Mesh penetrating the cecum and bladder following inguinal hernia surgery: a case report

Tension-free repair using mesh is a common inguinal hernia surgical procedure. However, various complications such as mesh-related infection and recurrence may develop as a result. Moreover, although rare, the...

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Optical Coherence Tomography Evolution in a Case of X-Linked Juvenile Retinoschisis: 15 Years of Follow-Up

Purpose: We present the evolution of X-linked juvenile retinoschisis (XLRS) in a male patient using optical coherence tomography (OCT) with a long-term follow-up time of 15 years. Case Description: A 10-year-old male patient presented at the Medical Retina Department of our hospital complaining for blurred vision in both eyes. At the initial presentation in 2001, his best corrected visual acuity (BCVA) was 6/12 in both eyes on the Snellen chart. Based on clinical and OCT findings, the diagnosis of XLRS was made, and it was confirmed by genetic testing. No treatment was performed, but the patient was regularly examined. His BCVA and OCT findings remained relatively stable from 2001 to 2012, when BCVA decreased to 6/18 and 6/24 in the right and left eye, respectively. In 2016, his BCVA was 6/24 and 6/36 in right and left eye, respectively, while OCT depicted significant macular thinning, accompanied by irregularities of the foveal contour in both eyes. Conclusion: Patients with XLRS should be monitored regularly to evaluate the progression of the disease and manage the potential complications.
Case Rep Ophthalmol 2017;8:459–464

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The unregulated use of melanotan-II is of public health interest to Australian dermatologists

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Expressions of p53 and PUMA in fibroblasts of systemic sclerosis patients are normal at transcription level

Summary

Background

Systemic sclerosis (SSc) fibroblasts show resistance apoptosis mechanisms, which enhances the fibrosis stage of the disease. Impaired function of p53 upregulated modulator of apoptosis (PUMA) has been related to deficits in p53-dependant apoptosis pathway. This study aimed to evaluate the transcriptional levels of p53 and PUMA mRNAs in fibroblasts from SSc patients and compare it with healthy individuals.

Methods

In this case-control study, skin biopsy samples were obtained from 19 patients with diffuse cutaneous SSc (DcSSc) and 16 healthy controls. Afterward, dermal fibroblasts were isolated and cultured. After extraction of total RNA from cultured fibroblasts, complementary DNA (cDNA) was synthesized. mRNA quantification was carried out using real-time PCR, SYBR Green PCR master mix, and specific primers for p53 and PUMA.

Results

No significant alteration was observed in mRNA expression levels of p53 and PUMA (P = .99 and .23, respectively) in fibroblasts from SSc patients compared with controls.

Conclusions

Apoptosis pathways are impaired in fibroblasts from patients with SSc, leading to chronic fibrosis. Nonetheless, PUMA/p53 pathway may not be involved in dysfunction of apoptosis mechanisms in fibroblasts of patients with SSc.

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Checkpointinhibitoren beim nichtkleinzelligen Lungenkarzinom

Zusammenfassung

Hintergrund

Die moderne Immuntherapie mit Checkpointinhibitoren hat unaufhaltsam Einzug in die Behandlung des nichtkleinzelligen Lungenkarzinoms (NSCLC) gehalten.

Fragestellung

Studien zu Checkpointinhibitoren beim fortgeschrittenen NSCLC wurden auf ihre Ergebnisse hinsichtlich Effektivität und Toxizität analysiert und bewertet.

Material und Methode

Phase-I-, Phase-II- und Phase-III-Studienergebnisse zu neuen Checkpointinhibitoren beim fortgeschrittenen NSCLC wurden aus der Literatur (Pubmed) und aus Beiträgen auf großen internationalen Kongressen (ASCO, ESMO, WCLC) zusammengestellt.

Ergebnisse

Für die beiden PD-1-Antikörper Nivolumab und Pembrolizumab existieren bereits große Phase-III-Studien beim fortgeschrittenen NSCLC in der Second- und First-Line-Therapie. Zulassungen sind für Nivolumab (ohne Markerbezug, Zweitlinie) und Pembrolizumab (bei PD-L1-Expression ≥ 1 % „tumor proportion score", ​TPS; Zweit- und Drittlinie) beim fortgeschrittenen NSCLC und für Pembrolizumab in der Erstlinie bei Hochexpression des Immunmarkers PD-L1 (≥50 % TPS) von der EMA (European Medicines Agency) ausgesprochen worden. Erste Ergebnisse von Phase-III-Studien mit PD-L1-Antikörpern sind für das Atezolizumab bereits berichtet worden (OAK-Studie) oder werden für das Durvalumab aktuell noch erwartet (MYSTIC-Studie). Für Kombinationen mit konventioneller Chemotherapie und Kombinationen mit anderen Checkpointinhibitoren wie CTLA4-Antikörpern fehlen noch die abschließenden Ergebnisse von großen Phase-II- bzw. Phase-III-Studien.

Schlussfolgerungen

Die moderne Immuntherapie mit einem PD-1-Antikörper hat sich als integrale Behandlungsoption beim fortgeschrittenen NSCLC klar etabliert. In Zukunft wird die Suche nach besseren prädiktiven Faktoren und Markern für einen eher selektiven Einsatz dieser hochwirksamen, aber spezifischen Medikamente essenziell werden.

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Efficacy and safety of ixekizumab for the treatment of moderate-to-severe plaque psoriasis: Results through 108 weeks of a randomized, controlled phase 3 clinical trial (UNCOVER-3)

Ixekizumab, a high-affinity monoclonal antibody that selectively targets interleukin 17A, is efficacious in treating moderate-to-severe plaque psoriasis through 60 weeks.

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A new evidence-based risk stratification system for cutaneous squamous cell carcinoma into low, intermediate, and high risk groups with implications for management

Most primary cutaneous squamous cell carcinomas are cured with surgery. A subset, however, may develop local and nodal metastasis that may eventuate in disease-specific; death. This subset has been variably termed high risk. Herein, we review; an emerging body of data on the risks of these outcomes and propose an evidence-based; risk stratification for low-, intermediate-, and high-risk tumors that takes into; account both tumor and patient characteristics. Finally, we discuss a framework for; management of these tumors on the basis of data, when available, and our; recommendations when data are sparse.

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