Efficacy and safety results of micellar water, cream and serum for rosacea in comparison to a control group

Background: Rosacea is a common inflammatory skin disorder with centrofacial erythema, flushing, telangiectasia, papules/pustules, and possible ocular or phymatous manifestation. Patients' skin is particularly sensitive to chemical and physical stimuli leading to burning, stinging, dryness, and skin tightness. Objective: Dermatological evaluation of the efficacy and safety of skin care products designed for centrofacial erythema in rosacea patients, in comparison with a control group using objective measurements. Rosacea symptoms (itching, tension, warmth, burning, dryness) and quality of life were examined. Methods Sixty Caucasians with centrofacial erythema were enrolled in an 8-week prospective study, fifty of them exclusively using the study products (micellar water, cream, and serum) with ten participants randomly assigned to a control group. Patients were evaluated at baseline (V0), at 4 weeks (V1), and at 8 weeks (V2). Three-dimensional objective measurements (VECTRA(R)) as well as standardized questionnaires were used. Results: Results were compared with the control group. A significant reduction of 16% in skin redness as indicated by VECTRA(R)analysis was seen in the intervention group comparing V0-V2. Furthermore, rosacea-associated symptoms diminished by 57.1%, while life quality of affected patients within the intervention group improved by 54.5% comparing V0-V2, respectively. Conclusions: A skin care regime suitable for sensitive and redness-prone skin led to an enhanced clinical appearance, to a decrease of associated symptoms in rosacea patients, and to an improved life quality

Subcutaneous Immunotherapy with a Depigmented Polymerized Birch Pollen Extract – A New Therapeutic Option for Patients with Atopic Dermatitis

Background: Birch pollen is an important outdoor allergen able to aggravate symptoms in atopic dermatitis (AD). Specific immunotherapy (SIT), an established procedure for allergic airway diseases, might also represent an attractive therapeutic option for the causal treatment of allergen-triggered cutaneous symptoms in these patients. Studies with house dust mite SIT have already shown beneficial effects in AD patients, whereas the safety and efficacy of SIT with birch pollen extract in AD patients have not been studied so far. The aim of this study was to evaluate for the first time the safety and efficacy of SIT with a depigmented polymerized birch pollen extract in AD patients. Methods: Fifty-five adult patients with moderate-to-severe AD and clinically relevant sensitization to birch pollen received SIT for 12 weeks. SIT was continued during birch pollen season. The assessment of safety, the total SCORAD value, and the Dermatology Life Quality Index (DLQI) were evaluated. Results: The median total SCORAD value was reduced by 34% (p < 0.001) during the course of treatment and the mean DLQI improved by 49% (p < 0.001) despite strong simultaneous birch pollen exposure. Eight patients (14.5%) developed systemic reactions and 19 patients (34.5%) developed local reactions which were of mild intensity in most cases. No patient discontinued the study prematurely due to adverse drug reactions. Coseasonal treatment was well tolerated. Conclusion: SIT with a depigmented polymerized birch pollen extract leads to significant improvement of the SCORAD value and the DLQI in patients suffering from moderate-to-severe AD sensitized to birch pollen.Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich

In Vitro and In Vivo Efficacy of Monepantel (AAD 1566) against Laboratory Models of Human Intestinal Nematode Infections

Soil-transmitted helminthiases affect more than one billion people among the most vulnerable populations in developing countries. Currently, control of these infections primarily relies on chemotherapy. Only five drugs are available, all of which have been in use for decades. None of the drugs are efficacious using single doses against all soil-transmitted helminths (STH) species and show low efficacy observed against Trichuris trichiura. In addition, the limited availability of current drug treatments poses a precarious situation should drug resistance occur. Therefore, there is great interest to develop novel drugs against infections with STH. Monepantel, which belongs to a new class of veterinary anthelmintics, the amino-acetonitrile derivatives, might be a potential drug candidate in humans. It has been extensively tested against livestock nematodes, and was found highly efficacious and safe for animals. Here we describe the in vitro and in vivo effect of monepantel, on Ancylostoma ceylanicum, Necator americanus, Trichuris muris, Strongyloides ratti, and Ascaris suum, five parasite-rodent models of relevance to human STH. Since we observed that monepantel showed only high activity on one of the hookworm species and lacked activity on the other parasites tested we cannot recommend the drug as a development candidate for human soil-transmitted helminthiases

Entfaltung von Kreativität bei jüngeren Kindern mittels Figurenkonstruktion und Figurenspiel

Kreativität ist ein aktuelles Thema in der gegenwärtigen Pädagogik und stellt ein übergeordnetes Bildungsziel der Schule dar. In dieser praxisorientierten Arbeit wird auf die Figurenkonstruktion und auf das Figurenspiel als Methoden zur Entfaltung von Kreativität bei jüngeren Kindern eingegangen. Es wird erklärt, was Kreativität ist und was dafür spricht, dass diese im Herstellen von einzigartigen Figuren und im Figurenspiel gefördert werden kann. Dazu werden ausgewählte Theorien herbeigezogen, die sowohl die Kreativität wie auch das Figurenspiel erläutern. So wird die Kreativität in Bezug auf die Persönlichkeit, den Prozess, das Produkt und das Umfeld betrachtet und auch die Verbindungen zum Spiel, zum Flow-Erleben und zur Schule werden hergestellt. Ausserdem bietet die vorliegende Arbeit einen Überblick über das Figurenspiel, welcher unter anderem auf die verschiedenen Figurentypen, Bühnen und Potentiale dessen eingeht. Unter Anwendung der theoretischen Grundlagen wurden Themennachmittage zur Figurenkonstruktion und zum Figurenspiel gestaltet, welche die Entfaltung der Kreativität bei Kindern einer zweiten Primarschulklasse fördern. Mit Hilfe von gezielten Beobachtungen, Filmmitschnitten sowie Analysen von schriftlichen Dokumenten und Fragebögen wurden Daten gesammelt, welche in vorliegender Arbeit qualitativ analysiert und interpretiert werden. Ein besonderes Augenmerk wird dabei auf die elf Merkmale einer kreativen Persönlichkeit nach Guilford gelegt, zu welchen unter anderem die Vorstellungskraft, Assoziationsfähigkeit, Originalität, Spontaneität und die Sensibilität zählen (vgl. Seitz, 2012, S. 40ff). Anhand dieser Auswertungen wird aufgezeigt, wie und in welchen spezifischen Details eine solche kreative Entfaltung beobachtbar war

Arcanobacterium pluranimalium leading to a bovine mastitis: species identification by a newly developed pla gene based PCR

We are describing a clinical case of bovine mastitis due to Arcanobacterium pluranimalium in a Holstein-Friesian heifer, delivering bloody milk on the left hindquarter. Moreover, we report on the development and evaluation of PCR primers based on the pluranimaliumlysin (pla) gene for the identification of this species. With the primer pair PlaF/PlaR the A. pluranimalium type strain as well as the mastitis isolate 704 revealed a correctly sized amplification product (458 bp), whereas no amplification product was obtained for all non-target strains. The established PCR provides a new and convenient tool for the mastitis diagnostic to differentiate between A. pluranimalium and Trueperella pyogenes. Dieser Bericht beschreibt den Fall einer Holstein-Friesian Färse mit klinischer Mastitis (blutige Milch, Hinterviertel links), die durch A. pluranimalium verursacht wurde. Zudem wurden im Rahmen dieser Arbeit PCR Primer, basierend auf dem Pluranimaliumlysin (pla) Gen, zur Identifizierung von A. pluranimalium evaluiert. Sowohl der Referenzstamm wie auch das klinische Isolat 704 zeigten korrekte Amplifizierungsprodukte (458 bp). Alle nicht-Zielstämme waren in der PCR negativ. Die etablierte PCR stellt damit für die Mastitis-Diagnostik ein praktisches Hilfsmittel dar, das zur Unterscheidung zwischen A. pluranimalium und Trueperella pyogenes herangezogen werden kann

A high‐dose, depigmented polymerized birch pollen extract for subcutaneous allergen immunotherapy has a favourable efficacy/safety ratio

Abstract Background Subcutaneous allergen immunotherapy (SCIT) with depigmented, polymerized (DPP) birch pollen extract has been marketed at doses of up to 1000 DPP units/mL since 2001. We sought to determine the dose‐dependent efficacy of a DPP birch pollen extract formulation in patients suffering from birch‐pollen‐induced allergic rhinitis or rhinoconjunctivitis with or without intermittent asthma. Methods A titrated conjunctival provocation test (CPT) was applied as a surrogate marker. This Phase II randomized, double‐blind, parallel‐group, dose‐ranging clinical trial was performed at 39 centres in Germany, Lithuania and Poland. After randomization to four dose‐level groups (100, 1000, 5000 and 10,000 DPP units/mL) and up‐dosing, participants received maintenance SCIT with five monthly subcutaneous injections. The primary endpoint was the proportion of patients in whom a higher concentration of birch pollen (vs. baseline) was needed to elicit a positive CPT. Results Three hundred forty‐three patients were included (mean (range) age: 42.6 (19–70)). The highest CPT responder rates were seen in the higher dose‐level groups. In the intention‐to‐treat analysis, the difference between the 100 and 10,000 groups was statistically significant (p = 0.0118). Although the proportion of patients with ≥1 treatment‐emergent adverse events increased with the dose, almost all these events were mild (65.6%) or moderate (18.5%). Conclusion Judging by the results of a CPT, the efficacy/safety ratio in SCIT appears to be favourable for a high‐dose‐level preparation of a DPP birch pollen extract

Persistence in allergen immunotherapy: A longitudinal, prescription data‐based real‐world analysis

Abstract Introduction Allergic rhinitis (AR) is a widespread disease with increasing prevalence in developed countries. The only treatment that tackles the underlying causes is allergen immunotherapy (AIT). This treatment is performed through two application routes, the subcutaneous immunotherapy (SCIT) or the sublingual immunotherapy (SLIT). However, persistence during the long course of treatment over 3 years is key for the efficacy of this treatment option. The impaired adherence significantly impacts public health resources. The aim of this study was to assess the persistence of AIT for both application routes. Methods IQVIATM LRx was used to identify patients starting AIT between 2009 and 2018 with grass pollen (GP), early flowering tree pollen (EFTP) and house dust mite (HDM) allergens. Patients were classified within each allergen category by AIT groups (subcutaneous depigmented polymerised allergen AIT [dSCIT], other subcutaneous AIT [oSCIT] and SLIT) and age (5‐11 years, 12‐17 years, 18+ years). Furthermore, they were followed up for up to 3 years until the cessation of treatment. Patients, who were still on treatment after 3 years were deemed to be censored. Kaplan‐Meier curves of persistence were generated and compared by log‐rank tests. Results The number of patients included in the three allergen categories was 38,717 GP, 23,183 EFTP, and 41,728 HDM AIT. In all allergen categories and for any product group, patient persistence decreased with increasing age class with the difference between 5‐11 years and 12‐17 years greater than between the latter and 18+ years. The percentage of patients completing the first year of AIT was low, particularly for SLIT where 22.2%–27.1% of patients remained persistent after 12 months. The equivalent figures for dSCIT were 52.0%–64.1% and for oSCIT 38.3%–50.3%. Conclusion Persistence in AIT in AR was low in this retrospective prescription‐based database and was clearly linked to patient age and application route

Subcutaneous immunotherapy with depigmented-polymerized allergen extracts: a systematic review and meta-analysis

BackgroundDouble-blind, placebo-controlled trials (DBPCTs) have confirmed the efficacy of allergen-specific immunotherapy (AIT) with depigmented-polymerized allergen extracts (DPAEs). This systematic review evaluates the efficacy of AIT using different allergens in different severity stages of rhinoconjunctivitis with or without asthma in the pollen studies and asthma and rhinitis in the house dust mite studies in comparison to placebo.MethodsWe used MEDLINE, Embase, CENTRAL and LILACS databases to review DBPCTs published until July 2016. The combined symptom and medication score (cSMS) served as primary endpoint. The total rhinoconjunctivitis symptom score (RCSS) and total score in Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) were secondary efficacy endpoints. Solicited local and systemic adverse events were secondary safety endpoints. We assumed a random effects model with standardized mean differences (SMDs) or mean differences as summary statistics. In a subgroup analysis, we classified the studies following the GINA (Global Initiative for Asthma) and ARIA (Allergic Rhinitis and its Impact on Asthma) guidelines for rhinoconjunctivitis and asthma severity.ResultsSix DBPCTs in pollen and 2 trials in house dust mites (HDM) were selected. Patients (N=915) with intermittent or mild persistent asthma were included in 3 (37.5%) and 5 (62.5%) trials, respectively. Two (25%) HDM studies included patients with moderate persistent asthma, 4 trials patients with moderate-to-severe rhinoconjunctivitis. Treatment periods ranged from 12 to 24months. AIT with DPAEs yielded significantly lower cSMS (SMD: 1.9, 95% CI: 0.9-2.8) and RQLQ (SMD: 0.3, 95% CI: 0.1-0.5) values than did placebo. An exploratory analysis of cSMS and RCSS suggested that the efficacy of AIT treatment with DPAEs was higher in trials including patients with more severe rhinoconjunctivitis and asthma. A publication bias was not detected. Heterogeneity between individual studies was explained by differences in severity. Patients receiving DPAEs did not experience a significantly higher risk of local (OR: 1.55, 95% CI: 0.86-2.79) or systemic reactions (OR: 1.94, 95% CI: 0.98-3.84).ConclusionsCompared to placebo, AIT with DPAEs is effective in patients with pollen- or HDM-induced rhinoconjunctivitis with or without allergic asthma and improves health-related quality of life. It does not differ significantly in safety and tolerability