31 research outputs found
The role of the melanoma gene MC1R in Parkinson disease and REM sleep behavior disorder
The MC1R gene, suggested to be involved in Parkinson disease (PD) and melanoma, was
sequenced in PD patients (n=539) and controls (n=265) from New-York, and PD patients (n=551),
rapid eye movement sleep behavior disorder (RBD) patients (n=351) and controls (n=956) of
European ancestry. Sixty-eight MC1R variants were identified, including 7 common variants with
frequency>0.01. None of the common variants was associated with PD or RBD in the different
regression models. In a meta-analysis with fixed-effect model, the p.R160W variant was
associated with an increased risk for PD (OR=1.22, 95%CI 1.02-1.47, p=0.03) but with significant
heterogeneity (p=0.048). Removing one study that introduced the heterogeneity resulted in nonsignificant
association (OR=1.11, 95%CI 0.92-1.35, p=0.27, heterogeneity p=0.57). Rare variants
had similar frequencies in patients and controls (10.54% and 10.15%, respectively, p=0.75), and
no cumulative effect of carrying more than one MC1R variant was found. The current study does
not support a role for the MC1R p.R160W and other variants in susceptibility for PD or RBD
Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial
Background: Tranexamic acid reduces surgical bleeding and reduces death due to bleeding in patients with trauma.
Meta-analyses of small trials show that tranexamic acid might decrease deaths from gastrointestinal bleeding. We
aimed to assess the effects of tranexamic acid in patients with gastrointestinal bleeding.
Methods: We did an international, multicentre, randomised, placebo-controlled trial in 164 hospitals in 15 countries.
Patients were enrolled if the responsible clinician was uncertain whether to use tranexamic acid, were aged above the
minimum age considered an adult in their country (either aged 16 years and older or aged 18 years and older), and
had significant (defined as at risk of bleeding to death) upper or lower gastrointestinal bleeding. Patients were
randomly assigned by selection of a numbered treatment pack from a box containing eight packs that were identical
apart from the pack number. Patients received either a loading dose of 1 g tranexamic acid, which was added to
100 mL infusion bag of 0·9% sodium chloride and infused by slow intravenous injection over 10 min, followed by a
maintenance dose of 3 g tranexamic acid added to 1 L of any isotonic intravenous solution and infused at 125 mg/h
for 24 h, or placebo (sodium chloride 0·9%). Patients, caregivers, and those assessing outcomes were masked to
allocation. The primary outcome was death due to bleeding within 5 days of randomisation; analysis excluded patients
who received neither dose of the allocated treatment and those for whom outcome data on death were unavailable.
This trial was registered with Current Controlled Trials, ISRCTN11225767, and ClinicalTrials.gov, NCT01658124.
Findings: Between July 4, 2013, and June 21, 2019, we randomly allocated 12 009 patients to receive tranexamic acid
(5994, 49·9%) or matching placebo (6015, 50·1%), of whom 11 952 (99·5%) received the first dose of the allocated
treatment. Death due to bleeding within 5 days of randomisation occurred in 222 (4%) of 5956 patients in the
tranexamic acid group and in 226 (4%) of 5981 patients in the placebo group (risk ratio [RR] 0·99, 95% CI 0·82–1·18).
Arterial thromboembolic events (myocardial infarction or stroke) were similar in the tranexamic acid group and
placebo group (42 [0·7%] of 5952 vs 46 [0·8%] of 5977; 0·92; 0·60 to 1·39). Venous thromboembolic events (deep vein
thrombosis or pulmonary embolism) were higher in tranexamic acid group than in the placebo group (48 [0·8%] of
5952 vs 26 [0·4%] of 5977; RR 1·85; 95% CI 1·15 to 2·98).
Interpretation: We found that tranexamic acid did not reduce death from gastrointestinal bleeding. On the basis of our
results, tranexamic acid should not be used for the treatment of gastrointestinal bleeding outside the context of a
randomised trial
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YouTube as a source of information on sunscreen: An analysis of content and quality
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Sunscreen compliance with American Academy of Dermatology recommendations: a 2022 update and cross-sectional study
Lichen Simplex Chronicus Itch: An Update
Lichen simplex chronicus is a form of chronic localized pruritus with a secondary dermatitis, and one of the most common types of chronic itch conditions, estimated to affect more than 10% of the general population. However, despite its prevalence and burden, there has been limited research into the pathogenesis and aetiology of lichen simplex chronicus, which, historically, made it a challenging condition to treat. In recent years, our understanding of this condition, along with that of pruritus and the itch-scratch cycle, has increased greatly, enabling a substantial increase in treatment options. In addition, there are several new promising treatments currently in development and trials. This article discusses the definition, epidemiology, clinical characteristics, pathophysiology, and current therapeutic options for lichen simplex chronicus, in order to highlight recent advancements in this field
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Analysis of fibroblast pen usage amongst TikTok social media users
Social media networks serve as convenient platforms for the dissemination of information, including that which pertains to healthcare. However, social media networks may also disseminate incorrect information, and may even propagate potentially harmful skincare trends. Since its inception in 2016, TikTok, a social media platform wherein users can create and share videos, has served as a tool for the propagation of multiple, potentially dangerous cosmetic trends, most recently the usage of fibroblast pens. Fibroblast pens, also known as plasma pens, are toted to produce a variety of skincare benefits. However, many of the pens being sold commercially, and subsequently used on TikTok, are not FDA-regulated. Potential adverse effects include the development of dyspigmentation, scarring, and mechanical burns of the skin. This study assessed social media content to improve our understanding of fibroblast pen usage amongst TikTok creators. An initial search of public TikTok posts tagged with "#PlasmaPen," "#PlasmaPenTreatment," "#FibroblastPlasma," or "#FibroblastPlasmaPen" identified 200 posts, of which 78 were eliminated after accounting for overlapping posts between hashtags, posts that were later deleted by the user, and those in languages other than English. We analyzed posts according to creator type and classified them into four main themes. The 78 videos were later re-viewed to provide more detailed subdivisions within the four main themes. Analysis showed that 36% of the posts were created by lay-person TikTok users, followed by 25% of posts being created by self-proclaimed fibroblast skin tightening specialists. Major themes include advertisement of the fibroblast pen (61%), experience with the fibroblast pen (26%), education on the fibroblast pen's uses and benefits (6.5%), and warnings related to usage of the pen (6.5%). TikTok users are more likely to encounter a post regarding fibroblast pen usage from uncredentialled, non-medical professional accounts. Only 6.5% of posts were created with the intention of serving as a warning to users, with most of these posts being created by medical doctors. Dermatologists should be aware of the misinformation regarding fibroblast pens and consider posting on social media to raise awareness about this potentially dangerous skincare trend
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How to get rid of itching
Itch is an unpleasant sensation arising from a variety of dermatologic, neuropathic, systemic, and psychogenic etiologies. Various itch pathways are implicated according to the underlying etiology. A variety of pruritogens, or itch mediators, as well as receptors have been identified and provide potential therapeutic targets. Recent research has primarily focused on targeting inflammatory cytokines and Janus kinase signaling, protease-activated receptors, substance P and neurokinin, transient receptor potential-vanilloid ion channels, Mas-related G-protein-coupled receptors (MRGPRX2 and MRGPRX4), the endogenous opioid and cannabinoid balance, and phosphodiesterase 4. Periostin, a newly identified pruritogen, should be further explored with clinical trials. Drugs targeting neural sensitization including the gabergic system and P2X3 are other potential drugs for chronic itch. There is a need for more targeted therapies to improve clinical outcomes and reduce side effects
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Nodular Melanoma: A Review of Pathogenesis, Presentation, Diagnosis, and Treatment
Nodular melanoma is the second most common subtype of melanoma. Unlike other subtypes, nodular melanoma is characterized by early vertical growth rather than the typical initial radial growth of most melanomas. As a result, nodular melanoma presents clinically in a more aggressive phenotype. Given its more aggressive nature and intrinsic ability to mimic benign lesions, a modified acronym has been developed to allow clinicians to better evaluate, diagnose and treat nodular melanoma in earlier stages. Surgical excision with wide margins is the gold standard of nodular melanoma therapy; however, an emphasis in early detection, diagnosis, staging, and treatment needs to be emphasized among clinicians due to its dismal prognosis in later stages, as compared to other subtypes. A better understanding of the molecular pathophysiology that allows nodular melanoma to act aggressively very early in diagnosis is necessary for the development of therapeutics that may effectively target lesions in more advanced stages
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Commentary: Laser Tattoo Removal: Laser Principles and an Updated Guide for Clinicians
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Evaluation of risk in chronic cutaneous inflammatory conditions for malignant transformation
Skin carcinomas are the most common form of cancer, and every year thousands of people die from skin cancer-related malignancies. Chronic inflammation is linked to the development and progression of cancer in multiple organ systems - about 20% of all human cancers are a result of chronic inflammation - skin included. While acute inflammation under normal circumstances is a mechanism for host defence and tissue regeneration following insult by trauma or infection by pathogens, over the long term it can drive oncogenic transformation of epithelial cells and promote cancer development, growth and metastasis. Therefore, inflammatory conditions may put individuals at a higher risk to developing skin malignancies. Many skin conditions are characterized by chronic inflammatory processes. These conditions may be particularly susceptible to malignant transformation and predispose patients to develop skin malignancies. As more pathophysiology of chronic inflammatory skin conditions is unveiled, we find that many of these conditions are characterized by immune dysregulation and signalling that result in chronic activation and upregulation of pro-inflammatory chemokines and cytokines, leading to downstream processes that further exacerbate inflammatory processes and cause abnormal cell growth and apoptosis. Here, we review the major chronic cutaneous inflammatory diseases that may have an increased risk of skin malignancies, including atopic dermatitis, psoriasis, discoid lupus erythematosus, lichen planus, hidradenitis suppurativa, prurigo nodularis, lichen sclerosus, systemic sclerosis and morphea, chronic leg ulcers, seborrheic keratoses and basal cell carcinoma. We evaluate the evidence for increased incidence and prevalence, the risk factors associated, the populations at heightened risk and the best management practices