Catastrophic Floods May Pave the Way for Increased Genetic Diversity in Endemic Artesian Spring Snail Populations

The role of disturbance in the promotion of biological heterogeneity is widely recognised and occurs at a variety of ecological and evolutionary scales. However, within species, the impact of disturbances that decimate populations are neither predicted nor known to result in conditions that promote genetic diversity. Directly examining the population genetic consequences of catastrophic disturbances however, is rarely possible, as it requires both longitudinal genetic data sets and serendipitous timing. Our long-term study of the endemic aquatic invertebrates of the artesian spring ecosystem of arid central Australia has presented such an opportunity. Here we show a catastrophic flood event, which caused a near total population crash in an aquatic snail species (Fonscochlea accepta) endemic to this ecosystem, may have led to enhanced levels of within species genetic diversity. Analyses of individuals sampled and genotyped from the same springs sampled both pre (1988–1990) and post (1995, 2002–2006) a devastating flood event in 1992, revealed significantly higher allelic richness, reduced temporal population structuring and greater effective population sizes in nearly all post flood populations. Our results suggest that the response of individual species to disturbance and severe population bottlenecks is likely to be highly idiosyncratic and may depend on both their ecology (whether they are resilient or resistant to disturbance) and the stability of the environmental conditions (i.e. frequency and intensity of disturbances) in which they have evolved

Hand eczema

Hand eczema is an inflammation of the skin; the cause is often multifactorial. Initial management includes avoiding causative irritants or allergens (e.g., by wearing impermeable gloves) and applying emollients and potent topical glucocorticoids

REVIEW ARTICLE: Toenail onychomycosis: an important global disease burden

Onychomycosis is a fungal infection of the nail plate or nail bed. It does not usually cure itself and it can trigger more infectious lesions in other parts of the body. The reported prevalence of onychomycosis is increasing in Western countries, presumably due to lifestyle changes and the ageing of the population. Approximately 10% of the general population, 20% of the population aged &gt;60 years, up to 50% of people aged &gt;70 years and up to one-third of diabetic individuals have onychomycosis. Care should be taken for the accurate diagnosis and timely treatment of toenail onychomycosis to prevent complications. Current treatment options have relatively limited therapeutic success, particularly long-term. Oral medications are associated with high recurrence rates and treatment failure, and are not suitable for many cases due to potential adverse effects. Topical medications are recommended only for mild to moderate cases. The cost of therapies may also be prohibitive in some cases. In the light of these issues, more research is warranted for the investigation and development of more effective and economical options for the treatment and prophylaxis of toenail onychomycosis. In patient populations such as diabetic individuals, where onychomycosis can provoke lower extremity complications, professional podiatry care of toenails and feet should be encouraged.</p

Psoriatic Arthritis

Psoriatic arthritis (PsA) represents an inflammatory arthropathy associated with psoriasis. PsA has long been considered a disease with a low inflammatory profile, but growing evidence has recently recognized its multisystemic nature and association with extra-articular involvement in the form of colitis, uveitis, metabolic syndrome, and atherosclerosis.In subjects susceptible, through a complex interaction of a predisposing genetic background, an altered immune response mainly mediated by proinflammatory cytokines induces the inflammatory state.Articular inflammatory processes can involve axial skeleton (spondylitis), peripheral joints (peripheral arthritis), insertion sites of tendons and ligaments into bone (enthesitis), proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints, and soft tissue of digits (dactylitis). Any of these manifestations can occur singularly or in any of the possible combinations.Main radiological findings can be represented by articular erosions, exuberant new bone formations, osteolysis, periostitis, enthesitis, nonmarginal syndesmophytes, and ankylosis. In early and active phases of the disease, inflammatory aspects can be detected by use of magnetic resonance imaging (MRI) and ultrasonography.Diagnosis in early phases and immediate and effective therapy may be able to reduce disease severity, improving cutaneous, articular, patients' function and quality of life (QOL), and psychosocial outcomes.Inhibition of the structural radiological damage, clinical remission, and improvement of the patients' QOL represent the main aim of the treatment.The current treatment for nonsevere articular form consists initially of nonsteroidal antiinflammatory drugs (NSAIDs). Conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) represent therapeutic options in refractory cases, but biologic agents (bDMARDs), represented by tumor necrosis factor alpha (TNF-α), IL-12/23R, and IL-17 inhibitors, are then recommended in resistant patients.Among the emerging targeted synthetic DMARDs (tsDMARDs), apremilast (APR), a molecule that inhibits the activity of phosphodiesterase 4 (PDE4), has shown antiinflammatory effects. Furthermore, tofacitinib, a Janus kinase (JAK) inhibitor, has been recently found effective in PsA patients who had previously had an inadequate response to csDMARDs.The clinical heterogeneity of the disease and the multifaceted pathogenetic aspects involving multiple cytokines, cell lines, and molecules need to be further investigated with a collaborative and translational effort to improve outcomes of patients affected by PsA