HPV vaccine update: new indications and controversies

Human papillomavirus (HPV) has a predilection for infecting epidermal and mucosal surfaces such as those of the anogenital region. HPV causes substantial pre-malignant, malignant, and benign disease in both women and men, ranging from cervical, vulvar, penile, and anal cancers to condyloma acuminata (genital warts). Although HPV vaccination is becoming more common, infection rates remain high in both genders. Perception of HPV vaccine has largely centered on its ability to prevent cervical cancer in women, though indication for its use in men is expanding. The benefits to men include prevention of genital warts and, more recently, regulatory approval was expanded in the US for prevention of anal cancer. Herein, we review HPV vaccine with a focus on its new indication in men and existing controversies.     

Moisturizers: The Slippery Road

Moisturizers are an important part of a dermatologist''s armamentarium although little is written and well, a less is truly known about them. There is a cornucopia of projected skin products in the market whose real scientific role is not proven. These products although at times are regarded as mere cosmetics but have a well-known role in many skin disorders. Adequate knowledge about their mechanism of action, dosage, usage, and adverse effects is must for a dermatologist in this era. This article aims to bring forth the ever hidden facts of the much-hyped moisturizers. It is probably the first of its kind covering all aspects of moisturizers ranging from basic science to clinical usage, a subject that receives a short shrift in the current dermatological text.     

Molecular insight into the viral biology and clinical features of trichodysplasia spinulosa

Trichodysplasia spinulosa (TS) is a disfiguring skin disease that occurs most frequently in patients receiving immunosuppressive therapies, and is thus frequently associated with organ transplantation. TS is characterized clinically by folliculocentric papular eruption, keratin spine formation and development of leonine face; and histologically by expansion of the inner root sheath epithelium and high expression of the proliferative marker Ki‐67. Recent discovery of the TS‐associated polyomavirus (TSPyV) and emerging studies demonstrating the role of TSPyV tumour antigens in cell proliferation pathways have opened a new corridor for research on TS. In this brief review, we summarize the clinical and histological features of TS and evaluate the current options for therapy. Furthermore, we address the viral aetiology of the disease and explore the mechanisms by which TSPyV may influence TS development and progression. As reports of TS continue to rise, clinician recognition of TS, as well as accompanying research on its underlying pathogenesis and therapeutic options, is becoming increasingly important. It is our hope that heightened clinical suspicion for TS will increase rates of diagnosis and will galvanize both molecular and clinical interest in this disease.     

Does caffeine impair cerebral oxygenation and blood flow velocity in preterm infants?

Aim: The aim of the study is to assess the effects of an intravenous 10 mg/kg loading dose of caffeine base in cerebral oxygenation, cerebral Doppler blood flow velocity and cardiac output in preterm infants. Methods: Preterm neonates <34 weeks gestation were investigated at 1 and 4 h following the loading dose of caffeine using Doppler cerebral sonography, cardiac echocardiography and cerebral spatially resolved near‐infrared spectroscopy. Results: Forty infants were studied with a mean gestational age (mean ± standard deviation) of 27.7 (±2.5) weeks, birth weight of 1155 (±431) g and a postnatal age of 2.8 (±2.2) days. Mean Anterior Cerebral Artery peak and time average mean blood flow velocity fell significantly by 14% and 17.7%, respectively at 1 h post‐caffeine loading dose, which recovered partially by 4 h. Cerebral Tissue Oxygenation Index fell from pre‐dose levels by 9.5% at 1 h with partial recovery to 4.9% reduced at 4 h post‐dose. There were no significant changes in left or right ventricular output, transcutaneous oxygen saturation, transcutaneous PCO₂ or total vascular resistance. Conclusions: A loading dose of 10 mg/kg caffeine base resulted in significant reduction at 1 h post‐dose in cerebral oxygenation and cerebral blood flow velocity with partial recovery at 4 h.     

钾离子是控制T细胞抗癌能力的关键所在

<正>据Vodnala SK 2019年3月29日[Science,2019,363(6434):pii:eaau0135.]报道,美国癌症研究所(NCI)癌症研究中心(CCR)的研究人员发现,促进肿瘤在肿瘤杀伤性免疫细胞存在的条件下持续生长的一种方式是钾离子调控的。这项发现揭示了一种可以增强抗肿瘤免疫治疗的新方法。死亡的癌细胞会释放出钾离子,而在一些肿瘤中,钾的含量会达到很高的水平。该研究小组发现,钾的升高会导致T细胞保持干细胞样的质量,或"干细胞性",这与它们在免疫治疗过程中消除癌症的能力密切相关。研究结果表明,增加T细胞对钾的接触——或者模仿高钾的效果——可以使癌症免疫治疗更有效。     

Role of mutational analysis in diagnosis of tuberous sclerosis complex

We describe three cases in whom identification of a disease-causing mutation in the TSC1 or TSC2 gene preceded the appearance or detection of symptoms sufficient for a clinical diagnosis of tuberous sclerosis complex (TSC). We suggest that genetic testing be given a more prominent role in the evaluation of individuals with a family history of TSC or symptoms suggestive of TSC and propose that diagnostic criteria be revised to include genetic testing.