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Advancements in phosphodiesterase (PDE)-targeted therapies have shown promise in recent years for treating patients with a variety of autoimmune diseases. This review summarizes the development of PDE4 inhibitors and the associated literature with a focus on treatments for autoimmune diseases. After the initial investigations of the prototypic PDE inhibitor, rolipram, more selective inhibitors targeting the PDE4 isozyme have been developed. With phase II and phase III clinical trials currently underway to evaluate the safety and efficacy of the latest generation of PDE4 inhibitors, namely apremilast, a new class of treatments may be around the corner for patients suffering from chronic, autoimmune diseases. [ABSTRACT FROM AUTHOR]

Sorbitan sesquioleate (SSO), an emulsifier in many corticosteroids, was previously found positive in 8.9% of 112 dermatitis patients.The objective of this study was to present data on 24 of 591 dermatitis patients with reactions to SSO and/or sorbitan monooleate (SMO) on patch testing.A retrospective chart review was conducted on 591 consecutive dermatitis patients patch tested from November 2008 to May 2010. In addition to being tested to a modified North American Contact Dermatitis Group standard series, all patients were tested to a cosmetic series.Of the 591 patients tested, 24 reacted to SSO and/or SMO (4.1%), 19 (3.2%) reacted to SSO alone, 1 (0.17%) to SMO alone, and 4 (0.68%) reacted to both. Of the 24 sorbitan-allergic patients, 2 (8.3%) reacted to any of 4 corticosteroid screening chemicals tested.In this follow-up study, 4.1% of 591 dermatitis patients reacted to SSO and/or SMO. Given the presence of SSO in many popular topical corticosteroid formulations, clinicians should consider allergy to sorbitans when patients do not improve with topical corticosteroid therapy. [ABSTRACT FROM AUTHOR]

Objective: To quantify the type, prevalence, and cost of imaging following inpatient falls, identify factors associated with post-fall imaging, and determine correlates of positive versus negative imaging., Design: Single-center retrospective cohort study of inpatient falls. Data were collected from the hospital's adverse event reporting system, DrQuality. Age, sex, date, time, and location of fall, clinical service, Morse Fall Scale/fall protocol, admitting diagnosis, and fall-related imaging studies were reviewed. Cost included professional and facilities fees for each study., Setting: Four hundred and fifteen bed urban academic hospital over 3 years (2008-2010)., Patients: All adult inpatient falls during the study period were included. Falls experienced by patients aged <18 years, outpatient and emergency patients, visitors to the hospital, and staff were excluded., Measurements and Main Results: Five hundred and thirty inpatient falls occurred during the study period, average patient age 60.7 years (range 20-98). More than half of falls were men (55%) and patients considered at risk of falls (56%). Falls were evenly distributed across morning (33%), evening (34%), and night (33%) shifts. Of 530 falls, 178 (34%) patients were imaged with 262 studies. Twenty percent of patients imaged had at least one positive imaging study attributed to the fall and 82% of studies were negative. Total cost of imaging was $160,897, 63% ($100,700) from head computed tomography (CT)., Conclusion: Inpatient falls affect patients of both sexes, all ages, occur at any time of day and lead to expensive imaging, mainly from head CTs. Further study should be targeted toward clarifying the indications for head CT after inpatient falls and validating risk models for positive and negative imaging, in order to decrease unnecessary imaging and thereby limit unnecessary cost and radiation exposure.

Introduction: The biologic, Ustekinumab (Stelara®, Centocor, Inc., Malvern, PA, USA), is a fully human monoclonal antibody with a high affinity for the shared p40 subunit of interleukins 12 and 23 (IL-12 and IL-23). Approved for use in treating moderate-to-severe psoriasis in 2009, there has been considerable interest in the long-term safety of ustekinumab., Areas Covered: This review discusses the use of ustekinumab in the treatment of psoriasis and its potential to be an effective and well-tolerated therapy. A literature search was performed for articles published through April 2013 to identify any safety concerns., Expert Opinion: Our results indicate that ustekinumab has demonstrated higher efficacy rates as compared to traditional therapies; and with a favorable dosing schedule and stable safety profile, patients with recalcitrant disease will now have another option for treatment.

Background: Sorbitan sesquioleate (SSO), an emulsifier in many corticosteroids, was previously found positive in 8.9% of 112 dermatitis patients., Objective: The objective of this study was to present data on 24 of 591 dermatitis patients with reactions to SSO and/or sorbitan monooleate (SMO) on patch testing., Methods: A retrospective chart review was conducted on 591 consecutive dermatitis patients patch tested from November 2008 to May 2010. In addition to being tested to a modified North American Contact Dermatitis Group standard series, all patients were tested to a cosmetic series., Results: Of the 591 patients tested, 24 reacted to SSO and/or SMO (4.1%), 19 (3.2%) reacted to SSO alone, 1 (0.17%) to SMO alone, and 4 (0.68%) reacted to both. Of the 24 sorbitan-allergic patients, 2 (8.3%) reacted to any of 4 corticosteroid screening chemicals tested., Conclusions: In this follow-up study, 4.1% of 591 dermatitis patients reacted to SSO and/or SMO. Given the presence of SSO in many popular topical corticosteroid formulations, clinicians should consider allergy to sorbitans when patients do not improve with topical corticosteroid therapy.