Immune response to topical sodium lauryl sulfate differs from classical irritant and allergic contact dermatitis.

Sodium lauryl sulfate (SLS) is used as a control irritant in patch testing for allergic contact dermatitis (ACD). However, up to 20% of those tested react to SLS, whereby the pathophysiological basis of this reaction is still unclear. To mimic patch test reactions, we repeatedly applied SLS to the skin of wild-type mice.

Impact of the COVID-19 pandemic on the education and procedural volume of fellows in critical care medicine - a cross-sectional survey.

Background: The COVID-19 pandemic has changed the way medical education is delivered. The purpose of this study was to assess the impact of the COVID-19 pandemic on the education and procedural volume of critical care and pulmonary critical care fellows.

Methods: We conducted a cross-sectional, internet-based, voluntary, anonymous, national survey of adult critical care fellows and academic attending physicians in critical care and pulmonary critical care fellowship programs in the United States between December 2020 and February 2021.

Development of Compartment Syndrome after Radial Artery Puncture in a Patient with Acute Hypoxemic Respiratory Failure due to COVID-19.

A 71-year-old man who was recently hospitalized for COVID-19 pneumonia complicated by acute hypoxemic respiratory failure and severe ARDS requiring noninvasive ventilation was transferred to our hospital from a rehabilitation facility for new onset right wrist and hand pain and swelling which had been attributed to arterial thrombosis and empirically treated with therapeutic anticoagulation. He developed numbness and paralysis in his right hand and was diagnosed with right forearm compartment syndrome requiring emergent fasciotomy. After a prolonged hospital stay complicated by respiratory failure requiring mechanical ventilation, he was discharged with improved, but not resolved, sensorimotor deficits.

Development of a large spontaneous pneumothorax after recovery from mild COVID-19 infection.

A previously healthy 37-year-old man presented with fevers and myalgias for a week with a minimal dry cough. Initial SARS-CoV-2 nasopharyngeal testing was negative, but in light of high community prevalence, he was diagnosed with COVID-19, treated with supportive care and self-quarantined at home. Three days after resolution of all symptoms, he developed sudden onset chest pain.

Filaggrin Expression and Processing Deficiencies Impair Corneocyte Surface Texture and Stiffness in Mice.

Abundant corneocyte surface protrusions, observed in patients with atopic dermatitis with filaggrin loss-of-function mutations, are inversely associated with levels of natural moisturizing factors (NMFs) in the stratum corneum. To dissect the etiological role of NMFs and filaggrin deficiency in surface texture alterations, we examined mouse models with genetic deficiencies in the synthesis or degradation of filaggrin monomers for NMFs, cell stiffness (elastic modulus) and corneocyte surface protrusion density (dermal texture index). Five neonatal and adult mouse models carrying inactivating mutations of SASPase (Sasp), filaggrin (Flg and Flg), filaggrin-hornerin (FlgHrnr), and bleomycin hydrolase (Blmh) were investigated.

Transient epidermal barrier deficiency and lowered allergic threshold in filaggrin-hornerin (FlgHrnr ) double-deficient mice.

Background: Filaggrin (Flg) and hornerin (Hrnr) share similar structural and functional features. Both proteins have been implicated as essential proteins for skin barrier maintenance. Loss-of-function mutations of these genes constitute a risk factor for atopic dermatitis and eczema-related asthma.

A Yin and Yang in Epithelial Immunology: The Roles of the α(CD103)β Integrin in T Cells.

The proper function(s) of cell-surface receptors is crucial for the regulation of adaptive immune responses. One such receptor is the α(CD103)β integrin, whose history in science is closely linked with the evolution of our knowledge of immune regulation. Initially described as a marker of intraepithelial T-lymphocytes, this leukocyte integrin is now seen as a dynamically regulated receptor involved in the functional differentiation of some cytotoxic T cells as well as regulatory T cells, thus presumably contributing to the fine-tuning of immune reactions in epithelial compartments.

The effect of epidermal levels of urocanic acid on 25-hydroxyvitamin D synthesis and inflammatory mediators upon narrowband UVB irradiation.

Background/purpose: Urocanic acid (UCA) absorbs ultraviolet (UV)B radiation in the epidermis which may interfere with phototherapy. Therefore, the influence of individual levels of UCA on immune reactivity and vitamin D synthesis induced by narrowband UVB radiation was assessed.

Methods: Twenty-eight subjects with irritant contact dermatitis of the hands were irradiated with suberythemal doses of narrowband UVB radiation on their unaffected lower forearms on three consecutive days.

Improving the Quality of Handoffs in Patient Care Between Critical Care Providers in the Intensive Care Unit.

With the ever-increasing adoption of shift models for intensive care unit (ICU) staffing, improving shift-to-shift handoffs represents an important step in reducing medical errors. The authors developed an electronic handoff tool integrated within the existing electronic medical record to improve handoffs in an adult ICU. First, stakeholder (staff intensivists, fellows, and nurse practitioners/physician assistants) input was sought to define what elements they perceived as being essential to a quality handoff.

Integrin αE (CD103) is induced but plays no pathogenic role in psoriasiform skin lesions of TGFβ1 transgenic mice.

T-cells expressing αE (CD103), an integrin induced by TGFβ on T-cells in vitro, accumulate within epithelia in inflammatory disorders, including psoriasis. However, it is unclear, if and how αE (CD103) contributes to skin inflammation. Using two complementary approaches, we have investigated αE (CD103) in psoriasis-like skin inflammation of mice with transgenic epidermal expression of human TGFβ1: αE (CD103) was inhibited by function-blocking antibodies in vivo, and double-mutants with additional αE (CD103)-depletion were generated in two different genetic backgrounds.

Impact of runoff water from an experimental agricultural field applied with Vertimec® 18EC (abamectin) on the survival, growth and gill morphology of zebrafish juveniles.

Edge-of-field waterbodies in tropical agroecosystems have been reported to be especially prone to pesticide contamination through runoff resulting from intensive irrigation practices and tropical rainfall. In the present study, the effects of runoff from an experimental agricultural field applied with Vertimec(®) 18EC (active ingredient: abamectin) on zebrafish were evaluated. To this end, the experimental field was applied with the Vertimec(®) 18EC dose recommended for strawberry crop in Brazil, whereas another field was treated with water only to serve as control.

Pain reduced by low-level laser therapy during use of orthodontic separators in early mixed dentition.

Objective: The purpose of this work was to investigate whether low-level laser therapy (LLLT) applied at a defined distance from the gingiva has a pain-reducing effect in young patients undergoing orthodontic separation during the early mixed-dentition stage.

Materials And Methods: A total of 40 children in early mixed dentition (mean age 8.05 years) who required separation of molars were included.

Integrin αE(CD103) Is Involved in Regulatory T-Cell Function in Allergic Contact Hypersensitivity.

Murine contact hypersensitivity (CHS) is a dendritic cell (DC)-dependent T-cell-mediated inflammation with CD8+ T cells as effectors and CD4+ T cells as regulators (Treg cells) that models human allergic contact dermatitis. The integrin αE(CD103) is expressed by some T-cell and DC subsets and has been implicated in epithelial lymphocyte localization, but its role in immune regulation remains enigmatic. We have identified a function for CD103 in the development of cutaneous allergic immune responses.

Internalization routes of cell-penetrating melanoma antigen peptides into human dendritic cells.

Optimized delivery of antigens combined with sustainable maturation of dendritic cells (DCs) is crucial for generation of effective antitumoral immune responses. Multiple approaches for ex vivo antigen loading and improvement in immunogenicity have been described. We have recently established a single-step protocol consisting of a fusion peptide (a sequence of the melanoma antigen Melan-A and a cationic cell-penetrating HIV TAT domain) bound in complexes with a toll-like receptor agonist.

Immunostimulatory activity of murine keratinocyte-derived exosomes.

It has long been known that keratinocytes influence cutaneous immunity through secretion of soluble factors. Exosomes, small membrane vesicles of endocytotic origin, have been implicated in intercellular communication processes such as the transfer of tumor cell antigens and the activation of recipient dendritic cells (DC). However, little is known about immunomodulatory functions of keratinocyte-derived exosomes.

Association of low serum 25-hydroxyvitamin D levels and sepsis in the critically ill.

Objective: We hypothesized that deficiency in 25-hydroxyvitamin D prior to hospital admission would be associated with sepsis in the critically ill.

Design: Two-center observational study of patients treated in medical and surgical ICUs.

Setting: Two hundred nine medical and surgical intensive care beds in two teaching hospitals in Boston, MA.

Vitamin D in acute kidney injury.

Vitamin D deficiency is common in critically ill patients and associated with increased mortality, as well as an increased risk of acute kidney injury. The occurrence of acute kidney injury by itself substantially increases critical care mortality. In addition to regulating calcium and phosphorus homeostasis and bone metabolism, vitamin D has pleotropic effects on the immune response.

The difference between critical care initiation anion gap and prehospital admission anion gap is predictive of mortality in critical illness.

Objective: We hypothesized that the delta anion gap defined as difference between critical care initiation standard anion gap and prehospital admission standard anion gap is associated with all cause mortality in the critically ill.

Design: Observational cohort study.

Setting: Two hundred nine medical and surgical intensive care beds in two hospitals in Boston, MA.

Association of low serum 25-hydroxyvitamin D levels and acute kidney injury in the critically ill.

Objective: Given the importance of inflammation in acute kidney injury and the relationship between vitamin D and inflammation, we sought to elucidate the effect of vitamin D on acute kidney injury. We hypothesized that deficiency in 25-hydroxyvitamin D prior to hospital admission would be associated with acute kidney injury in the critically ill.

Design: Two-center observational study of patients treated in medical and surgical intensive care units.

Low serum 25-hydroxyvitamin D at critical care initiation is associated with increased mortality.

Objective: We hypothesized that deficiency in 25-hydroxyvitamin D at critical care initiation would be associated with all-cause mortalities.

Design: Two-center observational study.

Setting: Two teaching hospitals in Boston, MA.

Inflammatory responses to pulmonary application of PEI-based siRNA nanocarriers in mice.

Polymeric non-viral vector systems for pulmonary application of siRNA are promising carriers, but have failed to enter clinical trials because of safety and efficiency problems. Therefore, improving their transfection efficiency, as well as their toxicological profile, is the subject of intensive research efforts. Six different poly(ethylene imine) (PEI)-based nanocarriers, with hydrophilic and hydrophobic PEG modifications, were toxicologically evaluated for pulmonary application in mice.

Neighborhood poverty rate and mortality in patients receiving critical care in the academic medical center setting.

Background: Poverty is associated with increased risk of chronic illness but its contribution to critical care outcome is not well defined.

Methods: We performed a multicenter observational study of 38,917 patients, aged ≥ 18 years, who received critical care between 1997 and 2007. The patients were treated in two academic medical centers in Boston, Massachusetts.

Association of low serum 25-hydroxyvitamin D levels and mortality in the critically ill.

Objective: We hypothesized that deficiency in 25-hydroxyvitamin D before hospital admission would be associated with all-cause mortality in the critically ill.

Design: Multicenter observational study of patients treated in medical and surgical intensive care units.

Setting: A total of 209 medical and surgical intensive care beds in two teaching hospitals in Boston, MA.