Safety and efficacy of fluticasone propionate in the topical treatment of skin diseases

Fluticasone propionate - the first carbothioate corticosteroid - has been classified as a potent anti-inflammatory drug for dermatological use. It is available as 0.05% cream and 0.005% ointment formulations for the acute and maintenance treatment of patients with dermatological disorders such as atopic dermatitis, psoriasis and vitiligo. This glucocorticoid is characterized by high lipophilicity, high glucocorticoid receptor binding and activation, and a rapid metabolic turnover in skin. Although skin blanching following fluticasone propionate exceeds that of corticosteroids of medium strength, several clinical trials demonstrate a low potential for cutaneous and systemic side-effects, even in difficult-to-treat areas like the face, the eyelids and intertriginous areas. Even among paediatric patients with atopic dermatitis, fluticasone propionate proved to be safe and effective. These pharmacological and clinical properties are reflected by the high therapeutic index of this glucocorticoid

Impact of Emerging Antiviral Drug Resistance on Influenza Containment and Spread: Influence of Subclinical Infection and Strategic Use of a Stockpile Containing One or Two Drugs

BACKGROUND: Wide-scale use of antiviral agents in the event of an influenza pandemic is likely to promote the emergence of drug resistance, with potentially deleterious effects for outbreak control. We explored factors promoting resistance within a dynamic infection model, and considered ways in which one or two drugs might be distributed to delay the spread of resistant strains or mitigate their impact. METHODS AND FINDINGS: We have previously developed a novel deterministic model of influenza transmission that simulates treatment and targeted contact prophylaxis, using a limited stockpile of antiviral agents. This model was extended to incorporate subclinical infections, and the emergence of resistant virus strains under the selective pressure imposed by various uses of one or two antiviral agents. For a fixed clinical attack rate, R(0) rises with the proportion of subclinical infections thus reducing the number of infections amenable to treatment or prophylaxis. In consequence, outbreak control is more difficult, but emergence of drug resistance is relatively uncommon. Where an epidemic may be constrained by use of a single antiviral agent, strategies that combine treatment and prophylaxis are most effective at controlling transmission, at the cost of facilitating the spread of resistant viruses. If two drugs are available, using one drug for treatment and the other for prophylaxis is more effective at preventing propagation of mutant strains than either random allocation or drug cycling strategies. Our model is relatively straightforward, and of necessity makes a number of simplifying assumptions. Our results are, however, consistent with the wider body of work in this area and are able to place related research in context while extending the analysis of resistance emergence and optimal drug use within the constraints of a finite drug stockpile. CONCLUSIONS: Combined treatment and prophylaxis represents optimal use of antiviral agents to control transmission, at the cost of drug resistance. Where two drugs are available, allocating different drugs to cases and contacts is likely to be most effective at constraining resistance emergence in a pandemic scenario

Improved distances and ages for stars common to TGAS and RAVE

ABSTRACT We combine parallaxes from the first Gaia data release with the spectrophotometric distance estimation framework for stars in the fifth RAVE survey data release. The combined distance estimates are more accurate than either determination in isolation – uncertainties are on average two times smaller than for RAVE-only distances (three times smaller for dwarfs), and 1.4 times smaller than TGAS parallax uncertainties (two times smaller for giants). We are also able to compare the estimates from spectrophotometry to those from Gaia, and use this to assess the reliability of both catalogues and improve our distance estimates.We find that the distances to the lowest log g stars are, on average, overestimated and caution that they may not be reliable. We also find that it is likely that the Gaia random uncertainties are smaller than the reported values. As a byproduct we derive ages for the RAVE stars, many with relative uncertainties less than 20 percent. These results for 219 566 RAVE sources have been made publicly available, and we encourage their use for studies that combine the radial velocities provided by RAVE with the proper motions provided by Gaia. A sample that we believe to be reliable can be found by taking only the stars with the flag notification ‘flag_any=0’. Key words: Galaxy: fundamental parameters – methods: statistical –Funding for the research in this study came from the Swedish National Space Board, the Royal Physiographic Society in Lund, and some of the computations were performed on resources provided by the Swedish National Infrastructure for Computing (SNIC) at Lunarc under project SNIC 2016/4-17. Funding for RAVE has been provided by: the Australian Astronomical Observatory; the Leibniz-Institut fuer Astrophysik Potsdam (AIP); the Australian National University; the Australian Research Council; the French National Research Agency; the German Research Foundation (SPP 1177 and SFB 881); the European Research Council (ERC-StG 240271 Galactica); the Istituto Nazionale di Astrofisica at Padova; The Johns Hopkins University; the National Science Foundation of the USA (AST-0908326); the W. M. Keck foundation; the Macquarie University; the Netherlands Research School for Astronomy; the Natural Sciences and Engineering Research Council of Canada; the Slovenian Research Agency (research core funding No. P1-0188); the Swiss National Science Foundation; the Science & Technology Facilities Council of the UK; Opticon; Strasbourg Observatory; and the Universities of Groningen, Heidelberg and Sydney. The RAVE web site is https://www.rave-survey.org. This work has made use of data from the European Space Agency (ESA) mission Gaia (https://www.cosmos.esa.int/gaia), processed by the Gaia Data Processing and Analysis Consortium (DPAC; https://www.cosmos.esa.int/web/gaia/dpac/consortium). Funding for the DPAC has been provided by national institutions, in particular the institutions participating in the Gaia Multilateral Agreement

Structural Insight into Archaic and Alternative Chaperone-Usher Pathways Reveals a Novel Mechanism of Pilus Biogenesis

AVZ is supported by the Finnish Academy (grants 140959 and 273075; http://sciencenordic.com/partner/academy-finland) and Sigrid Juselius Foundation (grant 2014; www.sigridjuselius.fi/foundation). SMis supported by the Wellcome Trust (Senior Investigator Award 100280, Programme grant 079819; http://www.wellcome.ac.uk) The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

A note on the Kutta condition in Glauert's solution of the thin aerofoil problem

Glauert's classical solution of the thin aerofoil problem (a coordinate transformation, and splitting the solution into a sum of a singular part and an assumed regular part written as a Fourier sine series) is usually presented in textbooks on aerodynamics without a great deal of attention being paid to the rôle of the Kutta condition. Sometimes the solution is merely stated, apparently satisfying the Kutta condition automatically. Quite often, however, it is misleadingly suggested that it is by the choice of a sine series that the Kutta condition is satisfied. It is shown here that if Glauert's approach is interpreted in the context of generalised functions, (1) the whole solution, i.e. both the singular part and any non-Kutta condition solution, can be written as a sine-series, and (2) it is really the coordinate transformation which compels the Kutta condition to be satisfied, as it enhances the edge singularities from integrable to non-integrable, and so sifts out solutions not normally representable by a Fourier series. Furthermore, the present method provides a very direct way to construct other, more singular solutions. A practical consequence is that (at least, in principle) in numerical solutions based on Glauert's method, more is needed for the Kutta condition than a sine series expansion

Acute kidney disease and renal recovery : consensus report of the Acute Disease Quality Initiative (ADQI) 16 Workgroup

Consensus definitions have been reached for both acute kidney injury (AKI) and chronic kidney disease (CKD) and these definitions are now routinely used in research and clinical practice. The KDIGO guideline defines AKI as an abrupt decrease in kidney function occurring over 7 days or less, whereas CKD is defined by the persistence of kidney disease for a period of > 90 days. AKI and CKD are increasingly recognized as related entities and in some instances probably represent a continuum of the disease process. For patients in whom pathophysiologic processes are ongoing, the term acute kidney disease (AKD) has been proposed to define the course of disease after AKI; however, definitions of AKD and strategies for the management of patients with AKD are not currently available. In this consensus statement, the Acute Disease Quality Initiative (ADQI) proposes definitions, staging criteria for AKD, and strategies for the management of affected patients. We also make recommendations for areas of future research, which aim to improve understanding of the underlying processes and improve outcomes for patients with AKD

Symbol Nomenclature for Graphical Representations of Glycans

ISSN:0959-665

The selection function of the RAVE survey

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