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International Journal of Women's... Oct 2024Hidradenitis suppurativa (HS) is a chronic skin disease characterized by recurrent nodules that affect areas with a high density of apocrine sweat glands, such as the...
BACKGROUND
Hidradenitis suppurativa (HS) is a chronic skin disease characterized by recurrent nodules that affect areas with a high density of apocrine sweat glands, such as the axillae and groin. Androgens are implicated in the pathophysiology of HS. Therefore, spironolactone, an antiandrogen therapy, is recommended. However, data on its use in women of childbearing age are limited, especially since its antiandrogenic effects may affect menstruation, fertility, and pubertal development.
OBJECTIVE
To evaluate the efficacy and safety of spironolactone in the treatment of hidradenitis suppurativa in women of childbearing age and to identify factors associated with treatment response.
METHODS
A retrospective analysis was conducted on female patients aged 12 to 50 with HS treated with spironolactone at Michigan Medicine dermatology clinics from 2000 to 2021. The patients' demographic data, HS characteristics, and spironolactone responses were examined. Statistical assessments were performed to determine the efficacy indicators.
RESULTS
Of the 157 patients reviewed, 31 showed an improvement in treatment. Variables such as axillary involvement, previous treatment failures, and use of intralesional steroids were linked to a lack of improvement in spironolactone. Through adjusted multiple logistic regression analysis, a significant association was observed between improvement status and Hurley stage 3 (odds ratio = 0.15 [95% CI: 0.02-0.79], = .036), suggesting that patients with Hurley stage 3 were 85% less likely to exhibit improvement in spironolactone therapy.
LIMITATIONS
The study's retrospective nature and reliance on single-center data can limit generalizability. The sample size is limited and therefore affects the study's statistical power.
CONCLUSION
Thus, spironolactone may offer therapeutic benefits for HS in women of childbearing age. However, patients with severe disease (Hurley stage 3) had reduced response rates. Further prospective studies are recommended to validate these findings and determine the most suitable patient profile for spironolactone therapy for HS.
PubMed: 38957411
DOI: 10.1097/JW9.0000000000000159 -
BMC Anesthesiology Jul 2024Nefopam and propacetamol are the most commonly used analgesics in postoperative multimodal analgesic regimens. Distinct mechanisms are involved in each drug's... (Randomized Controlled Trial)
Randomized Controlled Trial Comparative Study
Comparison of analgesic effectiveness between nefopam and propacetamol in living kidney donors following rectus sheath block after hand-assisted living donor nephrectomy: a prospective, randomized controlled trial.
BACKGROUND
Nefopam and propacetamol are the most commonly used analgesics in postoperative multimodal analgesic regimens. Distinct mechanisms are involved in each drug's anti-nociceptive effects. No studies have compared pain relief efficacy between the two drugs in patients undergoing transplantation surgery. Here, we investigated whether the administration of nefopam or propacetamol to healthy living kidney donors who underwent rectus sheath block (RSB) for parietal pain could reduce the subsequent opioid dose necessary to produce adequate analgesia.
METHODS
This prospective, randomized controlled trial included 72 donors undergoing elective hand-assisted living donor nephrectomy into two groups: propacetamol (n = 36) and nefopam (n = 36). Intraoperative RSB was performed in all enrolled donors. The primary outcome was the total volume of intravenous opioid-based patient-controlled analgesia (PCA) used on postoperative day 1 (POD 1). Additionally, the Numeric Rating Scale scores for flank (visceral) and umbilicus (parietal) pain at rest and during coughing were compared, and the Korean adaptation of the Quality of Recovery-15 Questionnaire (QoR-15 K) was evaluated on POD 1.
RESULTS
Both groups had similar preoperative and intraoperative characteristics. On POD 1, the total amount of PCA infusion was significantly lower in the nefopam group than in the propacetamol group (44.5 ± 19.3 mL vs. 70.2 ± 29.0 mL; p < 0.001). This group also reported lower pain scores at the flank and umbilical sites and required fewer rescue doses of fentanyl in the post-anesthesia care unit. However, pain scores and fentanyl consumption in the ward were comparable between groups. The QoR-15 K scores were similar between groups; there were substantial improvements in breathing, pain severity, and anxiety/depression levels in the nefopam group. The incidences of postoperative complications, including sweating and tachycardia, were similar between groups.
CONCLUSION
Compared with propacetamol, nefopam provides a greater analgesic effect for visceral pain and enhances the effects of blocks that reduce the opioid requirement in living kidney donors with parietal pain managed by RSB.
TRIAL REGISTRATION
The trial was registered prior to patient enrollment in the clinical trial database using the Clinical Research Information Service (registration no. KCT0007351 , Date of registration 03/06/2022).
Topics: Humans; Nefopam; Nephrectomy; Male; Female; Prospective Studies; Living Donors; Pain, Postoperative; Acetaminophen; Nerve Block; Adult; Analgesics, Non-Narcotic; Middle Aged; Analgesics, Opioid; Analgesia, Patient-Controlled; Rectus Abdominis
PubMed: 38956473
DOI: 10.1186/s12871-024-02607-5 -
Journal of Drugs in Dermatology : JDD Jul 2024Syringomas are benign neoplasms derived from eccrine sweat glands. Eruptive syringomas are a subtype of syringomas and are typically located on the chest, neck, and...
Syringomas are benign neoplasms derived from eccrine sweat glands. Eruptive syringomas are a subtype of syringomas and are typically located on the chest, neck, and abdomen during puberty or childhood. Herein, we present a 20-year-old African American female with an atypical case of eruptive syringomas, characterized by an unusual distribution on her chest, abdomen, and anterior and posterior bilateral extremities. This case underscores the importance of recognizing diverse presentations of skin conditions in patients with skin of color and adds to the limited reports of eruptive syringoma in these populations. We present and emphasize this atypical manifestation of eruptive syringomas in an individual with darker skin to promote awareness and improve diagnosis and patient outcomes.J Drugs Dermatol. 2024;23(7):564-566. doi:10.36849/JDD.8103.
Topics: Humans; Syringoma; Female; Sweat Gland Neoplasms; Young Adult; Skin Pigmentation; Black or African American
PubMed: 38954623
DOI: 10.36849/JDD.8103 -
Clinical, Cosmetic and Investigational... 2024Hypohidrotic ectodermal dysplasia (HED) is a genetic disorder that influences structures of ectodermal origin, such as teeth, hair, and sweat glands. Compared with...
INTRODUCTION
Hypohidrotic ectodermal dysplasia (HED) is a genetic disorder that influences structures of ectodermal origin, such as teeth, hair, and sweat glands. Compared with autosomal recessive and dominant modes of inheritance, the X-linked HED (XLHED) characterized by Hypodontia/Oligodontia teeth, Absent/sparse hair, Anhidrosis/hypohidrosis, and characteristic facial features, is the most frequent and its primary cause is the mutation of ectodysplasin A (EDA) gene. This research aimed to expound the clinical and molecular features of a Chinese male with XLHED and to summarize and compare several previous findings.
METHODS
Genomic DNA was obtained from the peripheral blood of the proband and his family members, then Sanger sequencing was used to perform a mutational analysis of . Real-time quantitative PCR and Western blotting were used to detect EDA expression. The transcriptional activity of NF-κB was detected using a luciferase assay.
RESULTS
The probandwith XLHED was identified a novel mutation, c.1119G>C(p.M373I), that affected the molecular analysis of transmembrane protein exon8 mutations, inherited from the mother. He showed a severe multiple-tooth loss, with over 20 permanent teeth missing and sparse hair and eyebrows, dry, thin, and itching skin. Furthermore, his sweating function was abnormal to a certain extent.
DISCUSSION
The functional study showed that this novel mutant led to a significant decrease in the EDA expression level and transcriptional activity of NF-κB. Our findings extend the range of mutations in XLHED patients, which provides the basis and idea for further exploring the pathogenesis of XLHED.
PubMed: 38952411
DOI: 10.2147/CCID.S451125 -
ACS Applied Materials & Interfaces Jul 2024An essential requirement for biomedical devices is the capability of conformal adaptability on diverse irregular 3D (three-dimensional) nonflat surfaces in the human...
An essential requirement for biomedical devices is the capability of conformal adaptability on diverse irregular 3D (three-dimensional) nonflat surfaces in the human body that may be covered with liquids such as mucus or sweat. However, the development of reversible adhesive interface materials for biodevices that function on complex biological surfaces is challenging due to the wet, slippery, smooth, and curved surface properties. Herein, we present an ultra-adaptive bioadhesive for irregular 3D oral cavities covered with saliva by integrating a kirigami-metastructure and vertically self-aligning suction cups. The flared suction cup, inspired by octopus tentacles, allows adhesion to moist surfaces. Additionally, the kirigami-based auxetic metastructure with a negative Poisson's ratio relieves the stress caused by tensile strain, thereby mitigating the stress caused by curved surfaces and enabling conformal contact with the surface. As a result, the adhesive strength of the proposed auxetic adhesive is twice that of adhesives with a flat backbone on highly curved porcine palates. For potential application, the proposed auxetic adhesive is mounted on a denture and performs successfully in human subject feasibility evaluations. An integrated design of these two structures may provide functionality and potential for biomedical applications.
PubMed: 38949691
DOI: 10.1021/acsami.4c03363 -
Molecular Imaging and Radionuclide... Jun 2024A 58-year-old man presenting with dyspnea, weight loss, and night sweating underwent F-fluorodeoxyglucose positron emission tomography/computed tomography (F-FDG PET/CT)...
A 58-year-old man presenting with dyspnea, weight loss, and night sweating underwent F-fluorodeoxyglucose positron emission tomography/computed tomography (F-FDG PET/CT) because of a suspicion of malignancy. F-FDG PET/CT demonstrated mild to moderate uptake on nasal, cricoid, and tracheobronchial tree cartilages and costovertebral junctions. The diagnosis was relapsing polychondritis, which is a rare multisystem disease characterized by inflammation of cartilage. In addition, subsequent F-FDG PET/CT after treatment showed complete metabolic response.
PubMed: 38949460
DOI: 10.4274/mirt.galenos.2023.80958 -
Cureus May 2024Pheochromocytoma is a rare endocrine tumor originating from chromaffin cells of the adrenal medulla, which leads to the overproduction of catecholamines. Most symptoms,...
Pheochromocytoma is a rare endocrine tumor originating from chromaffin cells of the adrenal medulla, which leads to the overproduction of catecholamines. Most symptoms, ranging from simple headaches to life-threatening cardiac arrests, are due to excess catecholamines. Usually, patients present with persistent or paroxysmal hypertension, headaches, sweating, and palpitations. Here, we describe a case that initially presented as an acute coronary syndrome and was treated accordingly. However, she had a history of nocturnal awakenings and panic attacks, which she had ignored for a month. On further evaluation, it turned out to be pheochromocytoma. This case report will surely help physicians better diagnose and treat such cases.
PubMed: 38947651
DOI: 10.7759/cureus.61389 -
The Pan African Medical Journal 2024Syringomatous tumor of the nipple is a benign, locally infiltrative tumor. There are reports in the literature of tumor recurrence in cases of incomplete excision....
Syringomatous tumor of the nipple is a benign, locally infiltrative tumor. There are reports in the literature of tumor recurrence in cases of incomplete excision. Clinical and mammographic findings in syringomatous tumors are like those of breast carcinoma and the pathologist has a fundamental role in final tumor diagnosis. Therefore, the aim of this study was to report a case of syringoma located in the areolar region. A 33-year-old woman reported that she had noticed a nodule in her left areolar region 4 years previously (February 2019). A breast ultrasound was performed, detecting intraparenchymatous breast cysts. Surgical resection of the nodule was indicated although it was not performed. Two years later, in August 2021, the patient underwent a mastopexy with prosthesis inclusion. Histopathology study of the surgical specimen revealed a syringomatous tumor with positive margins. Thirteen (13) months after diagnosis (September 3, 2021 - October 16, 2022), the patient is doing well and receives clinical follow-up.
Topics: Humans; Female; Adult; Breast Neoplasms; Nipples; Syringoma; Ultrasonography, Mammary; Sweat Gland Neoplasms; Follow-Up Studies; Mammaplasty
PubMed: 38946744
DOI: 10.11604/pamj.2024.48.1.37845 -
Advanced Science (Weinheim,... Jul 20242D transition metal borides (MBenes) with abundant surface terminals hold great promise in molecular sensing applications. However, MBenes from etching with...
2D transition metal borides (MBenes) with abundant surface terminals hold great promise in molecular sensing applications. However, MBenes from etching with fluorine-containing reagents present inert -fluorine groups on the surface, which hinders their sensing capability. Herein, the multilayer fluorine-free MoBT MBene (where T represents O, OH, and Cl) with hydrophilic structure is prepared by a hydrothermal-assisted hydrochloric acid etching strategy based on guidance from the first-principle calculations. Significantly, the fluorine-free MoBT-based humidity sensor is fabricated and demonstrates low resistance and excellent humidity performance, achieving a response of 90% to 98%RH and a high resolution of 1%RH at room temperature. By combining the experimental results with the first-principles calculations, the interactions between MoBT and HO, including the adsorption and intercalation of HO, are understood first in depth. Finally, the portable humidity early warning system for real-time monitoring and early warning of infant enuresis and back sweating illustrates its potential for humidity sensing applications. This work not only provides guidance for preparation of fluorine-free MBenes, but also contributes to advancing their exploration in sensing applications.
PubMed: 38946710
DOI: 10.1002/advs.202404178 -
Work (Reading, Mass.) Jun 2024Nurses are among high-risk occupational groups during the outbreak of epidemics. Therefore, these people are required to use personal protective equipment (PPE)....
BACKGROUND
Nurses are among high-risk occupational groups during the outbreak of epidemics. Therefore, these people are required to use personal protective equipment (PPE). Previous studies have shown that the use of personal protective equipment can affect people's thermal strain and mental workload.
OBJECTIVE
The present study was conducted with the aim of objectively and subjectively evaluating the use of protective clothing on the thermal strain and mental workload of nurses during the covid-19 pandemic.
METHODS
This cross-sectional study was divided into two groups with a sample size of 300 people who were selected by systematic random method. In the first group, 120 people were objectively evaluated (use of protective clothing). In the second group, 180 people only completed the questionnaire of mental workload, feeling of heat and sweating and other information related to the type of clothing and the duration of its use, etc. Measurements were done in August and September of 2021 and in the morning shift of hospitals. Data were analyzed using SPSS version 21 software and chi-square, independent T-test and linear regression tests.
RESULTS
The average age and average working hours per month of the participants in the study were 33.51±7.88 years, 187.91±35.37 hours, respectively. The results showed that the predicted average vote (PMV) index and the predicted percentage of dissatisfied (PPD), moisture felt on the skin surface, the feeling of desirability and pleasantness of the temperature, the weight of sweat and the humidity inside the clothes between the two groups of people using insulated clothes There is a significant difference between medicine and dressing (P < 0.05). There was a significant relationship between mental workload and type of clothing, average working hours per month.
CONCLUSIONS
The use of medical isolation clothes causes a high heat load on nurses and can increase their mental workload. On the other hand, people using normal gowns suffer from a high mental workload due to the fear of disease due to the uncertainty of high-level protection. In addition, medical isolation clothes increase the humidity of the skin due to their impermeability, which causes skin complications.
PubMed: 38943418
DOI: 10.3233/WOR-230396