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Dermatology Practical & Conceptual Apr 2024Pemphigus vulgaris (PV) is an autoimmune disease primarily affecting the oral mucosa.
Evaluation of the Quality of Life and the Demographic and Clinical Characteristics of Patients With Pemphigus With Oral Mucosal İnvolvement: A Multicenter Observational Study.
INTRODUCTION
Pemphigus vulgaris (PV) is an autoimmune disease primarily affecting the oral mucosa.
OBJECTIVES
This study aimed to determine the demographic, clinical and treatment characteristics of PV patients with oral mucosal involvement and to assess the impact on their quality of life.
METHODS
We conducted a prospective observational study among 106 patients diagnosed with PV and presenting oral mucosal involvement. Demographic data, clinical and treatment characteristics, and quality of life questionnaires were recorded.
RESULTS
The study included 106 patients, 55 (51.89%) were male and there was a predominance of the mucocutaneous subtype in 83 individuals (78.38%). Oral mucosa was the initial site of manifestation in 44 patients (41.51%). Bilateral buccal mucosa was the most frequently affected site. The predominant symptom reported was a burning sensation, noted in 91 patients (85.85%). Oral mucosal examination revealed erosions in 85.85% of the patients. Systemic steroids were the most commonly administered treatment, and rituximab was used in 18 patients (16.98%). A positive and significant correlation was found between pemphigus severity and Oral Health Impact Profile-14, Dermatology Life Quality Index and Dermatological Quality of Life Scale scores (P < 0.05). The presence of superficial ulcers, flaccid bullae, lesion diameter ≥1 cm, and >10 lesions were factors that markedly diminished quality of life. Complete response to treatment was noted in all patients administered rituximab.
CONCLUSIONS
The most common area of involvement was bilateral buccal mucosa, and the severity of PV closely correlated with a decline in quality of life measures. These results highlight the need for careful clinical oversight of PV, taking into account its effects on patients quality of life.
PubMed: 38810063
DOI: 10.5826/dpc.1402a99 -
World Journal of Clinical Cases May 2024There is limited literature on managing the airway of patients with linear immunoglobulin A (IgA) bullous dermatosis, a rare mucocutaneous disorder that leads to the...
BACKGROUND
There is limited literature on managing the airway of patients with linear immunoglobulin A (IgA) bullous dermatosis, a rare mucocutaneous disorder that leads to the development of friable bullae. Careful clinical decision making is necessary when there is a risk of bleeding into the airway, and a multidisciplinary team approach may lead to decreased patient morbidity during these high-risk scenarios, especially when confronted with an unusual cause for bleeding.
CASE SUMMARY
A 45-year-old African American female presented to our ambulatory surgical center for right corneal transplantation due to corneal perforation after blunt trauma in the setting of cicatricial conjunctivitis and diffuse corneal neovascularization from linear IgA bullous dermatosis. The diagnosis of IgA dermatosis was recent, and the patient had been lost to follow-up. The severity of the disease and extent of airway involvement was unknown at the time of the surgery. Significant airway bleeding was noticed upon intubation and the otorhinolaryngology team had to be called to the operating room. The patient required transfer to the intensive care unit where a multidisciplinary team was involved in her case. The patient was extubated on postoperative day 4.
CONCLUSION
A multidisciplinary approach to treating this disease is the best course of action before a surgical procedure. In our case, key communication between the surgery, anesthesia, and dermatology teams led to the quick and safe treatment of our patient's disease. Ambulatory surgery should not be considered for these cases unless they are in full remission and there is no mucous membrane involvement.
PubMed: 38808340
DOI: 10.12998/wjcc.v12.i13.2263 -
CMAJ : Canadian Medical Association... May 2024
Topics: Humans; Amyloidosis; Blister; Immunoglobulin Light Chains; Male; Female; Oral Hemorrhage; Aged; Immunoglobulin Light-chain Amyloidosis; Middle Aged
PubMed: 38802132
DOI: 10.1503/cmaj.240119 -
Pharmaceutics May 2024The identification of novel therapeutic strategies for ovarian cancer (OC), the most lethal gynecological neoplasm, is of utmost urgency. Here, we have tested the...
BACKGROUND
The identification of novel therapeutic strategies for ovarian cancer (OC), the most lethal gynecological neoplasm, is of utmost urgency. Here, we have tested the effectiveness of the compound 2c (4-hydroxy-2,6-bis(4-nitrobenzylidene)cyclohexanone 2). 2c interferes with the cysteine-dependent deubiquitinating enzyme (DUB) UCHL5, thus affecting the ubiquitin-proteasome-dependent degradation of proteins.
METHODS
2c phenotypic/molecular effects were studied in two OC 2D/3D culture models and in a mouse xenograft model. Furthermore, we propose an in silico model of 2c interaction with DUB-UCHL5. Finally, we have tested the effect of 2c conjugated to several linkers to generate 2c/derivatives usable for improved drug delivery.
RESULTS
2c effectively impairs the OC cell line and primary tumor cell viability in both 2D and 3D conditions. The effectiveness is confirmed in a xenograft mouse model of OC. We show that 2c impairs proteasome activity and triggers apoptosis, most likely by interacting with DUB-UCHL5. We also propose a mechanism for the interaction with DUB-UCHL5 via an in silico evaluation of the enzyme-inhibitor complex. 2c also reduces cell growth by down-regulating the level of the transcription factor E2F1. Eventually, 2c activity is often retained after the conjugation with linkers.
CONCLUSION
Our data strongly support the potential therapeutic value of 2c/derivatives in OC.
PubMed: 38794326
DOI: 10.3390/pharmaceutics16050664 -
Genes May 2024Pathogen perception generates the activation of signal transduction cascades to host defense. White pine blister rust (WPBR) is caused by J.C. Fisch and affects a...
Pathogen perception generates the activation of signal transduction cascades to host defense. White pine blister rust (WPBR) is caused by J.C. Fisch and affects a number of species of . One of the most severely affected species is Engelm (whitebark pine). WPBR resistance in the species is a polygenic and complex trait that requires an optimized immune response. We identified early responses in 2-year-old seedlings after four days of fungal inoculation and compared the underlying transcriptomic response with that of healthy non-inoculated individuals. A de novo transcriptome assembly was constructed with 56,796 high quality-annotations derived from the needles of susceptible and resistant individuals in a resistant half-sib family. Differential expression analysis identified 599 differentially expressed transcripts, from which 375 were upregulated and 224 were downregulated in the inoculated seedlings. These included components of the initial phase of active responses to abiotic factors and stress regulators, such as those involved in the first steps of flavonoid biosynthesis. Four days after the inoculation, infected individuals showed an overexpression of chitinases, reactive oxygen species (ROS) regulation signaling, and flavonoid intermediates. Our research sheds light on the first stage of infection and emergence of disease symptoms among whitebark pine seedlings. RNA sequencing (RNA-seq) data encoding hypersensitive response, cell wall modification, oxidative regulation signaling, programmed cell death, and plant innate immunity were differentially expressed during the defense response against .
Topics: Pinus; Plant Diseases; Gene Expression Regulation, Plant; Disease Resistance; Basidiomycota; Transcriptome; Seedlings; Gene Expression Profiling; Plant Proteins
PubMed: 38790231
DOI: 10.3390/genes15050602 -
Scientific Reports May 2024Herpes simplex virus (HSV) is a causative agent of fever blister, genital herpes, and neonatal herpes. Nowadays, edible algae are recognized as health food due to high...
Herpes simplex virus (HSV) is a causative agent of fever blister, genital herpes, and neonatal herpes. Nowadays, edible algae are recognized as health food due to high nutrition content and their many active compounds that are beneficial to health. The purpose of this study is to investigate the inhibitory effects of algal polysaccharide extract from Cladophora spp. against herpes simplex virus type 1 and type 2 on Vero cells. In this study, the structure of polysaccharide extract is presented as S=O and C-O-S of the sulfate group, as identified by the FT-IR technique. The toxicity of algal polysaccharide extract on Vero cells was determined by MTT assay. The algal extract showed low toxicity on the cells, with 50% cytotoxic concentration (CC) value greater than 5000 µg mL. The inhibition of HSV infection by the algal extract was then evaluated on Vero cells using plaque reduction assay. The 50% effective concentration (EC) values of algal extract exhibited antiviral activity against HSV-1 upon treatment before, during, and after viral adsorption with and without removal of the extract were 70.31, 15.17, > 5000 and 9.78 µg mL, respectively. Additionally, the EC values of algal extract against HSV-2 upon treatment before, during and after viral adsorption with, and without removal of the extract were 5.85, 2.57, > 5000 and 26.96 µg mL, respectively. Moreover, the algal extract demonstrated direct inactivation of HSV-1 and HSV-2 virions as well as inhibitory effect against HSV replication. Accordingly, algal polysaccharide extract containing sulfated polysaccharides showed strong activity against HSV. Therefore, it is proved to be useful to apply Cladophora spp. polysaccharide extract as an anti-HSV agent.
Topics: Animals; Chlorocebus aethiops; Vero Cells; Polysaccharides; Antiviral Agents; Chlorophyta; Herpesvirus 1, Human; Herpes Simplex; Plant Extracts; Herpesvirus 2, Human
PubMed: 38789457
DOI: 10.1038/s41598-024-60941-7 -
Insects May 2024Despite being the most widespread blister beetle subfamily, Nemognathinae is unfairly understudied in China. In this study, a new genus and species, Pan, from northern...
Despite being the most widespread blister beetle subfamily, Nemognathinae is unfairly understudied in China. In this study, a new genus and species, Pan, from northern China is described and illustrated. The antennae, elytra, hind wings, and claws of the new genus form a truly unique set of characteristics never observed in other genera of Nemognathini Laporte de Castelnau, 1840. Three species from China are newly recorded and illustrated: (Tauscher, 1812), (Fairmaire 1889), and Aksentjev, 1978. The genus Tan, 1981, is transferred from the tribe Meloini Gyllenhal, 1910, to Nemognathini based on an examination of the types. Aiming to test the morphology-based placement of the new genus, we conducted molecular phylogenetic analyses using two mitochondrial (, ) and three nuclear markers (, , ). The results confirm our tribal assignment of the new genus and support a clade that consists of , Pan and Bologna, 2018, cf. , and cf. .
PubMed: 38786894
DOI: 10.3390/insects15050338 -
Anatomy & Cell Biology May 2024Pneumatisation of the maxillary sinus (MS) is variable. The archived cone-beam computed tomography file of a 54-year-old female was retrospectively evaluated...
Pneumatisation of the maxillary sinus (MS) is variable. The archived cone-beam computed tomography file of a 54-year-old female was retrospectively evaluated anatomically. Nasal or retrobullar recesses of the MSs (NRMS) were found. The MSs were bicameral. NRMSs extended from the postero-lateral chambers of the MSs into the lateral nasal walls. The right NRMS was reached superior to the middle turbinate and the ethmoidal bulla was applied on its anterior side. The left NRMS had two medial pouch-like ends, one beneath the ethmoidal bulla and the other on the anterior side of the basal lamella of the middle turbinate. Additional anatomical findings were the uncinate bulla, infraorbital recesses of the MS, maxillary recess of the sphenoidal sinus, and atypical posterior insertions of the superior nasal turbinates, maxillo-ethmoido-sphenoidal and ethmoido-sphenoidal. The NRMS is a novel finding and could lead to erroneous endoscopic corridors if not documented before the interventions.
PubMed: 38773954
DOI: 10.5115/acb.24.023 -
Malaria Journal May 2024Perennial malaria chemoprevention (PMC) aims to protect children at risk from severe malaria by the administration of anti-malarial drugs to children of defined ages... (Observational Study)
Observational Study
BACKGROUND
Perennial malaria chemoprevention (PMC) aims to protect children at risk from severe malaria by the administration of anti-malarial drugs to children of defined ages throughout the year. Sulfadoxine-pyrimethamine (SP) has been widely used for chemoprevention in Africa and a child-friendly dispersible tablet formulation has recently become available.
METHODS
This qualitative non-interventional observational study was conducted in Benin, Côte d'Ivoire, and Mozambique between February and June 2022. Prototype blister packs, dispensing boxes and job aids designed to support dispersible SP deployment for PMC were evaluated using focus group discussions (FGD) and semi-structured in-depth individual interviews (IDI) with health authorities, health personnel, community health workers (CHWs) and caregivers. The aim was to evaluate knowledge and perceptions of malaria and chemoprevention, test understanding of the tools and identify gaps in understanding, satisfaction, user-friendliness and acceptability, and assess the potential role of CHWs in PMC implementation. Interviews were transcribed and imported to ATLAS.ti for encoding and categorization. Thematic content analysis used deductive and inductive coding with cross-referencing of findings between countries and participants to enrich data interpretation. Continuous comparison across the IDI and FGD permitted iterative, collaborative development of materials.
RESULTS
Overall, 106 participants completed IDIs and 70 contributed to FGDs. Malaria was widely recognised as the most common disease affecting children, and PMC was viewed as a positive intervention to support child health. The role of CHWs was perceived differently by the target groups, with caregivers appreciating their trusted status in the community, whereas health authorities preferred clinic-based deployment of PMC by health professionals. Empirical testing of the prototype blister packs, dispensing boxes and job aids highlighted the context-specific expectations of respondents, such as familiar situations and equipment, and identified areas of confusion or low acceptance. A key finding was the need for a clear product identity reflecting malaria.
CONCLUSION
Simple modifications profoundly affected the perception of PMC and influenced acceptability. Iterative quantitative investigation resulted in PMC-specific materials suited to the local context and socio-cultural norms of the target population with the aim of increasing access to chemoprevention in children most at risk of severe malaria.
Topics: Mozambique; Benin; Malaria; Antimalarials; Chemoprevention; Humans; Cote d'Ivoire; Drug Combinations; Pyrimethamine; Sulfadoxine; Child, Preschool; Female; Male; Drug Packaging; Infant; Child; Adult
PubMed: 38773567
DOI: 10.1186/s12936-024-04977-0 -
Cureus Apr 2024Coma blisters, or coma bullae, are lesions often seen in the setting of impaired consciousness. Most commonly associated with drug-induced comas, coma bullae have been...
Coma blisters, or coma bullae, are lesions often seen in the setting of impaired consciousness. Most commonly associated with drug-induced comas, coma bullae have been repeatedly linked to central nervous system (CNS) depressing agents, such as opiates. These lesions are believed to develop due to a complex multifactorial process involving external pressure on the skin, which leads to hypoxia and eventual death of eccrine sweat glands. In addition, the vasoactive and inflammatory properties of CNS depressing agents may play a role in this process. Come bullae usually develop on pressure points 48-72 hours after the onset of impaired consciousness and are self-limiting. We present the case of a 68-year-old male who was brought to the emergency department after being found unresponsive on the street. The urine drug screen was positive for cocaine and fentanyl. The initial examination showed several large, non-tender bullae on his scalp that continued to expand over two days. He subsequently developed similar lesions on his thighs, right shoulder, and knuckles. Dermatology was consulted and clinically diagnosed the patient with coma bullae, likely attributed to his altered consciousness and opiate use. Notably, more violaceous bullae were found on the bilateral lower extremities, with dermatology suspecting additional vasculitic features related to concurrent opiate and cocaine use. Skin biopsy and aspiration were deferred to avoid the risk of infection, and the patient was discharged per dermatology's recommendations for no immediate intervention. He continued to follow with wound care for the next six months, with most of the bullae healing. However, eschars developed over the scalp and left lower extremity, requiring debridement by general surgery. This case report underscores a unique manifestation of coma bullae. Unlike typical presentations localized to pressure-dependent areas and appearing after two to three days of unconsciousness, our patient exhibited blisters in atypical sites with associated vasculitic features. Moreover, the development of eschars over time may be linked to ongoing vasoactive drug use, reperfusion injury, and social determinants of health. This case highlights the complex and multifactorial nature of coma bullae, emphasizing the challenges in wound care and management despite their expected self-resolution.
PubMed: 38770478
DOI: 10.7759/cureus.58646