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Methimazole is commonly prescribed for patients with hyperthyroidism. It typically exhibits a well-tolerated profile, with common side effects including gastrointestinal disorders and rash. However, more serious rare yet adverse reactions, notably agranulocytosis and hepatotoxicity have been documented in literature. Here we present a case of a 27-year-old female, recently diagnosed with Graves' disease, who was prescribed methimazole and developed severe pruritus with cholestatic jaundice 13 days later. Concomitant causes of liver disease were ruled out. The treatment was discontinued, and a switch to corticosteroid therapy with a regimen of radioactive iodine sessions was initiated. The patient's condition showed a resolution of pruritus and jaundice, a disappearance of cytolysis with an aggravation of cholestasis followed by a gradual decrease, leading to the liver function normalization after 2 years. Methimazole-induced cholestatic jaundice is a rare yet severe adverse effect. Patients should be aware of this complication and advised to immediately stop taking the treatment when suggestive symptoms (pruritus, jaundice, dark urine, light-colored stool) occur. [ABSTRACT FROM AUTHOR]

A camping trip will quickly become unpleasant if a horde of mosquitoes descends while you pitch your tent, or you find yourself in a patch of poison oak. Whether due to an insect bite, a poisonous plant, or a chronic skin disease, everyone has experienced the urgent sensation of itch and the sweet relief of scratching. The itch–scratch cycle is so powerful that just reading about itch or seeing someone scratching elicits a strong desire to scratch. Itch is a unique sensation that is mediated by specialized neurons that innervate the skin. In this primer, we will discuss recent advancements that define the molecules and cells that mediate acute itch and that promote chronic itch associated with inflammatory diseases. Murphy et al. provide an overview of the receptors and neural circuits that mediate itch and explain how they contribute to itch disorders. [ABSTRACT FROM AUTHOR]

Background: The nod-like receptor family pyrin domain-containing 3 (NLRP3) has been implicated in various skin diseases. However, its role in mediating 2, 4-dinitrofluorobenzene (DNFB)-induced chronic itch remains unclear. Methods: Widetype (WT) and Nlrp3 deletion (Nlrp3-/-)mice, the expression of transient receptor potential (TRP) ankyrin 1 (TRPA1) inhibitor or recombinant mice interleukin-18 (IL-18) were used to establish and evaluate the severity of DNFB-mediated chronic itch. Quantitative real-time PCR, western blotting, immunohistochemistry staining, immunofluorescence staining and enzyme-linked immunosorbent assay (ELISA) was used to examine the expression of NLRP3 inflammasome, type 2 immunity and receptors in dorsal root ganglion (DRG) neurons related with chronic itch. Flow cytometry was performed to quantify the frequency of type 2 immune cells. Results: This study revealed that the NLRP3 inflammasome was activated in the skin of DNFB-induced chronic itch mice. Surprisingly, the absence of Nlrp3 exacerbated itch behavior. In Nlrp3-/- mice, IL-18 expression was downregulated, whereas markers of type 2 immunity, such as IL-4 and thymic stromal lymphopoietin (TSLP), were significantly upregulated in the skin. Furthermore, TRPA1 and its colocalization with the IL-4 receptor were increased in the DRG. Inhibition of TRPA1 or administration of recombinant IL-18 significantly reduced DNFB-induced itch behavior in Nlrp3-/- mice. Recombinant IL-18 also decreased the expression of TRPA1, IL-4, and TSLP. Discussion: These findings suggested that the absence of Nlrp3 aggravated DNFB-induced chronic itch by exacerbating type 2 immunity in the skin and enhancing the IL-4/TSLP-TRPA1 axis, potentially driven by reduced IL-18 levels. [ABSTRACT FROM AUTHOR]

Objective: There is a lack of research on epidural esketamine for labor analgesia. The purpose of this research is to compare the efficacy of epidural esketamine and sufentanil on labor analgesia and postpartum depression. Methods: A total of 187 cephalic full-term parturients with single-fetus vaginal delivery were collected in this retrospective study from Jan 2022 to Jan 2023. Parturients were categorized into two groups according to anesthetics: the esketamine group (Group KR, n = 97) with patient-controlled epidural analgesia with 0.3 mg/ml esketamine and 0.083% ropivacaine in 240 ml of normal saline and the Sufentanil group (Group SR, n = 90) with 0.3 µg/ml sufentanil and 0.083% ropivacaine in 240 ml of normal saline. The Visual Analogue Scale, Ramsay Sedation Scale, and Modified Bromage Score were recorded before, 5, 10, and 30 min after analgesia, when the uterine orifice was fully opened, and after delivery. The Edinburgh Postnatal Depression Scale(EPDS) scores at 3 and 42 days after delivery were recorded. The maternal and infant outcomes and occurrence of maternal adverse reactions were recorded. Results: The VAS scores after analgesia at 5,10,30 min and when the cervix was fully opened were higher in Group KR than Group SR (all P < 0.05). RSS scores at 5,10,30 min after analgesia in group KR were lower in Group KR than Group SR (all P < 0.05). Compared with group SR, significant decreases were shown in the EPDS and the incidence of postpartum depression at 42 days after delivery in Group KR (all P < 0.05). Group KR has considerably decreased rates of pruritus compared to Group SR (P < 0.05). The other adverse effects showed no significant difference (all P > 0.05). The maternal and neonatal outcomes were not significantly different between the two groups (all P > 0.05). Conclusions: In comparison to sufentanil, epidural esketamine for labor analgesia may exhibit a better sedative effect, and a low incidence of pruritus, but a limited analgesic effect. It may be associated with a lower risk of postpartum depression. Further exploration of the optimal regimen and dosage of esketamine for epidural labor analgesia would be necessary. [ABSTRACT FROM AUTHOR]

Background Objective Animals Materials and Methods Results Conclusions and Clinical Relevance Janus kinase inhibitors (JAKi) have been shown to reduce pruritus and improve associated inflammatory skin lesions in canine atopic dermatitis (cAD).To evaluate the efficacy and safety of ilunocitinib, in comparison to oclacitinib, for the control of cAD in a randomised, blinded trial.Three‐hundred‐and‐thirty‐eight dogs with cAD.Dogs were randomised to receive oclacitinib (0.4–0.6 mg/kg twice daily for 14 days; then once daily) or ilunocitinib (0.6–0.8 mg/kg once daily), for up to 112 days. Owners assessed pruritus using an enhanced Visual Analog Scale (PVAS). Investigators assessed skin lesions using the Canine Atopic Dermatitis Extent and Severity Index, 4th interaction (CADESI‐04).Reduction in pruritus and CADESI‐04 scores was similar for both treatment groups from Day (D)0–D14. PVAS scores increased between D14 and D28 for oclacitinib and decreased for ilunocitinib. On D28 to D112, mean PVAS and CADESI‐04 scores were significantly lower for ilunocitinib compared to oclacitinib (p ≤ 0.003 and p ≤ 0.023, respectively). On D28 to D112, a greater number of ilunocitinib‐treated dogs achieved clinical remission of pruritus (i.e. PVAS score <2). Subjective assessment of overall response was significantly better for ilunocitinib on D28 to D112 (p ≤ 0.002). Both drugs demonstrated similar safety throughout the study.Ilunocitinib rapidly and safely controlled signs of cAD. Ilunocitinib demonstrated significantly better control of pruritus and skin lesions compared to oclacitinib, with more dogs achieving clinical remission of pruritus. [ABSTRACT FROM AUTHOR]

Primary biliary cholangitis (PBC) is an autoimmune disease that damages the small to medium bile ducts of the liver. Left untreated, PBC leads to cirrhosis and liver failure. Until recently the only approved treatments for PBC were ursodeoxycholic acid (UDCA) and obeticholic acid, with fibrates used off-label. Common symptoms (pruritus and fatigue) are poorly managed by these treatments, and about 20–30% of people with PBC have an inadequate response to first-line treatment with UDCA. Ongoing drug development efforts have led to US Food and Drug Administration approval of elafibranor and seladelpar, two peroxisome proliferator-activated receptor agonists. The approval of new therapeutic agents is expected to enable a more personalised approach to treatment. [ABSTRACT FROM AUTHOR]

Combining non-sedating antihistamines (NSAs) with montelukast (MON) has been found to significantly enhance the therapeutic efficacy against daytime and composite nasal symptoms, including rhinorrhea, sneezing, and itching. This article reviews the current analytical methods employed for the identification and quantitative determination of MON in combination with NSAs in various marketed formulations. The most commonly used methods for the determination of MON and NSAs in combination are chromatographic methods (high-performance liquid chromatography [HPLC] and thin-layer chromatography) and spectrometry methods (spectrofluorometry and spectrophotometry). Recent preferences in the analysis of MON and NSAs in combination samples prove the primacy of HPLC (61%) and confirm the general trends moving toward more sensitive methods, with a higher resolution potential, consumption of small quantities of samples and reagents, and requiring less analysis time. [ABSTRACT FROM AUTHOR]

Background: Pruritus significantly impacts quality of life, leading to increased interest in complementary and alternative medicines (CAMs) as potential treatments. This review explores the efficacy of various CAMs for pruritus. Methods: A comprehensive review was conducted on the effectiveness of several CAMs for pruritus. The Jadad Scale was used to assess the quality of evidence for CAM therapies when relevant. Key CAM therapies reviewed include capsaicin, acupuncture, menthol, camphor, phenol group medicines, oatmeal, and tar. Results: For capsaicin, several RCTs reported efficacy in reducing pruritus but were limited by issues with patient blinding. The average Jadad score was 3.7. Acupuncture RCTs had mixed results, with some suggesting benefits in uremic and histamine-induced pruritus. The average Jadad score was 3. Evidence for other CAMs like menthol, camphor, and oatmeal was limited. Conclusion: While some studies indicate potential anti-pruritic effects of capsaicin and acupuncture, overall evidence quality is moderate due to study design limitations. Future research should pragmatically compare CAMs to conventional therapies, reflecting real-world clinical use. In the meantime, dermatologists can use this evolving research to provide patients with evidence-based guidance on CAM treatments for pruritus. [ABSTRACT FROM AUTHOR]

Background: Kidney failure at any age has a significant impact on quality of life (QoL) but the overall symptom burden for children and young people (CYP) is poorly described. Kidney failure has no cure and whilst transplantation is the preferred management option, it is not always possible, with patients requiring supportive care at the end of their lives. Aim: To use the literature to understand the symptom burden for CYP with kidney failure who are approaching end-of-life. Methods: Using three databases, a systematic literature review was performed to identify eligible studies to extract data on symptoms experienced in CYP aged < 21 years with kidney failure. Data extraction was completed by two authors using a pre-designed proforma. Study quality assessment was undertaken using the BMJ AXIS tool. Results: A total of 20,003 titles were screened to yielding 35 eligible studies including 2,862 CYP with chronic kidney disease (CKD), of whom 1,624 (57%) had CKD stage 5. The studies included a median of 30 (range 7–241) patients. Symptoms were subcategorised into eight groups: sleep, mental health, gastrointestinal, dermatology, ear, nose and throat (ENT), neurology, multiple symptoms, and ophthalmology. The prevalences of the most commonly reported symptoms were: restless leg syndrome 16.7–45%, sleep disordered breathing 20–46%, hypersomnia 14.3–60%, depression 12.5–67%, anxiety 5.3–34%, overall gastrointestinal symptoms 43–82.6%, nausea and vomiting 15.8–68.4%, abdominal pain 10.5–67.4%, altered appetite or anorexia 19–90%, xerosis 53.5–100%, pruritis 18.6–69%, headache 24–76.2% and ophthalmological symptoms 26%. Within each subgroup, the symptom definitions used were heterogeneous, the methods of assessment were varied and some symptoms, such as pain and constipation, were poorly represented. Conclusions: There is a marked lack of evidence relating to the symptom burden for CYP with CKD. This study highlights the high symptom prevalence, particularly in relation to sleep, mental health, headache, dermatological and gastrointestinal symptoms. There is a need for consensus recommendations on the evaluation and management of symptoms for CYP with CKD approaching end-of-life. PROSPERO ID: CRD42022346120. [ABSTRACT FROM AUTHOR]

Background: Systemic inflammation is considered a major player in the pathogenesis of epidermolysis bullosa (EB), but its pattern has only been described in small heterogeneous cohorts. There is controversy if and how systemic inflammation should be therapeutically targeted. Methods: We examined serum proinflammatory, anti‐inflammatory, and itch related cytokines in a paediatric cohort of 29 patients with junctional and dystrophic EB. The cytokine that emerged as the most relevant was measured in a validation cohort of 42 patients during follow‐up visits over 2 years. Results: IL‐6 showed the most consistent and highest aberration dominating systemic inflammation. IL‐6 correlated with wound body surface area (BSA) in both, finding and validation cohorts. Patients with less than 3% wound BSA had normal IL‐6, while IL‐6 levels significantly increased at more than 5% and 10% of wound BSA. TGF‐β was only marginally elevated in patients with severe recessive dystrophic EB, while TNF‐α, IFN‐γ and IL‐1β varied inconsistently. Patients reporting itch showed elevations in type 2 immunity (IgE, TSLP, IL4 and/or IL‐31, respectively). Conclusions: Our data suggest a dominant skin barrier and wound healing inflammatory pattern in junctional and dystrophic EB that depends on the wound area and not on the EB type. In EB, itch mediators may be similar to other pruritic disorders. [ABSTRACT FROM AUTHOR]

Background & Aims: Approximately 40% of patients with Primary Biliary Cholangitis (PBC) show incomplete response to ursodeoxycholic acid, thus needing second‐line treatment to prevent disease progression. As no head‐to‐head comparison study is available, we used a network meta‐analysis (NMA) to compare efficacy and safety of available second‐line therapies. Methods: We performed a systematic literature review including randomised, placebo‐controlled trials of patients with PBC and incomplete response, or intolerance, to ursodeoxycholic acid, and compared relative risks (RRs) for primary (biochemical response at 52‐week) and secondary outcomes [incidence of new‐onset pruritus and serious adverse events (SAEs)]. Results: The NMA included three studies, each testing obeticholic acid (OCA), seladelpar or elafibranor versus placebo (active therapy/placebo: 379/191 patients). All treatments significantly increased the RR for biochemical response with an advantage of elafibranor versus seladelpar (RR: 4.37, 95% CI: 1.01–18.87). OCA 5–10 mg/10 mg was associated with a higher risk of new‐onset pruritus compared to placebo (RR: 1.43; 95% CI: 1.09–1.88/RR: 1.79; 95% CI: 1.37–2.33), while seladelpar decreased this risk (RR: 0.30; 95% CI: 0.12–0.80). Compared to placebo, OCA 5–10 mg/10 mg was associated with an increased risk of SAE (RR: 3.82; 95% CI: 1.46–10.02/RR 2.67; 95% CI: 1.00–7.08). Conclusions: Among second line therapies for patients with PBC, elafibranor is slightly more effective in obtaining biochemical response than seladelpar that, on the other hand, is the only drug associated with a lower incidence of pruritus. While of similar efficacy, OCA was associated with increased pruritus and SAEs. These findings may help personalise second‐line treatment in patients with PBC. [ABSTRACT FROM AUTHOR]

A 29‐year‐old female presented to a rheumatology‐dermatology clinic with a pruritic rash that began 6 months prior, after a viral illness. She had previously been diagnosed with eczema and treated with antihistamines and topical steroids without improvement. She also noted fatigue, hair loss, and severe scalp pruritus. Physical examination was notable for violaceous periorbital edema, scaly erythematous papules on the metacarpophalangeal joints of bilateral hands, dilated capillaries of the proximal nail folds, scaly plaques on bilateral elbows, and excoriated erythematous plaques on upper chest, back and hips. The patient reported no muscle weakness, and strength testing and creatinine phosphokinase were normal. Magnetic resonance imaging of the thigh showed no evidence of inflammation or edema. Antibody testing was negative. A diagnosis of clinically amyopathic dermatomyositis was made. Computed tomography scans of the chest, abdomen and pelvis, colonoscopy, and mammogram showed no evidence of cancer. The patient was initiated on methotrexate. Her cutaneous manifestations persisted with debilitating intractable pruritus, and thus, she was transitioned to mycophenolate mofetil, again with minimal improvement. Intravenous immunoglobulin was not approved by insurance given the lack of muscle involvement in her disease. This patient's case highlights a common clinical scenario in rheumatology and dermatology and raises several important issues related to the immunologic underpinnings of cutaneous lupus erythematosus (CLE) and dermatomyositis (DM): What is the role of type I interferon (IFN) in triggering skin disease in CLE and DM? What is the role of IFN in the pathogenesis of skin inflammation in CLE and DM? Can we apply what we know about IFN‐targeted therapeutics in CLE and DM to develop better treatments for skin disease? [ABSTRACT FROM AUTHOR]

Background Atopic dermatitis (AD) is a chronic skin disease characterized by intense itch and eczematous skin lesions. Some patients with AD continue to experience flares and substantial clinical burden, despite ongoing systemic treatment. Objectives To assess the efficacy and safety of once-daily upadacitinib (UPA), initiated at 15 mg and dose-escalated to 30 mg based on clinical response, compared with dupilumab (DUPI) as per its label, and present the week 16 primary analysis results. Methods Level Up is a phase IIIb/IV global randomized open-label efficacy assessor-blinded study evaluating UPA vs. DUPI in adolescents and adults with moderate-to-severe AD who had an inadequate response to systemic therapy or when use was inadvisable. Patients were randomized to UPA or DUPI for 16 weeks of treatment (period 1). Patients on UPA were started on 15 mg and dose-escalated to 30 mg if they did not achieve an Eczema Area and Severity Index reduction of at least 50% (EASI 50) or a ≥ 4-point Worst Pruritus Numerical Rating Scale (WP-NRS) improvement on or after week 4, or an EASI reduction of at least 75% (EASI 75) on or after week 8. The primary endpoint was simultaneous achievement of an EASI reduction of at least 90% (EASI 90) and WP-NRS 0/1 at week 16. Ranked secondary endpoints included skin and itch responses at varying response levels and timepoints. Safety measures were assessed throughout the study. Results Superior efficacy in achieving simultaneous EASI 90 and WP-NRS 0/1 response at week 16 was demonstrated with UPA vs. DUPI (19.9% vs 8.9%, respectively; P < 0.001). UPA showed superiority over DUPI for all ranked secondary endpoints, with post hoc analyses exhibiting higher itch response rates as early as day 2. No new safety signals were identified in this period. Conclusions Treatment of moderate-to-severe AD with UPA, initiated at 15 mg and dose-escalated based on clinical response, demonstrated superiority over DUPI per its label for the primary endpoint of simultaneous achievement of near-complete skin clearance (EASI 90) and little-to-no itch (WP-NRS 0/1) at week 16, with all ranked secondary endpoints demonstrating superiority at varying skin and itch response levels and timepoints. No new safety signals were identified vs. the previously reported safety profiles of UPA and DUPI. [ABSTRACT FROM AUTHOR]

The authors emphasize the importance of nurses' interpersonal relations and incorporate a theoretical perspective that promotes an understanding of the multiple dilemmas that patients and families experience in their journey of improving health and well-being. A detailed explanation of Peplau's theory of interpersonal relations is provided, including the three phases involved in developing nurse-patient relationships, and the challenges associated with each phase are reviewed with a focus on interpersonal competencies. Peplau's theory of interpersonal relations promotes a scholarly practice dedicated to the wholeness, complexity, and context of interpersonal relationships. [ABSTRACT FROM AUTHOR]

Limited data existed on the efficacy and safety of novel antiepileptic drugs (pregabalin and gabapentin) in treating pruritus. To assess their role in managing either acute or chronic pruritus. A systematic search was conducted in PubMed, EMBASE, the Cochrane Library, and Web of Science databases for relevant randomized controlled trials. Pooled odd ratio (OR) with 95% CI were performed using RevMan5.4 and R4.3.1. Analysis of 27 articles involving 2,016 patients showed significant reduction in pruritus incidence (OR, 0.30 [CI, 0.22–0.4]; I2=1%) and improvements in VAS (MD, 2.76 [CI, 0.95–4.57]; I2=98%) and 5-D scores (MD, 3.42 [CI, 2.10–4.75]; I2=92%) with pregabalin/gabapentin compared to controls. Adverse effects mainly included dizziness, somnolence, nausea and vomiting, dry mouth, constipation, and anxiety, with no significant difference between the groups (OR, 1.08 [CI, 0.32–3.59]; I2=76%). The novel antiepileptic drugs pregabalin and gabapentin demonstrated significant therapeutic value in the treatment of pruritus, with a favorable safety profile. Compared to commonly used pruritus treatments such as antihistamines and antidepressants, these medications offered a promising alternative. [ABSTRACT FROM AUTHOR]

Aim: To analyse the potential drivers (glucose level, complications, diabetes type, gender, age and mental health) of diabetes symptoms using continuous glucose monitoring (CGM) and ecological momentary assessment. Materials and Methods: Participants used a smartphone application to rate 25 diabetes symptoms in their daily lives over 8 days. These symptoms were grouped into four blocks so that each symptom was rated six times on 2 days (noon, afternoon and evening). The symptom ratings were associated with the glucose levels for the previous 2 hours, measured with CGM. Linear mixed‐effects models were used, allowing for nested random effects and the conduct of N = 1 analysis of individual associations. Results: In total, 192 individuals with type 1 diabetes and 179 with type 2 diabetes completed 6380 app check‐ins. Four symptoms showed a significant negative association with glucose values, indicating higher ratings at lower glucose (speech difficulties, P =.003; coordination problems, P =.00005; confusion, P =.049; and food cravings, P =.0003). Four symptoms showed a significant positive association with glucose values, indicating higher scores at higher glucose (thirst, P =.0001; urination, P =.0003; taste disturbances, P =.021; and itching, P =.0120). There were also significant positive associations between microangiopathy and eight symptoms. Elevated depression and diabetes distress were associated with higher symptom scores. N = 1 analysis showed highly idiosyncratic associations between symptom reports and glucose levels. Conclusions: The N = 1 analysis facilitated the creation of personalized symptom profiles related to glucose levels with consideration of factors such as complications, gender, body mass index, depression and diabetes distress. This approach can enhance precision monitoring for diabetes symptoms in precision medicine. [ABSTRACT FROM AUTHOR]

Treatment planning can be difficult. We have a finite number of resources compared to an often seemingly infinite number of issues which our patient may present with. Skin health is not a one size fits all approach and therefore we need to review patients holistically and understand the physiology beyond 'skin deep'. During hormonal changes, symptoms such as hot flushes, night sweats, itching, dryness and anxiety are commonly reported and are interlinked with gut health, stress, and sleep issues. This paper explores the multimodal treatment of skin during menopause, examining the physiological changes and related interventions to maintain skin health. [ABSTRACT FROM AUTHOR]

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Ribociclib, a cyclin-dependent kinase 4/6 (CDK4/6) inhibitor, is commonly used to treat hormone receptor-positive (HR+), human epidermal growth factor receptor 2/neu negative (HER2/neu-) breast cancer. While effective in inhibiting cancer cell proliferation, ribociclib has been associated with various dermatologic side effects, including vitiligo. This condition, characterized by the loss of skin pigmentation, occurs due to the destruction of melanocytes. In breast cancer patients undergoing ribociclib therapy, though the exact pathophysiological mechanisms remain under investigation, a possible hypothesis suggests that the development of vitiligo may signal an immune-mediated response, potentially reflecting the drug's influence on immune modulation. This report presents a case of HR+ and HER2/neu− metastatic breast carcinoma treated with CDK4/6 inhibitor plus endocrine therapy with the development of vitiligo during the treatment. [ABSTRACT FROM AUTHOR]

Background This study determines the clinical and paraclinical characteristics of children with Toxocara canis infection and serum eosinophil cut-off values for predicting toxocariasis in the group displaying symptoms of itching, urticaria and erythema. Methods A cross-sectional study was conducted during March and April 2023 with a sample size of 986 children aged 3–15 y. Results In total, 140 (14.2%) of the 986 participants had anti- T canis antibodies. The most frequently experienced symptoms in this group were itching (10.1%), abdominal pain (8.2%) and urticaria (3.3%). The rate of IgE increased (37%), and the rates of mild and high eosinophilia were 38% and 2.2%, respectively. There were significant differences in IgE concentration and eosinophil count, and for both IgE concentration and eosinophil count between the two groups with and without toxocariasis. The optimal threshold for eosinophil to predict toxocariasis was 0.38 K/µL, with itching, urticaria and erythema resulting in a sensitivity of 61.5%, a specificity of 82.1% and a receiver operating characteristic curve (area under the curve) of 0.71. Conclusions This study confirmed a positive association between IgE concentration, eosinophil count and positive serology for T. canis. A general blood count, including eosinophils, is a simple test that can be performed in hospitals. Clinicians should target and screen for T.oxocara canis infection when children display clinical symptoms of itching, urticaria, erythema and eosinophilia. Clinical trial registration number NCT05208333 [ABSTRACT FROM AUTHOR]

To examine the impact of an educational approach incorporating behavioral modification and the Health Belief Model on the adherence to skin moisturizing care, itch severity, self-efficacy, and quality of life among individuals diagnosed with psoriasis vulgaris. A study involving 108 psoriasis vulgaris patients (November 2022–October 2023) utilized random allocation to form experimental and control groups. The control group received standard care, including medication guidance, general health education, and basic nursing support. In contrast, the experimental group underwent an enhanced intervention that combined behavior modification techniques and education based on the Health Belief Model. This included biweekly educational sessions, personalized behavioral assessments, and self-monitoring tools like self-supervision cards, which were not provided to the control group. Assessments pre- and post-intervention measured itchiness, self-efficacy, and quality of life. Comparative analyses included pruritus, self-efficacy, adherence, and quality of life using various scales. The study aimed to evaluate the impact of combined interventions on these parameters in psoriasis patients. Following the intervention, both groups exhibited improvements in itching degree, itching frequency, and affected areas compared to pre-intervention levels, with the experimental group showing superior outcomes over the control group. GSES scores in both groups increased post-intervention, with the experimental group surpassing the control group. Both groups demonstrated enhanced scores post-intervention across various aspects, including forgetting to use medication, willingness to use medication, influencing factors, medication timing, frequency, and quality of life (assessed by DLQI). Furthermore, MORISKY scores for medication timing, frequency, and self-discontinuation decreased in both groups post-intervention, with the experimental group recording lower scores than the control group. DLQI scores for symptom feelings, daily life, leisure and recreation, work and study, interpersonal relationships, and treatment were reduced in both groups after the intervention, with the experimental group showing lower scores than the control group. Combining behavior modification and health belief model education effectively improves adherence to skincare, relieves itching in psoriasis patients, and enhances self-efficacy and overall quality of life. [ABSTRACT FROM AUTHOR]

A 3‐year‐old male sugar glider presented with pruritus and alopecia primarily affecting the back and neck regions. Dermatologic diagnostics ruled out common causes. Skin biopsies revealed cutaneous epitheliotropic T‐cell lymphoma, a rare condition in sugar gliders. Despite treatment, the glider's condition worsened, leading to death. This case highlights the importance of thorough diagnostic evaluation in exotic pets. [ABSTRACT FROM AUTHOR]

Purpose: To systematically evaluate evidence from published systematic reviews for the effectiveness of rehabilitation interventions in adults with burn injury. Materials and methods: A comprehensive literature review conducted using medical and health science electronic databases up to 31 July 2022. Two independent reviewers selected studies, extracted data, and assessed methodological study quality using A Measurement Tool to Assess Systematic Reviews (AMSTAR-2), and the certainty of evidence for reported outcomes using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) tool. Results: Twenty-one systematic reviews evaluated five categories of interventions: physical, psychological, technology-aided modalities, educational and occupational programs, complementary and alternative medicine. Outcomes included fitness level, hand function, oedema, pain, pruritus, psychological state, quality of life, range of motion, return to work, strength, scar characteristics, level of impairment and burn knowledge. The methodological quality was rated as "critically low" for all reviews. Quality of evidence for the effectiveness of evaluated interventions ranged from "moderate to very low." Conclusions: Beneficial effects of inhaled aromatherapy and extracorporeal shockwave therapy on pain reduction; inhaled or massage aromatherapy, music therapy on anxiety were reported. Safety of interventions was not evaluated, due to the lack of adverse event reporting in primary studies and the included reviews. IMPLICATIONS FOR REHABILITATION: Burn injury is a leading cause of severe morbidity, and long-term disability, with significant health and economic burden. There is emerging evidence to support the use of complementary and alternative medicine interventions (such as aromatherapy and music therapy) for alleviating anxiety. Extracorporeal shockwave therapy with comprehensive rehabilitation therapy has positive effects on pain reduction. These interventions may be considered as adjunctive tools to enhance burn rehabilitation care and improve patient outcomes. However, further robust studies are required to strengthen the evidence, explore adverse effects and associated cost efficiency. [ABSTRACT FROM AUTHOR]

Background and Objective: Uremic pruritus is a persistent condition that is difficult to cure in patients with end-stage renal disease who are having regular dialysis. It is highly prevalent, and current therapies have limited effectiveness and can cause significant adverse effects. Several trials have provided evidence that difelikefalin can be an effective treatment for uremic pruritus, with few side responses. However, it is important to note that the available evidence is limited. This study collected published randomized controlled trials for systematic review and Meta-analysis, to explore the efficacy and safety of difelikefalin treating uremic pruritus and to provide evidence-based medical evidence for clinical treatment. Methods: A systematic literature search was conducted in PubMed, EMBASE, Web of Science, the Cochrane Library Data from building libraries to 6 January 2024. We extracted data from eligible studies to analyze the efficacy and safety of difelikefalin in the treatment of hemodialysis patients with pruritus. Results: This study comprised 9 trials with 4,118 people. The meta-analysis demonstrated that difelikefalin is more effective than placebo in treating uremic pruritus. Specifically, difelikefalin resulted in a greater improvement in WI-NRS scores of at least 3 points from baseline (OR = 1.98) and at least 4 points from baseline (OR = 1.94). Additionally, difelikefalin led to a decrease in the total score of the 5-D itch scale (MD = 1.56), a decrease in the skindex-10 scale score (MD = 4.92), and a decrease in the WI-NRS scale score (MD = 0.91). Conclusion: Difelikefalin demonstrates significant efficacy in alleviating pruritus in individuals suffering from uremia. Althogh it has adverse events, they are mild. [ABSTRACT FROM AUTHOR]

Introduction: Checkpoint inhibitors are increasingly important in anti-cancer treatment. Therefore, knowledge of immune-related cutaneous adverse events (ir-cAE) is crucial for therapy management and continuation. Objective: The study aimed to analyze the incidence of cutaneous adverse events caused by checkpoint inhibitor therapy, including their clinical presentation, management, and impact on further treatment. Methods: This is a descriptive, monocentric retrospective study that uses data from the electronic health record system at a tertiary referral hospital in Central Switzerland from September 2019 to September 2022. The electronic health records of patients who received a therapy with checkpoint inhibitors were examined for age, sex, type of immunotherapy, time to occurrence of ir-cAEs, characteristics of the ir-cAEs, the treatment approach, and the continuation or cessation of the therapy due to ir-cAEs. Results: Out of 431 patients, for 131 patients (30.4%) at least one ir-cAE event was documented. In particular, 109 (25.3%) experienced pruritus and 61 (14.2%) showed a maculopapular exanthema. The severity of the ir-cAE was mild in 88 patients (67.2% out of those with ir-cAEs). Ir-cAE were observed in 10 out of 20 patients (50%) treated with ipilimumab/nivolumab and in 15 out of 24 (62.5%) treated with durvalumab. In 15 patients (3.5%), checkpoint inhibitor therapy had to be discontinued due to cutaneous side effects. Conclusions: This study showed that approximately one third of the patients experienced ir-cAEs. The most frequently observed ir-cAEs were pruritus, maculopapular exanthema and xerosis cutis. In general, the dermatological manifestations are mild and responsive to topical treatment or self-limiting with no requirement for treatment interruption. [ABSTRACT FROM AUTHOR]

The Special Issue "Cannabis sativa: From Plants to Humans" explores recent developments in the study of Cannabis sativa, covering topics such as its cultivation, industrial applications, pharmaceutical uses, and health risks associated with psychoactive derivatives. The issue delves into the chemical profile of hemp inflorescences, the medicinal benefits of cannabinoids, and the potential therapeutic applications of cannabis-based products. Additionally, it addresses the challenges posed by pathogens affecting cannabis and hemp crops, as well as the allergenic profile of different chemotypes of Cannabis sativa. The research presented in the issue underscores the dual nature of Cannabis sativa as a source of beneficial bioactive compounds and a psychoactive substance with potential adverse health effects. [Extracted from the article]

Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) is a newly identified type of coronavirus that causes coronavirus disease-2019 (COVID-19) and has been associated with numerous skin manifestations. Although COVID-19 primarily affects the respiratory system, it can also involve many systems, such as the cardiovascular, gastrointestinal, and urogenital systems, in the course of the disease. Skin findings can be observed frequently in the course of the disease. Pityriasis lichenoides (PL) is an inflammatory skin disease that includes pityriasis lichenoides et varioliformis acuta (PLEVA) and pityriasis lichenoides chronica (PLC). PLEVA is characterized by erythematous papules, vesicles, ulcers, and hemorrhagic crust formation, which can be observed in the lesions over time. PLC is characterized by red-brown papules and plaques with mica-like scales. Extrinsic antigens such as drugs, infections, and vaccines can trigger the immune system and cause disease development. In addition, immune complex-mediated hypersensitivity reactions due to etiological factors and clonal T-lymphocyte proliferation are also involved in the etiopathogenesis of the disease. Viral infectious agents in etiology include Epstein-Barr virus, cytomegalovirus, varicella-zoster virus, and parvovirus-B19. SARS-CoV-2 may play an important role in the etiopathogenesis of dermatological diseases. Although the apparent relationship between PL and SARS-CoV-2 is not fully understood, cases of SARS-CoV-2-triggered PL have been reported. This case report presents a rare case of PLC triggered by SARS-CoV-2 infection. [ABSTRACT FROM AUTHOR]

Background: Hemodialysis is carried out in ESRD patients where an attempt is made to filter the blood out of the body. However, 80% or more patients consequently have skin problems related to seriously affected kidneys as well as the treatment through dialysis. The skin manifestations are dry skin xerosis, itching pruritus, changes in color pigmentation black and white patches, and skin infections - bacterial, fungal viral, and brittle nails and hair this is due to changes in blood chemistry. An experienced doctor can diagnose the cause of the problem and advise on the way out. Sometimes, patients can help maintain the skin's health with lotions or medications to avoid scratching. Purpose: This study aimed to examine hemodialysis patients' cutaneous symptoms to assess their prevalence and clinical features. Patients need hemodialysis; however, it might cause skin problems. This cross-sectional study was conducted at Bisha King Abdullah Hospital between February 2021 and April 2021. A total of 40 hemodialysis patients were included in the study. Results: The study analyzed participants aged 24-35 and 35-45, with a majority of females. It found no significant association between serum calcium levels and skin problems, xerosis, or pruritus. However, KT/V levels were significantly associated with xerosis and pruritus, and blood hemoglobin levels did not. Conclusion: The present study provides insights into the frequency of cutaneous manifestations among patients undergoing hemodialysis, underscoring the need for customized therapies aimed at addressing these dermatological issues. Future investigations should prioritize the development of improved healthcare solutions for patients with these medical disorders, taking into consideration both the renal and dermatological components. [ABSTRACT FROM AUTHOR]

Even though pruritus affects a significant number of people with chronic disease, it is rarely adequately treated. Drug therapies often rely on antihistamines, which have not shown to be beneficial in systemic pruritus. Hydroxyzine is frequently used to treat pruritus associated with kidney failure. Since Canada's sole manufacturer of hydroxyzine is no longer making this product, this is an ideal time to review the mechanisms of itch in advanced organ failure and the specific therapies that give relief. Although there is literature describing itch in patients with cancer, this article is limited to pathogenesis and treatment of systemic itch secondary to chronic, noncancer diseases. We summarize recent systematic reviews, although the studies included in these reviews are often small, and mostly cohort studies. [ABSTRACT FROM AUTHOR]

Background: Lokivetmab, a caninised monoclonal antibody against interleukin (IL)‐31, is an effective treatment for the pruritus associated with canine atopic dermatitis (cAD). Objectives: To investigate the efficacy and safety of lokivetmab during long‐term treatment defined as at least three consecutive lokivetmab injections in atopic dogs under field conditions. To assess individual factors influencing treatment outcome and adverse events. Animals: 150 dogs with cAD. Materials and Methods: Medical records of dogs treated with lokivetmab were reviewed, and owners and/or veterinarians were contacted as needed for follow‐up. A decrease of the pruritus Visual Analog Scale (PVAS) score by ≥2 or a PVAS score ≤2 after treatment was considered as treatment success. Logistic regression was used to investigate the influence of a variety of factors on outcome: type of cAD (food versus environment), age at first lokivetmab administration, disease chronicity, dosage and/or secondary infection. Any adverse event that occurred during the study period was recorded. Results: Lokivetmab reduced the PVAS score with long‐term use (p < 0.01); the success rate was 53 of 69 total dogs (77%). The probability of treatment failure decreased with increasing treatment duration. None of the factors investigated influenced the treatment outcome. Twelve dogs of 150 (8%) showed adverse events such as gastrointestinal signs or lethargy. Conclusion and Clinical Relevance: Lokivetmab appears to be an effective and safe long‐term anti‐itch therapy for dogs with cAD. [ABSTRACT FROM AUTHOR]

Generalised pustular psoriasis of pregnancy (GPPP) is a rare dermatosis that presents in the third trimester. It merits careful clinical assessment given the difficulty in diagnosis, impact on maternal health and association with placental insufficiency. We present a case of generalised pustulosis in a pregnant woman at 30 weeks' gestation and describe the clinico-pathological challenges in obtaining a diagnosis of GPPP. Furthermore, we provide evidence from cardiotocography and ultrasound of evolving fetal compromise and describe how intensive management can facilitate a positive maternal–fetal outcome. [ABSTRACT FROM AUTHOR]

OBJECTIVE: This study investigated the effects of recombinant equine IL-31 (eIL-31) in vivo and in vitro. METHODS: Equine IL-31 mRNA sequences were verified by sequencing. Recombinant eIL-31 was produced using mammalian and bacterial expression systems. From November 2019 through February 2021, 12 normal horses, 6 to 10 years old with no history or clinical signs consistent with allergic skin disease, were injected ID with eIL-31 and saline in 2 challenge studies. Pruritus-associated behaviors were recorded for a minimum of 15 minutes preinjection and 4 hours postinjection. Adherent monocytes from 3 pruritic horses, exhibiting insect bite hypersensitivity and/or atopic dermatitis, were stimulated with bacterial eIL-31, and subsequent phosphorylation of signal transducer and activator of transcription 3 (STAT3) was measured by western blot and AlphaLISA. RESULTS: The bacterial eIL-31 was produced with greater purity than the mammalian eIL-31 (> 95% vs 70%). Pruritus was elicited by both recombinant proteins. The mammalian eIL-31 induced mild pruritus (cumulative seconds spent itching postinjection ranged from 6 to 313). The bacterial eIL-31 induced marked pruritus in some horses (a cumulative maximum of 5,529 seconds spent itching in 1 horse) and a milder response in others (range of cumulative seconds spent itching, 17 to 2,313). Most pruritus occurred after 2 hours and subsided by 4 hours postinjection. Bacterial eIL-31 induced STAT3 phosphorylation in adherent monocytes from allergic horses. CONCLUSIONS: In this proof-of-concept study, IL-31 was found to mediate pruritus and was associated with STAT3 phosphorylation in horses as in other species. CLINICAL RELEVANCE: Interleukin 31 is a promising therapeutic target for equine allergic pruritus. [ABSTRACT FROM AUTHOR]

Background and Aims: Hyaluronidase‐facilitated subcutaneous immunoglobulin (fSCIG) consists of subcutaneous human immunoglobulin G (IgG) 10% with recombinant human hyaluronidase (rHuPH20) and can be administered at the same dose and interval as intravenous IgG (IVIG). fSCIG recently received US approval as maintenance therapy for adults with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and European approval for adults and children with CIDP after stabilization with IVIG. Methods: ADVANCE‐CIDP 3 (NCT02955355) was an open‐label long‐term extension of the Phase 3 double‐blind randomized placebo‐controlled ADVANCE‐CIDP 1 study (NCT02549170) that examined fSCIG safety and efficacy as maintenance CIDP therapy. Primary outcomes were safety, tolerability, and immunogenicity. Efficacy was an exploratory outcome. Results: The study provided 220 patient‐years of follow‐up data from 85 patients. Median (range) exposure was 33 (0–77) months. Patients received fSCIG every 4 weeks (88.2%) or every 3 weeks (11.8%). Median (range) 4‐weekly IgG dose equivalent was 64.0 (28.0–200.0) g. Mean (standard deviation) infusion duration was 135.5 (62.8) minutes. Most adverse events (AEs) were mild or moderate and self‐limiting. Of the 1406 AEs, only 48 were severe and 30 were serious. fSCIG‐related AEs (n = 798) included infusion site reactions such as pain, redness, and pruritus. Three infusions (0.1%) were reduced in rate, interrupted, or stopped due to intolerability. Relapse occurred in 10 of 77 patients (13.0%); annual relapse rate was 4.5%. An anti‐rHuPH20 antibody titer ≥1:160 was detected in 14 of 84 patients (16.7%); patients who tested positive (≥1:160) had similar relapse rates versus those who tested negative (16.7% vs. 12.3%, respectively). Interpretation: ADVANCE‐CIDP 3 demonstrated favorable fSCIG long‐term safety and tolerability consistent with its established safety profile, and a low relapse rate, supporting use as maintenance CIDP treatment. [ABSTRACT FROM AUTHOR]

Leukorrhea is one of the most common reasons for consultation in gynecology. A distinction must be made between physiological leukorrhea, the variations of which are linked to hormonal changes or specific conditions such as pregnancy or menopause, and pathological leukorrhea. Among the latter, infections are the most common, bacterial or candidal vaginosis accompanied by abnormal vaginal discharge, vulvar and vaginal pruritus and burning sensations. They are a source of discomfort for women with a risk of transmission to sexual partners. How can they be distinguished? What appropriate management is needed to preserve women's well-being and prevent complications? [ABSTRACT FROM AUTHOR]

Background and Objective: Hepcidin, an endogenous peptide hormone, binds to ferroportin and is the master regulator of iron trafficking. Rusfertide, a synthetic peptide, is a potent hepcidin mimetic. Clinical studies suggest rusfertide may be effective in the treatment of polycythemia vera. This study investigated the dose-ranging pharmacokinetics, pharmacodynamics, and safety of a lyophilized formulation of rusfertide. Methods: A randomized open-label crossover study was conducted in two groups of healthy adult subjects to evaluate the safety, tolerability, pharmacokinetics, and pharmacodynamics of subcutaneous rusfertide doses that ranged from 10 to 60 mg of a lyophilized formulation and 20 mg of an aqueous prefilled syringe formulation that were used in clinical trials. Results: Rusfertide showed a rapid initial absorption. Median time to peak plasma concentrations for the lyophilized formulation was 24 h for doses of 10–30 mg and 2–4 h for doses of 45 and 60 mg. Mean terminal half-life ranged from 19.6 to 57.1 h. Rusfertide peak concentration and area under the concentration–time curve increased with an increasing dose, but in a less than dose-proportional manner. Metabolites M4 and M9 were identified as major metabolites. At the rusfertide 20-mg dose, the lyophilized formulation had an area under the concentration–time curve from time zero to infinity approximately 1.5-fold higher than the aqueous formulation. The elimination half-life was comparable for the two formulations. Dose-related decreases in serum iron and transferrin-iron saturation were seen following rusfertide treatment. The majority of treatment-emergent adverse events were mild; treatment-related treatment-emergent adverse events seen in ≥10% of subjects were injection-site erythema and injection-site pruritus. Conclusions: Rusfertide was well tolerated; the pharmacokinetic and pharmacodynamic results indicate that lyophilized rusfertide is suitable for once-weekly or twice-weekly administration. Plain Language Summary: Hepcidin is a natural peptide hormone produced by the liver that is responsible for iron homeostasis. Rusfertide is a potent peptide mimetic of hepcidin that is being investigated for the treatment of polycythemia vera. This trial was conducted in two groups of healthy subjects to describe the pharmacokinetics and pharmacodynamics of subcutaneous rusfertide. Doses of 10–60 mg of a lyophilized powder formulation and 20 mg of an aqueous formulation were studied in a randomized manner. Following subcutaneous dosing, maximum plasma concentration and exposure measured by area under the concentration–time curve increased with dose but in a less than proportional manner. Rusfertide reduced serum iron and transferrin-iron saturation in a dose-related manner. Rusfertide was generally well tolerated. Side effects seen in more than 10% of subjects that were considered possibly related to treatment were injection-site redness and itching. [ABSTRACT FROM AUTHOR]

Frontal fibrosing alopecia (FFA) is a primary cicatricial alopecia characterized by hairline recession, pruritus, and facial papules (FP). Various therapies are used to stabilize disease activity and induce remission. However, FP of FFA is resistant to treatment in many cases. In this review, we searched the PubMed and Google Scholar databases to screen the published literature on treatment options for FP in the context of FFA. Overall, 12 studies were included in this review. Available literature suggests a noticeable improvement in resistant‐to‐treatment FP in FFA patients with oral isotretinoin. The available evidence is limited and is derived from retrospective studies and case reports/series. Systemic isotretinoin can be considered a promising therapeutic regimen for treating resistant‐to‐treatment FP of FFA patients. However, more extensive, well‐designed studies are necessary for confirmatory evidence. [ABSTRACT FROM AUTHOR]

Purpose: The number of clinical reports of acupuncture therapy in chronic kidney disease (CKD) is gradually increasing. This systematic review and meta-analysis aim to examine the therapeutic role of acupuncture therapy in kidney function and common symptoms in CKD patients. Methods: We searched Embase, PubMed, Scopus, Web of Science, China National Knowledge Infrastructure, WanFang, and WeiPu for randomized controlled trials comparing acupuncture treatment with control or placebo groups. We assessed the effect of acupuncture therapy in CKD patients using a meta-analysis with the hartung-knapp-sidik-jonkman random effects model. In addition, we visualized keyword co-occurrence overlay visualization with the help of VOSviewer software to describe the research hotspots of acupuncture therapy and CKD. Results: A total of 24 studies involving 1494 participants were included. Compared to the control group, acupuncture therapy reduced serum creatinine levels (standardized mean difference [SMD]: −0.57; 95% CI −1.05 to −0.09) and relieved pruritus (SMD: −2.20; 95% CI −3.84, −0.57) in patients with CKD, while the TSA showed that the included sample size did not exceed the required information size. The included studies did not report acupuncture-related adverse events. Conclusions: Acupuncture is an effective and safe treatment for improving kidney function and relieving pruritic symptoms in patients with CKD, but the very low evidence may limit this conclusion. The TSA suggests that high-quality trials are needed to validate the efficacy of acupuncture therapy. Acupuncture therapy may improve kidney function and relieve pruritus symptoms in CKD patients, but both are very low evidence. Trial sequential analysis shows insufficient evidence for acupuncture therapy in CKD patients. Future research could focus on the role of acupuncture for functional capacity, insomnia, and pain in CKD patients. [ABSTRACT FROM AUTHOR]

Background: Chronic kidney disease‐associated pruritus is a distressing symptom and has a far‐reaching impact on patients' sleep and quality of life for most patients receiving haemodialysis. Traditional therapies have limited effectiveness. Objectives: This study aimed to invent a self‐operated ice roller and evaluate its efficacy in relieving pruritus, sleep quality, and quality of life. Design: This study was experimental with a two‐arm parallel group design. Participants: A convenient sampling method was used to recruit 60 patients receiving haemodialysis who reported pruritus (5D‐Itch Scale score >5) lasting over 4 weeks in Taiwan. The participants were randomly assigned to one of two groups: the intervention group used an ice roller for 7 days, while the control group received no anti‐pruritus treatment. Measurements: This study was experimental with a two‐arm parallel group design. The measurement instruments included the 5D‐Itch Scale, Pittsburgh Sleep Quality Index and WHOQOL‐BREF‐Taiwan Version. The analysis of covariance, chi‐square, Independent t tests, and partial Eta2 (η2p) were used to analyse the data. Results: The participants' mean age was 62.77 years. Application of the ice roller significantly decreased overall pruritus (p <.05; η2p =.09) and distribution of pruritus‐associated bodily parts (p =.03; η2p =.08). There were no statistically significant differences in sleep quality and related indicators between the experimental and control groups at the study endpoint. Regarding quality of life, only the social relationship domain significantly differed between the two groups (p =.02; η2p =.08). Conclusions: The ice roller can decrease pruritus and its distribution in patients receiving haemodialysis, serving as an adjunct therapy alongside conventional anti‐pruritus treatments. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Dermatovenereology is the property of Xi'an Jiaotong University Periodicals Center 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: Unlike other chronic liver disorders, in primary biliary cholangitis (PBC), systemic oxidative stress (SOS) worsens along with liver disease progression status (DPS), influencing muscle metabolism, muscle quantity (MQ), and itch pathways. Synergistically, cholestasis contributes to reduced vitamin D absorption, with a negative impact on MM and SOS. Despite this evidence, the prevalence of sarcopenia in PBC, and the SOS-MQ relationship comparing PBC with other CLDs, has never been investigated. Moreover, the relationship between vitamin D and MQ-SOS, and the correlation between SOS and pruritus severity, remains unexplored in PBC. Methods: A total of 40 MASLD, 52 chronic HBV infections, 50 chronic HCV infections, and 41 ursodeoxycholic acid/antioxidant-naïve PBC patients were enrolled. Biochemical, nutritional, and liver stiffness (LSM) data were collected, and sarcopenia was assessed after a normalizing 3-month dietetic–physical exercise regimen. The d-ROMs/BAP tests evaluated SOS. The validated "PBC-40 questionnaire" estimated pruritus and quality of life (QoL). Results: Unlike other CLDs, in PBC patients, sarcopenia was more prevalent in initial mild fibrosis (PBC: 57.10% vs. MASLD: 30.76%, HBV: 22.60%, HCV: 20.70%, all p < 0.0001), and SOS significantly correlated with MQ (dROMs-ASM/h2, p: 0.0002; BAP-ASM/h2: p: 0.0092). PBC patients presented lower vitamin D levels and a significant correlation of these with SOS and MQ (all p < 0.0001). SOS also correlated with pruritus severity (dROMs, R: 0.835; BAP, R: −0.775, p < 0.0001). QoL impairment was significantly more represented in PBC individuals with sarcopenia, SOS imbalance, and relevant pruritus (p: 0.0228). Conclusions: In PBC, SOS correlates with MQ impairment and pruritus severity, configuring two independent relationships simultaneously impacting QoL. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Academic Research in Nursing (JAREN) is the property of Hemsirelikte Egitim ve Arastirma Dergisi 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.)

Copyright of Bagcilar Medical Bulletin / Bağcılar Tıp Bülteni is the property of Galenos Yayinevi Tic. LTD. STI 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.)

Monocytes and macrophages are at the frontline of defense against pathogens. Human cytomegalovirus (HCMV) uses myeloid cells as vehicles to facilitate viral dissemination. HCMV infection in monocytes and macrophages leads to the downregulation of several cell surface markers via an undefined mechanism. Previously, we showed that HCMV pUL42 associates with the Nedd4 family ubiquitin E3 ligases through the PPXY motif on pUL42 and downregulates Nedd4 and Itch proteins in HCMV‐infected fibroblasts. Homologous proteins of HCMV pUL42, such as HHV‐6 U24, downregulate cell surface markers. To reveal the downregulation property of pUL42, we focused on CD86, the key costimulatory factor for acquired immunity. Here, we constructed CD86‐expressing THP‐1 cells using a retroviral vector and analyzed the effects of HCMV infection and pUL42 on CD86 downregulation. Disruption of the PPXY motifs of pUL42 (UL42PA) decelerated the degradation of CD86 in recombinant virus‐infected cells, indicating the involvement of Nedd4 family functions. However, no direct interactions were observed between CD86 and Itch. Interestingly, unlike fibroblast infection, the expression of Nedd4 and Itch proteins increased in HCMV‐infected THP‐1 cells, accompanied by an increase in their transcript levels. Although the function of pUL42 did not relate to the increase of Nedd4 and Itch proteins, pUL42 should affect these Nedd4 proteins to downregulate CD86. [ABSTRACT FROM AUTHOR]