Marginal Traction Alopecia: Hair Care Practices, Severity Score and Trichoscopic Features in Lagos, Nigeria.

BACKGROUND: Marginal traction alopecia (MTA) is commonly observed in adult females. Studies of prevalence, severity, trichoscopy and severity scoring are few. OBJECTIVE: The aim of this study was to determine the community prevalence, pattern, severity score and trichoscopy features of MTA amongst adult Nigerian females. Patient and method: This was a cross-sectional descriptive study of a cohort of 207 adult females in a community in Lagos, Nigeria. The participants were clinically evaluated for MTA. Sociodemographic, clinical and trichoscopy data was documented. Severity score was documented using the MTA severity score. Data was analyzed using SPSS version 22. RESULTS: The mean age of participants was 43±12.8 years and the prevalence of MTA was 76.3%. Marginal traction alopecia was frontoccipital in 65.2%. The MTA score was 1-3 in 22.2%, 4-6 in 29.7% and ≥6 in 48.1%. Fringe sign was observed in 30.4%, folliculitis in 9.5% and 13.9% had tight weaves. Trichoscopic features included preserved honeycomb pigment, preserved white dot architecture, varying hair length and single hairs from hair follicles. CONCLUSION: Marginal traction alopecia is common in Nigerian women. It is mostly severe, severity is not significantly associated with haircare practices and it is represented by common trichoscopy features. Appropriate awareness and education of females on hair styles can mitigate this hair loss.

CONTEXTE: L'alopécie de traction marginale (ATM) est couramment observée chez les femmes adultes. Les études de la prévalence, de la gravité, de la trichoscopie et de la notation de la gravité sont peu nombreuses. OBJECTIF: L'objectif de cette étude était de déterminer la prévalence, le modèle, le score de gravité et le score de gravité de la communautaire, le modèle, le score de gravité et les caractéristiques trichoscopiques de l'ATM chez les femmes adultes nigérianes. PATIENTE ET MÉTHODE: Il s'agissait d'une étude descriptive transversale d'une cohorte de 207 femmes adultes dans une communauté de Lagos, au Nigeria. Les participantes ont été évaluées cliniquement pour l'HTA. Les données socio-démographiques, cliniques et trichoscopiques ont été documentées. Le score de sévérité a été documenté en utilisant le score de gravité de l'ATM. Les données ont été analysées en utilisant. RÉSULTATS: L'âge moyen des participants était de 43±12,8 ans et la prévalence de l'ATM était de 76,3 % prévalence de l'AEM était de 76,3%. L'alopécie marginale de traction était frontoccipital dans 65,2 % des cas. Le score de l'ATM était de 1-3 dans 22,2%, 4-6 dans 29,7%. et ≥6 dans 48,1 %. Le signe de la frange a été observé dans 30,4%, la folliculite dans 9,5 % et 13,9 % présentaient des tissages serrés. Les caractéristiques trichoscopiques comprenaient pigment en nid d'abeille préservé, architecture de points blancs préservée, une longueur de cheveux variable et des poils isolés des follicules pileux. CONCLUSION: L'alopécie marginale de traction est fréquente chez les femmes nigérianes. Elle est le plus souvent sévère, sa sévérité n'est pas significativement associée aux pratiques de soins capillaires et elle est représentée par des caractéristiques trichoscopiques communes.Une sensibilisation et une éducation appropriées des femmes en matière de coiffure peuvent atténuer cette perte de cheveux. MOTS CLÉS: Alopécie marginale de traction, Pratiques de soins capillaires, Caractéristiques trichoscopiques, Évaluation de la gravité de l'alopécie de traction marginale.

Teaming up to take down costs.

By linking specialty-specific clinical teams with supply chain experts, Saint Luke's Health System established cost-containment strategies that align with clinical pathways and create new leverage with vendors. Since the initiative launched in January 2013, Saint Luke's has reduced medical supply costs by more than $6 million. In several instances, physicians have led the way in formulating cost-cutting ideas that exceeded the expectations of supply chain administrators.

Nonviral base editing of KCNJ13 mutation preserves vision in a model of inherited retinal channelopathy.

Clinical genome editing is emerging for rare disease treatment, but one of the major limitations is the targeting of CRISPR editors' delivery. We delivered base editors to the retinal pigmented epithelium (RPE) in the mouse eye using silica nanocapsules (SNCs) as a treatment for retinal degeneration. Leber congenital amaurosis type 16 (LCA16) is a rare pediatric blindness caused by point mutations in the KCNJ13 gene, a loss of function inwardly rectifying potassium channel (Kir7.1) in the RPE. SNCs carrying adenine base editor 8e (ABE8e) mRNA and sgRNA precisely and efficiently corrected the KCNJ13W53X/W53X mutation. Editing in both patient fibroblasts (47%) and human induced pluripotent stem cell-derived RPE (LCA16-iPSC-RPE) (17%) showed minimal off-target editing. We detected functional Kir7.1 channels in the edited LCA16-iPSC-RPE. In the LCA16 mouse model (Kcnj13W53X/+ΔR), RPE cells targeted SNC delivery of ABE8e mRNA preserved normal vision, measured by full-field electroretinogram (ERG). Moreover, multifocal ERG confirmed the topographic measure of electrical activity primarily originating from the edited retinal area at the injection site. Preserved retina structure after treatment was established by optical coherence tomography (OCT). This preclinical validation of targeted ion channel functional rescue, a challenge for pharmacological and genomic interventions, reinforced the effectiveness of nonviral genome-editing therapy for rare inherited disorders.

Systematic review: probiotics in the management of lower gastrointestinal symptoms - an updated evidence-based international consensus.

BACKGROUND: In 2013, a systematic review and Delphi consensus reported that specific probiotics can benefit adult patients with irritable bowel syndrome (IBS) and other gastrointestinal (GI) problems. AIM: To update the consensus with new evidence. METHODS: A systematic review identified randomised, placebo-controlled trials published between January 2012 and June 2017. Evidence was graded, previously developed statements were reassessed by an 8-expert panel, and agreement was reached via Delphi consensus. RESULTS: A total of 70 studies were included (IBS, 34; diarrhoea associated with antibiotics, 13; diarrhoea associated with Helicobacter pylori eradication therapy, 7; other conditions, 16). Of 15 studies that examined global IBS symptoms as a primary endpoint, 8 reported significant benefits of probiotics vs placebo. Consensus statements with 100% agreement and "high" evidence level indicated that specific probiotics help reduce overall symptom burden and abdominal pain in some patients with IBS and duration/intensity of diarrhoea in patients prescribed antibiotics or H. pylori eradication therapy, and have favourable safety. Statements with 70%-100% agreement and "moderate" evidence indicated that, in some patients with IBS, specific probiotics help reduce bloating/distension and improve bowel movement frequency/consistency. CONCLUSIONS: This updated review indicates that specific probiotics are beneficial in certain lower GI problems, although many of the new publications did not report benefits of probiotics, possibly due to inclusion of new, less efficacious preparations. Specific probiotics can relieve lower GI symptoms in IBS, prevent diarrhoea associated with antibiotics and H. pylori eradication therapy, and show favourable safety. This study will help clinicians recommend/prescribe probiotics for specific symptoms.

Interleukin-1 beta independently stimulates production of prostaglandin E2 and cyclic AMP from human decidual cells.

Interleukin-1 beta (IL-1 beta) increased the production of cyclic AMP and prostaglandin E2 (PGE2) by cultured human decidual cells during 24 h of stimulation, but not over short incubation times (< 6 h). At concentrations of IL-1 beta ranging from 1 to 100 pg/ml, there were parallel changes in cyclic AMP and PGE2 levels, but 1000 pg of IL-1 beta/ml inhibited cyclic AMP production while still stimulating PGE2 synthesis. The possible link between cyclic AMP and PGE2 was therefore studied further. Inhibition of IL-1 beta-stimulated PGE2 synthesis by indomethacin and direct addition of PGE2 had no effect on cyclic AMP levels, indicating that PGE2 did not increase cyclic AMP production by human decidual cells and confirming the independent synthesis of cyclic AMP and PGE2. The increase in cyclic AMP production induced by IL-1 beta is dependent on protein synthesis, but it is not known which component of the adenylate cyclase is increased. A phosphodiesterase inhibitor potentiated the effects of IL-1 beta on cyclic AMP synthesis, indicating that the cytokine may increase cyclic AMP metabolism. We suggest that high concentrations of IL-1 beta activate phosphodiesterase activity more than adenylate cyclase, which gives rise to the low levels of cyclic AMP noted above. IL-1 beta also decreased forskolin-stimulated cyclic AMP production, which again indicates increased cyclic AMP metabolism. Since most concentrations of IL-1 beta alone increased cyclic AMP levels, this stimulation must out-weigh the increase in metabolism apparent in the presence of forskolin, phosphodiesterase inhibitor or high levels of interleukin. It is clear that IL-1 beta increased decidual PGE2 production independently of cyclic AMP, and that other second messenger must mediate the action of this cytokine.

A pharmacological analysis of the responses of the gastrointestinal smooth muscle of the bat to transmural and periarterial nerve stimulation.

A comparative study of the responses of the gastrointestinal tract of the guinea-pig and of the fruit-eating bat Eidolon helvum to transmural nerve stimulation (TNS) was made. The stomach and rectum of the guinea-pig, the bat and the guinea-pig ileum contracted in response to TNS. These contractions were cholinergic in nature because atropine blocked and physostigmine potentiated them. Tetrodotoxin reversibly abolished these contractions suggesting that they were nerve-mediated. The bat isolated ileum usually responded to TNS with mixed motor and inhibitory components. In some cases, there were only motor or inhibitory components. The motor component was abolished by atropine and potentiated by physostigmine. However, the inhibitory component was non-adrenergic and non-cholinergic (NANC). Tetrodotoxin abolished the motor component without influencing the inhibitory components. Periarterial nerve stimulation of the bat ileum produced a relaxation that was blocked by bretylium, propranolol, phentolamine, reserpine and tetrodotoxin. It is concluded that the bat gastrointestinal smooth muscle, like the guinea-pig, has cholinergic excitatory innervation; however, the bat ileum has both a cholinergic excitatory innervation and a nonadrenergic and non-cholinergic inhibitory component.

Prostanoid production by rat aortic endothelial cells by bradykinin and histamine.

The present studies demonstrate that rat aortic endothelial cells, when stimulated with either bradykinin or histamine, caused the release of both PGI2 and PGE2. The method has also been used to characterize the histamine receptor involved which is H1-subtype. The findings suggest that prostanoid production by bradykinin and histamine constitutes an alternative mechanism to endothelium-derived relaxing factor in mediating vasodilatation.

The effect of different immunosuppressants on alloantigen dependent and independent factors involved in the development of chronic rejection in an animal model.

The aim of this study was to compare the effects of cyclosporine, tacrolimus, mycophenolate mofetil and SDZ RAD on an animal model of transplant arteriosclerosis involving alloantigen dependent and independent mechanisms.

Adolescent unwed prospective fathers: readiness for fatherhood and behaviors toward the mother and the expected infant.

Despite the increased emphasis on assessing and meeting the needs of unmarried pregnant adolescents, less than adequate attention has been directed toward understanding unwed adolescent prospective fathers who frequently are the mates of pregnant teenagers. As part of a prenatal education intervention study, 28 unmarried adolescent fathers responded to a questionnaire containing items about their readiness for fatherhood, antepartal behavioral interactions, and projected postpartal behaviors with their pregnant adolescent partners, as well as their projected behaviors with their infants. The adolescent males reported that initially they either were definitely unready for paternity (75%) or were undecided about readiness for fatherhood (21%). However, as pregnancy advanced beyond the second trimester, only 57% of the respondents did not want to become fathers. To a significant extent, those who did not were least likely to engage in behaviors supportive of their mate's health antepartally, or to indicate a desire to care for and interact with their expected infant. In addition, they tended to project lower levels of postnatal involvement with the adolescent mothers of their children as compared to those males who were more accepting of their pending fatherhood. Moreover, males who had maintained long prepregnancy relationships with their mates tended to be more supportive of them prenatally, and to perceive themselves as maintaining close relationships with both the mothers and infants after delivery. Finally, 86% of the adolescent fathers planned to work to contribute to the support of their infants. The data demonstrate that unreadiness for fatherhood may be associated with responsible as well as irresponsible behaviors. Accordingly, these data are interpreted as having implications for the establishment of programs and policies which focus on the adolescent male population in order to interdict the high rate of unwed adolescent pregnancy.

PIP: Despite the increased emphasis on assessing and meeting the needs of unmarried pregnant adolescents, less than adequate attention has been directed toward understanding unwed adolescent prospective fathers who frequently are the mates of pregnant teenagers. As part of a prenatal education intervention study, 28 unmarried adolescent fathers, responded to a questionnaire containing items about their readiness for fatherhood, antepartal behavioral interactions, and projected postpartal behaviors with their pregnant adolescent partners, as well as their projected behaviors with their infants. The adolescents males reported that initially they either were definitely unready for paternity (75%) or were undecided about readiness for fatherhood (21%). However, as pregnancy advanced beyond the 2nd trimester, only 57% of the respondents did not want to become fathers. To a significant extent, those who did not were least likely to engage in behaviors supportive of their mate's health antepartally, or to indicate a desire to care for and interact with their expected infant. In addition, they tended to project lower levels of postnatal involvement with the adolescent mothers of their children as compared to those males who were more accepting of their pending fatherhood. Males who had maintained long pregnancy relationships with their mates tended to be more supportive of them prenatally, and to perceive themselves as maintaining close relationships with both the mathers and infants after delivery. 86% of the adolescent father planned to work to contribute to the support of their infants. The data demonstrate that unreadiness for fatherhood may be associated with responsible as well as irresponsible behaviors. Data are interpreted as having implications for the establishment of programs and poliicies which focus on the adolescents male population in order to interdict the high rate of unwed adolescent pregnancy.

The "interleukin 1 receptor antagonist" is a partial agonist of prostaglandin synthesis by human decidual cells.

In many systems the interleukin-1 receptor antagonist opposes the effects of interleukin-1 beta. We considered that it might block interleukin-1 beta-stimulated prostaglandin production from human decidual cells. Very high levels of interleukin-1 receptor antagonist (> 1000 pg/ml) had limited inhibitory effects on IL-1 beta-stimulated PGE2 synthesis, and lower levels of antagonist (< 1000 pg/ml) increased the effects of IL-1 beta. Low concentrations of the antagonist alone (1-100 pg/ml) increased basal PGE2 production, whereas higher levels (10-100 ng/ml) had less effect. It seems, therefore, that in human decidua the "antagonist" is more accurately described as a partial agonist. It has been suggested that the IL-1 receptor antagonist could be used to inhibit decidual prostaglandin synthesis and thereby prevent preterm labor, but this report shows that caution should be exercised before using the receptor antagonist.

Decidual adenylate cyclase and prostaglandin production in vitro.

Human decidua contains an active adenylate cyclase, and a number of studies indicate that adenylate cyclase is functionally linked to increased in vitro prostaglandin synthesis. Increased decidual prostaglandin synthesis is associated with parturition, and therefore activation of adenylate cyclase may be involved in the control of human parturition. In this study, third trimester human decidual cells were preincubated for no more than 24 h prior to stimulation with a number of reagents which increase cellular cyclic AMP levels. Forskolin rapidly increased intracellular and extracellular cyclic AMP levels, but there was no increase in prostaglandin E2 biosynthesis during incubations ranging from 5 min up to 24 h. Dibutyryl cyclic AMP or 8-bromo-cyclic AMP were also without effect on PGE2 production, which suggests that the adenylate cyclase was not linked to the mechanisms regulating prostaglandin production. Cholera toxin increased basal cyclic AMP and PGE2 synthesis, and was without effect on IL-1 beta-stimulated PGE2 levels. PGE2 synthesis was increased by 24 h culture with IL-1 beta in all the cell preparations, indicating that the cells were biologically active, and that the lack of effect of changes in cyclic AMP synthesis on PGE2 levels could not be attributed to a defect in the prostaglandin synthetic pathway. Our findings did not agree with earlier work which showed that changes in cyclic AMP were correlated with changes in PGE2 production by human decidual cells. It is clear that in the previous studies the decidual cells were preincubated for 4-7 days prior to stimulation, in contrast with 24 h in our investigation.(ABSTRACT TRUNCATED AT 250 WORDS)

Release of eicosanoids from cultured rat aortic endothelial cells; studies with arachidonic acid and calcium ionophore A23187.

The release of prostanoids from the three different vascular cell types derived from rat aortic explants has been studied in vitro. Under resting conditions and when incubated with exogenous arachidonic acid (AA, 10 microM), the endothelial cells (EC) produced the highest concentration of prostacyclin (PGI2 PGE2 PGF2 alpha TxA2). In contrast, PGE2 was the major prostanoid produced by the smooth muscle cells and fibroblasts. Pretreatment of EC with aspirin (10 microM) or indomethacin (10 microM) effectively inhibited the production of prostanoids by these cells. Incubation with the calcium ionophore A23187 (10 microM) did not stimulate production of PGI2 or leukotriene B4 (LTB4) by EC. However, treatment of EC with a combination of A23187 and AA led to production of amounts of both PGI2 and LTB4 which were greater than the summed values for the different drug treatments. These findings indicate that the concentration of substrate, AA, is a limiting factor in prostanoid formation by these cultured vascular cells but that rat EC are relatively poor in the enzymes required for leukotriene formation.

Isolation, characterisation, growth and culture of endothelial cells from the rat aorta.

Rat aortic endothelial cells have been isolated by the explantation technique and grown in culture. They have been identified morphologically using standard staining techniques, biochemically by identification of angiotensin convertase and have been positively stained for Factor VIII-related antigen by immunofluorescence using both anti-human and anti-rat Factor VIII antibodies. The explantation technique is a successful alternative to enzyme digestion which is not applicable to rat aortic endothelial cells because of the nature of their attachment to the subendothelial layer.