Induction of cell cycle arrest and apoptosis in JAR trophoblast by antimalarial drugs

Chloroquine, quinine, artemisinin, and pyrimethamine are generally considered safe drugs for treatment of malaria during pregnancy; however, high doses of these drugs are detrimental with adverse outcome of pregnancy. Since antimalarial drugs interaction with placental cells has not been addressed, in this study, we employed a non-radioactive proliferation assay and lactate dehydrogenase (LDH) release assays to investigate the effect of these drugs on JAR trophoblastic cell survival. All drug treatment resulted in inhibition of cell proliferation in a dose-dependent fashion (p < 0.05) with IC50 at 6.96, 6.49, 6.69, and 6.89 microg/mL for chloroquine, quinine, artemisinin and pyrimethamine, respectively. In addition, the inhibition of cell proliferation was accompanied by increased cytotoxicity. Analysis of the progression of the cell cycle showed that these drugs triggered G0/G1 and S phase arrest. Furthermore, these antimalarial drugs induced apoptotic cell death as visualized by DNA fragmentation analysis techniques. Findings in this study revealed that cytotoxicity of these drugs on human placental trophoblast is mediated by both cell cycle arrest and induction of cell death and this could have important implications for the use of antimalarial drugs for treating malaria during pregnancy.     

Pregnancy‐associated acquired arteriovenous malformation of the nail unit: a novel cause of localized erythronychia

Localized longitudinal erythronychia describes a solitary red streak limited to a single nail unit. Localized longitudinal erythronychia can be caused by both benign and malignant entities. Most commonly, the cause is a benign process, such as an onychopapilloma. We report a case of an acquired subungual arteriovenous malformation that presented as localized longitudinal erythronychia during pregnancy. To our knowledge, this is the first report of localized longitudinal erythronychia arising from a pregnancy‐associated arteriovenous malformation of the nail unit.     

Chicken Essence for Cognitive Function Improvement: A Systematic Review and Meta-Analysis

Chicken essence (CE) is a popular traditional remedy in Asia, which is believed to improve cognitive functions. CE company claimed that the health benefits were proven with research studies. A systematic review was conducted to determine the cognitive-enhancing effects of CE. We systematically searched a number of databases for randomized controlled trials with human subjects consuming CE and cognitive tests involved. Cochrane’s Risk of Bias (ROB) tool was used to assess the quality of trials and meta-analysis was performed. Seven trials were included, where six healthy subjects and one subject with poorer cognitive functions were recruited. One trial had unclear ROB while the rest had high ROB. For executive function tests, there was a significant difference favoring CE (pooled standardized mean difference (SMD) of −0.55 (−1.04, −0.06)) and another with no significant difference (pooled SMD of 0.70 (−0.001, 1.40)). For short-term memory tests, no significant difference was found (pooled SMD of 0.63 (−0.16, 1.42)). Currently, there is a lack of convincing evidence to show a cognitive enhancing effect of CE.     

The effect of combined hyaluronic acid filler injection and radiofrequency treatment: A clinic histological analysis

Background

Hyaluronic acid (HA) filler injections have increased in popularity. They are usually performed in combination with other treatment modalities, including lasers and energy-based devices, to enhance cosmetic results. Theoretically, HA and other filler injections should be performed after laser- or energy-based device treatments. In some instances, however, practitioners are asked to administer laser- or energy-based device treatment after HA dermal filler injection. There is a concerning possibility of HA filler degradation as a result of bulk heating generated by lasers or energy-based devices, especially radiofrequency (RF).

Aim

To evaluate the effect of RF treatment at different time points on HA degradation in vivo, using clinicohistological analysis.

Patients/methods

Fourteen volunteers were recruited and received intradermal HA filler injections in four sites on the abdomen. One site served as the control, and the other three sites were treated with monopolar RF on the same day after injection, at 14 and 28 days post-injection. Skin biopsies were performed at baseline and 56 days after HA injection. Histopathological sections were reviewed for residual filler in the tissue.

Results

The results showed that HA grading scores decreased in five (35.71%), one (7.14%), and one (7.14%) participants when RF was performed immediately, 14 and 28 days after injection, respectively.

Conclusion

In conclusion, RF treatment after HA filler injection may affect the integrity of the HA filler in the tissue, especially if RF treatment was performed on the same day after HA injection.     

Dihydroxyacetone: a safe camouflaging option in vitiligo

Background Most treatment protocols for vitiligo usually do not result in complete repigmentation. Therefore, cosmetically acceptable camouflage, low cost and easy to handle alternatives are warranted. Objective To evaluate the efficacy of low‐cost self‐tanner available in the Thai market in normal subjects with skin types III, IV, and V, and the efficacy for camouflage of 6% dihydroxyacetone (DHA) cream in the treatment of vitiligo on exposed areas of Asian skin. Methods The study was divided into two parts. Part 1 is a prospective study of 15 healthy volunteers using three different DHA creams which were available in the Thai market with concentrations of 3.5%, 4.2%, and 5%. Part 2 was a retrospective study of 20 patients suffering from vitiligo affecting the face and/or hands and feet who were treated with 6% DHA. The data were collected through direct examination, telephone interview, face‐to‐face interview, and photographs. Results In healthy volunteers, we found that color matching was achieved by using a higher concentration of DHA in darker‐skin subjects. Most of the vitiligo patients (88.9%) reported moderate to marked satisfaction with the cosmetic results of 6% DHA cream. Conclusion Dihydroxyacetone offers a safe and effective therapeutic option for recalcitrant vitiligo. Dark‐skin subjects need a higher concentration of DHA cream than lighter‐skin subjects.     

Disparities in Access to Systemic Treatment for Breast Cancer in Thailand and Major Asian Territories

PurposeBreast cancer (BC) treatment has shifted from chemotherapy to targeted therapy. Several targeted agents have demonstrated an improvement in survival. Given that national healthcare resources were correlated with the cancer mortality-to-incidence ratio, we compared access to BC drugs in Thailand with that in other Asian countries.MethodsBC experts involved in the Breast International Group (BIG)-Asia in six representative groups for countries or special administrative region (SAR) in Asia (Hong Kong SAR, Japan, Korea, Taiwan, Thailand, and Singapore) were invited to participate in the survey. The questionnaire addressed national health reimbursement schemes, molecular testing for early BC (EBC), availability and accessibility of BC drugs. Accessibility and reimbursement of the drugs were reported based on their listing as essential medicines in the World Health Organization Model List of Essential Medicines (WHO-EML) and their nomination as effective drugs in the European Society for Medical Oncology-Magnitude of Clinical Benefit Scale (ESMO-MCBS). The study was approved by all participating BIG-Asia organizations in November 2021.ResultsGenomic tests for EBC were non-reimbursable in all surveyed territories. Reimbursement and co-payment of BC drugs vary between and within these regions (particularly Thailand). Most drugs in the WHO-EML and ESMO-MCBS (A/B for EBC and 4/5 for advanced BC) were accessible in all surveyed territories. However, the accessibility of effective but costly WHO-EML and ESMO-MCBS drugs was not uniform in Thailand. There was an evident disparity for individuals covered by the Thai Social Security/Universal Health Coverage schemes.ConclusionEssential BC drugs are generally accessible in selected BIG-Asia countries or SAR. There is a disparity in accessing high-cost drugs in Thailand compared with other Asian territories.