Canadian Burden of Skin Disease From 1990 to 2017: Results From the Global Burden of Disease 2017 Study

Background: Skin diseases can have high morbidity that can be costly to society and individuals. To date, there has been no comprehensive assessment of the burden of skin disease in Canada. Objectives: To evaluate the burden of 18 skin and subcutaneous diseases from 1990 to 2017 in Canada using the Global Burden of Disease (GBD) data. Methods: The 2017 GBD study measures health loss from 359 diseases and injuries in 195 countries; we evaluated trends in population health in Canada from 1990 to 2017 using incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs). Data are presented as rates (per 100 000), counts, or percent change with the uncertainty interval in brackets. Results: From 1990 to 2017 for all skin diseases, DALY rates increased by 8 to 971 per 100 000 (674-1319), YLD rates increased by 8 to 897 per 100 000 (616-1235), YLL rates increased by 4 to 74 per 100 000 (53-89), and death rates increased by 18 to 5 per 100 000 (3-6). DALY rates for melanoma increased by 2 to 54 per 100 000 (39-68), for keratinocyte carcinoma by 14 to 17 per 100 000 (16-19), and for skin and subcutaneous disease by 8 to 900 per 100 000 (619-1233). The observed over expected ratios were higher for skin and subcutaneous disease (1.37) and keratinocyte carcinoma (1.17) and were lower for melanoma (0.73). Conclusions: The burden of skin disease has increased in Canada since 1990. These results can be used to guide health policy regarding skin disease in Canada. © The Author(s) 2020

Conjunctivitis in atopic dermatitis patients with and without dupilumab therapy - international eczema council survey and opinion.

Background: Conjunctivitis is common in patients with atopic dermatitis (AD) in general and a commonly reported adverse event in AD clinical trials with dupilumab. Objective: To survey opinions and experience about conjunctivitis occurring in AD, including those during dupilumab treatment in a group of AD experts from the International Eczema Council (IEC). Methods: Electronic survey and in-person discussion of management strategies. Results: Forty-six (53.5%) IEC members from 19 countries responded to the survey. Consensus was reached for several statements regarding diagnostic workup, referral and treatment. IEC members suggest that patients with AD should (i) routinely be asked about ocular complaints or symptoms, (ii) obtain information about the potential for conjunctivitis before starting dupilumab therapy and (iii) if indicated, be treated with dupilumab despite previous or current conjunctivitis. In cases of new-onset conjunctivitis, there was consensus that dupilumab treatment should be continued when possible, with appropriate referral to an ophthalmologist. Limitations: The study relies on expert opinion from dermatologists. Responses from few dermatologists without dupilumab access were not excluded from the survey. Conclusion: The IEC recommends that dermatologists address conjunctivitis in patients with AD, especially during treatment with dupilumab

Dapagliflozin: a sodium glucose cotransporter 2 inhibitor in development for type 2 diabetes

Type 2 diabetes mellitus (T2DM) is a growing worldwide epidemic. Patients face lifelong therapy to control hyperglycemia and prevent the associated complications. There are many medications, with varying mechanisms, available for the treatment of T2DM, but almost all target the declining insulin sensitivity and secretion that are associated with disease progression. Medications with such insulin-dependent mechanisms of action often lose efficacy over time, and there is increasing interest in the development of new antidiabetes medications that are not dependent upon insulin. One such approach is through the inhibition of renal glucose reuptake. Dapagliflozin, the first of a class of selective sodium glucose cotransporter 2 inhibitors, reduces renal glucose reabsorption and is currently under development for the treatment of T2DM. Here, we review the literature relating to the preclinical and clinical development of dapagliflozin

Influences of non-singular stresses on plane-stress near-tip fields for pressure-sensitive materials and applications to transformation toughened ceramics

In this paper, we investigate the effects of the non-singular stress ( T stress) on the mode I near-tip fields for elastic perfectly plastic pressure-sensitive materials under plane-stress and small-scale yielding conditions. The T stress is the normal stress parallel to the crack faces. The yield criterion for pressure-sensitive materials is described by a linear combination of the effective stress and the hydrostatic stress. Plastic dilatancy is introduced by the normality flow rule. The results of our finite element computations based on a two-parameter boundary layer formulation show that the total angular span of the plastic sectors of the near-tip fields increases with increasing T stress for materials with moderately large pressure sensitivity. The T stress also has significant effects on the sizes and shapes of the plastic zones. The height of the plastic zone increases substantially as the T stress increases, especially for materials with large pressure sensitivity. When the plastic strains are considered to be finite as for transformation toughened ceramics, the results of our finite element computations indicate that the phase transformation zones for strong transformation ceramics with large pressure sensitivity can be approximated by those for elastic-plastic materials with no limit on plastic strains. When the T stress and the stress intensity factor K are prescribed in the two-parameter boundary layer formulation to simulate the crack-tip constraint condition for a single-edge notch bend specimen of zirconia ceramics, our finite element computation shows a spear shape of the phase transformation zone which agrees well with the corresponding experimental observation.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/42782/1/10704_2004_Article_BF00018779.pd