Topical treatment of psoriasis: questionnaire results on topical therapy as long-term continuous treatment and use on specific body sites.

Background: Currently, no formalized international consensus guidelines exist to direct optimal topical treatment including long-term treatment.

Objective: In this survey, we aim to examine if and which topicals are used in clinical practice in long-term continuous treatment of psoriasis and how topicals are used in treating specific sites of the body.

Methods: A questionnaire was distributed electronically to dermatologists from the International Psoriasis Council (IPC) representing 26 countries.

Human and computational models of atopic dermatitis: A review and perspectives by an expert panel of the International Eczema Council.

Atopic dermatitis (AD) is a prevalent disease worldwide and is associated with systemic comorbidities representing a significant burden on patients, their families, and society. Therapeutic options for AD remain limited, in part because of a lack of well-characterized animal models. There has been increasing interest in developing experimental approaches to study the pathogenesis of human AD in vivo, in vitro, and in silico to better define pathophysiologic mechanisms and identify novel therapeutic targets and biomarkers that predict therapeutic response.

Topical treatment of psoriasis: questionnaire results on topical therapy accessibility and influence of body surface area on usage.

Background: Topical treatment of mild to moderate psoriasis is first-line treatment and exhibits varying degrees of success across patient groups. Key factors influencing treatment success are physician topical treatment choice (high efficacy, low adverse events) and strict patient adherence. Currently, no formalized, international consensus guidelines exist to direct optimal topical treatment, although many countries have national guidelines.

CC-223, a Potent and Selective Inhibitor of mTOR Kinase: In Vitro and In Vivo Characterization.

mTOR is a serine/threonine kinase that regulates cell growth, metabolism, proliferation, and survival. mTOR complex-1 (mTORC1) and mTOR complex-2 (mTORC2) are critical mediators of the PI3K-AKT pathway, which is frequently mutated in many cancers, leading to hyperactivation of mTOR signaling. Although rapamycin analogues, allosteric inhibitors that target only the mTORC1 complex, have shown some clinical activity, it is hypothesized that mTOR kinase inhibitors, blocking both mTORC1 and mTORC2 signaling, will have expanded therapeutic potential.

A randomized controlled study of combination therapy with alefacept and narrow band UVB phototherapy (UVB) for moderate to severe psoriasis: efficacy, onset, and duration of response.

Background: Alefacept is an effective intermittent treatment for psoriasis that can provide long-lasting remissions. Combination therapy with narrow-band ultraviolet B (nbUVB) phototherapy may enhance treatment outcomes and accelerate the onset of clinical response.

Objective: To assess the efficacy of alefacept in combination with nbUVB phototherapy compared to alefacept alone in subjects with moderate to severe psoriasis.

Prevention of tumorigenesis in p53-null mammary epithelium by rexinoid bexarotene, tyrosine kinase inhibitor gefitinib, and celecoxib.

The chemopreventive effects of three agents, rexinoid bexarotene, tyrosine kinase inhibitor gefitinib, and celecoxib, were tested on mammary tumor development arising in p53-null mammary epithelium. The rexinoid bexarotene was the most efficacious inhibitor as it reduced mammary tumor development by 75% in virgin mice and significantly delayed mean tumor development by 98 days in hormone-stimulated mice. The tyrosine kinase inhibitor gefitinib reduced mammary tumor incidence by 50% in virgin mice but did not significantly delay mean tumor latency in hormone-stimulated mice.

Large surface photodynamic therapy with aminolevulinic acid: treatment of actinic keratoses and beyond.

Photodynamic therapy (PDT) with topical aminolevulinic acid (ALA) is currently approved in the US and Canada for the spot treatment of non-hypertrophic actinic keratoses of the face and scalp. Dermatologists are currently using ALA-PDT on larger skin surfaces for the treatment of extensive actinic keratoses, sun damage P and acne. This article reviews the safety and efficacy of large surface ALA-PDT for the treatment of actinic keratoses and photodamage.

DAB389EGF fusion protein therapy of refractory glioblastoma multiforme.

Primary brain tumors including anaplastic astrocytomas and glioblastoma multiforme are difficult to treat because of their locally invasive nature and chemoradioresistance. Novel therapies are needed. One class of therapeutics is fusion proteins consisting of peptide toxins fused to brain tumor selective ligands.

The retinoid X receptor-selective retinoid, LGD1069, prevents the development of estrogen receptor-negative mammary tumors in transgenic mice.

Despite the effectiveness of the selective estrogen receptor (ER) modulators in preventing ER-positive breast cancer, chemopreventive agents still need to be developed for the prevention of ER-negative breast cancers. The naturally occurring retinoids are promising agents for the prevention of human cancers but are too toxic for long-term chronic use. We previously demonstrated that the chemopreventive effects of the retinoids could be separated from the toxicity by using an RXR-selective retinoid, LGD1069.

A data-generated basis for medical ethics education: categorizing issues experienced by students during clinical training.

Purpose: To use issues identified by students in order to establish an experience- and evidence-based approach to medical ethics education.

Method: A total of 628 sophomore and senior students at the State University of New York at Buffalo School of Medicine and Biomedical Sciences were asked to identify incidents during their clinical training that had raised ethical concerns. The sophomores were surveyed during two time periods: 1979-80, and 1991-92 and 1992-93; the seniors were surveyed in 1991-92 and 1992-93.

The educational effect of clinical rotations in nonindustrialized countries.

Background: Rotations by American medical students in foreign countries have been common in US medical schools for nearly half a century. Although anecdotal literature makes claims for the significant educational value of these foreign rotations, neither the nature and educational consequences of these experiences, nor the students' impressions, have been thoroughly documented.

Methods: To document the educational impact of clinical rotations in developing countries, all 30 students at the University of Buffalo who participated in such rotations during a period of 7 years were given a questionnaire to complete.

Establishing a rural hospital cooperative: a case study.

Rural hospitals have traditionally been the providers of health services in rural areas. In recent years, however, rural hospitals have come under increasing economic and regulatory stress. Rural hospital cooperatives represent a new level of shared management that addresses mutual problems using a horizontal organizational model.

American medical students broaden their horizons in the Third World.

Every year for several decades some American medical students have been visiting Third World countries in order to participate in the practices there. These experiences have proved invaluable in helping them to work in the USA among minorities having unorthodox views on health and disease.

A university rural teaching practice: a model for collaboration in rural health care.

After nearly two decades of Federal, State and local incentives, primary medical services in rural areas remain for short of target. Numerous demonstration projects supported by public and private funds have had some success but models with both broad replicability and independence of external start-up and/or maintenance support are rare. The Department of Family Medicine at the State University of New York at Buffalo has established a novel collaborative network of public and private organizations to emplace a four-physician rural group practice concurrently accomplishing three major goals: high quality primary and specialty medical services to two medically underserved populations; enriched training opportunities for students, residents, and fellows; and financial viability.

The role of the clergy in community mental health service: a critical assessment.

Efforts to expand mental health manpower have taken three major directions: (1) increased use of consultation, (2) creating entirely new roles, and (3) offering training to persons engaged in roles or occupations presumably at strategic points of contact between the public and the mental health system (clergy, police, hairdressers, and bartenders). In this paper the role of modern clergy is examined along several dimensions in order to provide a more rational basis for determining their true potential as mental health service extenders or gatekeepers. Role aspects examined are: public acceptance, approachability, community stature, role separation, and professional identity.

The mental health gatekeeper role: a paradigm for conceptual pretest. Proposal for a preliminary test of potential effectiveness.

Two of the major themes in the community psychiatry movement have been the employment of new and different types of persons in service roles and the maintenance of clients in the community, whenever possible, with avoidance of institutionalisation. A logical outcome of the combination of these two themes has been an increasing interest in the role of persons with fixed social roles within the community as gatekeepers for actual direct service or appropriate referrals into the mental health service system. Police, clergy and bartenders are among the social roles that have received serious consideration and, in some cases, actual use as points of entry and actual service.

The bartender as a mental health service gatekeeper: a role analysis.

Efforts to expand mental health manpower have taken three major directions: (1) increased use of consultation, (2) creating entirely new roles, and (3) offering training to persons engaged in roles or occupations presumably at strategic points of contact between the public and the mental health system. Among such roles are clergy, police, hairdressers, and bartenders. Little effort has been made to analyze systematically this third approach to assess its true utility for mental health service.