Exploring the Clinical Assessment, Guidelines, and Options for the Treatment of Generalized Pustular Psoriasis [Podcast].

Acute episodes of generalized pustular psoriasis (GPP), known as "flares", are characterized by the widespread appearance of pustules with surrounding skin erythema, and are often accompanied by systemic symptoms. The clinical course of GPP is unpredictable, and symptoms vary in extent and severity; the disease may be relapsing-remitting with recurrent episodes of pustulosis, or be more persistent. The triggers that may lead to flares include withdrawal of corticosteroids, stress, pregnancy, and infections.

Colorectal Cancer Screening Knowledge and Practices Among Practicing Obstetrician-Gynecologists and Residents.

Background: Colorectal cancer (CRC) is the second leading cause of cancer death in the US, the third most diagnosed cancer in women, and the second leading cause of cancer death in women. The aims of our study are to (1) investigate knowledge of and adherence to CRC screening guidelines by obstetrician-gynecologists (Ob/Gyns) and (2) assess whether this knowledge/adherence vary by demographic and practice characteristics.

Methods: An anonymous cross-sectional survey was distributed to a convenience sample of 142 practicing Obs/Gyns drawn from National Medical Association section members/conference attendees and hospital Ob/Gyn department members.

Additive-Manufactured Stochastic Polyimide Foams for Low Relative Permittivity, Lightweight Electronic Architectures.

Polyimides are widely utilized engineering polymers due to their excellent balance of mechanical, dielectric, and thermal properties. However, the manufacturing of polyimides into complex multifunctional designs can be hindered by dimensional shrinkage of the polymer upon imidization and post processing methods and inability to tailor electronic or mechanical properties. In this work, we developed methods to three-dimensional (3D) direct ink write polyimide closed-cell stochastic foams with tunable densities.

Brodalumab to the Rescue: Efficacy and Safety of Brodalumab in Patients with Psoriasis and Prior Exposure or Inadequate Response to Biologics.

While biologic therapies for psoriasis are effective for many patients, some patients may lose response, have inadequate control of disease, or develop intolerance to certain biologic agents. It may therefore be beneficial for patients whose psoriasis fails to respond to one biologic to switch to a different biologic therapy, in particular one with a different mechanism of action. However, it remains unclear how prior biologic exposure or lack of response affects the efficacy and safety of subsequent biologics in patients with moderate-to-severe psoriasis.

Importance of Complete Skin Clearance in Psoriasis as a Treatment Goal: Implications for Patient-Reported Outcomes.

Psoriasis is associated with physical, psychological, social, and economic burdens that lead to substantial impairment over a patient’s lifetime. It is important to understand how different skin clearance levels may relate to patient perceptions of psoriasis symptoms and health-related quality of life. Here, we highlight notable advantages to complete skin clearance relative to high levels of efficacy without complete skin clearance, including meaningful improvements in patient-reported signs and symptoms of psoriasis, a higher mean proportion of symptom-free days, and significant improvements in quality of life.

Malignancy Rates in Brodalumab Clinical Studies for Psoriasis.

Background: Brodalumab is a fully human anti-interleukin-17 receptor A monoclonal antibody efficacious for the treatment of adults with moderate-to-severe plaque psoriasis.

Objective: This study summarizes malignancy rates in psoriasis clinical studies of brodalumab.

Methods: Data were pooled from one phase II study and three large, multicenter, phase III randomized studies of brodalumab for the treatment of psoriasis, including two studies with randomization to brodalumab, ustekinumab, or placebo.

Impact of Clinical Specialty Setting and Geographic Regions on Disease Management in Patients with Psoriatic Arthritis in the United States: A Multicenter Observational Study.

Background: Information on the factors that influence treatment management decisions for psoriatic arthritis (PsA) is limited.

Objective: Our objective was to evaluate the impact of clinical specialty setting and geographic region on the management of patients with PsA in the USA.

Methods: LOOP was a multicenter, cross-sectional, observational study conducted across 44 sites in the USA.

High Surface Area Electrodes Derived from Polymer Wrapped Carbon Nanotubes for Enhanced Energy Storage Devices.

Electrical double layer capacitors store energy on two adjacent layers, resulting in fast charging and discharging, but their energy density is limited by the available surface area. In this study, using poly(methyl methacrylate) assisted sonication, carbon nanotube buckypapers with specific surface area as high as 950 m(2)/g have been processed. Performance of these high surface area buckypapers have been evaluated as supercapacitor electrodes.

Individually Dispersed Wood-Based Cellulose Nanocrystals.

Good dispersion of cellulose nanocrystals (CNCs) in the polymer matrix is one of the key factors to obtaining good properties in the resulting nanocomposites. However, the preparation of individually dispersed CNCs in solvents or in polymer matrices has been a challenge. In this study, individually dispersed wood-based CNCs have been successfully prepared in solvents, including dimethylformamide (DMF), H2O, and a mixture of H2O/DMF, by sonication of moisture-containing CNCs.

Nasal fractures in children and adolescents: Mechanisms of injury and efficacy of closed reduction.

Objectives: To determine the most common mechanisms of traumatic nasal deformity referred to pediatric otolaryngology. To examine the efficacy of closed reduction of nasal fractures in children and adolescents based on the parents' and surgeons' ratings of post-reduction nasal symmetry.

Methods: Case series and chart review within an urban, tertiary pediatric otolaryngology practice.

Gel Spinning of Polyacrylonitrile/Cellulose Nanocrystal Composite Fibers.

Polyacrylonitrile (PAN)/cellulose nanocrytal (CNC) fibers containing 0, 1, 5, and 10 wt % CNCs have been successfully produced by gel spinning. The rheological properties of solutions were investigated and the results showed that the complex viscosity and storage modulus of solutions were significantly affected by the presence of CNCs in the solution. Structure, morphology, mechanical properties and dynamic mechanical properties of these fibers have been investigated.

Polyacrylonitrile fibers containing graphene oxide nanoribbons.

Graphene oxide nanoribbon (GONR) made by the oxidative unzipping of multiwalled carbon nanotube was dispersed in dimethylformamide and mixed with polyacrylonitrile (PAN) to fabricate continuous PAN/GONR composite fibers by gel spinning. Subsequently, PAN/GONR composite fibers were stabilized and carbonized in a batch process to fabricate composite carbon fibers. Structure, processing, and properties of the composite precursor and carbon fibers have been studied.

Thiol-ene/acrylate substrates for softening intracortical electrodes.

Neural interfaces have traditionally been fabricated on rigid and planar substrates, including silicon and engineering thermoplastics. However, the neural tissue with which these devices interact is both 3D and highly compliant. The mechanical mismatch at the biotic-abiotic interface is expected to contribute to the tissue response that limits chronic signal recording and stimulation.

Three-Dimensional Flexible Electronics Enabled by Shape Memory Polymer Substrates for Responsive Neural Interfaces.

Planar electronics processing methods have enabled neural interfaces to become more precise and deliver more information. However, this processing paradigm is inherently 2D and rigid. The resulting mechanical and geometrical mismatch at the biotic-abiotic interface can elicit an immune response that prevents effective stimulation.

Treatment of moderate to severe plaque psoriasis with concomitant efalizumab and narrow-band ultraviolet B phototherapy.

Background: Efalizumab therapy and narrow-band ultraviolet B (NB-UVB) phototherapy have different mechanisms of action; combined therapy may be more effective than either treatment alone in treating moderate to severe plaque psoriasis.

Methods: This study investigated the efficacy and safety of efalizumab (1 mg/kg/wk) combined with NB-UVB 3 times a week for 12 weeks, followed by efalizumab monotherapy for 12 additional weeks.

Results: Twenty patients were enrolled with mean Psoriasis Area and Severity Index (PASI) of 12.

Open label trial of alefacept in palmoplantar pustular psoriasis.

Background: Palmoplantar pustular psoriasis (PPP) is difficult to treat. We assessed the effectiveness of alefacept in PPP and the safety of a 30 mg/week dose.

Methods: Fifteen individuals with PPP were started on 15 mg/week intramuscularly (IM) alefacept.

alpha1-Antitrypsin deficiency presenting with panniculitis and incidental discovery of chronic obstructive pulmonary disease.

A 60-year-old man presented to the Emergency Department (ED) with large, painful, indurated plaques on the right thigh, left abdomen, left chest, and right chest, which began without any preceding trauma on the right thigh 3 weeks prior to presentation in the ED. He was initially treated with cefazolin 1 g three times daily as home infusions. When the lesions continued to progress, he was admitted to the hospital and placed on amoxicillin/clavulanate and vancomycin.

Contact urticaria from curcumin.

Turmeric, a spice derived from the rhizome of the plant Curcuma longa, contains the chemical curcumin, which is responsible for turmeric's taste, color, and biologic properties. Curcumin is used as a spice in foods, as a treatment in traditional medicine, as a dye for fur, and as a component in nutritional supplements. A few cases of allergic contact dermatitis from curcumin have been reported.

Lesions resembling malignant atrophic papulosis in a patient with progressive systemic sclerosis.

Malignant atrophic papulosis (MAP), or Degos syndrome, is a rare disorder of unknown etiology. It is characterized by a deep subcutaneous vasculopathy resulting in atrophic, porcelain-white papules. We report the case of a 42-year-old woman with a history of progressive systemic sclerosis who presented with painful subcutaneous nodules on her abdomen along with chronic atrophic papules on her upper and lower limbs.

Alefacept: a novel biologic in the treatment of psoriasis.

Recognition of psoriasis as a T-cell-mediated immune disease has led to the development of various therapeutic approaches directed against the T cell and T-cell processes such as activation, trafficking and cytokine release. The novel and selective biologic agent alefacept, with an effect of selective apoptotic reduction in memory-effector T cells, has been given FDA approval for the treatment of adult patients with moderate to severe chronic plaque psoriasis who are candidates for systemic therapy or phototherapy. The clinical profile of this novel biologic agent is presented here.

Relapsing polychondritis.

A 43-year-old Chilean man presented with a 5-month history of progressive hypertrophy of the ears bilaterally. He was seen initially by a dermatologist in Chile for complaints of erythema and swelling of the ears, and had been treated unsuccessfully with topical steroids and antimicrobial ointments. On presentation to our clinic, the hypertrophy had stabilized and the erythema had resolved, but he complained of decreased hearing due to narrowing of the external auditory canal.