The influence on skin care of the use of emollients for skin lesions during the course of atopic dermatitis

Background/objective. In this paper, we discuss the principle of skin care with emollients in patients with atopic dermatitis.Patients and methods. The study included 22 patients with features of atopic skin. The indicator of atopic dermatitis (W-AZS), and the Eczema Area and Severity Index (EASI) indicator were used to measure the condition of the skin, and a questionnaire about methods of care for the skin was evaluated.Results. The mean value of the W-AZS indicator in patients using emollients was 34.42 ± 20.64, but in the group of respondents who did not use moisturising-greasing preparations it was 75.95 ± 11.58. The differences were statistically significant (p < 0.005). Furthermore, respondents who used emollients several times a week showed statistically significantly higher values of W-AZS indicator than respondents who used emollients twice a day or more often. These values of W-AZS were as follows: 65.13 ± 10.72 (SD) for people who used emollients several times a week, 17.13 ± 7.34 in patients who used emollients twice a day, and 8.66 ± 1.26 for patients who used emollients several times a day. The W-AZS indicator values due to frequent use of ‘leave-off’ type of emollients were as follows: 10.75 ± 2.49 (SD) for warm water and 12.05 ± 6.43 for cold water. Respondents who used hot water for their bath (over 38°C) received significantly higher values of W-AZS indicator.Conclusions. The study showed the significant effects of emollients, with a particular emphasis on frequency of use. It also stressed the importance of water temperature for bathing with emollients. The EASI indicatoris less precise than the W-AZS indicator

Keratinization Disorders and Genetic Aspects in Palmar and Plantar Keratodermas

Palmoplantar keratoderma (PPK) is a heterogeneous group of hereditary and acquired disorders characterized by abnormal thickening of the palms and soles. There are three clinical patterns: diffuse, focal, and punctuate. Palmoplantar keratodermas can be divided into the following functional subgroups: disturbed gene functions in structural proteins (keratins), cornified envelope (loricrin, transglutaminase), cohesion (plakophilin, desmoplakin, desmoglein 1), cell-to-cell communication (connexins) and transmembrane signal transduction (cathepsin C). Unna-Thost disease is the most common variety of hereditary PPK. Mutations in keratin 1 have been reported in Unna-Thost disease. We report 12 cases in which Unna-Thost disease was diagnosed. Genealogical study demonstrated that the genodermatosis was a familial disease inherited as an autosomal dominant disorder. Dermatological examination revealed yellowish hyperkeratosis on the palms and soles. Oral mucosa, teeth, and nails remained unchanged. Histopathological examination of the biopsy sample taken from the soles of the patients showed orthokeratotic keratosis, hypergranulosis, and acanthosis without epidermolysis.  </p

Stevens Johnson syndrome after carbamazepine and SJS/TEN overlap syndrome after amoxicillin: case reports and a review

We present a case of Stevens Johnson syndrome in a child after carbamazepine application and Stevens Johnson/TEN overlap syndrome in an adult after amoxicillin application. On the basis of two reported cases we review the most commonly associated drugs, the postulated pathogenesis, clinical manifestation and management in these severe life-threatening diseases. We especially discuss the controversial systemic corticosteroid therapy. Topical care is also discussed

Evaluation of serum heat shock protein 70 concentration in women with recurrent miscarriages

Background. Heat shock proteins (Hsp) were discovered over 50 years ago and are commonly called ‘stress proteins’. Hsp proteins play an important role in a cell, in that they provide protection against cellstress factors and environmentally negative factors. The most conservative, and the best known, heat shock proteins are Hsp 70 subfamily proteins. It has been suggested that an increase of Hsp 70 in the blood during pregnancy has a negative impact. The aetiology of recurrent miscarriages in more than 60% of women remains unexplained. Therefore the aim of this study was to evaluate the usefulness of Hsp 70 assessment in the diagnosis of recurrent miscarriages.Material and methods. The study group consisted of 100 women (aged 36.0 ± 4.9 years) who had experienced repeated miscarriages. The reference group consisted of 60 women (aged 36.1 ± 3.6 years), who had been pregnant at least twice and who had given birth by a spontaneous labour without complications. Hsp 70 was determined in the serum.Results. We found no significant differences in the Hsp 70 concentration between the women with recurrent miscarriages and the reference group. While median serum Hsp 70 was the most elevated in the women with the highest number of miscarriages, this difference was not significant.Conclusion. Based on the obtained results, it is difficult to determine whether Hsp 70 plays a causative role in recurrent miscarriages. However, taking into account the fact that the role of Hsp 70 in the course of normal and pathological pregnancy is not yet completely understood, it may be worth expanding the study to include a larger group of women with recurrent miscarriages

The assessment of usefulness of HE4 and CA125 quantification for the diagnostics of endometrial cancer

Endometrial cancer is one of the most prevalent uterine malignancies. This disease occurs mostly in older women, frequently affected with other comorbidities. Hence, it is important to search for novel, less burdensome diagnostic modalities, enabling the objective assessment of the patient’s status and facilitating qualification to relevant risk groups prior to surgical treatment.The aim of this study was to verify the usefulness of CA125 and HE4 in the evaluation of endometrial cancer.The study included 308 women treated at University Hospital No. 2 in Bydgoszcz. The study group included 180 patients operated due to endometrial cancer. The control group included 128 women operated due to perineal statics disorders. The concentrations of tumour markers were measured with ELISA-based ready-to-use diagnostic kits.Patients with endometrial cancer and healthy women differed significantly in terms of HE4 concentrations (P = 0.001). The serum concentration of HE4 in stage I endometrial cancer patients was significantly higher (Me = 88.37 pM) than in healthy women (Me = 46.14) (P = 0.007). The analysis of ROC curves with the determination of the area under curve showed 66.7% sensitivity and 78.1% specificity of HE4. AUC for HE4 amounted to 0.721 and was the highest of all markers.Our analysis revealed that HE4 is useful in the detection of endometrial cancer, while Human Epididymis Protein 4 can potentially be used for screening purposes. CA125 antigen, previously used in the diagnostic process, is useless or may possess limited usefulness. There is a need for further studies on larger populations of female patients

Mycophenolic Acid Metabolites Acyl-Glucuronide and Glucoside Affect the Occurrence of Infectious Complications and Bone Marrow Dysfunction in Liver Transplant Recipients.

BACKGROUND Mycophenolic acid (MPA) prodrugs are anti-proliferative immunosuppressive agents commonly used after organ transplantation. Although they are generally well tolerated by patients, adverse effects may occur. It is postulated that MPA metabolites could also contribute to these adverse effects. MATERIAL AND METHODS The objective of this study was the assessment of concentrations of total MPA and its metabolites, phenyl glucuronide (MPAG), acyl glucuronide (AcMPAG) and glucoside (GluMPA), using liquid chromatography combined with mass spectrometry (LC/MS/MS) in two groups: kidney transplant recipients and liver transplant patients. Associations of MPA and its metabolites with adverse effects were analyzed. RESULTS The study group consisted of 211 recipients of liver or kidney transplants who received immunosuppressive therapy, including MPA prodrugs. Multivariant analysis showed a positive influence of MPA on gastroenterotoxicity in kidney transplant recipients. In liver patients, gastroenterotoxicity was associated with lower MPAG concentrations. A positive influence of AcMPAG on bacterial infections in liver transplant patients was observed. In liver transplant recipients, a positive influence of MPA and a negative influence of GluMPA levels on the PLT count were revealed. MPA and its metabolites did not influence the hemoglobin levels in both groups. There were no significant relationships among MPA, its metabolites and WBC counts. CONCLUSIONS In kidney transplant recipients, total MPA trough concentration is associated with gastroenterotoxicity and its monitoring could have important role in management of gastrointestinal complications. The quantification of AcMPAG in liver recipients receiving MPA may be helpful in avoiding bacterial infections. GluMPA seems to have a toxic effect on thrombopoiesis

Analysis of serum protein fractions from women with recurrent miscarriage

Recurrent miscarriage occurs in 1 - 5 % of women at reproductive age. The most common cause of recurrent miscarriage is chromosomal abnormalities of the embryo (41%), chromosomal aberrations parents (10%), anatomical abnormalities of the uterus (5%), infectious and hormonal factors. In about 25% of women, no cause of recurrent miscarriage is usually found. Therefore it seems important to study all factors possibly inducing pregnancy disorders. Objective: The aim of this study was to find a difference in serum protein fractions between women with primary and secondary recurrent miscarriage. Methods: The study group consisted of 52 women (aged 36.0±4.9) with recurrent miscarriage. Nine of them (17%) reported one earlier regular pregnancy ending with childbirth without complications. Control group comprised 30 non-pregnant women (aged 36.1±3.6), who had given vaginal birth to healthy children at least twice. Serum protein fractions were separated by electrophoresis in the SDS PAGE buffer system using a Mini PROTEAN 3 cell device. BioRad SDS PAGE Molecular Weight Standards covering mass range of 6.5-200 kDa were used as a reference. Gels were stained with Coomassie Blue R 250 solution. BioRad QuantityOne software was used for the assessment of molecular weight of each protein fraction. Results: Electrophoretic separation revealed 39 protein fractions of 10 243 kDa. Particularly interesting was a 38 kDa fraction present exclusively in serum of women with recurrent pregnancy, who had never given birth. Another fraction (74 kDa), not detected in the control group, was found in all women with recurrent pregnancy loss. Protein fractions of 76 and 151 kDa were present only in the control group. Conclusions: The presence of the protein fractions of low- or mid-weight in serum from women with recurrent miscarriage may potentially play a role in the pathomechanism of this disorder

Effectiveness of EFFACLAR H ISO-BIOME preparations as an adjunct to conventional treatment of acne vulgaris — results of an observational study

Background: Although topical dermocosmetics are widely used care products, only a few studies investigated their effectiveness in enhancing the tolerance and efficacy of medical anti-acne therapies. The primary objective of this study was to assess the safety and efficacy of EFFACLAR H ISO-BIOME cream and washing cream as an adjunct to pharmacological treatment (local and/or systemic) administered for at least 12 weeks in patients with mild to very severe acne vulgaris. Material and methods: This observational study was conducted in patients (n = 306) aged 14 years and over with mild to very severe [Global Acne Severity Scale (GEA) 1–5] acne vulgaris. Participants were instructed to apply the EFFACLAR H ISO-BIOME cream and washing cream twice daily for at least 12 weeks along with prescribed anti-acne therapy (topical agents, oral isotretinoin, or systemic antibiotics/ /spironolactone combined with topical agents). Results: The treatment regimen led to an improvement in GEA scores in 88.9% of all patients (p &lt; 0.05). Statistically significant changes were observed in the reduction of sebum secretion, number of papules and pustules, postinflammatory hyperpigmentation, and erythema (p &lt; 0.05). The vast majority of dermatologists and patients rated the tolerance of the products as very good (97% and 94%, respectively). The quality of life of most patients improved by the end of the study. Conclusions: EFFACLAR H ISO-BIOME cream and washing cream are safe and effective products used as adjunctive treatment to topical or systemic therapy of mild to very severe acne vulgaris

Expression and function of proton-sensing G-protein-coupled receptors in inflammatory pain

<p>Abstract</p> <p>Background</p> <p>Chronic inflammatory pain, when not effectively treated, is a costly health problem and has a harmful effect on all aspects of health-related quality of life. Despite the availability of pharmacologic treatments, chronic inflammatory pain remains inadequately treated. Understanding the nociceptive signaling pathways of such pain is therefore important in developing long-acting treatments with limited side effects. High local proton concentrations (tissue acidosis) causing direct excitation or modulation of nociceptive sensory neurons by proton-sensing receptors are responsible for pain in some inflammatory pain conditions. We previously found that all four proton-sensing G-protein-coupled receptors (GPCRs) are expressed in pain-relevant loci (dorsal root ganglia, DRG), which suggests their possible involvement in nociception, but their functions in pain remain unclear.</p> <p>Results</p> <p>In this study, we first demonstrated differential change in expression of proton-sensing GPCRs in peripheral inflammation induced by the inflammatory agents capsaicin, carrageenan, and complete Freund's adjuvant (CFA). In particular, the expression of TDAG8, one proton-sensing GPCR, was increased 24 hours after CFA injection because of increased number of DRG neurons expressing TDAG8. The number of DRG neurons expressing both TDAG8 and transient receptor potential vanilloid 1 (TRPV1) was increased as well. Further studies revealed that TDAG8 activation sensitized the TRPV1 response to capsaicin, suggesting that TDAG8 could be involved in CFA-induced chronic inflammatory pain through regulation of TRPV1 function.</p> <p>Conclusion</p> <p>Each subtype of the OGR1 family was expressed differently, which may reflect differences between models in duration and magnitude of hyperalgesia. Given that TDAG8 and TRPV1 expression increased after CFA-induced inflammation and that TDAG8 activation can lead to TRPV1 sensitization, it suggests that high concentrations of protons after inflammation may not only directly activate proton-sensing ion channels (such as TRPV1) to cause pain but also act on proton-sensing GPCRs to regulate the development of hyperalgesia.</p

Nanoparticle as a novel tool in hyperthermic intraperitoneal and pressurized intraperitoneal aerosol chemotheprapy to treat patients with peritoneal carcinomatosis

The treatment of peritoneal surface malignances has changed considerably over the last thirty years. Unfortunately, the palliative is the only current treatment for peritoneal carcinomatosis (PC). Two primary intraperitoneal chemotherapeutic methods are used. The first is combination of cytoreductive surgery (CRS) and Hyperthermic IntraPEritoneal Chemotherapy (HIPEC), which has become the gold standard for many cases of PC. The second is Pressurized IntraPeritoneal Aerosol Chemotheprapy (PIPAC), which is promising direction to minimally invasive as safedrug delivery. These methods were improved through multicenter studies and clinical trials that yield important insights and solutions. Major method development has been made through nanomedicine, specifically nanoparticles. Here, we are presenting the latest advances of nanoparticles and their application to precision diagnostics and improved treatment strategies for PC. These advances will likely develop both HIPEC and PIPAC methods that used for in vitro and in vivo studies. Several benefits of using nanoparticles will be discussed including: 1) Nanoparticles as drug delivery systems; 2) Nanoparticles and Near Infrred (NIR) Irradiation; 3) use of nanoparticles in perioperative diagnostic and individualized treatment planning; 4) use of nanoparticles as anticancer dressing's, hydrogels and as active beeds for optimal reccurence prevention; and 5) finally the curent in vitro and in vivo studies and clinical trials of nanoparticles. The current review highlighted use of nanoparticles as novel tools in improving drug delivery to be effective for treatment patients with peritoneal carcinomatosis