Isotretinoin-induced skeletal hyperostosis

We describe a case of skeletal hyperostosis in a 29 year old man presenting with non-inflammatory back pain with a past history of isotretinoin therapy for acne. The development of skeletal hyperostosis, predominantly of the spine, has been reported in association with isotretinoin use and has a radiographic picture similar to diffuse idiopathic skeletal hyperostosis. The prevalence and severity of this condition appears to correlate with duration of therapy. Isotretinoin is a well-established treatment for severe acne. It is important for the rheumatologist be aware of this phenomenon when assessing young patients with musculoskeletal symptoms and evidence of radiological abnormalities.Scott W Graf, and Samuel L Whittl

Evolution of magnetic interactions in a pressure-induced Jahn-Teller driven magnetic dimensionality switch

We present the results of high-field magnetization and muon-spin relaxation measurements on the coordination polymer CuF 2 (H 2 O) 2 (pyrazine) in pressures up to 22.5 kbar. We observe a transition from a quasi-two-dimensional to a quasi-one-dimensional antiferromagnetic phase at 9.1 kbar, driven by a rotation of the Jahn-Teller axis. Long-range antiferromagnetic ordering is seen in both regimes, as well as a phase separation in the critical pressure region. The magnetic dimensionality switching as pressure is increased is accompanied by a halving of the primary magnetic exchange energy J and a fivefold decrease in the ordering temperature T N . J decreases gradually with pressure in the two-dimensional phase, and then increases in the one-dimensional regime. We relate both effects to the changes in the crystal structure with applied pressure

c-Axis Transport and Resistivity Anisotropy of Lightly- to Moderately-Doped La_{2-x}Sr_{x}CuO_{4} Single Crystals: Implications on the Charge Transport Mechanism

Both the in-plane and the out-of-plane resistivities (\rho_{ab} and \rho_{c}) are measured in high-quality La_{2-x}Sr_{x}CuO_{4} (LSCO) single crystals in the lightly- to moderately-doped region, x = 0.01 to 0.10, and the resistivity anisotropy is determined. In all the samples studied, the anisotropy ratio \rho _{c}/\rho_{ab} quickly increases with decreasing temperature, although in non-superconducting samples the strong localization effect causes \rho _{c}/\rho_{ab} to decrease at low temperatures. Most notably, it is found that \rho_{c}/\rho_{ab} at moderate temperatures (100 - 300 K) is almost completely independent of doping in the non-superconducting regime (x = 0.01 to 0.05); this indicates that the same charge confinement mechanism that renormalizes the c-axis hopping rate is at work down to x = 0.01. It is discussed that this striking x-independence of \rho_{c}/\rho_{ab} is consistent with the idea that holes form a self-organized network of hole-rich regions, which also explains the unusually metallic in-plane transport of the holes in the lightly-doped region. Furthermore, the data for x > 0.05 suggest that the emergence of the superconductivity is related to an increase in the c-axis coupling.Comment: 7 pages, 5 figures, submitted to Phys. Rev.

Genetic Variants in HSD17B3, SMAD3, and IPO11 Impact Circulating Lipids in Response to Fenofibrate in Individuals With Type 2 Diabetes

Individuals with type 2 diabetes (T2D) and dyslipidemia are at an increased risk of cardiovascular disease. Fibrates are a class of drugs prescribed to treat dyslipidemia, but variation in response has been observed. To evaluate common and rare genetic variants that impact lipid responses to fenofibrate in statin-treated patients with T2D, we examined lipid changes in response to fenofibrate therapy using a genomewide association study (GWAS). Associations were followed-up using gene expression studies in mice. Common variants in SMAD3 and IPO11 were marginally associated with lipid changes in black subjects (P < 5 × 10 -6 ). Rare variant and gene expression changes were assessed using a false discovery rate approach. AKR7A3 and HSD17B13 were associated with lipid changes in white subjects (q < 0.2). Mice fed fenofibrate displayed reductions in Hsd17b13 gene expression (q < 0.1). Associations of variants in SMAD3, IPO11, and HSD17B13, with gene expression changes in mice indicate that transforming growth factor-beta (TGF-β) and NRF2 signaling pathways may influence fenofibrate effects on dyslipidemia in patients with T2D

Geographical and temporal distribution of SARS-CoV-2 clades in the WHO European Region, January to June 2020

We show the distribution of SARS-CoV-2 genetic clades over time and between countries and outline potential genomic surveillance objectives. We applied three available genomic nomenclature systems for SARS-CoV-2 to all sequence data from the WHO European Region available during the COVID-19 pandemic until 10 July 2020. We highlight the importance of real-time sequencing and data dissemination in a pandemic situation. We provide a comparison of the nomenclatures and lay a foundation for future European genomic surveillance of SARS-CoV-2.Peer reviewe

Update on the diagnosis and management of gout

Gout is a common clinical problem encountered by both general and specialist clinicians. The key principles in gout management include establishing a definitive diagnosis, the swift treatment of acute attacks, and using urate-lowering therapies appropriately to prevent further attacks and joint damage. The gold standard diagnostic tool for gout remains the identification by polarised light microscopy of monosodium urate crystals in synovial fluid or in a tophus. Emerging diagnostic imaging techniques and novel therapies show promise in the diagnosis and treatment of gout. In most cases, using existing therapies judiciously remains the key determinant of success in managing gout.Kimberley Ting, Scott W Graf, Samuel L Whittl