of childhood psoriasis on various aspects of caregivers' QoL.

CASE-REPORT Dysregulation of gene expression in a patient with depressive disorder after transient ischemic attack confirmed by a neurophysiological neuromarker.

The aim of this study was to evaluate dysregulation of gene expression associated with the cellular stress response in a patient with a post-"warning stroke" depressive disorder confirmed by the presence of a neurophysiological neuromarker through the use of quantitative EEG and event-related potentials. The patient was tested for seven genes associated with the stress reaction: HSPA1A, HSPB1, IL6, IL10, CRP, and HSF-1 along with NF-κB, compared to gene expression in health controls. A 54-year-old patient with a past history of schizophrenia (at the age of 20), and of transient ischemic attack (at the age of 53) and depressive disorder confirmed by functional, cognitive, emotional, and affectional diagnostics underwent additional testing for expression of the genes associated with stress response. The expression of genes coding for heat shock protein (HSPA1A, HSPB1), interleukins (IL6, IL10), and C-reactive protein was tested along with factors that regulate their expression. The results of the tests conducted on this patient were compared with 42 healthy control subjects. Diagnostic testing revealed upregulation in expression of these genes, presenting as increased expression of the target genes and of the regulatory genes. A post-"warning stroke" depressive disorder appears to be associated with overexpression of the genes coding for HSP and interleukins. Further research on larger groups of people may provide grounds for treatment modification.

Effects of 6-week specific low-intensity training on selected aerobic capacity parameters and HSPA1A, HSPB1, and LDHb gene expression in high-level rowers.

The aim of this study was to demonstrate the effects of 6-week low-intensity training on changes in indicators of aerobic capacity and on HSPA1A, HSPB1, and LDHb expression in white blood cells in high level rowers. We hypothesized that the type of training would have an impact not only on the adaptation of athletes to the aerobic nature of the exercises, but also on the expression of genes, designated during exercises "until refusal". Nine Polish lightweight male rowers (21.8 ± 3.77 years of age, 74.2 ± 1.7 6 kg, 184.8 ± 4.58 cm) of high level participated in the experiment. To determine the anaerobic threshold (AnT) and peak oxygen uptake (VO2max) at the beginning and end of the 6-week training period, the subjects performed the test "till exhaustion", with increasing load. Directly before and after the test, blood samples were collected from the ulnar vein for isolation of RNA. Consecutively, reverse transcription and real time polymerase chain reaction amplification was performed. A significant influence of applied training on physiological parameters such as VO2max (P = 0.0001), AnT (W/AT) (P = 0.0007), and maximal acid lactate concentration (P = 0.018) as well as on HSPA1A expression (P = 0.0129) in rowers were detected. The 6-week low-intensity aerobic training significantly affected the physiological parameters and HSPA1A expression in the rowers. Therefore, we suggest that the response of leukocytes by activating HSPA1A was dependent on the type of training. The 6-week period proved sufficiently long to of adapting leukocytes in athletes to high intensity exercises.

Changes in the acid-base balance and lactate concentration in the blood in amateur ultramarathon runners during a 100-km run.

The aim of this study was to analyse the acid-base balance and partial pressure of blood gases of participants during a 100-km run. Fourteen experienced amateur ultramarathon runners (age: 43.36±11.83 years; height: 175.29±6.98 cm; weight: 72.12±7.36 kg) completed the 100-km run. Blood samples were taken before the run; after 25, 50, 75, and 100 km; and 12 and 24 hours after the run. There were significant differences (p<0.05) between the mean values registered for acid-alkaline balance, buffering alkalies, and current bicarbonate in each segment of the run, especially during the third, fourth, and fifth segments of the run (i.e., between 50 and 100 km), and there were only significant differences associated with buffering alkalies and current bicarbonate during the recovery. However, all the changes were within the physiological norm. A significant decrease in the compressibility of oxygen was observed after 100 km (from 92.80±15.67 to 88.36±13.71 mmHg) and continued during the recovery to 75.06±8.60 mmHg 12 h after the run. Also there was a decrease in saturation to a mean value of 93.78±3.10 at 12 h after the run. Generally the amateurs runners are able to adjust their running speed so as not to provoke a significant acid-base imbalance or lactate acid accumulation.

Antimicrobial resistance in Escherichia coli strains isolated from Swiss weaned pigs and sows.

Based on Directive (EC) No 99/2003, monitoring programs on the development of antimicrobial resistance in bacteria from livestock are implemented in many European countries. The aim of the present study was (i) to establish comprehensive baseline data on the antimicrobial resistance situation in Escherichia coli isolates obtained from healthy pigs (pooled fecal samples) originating from 60 Swiss pig-breeding farms, and (ii) to analyze differences in the resistance frequency between Escherichia coli isolates from weaned pigs and sows. Susceptibility testing (disc diffusion method) was performed on 429 isolates from weaned pigs and 431 isolates from sows. Overall, 17.7% of the isolates from weaned pigs and 22.5% of the Escherichia coli isolates from sows were susceptible to all antibiotics tested. Low resistance prevalence was found for amoxicillin, amoxicillin/clavulanic acid, ampicillin, cefquinome, ciprofloxacin, colistin, florfenicol, and gentamicin. The most frequently found resistances were against streptomycin (60.6% of the isolates from weaners and 64.3% of the isolates from sows), sulfonamide (51.5% and 26.9%), tetracycline (35.2% and 22.0%), and trimethoprim (27.5% and 11.1%). With exception of colistin, most resistances were found for those antibiotics commonly used on the farms. Except for ciprofloxacin and streptomycin, isolates from weaned pigs showed higher resistance prevalence than those from sows. This difference was significant for cefquinome, florfenicol, sulfonamide, tetracycline, and trimethoprim (p<0.05).

Dynamics of Campylobacter spp. spread investigated in 14 broiler flocks in Switzerland.

Ten conventional and four extensive outdoor broiler flocks, distributed over nine farms, were investigated twice per week during a 35-58-day rearing period to observe the dynamics of Campylobacter spp. spread within these flocks. Strains isolated during this period were genotyped by restriction fragment length polymorphism analysis of the flaA gene and macrorestriction profiling with pulsed field gel electrophoresis. A total of 4112 samples were collected; 157 (3.8%) of these samples were Campylobacter positive, with all C. jejuni. The positive samples were distributed over three conventional and two extensive outdoor flocks on five farms. These five positive flocks were colonized from the fifth to the seventh week of age and remained colonized until slaughter. Each of the flocks showed a flock-specific genotype of Campylobacter that predominated until slaughter. Presuming different ways of entry, a combination of this fact and the observed dynamics of C. jejuni spread within the flocks indicates that a single source from the environment may have been responsible for the colonization of each flock. These conclusions may serve to further develop combat strategies at farm level.

Prevalence and characteristics of Shiga toxin-producing Escherichia coli, Salmonella spp. and Campylobacter spp. isolated from slaughtered sheep in Switzerland.

Caecum samples collected from 653 slaughtered sheep from two Swiss abattoirs were examined. The aim of this study was: (i) to determine the prevalence of Shiga toxin-producing Escherichia coli (STEC), Salmonella spp. and Campylobacter spp.; (ii) to further characterize isolated strains; and (iii) to discuss the results obtained with their relevance to food safety. The percentage of samples testing positive for STEC by a polymerase chain reaction was 29.9%. The prevalence of positive Salmonella spp. samples was 11.0% and of Campylobacter spp. 17.5%. In 55.3% of the 76 isolated non-O157 STEC strains, stx2 variants (mostly stx2d) were detected. Additional virulence factors were harbored by 55.3% of the STEC strains, 10.5% of them being eae positive, 55.3% ehxA positive and 2.6% astA positive. All isolated salmonella were identified as Salmonella enterica subsp. diarizonae serovar 61:k:1,5,(7). Pulsed-field gel electrophoresis (PFGE) was performed for genotyping and 22 different restriction endonuclease digestion profiles were found among these strains for the different farms of origin. Of the 114 isolated Campylobacter spp. strains, 64.9% were shown to be Campylobacter jejuni and 35.1% Campylobacter coli, nine strains showed resistance against tetracycline, ciprofloxacin/nalidixic acid or streptomycin. In conclusion, sheep are a reservoir for the pathogens of latent zoonoses as non-O157 STEC, S. enterica subsp. diarizonae and Campylobacter spp. The maintenance of slaughter hygiene is consequently of crucial importance. It can be measured in daily practice by "slaughter-process-controls" and regular microbiological monitoring of carcasses. These are valuable tools for verifying slaughter hygiene according to hazard analysis critical control point principles.