Which acne treatment has the best influence on health-related quality of life? Literature review by the European Academy of Dermatology and Venereology Task Force on Quality of Life and Patient Oriented Outcomes

According to results of a recent literature search performed by the European Academy of Dermatology and Venereology (EADV) Task Forces (TF) on Quality of Life and Patient Oriented Outcomes (QoL and PO) and Acne, Rosacea and Hidradenitis Suppurativa (ARHS), most of the publications where health‐related (HR) QoL of acne patients was studied were clinical trials. Members of the EADV TF on QoL and PO decided to detect which acne treatment has the best influence on HRQoL of acne patients. A new literature search was organized to find publications on acne treatment where the HRQoL of patients was assessed as an outcome measure. From 186 papers with HRQoL assessment, 37 papers were included for further analysis. Our results revealed that oral isotretinoin had the best influence on HRQoL of acne patients. Several other treatment methods also showed good effects on the HRQoL of acne patients. Oral isotretinoin and norethindrone acetate/ethinyl estradiol, topical clindamycin phosphate/benzoyl peroxide and adapalene/benzoyl peroxide showed significantly better effect on HRQoL than placebo. There is limited number of the high‐quality studies on acne treatment where HRQoL was assessed. Dermatology‐specific and acne‐specific instruments showed much better sensitivity to successful therapeutic intervention than generic HRQoL instruments. The most frequently used HRQoL instrument was the Dermatology Life Quality Index questionnaire.FSW - Self-regulation models for health behavior and psychopathology - ou

Characterization of Synaptically Connected Nuclei in a Potential Sensorimotor Feedback Pathway in the Zebra Finch Song System

Birdsong is a learned behavior that is controlled by a group of identified nuclei, known collectively as the song system. The cortical nucleus HVC (used as a proper name) is a focal point of many investigations as it is necessary for song production, song learning, and receives selective auditory information. HVC receives input from several sources including the cortical area MMAN (medial magnocellular nucleus of the nidopallium). The MMAN to HVC connection is particularly interesting as it provides potential sensorimotor feedback to HVC. To begin to understand the role of this connection, we investigated the physiological relation between MMAN and HVC activity with simultaneous multiunit extracellular recordings from these two nuclei in urethane anesthetized zebra finches. As previously reported, we found similar timing in spontaneous bursts of activity in MMAN and HVC. Like HVC, MMAN responds to auditory playback of the bird's own song (BOS), but had little response to reversed BOS or conspecific song. Stimulation of MMAN resulted in evoked activity in HVC, indicating functional excitation from MMAN to HVC. However, inactivation of MMAN resulted in no consistent change in auditory responses in HVC. Taken together, these results indicate that MMAN provides functional excitatory input to HVC but does not provide significant auditory input to HVC in anesthetized animals. We hypothesize that MMAN may play a role in motor reinforcement or coordination, or may provide modulatory input to the song system about the internal state of the animal as it receives input from the hypothalamus

Auditory-evoked action potential activity in MMAN and HVC.

<p>Simultaneous multiunit activity from ipsilateral MMAN and HVC in response to playback of the bird's own song (BOS), the BOS in reverse (REV), and conspecific (CON) song. For both HVC and MMAN, top row, raw data for a single playback of each song; middle row, raster plot of activity to thirty iterations of each song; bottom row, peri-stimulus time histogram (PSTH) of the cumulative response to each song playback. Bin size = 25 ms. The response strength (RS) for each response is given, * indicates a RS that was significantly greater than 0 (one-tailed t-test; p<0.05). For MMAN response to REV, p = 0.06; CON, p = 0.08.</p

GABA inactivation of the area ventral to MMAN resulted in a reduction in auditory responses in HVC.

<p>A, Left, HVC response to ten iterations of BOS before, during, and after GABA application. Right, normalized response to BOS. B. Location of the GABA injection (*). Dye was located ventral to LPS and medial to Area X (outlined by dotted line). The midline is indicated by the line (arrow). Scale bar, 200 µm. M, medial; V, ventral.</p

Comparison of auditory responses and song selectivity in simultaneously recorded multiunit activity in MMAN and HVC.

<p>A. Comparison of the response strength in HVC and MMAN. HVC had a significantly larger RS to BOS than did MMAN (*; paired t-test, p<0.05). The response to REV and CON in HVC and MMAN were not significantly different (REV, p = 0.17; CON, p = 0.47). B. Z-score for auditory-evoked activity in HVC and MMAN. HVC had a significantly higher z-score to BOS than did MMAN (*; paired t-test, BOS, p<0.01). The response in HVC and MMAN to REV and CON were not significantly different (REV, p = 0.20; CON, p = 0.15). C. Comparison of z-scores from simultaneous recorded activity in HVC and mMAN. Black diagonal line is the unity line. D. Both HVC and MMAN were selective for BOS vs REV and BOS vs CON. Selectivity was defined as d′>0.5 (dashed horizontal line). E. HVC was more selective for BOS versus CON than simultaneously recorded MMAN, as many points lie above the unity line than expected at random (p<0.05). The points for BOS versus CON did not lie significantly above the unity line than expected at random (p>0.05). The grey bars demark non-significant d′ values for MMAN and HVC; i.e., −0.5>d′>0.5.</p

Schematic of the feedback loop to HVC through MMAN.

<p>For clarity, anatomical connections are only shown for the right hemisphere. HVC projects to the robust nucleus of the archipallium (RA), which projects to the (DMP). DMP projects bilaterally to MMAN. RA also projects to premotor nuclei that control the syrinx and respiration (PAm and RAm). Abbrev: DMP, dorsomedial nucleus of the posterior thalamus; MMAN, medial magnocellular nucleus of the nidopallium; nXIIts, tracheosyringeal part of the hypoglossal nucleus; PAm, paraambigualis; RAm, retroambigualis.</p

Inactivation of MMAN resulted in little change in HVC auditory responses.

<p>A. Example of auditory evoked activity in MMAN and HVC before (left) and with (right) GABA application to MMAN. Top trace, PSTH of HVC response to ten iterations of BOS playback. Bin size, 25 ms. Middle trace, single, raw example of multiunit activity in HVC. Bottom trace, sonogram of BOS. B. Location of GABA application in MMAN approximated by rhodamine labeling (arrows). LMAN is outlined to the right of the dye (dotted semicircle, *). Scale bar, 200 µm. The dashed vertical line denotes the midline. Dorsal is upward. C. Average response of HVC to BOS presentation before (pre), during (GABA) and after (post) BOS presentation. In two experiments (filled squares) GABA application to MMAN did not produce a significant change in HVC response. In one experiment (open squares) there was a significant decrease in the HVC response to BOS during GABA application compared to pre and post GABA application (ANOVA, p<0.5, Tukey post-hoc). In one bird (open stars) the response to BOS increased throughout the duration of the experiment (pre, GABA, and post were all significantly different than each other; p<0.5, ANOVA, Tukey post-hoc). D. Normalized responses of data shown in C.</p