Five‐year experience in the treatment of alopecia areata with DPC

Background The effectiveness of Diphencyprone (DPC) in alopecia areata (AA) was demonstrated in several studies with highly variable response rates ranging from 5% to 85%. Objective The response rate and variable factors affecting the prognosis were studied focusing on long‐term follow‐up with or without maintenance therapy. Methods A total of 135 cases of AA were treated with DPC. Patients were divided into five groups according to the area of scalp affected: Grade 1 AA: 25–49% scalp affection; Grade 2 AA: 50–74% scalp affection; Grade 3 AA: 75–99% scalp affection; alopecia totalis and alopecia universalis. An initial response was defined as appearance of new terminal hair within treated sites. Excellent response was defined as terminal hair covering >75% of the scalp. Relapse meant >25% hair loss. Maintenance therapy meant ongoing therapy once every 1–4 weeks after excellent response. Follow‐up was performed to detect any relapse of AA. Results Ninety‐seven patients continued therapy for ≥3 months. After an initial 3 month lag, cumulative excellent response was seen in 15 patients (15.4%), 47 patients (48.5%), 51 patients (52.6%) and 55 patients (55.7%) after 6, 12, 18 and 24 months respectively in a mean median time of 12 months. The only patient variable affecting the prognosis was baseline extent of AA. Excellent response was seen in 100%, 77%, 54%, 50% and 41% in Grade 1, Grade 2, Grade 3, AA totalis and AA universalis patients respectively. Side‐effects were few and tolerable. Hair fall >25% occurred in 17.9% of patients on maintenance and 57.1% of patients without maintenance therapy (P‐value = 0.025). Conclusion Diphencyprone is an effective and safe treatment of extensive AA. A long period of therapy is needed and will increase the percentage of responders especially in alopecia totalis and universalis. Maintenance therapy is recommended to reduce the risk of relapse.     

Lichen planus and cicatricial conjunctivitis: disease course and response to therapy of 11 patients

Background Lichen planus is an autoimmune, inflammatory dermatosis of unknown cause that affects the skin and mucous membranes. Objective The aim of this study was to report the clinical features and response to therapy in a series of patients with ocular lichen planus. Methods A retrospective chart review was performed to identify patients with ocular lichen planus. Information about clinical presentation, treatment, and therapeutic response was extracted from the medical records. Results Eleven patients with ocular lichen planus were identified. The diagnosis was confirmed histologically for 10 patients. Nine patients were women. The average time from onset of ocular symptoms to diagnosis was 4.1 years. Eight patients had mucous membrane involvement at other sites. Disease was well controlled in eight patients. Conclusion Lichen planus should be considered in the differential diagnosis of cicatricial conjunctivitis, especially when severe lichen planus is noted at other sites.     

Meeting the Developmental Needs of Young Adults Diagnosed with Serious Mental Health Challenges: the Emerge Model

The Journal of Behavioral Health Services & Research - Adult providers struggle to engage 18–25-year olds despite high rates of serious mental health challenges observed among this age...     

Raising Backyard Poultry in Rural Bangladesh: Financial and Nutritional Benefits,but Persistent Risky Practices

Poultry is commonly raised by households in rural Bangladesh. In 2007, the Government of Bangladesh began a mass media campaign to disseminate 10 recommended precautions to prevent transmission of H5N1 from poultry to humans. This longitudinal study explored the contribution of backyard poultry on household economy and nutrition and compared poultry‐raising practices to government recommendations. From 2009 to 2012, we enrolled a nationally representative sample of 2489 primary backyard poultry raisers from 115 rural villages selected by probability proportional to population size. Researchers interviewed the raisers to collect data on poultry‐raising practices. They followed the raisers for 2–12 months to collect data on household income and nutrition from poultry. Income from backyard poultry flocks accounted for 2.8% of monthly household income. Return on annual investment (ROI) per flock was 480%. Yearly, median family consumption of eggs was one‐fifth of the total produced eggs and three poultry from their own flock. Respondents’ reported practices conflicted with government recommendations. Sixty per cent of raisers had never heard of avian influenza or ‘bird flu’. Among the respondents, 85% handled sick poultry or poultry that died due to illness, and 49% slaughtered or defeathered sick poultry. In 37% of households, children touched poultry. Fifty‐eight per cent never washed their hands with soap after handling poultry, while <1% covered their nose and mouth with a cloth when handling poultry. Only 3% reported poultry illness and deaths to local authorities. These reported practices did not improve during the study period. Raising backyard poultry in rural Bangladesh provides important income and nutrition with an excellent ROI. Government recommendations to reduce the risk of avian influenza transmission did not impact the behaviour of poultry producers. Further research should prioritize developing interventions that simultaneously reduce the risk of avian influenza transmission and increase productivity of backyard poultry.     

Normal cycling patterns of hematopoietic stem cell subpopulations: an assay using long-term in vivo BrdU infusion

It was found in a long-term bromodeoxyuridine (BrdU) infusion study that two or more different subpopulations of bone marrow stem cells exist in mice. One of these subpopulations appears to be noncycling and forms approximately 10% of eight-day CFU-S. Another one, a subpopulation of slowly cycling bone marrow cells, is represented as 14- day CFU-S. The 14-day CFU-S have a regular increment in the percentage of the subpopulation entering the cycle over time, with a cell generation half-time of 21 days. The cycling status in these experiments was ascertained by in vivo continuous long-term BrdU infusion. An improved method is presented for long-term BrdU infusion with UV killing of cycled cells.     

Erythema nodosum und Infektionskrankheiten.

• 1 Bericht über 12 Fälle von Erythema nodosum bei Erwachsenen und älteren Personen, bei welchen als ätiologie des Ausschlages angenommen wird: frische Tuberkulose in zwei Fällen, Infektion von grippeähnlichem Typ in zwei Fällen, Infektionen der oberen Luftwege bei alten Frauen in drei Fällen, Angina in zwei Fällen und endlich septische Infektionen in drei Fällen.
• 2 Erörterung der ätiologie des Erythema nodosum. Der Ausschlag ist ein Ausdruck für eine an und für sich unspezifische Reaktionsweise, die bei verschiedenen Infektionen vorkommt. So im Kindes- und Jugendalter vorwiegend bei frischer Tuberkuloseinfektion, während Erythema nod. älterer Individuen und Rezidiven des Ausschlages im allgemeinen gewöhnlich durch andere Infektionen verschiedener Art verursacht sein dürften. Der bereits manifesten Tuberkulose wird also keine ätiologische Bedeutung beigemessen und auch bei einem nicht tuberkuloseinfizierten Individuum muss der Ausschlag auftreten können. Ausser den soeben angeführten exogenen Faktoren gibt es sicherlich auch endogene Momente von Bedeutung für die Entstehung des Ausschlages.
• 3 Jeder Fall von Erythema nodosum muss für sich analysiert und ätiologisch aufgeklärt werden. Prognose und Behandlung sind nämlich von den Grundkrankheiten abhängig.