Intracranial thrombosed anastomosing hemangioma: Case report

An anastomosing hemangioma is a relatively new diagnosis of a benign vascular lesion that is typically found in the genitourinary tract. On imaging, anastomosing hemangiomas have a broad differential diagnosis and can resemble malignant lesions such as angiosarcoma. Here we present a case of a 33-year-old male with seizures who on imaging was found to have a presumed recurrent intracranial meningioma. After surgical resection of his lesion, this case was pathologically diagnosed as having anastomosing hemangioma. To our knowledge, this is the first report of a case of a thrombosed anastomosing hemangioma located at intracranial and intradural region.     

Mental Health and the Maintenance of Kinship in South Africa

ABSTRACT

At the turn of the millennium, people with mental disturbance often lived in circumstances of economic marginalization in South Africa. The historical material of one low-income urban area reveals the place of kin relations and reciprocity in enabling negotiation of a more fluid set of responses to mental illness. In this sociocultural context, “stigma” was not an inevitable reaction to mental illness, and a more complex set of social dynamics could mitigate marginalization. Research on how changing informal care practices relate to state-based community care continues to be important to inform contemporary health reforms.     

Population pharmacokinetics and exposure‐response modeling analyses of guselkumab in patients with psoriatic arthritis

Guselkumab is an anti‐interleukin‐23 human monoclonal antibody effective in treating psoriatic arthritis (PsA). To characterize the pharmacokinetics (PKs) and exposure‐response relationship of guselkumab in PsA, population PKs, and exposure‐response modeling, analyses were conducted using data from pivotal phase III studies of subcutaneous guselkumab in patients with PsA. The observed serum concentration‐time data of guselkumab were adequately described by a one‐compartment linear PK model with first‐order absorption and elimination. Covariates identified as contributing to the observed guselkumab PK variability were body weight and diabetes comorbidity; however, the magnitude of the effects of these covariates was not considered clinically relevant, and dose adjustment was not warranted for the patient population investigated. Positive exposure‐response relationships were demonstrated with landmark and longitudinal exposure‐response analyses between guselkumab exposure and clinical efficacy end points (American College of Rheumatology [ACR] 20%, 50%, and 70% improvement criteria and Investigator’s Global Assessment [IGA] of psoriasis) at weeks 20 and/or 24, with no clinically relevant differences observed in improvement of PsA signs and symptoms between the two guselkumab treatment regimens evaluated (100 mg every 4 weeks or 100 mg at weeks 0 and 4, then every 8 weeks). Baseline Disease Activity Score in 28 joints (DAS28), Psoriasis Area and Severity Index (PASI) score, and/or C‐reactive protein level were identified as influencing covariates on guselkumab exposure‐response model parameters. These results provide a comprehensive evaluation of subcutaneous guselkumab PKs and exposure‐response relationship that supports the dose regimen of 100 mg at weeks 0 and 4, then every 8 weeks in patients with PsA.

Study Highlights

• WHAT IS THE CURRENT KNOWLEDGE ON THE TOPIC?

Guselkumab, an IL‐23 antagonist, is approved for use in adults with psoriasis or psoriatic arthritis (PsA). Subcutaneous guselkumab concentration data in patients with psoriasis are adequately described by a one‐compartment linear pharmacokinetic (PK) model with first‐order absorption and elimination, and systemic exposure is associated with clinical measures of treatment response in these patients.

• WHAT QUESTION DID THIS STUDY ADDRESS?

These analyses aimed to describe subcutaneous guselkumab PKs in adults with PsA based on data from two phase III studies, quantify the effects of intrinsic or extrinsic factors that may contribute significantly to PK variability, characterize the relationships between guselkumab exposure and clinical efficacy measures in adults with PsA, and evaluate the impact of covariates on clinical efficacy.

• WHAT DOES THIS STUDY ADD TO OUR KNOWLEDGE?

This is the first report of population PK and exposure‐response analyses of guselkumab in patients with PsA. The observed guselkumab concentration‐time data were adequately described by a one‐compartment linear population PK model with first‐order absorption and elimination. The major model parameters were consistent with those previously reported for guselkumab in patients with psoriasis. As in patients with psoriasis, the covariates identified as significantly contributing to guselkumab PK variability were body weight and diabetes comorbidity, with similar effects, which were not considered clinically relevant. Subcutaneous guselkumab 100 mg every 4 or 8 weeks resulted in similar improvements in the signs and symptoms of PsA, with no dose adjustment warranted for any of the subgroups identified in the covariate analyses.

• HOW MIGHT THIS CHANGE CLINICAL PHARMACOLOGY OR TRANSLATIONAL SCIENCE?

These results were used to support the approval of guselkumab for use in adults with PsA and inform the product label.     

Examining the effects of initial smoking abstinence on response to smoking-related stimuli and response inhibition in a human laboratory model

Rationale

Research is needed on initial smoking abstinence and relapse risk.

Objective

This study aims to investigate the effects of different durations of initial abstinence on sensitivity to smoking-related stimuli and response inhibition in the context of a larger battery of outcome measures.

Methods

Smokers were randomly assigned to receive payment contingent on smoking abstinence across all 15 study days (15C) or just the final 2 days (2C). Smoking status and subject ratings were assessed daily. Participants completed fMRI sessions at baseline and day 14 during which they completed craving ratings after exposure to smoking-related and neutral stimuli and performed a response inhibition task. On day 15, participants completed a smoking preference session involving 20 exclusive choices between smoking and money.

Results

The payment contingencies were effective in producing greater smoking abstinence in the 15C vs. 2C conditions. Ratings of withdrawal decreased, while ratings of ease and confidence in abstaining increased in the 15C vs. 2C conditions across the 15-day study. 15C participants were less likely to choose the smoking option in the preference session. 15C participants reported greater reductions in craving compared to the 2C participants in the presence of smoking-related and neutral stimuli (i.e., decreases in generalized craving), but no differences were noted in cue reactivity per se or in response inhibition.

Conclusions

Results systematically replicate prior observations that a period 2 weeks of initial abstinence decreases the relative reinforcing effects of smoking and improves other outcomes associated with relapse risk compared to the initial day or two of a cessation effort, and extends them by underscoring the importance of generalized rather than cue-induced craving in relation to relapse risk during the initial weeks of smoking cessation.     

The predictive value of malnutrition for functional and cognitive status in elderly hemodialysis patients

International Urology and Nephrology - The study aims to objectively and precisely describe, in elderly dialysis patients from a single center, the prevalence of malnutrition and severe...     

Resveratrol (3, 5, 4′-Trihydroxy-trans-Stilbene) Attenuates a Mouse Model of Multiple Sclerosis by Altering the miR-124/Sphingosine Kinase 1 Axis in Encephalitogenic T Cells in the Brain

Journal of Neuroimmune Pharmacology - Resveratrol (3,5,4′-trihydroxy-trans-stilbene) (RES) is a naturally-derived phytoestrogen found in the skins of red grapes and berries and has potential...     

Acne Knowledge of Hispanic Parents of Teenagers with Mild to Moderate Acne

We performed a cross‐sectional study of Hispanic and non‐Hispanic parents of children with acne using a survey designed to determine their level of awareness of acne and its treatment; 82% of Hispanic parents and 40% of non‐Hispanic parents agreed that a health care provider should treat mild acne (p < 0.001). Hispanic parents of adolescents with acne agreed more frequently than non‐Hispanic parents that children with mild and moderate acne should be taken to a health care provider for treatment, but they tended not to visit health care providers. Future studies should aim to determine the reasons for this discrepancy, after which culturally sensitive educational programs can be developed to address this disparity.     

Central monoamine activity in genetically distinct strains of mice following a psychogenic stressor: effects of predator exposure

The effects of psychogenic stressors, rat exposure and fox urine odor, on central monoamine functioning was assessed in two inbred strains of mice, BALB/cByJ and C57BL/6ByJ, thought to be differentially reactive to stressors. These stressors markedly increased NE utilization, as reflected by MHPG accumulation, in the locus coeruleus, hippocampus, prefrontal cortex and central amygdala. Likewise, the 5-HT metabolite, 5-HIAA, was elevated in hippocampus, prefrontal cortex and central amygdala, and to some extent DOPAC accumulation was increased in the prefrontal cortex. In most brain regions, the neurochemical effects of the stressors were comparable in the two mouse strains. However, central amygdala 5-HIAA elevations as well as DOPAC increases in the prefrontal cortex elicited by fox odor were greater in C57BL/6ByJ than in BALB/cByJ mice. Although BALB/cByJ mice are more behaviorally reactive than C57BL/6ByJ mice, and also show greater corticosterone elevations in response to neurogenic and systemic stressors, it was previously shown that differential corticosterone changes were not elicited by a predator exposure. Taken together with earlier findings, it appears that despite greater behavioral reactivity/anxiety, the strain-specific neurochemical changes elicited may be situation-specific such that the profile apparent in response to neurogenic and systemic stressors may not be evident in response to predator-related threats.