The clinical spectrum of COVID-19-associated cutaneous manifestations: An Italian multicenter study of 200 adult patients.
- 作者列表："Marzano AV","Genovese G","Moltrasio C","Gaspari V","Vezzoli P","Maione V","Misciali C","Sena P","Patrizi A","Offidani A","Quaglino P","Arco R","Caproni M","Rovesti M","Bordin G","Recalcati S","Potenza C","Guarneri C","Fabbrocini G","Tomasini C","Sorci M","Lombardo M","Gisondi P","Conti A","Casazza G","Peris K","Calzavara-Pinton P","Berti E","Italian Skin COVID-19 Network of the Italian Society of Dermatology and Sexually Transmitted Diseases.
BACKGROUND:COVID-19 is associated with a wide range of skin manifestations. OBJECTIVE:To describe the clinical characteristics of COVID-19-associated skin manifestations and explore the relationships among the 6 main cutaneous phenotypes and systemic findings. METHODS:Twenty-one Italian Dermatology Units were asked to collect the demographic, clinical, and histopathologic data of 200 patients with COVID-19-associated skin manifestations. The severity of COVID-19 was classified as asymptomatic, mild, moderate, or severe. RESULTS:A chilblain-like acral pattern was significantly associated with a younger age (P < .0001) and, after adjusting for age, significantly associated with less severe COVID-19 (P = .0009). However, the median duration of chilblain-like lesions was significantly longer than that of the other cutaneous manifestations taken together (P < .0001). Patients with moderate/severe COVID-19 were more represented than those with asymptomatic/mild COVID-19 among the patients with cutaneous manifestations other than chilblain-like lesions, but only the confluent erythematous/maculo-papular/morbilliform phenotype was significantly associated with more severe COVID-19 (P = .015), and this significance disappeared after adjustment for age. LIMITATIONS:Laboratory confirmation of COVID-19 was not possible in all cases. CONCLUSIONS:After adjustment for age, there was no clear-cut spectrum of COVID-19 severity in patients with COVID-19-related skin manifestations, although chilblain-like acral lesions were more frequent in younger patients with asymptomatic/pauci-symptomatic COVID-19.
背景: 新型冠状病毒肺炎与广泛的皮肤表现相关。 目的: 描述COVID-19-associated例皮肤表现的临床特点，探讨6种主要皮肤表型与全身表现的关系。 方法: 要求21个意大利皮肤科收集200例有COVID-19-associated种皮肤表现的患者的人口统计学、临床和组织病理学数据。新型冠状病毒肺炎的严重程度分为无症状、轻度、中度或重度。 结果: 冻疮样肢端模式与较年轻的年龄显著相关 (P <.0001)，调整年龄后，与较不严重的新型冠状病毒肺炎显著相关 (P = .0009)。然而，冻疮样病变的中位持续时间显著长于其他皮肤表现 (P <.0001)。在具有冻疮样病变以外的皮肤表现的患者中，中度/重度新型冠状病毒肺炎的患者比无症状/轻度新型冠状病毒肺炎的患者更有代表性，但只有融合的红斑/斑丘疹/麻疹样表型与更严重的新型冠状病毒肺炎显著相关 (P = .015)，并且这种显著性在调整年龄后消失。 局限性: 并非所有病例的实验室证实均为新型冠状病毒肺炎。 结论: 对年龄进行校正后，尽管冻疮样肢端病变在无症状/有症状新型冠状病毒肺炎的年轻患者中更常见，但在新型冠状病毒肺炎相关皮肤表现的患者中，没有明确的新型冠状病毒肺炎严重程度谱。
METHODS::The ATP binding-cassette superfamily corresponds the mostly transmembrane transporters family found in humans. These proteins actively transport endogenous and exogenous substrates through biological membranes in body tissues, so they have an important role in the regulation of many physiological functions necessary for human homeostasis, as well as in response regulation to several pharmacological substrates. The development of multidrug resistance has become one of the main troubles in conventional chemotherapy in different illnesses including cancer, being the increased efflux of antineoplastic drugs the main reason for this multidrug resistance, with a key role of the ABC superfamily. Likely, the interindividual variability in the pharmacological response among patients is well known, and may be due to intrinsically factors of the disease, genetic and environmental ones. Thus, the understanding of this variability, especially the genetic variability associated with the efficacy and toxicity of drugs, can provide a safer and more effective pharmacological treatment, so ABC genes are considered as important regulators due to their relationship with the reduction in pharmacological response. In this review, updated information about transporters belonging to this superfamily was collected, the possible role of these transporters in cancer, the role of genetic variability in their genes, as well as some therapeutic tools that have been tried to raise against main transporters associated with chemoresistance in cancer.
METHODS:BACKGROUND:Cholinergic neurotransmission regulates neuroinflammation in Parkinson disease (PD). RESEARCH DESIGN AND METHODS:The authors conducted a delayed-start study of donepezil for cognitive decline in non-demented PD patients. The study consisted of a 96-week randomized placebo-controlled double-blind phase 1, followed by a 24-week donepezil extension phase 2. The primary outcome measure was a change in the Mini-Mental State Examination (MMSE) at week 120. RESULTS:A total of 98 patients were randomly allocated to the early-start (donepezil-to-donepezil) and delayed-start (placebo-to-donepezil) groups. Mean (SD) of the baseline MMSE was 27.6 (2.0) and 28.0 (2.1), respectively. MMSE change at week 120 was better in the early-start group than in the delayed-start group, but the difference was not significant. The MMSE declined in apolipoprotein ε4 carriers, but not in non-carriers, and the factor interaction (intervention × ε4 genotype) was highly significant (P < 0.001). Analyzed with the interaction, the difference was significant (group difference 1.95 [0.33 to 3.57], P = 0.018). The MMSE decline slope in phase 1 was significantly better in the early-start group than in the delayed-start group (P = 0.048). CONCLUSIONS:Cognitive function deteriorated in ε4 carriers, but not in non-carriers, and early-start donepezil may postpone cognitive decline in the former.
METHODS::Since the discovery of dental pulp stem cells, a lot of teams have expressed an interest in dental pulp regeneration. Many approaches, experimental models and biological explorations have been developed, each including the use of stem cells and scaffolds with the final goal being clinical application in humans. In this review, the authors' objective was to compare the experimental models and strategies used for the development of biomaterials for tissue engineering of dental pulp with stem cells. Electronic queries were conducted on PubMed using the following terms: pulp regeneration, scaffold, stem cells, tissue engineering and biomaterial. The extracted data included the following information: the strategy envisaged, the type of stem cells, the experimental models, the exploration or analysis methods, the cytotoxicity or viability or proliferation cellular tests, the tests of scaffold antibacterial properties and take into account the vascularization of the regenerated dental pulp. From the 71 selected articles, 59% focused on the "cell-transplantation" strategy, 82% used in vitro experimentation, 58% in vivo animal models and only one described an in vivo in situ human clinical study. 87% used dental pulp stem cells. A majority of the studies reported histology (75%) and immunohistochemistry explorations (66%). 73% mentioned the use of cytotoxicity, proliferation or viability tests. 48% took vascularization into account but only 6% studied the antibacterial properties of the scaffolds. This article gives an overview of the methods used to regenerate dental pulp from stem cells and should help researchers create the best development strategies for research in this field.