JAK 1-3 inhibitors and TYK-2 inhibitors in dermatology: Practical pearls for the primary care physician.

Guidelines for primary care clinicians on monitoring and safety guidelines regarding Janus kinase and tyrosine kinase 2 inhibitors in the treatment of inflammatory skin conditions are often unclear. This review aims to provide the primary care physician with a review of clinically relevant and updated information regarding the monitoring and overall profile of these medications. To do so, a systematic review was conducted using the PubMed database and relevant Food and Drug Administration (FDA) approved drug inserts from manufacturers.

Cannabidiol in Dermatology: Proposed Mechanism of Action and Potential Medication Interactions.

In the setting of increasing patient-reported cannabidiol (CBD) usage in the dermatologic setting, it is of great importance that clinicians become aware of potential medication interactions that may arise from cannabidiol usage in order to ensure safe and efficacious medication therapy. This brief review aimed to bring awareness to the mechanism of CBD while highlighting potential interactions between CBD and medication therapy for commonly encountered dermatologic conditions, including acne, allergic contact dermatitis, atopic dermatitis, pruritus, skin aging, skin cancer, and psoriasis.

Utility of Gene Expression Profiling in Skin Cancer: A Comprehensive Review.

Understanding the metastatic potential of a skin cancer is essential to effective management. Gene expression profiling (GEP) is an innovative technology that has allowed for a better understanding of tumor biology in various skin cancers. Current methods focus on identifying and quantifying ribonucleic acid (RNA) transcripts in tissue samples.

How does ethnicity affect presence of advance care planning in care records for individuals with advanced disease? A mixed-methods systematic review.

Background: Advance care planning (ACP) is the process supporting individuals with life-limiting illness to make informed decisions about their future healthcare. Ethnic disparities in ACP have been widely highlighted, but interpretation is challenging due to methodological heterogeneity. This review aims to examine differences in the presence of documented ACP in individuals' care records for people with advanced disease by ethnic group, and identify patient and clinician related factors contributing to this.

Opportunistic viral surveillance confirms the ongoing disease threat grey squirrels pose to sympatric red squirrel populations in the UK.

Background: Red Squirrels United was a UK landscape-scale grey squirrel management programme undertaken between 2016 and 2020.

Methods: A total of 11034 grey squirrels were removed by culling, with 1506 necropsied and 1405 suitable for adenovirus (AdV) or squirrelpox virus (SQPV) quantitative PCR (qPCR) analysis. Spleen, lip or hair were extracted, and DNA was isolated, with samples tested in duplicate by qPCR.

Interprofessional Naloxone Student Training to Manage Suspected Opioid Overdose.

Purpose: The study purpose was to examine the effect of interprofessional naloxone training on students' knowledge, confidence, and interprofessional collaboration competency. The overarching goal was to decrease mortality related to opioid overdoses.

Design/methods: A training session for interprofessional students consisted of a lecture presentation, demonstration, and hands-on practice regarding appropriate administration of naloxone for suspected opioid overdose.

Parkinson's disease and palliative care: a quality of care Delphi study.

Objectives: Extending palliative care services to those with long-term neurological conditions is a current aim of UK health policy. Lack of holistic guidelines for palliative and end-of-life care, and differing models of service provision, has resulted in heterogeneity in care access and quality. There is a need for evidence-based standards of care to audit Parkinson's services and drive improvements.

From Nursing Assistant to Nurse: Scoping Review of Transitional Career Opportunities.

Nursing assistants (NAs) are an integral component of the older adult nursing care team. Although NAs provide the majority of hands-on care, they often experience disproportionate personal and professional challenges related to their roles and responsibilities. Likewise, NAs may have minimal opportunity to transition into a nursing career.

Enhanced metastatic risk assessment in cutaneous squamous cell carcinoma with the 40-gene expression profile test.

To clinically validate the 40-gene expression profile (40-GEP) test for cutaneous squamous cell carcinoma patients and evaluate coupling the test with individual clinicopathologic risk factor-based assessment methods. In a 33-site study, primary tumors with known patient outcomes were assessed under clinical testing conditions (n = 420). The 40-GEP results were integrated with clinicopathologic risk factors.

Ways of Being Together During the COVID-19 Pandemic: Support Bubbles and the Legal Construction of Relationships.

This article focuses on the concept of the support bubble. The concept was introduced in New Zealand in March 2020 in the context of the COVID-19 pandemic to denote a network of people with whom a person could have physical contact, and was later taken up in various forms elsewhere, particularly in the UK. The article focuses on the meaning that was attached to the concept and to the ways of being together that it encapsulated and stipulated.

A Dermatologist's Guide to Implementation of Gene Expression Profiling in the Management of Melanoma.

With the advent of effective therapeutics, melanoma mortality rates have decreased, yet incidence rates are continuing to rise, making accurate prognostication for risk of recurrence increasingly important. Gene expression profiling (GEP) is a clinically available, objective metric that can be used in conjunction with traditional clinicopathological staging to help physicians stratify risk in melanoma patients. There is a gap in guidance from the American Joint Committee on Cancer (AJCC) and the National Comprehensive Cancer Network (NCCN) regarding how to utilize GEP in melanoma care.

Do you need compassion to work in palliative medicine?

Compassion is deemed a "basic social emotion" (Nussbaum) and decreed a National Health Service core value-yet, what does 'compassion' really mean? Moreover, why is it so important, how can we deliver it best and how do we measure achievement here?This essay will argue that compassion stands apart from other forms of interpersonal engagement as a deeply human recognition of another's suffering which inherently motivates action to do something about this. There are two inextricable elements here: the role of suffering, and the resultant call to action it motivates.The role of compassion pivots on suffering, and thus, our interpretation of suffering and what we consider its upstream cause: the problem to be fixed.

Perforating Granuloma Annulare Appearing as a Psoriasiform Lesion.

We present a 54-year-old Caucasian female with a history of diabetes mellitus, multiple sclerosis, and ulcerative colitis who presented with nail dystrophy, polyarthralgia in her hands and hips, myalgia, proximal myopathy, dactylitis, and psoriasiform-appearing progressive, painful plaques on the dorsal aspect of her hands. Histologic examination of the lesion from the left index finger revealed an interstitial and necrobiotic granulomatous dermatitis with connective tissue mucin deposition associated with a perivascular lymphoid infiltrate. Additionally, there was focal transepidermal elimination of the necrobiotic material.

Serotype Panama: An exceptionally virulent cause of illness in children?

serotype Panama accounts for <1% of all reported cases of Salmonellosis. Previous reports suggest that it may be unusually virulent in children. We report the case of a family, five of six of whom developed a diarrheal illness due to this organism following exposure during a trip to Costa Rica.

Simulation Enhances Soft Skills Among Inter-Professionals Participating in an International Service-Learning Experience to a Resource-Limited Country.

This article was migrated. The article was marked as recommended. Soft skills are the hallmark of a master healthcare provider.

Respiratory failure caused by lipoid pneumonia from vaping e-cigarettes.

A young female vaper presented with insidious onset cough, progressive dyspnoea on exertion, fever, night sweats and was in respiratory failure when admitted to hospital. Clinical examination was unremarkable. Haematological tests revealed only thrombocytopenia, which was long standing, and her biochemical and inflammatory markers were normal.

Corrigendum: Phylogenetic ctDNA analysis depicts early-stage lung cancer evolution.

This corrects the article DOI: 10.1038/nature22364.

A Review of the Global Guidelines on Surgical Margins for Nonmelanoma Skin Cancers.

Adequate treatment and follow-up of a patient with nonmelanoma skin cancer is of utmost concern for a clinician. However, there is a lack of international consensus on recommendations for surgical excision margins. Furthermore, lack of familiarity of the published guidelines leads to a variety in practice styles.

Phylogenetic ctDNA analysis depicts early-stage lung cancer evolution.

The early detection of relapse following primary surgery for non-small-cell lung cancer and the characterization of emerging subclones, which seed metastatic sites, might offer new therapeutic approaches for limiting tumour recurrence. The ability to track the evolutionary dynamics of early-stage lung cancer non-invasively in circulating tumour DNA (ctDNA) has not yet been demonstrated. Here we use a tumour-specific phylogenetic approach to profile the ctDNA of the first 100 TRACERx (Tracking Non-Small-Cell Lung Cancer Evolution Through Therapy (Rx)) study participants, including one patient who was also recruited to the PEACE (Posthumous Evaluation of Advanced Cancer Environment) post-mortem study.

Tracking the Evolution of Non-Small-Cell Lung Cancer.

Background: Among patients with non-small-cell lung cancer (NSCLC), data on intratumor heterogeneity and cancer genome evolution have been limited to small retrospective cohorts. We wanted to prospectively investigate intratumor heterogeneity in relation to clinical outcome and to determine the clonal nature of driver events and evolutionary processes in early-stage NSCLC.

Methods: In this prospective cohort study, we performed multiregion whole-exome sequencing on 100 early-stage NSCLC tumors that had been resected before systemic therapy.