Dexmedetomidine in gastrointestinal endoscopic procedures

Gastrointestinal endoscopy is the gold standard in the examination and the treatment of the diseases of gastrointestinal system, but the disadvantage of being painful process. At this point the sedative and analgesic agents may be important. Dexmedetomidine is a new sedoanalgesic agent which is alternative to benzodiazepines and opioids. It has analgesia, amnesia, sedative and anxiolytic properties. The use of dexmedetomidine as the sole anesthetic agent and as the adjuvant analgesic agent has been published but has not been approved because of the inconsistency of efficacy and safety. The author has been collected the published papers in the literature. This article is aimed to describe the use of dexmedetomidine in various gastrointestinal endoscopic procedures.     

Growth of Mycobacterium leprae in a redox system: III. Evidence of growth at low temperature (psychrophilia) and, further refinement of growth medium

Considerable growth enhancement, largely as non-acid fast, slender and long rods has been seen when incubated at 10 degrees C. Concentration of some of the media constituents have been reduced that has improved the quantum of growth. A remarkable proneness to physical disintegration of the grown bacilli has been seen and its significance discussed. Also, the possible immunogenic advantage of non-AF M. leprae has been discussed. The question of identification is still not solved, and work is in progress.     

Changing patterns of HIV related ocular disease

Cytomegalovirus (CMV) retinitis is the commonest ocular complication of AIDS and the prevention of recurrence has been dependent on lifelong maintenance treatment. Recently there has been a dramatic downturn in the number of new cases of CMV retinitis, which has been attributed to the introduction of highly active antiretroviral therapy (HAART) and subsequent improved survival. Whereas paucity of inflammation has been considered to be the hallmark of the ophthalmic manifestations of AIDS, with immune recovery, a new pattern of ophthalmic AIDS has emerged. This is characterised by a heightened inflammatory response and more frequent complications associated with this response--for example, vitritis, cystoid macular oedema. In spite of this, regression of CMV retinitis has been reported, as well as absence of reactivation or progression after withdrawal of anti-CMV maintenance treatment. How long this situation will continue is not known and we remain cautious about the future of CMV retinitis and other opportunistic ocular infections.     

COVID-19 and artificial intelligence: Experts and dermatologists perspective

Introduction

Artificial intelligence (AI) has an important role to play in future healthcare offerings. Machine learning and artificial neural networks are subsets of AI that refer to the incorporation of human intelligence into computers to think and behave like humans.

Objective

The objective of this review article is to discuss perspectives on the AI in relation to Coronavirus disease (COVID-19).

Methods

Google Scholar and PubMed databases were searched to retrieve articles related to COVID-19 and AI. The current evidence is analysed and perspectives on the usefulness of AI in COVID-19 is discussed.

Results

The coronavirus pandemic has rendered the entire world immobile, crashing economies, industries, and health care. Telemedicine or tele-dermatology for dermatologists has become one of the most common solutions to tackle this crisis while adhering to social distancing for consultations. While it has not yet achieved its full potential, AI is being used to combat coronavirus disease on multiple fronts. AI has made its impact in predicting disease onset by issuing early warnings and alerts, monitoring, forecasting the spread of disease and supporting therapy. In addition, AI has helped us to build a model of a virtual protein structure and has played a role in teaching as well as social control.

Conclusion

Full potential of AI is yet to be realized. Expert data collection, analysis, and implementation are needed to improve this advancement.     

Adipose tissue,fillers, and skin tightening

The role of adipose tissue has long been underestimated in esthetic dermatology. With the development of liposculpture and lipolysis, subcutaneous adipose tissue has gained an increasing interest. Harvested tissue has been used for lipofilling. In recent years, a better understanding of adipocyte physiology and its role in aging opened a new road for targeted treatments. Subcutaneous adipose tissue is no longer an innocent bystander in the combat of aging and the correction in esthetics. Adipose tissue is of importance for metabolic function and thermoregulation. Adipose tissue is involved in inflammation. Adipose tissue is heterogeneous in sense of function, color and size of adipocytes. The tissue is an important source of somatic stem cells.     

Vitiligo: a review of some facts lesser known about depigmentation

Vitiligo is a disorder that causes the destruction of melanocytes. It has three important factors underlying this destruction. The depigmented skin has many aberrant functions such as a muted response to contact allergens, a phenomenon also seen in mice that depigment. The white skin of those with vitiligo does not form non-melanoma skin cancers although the white skin of albinos, which has a similar color as vitiligo, is highly susceptible to skin cancer.     

二甲双胍在皮肤科的临床应用

二甲双胍是最常用的口服降糖药，研究表明它不仅有胰岛素增敏作用，还具有抗炎、抗雄激素和抗肿瘤作用。近来年，人们尝试使用二甲双胍治疗多种皮肤病，包括妇女多毛症、寻常性痤疮、化脓性汗腺炎、黑棘皮病、银屑病、黑素瘤和发疹性黄瘤等，并获得了不同程度的疗效。本文对二甲双胍在皮肤科的临床应用进展作一综述。     

Circumscribed palmar hypokeratosis associated with disseminated superficial actinic porokeratosis

Circumscribed palmar and plantar hypokeratosis (CPPH) is a recently described skin condition with particular clinical and histopathological findings. The etiopathogeny of CPPH is still unclear, but an abnormal clone of keratinocytes has been postulated as the possible origin. CPPH has been considered an entity with no potential malignant transformation, but recently, it has been recognized in association with signs of actinic keratosis in the same biopsy. CPPH has never been recognized in association with porokeratosis. Although these entities seem to be different, a possible relationship between them might be suggested.     

特应性皮炎与皮肤微生物态的关系

特应性皮炎是一种慢性、周期性、瘙痒性皮肤病。近年来,我国患病人数迅速上升,尽管越来越多的人深受其困扰,但目前病因尚不清楚,近年来发现皮肤微生物态对全身免疫功能及局部皮肤免疫功能有影响,皮肤屏障完整性的改变会导致皮肤微生物多样性的改变和皮肤菌群的紊乱,诱发并加重特应性皮炎。特应性皮炎的患者与健康人相比,发生皮肤感染的风险也更高。因此,特应性皮炎与皮肤微生物态的关系也成为近年来研究的热点。     

Two pediatric cases of isotretinoin-induced sacroiliitis successfully treated with adalimumab

Isotretinoin is widely used in severe acne. Isotretinoin has many side effects. Sacroiliitis is one of these side effects and has been rarely reported in the children. Herein, we present two children with isotretinoin-induced sacroiliitis resistant to anti-rheumatic drugs and successfully treated with adalimumab.     

Subcutaneous calcification presenting in a patient with mixed connective tissue disease and cutaneous polyarteritis nodosa

Subcutaneous calcification often occurs in connective tissue diseases, most commonly scleroderma and dermatomyositis, but is rarely found in mixed connective tissue disease (MCTD). Cutaneous polyarteritis nodosa (PAN) is usually a primary skin disorder and although associated with connective tissue disease, has not been reported previously in MCTD. Calcinosis in cutaneous PAN is not a recognized feature. We describe the case of a 37-year-old woman who presented with tender ulcerated subcutaneous nodules on the lower legs consistent with cutaneous PAN, and she also showed features of MCTD with extensive secondary subcutaneous calcification. The use of systemic immunosuppressive treatment has improved the clinical features of PAN and MCTD but treatment of the calcification has proved challenging. No single medical or surgical treatment has been shown to be consistently effective in subcutaneous calcification, but the introduction of diltiazem in our patient has resulted in some improvement.     

Epidermolysis bullosa acquisita associated with relapsing polychondritis: an association with eosinophilia?

Epidermolysis bullosa acquisita is a blistering disorder that has been associated with other autoimmune diseases. It has not previously been associated with relapsing polychondritis (RPC). RPC is an autoimmune disorder that frequently displays peripheral eosinophilia. The eosinophil has been implicated in mediation of tissue damage and bullae formation. RPC should be added to the list of diseases seen in association with EBA.     

炎症细胞因子白介素-6、肿瘤坏死因子-α、转化生长因子-β1在多囊卵巢综合征中作用机制及临床意义的研究进展

多囊卵巢综合征(PCOS)是妇科常见的一种内分泌紊乱疾病,近年来的研究发现其发病率正在逐年上升,对女性的生活质量产生了不同程度的影响.PCOS的发病机制复杂多样,目前仍未明确,故其治疗也缺乏针对性及特异性.但慢性炎症在其发病机制中的重要作用已经被证实,本文通过检索近年来的国内外相关文献,主要从与炎症密切相关的细胞因子[...     

Evidence for population level declines in adult HIV prevalence in Kenya

The HIV/AIDS epidemic in Kenya has been tracked through annual sentinel surveillance in antenatal clinics since 1990. The system started with 13 sites and now has over 35. Behaviours have been measured through national Demographic and Health Surveys in 1993, 1998, and 2003. The surveillance data indicate that prevalence has declined substantially starting in 1998 in five of the original 13 sites and starting in 2000 in another four sites. No decline is evident in the other five original sites although the 2004 estimate is the lowest recorded. Nationally, adult prevalence has declined from 10% in the late 1990s to under 7% today. Surveys indicate that both age at first sex and use of condoms are rising and that the percentage of adults with multiple partners is falling. It is clear that HIV prevalence is now declining in Kenya in a pattern similar to that seen in Uganda but seven or eight years later. Although the coverage of preventive interventions has expanded rapidly since 2000 this expansion was too late to account for the beginnings of the decline in prevalence. More work is needed to understand fully the causes of this decline, but it is encouraging to see Kenya join the small list of countries experiencing significant declines in HIV prevalence.     

A Case of Vitiligo after Kawasaki's Disease

Vitiligo is a common skin disease, but its pathogenesis has not been fully determined, though an autoimmune etiology is considered likely. Kawasaki disease (KD) is an acute multisystem vasculitis of childhood associated with coronary arteriopathy, and is diagnosed based on clinical criteria. Furthermore, vitiligo has been associated with several other diseases, but no report has been issued about the relationship between vitiligo and Kawasaki''s disease. The author''s report the case of an 8-year-old male child that presented with depigmented lesions, which developed from the desquamative skin lesions of Kawasaki''s disease.     

Treatment of Kimura's disease with cyclosporine

Kimura's disease is a rare, chronic inflammatory disease of unknown cause. It is characterized by painless subcutaneous swellings and lymphadenopathy, commonly affecting the head and neck region. This is associated with peripheral blood eosinophilia and raised serum IgE. It has distinct histological features of lymphoid follicles, eosinophilic infiltrate, fibrosis and vascular proliferation. The disease usually has a benign, indolent course. Traditionally, therapeutic options have included surgery, radiotherapy and steroids but response has been less than satisfactory. Recently, cyclosporine has been reported to be effective in the treatment of Kimura's disease. In this article, we present a middle-aged Chinese female with Kimura's disease for 20 years and her favourable response to cyclosporine.     

Atopic dermatitis and tacrolimus in adults

Topical treatment with tacrolimus is more effective than the placebo and the low potency corticosteroids in the treatment of atopic dermatitis (AD) in both adults and children while it has a similar potency as some topical corticosteroids of medium potency. Since it was put on the market, more evidence has been accumulating to make our previous statements and it has been demonstrated to have greater effectivity than topical pimecrolimus and oral cyclosporine. It is a safe drug and its side effects are of little importance. Specifically no side effects have been demonstrated due to its systemic absorption nor has there been any increase in skin infections. The most frequent side effect is burning sensation or increased pruritus in the area where the product is applied. It is more frequent if the lesions treated are very acute and is generally transitory, not causing the treatment to be discontinued. Furthermore, with the current information, it cannot be associated to an increase of any type of neoplasms.     

阿奇霉素治疗早期梅毒及其耐药的进展

青霉素是目前治疗梅毒的最佳方法，但在应用中仍存在着一定的局限性。阿奇霉素治疗早期梅毒简便可行、依从性好，且多项研究已证实其疗效，可作为青霉素过敏患者的替代治疗方案。同时阿奇霉素在梅毒预防控制的现场实施和用于治疗其他性病病原体合并感染有一定的优越性。近年来，出现基因突变引起的耐阿奇霉素的梅毒螺旋体，导致阿奇霉素治疗早期梅毒失败，并在一定的网络中传播，影响它在梅毒治疗中的进一步应用。     

先天性厚甲症研究进展

先天性厚甲症是一种少见的常染色体显性遗传性皮肤病,临床上分为两型,影响指（趾）甲、皮肤、口腔黏膜、喉、头发和牙齿,以指（趾）甲过度增厚伴营养不良为主要特征。目前在分子水平已经阐明I型先天性厚甲症是由角蛋白基因K6a和K16突变引起,而Ⅱ型先天性厚甲症则是由角蛋白基因K6b和K17突变引起。在治疗方面,主要是对症治疗,基因治疗已成为研究的热点,特别在应用小干扰RNA（siRNA）治疗先天性厚甲症的研究方面取得进展,已成为治疗遗传性皮肤病的一个新的方向。     

Simplified method of covering skin defects on the extremities

The following simplified and time-saving method of covering skin defects has been tested on 125 patients. Opsite foil is loosely attached to the donor skin area which has been previously dried and disinfected carefully before removing the split thickness skin graft using the dermatome. Thus the graft can be brought onto the defect without shrinkage. Fixation is simply performed by adhesive tape being covered by a compression bandage. The extremity is then immobilized by a Bycast bandage. This technique has proved to show good results that are fully compatible with other more time-consuming methods.