Efficacy and tolerability of a spray product containing hydroxypropyl chitosan, Climbazole and Piroctone olamine, applied twice weekly for the treatment of the Pitiriasis Versicolor

The aim of this study was to demonstrate the effectiveness of a product containing hydroxypropyl chitosan, Climbazole and Piroctone olamine, by monitoring the adherence and the penetration of the molecules in the skin. Confocal microscopy led us to show the persistence of the active compound for a long time in the stratum corneum, thanks to the presence of hydroxypropyl chitosan. This evidence suggests a new protocol of application (a biweekly application, rather than daily)

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

Defining Kawasaki disease and pediatric inflammatory multisystem syndrome-temporally associated to SARS-CoV-2 infection during SARS-CoV-2 epidemic in Italy: results from a national, multicenter survey

Background: There is mounting evidence on the existence of a Pediatric Inflammatory Multisystem Syndrome-temporally associated to SARS-CoV-2 infection (PIMS-TS), sharing similarities with Kawasaki Disease (KD). The main outcome of the study were to better characterize the clinical features and the treatment response of PIMS-TS and to explore its relationship with KD determining whether KD and PIMS are two distinct entities. Methods: The Rheumatology Study Group of the Italian Pediatric Society launched a survey to enroll patients diagnosed with KD (Kawasaki Disease Group - KDG) or KD-like (Kawacovid Group - KCG) disease between February 1st 2020, and May 31st 2020. Demographic, clinical, laboratory data, treatment information, and patients' outcome were collected in an online anonymized database (RedCAP®). Relationship between clinical presentation and SARS-CoV-2 infection was also taken into account. Moreover, clinical characteristics of KDG during SARS-CoV-2 epidemic (KDG-CoV2) were compared to Kawasaki Disease patients (KDG-Historical) seen in three different Italian tertiary pediatric hospitals (Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste; AOU Meyer, Florence; IRCCS Istituto Giannina Gaslini, Genoa) from January 1st 2000 to December 31st 2019. Chi square test or exact Fisher test and non-parametric Wilcoxon Mann-Whitney test were used to study differences between two groups. Results: One-hundred-forty-nine cases were enrolled, (96 KDG and 53 KCG). KCG children were significantly older and presented more frequently from gastrointestinal and respiratory involvement. Cardiac involvement was more common in KCG, with 60,4% of patients with myocarditis. 37,8% of patients among KCG presented hypotension/non-cardiogenic shock. Coronary artery abnormalities (CAA) were more common in the KDG. The risk of ICU admission were higher in KCG. Lymphopenia, higher CRP levels, elevated ferritin and troponin-T characterized KCG. KDG received more frequently immunoglobulins (IVIG) and acetylsalicylic acid (ASA) (81,3% vs 66%; p = 0.04 and 71,9% vs 43,4%; p = 0.001 respectively) as KCG more often received glucocorticoids (56,6% vs 14,6%; p < 0.0001). SARS-CoV-2 assay more often resulted positive in KCG than in KDG (75,5% vs 20%; p < 0.0001). Short-term follow data showed minor complications. Comparing KDG with a KD-Historical Italian cohort (598 patients), no statistical difference was found in terms of clinical manifestations and laboratory data. Conclusion: Our study suggests that SARS-CoV-2 infection might determine two distinct inflammatory diseases in children: KD and PIMS-TS. Older age at onset and clinical peculiarities like the occurrence of myocarditis characterize this multi-inflammatory syndrome. Our patients had an optimal response to treatments and a good outcome, with few complications and no deaths

Therapies versus placebo in the treatment of patchy alopecia areata

We report the results of a controlled trial on 119 patients affected by patchy alopecia areata involving less than 40% of the scalp. The statistical analysis showed no differences between the results obtained using squaric acid dibutylester, diphencyprone, minoxidil, and placebo in the treatment of this form of alopecia

Single opioid administration modifies gonadal steroids in both the CNS and plasma of male rats.

While morphine remains one of the most widely used opioids for the treatment of painful conditions, other opioids are also commonly employed. Because of the interactions between opioids and gonadal hormones, in particular opioid-induced hypogonadism, this study investigated the effects of widely used opioids on plasma testosterone and estradiol levels and brain testosterone levels in male rats. Animals were s.c. injected with two concentrations of morphine (5 or 10 mg/kg), fentanyl (0.05 or 0.1 mg/kg), tramadol (10 or 40 mg/kg), buprenorphine (0.05 or 0.1 mg/kg) or saline (0.7 ml/kg). Four or 24 h after treatment, the rats were deeply anesthetized to collect blood samples from the abdominal aorta and to perfuse the brains with saline. Plasma and brain hormone levels were measured by radioimmunoassay. In rats studied 4 h after treatment, all the opioids except tramadol 10 mg/kg decreased plasma testosterone in comparison with saline administration. At the same time, plasma estradiol levels were lower than control in the groups treated with the low doses of morphine, tramadol and buprenorphine, while estradiol remained at control levels in the other groups. Twenty-four hours after treatment, plasma testosterone levels were different (higher) than control in the animals treated with the low doses of morphine, fentanyl and buprenorphine. Estradiol was lower than control in the low dose groups, while the high doses did not produce any changes with respect to control. Four hours after treatment, brain testosterone was drastically decreased in all groups except buprenorphine, in which it remained at control levels. All groups returned to control levels at 24 h after treatment. In conclusion, opioids exert important effects on plasma and CNS sex hormone levels. The different magnitude and time-course of the effects of the different opiates on testosterone and estradiol levels are likely due to their different mechanism of action

Testosterone affects pain-related responses differently in male and female rats.

To evaluate the role of testosterone in pain modulation, we subcutaneously injected male and female rats with testosterone propionate (TP, 5 mg/kg in oil) or oil for 6 days; on the seventh day, all rats were subjected to the formalin test (10%, 50 microl). Behaviours were recorded in an open field (60 min). At the end of the formalin test, the rats were anaesthetized to collect blood from the abdominal aorta. Among the formalin-induced responses, licking was higher in females than males and was decreased by TP in females; jerking and flexing were only slightly affected by treatment. TP increased testosterone plasma levels in both sexes. These results indicate a role of testosterone in modulating formalin-induced responses. The effects appear to be different in males and females

Efficacy and tolerability of a spray product containing hydroxypropyl chitosan, climbazole and piroctone olamine, applied twice weekly for the treatment of the pitiriasis versicolor

Background: The aim of this study was to demonstrate the effectiveness of a product containing hydroxypropyl chitosan, climbazole and piroctone olamine, by monitoring the adherence and the penetration of the molecules in the skin. Confocal microscopy led us to show the persistence of the active compound for a long time in the stratum corneum, thanks to the presence of hydroxypropyl chitosan. This evidence suggests a new protocol of application (a biweekly application, rather than daily). Methods: Thirty patients (17 males, 13 females; average age 20.8 years) were selected from 3 dermatological centers: the Dermatological Clinic of "Federico II" University of Naples; the Dermatological outpatient clinic of Bologna private hospital "Villa Nigrisoli"; the Section of Cutaneous Appendages of the European Dermatological Institute of Milan. The study protocol entailed application of a topical spray product 2 evenings a week for 2 months. Confocal microscopy, dermoscopy and photographic documentation were performed at the moment of diagnosis (T0), 12 hours after the first application (T1), after 7 days (T2), after 1 month (T3) and after 2 months (T4). Results: The improvements of clinical symptoms were documented by dermoscopy and digital photos. Confocal microscopy shows the persistence of the product in the stratum corneum, at different times of observations. Conclusions: A biweekly application of a product containing hydroxypropyl chitosan, climbazole and piroctone olamine shows a clinical significative improvement, evaluated through digital photographs and dermoscopic images, with complete resolution at T4 in 100% of cases