Role of vitamin D deficiency and comorbidities in COVID-19

Recent manuscripts described the incidence of vitamin D hypovitaminosis in coronavirus disease 2019(COVID-19)patients.Vitamin D deficiency is also common in patients with comorbidities that are associated with a poor COVID-19 prognosis.In this letter,we review the literature regarding the association of comorbidities,vitamin D deficiency,and COVID-19.

Relationship between head and neck cancer therapy and some genetic endpoints

Head and neck cancer(HNC) is the sixth most common human malignancy worldwide. The main forms of treat ment for HNC are surgery, radiotherapy(RT) and che motherapy(CT). However, the choice of therapy de pends on the tumor staging and approaches, which are aimed at organ preservation. Because of systemic RT and CT genotoxicity, one of the important side effects is a secondary cancer that can result from the activity of radiation and antineoplastic drugs on healthy cells Ionizing radiation can affect the DNA, causing single and double-strand breaks, DNA-protein crosslinks and oxidative damage. The severity of radiotoxicity can be directly associated with the radiation dosimetry and the dose-volume differences. Regarding CT, cisplatin is stil the standard protocol for the treatment of squamous cell carcinoma, the most common cancer located in theoral cavity. However, simultaneous treatment with cisplatin, bleomycin and 5-fluorouracil or treatment with paclitaxel and cisplatin are also used. These drugs can interact with the DNA, causing DNA crosslinks, double and single-strand breaks and changes in gene expression. Currently, the late effects of therapy have become a recurring problem, mainly due to the increased survival of HNC patients. Herein, we present an update of the systemic activity of RT and CT for HNC, with a focus on their toxicogenetic and toxicogenomic effects.

Intestinal inflammation and the microbiota:Beyond diversity

The recent manuscript entitled“Relationship between clinical features and intestinal microbiota in Chinese patients with ulcerative colitis”reported a difference in the intestinal microbiota of patients with ulcerative colitis according to the severity of the colitis.The influence of the intestinal microbiota on the development and progress of gastrointestinal disorders is well established.Besides the diversity in the microbiome,the presence of virulence factors and toxins by commensal bacteria may affect an extensive variety of cellular processes,contributing to the induction of a proinflammatory environment.

SARS-CoV-2 infection in liver transplant recipients:A complex relationship

The recent manuscript reviewed investigations involving liver damage in coronavirus disease 2019(COVID-19)patients,and COVID-19 in patients with previous chronic hepatological diseases,such as patients with liver graft.The literature presents several conflicting results concerning the anti-SARS-CoV-2 response in patients with solid organ transplants,in liver transplant recipients.Therefore,we would like to humbly state a few points for consideration involving liver transplant recipients and COVID-19,such as the time since transplantation,comorbidities,and immunosuppressive regimens.

Coronavirus disease-2019 and the intestinal tract:An overview

Severe acute respiratory syndrome coronavirus-2(SARS-CoV-2) infection can progress to a severe respiratory and systemic disease named coronavirus disease–2019(COVID-19). The most common symptoms are fever and respiratory discomfort. Nevertheless, gastrointestinal infections have been reported, with symptoms such as diarrhea, nausea, vomiting, abdominal pain, and lack of appetite. Importantly, SARS-CoV-2 can remain positive in fecal samples after nasopharyngeal clearance. After gastrointestinal SARS-CoV-2 infection and other viral gastrointestinal infections, some patients may develop alterations in the gastrointestinal microbiota. In addition, some COVID-19 patients may receive antibiotics, which may also disturb gastrointestinal homeostasis. In summary, the gastrointestinal system, gut microbiome, and gut-lung axis may represent an important role in the development, severity, and treatment of COVID-19. Therefore, in this review, we explore the current pieces of evidence of COVID-19 gastrointestinal manifestations, possible implications, and interventions.

Scalp Psoriasis: Systematic Review Comparing Topical Treatments and Placebo

Patients with scalp psoriasis suffered from a lower quality of life relating to the highly visible site of their psoriatic lesions. In consequence this fact stimulates investigations involving treatments of this dermatologic disease. The aim of this review is to evaluate the topical treatments for scalp psoriasis compared with placebos. Methods: A systematic review was performed using searches in the database LILACS, MEDLINE, Cochrane Library, and Embase. As selection criteria were chosen eligible publications involving randomized controlled trials, patients with scalp psoriasis diagnosed clinically or by biopsy, interventions with topical treatments for scalp psoriasis compared with placebo. Outcome related to the reduction in severity of psoriasis of the scalp, assessed by physicians and patients, and assessment of adverse effects that required discontinuation of treatment. The results have shown that the patients were aged 12 to 97 years, including 3441 patients. Ten of the fifteen studies included reported gender data. Patients were mostly female. Twelve studies were about psoriasis’s severity. These studies in which the severity has been described, the classification of severity was mild (0 study), mild to moderate (1 study), moderate to severe (11 studies) and severe (0 study). In conclusion, topical corticosteroids, calcipotriol, ciclopirox olamine and associations between them are effective in the treatment of scalp psoriasis. Clobetasol propionate (0.05%) was the most effective active ingredient in several vehicles in the induction treatment of scalp psoriasis.

光化性唇炎:组织病理学和p53

Background: Chronic actinic cheilitis (AC) is a precursor of squamous cell carcinoma (SCC) of the lip. Objectives: To evaluate the histopathological characteristics that may help to identify AC more susceptible to carcinomatous transformation, to assess the p53 protein expression in AC, and to determine the value of the p53 expression as a marker of transformation into SCC of the lip. Methods: Seventy cases of chronic AC were reviewed, 31 of which were associated with SCCs. The samples were obtained from pathology reports of AC and SCC of the lip. Histopathology and immunohistochemical expression of the p53 protein were evaluated in isolated AC and in AC adjacent to SCC. Results: The intensity of the inflammatory infiltrate in the corium was the only histopathological finding significantly associated both with the presence of an invasive tumor and with the degree of epithelial atypia. Most AC(85%)were immunoreactive to the p53 protein. The p53 protein expression in cheilitis was not statistically associated with any other histopathological criteria. Conclusions: An intense inflammatory infiltrate in AC was predictive of an adjacent invasive SCC. In this study, the p53 protein immunoreactivity was not a marker of malignant transformation.

盘状红斑狼疮与吸烟:1项病例对照研究

Background: Discoid lupus erythematosus (DLE) is a chronic cutaneous disease affecting photoexposed areas and has also been associated with cigarette smoking. Objective: To evaluate the association between smoking and DLE. Methods: A casecontrol study was performed involving 57 cases diagnosed with DLE and 215 healthy controls. Results: Ahigher smoking prevalence was noted in DLE cases (84.2%) than controls (33.5%), and the odds ratio adjusted for gender, age and ultraviolet index in the city of origin was 14.4 (95%confidence interval 6.2-33.8; multiple logistic regression, p < 0.01). The cumulative smoking exposure was not related to premature DLE development. At the beginning of the disease, smokers had more extensive involvement than non-smokers; compromise of the upper arms was statistically related to smoking. Conclusion: Cigarette smoking was statistically associated with DLE development. Other studies are needed in order to evaluate the effects of smoking cessation on the course of disease.

血浆置换疗法治疗与α-1抗胰蛋白酶缺乏症相关的脂膜炎

Background. Alpha-1-antitrypsin is the principal serum protease inhibitor. In addition to the well-recognized association with early-onset emphysema and cirrhosis, alpha-1-antitrypsin deficiency may be associated with panniculitis. The treatment of this type of panniculitis presents a significant challenge. Previous attempts using immunosuppressive, anti-inflammatory, and cytotoxic drugs have shown variable resuls. Aim. To report a case of alpha-1-antitrypsin deficiency-associated panniculitis treated with plasma exchange therapy. Methods. A23-year-old patient developed painful red nodules on her thighs and buttocks with spontaneous ulceration and discharge of oily fluid. A skin biopsy specimen showed septal and lobular panniculitis. The serum alpha-1-antitrypsin level was 22 mg/dL. She was treated with plasma exchange therapy. Results. Treatment of this patient with plasma exchange therapy led to the control of the cutaneous lesions. Conclusions. Plasma exchange therapy represents an alternative treatment which restores serum and tissue alpha-1-antitrypsin levels. This method is proposed because of its clinical benefits and greater availability.

Sleep disturbances as an adverse effect of propranolol use in children with infantile hemangioma

Infantile hemangiomas(IHs)are the most prevalent benign vascular tumor in children,with an estimated rate of 5-10%.Most IHs resolve spontaneously after the proliferation stage,but about 12-24%develop with sequelae and complications which require pharmacological interventions[1].The beta blocker propranolol is considered as the first-line treatment for complicated cases of IHs[2].