Δευτέρα 27 Μαΐου 2019

Association between geographic tongue (GT) and fissured tongue with ABO blood group among adult psoriasis patients

Publication date: June 2019

Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 127, Issue 6

Author(s): Nabeeh A. Al Qahtani, Angeline Deepthi, Nada Mohammed Alhussain, Bashayer Ayesh Mohammed Al Shahrani, Hamza Alshehri, Amal Alhefzi, Betsy Joseph

Objective

We aimed to determine if there was any association between geographic tongue (GT) and fissured tongue with ABO blood group among adult psoriasis patients in Saudi Arabia.

Study Design

This hospital-based cross-sectional study included 100 consecutive new adult patients diagnosed with psoriasis and 100 case-matched participants in the control group (nonpsoriatic). Sociodemographic and dermatologic parameters, intraoral lesions (GT and fissured tongue), and ABO blood grouping and immunoglobulins were recorded and evaluated using χ2 or Fisher's exact test.

Results

A total of 74% of patients had an early age of onset, and 48% of them reported this disease in their parents. A total of 76% of those with generalized psoriasis had plaque type, whereas 78% with the localized type had pustular lesions. A total of 70% of psoriatic patients had O Rh-positive blood; 63% of tongue lesions seen in these patients were GT, and it was most prominent in O Rh-positive (64.28%) and O Rh-negative (62.50%) blood types. GT was prevalent among women (75.6%).

Conclusions

This study found a positive association of both GT and fissured tongue in this population of adult patients with psoriasis compared with a case-matched control population without psoriasis.

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
6948891480

Cornulin expression helped differentiate between low-grade and high-grade oral epithelial dysplasia, making it a potential adjunct for grading oral OEDs and a potential biomarker for risk of lesion progression.

Publication date: June 2019

Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 127, Issue 6

Author(s): Neetha Santosh, Kristin K. McNamara, F. Michael Beck, John R. Kalmar

Objective

The aim of this study was to evaluate expression of cornulin in oral mucosa as an adjunct to histopathologic grading of oral epithelial dysplasia (OED).

Study Design

Biomarker expression was assessed in normal oral mucosa, low-grade OED (LD), high-grade OED (HD), and oral squamous cell carcinoma (OSCC) by using immunohistochemistry. Photomicrographs were evaluated with Aperio Imagescope using a positive-pixel-counting algorithm. A histo-score (H-score) was calculated on the basis of staining intensity and the percentage of positive cells (%-staining). Intrarater reliability for H-score and %-staining was determined by calculating interclass correlation coefficients. Mean differences in H-scores and %-percent staining values were each analyzed by using an analysis of variance and Tukey's post hoc procedure.

Results

Cornulin expression progressively diminished with increasing grades of dysplasia and OSCC. Interclass correlation coefficients for H-score and %-staining were each greater than 0.99. Except for OSCC versus HD, all other pairwise comparisons were statistically significant (P < .0001) for H-score and %-staining.

Conclusions

Cornulin expression helped differentiate between low-grade and high-grade oral epithelial dysplasia, making it a potential adjunct for grading oral OEDs and a potential biomarker for risk of lesion progression. Longitudinal studies evaluating risk stratification based on cornulin expression may be warranted.

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
6948891480

Congenital and pediatric nasal lesion resection and their reconstructive outcomes


Congenital and pediatric nasal lesion resection and their reconstructive outcomes are not well studied. A surgeon must consider the site, size, depth, etiology, age, and effect on future function (including growth). As such, it is important to contrast the differences between the adult's and child's nose. The authors propose that more conservative resection and reconstructive methods may better serve congenital and pediatric nasal lesions. An Internal Review Board approved study of congenital and pediatric nasal lesions using a defect only approach from 2005 to 2017 was performed. Lesions, type of surgeries, complications, aesthetic outcome, and additional interventions were reviewed. One hundred twenty-seven patients met the study criteria with a median age at surgery of 5.4 years with follow-up of 1.4 years (1 week–11.3 years). The most common diagnosis was congenital melanocytic nevus (47, 37%). The lesions were located on more than 1 subunit in 34 (27%) patients with an average surface area of 3.7 (0.04–32) cm2. The most common primary procedure was excision and primary closure with adjacent tissue undermining/rearrangement (73, 57.4%) followed by full-thickness skin graft (23, 18.1%). The aesthetic outcome was considered acceptable in a high number of patients 117 (92%), while 10 (8%) patients had unacceptable aesthetic outcomes, mostly due to scarring. The authors' data supports the concept of minimal healthy tissue excision or lesion only excision when treating pediatric and congenital nasal lesions. Address correspondence and reprint requests to Erik M. Wolfswinkel, MD, Division of Plastic and Reconstructive Surgery, Keck School of Medicine of USC, 1510 San Pablo Street, Suite 415, Los Angeles, CA 90033; E-mail: Erik.Wolfswinkel@med.usc.edu; Pedram Goel, BS, Keck School of Medicine of the University of Southern California, Los Angeles, CA, 90033; E-mail: pedramgo@usc.edu Received 16 October, 2018 Accepted 15 January, 2019 The authors report no conflicts of interest. © 2019 by Mutaz B. Habal, MD.
Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
6948891480

Acta Ecologica Sinica

Evaluating soil biochemical/microbial indices as ecological indicators of different land use/cover in northern Iran

Publication date: Available online 25 May 2019

Source: Acta Ecologica Sinica

Author(s): Negar Moghimian, Seyed Mohsen Hosseini, Yahya Kooch, Behrouz Zarei Darki

Abstract

The objective of the study was to examine changes in microbial parameters have been used to monitor changes in soil quality under different land uses in north of Iran. The microbial parameters included microbial respiration (MR), substrate induced respiration (SIR), carbon availability index (CAI), microbial biomass carbon (MBC), microbial biomass nitrogen (MBN), ratio of MBC/MBN, metabolic quotient (qCO2) and microbial ratio were determined under different land use/cover, i.e. virgin natural forest (VNF), degraded natural forest (DNF), alder plantation (AP), sequoia plantation (SP), improved fallow (IF) and home garden (HG) areas in northern Iran. Five composed samples per land use/cover were taken from the top 10 cm of the soil. MR and SIR (0.45 and 1.66 mg CO2-C g−1 day−1, respectively) were found to be significantly higher under AP land uses than in the other areas. CAI did not differ for the land uses; MBC (591 and 590 mg kg−1, respectively) had higher significantly under SP and VNF land uses than in the other areas. MBN (64.25 and 62.33, respectively mg kg−1) was significantly higher in AP and VNF land uses, ratio of MBC/MBN (17.02) was higher in SP land use than other areas, HG had significantly higher qCO2 (0.0012 μg CO2-C mg−1 MBC day−1) and finally microbial ratio was significantly higher under IF (599.16) in comparison with HG > AP ≈ DNF > VNF > SP areas. Overall, our results indicate that AP land use (Alnus subcordata C. A. Mey.) increase of soil quality and alder plantation is suitable for rehabilitation of degraded natural forests.



Floristic inventory and biological spectra of Balakot, District Mansehra, Pakistan

Publication date: Available online 25 May 2019

Source: Acta Ecologica Sinica

Author(s): Muhammad Asif, Zafar Iqbal, Jan Alam, Abdul Majid, Farhana Ijaz, Niaz Ali, Inayat Ur Rahman, Sadam Hussain, Anees Khan, Ghulam Qadir

Abstract

This study was conducted to assess the floristic composition, biological spectra and phenology of Tehsil Balakot. Frequent visits were made in different seasons during 2012–13. Field notebook was used to record the data within field. Biological spectrum and leaf sizes classes were determined. The floristic diversity revealed 228 plant species belonged to 184 genera and 72 families. Asteraceae family contributed maximum number of species (27) followed by Rosaceae (18), Apiaceae and Lamiaceae (12) species each, Papilionaceae (11) species while remaining 67 families contributed less than 10 species. Herbaceous growth form was the most leading one (71%), followed by shrub (15%) and tree (14%), respectively. Biological spectrum revealed that hemicryptophytes (32.45%) were the most prevalent, followed by therophytes (31.57%), nanophanerophytes (15.35%), megaphanerophytes (13.59%) and chamaephytes (4.38%). Leaf spectra showed that microphyll (28.94%) were dominant, followed by nanophyll (27.19%), leptophyll (22.80%), mesophyll (14.03%) and megaphyll (7.01%). The flora was influenced by two flowering seasons i.e. March to August and September to February. In the first spell, 193 species were recorded, of these 15.54% trees, 15.02% shrubs, 63.21% herbs, 3.62% grasses and 2.59% ferns; while in the second spell, there were 35 species having 2.85% trees, 17.14% shrubs, 74.28% herbs, and 5.71% grasses. The flowering data shows that June and July were the utmost flowering months with 28.50% in 65 and 20.17% in 46 plant species.



Relationship between topography and the distribution of matorral plant species in the Saharan Atlas: Case of Djebel Amour, Algeria

Publication date: Available online 24 May 2019

Source: Acta Ecologica Sinica

Author(s): Mostafa Naceur Youcefi, Mustapha Daddi Bouhoun, Abdellah Kemassi, Mohamed Didi Ould El-Hadj

Abstract

One of the primary goals in community ecology is to determine the relative importance of processes and mechanisms that control biodiversity. The reduced coverage of vegetation and the severe losses of biodiversity in semiarid matorrals have recently become serious concerns in the Saharan Atlas in southern Algeria. In terms of research, the control of the spatial distribution of vegetation by the topographic factors has not received the attention it merits in Djebel Amour's region. This study combined several multivariate analyses to assess quantitatively the extent and nature of the topographic influence on the distribution of matorral plant species. Thirty plots (20 m × 20 m) were selected according to their physiognomy for the field survey of vegetation and topography in a semiarid mountainous region. The distributions of vegetation differed significantly amongst topographies, indicating different environmental conditions and determine a turnover of important species. Most species colonize downslopes, and only some persist on steep-slopes and summits. The low coverage of vegetation (36.98%) on steep-slopes was due to the serious soil erosion and rockiness 66.5–83.1%. The low average richness in summits (39.67) was due to elevation and negative effect of trees. Elevation, then rockiness and slope were respectively the main topographic factors influencing the distribution of matorral plants. The relationship between topography and distribution could be described by a linear model. Seventeen linear models were built for eleven floristic variables with three topographic factors, elevation, rockiness and slope explained 26–83% of the variance in distribution, also four groups of plant species were listed according to topographic positions. The suitability of plant species to the topographic factors should be considered in the restoration of matorrals in the study area. The results of this study will be useful for selecting the appropriate species and the potential sites for seeding to improving damaged matorral ecosystems in this area. However, additional investigations on soils, water availability and microclimate are required to clarify the mechanism of distribution of plant species in these ecosystems.



Effects of hexane extract of Lantana camara leaves on reproductive bioactivities of Dysdercus koenigii Fabricius (Heteroptera: Pyrrhocoreidae)

Publication date: Available online 24 May 2019

Source: Acta Ecologica Sinica

Author(s): Sunil Kayesth, Shailendra Kumar, Mohd Shazad, Kamal Kumar Gupta

Abstract

Effects of hexane extract of Lantana camara leaves were investigated on reproductive bioactivities of Dysdercus koenigii by assessing mating behavior, oviposition behavior and fertility of the adults emerged from treated fifth instar nymphs. Leaves of L. camara were extracted in hexane by 'cold extraction method'. The fifth instar nymphs were treated with the extract by 'dry film residual method' for 24 h and the adults emerged from these nymphs were used for the experiments. The results indicated that treated males showed altered courtship behaviour, lesser number of mounting attempts and took relatively more time to mate than the normal males. The treated females, very often, exhibited mating refusal and non-receptive behaviour towards the courting males. This led to decrease in percent successful mating. Also, the mating in the treated insects frequently got disrupted and terminated prior to insemination. The treatment of the females with the extract resulted in alteration of their oviposition behaviour. Consequently, the treated females laid lesser number of egg batches and total number of eggs in their life span. Although the eggs laid by the treated females were fertile, the percent hatchability was lesser than normal. The results signify that hexane leaf extract of Lcamara possesses phytochemicals, which adversely impaired the reproductive bioactivities of D. koenigii. Therefore, some of these compounds individually or synergistically can be employed in integrated pest management of D. koenigii by hampering its reproductive potential.



Using water and energy variation to explain the botanical richness pattern of Theaceae species in southern China

Publication date: Available online 24 May 2019

Source: Acta Ecologica Sinica

Author(s): Ming-Gang Zhang, Xia-Yun Zhao, Li-Jun Liu, Chen-Yu Huang

Abstract
Background

Energy and water availability are essential for biodiversity maintenance. In addition to the independent effects of water and energy on biodiversity, recent studies clarified that the effects of interaction between water and energy availability were indispensable.

Methods

In this exercise, by combining the species presence information and the environmental predictors, we produced species distribution models at 20 × 20 arc-minute resolution for 193 Theaceae species. Initially, the ordinary least square (OLS) regression was used to examine the stationary relationships between Theaceae diversity and climate. The statistical effects of water and energy on species diversity were detected using Geographically Weighted Regression analysis (GWR). Furthermore, the contour plots were used to view the statistical effects of the water and energy interaction on species diversity.

Results

The OLS results suggested that both energy and water availability are related to Theaceae species diversity. In GWR regression, the spatial variation of energy and water showed high explanatory power to the diversity pattern of Theaceae species. The patterns in the residuals of both OLS and GWR regression varied geographically. Therefore, the results of GWR regression were kept for further analysis. The value of diversity-water slopes decrease changed from positive to negative in extremely wet regions; In extremely dry conditions, the value of diversity-energy slopes decrease faster than other regions.

Conclusions

Our results support the following findings: 1) the latitudinal distribution of Theaceae species was limited by thermal tolerance, which support the freezing-tolerance hypothesis in macro-ecology; 2) Theaceae species diversity are sensitive to the instability of precipitation, while the limitation from energy availability is weak; 3) the effects of water and energy on species diversity are strong in dry regions. Those findings can provide further implications for Theaceae species conservation under climate change scenarios.



Species diversity, biological spectrum and phenological behaviour of vegetation of Biha Valley (Swat), Pakistan

Publication date: Available online 23 May 2019

Source: Acta Ecologica Sinica

Author(s): Akber Zeb, Zafar Iqbal, Shujaul Mulk Khan, Inayat Ur Rahman, Faizul Haq, Aftab Afzal, Ghulam Qadir, Farhana Ijaz

Abstract

A study was conducted to explore the plant biodiversity, phenology, life form and leaf size spectra of the vegetation of Biha Valley, District SWAT. The study area was surveyed thoroughly in different seasons of the year. Floristic diversity of the area consists of 202 plant species belonging to 154 genera and 70 families. There were two flowering seasons, 85.15% plant species flowers during May to August while 14.65% plant species flowers during the September to November. Biological spectrum of the area indicated that Therophytes (46.60%) was the dominant life form class, followed by Hemicryptophytes having 15.53%, Nanophanarophytes (11.65%), Megaphanerophytes (8.25%), Chamaephytes (7.77%), Geophytes (5.34%), Liana (2.91%) and Mesophanarophytes (1.94%). Leaf spectra of study area revealed that Microphylls was dominant with (41.26%) followed by Nanophylls (32.04%), Mesophylls (15.53%), Leptophylls (8.85%) and Megaphylls (2.91%).



Soil carbon stocks in plantations and natural forests of the sub-tropics

Publication date: Available online 23 April 2019

Source: Acta Ecologica Sinica

Author(s): Lu Shunbao, Xu Yan, Fu Xiangping, Zhang Yanjie

Abstract
Purpose

Soil carbon (C) storage plays an important role in the mitigation of atmospheric CO2 emission. Soil C pools under different vegetation are distinct and need to be investigated. However, there are still large quantities of data shortages, which should be remedied by field and systematic studies.

Materials and methods

Soil was collected at 0–10 cm depth from subtropical natural vegetation and plantations both in southeast China and southeast Queensland, Australia, respectively. Soil samples were assayed for soil organic C; organic N and inorganic N; and mineralization of SOC; total C, N, and P; and pH.

Results and discussion

Our results suggested soil C concentrations in natural vegetation ranged from 6.25% to 9.20%, whereas soil C concentrations in plantations ranged from 1.08% to 2.69%. No significant differences were found among vegetation along altitudinal gradients, whereas plantations with different tree species had different soil C concentrations, being higher in broadleaf-species plantations than in coniferous-species plantations. But there were no differences in soil C between single-species plantations and mixed-species plantations. Soil C concentrations in plantations were correlated with soil moisture, soil pH and dissolved organic C concentrations; Whereas soil C concentrations in natural vegetation were significantly correlated with soil moisture, soil pH and NO3 concentrations.

Conclusions

These results can contribute to the remedy of data shortages and provide the data necessary for model projections and informed decisions in the future.



Integration of Allelopathy and herbicide to control Asphodelus tenuifolius in chickpea crop

Publication date: April 2019

Source: Acta Ecologica Sinica, Volume 39, Issue 2

Author(s): Imtiaz Khan, Muhammad Ishfaq Khan, Hashmatullah

Abstract

Controlling Asphodelus tenuifolius in chickpea crop is a big challenge for the grower in the southern districts of Khyber Pakhtunkhwa-Pakistan. Keeping in view the yield losses due to weeds a research was conducted at Ahmadwala Research Station "District Karak" to control to A. tenuifolius. Herbicides, mulches and allelopathic weed extracts were evaluated during the experiment. The experiment was repeated thrice using Randomized Complete Block design with Chattan cultivar. The weed control treatments Viz. Stomp 330 EC (Pre) @ 2.5 L ha−1, Fenoxaprop-p-ethyl, Bromoxynil +MCPA (Tank mixture of herbicides), Starane-M, Eucalyptus leaves as mulch, wheat straw as mulch, allelopathic extract (Asphodelus tenuifolius) + Stomp, allelopathic Cyperus rotundus extract, allelopathic Sorghum halepense extract were tested and compare with the control treatment during the experiment. The data was recorded on A. tenuifolius density m−2 before and after treatment application, plant height, crude protein, crude fats, biological yield, and seed yield. The level of significance of all the treatments was (0.05). The results indicated that the minimum A. tenuifolius density was recorded in the plots treated with Stomp 330 EC (4.74 m−2) followed by herbicide Fenoxaprop-p-ethyl 6.9 EC (10.87 m−2). The maximum A. tenuifolius density was found in the control plots (81.64 m−2) which were left undisturbed. Among the chickpea yield components, the maximum plant height at maturity (48.98 cm) was recorded for Stomp 330 EC the lowest plant height was recorded for control plot. The maximum crude protein (17.68), crude fat (2.93) and oil content was (5.92%) was recorded in the plots treated with Stomp 330 EC and the minimum was found in the control plots. Similarly, the maximum biological yield (4058.7 kg ha−1) and seed yield (1282 kg ha−1) were recorded in Stomp 330 EC treated plots as biological and grain yield was observed for control plot. Therefore, it is recommended that using herbicides Stomp 330 EC and Fenoxaprop-p-ethyl is one of the effective weed control strategies for control of A. tenuifolius in chickpea growing areas.



Fungi infecting Escobaria cubensis and Melocactus holguinensis (Cactaceae) in northeastern Cuba

Publication date: April 2019

Source: Acta Ecologica Sinica, Volume 39, Issue 2

Author(s): Alena Reyes-Fornet, Elena Balbina Fornet Hernández, Yania Raquel Martínez Ondaro

Summary

Escobaria cubensis (Britton & Rose) D.R. Hunt and Melocactus holguinensis Areces (Cactaceae) are valuable Cuban natural heritage plants from ophiolite (serpentine) soils that are in Critical Danger of extinction. The in situ study on E. cubensis was conducted in Matamoros and that of M. holguinensis in La Ceja between May 2017 and July 2017, both in Holguín province. Samples in ex situ collections were also taken. The appearance of fungi somatic and reproductive structures was induced through wet chamber technique and isolation. Fungi were identified using taxonomic keys. Symptoms in E. cubensis consist of rotten soft roots, while M. holguinensisdisplays yellow spots followed by brown to blackish lesions with brown centers. Cacti death is the result of those infections. Pathogenicity tests showed that in E. cubensis, the fungi responsible for the symptoms are Fusarium oxysporum Schltdl. (or a complex), Colletotrichum gloeosporioides (Penz.) Penz. & Sacc and Penicillium sp. In M. holguinensisC. gloeosporioides causes the witnessed anthracnose in stems in both habitats. These fungi constitute a severe threat in natural habitat more for M. holguinensis than for E. cubensis. Results suggest that roots are the most vulnerable part of E. cubensis and stems appear to be more sensitive in M. holguinensis. C. lunata can infect both cacti, but no symptoms of illness have been seen either in situ or ex situ. Infection similarities seen both in nature and in collections could be because of inappropriate horticultural practices. Other fungi found are Aspergillus fumigatus Fresenius, A. niger van Tieghem, Cephalosporium sp., Cladosporium sp., Rhizopus sp. and Trichoderma sp. All fungi found in this study are new records for both hosts in Cuba. The results of this research allow to solve problems found in natural habitat and in ex situ collections. In addition, results suggest to collectors not to remove and use soil from the natural habitat, unless it is properly sterilized.



Assessment of density area and LNRF models in landslide hazard zonation (Case study: Alamout watershed, Qazvin Province, Iran)

Publication date: April 2019

Source: Acta Ecologica Sinica, Volume 39, Issue 2

Author(s): M. Eslami, S. Shadfar, A. Mohammadi-Torkashvand, E. Pazira

Abstract

Landslide is one of the natural disasters causing both life loss and financial damage. To plan and manage landslides better, it is necessary to produce landslide hazard zonation (LHZ) maps. Alamout watershed is one of the most susceptible landslides located in a mountainous area in north of Iran. At first, required information of layers such as geology, soil, elevation, slope, aspect, rainfall, and distance to fault, road, river, and land use factors from different sources were provided. Landslide inventory map was prepared using geological map, aerial photos and filed investigation with GPS. The map of each effective factor on the landslide was combined with the landslide distribution map to determine the weight of each factor. Landslide hazard zonation map was prepared with density area and LNRF methods in the Geographic Information System (GIS). The two models were evaluated with quality sum (Qs). Results showed that the density area method (Qs= 1.496) was more accurate than the LNRF model (Qs= 0.897). The results obtained from density area model indicated that very high hazard zones were approximately 33% of the study area. Additionally, low and very low hazard zones were almost 6.8% of the watershed. In the LNRF model, very low and low hazard zones were approximately 28% and high and very high hazard zones were 48% of the studying region.



Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
6948891480

Addictive Behaviors

Substance craving changes in university students receiving heart rate variability biofeedback: A longitudinal multilevel modeling approach

Publication date: October 2019

Source: Addictive Behaviors, Volume 97

Author(s): Nour Alayan, David Eddie, Lucille Eller, Marsha E. Bates, Dennis P. Carmody

Abstract
Background

Previously published findings from a study of university students living in substance use disorder (SUD) recovery housing showed an eight-session heart rate variability biofeedback (HRVB) intervention significantly reduced craving. That study, however, uncovered pronounced inter-participant variability in craving change patterns through the course of HRVB that warranted further exploration. The purpose of the current investigation was to examine how within- and between-person factors may have differentially influenced craving changes.

Methods

A longitudinal multilevel modeling approach was used with time at level-1 nested within persons at level-2. Multilevel models of change were estimated to model craving trajectories and predictor relationships over time as a function of age, sex, length of abstinence, daily HRVB practice, anxiety, depression, and stress.

Results

A quadratic pattern of craving reductions was found, indicating that craving reductions accelerated over time for some participants. Daily HRVB practice of >12 min and older age significantly enhanced craving reductions over time. Increases in depressive symptoms attenuated the effects of HRVB on craving. The other predictors were not significantly associated with craving in this study. The true R2 for the final model indicated that 20.5% of the variance in craving was explained by older age, daily HRVB >12 min, and within-person changes in depression.

Conclusions

HRVB shows promise as an accessible, scalable, and cost-effective complementary anti-craving intervention. Healthcare providers may help persons recovering from SUD to better manage substance craving by the routine and strategic use of HRVB practice.



The relationship of loot box purchases to problem video gaming and problem gambling

Publication date: October 2019

Source: Addictive Behaviors, Volume 97

Author(s): Wen Li, Devin Mills, Lia Nower

Abstract

Loot boxes are virtual items in many video games that let players "gamble" on an item of chance. Loot boxes bring an element of gambling into video games, which might prime video game users to engage in online gambling activities. However, few studies have focused on this emerging issue. The present study investigated the relationships between loot box purchases and both problem video gaming and problem gambling severity. Cross-sectional, self-report data were collected from 618 adult video gamers (M = 27 years of age, SD = 8.9, 63.7% male) via an online survey. Nearly half of the sample (44.2%) spent money on loot box purchases in the past year. Loot box purchasers played video games and gambled online more frequently, reported more extended gaming and online gambling sessions, and endorsed higher levels of problem video gaming and problem gambling severity as well as greater mental distress relative to those who did not buy loot boxes. Results from a series of path analyses revealed that loot box purchasing was directly related to problem video gaming and problem gambling severity as well as indirectly through increased video gaming/online gambling engagement, which in turn is related to elevated psychological distress. The present findings provide insight into the role of loot box purchasing in the transition from recreational engagement in video gaming and online gambling to problem video gaming and/or problem gambling.



History of regular nonmedical sedative and/or alcohol use differentiates substance-use patterns and consequences among chronic heroin users

Publication date: October 2019

Source: Addictive Behaviors, Volume 97

Author(s): Tabitha E.H. Moses, Mark K. Greenwald

Abstract
Background

Concurrent use of sedating substances (e.g. alcohol or benzodiazepines) with opioids is associated with increased negative consequences of opioid use; however, few studies have attempted to differentiate effects of using sedating substances on heroin-use outcomes. This study examines differences between heroin users who use alcohol or misuse sedatives regularly and those who do not.

Methods

Substance-use data were collected from 367 non-treatment seeking, chronic heroin-using, 18-to-55 year-old participants. We created 4 groups based on self-reported lifetime history of regular (at least weekly) substance use: heroin only (n = 95), heroin and sedatives (n = 21), heroin and alcohol (n = 151), and heroin, sedative, and alcohol (n = 100). Chi-square analyses and ANOVAs with Bonferroni post hoc tests were used to explore differences between these groups.

Results

Heroin users who denied lifetime alcohol or nonmedical sedative use regularly endorsed fewer consequences associated with any substance they had used. Total adverse consequences of heroin use (e.g. health problems) were significantly higher among those who misused sedatives regularly, irrespective of alcohol use history (F(3,361) = 10.21; p < .001). Regular alcohol use did not independently impact heroin consequences but was associated with increased use of other substances.

Conclusions

Although polysubstance use is normative among heroin users, the risks depend on the substances used. Regular sedative use is associated with increased heroin consequences whereas regular alcohol use is not. This study refines the investigation of polysubstance use and highlights subgroup differences depending on types of substances used regularly. This knowledge is critical for understanding substance-use motivations and creating avenues for harm reduction.



The fuzzy future: Time horizon, memory failures, and emotional distress in gambling disorder

Publication date: October 2019

Source: Addictive Behaviors, Volume 97

Author(s): Giovanna Nigro, Francesca D'Olimpio, Maria Ciccarelli, Marina Cosenza

Abstract

This study aimed to first investigate the interplay among self-rated ability in both retrospective and prospective memory, time perspective, and negative affectivity to gambling severity. Two hundred and three habitual players took part in the study. Participants were administered the South Oaks Gambling Screen (SOGS), the Consideration of Future Consequences scale (CFC-14), the Prospective and Retrospective Memory Questionnaire (PRMQ), as well as the Depression, Anxiety and Stress Scales-21 (DASS-21). Overall, data indicated that the higher the involvement in gambling, the higher the depression levels and the shorter the time horizon. The results of linear regression analysis showed that, along with gender, years of education, depression, and inattention to the future consequences of actual behavior, the negative self-perception of prospective memory functioning represents a significant predictor of gambling severity. Finally, to clarify if depression was on the path from prospective memory to gambling severity or if prospective memory was the mediator of the impact of depression on gambling severity, data were submitted to path analysis. Results indicated that depression has a direct effect on gambling severity and mediates the association between prospective memory and gambling involvement. The relation between gambling severity and prospective memory scores suggests that impairment in prospective memory plays a key role in adult problematic gambling.



Fatigue severity and electronic cigarette beliefs and use behavior

Publication date: October 2019

Source: Addictive Behaviors, Volume 97

Author(s): Michael J. Zvolensky, Kara Manning, Lorra Garey, Nubia A. Mayorga, Natalia Peraza

Abstract

Electronic cigarette (e-cigarette) use has risen dramatically in the United States. Clinically significant fatigue may represent one previously unexplored individual difference factor related to e-cigarette use patterns and e-cigarette specific cognitive processes. Fatigue reflects the experience of being tired, lacking energy, and feeling exhausted. Although fatigue is a normal bodily response, severe or chronic fatigue is maladaptive. Thus, the current study sought to evaluate clinically significant fatigue and its relation to perceived barriers for quitting e-cigarettes, perceived risks and perceived benefits of e-cigarette use, and e-cigarette dependence among 625 adult e-cigarette smokers (51.8% female, Mage = 34.91 years, SD = 10.29). Results indicated that severe fatigue was significantly related to greater perceived barriers to quitting (p < .001), perceived risks (p < .001) and perceived benefits (p < .001) of e-cigarette use, and greater e-cigarette dependence (p < .001); effects that were evident after adjusting for a range of other factors (e.g., combustible cigarette use, pain severity). These novel empirical results highlight the severity of fatigue as a potentially important construct in efforts to better understand beliefs related to e-cigarette use and e-cigarette dependence.



Psychosocial correlates in treatment seeking gamblers: Differences in early age onset gamblers vs later age onset gamblers

Publication date: October 2019

Source: Addictive Behaviors, Volume 97

Author(s): Steve Sharman, Raegan Murphy, John Turner, Amanda Roberts

Abstract
Background

Age of onset is an important factor in the development and trajectory of psychiatric disorders; however, little is known regarding the age of onset in relation to disordered gambling in treatment seeking samples in the UK. Utilising a large residential treatment seeking gambler cohort, the current study examined the relationship between age of gambling onset and a range of variables thought to be associated with disordered gambling.

Method

Data were collected from 768 gamblers attending residential treatment for disordered gambling. Individuals were grouped per the age they started gambling as either a child (≤12), adolescent (13–15), or young adult/adult (≤16). Data were analysed using linear, backward stepwise, and multinomial logistic regressions to identify significant relationships between age of onset and variables of theoretical significance.

Results

Results indicate the younger age of gambling onset was associated with increased gambling severity. Those who began gambling at an earlier age were more likely to have abused drugs or solvents, committed an unreported crime, been verbally aggressive and experienced violent outbursts. They are less likely to report a positive childhood family environment and are more likely to have had a parent with gambling and/or alcohol problems.

Discussion

Gamblers who began gambling at an earlier age experience negative life events and exhibit some antisocial behaviors more than later onset gamblers, indicating that when addressing gambling behavior, it is important to consider the developmental trajectory of the disorder, rather than merely addressing current gambling behavior. However, the direction of the relationship between gambling and significant variables is in some instance unclear, indicating a need for further research to define causality.



Cue-induced craving and symptoms of online-buying-shopping disorder interfere with performance on the Iowa Gambling Task modified with online-shopping cues

Publication date: September 2019

Source: Addictive Behaviors, Volume 96

Author(s): Patrick Trotzke, Katrin Starcke, Astrid Müller, Matthias Brand

Abstract
Background and aims

Subjects with buying-shopping disorder (BSD) continue to buy offline as well as online despite negative consequences. Previous studies indicate that subjects with BSD show cue-reactivity and craving when exposed to shopping cues and have problems in long-term advantageous decision-making. The current study aimed at investigating the effect of online-shopping cues on decision-making, and whether addiction-relevant concepts such as cue-reactivity/craving and the symptom severity of BSD are related to decision-making.

Methods

A non-clinical sample of 57 participants played a version of the modified Iowa Gambling Task (IGT), with online-shopping-related pictures shown either on the advantageous decks or on the disadvantageous decks (with control pictures on the opposing ones). Symptom severity of online-BSD and the craving to buy were assessed using questionnaires. In addition, the online-shopping pictures were rated concerning arousal, valence, and urge to buy.

Results

The participants who played the IGT with the online-shopping pictures displayed on the disadvantageous decks performed significantly poorer than the other group with online-shopping pictures on the advantageous decks. The between-group differences were moderated by craving reactions and the symptom severity of online-BSD: When online-shopping pictures were displayed on the disadvantageous decks, this only interfered with IGT performance in participants who had high craving reactions towards shopping cues and/or high symptom severity of online-BSD.

Conclusion

Results indicate that exposure to online-shopping cues interferes with advantageous decision-making, especially in individuals with craving reactions and high symptoms of online-BSD. Results contribute to the question of why some people continue to buy despite negative consequences.



Emotion dysregulation and cigarette dependence, perceptions of quitting, and problems during quit attempts among Spanish-speaking Latinx adult smokers

Publication date: September 2019

Source: Addictive Behaviors, Volume 96

Author(s): Michael J. Zvolensky, Justin M. Shepherd, Jafar Bakhshaie, Lorra Garey, Andres G. Viana, Natalia Peraza

Abstract

Latinx smokers in the United States (U.S.) represent an understudied health disparities group in terms of tobacco use. Despite scientific interest to elucidate individual difference risk factors for smoking, there is limited understanding of how emotional dysregulation relates to smoking outcomes among Spanish-speaking Latinx smokers. The purpose of the present investigation was therefore to explore emotion dysregulation in relation to cigarette dependence, perceived barriers for quitting, and severity of problems experienced during prior quit attempts. Participants were 363 Spanish-speaking Latinx daily smokers (58.7% female, Mage= 33.3 years, SD = 9.81). Results indicated that emotion dysregulation was significantly related to cigarette dependence, perceived barriers for quitting, and problems experienced during past quit attempts. Notably, the effects accounted for 7% to 15% of variance and were evident after adjusting for gender, income, education, number of medical conditions, depression symptoms, non-alcohol drug use, and alcohol consumption. The findings provide novel evidence that emotion dysregulation may represent an important individual difference factor for better understanding smoking-related outcomes among Latinx smokers and supports the need for greater attention to this affective vulnerability during smoking cessation treatment.



The epidemiology of prescription fentanyl misuse in the United States

Publication date: September 2019

Source: Addictive Behaviors, Volume 96

Author(s): Ty S. Schepis, Vita V. McCabe, Carol J. Boyd, Sean Esteban McCabe

Abstract
Background

US opioid overdose deaths continue to climb, with a 12.0% increase from 2016 to 2017. Fentanyl, a synthetic opioid, has been a major contributor to opioid-related overdose deaths. While fentanyl-related overdose is driven by illicit fentanyl, little is known about individuals who misuse prescription fentanyl, which is also linked to elevated overdose and mortality risk. This work aimed to fill that gap through analyses of prescription fentanyl misuse correlates.

Methods

Data were from the 2015–16 National Survey on Drug Use and Health (N = 114,043), a nationally representative survey of the non-institutionalized US population. Respondents were (all past-year): those misusing prescription fentanyl (PF); those misusing other (non-fentanyl) prescription opioids (NFPO); and population controls. Respondent groups were compared using multinomial regression on sociodemographics, physical health, mental health and substance use. The PF and NFPO misuse groups were compared on opioid misuse characteristics, using logistic regression.

Results

An estimated 4.4% misused NFPO, and 0.1% misused PF (past-year). Past-year heroin use was more common in those who misused PF (44.3%) than those who misused other NFPO (4.4%; relative risk ratio [RRR] = 7.1, 95%CI = 3.7–13.9) or population controls (0.1%, RRR = 35.1, 95%CI = 17.3–71.1). Non-alcohol substance use disorder (SUD) was similarly elevated in those who misused PF (78.7%) versus the other NFPO group (27.5%, RRR = 3.8, 95%CI = 1.8–8.2) or population controls (1.6%, RRR = 20.6, 95%CI = 9.4–45.5).

Conclusions

Respondents who misused prescription fentanyl were both more drug-involved generally and opioid-involved specifically; and likely need a combination of significant interventions and monitoring for their polysubstance use.



Overlapping epidemics of alcohol and illicit drug use among HCV-infected persons who inject drugs

Publication date: September 2019

Source: Addictive Behaviors, Volume 96

Author(s): Risha Irvin, Geetanjali Chander, Oluwaseun Falade-Nwulia, Jacquie Astemborski, Laura Starbird, Gregory D. Kirk, Mark S. Sulkowski, David L. Thomas, Shruti H. Mehta

Abstract
Background

Alcohol use in people who inject drugs (PWID) with hepatitis C virus (HCV) infection accelerates liver disease progression. This paper describes the prevalence and associated correlates of alcohol use among HCV antibody positive PWID.

Methods

In a large cohort of HCV antibody positive PWID (N = 1623) followed from 2005 to 2013, we characterized alcohol use using the AUDIT-C. We used multivariable logistic regression with generalized estimated equations to examine socio-demographic, clinical, and substance use correlates of alcohol use.

Results

At their initial visit, 41% reported no, 21% reported moderate, and 38% reported heavy alcohol use. The odds of moderate and heavy alcohol use increased with greater intensity of substance use represented by a composite summary variable which ranged from 0 to 3 substances (street-acquired prescription drugs, non-injection cocaine/heroin, and injection drugs) used. Compared to those who used no drugs, those who used 3 substances had 3.71 odds (95% CI: 3.07–4.48) of moderate alcohol use and 3.65 odds (95% CI: 3.20–4.16) of heavy alcohol use.

Conclusions

The prevalence of moderate/heavy alcohol use is high among HCV antibody positive PWID and occurs frequently in combination with other drug use. This may contribute to progressive liver fibrosis thus limiting the gains achieved from HCV cure. Public health interventions need to address the overlapping epidemics of HCV, alcohol use, and other substance use in this population.



Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
6948891480

Dermatologie , Vénéréologie

Lymphome cérébral primitif après immunothérapie d'un mélanome métastatique

Publication date: Available online 20 May 2019

Source: Annales de Dermatologie et de Vénéréologie

Author(s): M. Castel, C. Cotten, A. Deschamps-Huvier, M.-H. Commin, F. Marguet, F. Jardin, A.-B. Duval-Modeste, P. Joly

Résumé
Introduction

Les anticorps anti-PD-1 et anti-CTLA-4 sont des inhibiteurs de checkpoints du système immunitaire utilisés dans le traitement du mélanome. Les anti-PD-1 ont été récemment validés comme traitement du lymphome de Hodgkin. Le lymphome cérébral primitif est une forme rare de lymphome non hodgkinien pour lequel il existe peu de traitements efficaces. Des études ont montré l'efficacité des anticorps anti-PD-1 dans des lymphomes non hodgkiniens, dont le lymphome cérébral primitif.

Observation

Un patient de 59 ans présentait un mélanome métastatique traité depuis plusieurs mois par immunothérapie (anti-CTLA-4, puis anti-PD-1). Après 28 cures, le pembrolizumab était arrêté devant une rémission complète du mélanome. Une hémiparésie gauche survenait deux mois après l'arrêt de l'immunothérapie, révélant un lymphome cérébral primitif évolutif. Une chimiothérapie par méthotrexate à hautes doses était débutée, sans efficacité. Malgré une seconde ligne de traitement par chimiothérapie R-ICE (rituximab-ifosfamide, carboplatine et étoposide), le patient décédait des suites de son lymphome cérébral.

Discussion

Plusieurs hypothèses peuvent être avancées quant à un lien éventuel entre l'immunothérapie et la survenue du lymphome cérébral. Nous pouvons évoquer le contrôle d'un lymphome méconnu par l'immunothérapie, suivi d'un échappement et d'une progression rapide à l'arrêt du traitement, mais l'hypothèse d'un lymphome induit par l'immunothérapie n'est pas exclue. Enfin, l'immunothérapie peut n'avoir joué aucun rôle, l'association entre lymphome et mélanome étant bien connue.

Conclusion

Malgré l'impossibilité de conclure sur l'imputabilité de l'immunothérapie dans la survenue du lymphome cérébral primitif, ce cas soulève de nombreuses questions sur le possible rôle de l'immunothérapie dans la survenue de cancers secondaires, dont des lymphomes.

Summary
Background

Anti-PD-1 and anti-CTLA-4 monoclonal antibodies are used in melanoma, while anti-PD-1 are also used in Hodgkin's lymphoma. Primary central nervous system lymphoma is a rare form of non-Hodgkin's lymphoma with few effective treatments. However, several recent studies have reported multiple cases of non-Hodgkin's lymphoma and primary central nervous system lymphoma treated by anti-PD-1 antibodies with favourable responses.

Patients and methods

This study focuses on the case of a 59-year-old man with metastatic melanoma treated by immunotherapy (anti-CTLA-4 followed by anti-PD-1). He underwent 28 courses of therapy with pembrolizumab. Treatment was stopped after clinical and radiological remission. The patient presented left hemiparesis and a primary central nervous system lymphoma was diagnosed two months after discontinuation of immunotherapy. He started urgent high-dose methotrexate chemotherapy but without significant results. Despite second-line chemotherapy with R-ICE (rituximab-ifosfamide, carboplatin and etoposide), the patient died.

Discussion

Several hypotheses may be advanced regarding a possible relationship between immunotherapy and the occurrence of this primary central nervous system lymphoma. The lymphoma may have been pre-existing and controlled by immunotherapy, but progressing rapidly after treatment, or it may have been induced by the immunotherapy. However, immunotherapy may have played no role; the relationship between melanoma and lymphoma is well known.

Conclusion

While immunotherapy cannot be unequivocally incriminated in primary central nervous system lymphoma, this case raises many questions about the imputability of immunotherapy in the occurrence of secondary cancers, including lymphomas.



Exploration photodermatologique en France. Enquête de la Société Française de Photodermatologie

Publication date: Available online 15 May 2019

Source: Annales de Dermatologie et de Vénéréologie

Author(s): A. Moreau, M. Avenel-Audran, H. Adamski, F. Aubin, J.-C. Beani, C. Bedane, A. Bonnevalle, C. Boulitrop, J.-L. Bourrain, L. Boursault, H. Dutartre, M. Jeanmougin, F. Leonard, L. Machet, M.-C. Marguery, B. Rouchouse, J.-L. Schmutz, Groupe de la Société française de photodermatologie



Skin lightening and its motives: A historical overview

Publication date: Available online 12 May 2019

Source: Annales de Dermatologie et de Vénéréologie

Author(s): A. Petit



Infections humaines à poxvirus

Publication date: Available online 9 May 2019

Source: Annales de Dermatologie et de Vénéréologie

Author(s): G. Bohelay, T.-A. Duong

Résumé

Les infections à poxvirus (PXV) sont fréquemment responsables de manifestations cutanées. En France, certaines poxviroses sont fréquentes et bénignes (molluscum contagiosum), alors que d'autres sont exceptionnelles mais potentiellement graves (cowpoxvirus [CPXV]). Si seuls le virus de la variole et le molluscum contagiosum virus sont à réservoir humain et à transmission interhumaine, la plupart des infections à poxvirus sont des zoonoses avec un réservoir animal distinct. Seule une partie des poxvirus est responsable d'infections humaines, mais l'augmentation du nombre des nouveaux animaux de compagnie, parfois exotiques, et la rapidité des voyages internationaux exposent au risque de transmission de PXV zoonotiques à de nouveaux vecteurs et leur diffusion, à de nouvelles régions du monde. En France, le molluscum contagiosum, l'orf et le nodule du trayeur sont responsables de multiples consultations et sont bien connus des dermatologues. Toutefois d'autres parapoxvirus de présentations proches de l'orf ne doivent pas être méconnus ; ainsi le CPXV ou le monkeypox virus sont considérés comme des virus potentiellement émergents avec un fort risque d'épidémie et de diffusion du fait de l'exacerbation des transports internationaux et de la perte de la protection vaccinale antivariolique. Enfin, malgré une éradication déclarée, la variole fait l'objet d'une surveillance du fait d'un risque potentiel de réintroduction accidentelle ou volontaire par le bioterrorisme.

Summary

Poxvirus (PXV) infections are a common cause of cutaneous signs. In France, certain forms of poxvirus are frequent and benign (molluscum contagiosum), while others are rare but potentially serious (cowpox virus [CPXV]). Whereas only smallpox and molluscum contagiosum viruses have a human reservoir and are transmitted between humans, most poxvirus infections are zoonoses having only animal reservoirs. Only a small number of poxviruses are responsible for infection in humans, but the increasing number of new pets, some of which are exotic, coupled with the rapid rise in international travel are creating a greater risk of transmission of zoonotic PXV to new vectors and of spread of these diseases to new regions throughout the world. In France, molluscum contagiosum, orf and milkers' nodule give rise to numerous consultations and are well known to dermatologists. However, dermatologists must also be able to identify other parapoxviruses of similar presentation to orf; thus, CPXV and monkeypox are considered potentially emergent viruses with a high risk of epidemic and spread due to increasing international transport and the loss of the maximum protection against smallpox. Finally, despite its declared eradication, smallpox is currently being monitored because of the potential risk of reintroduction, whether accidentally or deliberately through bioterrorism.



Scores de sévérité dans le psoriasis de l'enfant : revue systématique de la littérature

Publication date: Available online 4 May 2019

Source: Annales de Dermatologie et de Vénéréologie

Author(s): J. Lavaud, E. Mahé

Résumé
Introduction

Le psoriasis touche 0,5 à 1 % des enfants en Europe. Il impacte de manière importante la qualité de vie. Depuis quelques années, des traitements systémiques ont été autorisés chez les enfants atteints de psoriasis modéré à sévère. L'évaluation de la sévérité de la maladie est donc importante pour la prise en charge de ces enfants. Il n'existe cependant pas d'uniformisation des scores de sévérité, ni de consensus national ou international concernant leur utilisation dans le psoriasis de l'enfant. L'objectif de ce travail était d'étudier l'utilisation des scores de sévérité clinique et de qualité de vie (critères et seuil définissant la sévérité) chez les enfants atteints de psoriasis.

Méthode

Une revue systématique de la littérature a été conduite à partir des bases de données PubMed et Embase. Des recherches complémentaires ont été réalisées à partir des références bibliographiques des articles sélectionnés. Les mots-clés suivants ont été utilisés : « psoriasis », avec « pediatric », « childhood », « infant », « Child » ou « adolescent », et « Severity of Illness Index », « sickness impact profile », « quality of life », « index », « measure » ou « score ». Une première sélection a été effectuée à partir du titre et du résumé des articles.

Résultats

Après évaluation de 1712 articles sur Medline et 233 sur Embase, 78 ont finalement été retenus. Le « Psoriasis Area and Severity Index » (PASI : 74,4 %) était le score le plus fréquemment utilisé, suivi par la « Surface Cutanée Atteinte » (SCA : 48,7 %) et le « Physician's Global Assessment » (PGA : 29,5 %). Le recours à des thérapies systémiques ou l'échec des traitements locaux ont également été utilisés comme critère de sévérité. Plus de la moitié des études ne spécifiaient pas le seuil de la sévérité. Nous avons aussi observé une grande hétérogénéité des seuils de définition de la sévérité du psoriasis. Les scores utilisés étaient souvent les mêmes quels que soient le type de psoriasis et l'âge des patients. Concernant la qualité de vie, la majorité des études utilisaient le « Children's Dermatology Life Quality Index » (CDLQI : 23,1 %) et le DLQI (5,1 %). Des scores de qualité de vie non spécifiques du psoriasis ont également été utilisés comme le « Pediatric Quality of Life Inventory » (Peds-QL : 6,4 %) et le Skindex (2,6 %). Il n'y avait pas non plus de définition du seuil de sévérité pour ces scores.

Discussion

Les scores de sévérité sont utilisés pour la plupart par analogie avec l'adulte, sans validation dans la population pédiatrique. Ils ne tiennent pas compte des spécificités pédiatriques : évolution de la SCA en fonction de l'âge, aspects cliniques du psoriasis, types cliniques. Les limites de la sévérité sont très mal définies chez l'enfant, qu'il s'agisse de la clinique ou de la qualité de vie. Cela rend difficile la comparaison entre les différents travaux et pose problème pour la prescription des traitements systémiques. Cette étude montre la nécessité de valider les scores de gravité et de qualité de vie, et de définir les seuils adaptés aux enfants.

Summary
Background

Psoriasis affects 0.5 to 1 % of children in Europe. It has a significant impact on quality of life. Recently, systemic treatments have been licensed for children with moderate-to-severe psoriasis. While scores to assess the severity of the disease are thus important for the management of these children, there is no standardization or consensus concerning their use in childhood psoriasis. The aim of this study was to examine the use of clinical severity scores and quality of life in children with psoriasis.

Patients and methods

A systematic literature review was conducted on PubMed and Embase. Further research was carried out using the bibliographic references in selected articles. The following keywords were used: "psoriasis" with "pediatric", "childhood", "infant", "child" or "adolescent", and "Severity of Illness Index", "sickness impact profile", "quality of life", "index", "measure" or "score". A first selection was made from the titles and abstracts of the selected articles.

Results

After evaluating 1712 articles on Medline and 233 on Embase, 78 were finally selected. The Psoriasis Area Severity Index (PASI: 74.4 %) was the most frequently found score followed by the Body Surface Area (BSA: 48.7 %) and the Physician's Global Assessment (PGA: 29.5 %). Recourse to systemic therapies and failure of topical treatments were also used as severity criteria. Over half the studies did not define a severity threshold. We also observed extensive heterogeneity in the definition of psoriasis severity. The same scores were often used regardless of psoriasis type or patient age. Regarding quality of life, most studies used the Children's Dermatology Life Quality Index (CDLQI: 23.1 %) and DLQI (5.1 %). Non-specific quality-of-life scores for psoriasis were also used, such as the Pediatric Quality of Life Inventory (Peds-QL: 6.4 %) and Skindex (2.6 %). Here again, no severity threshold was defined for these scores.

Discussion

Severity scores are chiefly used by analogy with adults but without validation in the pediatric population. They do not consider pediatric specificities such as progression of BSA according to age, clinical aspect, clinical types, etc. Severity thresholds are rarely defined in children, whether in terms of clinical score or quality of life. This can constitute a limitation in terms of both prescription of systemic treatments and comparison between different studies. Our study demonstrates the need to validate severity and quality-of-life scores and to define child-specific thresholds.



Etanercept reduces anxiety and depression in psoriasis patients, and sustained depression correlates with reduced therapeutic response to etanercept

Publication date: Available online 30 April 2019

Source: Annales de Dermatologie et de Vénéréologie

Author(s): A. Yang, X. Xin, W. Yang, M. Li, W. Yang, L. Li, X. Liu

Summary
Background

The purpose of this study was to explore the correlation of anxiety and depression with therapeutic response to etanercept in psoriasis patients.

Patients and methods

One hundred and thirty-three patients with moderate-to-severe plaque psoriasis undergoing etanercept treatment were consecutively enrolled in this prospective cohort study, with all patients receiving etanercept treatment for 6 months. Psoriasis Area and Severity Index (PASI) score was evaluated at baseline (M0) and at month 1 (M1), M3 and M6 after treatment, and PASI 75/90 responses were calculated. The Hospital Anxiety and Depression Scale-Anxiety (HADS-A) score and the HADS-Depression (HADS-D) score were used to evaluate patients' anxiety and depression at M0, M1, M3 and M6. Sustained anxiety/depression were defined as HADS-A/D score ≥ 8 points both at M0 and M1.

Results

Female gender and higher PASI score were associated with high risk of anxiety, while female gender, higher PASI score and longer disease duration were correlated with increased depression risk. After 6 months of etanercept treatment, 65.4% and 36.1% patients achieved PASI 75 and PASI 90 responses respectively, and both HADS-A and HADS-D scores were decreased. Most importantly, no correlation of baseline anxiety and depression with PASI 75 or PASI 90 response after 6 months of treatment was noted, while sustained depression, though not sustained anxiety, was observed to be correlated with decreased PASI 75 and PASI 90 responses.

Conclusions

Etanercept reduces anxiety and depression in psoriasis patients, and sustained depression correlates with reduced therapeutic response to etanercept.

Résumé
Introduction

Le but de ce travail était d'étudier la relation entre la réponse à l'étanercept et les niveaux d'anxiété et de dépression des patients atteints de psoriasis.

Patients et méthodes

Ont été inclus dans cette étude prospective 133 patients consécutifs atteints de psoriasis en plaques modéré à sévère ; tous ont reçu un traitement par étanercept d'une durée de six mois. Le score Psoriasis Area and Severity Index (PASI) était mesuré à l'inclusion (M0) et après 1,3 et 6 mois de traitement ; les réponses PASI 75 et PASI 90 (améliorations de respectivement 75% et 90% du score) ont été calculées. Les scores Hospital Anxiety and Depression Scale-Anxiety (HADS-A) pour l'anxiété et HADS-D pour la dépression ont été évalués à M0, M1, M3 et M6. Une anxiété ou une dépression persistantes étaient définies par des scores HADS-A ou D ≥ 8 points à la fois à M0 et M1.

Résultats

Le sexe féminin et un score PASI plus élevé étaient associés à une plus grande anxiété ; les mêmes facteurs plus la durée d'évolution de la maladie étaient associés à un score de dépression plus élevé. Après 6 mois d'étanercept, le PASI 75 et le PASI 90 étaient atteints par respectivement 65,4% et 36,1 % des patients, tandis que les scores HADS-A et HADS-D diminuaient tous les deux. Le point le plus important est qu'il n'est apparu aucune corrélation les niveaux d'anxiété et de dépression à M0 et les réponses PASI 75 ou PASI 90 à M6 ; en revanche, la dépression persistante, mais non l'anxiété persistante, était associée à une moins bonne réponse au traitement en termes de PASI 75 et de PASI 90.

Conclusions

L'étanercept réduit les niveaux d'anxiété et de dépression des patients atteints de psoriasis. Une dépression persistante est associée à une moins bonne réponse au traitement.



Dermite de rappel induite par le vémurafénib

Publication date: Available online 10 April 2019

Source: Annales de Dermatologie et de Vénéréologie

Author(s): A. Greliak, A. Le Guern, M. Bataille, D. Lebas, T. Wiart, P. Modiano

Résumé
Introduction

La dermite de rappel est une réaction inflammatoire survenant sur un site précédemment irradié et provoquée par l'administration d'un traitement. Dans de rares cas, il s'agit d'un traitement par inhibiteurs de BRAF ou de MEK.

Cas clinique

Nous rapportons le cas inhabituel d'une dermite de rappel survenue trois mois après l'introduction de l'association vémurafénib/cobimétinib.

Discussion

La dermite de rappel est une réaction cutanée qui doit être connue et qui peut exceptionnellement, comme dans notre observation, survenir tardivement après la fin de la radiothérapie.

Summary
Introduction

Radiation recall dermatitis is an uncommon inflammatory reaction of the skin appearing after several days to several years at the site of previous irradiation; it is precipitated by the use of triggering drugs, although rarely by BRAF or MEK inhibitors.

Patients and methods

We report an unusual case of recall dermatitis induced 3 months after initiation of vemurafenib and cobimetinib therapy.

Discussion

Radiation recall dermatitis is a cutaneous reaction that must be known and which in rare cases such as ours may occur a long time after the end of radiotherapy.



Psoriasis de l'enfant vu en milieu libéral : les aspects cliniques et épidémiologiques diffèrent des données habituellement publiées

Publication date: Available online 4 April 2019

Source: Annales de Dermatologie et de Vénéréologie

Author(s): E. Mahé, F. Maccari, M. Ruer-Mulard, N. Bodak, H. Barthelemy, C. Nicolas, E. Pépin, M. Pillette-Delarue, C. Buzenet, P.-L. Delaire, M. Nadaud, F. Bouscarat, D. Drouot-Lhoumeau, C. Lepelley-Dupont, A. Acher, A. Beauchet, F. Corgibet, Fédération française de formation continue et d'évaluation en dermatologie-vénéréologie et le GEM Resopso

Résumé
Introduction

Le psoriasis touche 0,2 à 0,7 % des enfants et est associé à l'obésité. Les études publiées ont été réalisées en milieu hospitalier. L'étude PsoLib a évalué le psoriasis de l'enfant consultant dans des cabinets privés en évaluant les aspects épidémiologiques et cliniques, ainsi que les comorbidités.

Méthodes

Il s'agissait d'une étude multicentrique, transversale et non interventionnelle d'enfants (0 à 18 ans) atteints de psoriasis, réalisée par 41 dermatologues travaillant dans des cabinets privés. Les aspects cliniques et thérapeutiques et les comorbidités ont été évalués de manière systématique. Nous avons comparé les données à l'étude χ-Psocar réalisée avec la même méthodologie dans des hôpitaux français.

Résultats

Au total, 207 enfants (filles : 60,4 % ; âge moyen : 10,5 ± 4,2 ans) ont été inclus. Le psoriasis du cuir chevelu (40,6 %) était le type clinique le plus fréquent, tandis que le type en plaques généralisées ne représentait que 26 % des cas. L'atteinte des ongles ou de la langue et le rhumatisme psoriasique étaient rarement observés. Moins de 1 % des enfants souffraient d'hypertension, de diabète de type 1 ou de dyslipidémie, mais 16,4 % étaient en surpoids et 7,0 % étaient obèses. La gravité (PGA maximum ≥ 4) était associée au surpoids (p = 0,01).

Conclusion

Le psoriasis du cuir chevelu est le type clinique de psoriasis le plus fréquent chez l'enfant. Les comorbidités et la localisation extracutanée sont rares. Même dans les cabinets privés, la gravité de la maladie est associée au surpoids.

Summary
Background

Psoriasis affects 0.2–0.7 % of children and is associated with obesity. Published studies have been conducted in hospital settings (tertiary care). The PsoLib study evaluated childhood psoriasis in private practice (secondary care) in terms of epidemiology, clinical aspects and comorbidities.

Patients and methods

This was a non-interventional, cross-sectional, multicenter study of children with psoriasis performed by 41 dermatologists working in private practice. The clinical and therapeutic aspects and comorbidities were systemically evaluated. We compared data to the χ-Psocar study performed in hospitals using the same methodology.

Results

In all, 207 children (girls: 60.4 %; mean age: 10.5 ± 4.2 years) were included. Scalp psoriasis (40.6 %) was the most frequent clinical type, while plaque psoriasis represented 26 % of cases. Nail, tongue, and arthritic involvement were rare. Less than 1 % of children suffered from hypertension, diabetes or dyslipidemia, but 16.4 % were overweight and 7.0 % were obese. Severity (PG ≥ 4 at peak) was associated with excess weight (P = 0.01).

Conclusion

Scalp psoriasis is the most frequent clinical type of psoriasis in childhood. Comorbidities and extracutaneous localization are rare. Even in private practice, the severity of the disease is associated with excess weight.



Réponse des auteurs à la correspondance à propos de l'article : « Maladie de Paget sur sein surnuméraire »

Publication date: April 2019

Source: Annales de Dermatologie et de Vénéréologie, Volume 146, Issue 4

Author(s): M.-H. Jegou, E. Lorier-Roy, Groupe Dermatolist, I. Roche



Correspondance à propos de l'article : « Maladie de Paget sur sein surnuméraire »

Publication date: April 2019

Source: Annales de Dermatologie et de Vénéréologie, Volume 146, Issue 4

Author(s): C. Perrin



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