R\uf6tliche L\ue4sion am Stamm

Anamnese 1 Ein 65-j\ue4hriger Patient, der im Gesichtsbereich bereits chronische Lichtsch\ue4den aufwies, wurde im Rahmen des Nierentransplantationsscreenings wegen einer neu aufgetretenen r\uf6tlichen L\ue4sion in unserer Ambulanz vorstellig. Der Patient selbst bemerkte die L\ue4sion nicht. Anamnese 2 Eine 59-j\ue4hrige Patientin kam wegen multipler N\ue4vi zur allj\ue4hrlichen Routinekontrolle. Die neu aufgetretene r\uf6tliche Papel am R\ufccken rechts war ihr nicht aufgefallen

The role of nicotinamide in acne treatment

Safe and effective treatment options for acne vulgaris are needed to address side effects and increasing rates of antibiotic resistance from current treatments. Nicotinamide is a vitamin with potent antiâ inflammatory properties that could offer a potential treatment option. We aim to summarize the relevant literature on the role of nicotinamide in acne vulgaris and discuss the next steps necessary to move this approach into clinical practice. We searched PubMed for clinical studies using nicotinamide for treatment of acne vulgaris. We summarized the 10 studies that met our search criteria. Six of eight studies using topical nicotinamide led to a significant reduction in acne compared with the patient’s baseline or performed similarly to another standardâ ofâ care acne treatment. Both studies using an oral supplement containing nicotinamide resulted in a significant reduction in acne compared with baseline. No major adverse side effects were noted. Our review suggests that topical and oral nicotinamide has an unclear effect on acne vulgaris due to the limited nature of the available literature. Additional studies are needed comparing nicotinamide to other firstâ line acne treatments and evaluating the efficacy and side effect profile of nicotinamide over an extended period of time.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138875/1/dth12481_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138875/2/dth12481.pd

The use of pediatric flexible bronchoscopy in the COVID-19 pandemic era

On March 11, 2020, the World Health Organization (WHO) declared the pandemic because of a novel coronavirus, called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In January 2020, the first transmission to healthcare workers (HCWs) was described. SARS-CoV-2 is transmitted between people because of contact, droplets, and airborne. Airborne transmission is caused by aerosols that remain infectious when suspended in air over long distances and time. In the clinical setting, airborne transmission may occur during aerosol generating procedures like flexible bronchoscopy. To date, although the role of children in the transmission of SARS-CoV-2 is not clear the execution of bronchoscopy is associated with a considerably increased risk of SARS-CoV-2 transmission to HCWs. The aim of this overview is to summarize available recommendations and to apply them to pediatric bronchoscopy. We performed systematic literature searches using the MEDLINE (accessed via PubMed) and Scopus databases. We reviewed major recommendations and position statements published at the moment by the American Association for Bronchology and Interventional Pulmonology, WHO, European Center for Disease Prevention and Control and expert groups on the management of patients with COVID-19 to limit transmission among HCWs. To date there is a lack of recommendations for safe bronchoscopy during the pandemic period. The main indications concern adults and little has been said about children. We have summarized available recommendations and we have applied them to pediatric bronchoscopy

Cascading effects of canopy mortality drive long-term changes in understorey diversity in temperate old-growth forests of Europe

Questions: We investigated the influence of protracted mortality of a dominant canopy tree (Abies alba) on long-term understorey dynamics. We ask (a) how tree regeneration and understorey species diversity and composition changed over 32 years; and (b) whether the observed changes were mainly driven by mortality of A. alba. Location: Three old-growth forest reserves dominated by A. alba and Fagus sylvatica in the Dinaric Mountains of Slovenia. Method: Tree layer and understorey regeneration and herbs were surveyed in 147 plots across the three forest reserves in 1983 and 2015. Soils were also sampled in 2015. The study period coincides with a protracted period of increased A. alba mortality in the canopy layer associated with anthropogenic emissions. Results: Between 1983 and 2015, the decline in canopy layer A. alba caused a recruitment pulse of F. sylvatica regeneration to the subcanopy tree layer across the three reserves. These changes were accompanied by a significant decline in plot level herb species richness. A model-based analysis of beta-diversity revealed significant community convergence during the study period, mainly caused by the loss of rare species. Ellenberg values indicate that these changes were mainly driven by loss of understorey light, while an increase in soil pH may have played a role also. Conclusions: This observational study suggests that the long-term decline of A. alba resulted in a cascade of processes - widespread F. sylvatica recruitment that impeded penetration of light to the forest floor, and possibly a change in soil conditions due to the decline of coniferous litter. These changes caused a significant loss of herb diversity and homogenization of the understorey community across the three sites. This study sheds light on the potential cascading consequences triggered by episodes of increased tree mortality resulting from global-change-type drivers

Comparison of Two Differently Processed Acellular Dermal Matrix Products for Root Coverage Procedures: A Prospective, Randomized Multicenter Study

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141116/1/jper1693-sup-0001.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/141116/2/jper1693.pd

paediatric respiratory disease past present and future

Paediatric respiratory disease has changed in the past 20 yrs; we could fill a whole issue of the journal paying tribute to our famous forebears. We are posing new challenges to our colleagues in the field of adult respiratory disease. They have to learn to deal with conditions that 20 yrs ago were rare in the adult chest clinic, such as cystic fibrosis (CF) and the long-term consequences of premature birth and congenital malformations of the respiratory tract. Furthermore, studies in childhood are challenging pathophysiological concepts throughout life. The many great prospective birth cohort studies have shed light on the different patterns of wheezing, their risk factors and their evolution through childhood. Who would have thought it was good to be born in a barn! It is becoming increasingly clear that even for "adult" diseases, such as chronic obstructive pulmonary disease (COPD), antenatal and early life events are at least as important as smoking in adulthood 1. CF has become a disease also of adults 2. Although many factors have contributed, the main reason has been the development of expert special CF centres, a model increasingly adopted by adult teams. This can serve as a model for other diseases; how a well-structured multidisciplinary approach to treatment can translate into benefits for patients. Perhaps numerically the most important achievement is in the field of public health. The benefit of the decrease in invasive bacterial infections, due to vaccination programmes for infants, is among the most important achievements of the past. Other areas of change include the survival of ever smaller preterm neonates. These children are reaching adult life with impaired lung function and abnormal computed tomography scans. What will happen to their ageing lungs? Interstitial lung disease (ILD) is becoming increasingly well understood, with new genetic entities, such as

Update of the European paediatric respiratory medicine syllabus

The 10-year-old European syllabus for paediatric respiratory medicine (PRM; also known as paediatric pulmonology) was updated by a consensus-based method using an expert task force for redrafting, and a subsequent Delphi process to achieve consensus. There was a high degree of consensus for the final syllabus, which has been streamlined and made more relevant to current practice. All modules are now mandatory apart from the undertaking of research projects, which is optional. Although there are still a number of countries in Europe which do not recognise PRM as a separate subspecialty, there are paediatric respiratory physicians practising in every country in Europe, and a current and harmonised European syllabus in the subspecialty remains important for defining the training and areas of practice of PRM practitioners

Congenital lobar emphysema: a case report

Congenital lobar emphysema is a rare variety of congenital malformation of lung characterized by over distension of a lobe of a lung due to partial obstruction of the bronchus. We are reporting a neonate admitted in the pediatric emergency ward with the respiratory distress since 16th day of life

Modulated structures in electroconvection in nematic liquid crystals

Motivated by experiments in electroconvection in nematic liquid crystals with homeotropic alignment we study the coupled amplitude equations describing the formation of a stationary roll pattern in the presence of a weakly-damped mode that breaks isotropy. The equations can be generalized to describe the planarly aligned case if the orienting effect of the boundaries is small, which can be achieved by a destabilizing magnetic field. The slow mode represents the in-plane director at the center of the cell. The simplest uniform states are normal rolls which may undergo a pitchfork bifurcation to abnormal rolls with a misaligned in-plane director.We present a new class of defect-free solutions with spatial modulations perpendicular to the rolls. In a parameter range where the zig-zag instability is not relevant these solutions are stable attractors, as observed in experiments. We also present two-dimensionally modulated states with and without defects which result from the destabilization of the one-dimensionally modulated structures. Finally, for no (or very small) damping, and away from the rotationally symmetric case, we find static chevrons made up of a periodic arrangement of defect chains (or bands of defects) separating homogeneous regions of oblique rolls with very small amplitude. These states may provide a model for a class of poorly understood stationary structures observed in various highly-conducting materials ("prechevrons" or "broad domains").Comment: 13 pages, 13 figure