Exploring the association between cardiovascular and other disease‐related risk factors in the psoriasis population: the need for increased understanding across the medical community

There is abundant and accumulating evidence on the classification of psoriasis as a systemic disease that exhibits a host of co‐morbidities. As a consequence, the second Interdisciplinary Conference on Co‐morbidities and Lifestyle Modification, convened by the International Psoriasis Council, has concluded that specialist physicians, primary care physicians and dermatologists are faced with an opportunity to impact, not just psoriasis disease understanding and management, but overall patient well‐being. The conference panel was represented by the disciplines of dermatology, cardiology, rheumatology, epidemiology, endocrinology, hepatology and gastroenterology, and medical specialists with particular expertise in obesity, diabetes mellitus, inflammation and genetics. The multiple co‐morbidities associated with psoriasis were reviewed with a view to identify possible mechanisms linking psoriatic disease with obesity, metabolic syndrome, diabetes, cardiovascular disease and non‐alcoholic fatty liver disease. Consensus was established on the association of psoriasis with other co‐morbidities and disease states. Consequently, there is a significant opportunity for specialist and primary care physicians to collaborate with dermatologists in the management of the overall health of psoriasis patients. First, there is an important need for physicians to routinely screen psoriasis patients for the multiple susceptibility risk factors and co‐morbidities associated with psoriasis. Second, the design and implementation of lifestyle modification plans including exercise, diet and the limitation of alcohol and tobacco intake, will not only benefit their general medical health but also their psoriasis.     

Does gum chewing reduce postoperative ileus following open colectomy for left‐sided colon and rectal cancer? – a prospective randomized controlled trial

OBJECTIVE: Postoperative ileus is common after colorectal resection and can prolong hospital stay. Gum chewing, a type of sham feeding, may to stimulate gut motility via cephalic-vagal stimulation, and thereby reduce the length of ileus. This study aimed to determine whether gum chewing in the immediate postoperative period facilitated recovery from ileus following resection for left-sided colorectal cancer. METHODS: In a prospective randomized control trial, 38 patients undergoing open surgery for left-sided colorectal cancer were allocated to standard postoperative care (control group, n = 19) or to standard postoperative care plus the immediate use of chewing gum (treatment group, n = 19). RESULT: Control patients passed flatus by mean of 2.7 days (SD 1.0) and faeces by 3.9 days (SD 1.5); for the treatment group, this was 2.4 days (SD 1.0) and 3.2 days (SD 1.5) respectively, (NS, P = 0.56 and P = 0.38). Length of hospital stay was 11.1 days (SD 7.3) in control group and 9.4 days (SD 2.5) in the treatment group (NS, P = 0.75). CONCLUSION: The addition of gum chewing to a standardized postoperative regimen did not reduce the period of postoperative ileus or shorten length of stay following open surgery for left-sided colorectal cancer.     

Analysis of factors that induce cysteine bonding state

Regarding the fact that the protein structure is principally encoded in its sequence, investigating the bonding state of cysteine has gained a great deal of attention due to its significance in the formation of protein structure. Due to lack of evident influence of free cysteines on the protein structure, it may be expected that only half-cystines convey encoded information. The results obtained from the analysis of amino acid distribution in proximity of both states of cysteines explicitly indicated that perquisite information for inducing cysteine bonding state is present even in the flanking amino acid sequences of free cysteines.     

Influence of intense light stimulation on trigeminal and cervical pain perception thresholds

Thirty-three migraineurs and 23 healthy controls were submitted to pressure algometry before and after light-induced discomfort was elicited by progressive light stimulation in a monoblind fashion. Pressure algometries were performed on the emergence of the supraorbital, infraorbital, mental and greater occipital nerves, and over the temporal muscles, always throughout the same sequence and from right to left. Measurements were carried out before and immediately after light stimulation and after 10 min of the second algometry. The final result for each site measured at each time-point was the mean of the three measurements. Light stimulation was carried out progressively until light-induced discomfort was reported, to a maximum of 20,000 lux. A heat-blocking glass protected patients' eyes. Migraineurs presented significant and persistent drops in pain perception thresholds after light stimulation, at all sites tested (P = 0.002 to < 0.0001). These drops were not seen in controls, in whom, conversely, a less significant increase was seen on right infraorbital and left temporal muscle sites. Our results indicate that in migraineurs, light may have a relevant role in trigeminal and cervical pain perception thresholds.     

Effect of Different Wavelengths on Superoxide Dismutase

IntroductionSuperoxide dismutase (SOD) is one of the most important antioxidant enzymes present in all oxygen-metabolizing cells. This enzyme eliminates toxins from our body, so it is vital to understand its action and activity under the influence of different wavelengths. The effects of different wavelengths of light in the visible range on SOD activity were investigated.MethodsEnzyme samples were irradiated with five different wavelengths for chromotization. The absorbance values of the control and treated enzymes were subsequently measured.ResultsA wavelength of 644 nm (red) showed the maximum increase in absorbance compared with all other color wavelengths used. Yellow showed least absorption.ConclusionRed color wavelength actually provides additional energy to the enzyme and hence the activation energy is lowered, compared with untreated enzyme.     

Thoracoscopic Splanchnicectomy: Pilot Evaluation of a Simple Alternative for Chronic Pancreatic Pain Control

Achieving adequate pain control in patients with chronic pancreatitis remains a surgical challenge. The quest for a procedure that retains all of the residual pancreatic tissue in the absence of ductal dilatation remains elusive. This study sought to evaluate the feasibility and efficacy of thoracoscopic splanchnicectomy and attempted to outline the surgical anatomy appropriate to an adequate denervation. Of 17 patients considered suitable for the procedure, 16 had a sucessful outcome, which was statistically significant (p < 0.001). The longest follow-up of 30 months suggests that the procedure may be more enduring than percutaneous procedures. However, the surgical anatomy is not predictable owing to the racemose arrangement of the splanchnic fibers, and a long pleurotomy with transection of all medial fibers is necessary to effect denervation. Thoracoscopic splanchnicectomy may effect immediate pain relief with negligible morbidity and absent mortality. Although the follow-up period is short, the patient with the longest follow-up remains pain-free at 30 months. This procedure warrants scrutiny for its role in long-term pancreatic pain control.     

Active surveillance characterizes human intratumoral T cell exhaustion

Intratumoral T cells that might otherwise control tumors are often identified in an “exhausted” state, defined by specific epigenetic modifications and upregulation of genes such as CD38, cytotoxic T-lymphocyte–associated protein 4 (CTLA4), and programmed cell death 1 (PD1). Although the term might imply inactivity, there has been little study of this state at the phenotypic level in tumors to understand the extent of their incapacitation. Starting with the observation that T cells move more quickly through mouse tumors the longer they reside there and progress toward exhaustion, we developed a nonstimulatory, live-biopsy method for the real-time study of T cell behavior within individual patient tumors. Using 2-photon microscopy, we studied native CD8⁺ T cell interaction with antigen-presenting cells (APCs) and cancer cells in different microniches of human tumors and found that T cell speed was variable by region and by patient and was inversely correlated with local tumor density. Across a range of tumor types, we found a strong relationship between CD8⁺ T cell motility and the exhausted T cell state that corresponded with our observations made in mouse models in which exhausted T cells moved faster. Our study demonstrates T cell dynamic states in individual human tumors and supports the existence of an active program in “exhausted” T cells that extends beyond incapacitating them.