1,720,974 research outputs found
Novel variant c.7795-1G>A of COL7A1 gene in a 12-month-old female child with recessive dystrophic epidermolysis bullosa treated with dupilumab
Full text linkWidespread rash in a 45-year-old woman after moxifloxacin administration
No full textA 45-year-old African woman presented with fever, throat pain, and a rapidly deteriorating rash after taking moxifloxacin for ten days. She exhibited extensive erythematous and purpuric macules, blisters, and significant mucosal involvement, covering 40% of her body surface area
How Hormonal Balance Changes Lives in Women with Psoriasis
Full text linkPsoriasis is a chronic, immune-mediated skin disease significantly impacting women, with disease severity often modulated by hormonal fluctuations. This review examines the influence of hormonal changes on the course of psoriasis in women, focusing on key life stages—including the menstrual cycle, pregnancy, postpartum, and menopause—and their impact on disease progression and symptomatology. Estrogen, the principal female sex hormone, plays a critical role in immune modulation. Variations in estrogen levels, which occur naturally throughout a woman’s life, are associated with fluctuations in psoriasis severity. Low estrogen levels, as seen during menstruation or menopause, are linked to symptom exacerbation, while elevated levels during pregnancy may reduce symptoms in some women. However, responses are variable, with others experiencing no change or worsening during pregnancy. Postpartum, the rapid decline in estrogen often triggers severe flare-ups, while menopause, marked by a sustained estrogen reduction, frequently correlates with increased disease severity and flare frequency. The review also addresses the profound impact of psoriasis on women’s quality of life, including physical discomfort, psychological distress, and social stigma. Additionally, fertility concerns are discussed, as severe psoriasis and associated treatments may increase the risk of adverse pregnancy outcomes. Consideration is given to hormonal therapies, lifestyle modifications, and their effects on psoriasis, underscoring the need for personalized treatment approaches that account for hormonal influences. Understanding these hormonal dynamics is essential for developing targeted, effective management strategies that enhance quality of life for women affected by psoriasis
Expanding the potential of monoclonal antibodies against interleukin-4 and interleukin-13 in genodermatoses: A case series on the efficacy and safety of dupilumab in epidermolysis bullosa and ichthyosis
No full textsyndrome in a patient undergoing stem cell transplantation: Can sirolimus be involved?
Full text linkAbstract We present a case of sirolimus‐induced drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome in a stem cell transplant patient. Sirolimus is an immunosuppressive drug that inhibits the mammalian target of rapamycin (mTOR) pathway. A 24‐year‐old male with a history of acute lymphoblastic leukemia (ALL) underwent testicular extraction followed by hematopoietic stem cell transplantation (HSCT). He presented with pruritic eczematous lesions, which were initially treated with topical steroids. However, he later developed diffuse xerosis, fever, chills, generalized edema, weight gain, eosinophilia, and leukopenia. Skin biopsy showed spongiotic dermatitis with eosinophils, suggesting a drug or atopic reaction. Investigations ruled out infections, and the RegiSCAR score indicated drug reaction syndrome with eosinophilia and systemic symptoms (DRESS). Sirolimus, an immunosuppressive drug, was suspected as the cause. Sirolimus was discontinued, and oral steroids were initiated. After 3 weeks of therapy, the patient showed improvement with resolution of symptoms. Although no cases of sirolimus‐induced DRESS syndrome have been reported, allergic reactions with eosinophilia induced by everolimus have been documented. In our case, the patient's history characterized by stem cell transplantation and multiple immunosuppressive therapies may have contributed to the development of DRESS syndrome after beginning sirolimus therapy. This case may be the first evidence of sirolimus‐induced DRESS syndrome in a stem cell transplant patient
Acute phase optimization in burn care: Online tools and comprehensive predictive models for adult and pediatric patients
No full textBackground
Severe burn injuries significantly challenge acute medical care, particularly in resource-limited environments. Current predictive scoring systems, often impractical and adult-focused, neglect crucial aspects like mechanical ventilation and length of hospital stay (LOS).
Methods
This study analyzed 2,618 severe burn patients, developing new predictive models for survival, mechanical ventilation, and LOS, based on promptly accessible factors applicable in any setting.
Results
We observed significant seasonality and clear age- and gender-specific patterns, highlighting the necessity for targeted interventions. We developed and publicly released new predictive models for mortality, mechanical ventilation, and LOS for both adult and pediatric populations.
Discussion
Targeting deficiencies in existing scoring systems, this study potentially advances acute burn management, with a particular focus on resource-limited settings. It provides crucial insights into the epidemiology, etiology, and prognostic factors of severe burn injuries, encapsulated in 10 actionable points. We also present an innovative freely accessible online assessment tool:
https://burn-scores.com
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Conclusion
By bridging gaps in current scoring methodologies and improving acute phase management, our research offers insights to improve clinical outcomes for severe burn patients globally. The integration of tailored predictive models and technology-driven solutions, especially relevant in resource-constrained settings, represents a major stride in enhancing the quality of burn care
Do Tumor SURVIVIN and MDM2 Expression Levels Correlate with Treatment Response and Clinical Outcome in Isolated Limb Perfusion for In-Transit Cutaneous Melanoma Metastases?
Full text linkIsolated limb perfusion (ILP) involves the local administration of high doses of anticancer drugs into a limb affected by unresectable locally advanced tumors (with special regard to in-transit melanoma metastases), minimizing systemic side effects. Tumor response to anticancer drugs may depend on the expression of apoptosis-related genes, such as SURVIVIN and MDM2. This retrospective cohort study investigated the association between tumor SURVIVIN and MDM2 expression levels and treatment response or clinical outcomes in patients undergoing ILP for in-transit melanoma metastases. The study cohort consisted of 62 patients with in-transit metastases who underwent ILP with tumor necrosis factor (TNF) and melphalan. Tissue samples were taken from the in-transit metastases, and RNA was extracted for gene expression analysis. Patients' response to treatment was assessed using clinical and radiological criteria two months after ILP, and disease response was classified as complete, partial, or stable/progressive disease. Disease-free survival (DFS) and overall survival (OS) were also analyzed. Expression of SURVIVIN and/or MDM2 was observed in 48% of patients; in these cases, complete response to ILP occurred in 40% of cases, with the overall response rate (complete + partial) being 85%. Patients with expression of MDM2 alone had a lower complete response rate (28%), while patients with expression of SURVIVIN alone had a higher complete response rate (50%). The combined expression of MDM2 and SURVIVIN resulted in a complete response rate of 30%. Patients without expression (of SURVIVIN or MDM2) had the highest complete response rate (58%). Survival analysis showed that high MDM2 expression was independently associated with a lower probability of a complete response to ILP. In addition, patients with MDM2 expression were three times more likely to have an incomplete response to ILP. This study highlights the importance of considering SURVIVIN and MDM2 expression in patients undergoing ILP for in-transit cutaneous melanoma metastases. High MDM2 expression was found to be an independent factor associated with a reduced likelihood of achieving a complete response to ILP, suggesting potential mechanisms of chemoresistance. These data support further research to explore the role of already available targeted therapies (i.e., MDM2 inhibitors) in improving tumor response to ILP in patients with in-transit melanoma metastases
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