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Skin pH mapping and its relationship with transepidermal water loss, hydration and disease severity in adult patients with atopic dermatitis.

Defective skin's acidic mantle is a component of atopic dermatitis (AD) pathophysiology. We mapped the skin pH and determine its relationship with transepidermal water loss (TEWL), hydration and disease severity.

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Anatomic Lead Placement Without Paresthesia Mapping Provides Effective and Predictable Therapy During the Trial Evaluation Period: Results From the Prospective, Multicenter, Randomized, DELIVERY Study.

The purpose of this study was to compare the trial success rate between anatomic lead placement (AP) and paresthesia-mapped (PM) lead placement techniques for spinal cord stimulation (SCS) using a nonlinear burst stimulation pattern.

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Bilateral subcostal transversus abdominis plane block as a component of multimodal analgesia.

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Reply: OnabotulinumtoxinA should be considered in medication overuse withdrawal in patients with chronic migraine.

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Cat Allergy as a Source Intensification of Atopic Dermatitis in Adult Patients.

Atopic dermatitis (AD) is characterized by exacerbations and remissions of eczematous skin, underlain by impaired skin barrier and aberrant Th2-type and Th-22 cytokine production. A number of allergens, in particular contact with fur animals, may aggravate the disease. This study seeks to define the influence of having a regular contact with a pet cat at home on the severity of symptoms and signs of AD. We addressed the issue using the SCORing Atopic Dermatitis (SCORAD) and visual analog (VAS) scores to assess the intensity of pruritus and by measuring the blood content of specific IgE and IL-4, IL-13, and IL-22 cytokines. The study group consisted of 47 adult patients suffering from AD since childhood, 18 of whom declared having regular contact with a cat and the remaining 29 who denied it. There also was a control group consisted of 16 healthy volunteers with no AD signs. The SCORAD and VAS scores were significantly higher in patients in contact with a cat than in those without it (median SCORAD 61.0 vs. 50.4 and VAS 9.0 vs. 4.0 points, respectively). The sIgE of a majority of patients (94.4%) in contact with a cat was in Class V-VI, compared with just a few patients (3.4%) with no such contact, having sIgE in the same classes (p < 0.001). Significant correlations were revealed between SCORAD and VAS scores and the class level of serum sIgE value. In addition, IL-22 was a single elevated cytokine, only in the patients in contact with a cat, and it correlated with pruritus severity. The results of the study underline the need to beware of the cat fur allergen, and they stress forethought and caution in acquiring and keeping a pet cat by patients suffering from AD.

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Inhibition of IL-6 expression by lignans and other constituents isolated from Schefflera rubriflora C. J. Tseng & G. Hoo.

Schefflera rubriflora, a plant native to Yunnan Province in China, is often used to treat ailments such as neuropathic pain, tracheitis, and cough. However, the active components imparting these pharmacological effects are largely unexplored. In this study, five novel lignans and three new derivatives of benzoid or pyran were isolated from the leaves and twigs of S. rubriflora. The structures of these compounds were determined by the comprehensive analyses of the 1D and 2D NMR spectra and ESI mass spectra and a comparison of the obtained data with those of the literature data. All the compounds were tested for the inhibition of IL-6 expression. Three of the isolated compounds could inhibit the expression by 52% to 72%.

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Hemodialysis-associated soft tissue amyloidomas of the chest and abdominal wall.

Amyloidoma is a highly unusual presentation of amyloidosis in tumoral or nodular form. Isolated soft tissue amyloidomas in individuals with end-stage renal disease on chronic hemodialysis is exceedingly rare, particularly in the era of advanced dialysis technologies. We report the case of a 55-year-old male with end-stage renal disease due to autosomal-dominant polycystic kidney disease, on HD for over 30 years, who was found to have soft-tissue, dialysis-related (β -microglobulin) amyloidomas (DRA). He presented with painful, palpable masses within the thoracic and abdominal walls. Serum β -microglobulin level was only mildly elevated at 24.9 mg/L. Biopsy confirmed amyloidosis with positivity for Congo Red staining and apple-green birefringence under polarized light. Amyloid subtyping with immunohistochemistry showed positive β -microglobulin staining within the deposits. Conservative therapy involving pain management and close monitoring resulted in eventual improvement in symptoms and thus proved to be a viable option for treatment.

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Ultrasound-guided superficial serratus plane block in dog cadavers: an anatomical evaluation and volume dispersion study.

To evaluate the anatomy of the serratus plane in dogs to establish the optimal landmarks for a superficial serratus plane (SSP) block and evaluate ropivacaine-methylene blue solution dispersion with three volumes of injection.

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Tailored Posterior-only Approach for C2 vertebral body lesions: Our Surgical Experience in 10 Patients.

C2 vertebral body (axis) lesions are often approached anteriorly combined with posterior stabilization of craniovertebral junction (CVJ). The anterior approach has its limitations. A posterolateral corridor is an alternative access to the C2 body lesions, and this alone may suffice in selected cases. We describe our experience with C2 body lesions, dealt primarily through posterior approach, and propose an algorithm in the management of such cases.

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Temporomandibular Disorders and Oral Features in Systemic Lupus Erythematosus Patients: An Observational Study of Symptoms and Signs.

: Systemic Lupus Erythematosus (SLE) is a connective tissue disease characterized by a wide range of pleomorphic pictures, including mucocutaneous, renal, musculoskeletal and neurological symptoms. It involves oral tissues, with hyposalivation, tooth decay, gingivitis, angular cheilitis, ulcers and glossitis. Temporomandibular disorders represent a heterogeneous group of inflammatory or degenerative diseases of the stomatognatic system, with algic and/or dysfunctional clinical features involving temporomandibular joint (TMJ) and related masticatory muscles. The aim of this study was to investigate the prevalence of oral manifestations and temporomandibular disorders (TMD) in SLE patients (Lp) compared with a control group. : Fifty-five patients (9 men and 46 women) with diagnosed Lupus were recruited in the study group. A randomly selected group of 55 patients, matched by sex and age, served as control group. The examination for TMD symptoms and signs was based on the standardized Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) through a questionnaire and clinical examination. : Lupus patients complained more frequently (95.8%) of oral and TMJ symptoms (dysgeusia, stomatodynia, masticatory muscle pain during function, neck and shoulder muscles pain and presence of tinnitus) but only xerostomia (χ=4,1548 =0,0415), temple headache (χ=4,4542 =0,035) and the sensation of a stuck jaw (Mid-p-test =0,043) were significant. About signs, cheilitis (=0,0284) oral ulcers (χ=4,0104 =0,045) and fissured tongue are significantly more frequent in study group. The salivary flow was significantly decreased in the study group respect to the control one (p<0.0001). As regard to the oral kinematics, restricted movements (RM) in protrusion and left lateral movement were significantly different between study group and controls. In particular, 85,2% of Lp showed limited protrusion versus 56,4% of controls (χ= 10,91 <0,001); 59,3% of Lp had also a limitation during left lateral movement versus 47,3% of controls (T=2,225 =0,0282). About bruxism, only the indentations on the lateral edges of the tongue were found in Lp group (72,7%), with a significant difference respect to controls (χ=7,37 =0,007). While masticatory muscles have an overlapping behavior in both groups, the findings collected show a more severe TMJ kinematic impairment in Lp than in controls, with protrusion and left lateral movements significantly different. In addition, a remarkable reduction of salivary flow has been detected in Lp compared to controls. In conclusion, this autoimmune disease seems to play a role in oral manifestations and TMJ disorders, causing an increase in orofacial pain and an altered chewing function.

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