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Chinese translation BACKGROUND: Hidradenitis suppurativa (HS) is a chronic, painful skin disease characterized by abscesses, nodules, and draining fistulas in the axilla and groin of young adults. OBJECTIVE: To evaluate the efficacy and safety of adalimumab, an anti-tumor necrosis factor-[alpha] antibody, in patients with moderate to severe HS. DESIGN: Phase 2, parallel, randomized, placebo-controlled trial consisting of a blinded 16-week period (period 1) and an open-label 36-week period (period 2). All study personnel, investigators, and patients remained blinded to treatment group throughout the study. (ClinicalTrials.gov: NCT00918255) SETTING: 26 academic and private practice medical centers in the United States and Europe. PATIENTS: 154 adult patients with moderate to severe HS who were unresponsive or intolerant to oral antibiotics. INTERVENTION: Patients were assigned in a 1:1:1 ratio to adalimumab, 40 mg/wk; adalimumab, 40 mg every other week (EOW); or placebo. All patients received adalimumab, 40 mg EOW, at the beginning of period 2 but switched to weekly dosing if the response was suboptimal (HS Physician's Global Assessment [PGA] score of moderate or worse) at weeks 28 or 31. MEASUREMENTS: The primary outcome measure (clinical response) was the proportion of patients achieving an HS-PGA score of clear, minimal, or mild with at least a 2-grade improvement relative to baseline at week 16. RESULTS: At week 16, 3.9% of placebo patients (2 of 51), 9.6% of EOW patients (5 of 52), and 17.6% of weekly patients (9 of 51) achieved clinical response (EOW vs. placebo strata-adjusted difference, 5.6% [95% CI, -4.0% to 15.3%]; P = 0.25; weekly vs. placebo strata-adjusted difference, 13.7% [CI, 1.7% to 25.7%]; P = 0.025). Serious adverse event rates were 3.9%, 5.8%, and 7.8% for placebo, EOW, and weekly patients, respectively (EOW vs. placebo difference, 1.8% [CI, -6.4% to 10.1%]; weekly vs. placebo difference, 3.9% [CI, -5.2% to 13.0%]). Significantly greater improvements in patient-reported outcomes and pain were seen in the weekly dosing group than in the placebo group. A decrease in response was seen after the switch from weekly to EOW dosing in period 2. LIMITATIONS: Weeks 16 to 52 of the study were open-label. The study was not powered to assess the risk for known serious adverse effects of adalimumab, such as tuberculosis, other serious infections, and demyelinating disorders. CONCLUSION: Adalimumab dosed once per week alleviates moderate to severe HS. PRIMARY FUNDING SOURCE: Abbott Laboratories. [ABSTRACT FROM AUTHOR]

Background: The clinical manifestations of Lyme borreliosis in North America and Europe seem to differ, but a systematic comparison has never been done.Objective: To compare European and U.S. patients with culture-confirmed erythema migrans.Design: Prospective, clinical cohort study.Setting: University medical centers in Westchester County, New York, and Ljubljana, Slovenia.Patients: 119 U.S. patients with Borrelia burgdorferi sensu stricto infection and 85 Slovenian patients with B. afzelii infection.Measurements: Interview, physical examination, and laboratory assays.Results: Compared with Slovenian patients, U.S. patients had erythema migrans for a briefer duration (median duration, 4 days compared with 14 days; P < 0.001) but were more likely to have systemic symptoms (P = 0.01), abnormal findings on physical examination (P < 0.001), and seroreactivity (P < 0.001). Central clearing of erythema migrans lesions was more likely in Slovenian patients (P < 0.001).Conclusions: Erythema migrans caused by B. afzelii in Slovenia and erythema migrans caused by B. burgdorferi in New York have distinct clinical presentations. Caution should be used when clinical and laboratory experience from one side of the Atlantic is applied to patients on the other. [ABSTRACT FROM AUTHOR]

Focuses on human granulocytic ehrlichiosis, a febrile illness. Cause of human granulocytic ehrlichiosis; Reference to a case study of a woman who was reinfected with human granulocytic ehrlichiosis; Indication that long-term immunity is not provided through a single infection of human granulocytic ehrlichiosis.