Search

Pablo Luis Ortiz-Romero,1 Octavio Servitje,2 María Teresa Estrach,3 Rosa María Izu-Belloso,4 Ricardo Fernández-de-Misa,5 Fernando Gallardo,6 Noemí López-Martínez,7 Alejandro Pérez-Mitru7 1Dermatology Department, Hospital 12 de Octubre, Institute I+12, Medical School, University Complutense, CIBERONC, Madrid, Spain; 2Dermatology Department, Hospital Universitari de Bellvitge, IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain; 3Dermatology Department, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain; 4Dermatology Department, Hospital de Basurto, Bilbao, Spain; 5Department of Dermatology and Research Unit, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain; 6Dermatology Department, Parc de Salut Mar-Hospital del Mar, Barcelona, Spain; 7Oblikue Consulting, Barcelona, SpainCorrespondence: Alejandro Pérez-MitruOblikue Consulting, C/Comte D’urgell, 240, 2-D, Barcelona 08036, SpainTel +34 932 521 377Fax +34 937 379 984Email alejandro.perez@oblikue.comAim: To identify the most common therapeutic options for the treatment of early-stage mycosis fungoides in Spain, quantify their associated healthcare resource use and costs.Methods: After reviewing the literature, a panel of 6 Spanish clinical dermatologists validated the treatments and healthcare resource use through a structured questionnaire. Individual responses were collected, analyzed and presented into a face-to-face meeting in order to reach a consensus. Cost categories considered were: drug acquisition and administration, photo/radiotherapy session and maintenance, clinical follow-up visits and laboratory tests. Costs were expressed in euros from 2018. The Spanish National Health System perspective was considered, taking into account direct health costs and time horizons of 1, 3 and 6 months.Results: Costs for the skin-directed treatments (SDT) assessed at 1, 3 and 6 months, were: Topical carmustine [€ 6,593.36, € 19,780.09 and € 27,592.78]; Phototherapy with psoralens and ultraviolet A light (PUVA) [€ 1,098.68, € 2,999.99 and € 3,187.60]; Narrow-band ultraviolet B phototherapy [€ 1,657.47, € 4,842.10 and € 4,842.10]; Total skin electron beam therapy (TSEBT) [€ 6,796.45, € 7,913.34 and € 7,913.34]. Cost for topical corticosteroids, being considered an adjuvant option, were € 17.16, € 51.49 and € 102.97. Costs for the assessed systemic treatments alone or in combination with SDT at 1, 3 and 6 months, were: Systemic retinoids [€ 2,026.03, € 5,206.63 and € 7,426.42]; Systemic retinoids + PUVA phototherapy [€ 3,066.50, € 8,271.26 and € 10,046.58]; Interferon alfa + PUVA phototherapy [€ 1,541.09, € 5,167.57 and € 6,404.55].Conclusion: According to the Spanish clinical practice, phototherapies in monotherapy were the treatments with the lowest associated costs regardless of the time horizon considered. TSEBT turned out as the treatment with the highest associated costs when considering 1 month. However, while considering 3 and 6 months the treatment with the highest associated costs was topical carmustine. The results of this analysis may provide critical information to measure the disease burden, to detect unmet medical needs and to advocate towards better treatments for this rare disease.Keywords: health care costs, health resources, mycosis fungoides, lymphoma, T-cell, cutaneous, surveys and questionnaires, Spain

Franck Gallardo,1 Bernard Mariamé,2 Remi Gence,3 Anne-Francoise Tilkin-Mariamé4 1NeoVirTech, SAS, Institut for Advanced Technology in Life Science (ITAV), Toulouse, France; 2ITAV USR3505 CNRS/LBME, UMR 5099 CNRS, Toulouse, France; 3INSERM UMR 1037, CRCT, University of Toulouse, Toulouse, France; 4INSERM 1220, IRSD, University of Toulouse, INSERM, INRA, ENVT, UPS, Toulouse, France Purpose: The Epstein–Barr virus (EBV)-associated cancer nasopharyngeal carcinoma (NPC) is rare in Europe and North America but is a real public health problem in some regions of the world, such as southern Asia, North Africa, and for Inuit populations. Due to the anatomy and location of the nasopharynx, surgery is rarely used to treat primary NPC cancers. Treatment by radiotherapy, combined or not with chemotherapy, are efficient for primary tumors but often do not protect against fatal relapses or metastases.Methods: Search for new therapeutic molecules through high content screening lead to the identification of Ivermectin (IVM) as a promising drug. IVM is a US Food and Drug Administration-approved macrocyclic lactone widely used as anthelmintic and insecticidal agent that has also shown protective effects against cancers.Results: We show here that IVM has cytotoxic activity in vitro against NPC cells, in which it reduces MAPKs pathway activation through the inhibition PAK-1 activity. Moreover, all macrocyclic lactones tested and a PAK1 inhibitor are cytotoxic in vitro for EBV-positive and EBV-negative NPC tumor cells. We have also shown that IVM intraperitoneal repeated injections, at US Food and Drug Administration-approved doses, have no significant toxicity and decrease NPC subcutaneous tumors development in nude mice.Conclusion: Macrocyclic lactones appear as promising molecules against NPC targeting PAK-1 with no detectable adverse effect. Keywords: nasopharyngeal carcinoma, ivermectin, macrocyclic lactones, P21-activated kinase 1, cytotoxicity

Abstract Reindeer herding (RDH) is a livelihood strategy deeply connected to Sami cultural tradition. This article explores the implications of two theoretical and methodological approaches for grasping complex socioenvironmental relationships of RDH in Subarctic Sweden. Based on joint fieldwork, two teams – one that aligns itself with political ecology (PE) and the other with social-ecological systems (SES) – compared PE and SES approaches of understanding RDH. Our purpose was twofold: 1) to describe the situation of Sami RDH through the lenses of PE and SES, exploring how the two approaches interpret the same empirical data; 2) to present an analytical comparison of the ontological and epistemological assumptions of this work, also inferring different courses of action to instigate change for the sustainability of RDH. Key informants from four sameby in the Kiruna region expressed strong support for the continuation of RDH as a cultural and economic practice. Concerns about the current situation raised by Sami representatives centered on the cumulative negative impacts on RDH from mining, forestry and tourism. PE and SES researchers offered dissimilar interpretations of the key aspects of the RDH socio-economic situation, namely: the nature and scale of RDH systems; the ubiquitous role of conflict; and conceptualizations of responses to changing socioenvironmental conditions. Due to these disparities, PE and SES analyses have radically divergent sociopolitical implications for what ought to be done to redress the current RDH situation. Keywords: Reindeer herding, political ecology, social-ecological systems, resilience, interdisciplinary, ontological assumptions, conflicts/consensus, adaptation

In conclusion, we present herein three teaching cases of active TB infection in psoriasis patients under biological therapy, even after correctly following the infection screening protocols and prescription of low-risk biologic drugs. In addition, real-world data on secukinumab showed patients with untreated LTBI who did not develop reactivation either, although isolated cases of I de novo i TB have also been reported.1 Case 3 had been diagnosed and correctly treated with isoniazid for LBTI prior secukinumab initiation but developed a typical TB infection 3 years later. I Dear Editor, i The increased risk of reactivation of latent tuberculosis infection (LTBI) in patients under treatment with anti-TNF-alpha drugs is widely known. [Extracted from the article]

Copyright of F@ro: Revista Teórica del Departamento de Ciencias de la Comunicación y de la Información is the property of Universidad de Playa Ancha de Ciencias de la Educacion and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Reliable prognostic factors for patients with primary cutaneous anaplastic large cell lymphoma (PCALCL) are lacking. Objective: To identify prognostic factors for specific survival in patients with PCALCL. Methods: Using the convenience sampling method, patients with PCALCL diagnosed from May 1986 to August 2017 in 16 University Departments were retrospectively reviewed. Results: One hundred eight patients were included (57 males). Median age at diagnosis was 58 years. All of them showed T1‐3N0M0 stages. Seventy per cent of the cases presented with a solitary lesion, mostly at the limbs. Complete response rate after first‐line treatment was 87%, and no advantage was observed for any of them (surgery, radiotherapy, chemotherapy or other approaches). Nodal and visceral progression rate was 11% and 2%, respectively. 5‐year specific survival (SSV) reached 93%; 97% for T1 patients and 84% for T2/T3 patients (P = 0.031). Five‐year SSV for patients developing early cutaneous relapse was 64%; for those with late or no relapse, 96% (P = 0.001). Estimated median SSV for patients showing nodal progression was 103 months (95% CI: 51–155 months); for patients without nodal progression, estimated SSV did not reach the median (P < 0.001). Nodal progression was an independent predictive parameter for shorter survival (P = 0.011). Conclusion: Multiple cutaneous lesions at presentation, early skin relapse and nodal progression portrait worse prognosis in patients with PCALCL. [ABSTRACT FROM AUTHOR]

Background: Ixekizumab (anti‐IL17A) is effective as treatment for moderate‐to‐severe plaque psoriasis, but real‐life data on effectiveness and safety are currently very limited. Objective: To evaluate the efficacy and safety of ixekizumab in a cohort of real‐life plaque psoriasis patients. Methods: Retrospective chart review of 100 patients with moderate‐to‐severe plaque psoriasis treated with ixekizumab at seven Spanish dermatological centres. Results: According to the as observed analysis, the percentage of patients achieving a 75% and 90% of reduction from the baseline score of Psoriasis Area and Severity Index (PASI) was 87.5%–50.0% at week 12–16; 88.3%–58.4% at week 24 and 82.9%–58.5% at week 52, respectively. The mean ± standard deviation (SD) score of PASI at baseline was 12.9 ± 9.2, and it declined rapidly after ixekizumab administration to 1.9 ± 4.0 (P < 0.001) at week 12–16 and was maintained at 1.7 ± 4.1 and 1.8 ± 2.9 at week 24 and 52, respectively. Ixekizumab response was not affected by clinical variables like body mass index, disease duration or the presence of psoriatic arthritis. However, the bio‐naive group showed significantly higher PASI 75 response rate at week 12–16 compared to patients previously exposed to biologic agents (P = 0.037). Twenty‐six (26%) patients experienced adverse events (AEs) during the follow‐up period, being most of them of mild‐to‐moderate intensity. The most common AE was local reaction at the site of injection (14/26; 53.8%). At the end of the observational period, 15 (15%) patients discontinued ixekizumab treatment due to limited clinical improvement (n = 11), adverse events (n = 3) or lost to follow‐up (n = 1) within a mean ± SD time of 6.0 ± 3.9 months. Conclusion: The present study illustrates the initial experience with ixekizumab in real‐world clinical practice confirming its usefulness and safety in the management of plaque psoriasis patients. [ABSTRACT FROM AUTHOR]

Hernia: del griego ERNOS, dislocación, quebradura. Se designa con el nombre de hernia, a un tumor formado por un órgano o una parte de órgano salido de la cavidad que normalmente lo contiene, por un orificio natural o accidental. Antiguamente se empleaba el sufijo "Cele", que es la palabra griega latinizada "Kele" que significa tumor y que se posponía al nombre de la víscera que estaba encerrado en la hernia, por ejemplo: enterocele - hernia intestinal-, cistocele - hernia vesical-, rectocele hernia rectal-, etc.