Sodium Channel Inhibitors Reduce DMPK mRNA and Protein

Myotonic dystrophy type 1 (DM1) is caused by an expanded trinucleotide (CTG)n tract in the 3′ untranslated region (UTR) of the dystrophia myotonica protein kinase (DMPK) gene. This results in the aggregation of an expanded mRNA forming toxic intranuclear foci which sequester splicing factors. We believe down‐regulation of DMPK mRNA represents a potential, and as yet unexplored, DM1 therapeutic avenue. Consequently, a computational screen for agents which down‐regulate DMPK mRNA was undertaken, unexpectedly identifying the sodium channel blockers mexiletine, prilocaine, procainamide, and sparteine as effective suppressors of DMPK mRNA. Analysis of DMPK mRNA in C2C12 myoblasts following treatment with these agents revealed a reduction in the mRNA levels. In vivo analysis of CD1 mice also showed DMPK mRNA and protein down‐regulation. The role of DMPK mRNA suppression in the documented efficacy of this class of compounds in DM1 is worthy of further investigation.     

Combined prevention for persons who inject drugs in the HIV epidemic in a transitional country: the case of Tallinn,Estonia

The study was undertaken to assess the potential effectiveness of combined HIV prevention on the very high seroprevalence epidemic among persons who inject drugs (PWID) in Tallinn, Estonia, a transitional country. Data from community-based cross-sectional (respondent-driven sampling) surveys of PWID in 2005, 2007, 2009, and 2011 were used together with mathematical modeling of injection-associated HIV acquisition to estimate changes in injection-related HIV incidence during these periods. Utilization of one, two, or three of the interventions available in the community (needle and syringes exchange program, antiretroviral treatment [ART], HIV testing, opioid substitution treatment) was reported by 42.5%, 30.5%, and 11.5% of HIV+ and 34.7%, 36.4%, and 5.7% of HIV– PWIDs, respectively, in 2011. The modeling results suggest that the combination of needle/syringe programs and provision of ART to PWID in Tallinn substantially reduced the incidence of HIV infection in this population, from an estimated 20.7/100 person-years in 2005 to 7.5/100 person-years in 2011. In conclusion, combined prevention targeting HIV acquisition and transmission-related risks among PWID in Tallinn has paralleled the downturn of the HIV epidemic in this population.     

Gastrointestinal pathology in transplant patients

The assessment of gastrointestinal (GI) specimens from transplant patients is complicated by the wide range of potentially rare pathologies that may be found in this clinical setting. Acute GI graft‐versus‐host disease (GvHD) is characterized by epithelial cell apoptosis, although there is increasing recognition that acute and/or chronic inflammation may also be present. By contrast, thus far there are no histological features known to be specific to chronic GI GvHD. Mycophenolate mofetil colitis may mimic both GvHD and inflammatory bowel disease, whereas both cytomegalovirus (CMV) and adenovirus infections can cause gland apoptosis. Post‐transplant lymphoproliferative disorder should be considered if a Crohn's‐like histological picture is seen, and granulomas in biopsies from umbilical cord blood recipients should raise a suspicion of cord colitis syndrome. Finally, the GI tract may be involved directly or indirectly by the disease that originally required haematopoietic stem cell or liver transplantation.     

Tinea corporis by Nannizia gypsea: delayed diagnosis due to unusual presentation

Fungal infections by dermatophytes can present with unusual clinical manifestations, which can cause diagnostic difficulties. The authors present the case of a patient with cutaneous infection by Nanizzia gypsea, initially treated erroneously with topical corticosteroids due to a wrong diagnosis. It was cured after antifungal treatment.     

长期服用抗精神病药脑电图异常相关因素分析

〔摘 要〕 目的：观察长期服用抗精神病药物的精神疾病患者的脑电图异常检出率，对其影响因素进行分析，提出预防措施。 方法：选取 2020 年 6 月至 2020 年 12 月期间在泉州市第三医院住院的长期服用抗精神病药物患者 256 例进行脑电图检查， 统计检出异常率；并观察不同药物种类、不同年龄段、不同服药时间患者的脑电异常率，对脑电图异常的危险因素进行分析。 结果：256 例患者中 154 例（60.16 %）出现脑电图异常，其中轻度异常在临床中最常见，重度异常最少见。不同药物种类中， 氯氮平使用者脑电图异常率最高；不同年龄段中，年龄＞ 60 岁脑电图异常率较高。结论：长期服用抗精神病药物患者出现 脑电图异常的影响因素主要为年龄＞ 60 岁、长期服用氯氮平，故临床需结合患者年龄合理选择药物，尽量选择对脑电图影 响较小的药物，且密切监测患者病情变化，适当调整或优化治疗方案。     

急诊眩晕症实施不同药物治疗疗效及安全性

目的针对急诊眩晕症患者通过实施不同药物进行治疗,观察及分析临床疗效。方法选取本院收治的急诊眩晕症患者108例,经随机分为对照组、氯丙嗪组、阿托品组、异丙嗪组,分别给不同药治疗后观察4组患者药物在治疗前后阶段的临床效果。结果与对照组相比,其他3组患者其总有效率均出现明显升高,组间差异存在统计学意义(P<0.05)。经治疗后,其他3组发生眩晕的次数改善效果均较好且安全性程度较高。结论对不同药物用于眩晕症稳定型眩晕治疗效果较为明显,不良反应大大降低,安全度高,不仅增强患者生活质量水平,且在急诊科中具有重要参考价值及意义。     

Anticoagulantes orales directos en cirugía dermatológica

Direct-acting oral anticoagulants (DOACs) have emerged as safer, easier-to-manage alternatives to traditional vitamin K antagonists and are used increasingly because they require no monitoring, have a wider therapeutic window, and react less with other drugs. However, there is little consensus on optimal perioperative management when these drugs are used in dermatologic surgery. This article describes the characteristics of DOACs and reviews current evidence on their use in this setting.