Advanced ankylosing spondylitis diagnosed after infection of the digestive tract — case report

Inflammatory spondyloarthrophaties (SpA) are a group of diseases with a close aetiology and clinical course. Infections , especially bacterial, of the digestive tract are possible causes of SpA. Infectious pathogens may penetrate the mucous membrane of the gastrointestinal tract, of the urogenital tracts, respiratory tract and induce the reactive arthritis or exacerbate the previously diagnosed, chronic SpA. Dysbiosis also plays an important role in the pathogenesis of SpA. In the report, authors presented a case of a patient with a long-time backbone pain, in whom Yersinia enterocolitica infection of the digestive tract preceded the peripheral arthritis and inflammatory pain of the spine. The radiological images showed the characteristic changes of the advanced ankylosing spondylitis

Skin Microbiome in Prurigo Nodularis

Prurigo nodularis (PN) is a chronic condition characterized by the presence of nodular lesions accompanied by intense pruritus. The disease has been linked to several infectious factors, but data on the direct presence of microorganisms in the lesions of PN are scarce. The aim of this study was to evaluate the diversity and composition of the bacterial microbiome in PN lesions by targeting the region V3-V4 of 16S rRNA. Skin swabs were obtained from active nodules in 24 patients with PN, inflammatory patches of 14 patients with atopic dermatitis (AD) and corresponding skin areas of 9 healthy volunteers (HV). After DNA extraction, the V3-V4 region of the bacterial 16S rRNA gene was amplified. Sequencing was performed using the Illumina platform on the MiSeq instrument. Operational taxonomic units (OTU) were identified. The identification of taxa was carried out using the Silva v.138 database. There was no statistically significant difference in the alpha-diversity (intra-sample diversity) between the PN, AD and HV groups. The beta-diversity (inter-sample diversity) showed statistically significant differences between the three groups on a global level and in paired analyses. Staphylococcus was significantly more abundant in samples from PN and AD patients than in controls. The difference was maintained across all taxonomic levels. The PN microbiome is highly similar to that of AD. It remains unclear whether the disturbed composition of the microbiome and the domination of Staphylococcus in PN lesions may be the trigger factor of pruritus and lead to the development of cutaneous changes or is a secondary phenomenon. Our preliminary results support the theory that the composition of the skin microbiome in PN is altered and justify further research on the role of the microbiome in this debilitating condition.This research was supported by the mini-Dgrant provided by the Polish Dermatological Society to Dr. Magdalena Zychowska (1/2020)

Kąpiele z podchlorynem sodu w atopowym zapaleniu skóry i ich wpływ na mikrobiom skóry

Introduction: Atopic dermatitis (AD) is a disease of multifactorial ethology. However, the bacterial microflora of the skin, especially Staphylococcus aureus, plays an important role in its the pathogenesis. Continuously, new therapies are sought which will block factors exacerbating the disease and significantly support the AD treatment. The aim of the study was to determine the effect of sodium hypochlorite baths on the eradication of St. aureus from the skin and to assess their effect on AD severity. Material and methods: The study was conducted among 56 patients suffering from AD. A half of the patients were randomly assigned to the group treated with sodium hypochlorite baths (study group) in addition to the standard therapy of AD, the remaining patients were treated with conventional treatment (control group). The severity of the disease and the intensity of the itch were assessed in each patient at the time of enrollment into the study and 6 weeks later. A skin smear was taken for microbiological examination with pathogen identification and semi-quantitative evaluation of the isolated bacteria strains. Results: Patients using baths in diluted sodium hypochlorite showed a greater improvement of AD severity compared to those using conventional treatment only (relative EASI improvement: 42.0% ± 32.9% vs. –33.1% ± 88.6%, p &lt; 0.01; relative SCORAD improvement: 33.5 ± 25.9% vs. –6.7 ± 36.8%, p &lt; 0.001). Additionally, a greater reduction of itch was observed in the study group compared to the control group (ΔNRS: 1.8 ± 2.2 vs. 0.7 ± 2.2, p = 0.04) as well as significant improvement of quality of life was noted (study group: mean DLQI before treatment: 12.7 ± 6.7 points, mean DLQI after treatment: 7.3 ± 5.4, p &lt; 0.001; control group: mean DLQI before treatment: 10.8 ± 7.5 points, mean DLQI after treatment: 8.7 ± 5.6, p &lt; 0.82). However, the relationship between the applied therapy and the eradication of St. aureus has not been confirmed. Conclusions: Bathing in diluted sodium hypochlorite allowed to reduce the intensity of AD and to improve the quality of life, while ensuring good tolerability and safety of the therapy. However, no significant effect of the therapy was observed on the reduction of the number of St. aureus colonies on the skin.Wstęp: Istotną rolę w patogenezie atopowego zapalenia skóry (AZS) odgrywa mikroflora bakteryjna skóry, zwłaszcza gronkowiec złocisty (Staphylococcus aureus). Stale poszukuje się nowych form terapii, które działałyby hamująco na czynniki zaostrzające proces chorobowy, a tym samym byłyby pomocne w leczeniu tej jednostki chorobowej. Celem obecnej pracy było zbadanie wpływu kąpieli z dodatkiem podchlorynu sodu na przebieg kliniczny AZS i stopień eradykacji St. aureus ze skóry. Materiał i metody: Badanie zostało przeprowadzone z udziałem 56 pacjentów chorujących na AZS, spośród których w sposób losowy połowa została przydzielona do grupy, która oprócz standardowej terapii stosowała także kąpiele w podchlorynie sodu (ramię lecznicze), natomiast pozostała część chorych stosowała jedynie standardowe leczenie AZS. U każdego pacjenta w momencie włączenia do badania i po 6 tygodniach oceniono nasilenie choroby oraz intensywność odczuwanego świądu, a także pobrano wymaz ze skóry w celu wykonania badania mikrobiologicznego z identyfikacją patogenu i oceną półilościową wyizolowanych szczepów Wyniki: U pacjentów stosujących kąpiele w rozcieńczonym podchlorynie sodu uzyskano większą poprawę AZS w porównaniu z osobami niestosującymi tej terapii (względna poprawa EASI: 42,0% ± 32,9% vs. –33,1% ± 88,6%; p < 0,01; względna poprawa SCORAD: 33,5 ± 25,9% vs. –6,7 ± 36,8%; p < 0,001). Dodatkowo w grupie badanej w porównaniu z grupą kontrolną doszło do większej redukcji świądu skóry (ΔNRS: 1,8 ± 2,2 vs. 0,7 ± 2,2; p = 0,04) oraz istotnej poprawy jakości życia: średnie DLQI w grupie stosującej kąpiele podchlorynowe: przed leczeniem 12,7 ± 6,7 punktów i po 6 tygodniach 7,3 ± 5,4 punktów; p < 0,001; w porównaniu z grupą bez kąpieli podchlorynowych: średnie DLQI przed leczeniem 10,8 ± 7,5 punktów i po 6 tygodniach 8,7 ± 5,6 punktów; p < 0,82. Nie potwierdzono natomiast związku stosowanej terapii podchlorynowej z eradykacją St. aureus. Wnioski: Kąpiele w rozcieńczonym podchlorynie sodu pozwoliły na zmniejszenie nasilenia atopowego zapalenia skóry oraz poprawę jakości życia, jednocześnie zapewniając dobrą tolerancję i bezpieczeństwo terapii. Nie wykazano natomiast istotnego wpływu terapii na redukcję liczby kolonii St. aureus na skórze

Skin Microbiome in Prurigo Nodularis

Prurigo nodularis (PN) is a chronic condition characterized by the presence of nodular lesions accompanied by intense pruritus. The disease has been linked to several infectious factors, but data on the direct presence of microorganisms in the lesions of PN are scarce. The aim of this study was to evaluate the diversity and composition of the bacterial microbiome in PN lesions by targeting the region V3-V4 of 16S rRNA. Skin swabs were obtained from active nodules in 24 patients with PN, inflammatory patches of 14 patients with atopic dermatitis (AD) and corresponding skin areas of 9 healthy volunteers (HV). After DNA extraction, the V3-V4 region of the bacterial 16S rRNA gene was amplified. Sequencing was performed using the Illumina platform on the MiSeq instrument. Operational taxonomic units (OTU) were identified. The identification of taxa was carried out using the Silva v.138 database. There was no statistically significant difference in the alpha-diversity (intra-sample diversity) between the PN, AD and HV groups. The beta-diversity (inter-sample diversity) showed statistically significant differences between the three groups on a global level and in paired analyses. Staphylococcus was significantly more abundant in samples from PN and AD patients than in controls. The difference was maintained across all taxonomic levels. The PN microbiome is highly similar to that of AD. It remains unclear whether the disturbed composition of the microbiome and the domination of Staphylococcus in PN lesions may be the trigger factor of pruritus and lead to the development of cutaneous changes or is a secondary phenomenon. Our preliminary results support the theory that the composition of the skin microbiome in PN is altered and justify further research on the role of the microbiome in this debilitating condition

Cytisine parameters measured in the 1.5 Tesla magnetic field

Introduction. Cytisine, Cytisinum (C11H14N2O), is an organic chemical compound. Cytisine is heterotricyclic compound that is the toxic principle in Laburnum seeds and is found in many members of the Fabaceae (legume, pea or bean) family. Aim. The aim of the study is to measure the influence of water on the form of drug in the magnetic field 1.5 Tesla. Material and methods. For this purpose, magnetic resonance imaging tests were performed to check the solubility of pure cytisine, Desmoxan tablets and Tabex capsules. Results. From a pharmacological point of view, both Desmoxan tablets and Tabex capsules should exert the same effect on the human body, this is due to the identical content of the active substance, in this case cytisine (1.5 mg). Conclusion. The differences in the results obtained may be related to additional excipients that contain medications, but it is believed that they should not have a negative impact on the action of the active substances

Cohort profile. the ESC-EORP chronic ischemic cardiovascular disease long-term (CICD LT) registry

The European Society of cardiology (ESC) EURObservational Research Programme (EORP) Chronic Ischemic Cardiovascular Disease registry Long Term (CICD) aims to study the clinical profile, treatment modalities and outcomes of patients diagnosed with CICD in a contemporary environment in order to assess whether these patients at high cardiovascular risk are treated according to ESC guidelines on prevention or on stable coronary disease and to determine mid and long term outcomes and their determinants in this population