Introduction: Evaluating the quality of care offered is a reliable indicator of the effectiveness of a health system. Developing countries are still lagging behind in implementing these principles. This work aims to e...Introduction: Evaluating the quality of care offered is a reliable indicator of the effectiveness of a health system. Developing countries are still lagging behind in implementing these principles. This work aims to evaluate the satisfaction of patients operated on and hospitalized in the surgery department at the municipality’s reference health center over a period of 6 months (June 2020 to December 2020). Materials and Methods: This is a quantitative, qualitative, transversal and evaluative study over a period of 6 months based on a self-administered questionnaire to patients who underwent surgery and were hospitalized in the surgery department of the reference health center of commune I upon leaving their hospitalization. The questions are structured around welcome, respect and privacy, care, accommodation conditions as well as overall satisfaction. Results: The survey included 260 patients, 60.8% of whom were male. The 31 - 40 year old age group was in the majority and the majority had completed primary education (42.3%). Married patients were the majority, i.e. 60.4% of cases. Patients were not insured in 66.5% of cases. Almost all of the patients surveyed found that the welcome, care, waiting time, respect and privacy were satisfactory. On the other hand, patients found the rooms and beds uncomfortable. Conclusion: The satisfaction survey reveals worrying data regarding the comfort of patients who must challenge caregivers in healthcare structures. Decision-makers should find useful information there to improve the quality of care.展开更多
Introduction: Late pregnancies are considered a public health problem linked to maternal mortality due to their complications. These risks, which worsen with maternal age, should be better known and taken into account...Introduction: Late pregnancies are considered a public health problem linked to maternal mortality due to their complications. These risks, which worsen with maternal age, should be better known and taken into account in monitoring these pregnancies. Objective: To evaluate the impact of age on the prevalence of obstetric and neonatal complications among parturients of 40 years old and over. Methodology: This was an 11-year retrospective analytical case control study from January 1, 2007 to December 31, 2017. The study population was female patients of 40 years old or older for cases and female patients younger than 40 years of control case. Results: In total, we collected 640 cases of parturients of 40 years old and over out of a total of 84,234 deliveries during the study period;i.e. a frequency of 0.76%. Spontaneous abortion increased in patients of 40 and over with 8.28%. Hypertension and diabetes were higher of women of 40 and over, 52.65%. Concerning the method of admission: 55% of parturients of 40 and over were referrals. Incidents occurring among women of 40 and over were more pronounced than in control cases. Complications during vaginal delivery, cervical tear, perineal tear, uterine dehiscence and uterine rupture are high in our cases, i.e. 11.88%;3.59%;2.19%;2.66. During our study, depending on the type of delivery, the cesarean rate was much higher among women of 40 and over than among control cases, i.e. 54.22% versus 12.24%. Hemorrhages in the 3rd trimester were the main indications for cesarean section. Hemorrhages in the 3rd trimester were more frequent with women of 40 and over, i.e. 10.47%;5.94% versus 1.74% and 0.42%. As for the different types of malformations in parturients, women under 40 years old fetal malformations were absent in 92.29%, on the other hand they were more frequent in patients with 40 years and over, i.e. a normal frequency of 36.72%. Conclusion: Pregnancy at a late age exposes the elderly patient and the newborn to several risks. During this study, an increase in maternal-fetal morbidity was observed with aged women.展开更多
Objective: To examine the prevalence of cutaneous disorders in children under 5 years old who attended a rural hospital in Southern Ethiopia.Methods: A prospective cross-sectional study was conducted from January 26 t...Objective: To examine the prevalence of cutaneous disorders in children under 5 years old who attended a rural hospital in Southern Ethiopia.Methods: A prospective cross-sectional study was conducted from January 26 to February 20, 2015 in children under 5 years old who attended Gambo Rural Hospital in West Arsi of the Oromia Region, Ethiopia.Results: A total of 324 children were included(59.6% male) whose median age was 16.4months. In total, 147 children [45.4%; 95% confidence interval(CI): 40.0%–50.8%]under 5 years had a skin problem, of which 101(68.7%) consulted for that reason. The other 46(31.3%) consulted for a general health problem and the dermatological condition was a secondary finding during the physical exploration. In 93 children(28.7%; 95% CI:20%–33.8%), it was the main disease, and in 54 children(16.5%; 95% CI: 13.0%–21.1%)it was concomitant with other diseases. The most common dermatological disease was scabies(n = 44, 13.6%; 95% CI: 10.3%–17.7%). Impetigo was diagnosed in 32 children(9.9%; 95% CI: 7.1%–13.3%), of which 23(71.9%) had complicated impetigo. Nineteen children(5.9%; 95% CI: 3.8%–9.0%) had eczema, 10(3.1%) had eczema associated to other conditions. The following most frequent skin problems were tinea(n = 9; 2.8%),infected wound and ulcer(n = 7; 2.2%), and burns(n = 6; 1.9%).Conclusions: Skin problems, mainly scabies, impetigo, and eczema were common in young children attended at a rural hospital in Southern Ethiopia. Children under 5 years should be examined thoroughly to rule out skin diseases, especially scabies.展开更多
Fournier’s gangrene is a form of necrotizing fasciitis that has multiple causes and is relatively uncommon in children. We report a case of Fournier’s gangrene of infectious origin in a 12-month-old infant following...Fournier’s gangrene is a form of necrotizing fasciitis that has multiple causes and is relatively uncommon in children. We report a case of Fournier’s gangrene of infectious origin in a 12-month-old infant following an insect bite. A rapid diagnosis and multidisciplinary care saved the patient.展开更多
Acrodermatitis enteropathica is a rare autosomal recessive genetic disorder characterised by periorificial dermatitis, alopecia and diarrhoea. It is caused by a mutation in the gene that codes for a membrane protein t...Acrodermatitis enteropathica is a rare autosomal recessive genetic disorder characterised by periorificial dermatitis, alopecia and diarrhoea. It is caused by a mutation in the gene that codes for a membrane protein that binds zinc. We report a case in a 7-month-old girl, admitted with altered general condition and scaly, pustular erythematous lesions, initially located in the occipital and cervical regions, and secondarily inguinal and on the knees. Management and outcome in this patient? Genetic assay was not available to confirm this rare genetic disease. A delay in establishing the diagnosis and a disastrous outcome did not save the patient despite the administration of zinc.展开更多
BACKGROUND Eccrine porocarcinoma(EPC)is a rare skin tumor that mainly affects the elderly population.Tumors often present with slow growth and a good prognosis.EPCs are usually distinguished from other skin tumors usi...BACKGROUND Eccrine porocarcinoma(EPC)is a rare skin tumor that mainly affects the elderly population.Tumors often present with slow growth and a good prognosis.EPCs are usually distinguished from other skin tumors using histopathology and immunohistochemistry.However,surgical management alone may be inadequate if the tumor has metastasized.However,currently,surgical resection is the most commonly used treatment modality.CASE SUMMARY A seventy-four-year-old woman presented with a slow-growing nodule in her left temporal area,with no obvious itching or pain,for more than four months.Histopathological examination showed small columnar and short spindle-shaped cells;thus,basal cell carcinoma was suspected.However,immunohistochemical analysis revealed the expression of cytokeratin 5/6,p63 protein,p16 protein,and Ki-67 antigen(40%),and EPC was taken into consideration.The skin biopsy was repeated,and hematoxylin and eosin staining revealed ductal differentiation in some cells.Finally,the patient was diagnosed with EPC,and Mohs micrographic surgery was performed.We adapted follow-up visits in a year and not found any recurrence of nodules.CONCLUSION This case report emphasizes the diagnosis and differentiation of EPC.展开更多
Introduction: Maternal mortality constitutes a public health problem and its rate is an indicator of a country’s development. Among the causes of maternal and perinatal death, high blood pressure associated with preg...Introduction: Maternal mortality constitutes a public health problem and its rate is an indicator of a country’s development. Among the causes of maternal and perinatal death, high blood pressure associated with pregnancy occupies a significant part. It represents 5% of direct maternal deaths. Objective: to study the maternal and perinatal prognosis of high blood pressure during pregnancy in the Tenenkou reference health center in Mali. Methodology: This was a descriptive, analytical and retrospective cross-sectional study over a period of twelve months from January 1, 2021 to December 31, 2021 and involving 144 cases of high blood pressure associated with pregnancy. Results: We obtained a frequency of 11.75%. The majority of patients 70.9% were aged between 20 - 35 years. The important risk factor found was young age. During our study, 46.5% of patients had performed at least one CPN and only 13.9% performed 04 CPN. Pre-eclampsia was the most common type of high blood pressure during pregnancy, i.e. 61.1%. Eclampsia and retroplacental hematoma were the most common maternal complications, respectively 27.8% and 11.1%. The most common fetal complications were premature births and fetal distress with 20.9% and 17.4% respectively. Conclusion: Hypertension associated with pregnancy still remains a major cause of maternal-fetal morbidity and mortality in our context where diagnosis is often late. The main clinical form was preeclampsia. Eclampsia and retroplacental hematoma were the most frequent maternal complications. Fetal complications were mainly prematurity and fetal distress.展开更多
Introduction: Uterine fibroid is a mixed mesenchymal tumor, developing from smooth muscle cells of the myometrium, separated by connective tissue. The majority of fibroids are asymptomatic and do not require any inter...Introduction: Uterine fibroid is a mixed mesenchymal tumor, developing from smooth muscle cells of the myometrium, separated by connective tissue. The majority of fibroids are asymptomatic and do not require any intervention or other exploratory measures. However, in some cases fibroids are symptomatic, their treatment should aim to improve symptoms and quality of life. Objectives: Describe the epidemiological-clinical aspects of uterine fibroids in the gynecology and obstetrics department of the reference health center of commune VI of the Bamako district. Methodology: This was a retrospective descriptive study carried out over a period of one year. It concerns all patients seen in consultation in the gynecology and obstetrics department of the reference health center of commune VI. Results: during the study period, the uterine fibroid frequency was 1.80%. During this same period, fibroids represented 5.59% of gyneco-obstetric pathologies operated on in the department. The 30 - 45 year old age group was the most represented with a frequency of 75.63%. The average age was 36.87 years ± 6.2 years with extremes of 25 and 63 years. Married women were the most represented 97.48%. The vast majority of our patients 95.8% were not postmenopausal. The multigravidas were the most represented, i.e. 37.50% with a large part of the pauciparous 41.29%. In our patients, 96.64% had a clinical symptom on their fibroid with the main reason for consultation being the sensation of a pelvic mass in 97.48%. We recorded three cases of infertility as associated factors. Ultrasound was performed in all patients. The location of the myxomatous nuclei was subserosal in the majority in 42.86% and with multiple nodules in 84.85% of cases. The main indication for myomectomy was the failure of medical treatment in 86.49% of cases. Surgical treatment was mainly a myomectomy 93.30%, a hysterectomy was indicated in 6.70%. No cases of death were recorded. Conclusion: Uterine fibroid is a gynecological pathology that exists in our department;its frequency is estimated at 5.59%. For better management of fibroids, it is necessary to have a good knowledge of the factors favoring the occurrence of uterine fibroids, their growth and the symptoms to prevent the appearance of it or even at best to operate. This prevention must be a concern for public health because fibromatous pathology is frequent, costly and hampers quality of life.展开更多
The evolutionary dynamics of cancer,characterized by its profound heterogeneity,demand sophisticated tools for a holistic understanding.This review delves into tumor phylogenetics,an essential approach bridging evolu-...The evolutionary dynamics of cancer,characterized by its profound heterogeneity,demand sophisticated tools for a holistic understanding.This review delves into tumor phylogenetics,an essential approach bridging evolu-tionary biology with oncology,offering unparalleled insights into cancer’s evolutionary trajectory.We provide an overview of the workflow,encompassing study design,data acquisition,and phylogeny reconstruction.No-tably,the integration of diverse data sets emerges as a transformative step,enhancing the depth and breadth of evolutionary insights.With this integrated perspective,tumor phylogenetics stands poised to redefine our understanding of cancer evolution and influence therapeutic strategies.展开更多
Objective To explore the effects of dermabrasion combined with ReCell on large superficial facial scars caused by burn, trauma and acnes. Methods Nineteen patients with large superficial facial scars were treated b...Objective To explore the effects of dermabrasion combined with ReCell on large superficial facial scars caused by burn, trauma and acnes. Methods Nineteen patients with large superficial facial scars were treated by the same surgeon with dermabrasion combined with ReCell?. According to the etiology, patients were classified into post-burning group (n=5), post-traumatic group (n=7) and post-acne group (n=7). Fifteen patients completed the follow-ups, 5 patients in each group. Healing time, complication rate, the preoperative and 18-month-post-operative assessments using Patient Satisfaction Score (PSS), Vancouver Scar Scale (VSS), and Patient and Observer Scar Assessment Scale (POSAS) of each group were analyzed to compare the effect of the combined therapy on outcomes.Results The healing time of post-burning group (19.6±4.0 days), post-traumatic group (15.8±2.6 days), and post-acne group (11.4±3.1 days) varied remarkably (F=7.701, P=0.007). The complication rates were 60%, 20%, and 0 respectively. The post-operative POSAS improved significantly in all groups (P〈0.05), where the most significant improvement was shown in the post-acne group (P〈0.05). The post-operative PSS and VSS improved only in the post-traumatic group and post-acne group (all P〈0.05), where the more significant improvement was also shown in the post-acne group (P〈0.05). Conclusions The combined treatment of dermabrasion and ReCell has remarkable effect on acne scars, moderate effect on traumatic scars and is not suggested for burn scars. POSAS should be applied to assess the therapeutic effects of treatments for large irregular scars.展开更多
Meloxicam(MLX) is efficient in relieving pain and inflammatory symptoms, which, however, is limited by the poor solubility and gastrointestinal side effects. The objective of this study is to develop a nanocrystal for...Meloxicam(MLX) is efficient in relieving pain and inflammatory symptoms, which, however, is limited by the poor solubility and gastrointestinal side effects. The objective of this study is to develop a nanocrystal formulation to enhance transdermal delivery of MLX. MLX nanocrystals were successfully prepared by the nanoprecipitation technique based on acidbase neutralization. With poloxamer 407 and Tween 80(80/20, w/w) as mixed stabilizers,MLX nanocrystals with particle size of 175 nm were obtained. The crystalline structure of MLX nanocrystals was confirmed by both differential scanning calorimetry and X-ray powder diffractometry. However, the nanoprecipitation process reduced the crystallinity of MLX.Nanocrystals increased both in vitro and in vivo transdermal permeation of MLX compared with the solution and suspension counterparts. Due to the enhanced apparent solubility and dissolution as well as the facilitated hair follicular penetration, nanocrystals present a high and prolonged plasma MLX concentration. And 2.58-and 4.4-fold increase in AUC0 →2 4 h was achieved by nanocrystals comparing with solution and suspension, respectively. In conclusion, nanocrystal is advantageous for transdermal delivery of MLX.展开更多
Objective:To analyze the antifungal effects of Chinese herb monomers,i.e.berberine,baicalin,eugenol and curcumin,on Candida albicans.Methods:After Candida albicans strain Y01-09 was incubated for 48 h in YEPD broth wh...Objective:To analyze the antifungal effects of Chinese herb monomers,i.e.berberine,baicalin,eugenol and curcumin,on Candida albicans.Methods:After Candida albicans strain Y01-09 was incubated for 48 h in YEPD broth which contained different concentrations of Chinese herb components,the cell cycle,fluorescent intensity and the size of cell volume were detected by flow cytometry.Results:The 4 Chinese herb monomers could affect the cell cycle of Candida albicans in different ranges.The ratio of cells in S-G2-M period decreased as the agents concentration increased,indicating that the cell division was inhibited.The fluorescent intensity of Candida albicans cells became weaker after being incubated,which reflected the loss of DNA fragments.The higher the concentration was,the weaker the fluorescent intensity became.The cell size,cell diopter and particle size changed much as the agents concentration increased.Conclusion:Chinese herb monomers play the antifungal role in inhibiting cell division.FCM could be used to determine the susceptibility of antifungal agents.展开更多
AIM:Eph receptor tyrosine kinases and their membrane bound receptor-like ligands, the ephrins, represent a bi-directional cell-cell contact signaling system that directs epithelial movements in development. The meanin...AIM:Eph receptor tyrosine kinases and their membrane bound receptor-like ligands, the ephrins, represent a bi-directional cell-cell contact signaling system that directs epithelial movements in development. The meaning of this system in the adult human gut is unknown. We investigated the Eph/ephrin mRNA expression in the intestinal epithelium of healthy controls and patients with inflammatory bowel disease (IBD). METHODS: mRNA expression profiles of all Eph/ephrin family members in normal small intestine and colon were established by real-time RT-PCR. In addition, differential expression in IBD was investigated by cDNA array technology, and validated by both real-time RT-PCR and immunohistochemistry. Potential effects of enhanced EphB/ephrin-B signaling were analyzed in an in vitro IEC-6 cell scratch wound model. RESULTS: Human adult intestinal mucosa exhibits a complex pattern of Eph receptors and ephrins. Beside the known prominent co-expression of EphA2 and ephrinAl, we found abundantly co-expressed EphB2 and ephrin-B1/2. Interestingly, cDNA array data, validated by real-time PCR and immunohistochemistry, showed upregulation of ephrin-B2 in both perilesional and lesional intestinal epithelial cells of IBD patients, suggesting a role in epithelial homeostasis. Stimulation of ephrin-B signaling in ephrin- B1/2 expressing rat IEC-6-cells with recombinant EphB1-Fc resulted in a significant dose-dependent acceleration of wound closure. Furthermore, fluorescence microscopy showed that EphB1-Fc induced coordinated migration of wound edge cells is associated with enhanced formation of lamellipodial protrusions into the wound, increased actin stress fiber assembly and production of laminin at the wound edge. CONCLUSION: EphB/ephrin-B signaling might represent a novel protective mechanism that promotes intestinal epithelial wound healing, with potential impact on epithelial restitution in IBD.展开更多
AIM: Eph receptors and ephrin ligands play a pivotal role in development and tissue maintenance. Since previous data have indicated an involvement of ephrin-B2 in epithelial healing, we investigated the gene expressi...AIM: Eph receptors and ephrin ligands play a pivotal role in development and tissue maintenance. Since previous data have indicated an involvement of ephrin-B2 in epithelial healing, we investigated the gene expression and downstream signaling pathways induced by ephrin-B mediated cell-cell signaling in intestinal epithelial cells. METHODS: Upon stimulation of ephrin-B pathways in IEC-6 cells with recombinant rat EphB1-Fc, gene expression was analyzed by Affymetrix rat genome 230 high density arrays at different time points. Differentially expressed genes were confirmed by real-time RT-PCR. In addition, MAP kinase pathways and focal adhesion kinase (FAK) activation downstream of ephrin-B were investigated by immunoblotting and fluorescence microscopy. RESULTS: Stimulation of the ephrin-B reverse signaling pathway in IEC-6 cells induces predominant expression of genes known to be involved into wound healing/cell migration, antiapoptotic pathways, host defense and inflammation. Cox-2, c-Fos, Egr-1, Egr-2, and MCP-1 were found among the most significantly regulated genes. Furthermore, we show that the expression of repair- related genes is also accompanied by activation of the ERKI/2 MAP kinase pathway and FAK, two key regulators of epithelial restitution. CONCLUSION: Stimulation of the ephrin-B reverse signaling pathway induces a phenotype characterized by upregulation of repair-related genes, which may partially be mediated by ERK1/2 pathways.展开更多
Mycosis fungoides(MF),the most common type of cutaneous T-cell lymphoma,has various unspecific clinical and histological characteristics.Its early diagnosis is challenging.The application of T-cell receptor(TCR) gene ...Mycosis fungoides(MF),the most common type of cutaneous T-cell lymphoma,has various unspecific clinical and histological characteristics.Its early diagnosis is challenging.The application of T-cell receptor(TCR) gene clonal rearrangement to the diagnosis of MF has been widely studied.In this study,we used polymerase chain reaction(PCR) to investigate the diagnostic significance of detecting TCR-γ and-β gene clonal rearrangement in the early diagnosis of mycosis fungoides.PCR for TCR-γ and TCR-β gene rearrangement was performed on 19 patients with suspected early MF,6 with typical MF,and 6 with chronic dermatitis.Of the 19 patients with suspected early MF,13 had TCR-γ gene clonal rearrangement,whereas none had TCR-β gene clonal rearrangement.All patients with typical MF had TCR gene clonal rearrangement,in which 4 showed TCR-γ clonal rearrangement,1 showed TCR-β gene clonal rearrangements,and 1 showed both.No patients with chronic dermatitis had TCR gene clonal rearrangement.These results indicate that TCR gene clonal rearrangement analysis is a useful tool in diagnosing early MF.TCR-γ gene is recommended to the routine analysis,whereas TCR-β gene has potential in combination toward intractable cases.展开更多
BACKGROUD Follicular dendritic cell(FDC)sarcomas are rare neoplasms that occur predominantly in the lymph nodes.They can also occur extranodally.Extranodal FDC sarcomas most commonly present as solitary masses.Inflamm...BACKGROUD Follicular dendritic cell(FDC)sarcomas are rare neoplasms that occur predominantly in the lymph nodes.They can also occur extranodally.Extranodal FDC sarcomas most commonly present as solitary masses.Inflammatory pseudotumor(IPT)-like FDC sarcomas,a subcategory of FDC sarcomas,are rarer than other sarcoma subtypes.They are composed of spindle or ovoid neoplastic cells and exhibit an admixture of plasma cells and prominent lymphoplasmacytic infiltration.Paraneoplastic pemphigus(PNP),also known as paraneoplastic autoimmune multiorgan syndrome,is a rare autoimmune bullous disease that is associated with underlying neoplasms.PNP has a high mortality,and its early diagnosis is usually difficult.CASE SUMMARY We describe a 27-year-old woman who presented with stomatitis,conjunctivitis,and skin blisters and erosions as her first symptoms of PNP with an intraabdominal IPT-like FDC sarcoma.The patient underwent surgical tumor resection and received tapering oral corticosteroid treatment.She showed no recurrence at the 1-year follow-up.CONCLUSION IPT-like FDC sarcomas are rare underlying neoplasms that have an uncommon association with PNP.PNP-associated FDC sarcomas predominantly occur in intra-abdominal sites and suggest a poor prognosis.Surgical resection is an essential and effective treatment for PNP and primary and recurrent FDC sarcomas.展开更多
The genovariation of endothelin receptor type B(EDNRB) was identified in a Chinese family with Waardenburg syndrome type I(WS1) in the present study. WS1 was diagnosed in a 19-year-old young man, his older sister and ...The genovariation of endothelin receptor type B(EDNRB) was identified in a Chinese family with Waardenburg syndrome type I(WS1) in the present study. WS1 was diagnosed in a 19-year-old young man, his older sister and aunt according to WS consortium criteria. After extracting genomic DNA from the peripheral blood samples, the coding exons and intronic regions of EDNRB were sequenced. A missense heterozygous mutation was found in the coding region of exon 2 in the EDNRB gene on chormosome 13 q22.3 of the proband. The same mutation was detected in the proband’s afflicted paternal aunt and first older sister. Subsequent polyphen analysis and three-dimensional modeling confirmed that the c.469 A>G heterozygous mutation in EDNRB was possibly pathogenic. This is the first report of EDNRB mutation as a potential disease-causing mutation in Chinese patients with WS1.展开更多
Extracellular vesicles(EVs)are cell-derived membranous particles that play a crucial role in molecular trafficking,intercellular transport and the egress of unwanted proteins.They have been implicated in many diseases...Extracellular vesicles(EVs)are cell-derived membranous particles that play a crucial role in molecular trafficking,intercellular transport and the egress of unwanted proteins.They have been implicated in many diseases including cancer and neurodegeneration.EVs are detected in all bodily fluids,and their protein and nucleic acid content offers a means of assessing the status of the cells from which they originated.As such,they provide opportunities in biomarker discovery for diagnosis,prognosis or the stratification of diseases as well as an objective monitoring of therapies.The simultaneous assaying of multiple EV-derived markers will be required for an impactful practical application,and multiplexing platforms have evolved with the potential to achieve this.Herein,we provide a comprehensive overview of the currently available multiplexing platforms for EV analysis,with a primary focus on miniaturized and integrated devices that offer potential step changes in analytical power,throughput and consistency.展开更多
The differentiation syndrome is an inflammatory reaction with increased capillary permeability that occurs in up to 25% of patients with acute promyelocytic leukemia treated with all-trans retinoic acid. A 50-year-old...The differentiation syndrome is an inflammatory reaction with increased capillary permeability that occurs in up to 25% of patients with acute promyelocytic leukemia treated with all-trans retinoic acid. A 50-year-old man with acute promyelocytic leukemia underwent chemotherapy with idarubicin and all-trans retinoic acid. On day +21 the patient developed pruritic prepatelar papules as well as several 10 mm subcutaneous nodules in both thighs accompanied by persistent fever. On the day +25 the patient presented with bilateral pulmonary crackles, infiltrates in the right lower lobe and severe hypotension which required dopamine infusion. Biopsy of one of the thighs nodules was performed. A Sweet syndrome associated to a differentiation syndrome was suspected. All-trans retinoic acid therapy was discontinued and dexamethasone was administered. In 48 h the patient showed remission of the fever and the infiltrates and the skin lesions acquired a residual aspect. It is debatable whether these two syndromes are distinct entities with common mechanisms or whether they are poles of the same spectrum. Dermatologists and hematologists must be aware of these two syndromes and its pathophysiologic association.展开更多
AIM: To describe the frequency and biophysical response of sensitive skin in Mexican subjects, using the lactic acid test.METHODS: The lactic acid stinging test was applied to 250 healthy volunteers, both sexes, 18 ye...AIM: To describe the frequency and biophysical response of sensitive skin in Mexican subjects, using the lactic acid test.METHODS: The lactic acid stinging test was applied to 250 healthy volunteers, both sexes, 18 years of age or older, without any active dermatoses on the test site. Volunteers were university students, workers of public institutions, and general population from San Luis Potosi, Mexico. Participants were not excluded based on socioeconomic status. Demographic data were obtained through a questionnaire. Skin phototype was obtained through colorimetry. Subjects were randomized to receive 10% lactic acid on one nasolabial fold and placebo on the other side. The presence and intensity of adverse sensations, such as itching, burning, or stinging, was evaluated through a 10-point VisualAnalogue Scale(VAS) prior to treatment and at 3, 5, 8 and 10 min after the intervention. Subjects with a VAS of 2 or higher were considered positive for the test. A VAS lower than 2 was considered a normal response to skin manipulation. Simultaneously, biophysical changes and barrier function were assessed by colorimetry, transepidermal water loss(TEWL), and capacitance. To decrease measurement variations by skin manipulation, the nasolabial fold was segmented in four areas of 1 cm2 for each time measurement. Descriptive analyses were made using central tendency measures. Analyses of data were performed using two-tailed c2 test, Fisher's test, t-test, logistic regression, or Mann-Whitney U test for non-parametric values between groups. RESULTS: Of the included 246 subjects, 68% were women and the mean age was 32 years. The most frequent skin phototype was Ⅴ(ranges Ⅱ-Ⅴ). Thirty-six percent of the subjects identified themselves as having sensitive skin. Fifty-two percent of the subjects were positive to the lactic acid stinging test, with a mean VAS of 4.5 at 3 min. Subjects with the self-diagnosis of sensitive skin were more likely to be positive for the test(80% vs 36%, P < 0.001). Lighter skin phototypes(types Ⅱ and Ⅲ) showed a higher response to the test compared to darker skin tones(type Ⅴ; OR = 0.88, P < 0.001). There were no statistical differences in baseline biophysical measurements. At 3 min, TEWL was significantly higher in subjects positive to the test(27.5 vs 23.7, P < 0.05). At 5 min, TEWL and capacitance showed statistical differences(26.0 vs 22.4, P < 0.05, and 239 vs 179, P < 0.05, respectively). After 5 min, values tended to return to baseline levels in both groups.CONCLUSION: Sensitive skin is frequent in our population. Darker skin phototypes have a lower prevalence of this syndrome, probably due to inherent differences in skin barrier function.展开更多
文摘Introduction: Evaluating the quality of care offered is a reliable indicator of the effectiveness of a health system. Developing countries are still lagging behind in implementing these principles. This work aims to evaluate the satisfaction of patients operated on and hospitalized in the surgery department at the municipality’s reference health center over a period of 6 months (June 2020 to December 2020). Materials and Methods: This is a quantitative, qualitative, transversal and evaluative study over a period of 6 months based on a self-administered questionnaire to patients who underwent surgery and were hospitalized in the surgery department of the reference health center of commune I upon leaving their hospitalization. The questions are structured around welcome, respect and privacy, care, accommodation conditions as well as overall satisfaction. Results: The survey included 260 patients, 60.8% of whom were male. The 31 - 40 year old age group was in the majority and the majority had completed primary education (42.3%). Married patients were the majority, i.e. 60.4% of cases. Patients were not insured in 66.5% of cases. Almost all of the patients surveyed found that the welcome, care, waiting time, respect and privacy were satisfactory. On the other hand, patients found the rooms and beds uncomfortable. Conclusion: The satisfaction survey reveals worrying data regarding the comfort of patients who must challenge caregivers in healthcare structures. Decision-makers should find useful information there to improve the quality of care.
文摘Introduction: Late pregnancies are considered a public health problem linked to maternal mortality due to their complications. These risks, which worsen with maternal age, should be better known and taken into account in monitoring these pregnancies. Objective: To evaluate the impact of age on the prevalence of obstetric and neonatal complications among parturients of 40 years old and over. Methodology: This was an 11-year retrospective analytical case control study from January 1, 2007 to December 31, 2017. The study population was female patients of 40 years old or older for cases and female patients younger than 40 years of control case. Results: In total, we collected 640 cases of parturients of 40 years old and over out of a total of 84,234 deliveries during the study period;i.e. a frequency of 0.76%. Spontaneous abortion increased in patients of 40 and over with 8.28%. Hypertension and diabetes were higher of women of 40 and over, 52.65%. Concerning the method of admission: 55% of parturients of 40 and over were referrals. Incidents occurring among women of 40 and over were more pronounced than in control cases. Complications during vaginal delivery, cervical tear, perineal tear, uterine dehiscence and uterine rupture are high in our cases, i.e. 11.88%;3.59%;2.19%;2.66. During our study, depending on the type of delivery, the cesarean rate was much higher among women of 40 and over than among control cases, i.e. 54.22% versus 12.24%. Hemorrhages in the 3rd trimester were the main indications for cesarean section. Hemorrhages in the 3rd trimester were more frequent with women of 40 and over, i.e. 10.47%;5.94% versus 1.74% and 0.42%. As for the different types of malformations in parturients, women under 40 years old fetal malformations were absent in 92.29%, on the other hand they were more frequent in patients with 40 years and over, i.e. a normal frequency of 36.72%. Conclusion: Pregnancy at a late age exposes the elderly patient and the newborn to several risks. During this study, an increase in maternal-fetal morbidity was observed with aged women.
基金Valencian Territorial Section of the Spanish Academy of Dermatology and Venereology(Sección Territorial Valenciana de la Academia Espa?ola de Dermatología y Venerología)(Solidary Grant No.1/2014)
文摘Objective: To examine the prevalence of cutaneous disorders in children under 5 years old who attended a rural hospital in Southern Ethiopia.Methods: A prospective cross-sectional study was conducted from January 26 to February 20, 2015 in children under 5 years old who attended Gambo Rural Hospital in West Arsi of the Oromia Region, Ethiopia.Results: A total of 324 children were included(59.6% male) whose median age was 16.4months. In total, 147 children [45.4%; 95% confidence interval(CI): 40.0%–50.8%]under 5 years had a skin problem, of which 101(68.7%) consulted for that reason. The other 46(31.3%) consulted for a general health problem and the dermatological condition was a secondary finding during the physical exploration. In 93 children(28.7%; 95% CI:20%–33.8%), it was the main disease, and in 54 children(16.5%; 95% CI: 13.0%–21.1%)it was concomitant with other diseases. The most common dermatological disease was scabies(n = 44, 13.6%; 95% CI: 10.3%–17.7%). Impetigo was diagnosed in 32 children(9.9%; 95% CI: 7.1%–13.3%), of which 23(71.9%) had complicated impetigo. Nineteen children(5.9%; 95% CI: 3.8%–9.0%) had eczema, 10(3.1%) had eczema associated to other conditions. The following most frequent skin problems were tinea(n = 9; 2.8%),infected wound and ulcer(n = 7; 2.2%), and burns(n = 6; 1.9%).Conclusions: Skin problems, mainly scabies, impetigo, and eczema were common in young children attended at a rural hospital in Southern Ethiopia. Children under 5 years should be examined thoroughly to rule out skin diseases, especially scabies.
文摘Fournier’s gangrene is a form of necrotizing fasciitis that has multiple causes and is relatively uncommon in children. We report a case of Fournier’s gangrene of infectious origin in a 12-month-old infant following an insect bite. A rapid diagnosis and multidisciplinary care saved the patient.
文摘Acrodermatitis enteropathica is a rare autosomal recessive genetic disorder characterised by periorificial dermatitis, alopecia and diarrhoea. It is caused by a mutation in the gene that codes for a membrane protein that binds zinc. We report a case in a 7-month-old girl, admitted with altered general condition and scaly, pustular erythematous lesions, initially located in the occipital and cervical regions, and secondarily inguinal and on the knees. Management and outcome in this patient? Genetic assay was not available to confirm this rare genetic disease. A delay in establishing the diagnosis and a disastrous outcome did not save the patient despite the administration of zinc.
文摘BACKGROUND Eccrine porocarcinoma(EPC)is a rare skin tumor that mainly affects the elderly population.Tumors often present with slow growth and a good prognosis.EPCs are usually distinguished from other skin tumors using histopathology and immunohistochemistry.However,surgical management alone may be inadequate if the tumor has metastasized.However,currently,surgical resection is the most commonly used treatment modality.CASE SUMMARY A seventy-four-year-old woman presented with a slow-growing nodule in her left temporal area,with no obvious itching or pain,for more than four months.Histopathological examination showed small columnar and short spindle-shaped cells;thus,basal cell carcinoma was suspected.However,immunohistochemical analysis revealed the expression of cytokeratin 5/6,p63 protein,p16 protein,and Ki-67 antigen(40%),and EPC was taken into consideration.The skin biopsy was repeated,and hematoxylin and eosin staining revealed ductal differentiation in some cells.Finally,the patient was diagnosed with EPC,and Mohs micrographic surgery was performed.We adapted follow-up visits in a year and not found any recurrence of nodules.CONCLUSION This case report emphasizes the diagnosis and differentiation of EPC.
文摘Introduction: Maternal mortality constitutes a public health problem and its rate is an indicator of a country’s development. Among the causes of maternal and perinatal death, high blood pressure associated with pregnancy occupies a significant part. It represents 5% of direct maternal deaths. Objective: to study the maternal and perinatal prognosis of high blood pressure during pregnancy in the Tenenkou reference health center in Mali. Methodology: This was a descriptive, analytical and retrospective cross-sectional study over a period of twelve months from January 1, 2021 to December 31, 2021 and involving 144 cases of high blood pressure associated with pregnancy. Results: We obtained a frequency of 11.75%. The majority of patients 70.9% were aged between 20 - 35 years. The important risk factor found was young age. During our study, 46.5% of patients had performed at least one CPN and only 13.9% performed 04 CPN. Pre-eclampsia was the most common type of high blood pressure during pregnancy, i.e. 61.1%. Eclampsia and retroplacental hematoma were the most common maternal complications, respectively 27.8% and 11.1%. The most common fetal complications were premature births and fetal distress with 20.9% and 17.4% respectively. Conclusion: Hypertension associated with pregnancy still remains a major cause of maternal-fetal morbidity and mortality in our context where diagnosis is often late. The main clinical form was preeclampsia. Eclampsia and retroplacental hematoma were the most frequent maternal complications. Fetal complications were mainly prematurity and fetal distress.
文摘Introduction: Uterine fibroid is a mixed mesenchymal tumor, developing from smooth muscle cells of the myometrium, separated by connective tissue. The majority of fibroids are asymptomatic and do not require any intervention or other exploratory measures. However, in some cases fibroids are symptomatic, their treatment should aim to improve symptoms and quality of life. Objectives: Describe the epidemiological-clinical aspects of uterine fibroids in the gynecology and obstetrics department of the reference health center of commune VI of the Bamako district. Methodology: This was a retrospective descriptive study carried out over a period of one year. It concerns all patients seen in consultation in the gynecology and obstetrics department of the reference health center of commune VI. Results: during the study period, the uterine fibroid frequency was 1.80%. During this same period, fibroids represented 5.59% of gyneco-obstetric pathologies operated on in the department. The 30 - 45 year old age group was the most represented with a frequency of 75.63%. The average age was 36.87 years ± 6.2 years with extremes of 25 and 63 years. Married women were the most represented 97.48%. The vast majority of our patients 95.8% were not postmenopausal. The multigravidas were the most represented, i.e. 37.50% with a large part of the pauciparous 41.29%. In our patients, 96.64% had a clinical symptom on their fibroid with the main reason for consultation being the sensation of a pelvic mass in 97.48%. We recorded three cases of infertility as associated factors. Ultrasound was performed in all patients. The location of the myxomatous nuclei was subserosal in the majority in 42.86% and with multiple nodules in 84.85% of cases. The main indication for myomectomy was the failure of medical treatment in 86.49% of cases. Surgical treatment was mainly a myomectomy 93.30%, a hysterectomy was indicated in 6.70%. No cases of death were recorded. Conclusion: Uterine fibroid is a gynecological pathology that exists in our department;its frequency is estimated at 5.59%. For better management of fibroids, it is necessary to have a good knowledge of the factors favoring the occurrence of uterine fibroids, their growth and the symptoms to prevent the appearance of it or even at best to operate. This prevention must be a concern for public health because fibromatous pathology is frequent, costly and hampers quality of life.
基金supported by the National Natural Science Founda-tion of China(approval number:32270677).
文摘The evolutionary dynamics of cancer,characterized by its profound heterogeneity,demand sophisticated tools for a holistic understanding.This review delves into tumor phylogenetics,an essential approach bridging evolu-tionary biology with oncology,offering unparalleled insights into cancer’s evolutionary trajectory.We provide an overview of the workflow,encompassing study design,data acquisition,and phylogeny reconstruction.No-tably,the integration of diverse data sets emerges as a transformative step,enhancing the depth and breadth of evolutionary insights.With this integrated perspective,tumor phylogenetics stands poised to redefine our understanding of cancer evolution and influence therapeutic strategies.
基金Supported by National Natural Science Foundation of China(81372063)
文摘Objective To explore the effects of dermabrasion combined with ReCell on large superficial facial scars caused by burn, trauma and acnes. Methods Nineteen patients with large superficial facial scars were treated by the same surgeon with dermabrasion combined with ReCell?. According to the etiology, patients were classified into post-burning group (n=5), post-traumatic group (n=7) and post-acne group (n=7). Fifteen patients completed the follow-ups, 5 patients in each group. Healing time, complication rate, the preoperative and 18-month-post-operative assessments using Patient Satisfaction Score (PSS), Vancouver Scar Scale (VSS), and Patient and Observer Scar Assessment Scale (POSAS) of each group were analyzed to compare the effect of the combined therapy on outcomes.Results The healing time of post-burning group (19.6±4.0 days), post-traumatic group (15.8±2.6 days), and post-acne group (11.4±3.1 days) varied remarkably (F=7.701, P=0.007). The complication rates were 60%, 20%, and 0 respectively. The post-operative POSAS improved significantly in all groups (P〈0.05), where the most significant improvement was shown in the post-acne group (P〈0.05). The post-operative PSS and VSS improved only in the post-traumatic group and post-acne group (all P〈0.05), where the more significant improvement was also shown in the post-acne group (P〈0.05). Conclusions The combined treatment of dermabrasion and ReCell has remarkable effect on acne scars, moderate effect on traumatic scars and is not suggested for burn scars. POSAS should be applied to assess the therapeutic effects of treatments for large irregular scars.
基金financially supported by Natural Science Foun-dation of Shanghai(16ZR1403500)
文摘Meloxicam(MLX) is efficient in relieving pain and inflammatory symptoms, which, however, is limited by the poor solubility and gastrointestinal side effects. The objective of this study is to develop a nanocrystal formulation to enhance transdermal delivery of MLX. MLX nanocrystals were successfully prepared by the nanoprecipitation technique based on acidbase neutralization. With poloxamer 407 and Tween 80(80/20, w/w) as mixed stabilizers,MLX nanocrystals with particle size of 175 nm were obtained. The crystalline structure of MLX nanocrystals was confirmed by both differential scanning calorimetry and X-ray powder diffractometry. However, the nanoprecipitation process reduced the crystallinity of MLX.Nanocrystals increased both in vitro and in vivo transdermal permeation of MLX compared with the solution and suspension counterparts. Due to the enhanced apparent solubility and dissolution as well as the facilitated hair follicular penetration, nanocrystals present a high and prolonged plasma MLX concentration. And 2.58-and 4.4-fold increase in AUC0 →2 4 h was achieved by nanocrystals comparing with solution and suspension, respectively. In conclusion, nanocrystal is advantageous for transdermal delivery of MLX.
文摘Objective:To analyze the antifungal effects of Chinese herb monomers,i.e.berberine,baicalin,eugenol and curcumin,on Candida albicans.Methods:After Candida albicans strain Y01-09 was incubated for 48 h in YEPD broth which contained different concentrations of Chinese herb components,the cell cycle,fluorescent intensity and the size of cell volume were detected by flow cytometry.Results:The 4 Chinese herb monomers could affect the cell cycle of Candida albicans in different ranges.The ratio of cells in S-G2-M period decreased as the agents concentration increased,indicating that the cell division was inhibited.The fluorescent intensity of Candida albicans cells became weaker after being incubated,which reflected the loss of DNA fragments.The higher the concentration was,the weaker the fluorescent intensity became.The cell size,cell diopter and particle size changed much as the agents concentration increased.Conclusion:Chinese herb monomers play the antifungal role in inhibiting cell division.FCM could be used to determine the susceptibility of antifungal agents.
基金Supported by the Gennan Research Society (DFG-SFB 585/A8) and the Dr. Heinz Maurer Grant KFB 1.7
文摘AIM:Eph receptor tyrosine kinases and their membrane bound receptor-like ligands, the ephrins, represent a bi-directional cell-cell contact signaling system that directs epithelial movements in development. The meaning of this system in the adult human gut is unknown. We investigated the Eph/ephrin mRNA expression in the intestinal epithelium of healthy controls and patients with inflammatory bowel disease (IBD). METHODS: mRNA expression profiles of all Eph/ephrin family members in normal small intestine and colon were established by real-time RT-PCR. In addition, differential expression in IBD was investigated by cDNA array technology, and validated by both real-time RT-PCR and immunohistochemistry. Potential effects of enhanced EphB/ephrin-B signaling were analyzed in an in vitro IEC-6 cell scratch wound model. RESULTS: Human adult intestinal mucosa exhibits a complex pattern of Eph receptors and ephrins. Beside the known prominent co-expression of EphA2 and ephrinAl, we found abundantly co-expressed EphB2 and ephrin-B1/2. Interestingly, cDNA array data, validated by real-time PCR and immunohistochemistry, showed upregulation of ephrin-B2 in both perilesional and lesional intestinal epithelial cells of IBD patients, suggesting a role in epithelial homeostasis. Stimulation of ephrin-B signaling in ephrin- B1/2 expressing rat IEC-6-cells with recombinant EphB1-Fc resulted in a significant dose-dependent acceleration of wound closure. Furthermore, fluorescence microscopy showed that EphB1-Fc induced coordinated migration of wound edge cells is associated with enhanced formation of lamellipodial protrusions into the wound, increased actin stress fiber assembly and production of laminin at the wound edge. CONCLUSION: EphB/ephrin-B signaling might represent a novel protective mechanism that promotes intestinal epithelial wound healing, with potential impact on epithelial restitution in IBD.
基金Supported by the German Research Society (DFG - SFB 585/A8) and the Dr. Heinz Maurer Grant KFB 1.7
文摘AIM: Eph receptors and ephrin ligands play a pivotal role in development and tissue maintenance. Since previous data have indicated an involvement of ephrin-B2 in epithelial healing, we investigated the gene expression and downstream signaling pathways induced by ephrin-B mediated cell-cell signaling in intestinal epithelial cells. METHODS: Upon stimulation of ephrin-B pathways in IEC-6 cells with recombinant rat EphB1-Fc, gene expression was analyzed by Affymetrix rat genome 230 high density arrays at different time points. Differentially expressed genes were confirmed by real-time RT-PCR. In addition, MAP kinase pathways and focal adhesion kinase (FAK) activation downstream of ephrin-B were investigated by immunoblotting and fluorescence microscopy. RESULTS: Stimulation of the ephrin-B reverse signaling pathway in IEC-6 cells induces predominant expression of genes known to be involved into wound healing/cell migration, antiapoptotic pathways, host defense and inflammation. Cox-2, c-Fos, Egr-1, Egr-2, and MCP-1 were found among the most significantly regulated genes. Furthermore, we show that the expression of repair- related genes is also accompanied by activation of the ERKI/2 MAP kinase pathway and FAK, two key regulators of epithelial restitution. CONCLUSION: Stimulation of the ephrin-B reverse signaling pathway induces a phenotype characterized by upregulation of repair-related genes, which may partially be mediated by ERK1/2 pathways.
基金supported by grant from Sichuan Provincial Sci-Tech Research Foundation (No.07SG004009)
文摘Mycosis fungoides(MF),the most common type of cutaneous T-cell lymphoma,has various unspecific clinical and histological characteristics.Its early diagnosis is challenging.The application of T-cell receptor(TCR) gene clonal rearrangement to the diagnosis of MF has been widely studied.In this study,we used polymerase chain reaction(PCR) to investigate the diagnostic significance of detecting TCR-γ and-β gene clonal rearrangement in the early diagnosis of mycosis fungoides.PCR for TCR-γ and TCR-β gene rearrangement was performed on 19 patients with suspected early MF,6 with typical MF,and 6 with chronic dermatitis.Of the 19 patients with suspected early MF,13 had TCR-γ gene clonal rearrangement,whereas none had TCR-β gene clonal rearrangement.All patients with typical MF had TCR gene clonal rearrangement,in which 4 showed TCR-γ clonal rearrangement,1 showed TCR-β gene clonal rearrangements,and 1 showed both.No patients with chronic dermatitis had TCR gene clonal rearrangement.These results indicate that TCR gene clonal rearrangement analysis is a useful tool in diagnosing early MF.TCR-γ gene is recommended to the routine analysis,whereas TCR-β gene has potential in combination toward intractable cases.
文摘BACKGROUD Follicular dendritic cell(FDC)sarcomas are rare neoplasms that occur predominantly in the lymph nodes.They can also occur extranodally.Extranodal FDC sarcomas most commonly present as solitary masses.Inflammatory pseudotumor(IPT)-like FDC sarcomas,a subcategory of FDC sarcomas,are rarer than other sarcoma subtypes.They are composed of spindle or ovoid neoplastic cells and exhibit an admixture of plasma cells and prominent lymphoplasmacytic infiltration.Paraneoplastic pemphigus(PNP),also known as paraneoplastic autoimmune multiorgan syndrome,is a rare autoimmune bullous disease that is associated with underlying neoplasms.PNP has a high mortality,and its early diagnosis is usually difficult.CASE SUMMARY We describe a 27-year-old woman who presented with stomatitis,conjunctivitis,and skin blisters and erosions as her first symptoms of PNP with an intraabdominal IPT-like FDC sarcoma.The patient underwent surgical tumor resection and received tapering oral corticosteroid treatment.She showed no recurrence at the 1-year follow-up.CONCLUSION IPT-like FDC sarcomas are rare underlying neoplasms that have an uncommon association with PNP.PNP-associated FDC sarcomas predominantly occur in intra-abdominal sites and suggest a poor prognosis.Surgical resection is an essential and effective treatment for PNP and primary and recurrent FDC sarcomas.
基金Supported by Medical Scientific Research Foundation of Guangdong Province(No.A2016271)Guangdong Natural Science Foundation(No.2016A030313208)
文摘The genovariation of endothelin receptor type B(EDNRB) was identified in a Chinese family with Waardenburg syndrome type I(WS1) in the present study. WS1 was diagnosed in a 19-year-old young man, his older sister and aunt according to WS consortium criteria. After extracting genomic DNA from the peripheral blood samples, the coding exons and intronic regions of EDNRB were sequenced. A missense heterozygous mutation was found in the coding region of exon 2 in the EDNRB gene on chormosome 13 q22.3 of the proband. The same mutation was detected in the proband’s afflicted paternal aunt and first older sister. Subsequent polyphen analysis and three-dimensional modeling confirmed that the c.469 A>G heterozygous mutation in EDNRB was possibly pathogenic. This is the first report of EDNRB mutation as a potential disease-causing mutation in Chinese patients with WS1.
基金funded by grants from the EPSRC(EP/M006204/1)the Michael J Fox Foundation+2 种基金the Selfridges Group Foundationthe NIHR Oxford Biomedical Research Centre to G.K.T and J.J.Dsupport from the John Fell Fund(HMD00470).
文摘Extracellular vesicles(EVs)are cell-derived membranous particles that play a crucial role in molecular trafficking,intercellular transport and the egress of unwanted proteins.They have been implicated in many diseases including cancer and neurodegeneration.EVs are detected in all bodily fluids,and their protein and nucleic acid content offers a means of assessing the status of the cells from which they originated.As such,they provide opportunities in biomarker discovery for diagnosis,prognosis or the stratification of diseases as well as an objective monitoring of therapies.The simultaneous assaying of multiple EV-derived markers will be required for an impactful practical application,and multiplexing platforms have evolved with the potential to achieve this.Herein,we provide a comprehensive overview of the currently available multiplexing platforms for EV analysis,with a primary focus on miniaturized and integrated devices that offer potential step changes in analytical power,throughput and consistency.
文摘The differentiation syndrome is an inflammatory reaction with increased capillary permeability that occurs in up to 25% of patients with acute promyelocytic leukemia treated with all-trans retinoic acid. A 50-year-old man with acute promyelocytic leukemia underwent chemotherapy with idarubicin and all-trans retinoic acid. On day +21 the patient developed pruritic prepatelar papules as well as several 10 mm subcutaneous nodules in both thighs accompanied by persistent fever. On the day +25 the patient presented with bilateral pulmonary crackles, infiltrates in the right lower lobe and severe hypotension which required dopamine infusion. Biopsy of one of the thighs nodules was performed. A Sweet syndrome associated to a differentiation syndrome was suspected. All-trans retinoic acid therapy was discontinued and dexamethasone was administered. In 48 h the patient showed remission of the fever and the infiltrates and the skin lesions acquired a residual aspect. It is debatable whether these two syndromes are distinct entities with common mechanisms or whether they are poles of the same spectrum. Dermatologists and hematologists must be aware of these two syndromes and its pathophysiologic association.
文摘AIM: To describe the frequency and biophysical response of sensitive skin in Mexican subjects, using the lactic acid test.METHODS: The lactic acid stinging test was applied to 250 healthy volunteers, both sexes, 18 years of age or older, without any active dermatoses on the test site. Volunteers were university students, workers of public institutions, and general population from San Luis Potosi, Mexico. Participants were not excluded based on socioeconomic status. Demographic data were obtained through a questionnaire. Skin phototype was obtained through colorimetry. Subjects were randomized to receive 10% lactic acid on one nasolabial fold and placebo on the other side. The presence and intensity of adverse sensations, such as itching, burning, or stinging, was evaluated through a 10-point VisualAnalogue Scale(VAS) prior to treatment and at 3, 5, 8 and 10 min after the intervention. Subjects with a VAS of 2 or higher were considered positive for the test. A VAS lower than 2 was considered a normal response to skin manipulation. Simultaneously, biophysical changes and barrier function were assessed by colorimetry, transepidermal water loss(TEWL), and capacitance. To decrease measurement variations by skin manipulation, the nasolabial fold was segmented in four areas of 1 cm2 for each time measurement. Descriptive analyses were made using central tendency measures. Analyses of data were performed using two-tailed c2 test, Fisher's test, t-test, logistic regression, or Mann-Whitney U test for non-parametric values between groups. RESULTS: Of the included 246 subjects, 68% were women and the mean age was 32 years. The most frequent skin phototype was Ⅴ(ranges Ⅱ-Ⅴ). Thirty-six percent of the subjects identified themselves as having sensitive skin. Fifty-two percent of the subjects were positive to the lactic acid stinging test, with a mean VAS of 4.5 at 3 min. Subjects with the self-diagnosis of sensitive skin were more likely to be positive for the test(80% vs 36%, P < 0.001). Lighter skin phototypes(types Ⅱ and Ⅲ) showed a higher response to the test compared to darker skin tones(type Ⅴ; OR = 0.88, P < 0.001). There were no statistical differences in baseline biophysical measurements. At 3 min, TEWL was significantly higher in subjects positive to the test(27.5 vs 23.7, P < 0.05). At 5 min, TEWL and capacitance showed statistical differences(26.0 vs 22.4, P < 0.05, and 239 vs 179, P < 0.05, respectively). After 5 min, values tended to return to baseline levels in both groups.CONCLUSION: Sensitive skin is frequent in our population. Darker skin phototypes have a lower prevalence of this syndrome, probably due to inherent differences in skin barrier function.