Salicylic Acid Peel Incorporating Triethyl Citrate and Ethyl Linoleate in the Treatment of Moderate Acne: A New Therapeutic Approach.

BACKGROUND: Acne affects many adolescents. Conventional therapy often results in side effects and poor adherence, and the treatment does not consider the psychological effect of acne on patients, which is comparable with that of disabling diseases. OBJECTIVES: To evaluate the efficacy and tolerability of a peel (30% salicylic acid, triethyl citrate and ethyl linoleate) combined with a home therapy with three topical agents (triethyl citrate, ethyl linoleate and salicylic acid 0.5% cream, lotion) in moderate acne of the face. DESIGN: Prospective, observational, multicenter, open-label, postmarketing, phase IV study. METHODS: Patients were assessed by comparing Global Acne Grading System (GAGS) score and total lesion count from 15 days before the first peel (T-15 ), after four salicylic peels (every 10 ± 2 days (T0 , T10 , T20 , T30 ), and 20 days after of the end of the study (T50 ). This treatment was associated to a home therapy. RESULTS: Fifty-three patients completed the study. The average GAGS score fell 49% between T-15 and T50 (p < .001). No patient withdrew for adverse events. CONCLUSIONS: This therapy was effective and well-tolerated in all cases. Chemo-exfoliation sessions ensured the continuous monitoring of clinical results and improved patient quality of life

New patient-oriented tools for assessing atrophic acne scarring

Scarring on visible areas such as the face is associated with negative psychological impact. Many patients with acne have clinically relevant scarring for which they seek treatment, implying that there is an impact on their lives. Currently there are no validated tools to assess the burden of atrophic acne scarring from the patient’s perspective or to assess treatment benefit. Methods Two patient-reported outcome measures, the self-assessment of clinical acne-related scars (SCARS) and the facial acne scar quality of life (FASQoL) tools, both specific to facial atrophic acne scarring, were developed according to Food and Drug Administration guidance methodology. Patient interviews were conducted first to elicit patient-important concepts about scarring, then to validate patients’ understanding of wording in the tools. These tools focus on symptoms (SCARS) and psychological and social well-being (FASQoL) and were designed to be suitable for self-completion and to be rapidly completed (2–5 min) within a clinical research setting. Results Concept elicitation interviews were conducted with 30 subjects and cognitive interviews with 20 subjects. With acne scarring, important concepts for patients included size, surface area affected, counts, and depth. The SCARS and FASQoL tools were shown to address relevant concepts that were easily understood by patients. Conclusion Two patient-reported measures, SCARS and FASQoL, have been developed to help clinicians assess the severity and impact of acne scars. Responsivity of these instruments to treatment will require further evaluation

Vaginal Colonization with Staphylococcus aureus in Healthy Women: A Review of Four Studies

Four studies assessed the frequency of vaginal Staphylococcus aureus colonization in healthy women and associated risk factors. An association was found between S. aureus vaginal colonization and colonization at the labia minora and the anterior nares. Significant risk factors associated with an increased risk of vaginal S. aureus in at least one study were a history of genital herpes simplex infection, insertion of tampons without an applicator, and the use of Rely (Procter & Gamble) tampons. The use of systemic antibiotics within 2 weeks of the vaginal culture decreased the risk of recovery of S. aureus. The overall frequency of vaginal S. aureus in the 808 women in the four studies was 9.2%

Linee guida sulla isotretinoina - consensus

Qualche anno addietro, si sparse la notizia che l'isotretinoina orale sarebbe stata ritirata dal commercio. In quel periodo fu pubblicato sugli Annales de Dermatologie un articolo scritto da un dermatologo francese preoccupato per quanto sarebbe successo a noi dermatologi, privati della isotretinoina orale, nella gestione dei pazienti con acne grave. Si prospettava un quadro di desolante ritorno al passato con \uec pazienti vittime di decisioni amministrative, scientificamente morto discutibili, prese con superficialit\ue0. Fortunatamente questo non accadde vista la infondatezza delle argomentazioni accusatorie avanzate. Da questa vicenda emerse la consapevolezza che alla base di quanto successo c'era una preoccupante disinformazione sulle caratteristiche del farmaco estesa ad ampie fasce di soggetti coinvolti nella gestione e nell'utilizzo del prodotto, medici di medicina generale, pediatri, farmacisti e pazienti. Alla luce di questo abbiamo sentito l'esigenza di colmare questa lacuna e di preparare una nota informativa, chiara e completa, sulle caratteristiche dell'isotretinoina orale. Tale documento era diretto, con modalit\ue0 e contenuti opportunamente adattati, alle singole categorie sopra riportate. L'obiettivo finale era quello di evitare che, a pazienti effettivamente bisognosi di tale trattamento, esso fosse negato con motivazioni inconsistenti o per disinformazione. Il lavoro congiunto di un board di dermatologi, appartenenti alle Societ\ue0 pi\uf9 rappresentative della Dermatologia Italiana, ha portato alla definizione di due documenti informativi sull'isotretinoina orale. Il primo \ue8 indirizzato a medici di medicina generale, pediatri e farmacisti ed il secondo ai pazienti. \uc8 in programmazione per il prossimo futuro la preparazione di linee guida aggiornate sull'utilizzo del farmaco ad uso dei dermatologi

Outcome measures for the evaluation of treatment response in hidradenitis suppurativa for clinical practice

Importance Although several clinician- and patient-reported outcome measures have been developed for trials in hidradenitis suppurativa (HS), there is currently no consensus on which measures are best suited for use in clinical practice. Identifying validated and feasible measures applicable to the practice setting has the potential to optimize treatment strategies and generate generalizable evidence that may inform treatment guidelines. Objective To establish consensus on a core set of clinician- and patient-reported outcome measures recommended for use in clinical practice and to establish the appropriate interval within which these measures should be applied. Evidence Review Clinician- and patient-reported HS measures and studies describing their psychometric properties were identified through literature reviews. Identified measures comprised an item reduction survey and subsequent electronic Delphi (e-Delphi) consensus rounds. In each consensus round, a summary of outcome measure components and scoring methods was provided to participants. Experts were provided with feasibility characteristics of clinician measures to aid selection. Consensus was achieved if at least 67% of respondents agreed with use of a measure in clinical practice. Findings Among HS experts, response rates for item reduction, e-Delphi round 1, and e-Delphi round 2 surveys were 76.4% (42 of 55), 90.5% (38 of 42), and 92.9% (39 of 42), respectively; among patient research partners (PRPs), response rates were 70.8% (17 of 24), 100% (17 of 17), and 82.4% (14 of 17), respectively. The majority of experts across rounds were practicing dermatologists with 18 to 19 years of clinical experience. In the final e-Delphi round, most PRPs were female (12 [85.7%] vs 2 males [11.8%]) and aged 30 to 49 years. In the final e-Delphi round, HS experts and PRPs agreed with the use of the HS Investigator Global Assessment (28 [71.8%]) and HS Quality of Life score (13 [92.9%]), respectively. The most expert-preferred assessment interval in which to apply these measures was 3 months (27 [69.2%]). Conclusions and Relevance An international group of HS experts and PRPs achieved consensus on a core set of HS measures suitable for use in clinical practice. Consistent use of these measures may lead to more accurate assessments of HS disease activity and life outcomes, facilitating shared treatment decision-making in the practice setting

Movement of saugers in the lower Tennessee River determined by radio telemetry, and implications for management

Since 1979, abundances of sauger (Stizostedion canadense) have declined in theTennessee River system. Reasons for this decline may include overharvest, loss of spawninghabitat, and low recruitment due to extreme flows. The purpose of this study was to investigatethe movements of saugers following winter concentration below Pickwick Dam, Tennessee.Thirty-seven saugers were implanted with radio transmitters directly below Pickwick Dam andwere tracked between December 1992 and June 1993. Four saugers moved upstream throughthe locks at Pickwick Dam: the remaining fish stayed within the first 30 km of the tailwaterthroughout the spawning season. Three areas below Pickwick Dam were identified as possibleMarch prespawn staging sites. After April 1, saugers in the tailwater area began a rapiddownstream migration to the main basin of Kentucky Lake. Some fish moved downstream morethan 200 km in less than 10 d in this semiclosed system. Movements encompassed four states(Kentucky, Tennessee, Mississippi, and Alabama) along the Tennessee River system,underscoring the need for interjurisdictional management

Assessment of summer trends of tropospheric radon isotopes in a coastal Antarctic station (Terra Nova Bay)

This work reports the first results of atmospheric radon measurements performed at the Italian Antarctic station located at Terra Nova Bay (74.69°S; 164.12°E) during summer campaigns of 1995-96, 1996-97 and 1997-98. Mean 222Rn concentrations was 0.51±0.43 Bq m-3(median = 0.37 Bq m-3), and ranged from 0.01 to 2.74 Bq m-3. On the average, these values were considered high, in comparison to results reported for other sites in Antarctica at equivalent latitudes. This could be explained by two causes: radon data for Terra Nova Bay were only for the summer period, when the ice-free area is at its maximum and thus the radon emission to the atmosphere; and by the larger ice-free area at Terra Nova Bay compared, for example, to measurements taken at another Antarctic site by the same technique (Ferraz station-62°05′S; 058°23.5′W). The mean 222Rn to 220Rn activitty ratio was 4.4±4.2, ranging between 0.1 and 45.3. The highest ratios indicated that some of observed surges of concentration of222Rn could be attributed to not local sources. Lower radon concentrations were observed during katabatic wind events. The diurnal radon variation followed the general trend observed for continental areas located at lower latitudes