Search

Polymer extrusion three dimensional (3D) printing, such as fused deposition modeling (FDM), has recently garnered attention due to its inherent process flexibility and rapid prototyping capability. Specifically, the addition of electrical components and interconnects into a 3D printing build sequence has received heavy interest for space applications. However, the addition of these components, along with the thermal load associated with space-based applications, may prove problematic for typical thermally insulating 3D printed polymer structures. The work presented here addresses thermally conductive polymer matrix composites (specifically, graphite, carbon fiber, and silver in an acrylonitrile butadiene styrene polymer matrix) to identify the effect of composite geometry and print direction on thermal anisotropic properties. The work also examines the effect of these composites on print quality, mechanical tensile properties, fracture plane analysis, micrograph imaging, and cube satellite thermal analysis. The thermal conductivity of 3D printed material systems in this work may enable the production of thermally stable 3D printed structures, supports, and devices. Key results of this work include anisotropic thermal conductivity for 3D printed structures related to print direction and filler morphology meaning that thermal conductivity can be controlled through a combination of print raster direction and material design. When the materials analyzed in this work are incorporated with other active cooling systems, space-based 3D printed applications can then be designed to incorporate increasing thermal loads, opening a new door to producing space-ready 3D printed structures.

Background Little is known about the adverse events (AEs) that lead to suspension of systemic treatments of psoriasis in clinical practice. Objective The study aimed to investigate to AEs associated with discontinuation of systemic therapy in patients with psoriasis in a clinical setting (Biobadaderm). Materials and methods Multicenter, prospective, cohort study of patients with moderate-to-severe plaque psoriasis receiving systemic therapies from January 2008 to November 2015, in 12 hospitals in Spain. The incidence rate (IR) was used to compare biologics and classic systemic therapies. Results A total of 4218 courses of treatment were used in 1938 patients. A total of 447 (11%) treatments were discontinued due to AEs. The IR of AE associated with discontinuation of systemic therapies was 13 events/100 patient-years (PY) (95%CI:12.14-13.93), 9.34 events/100PY (95% CI:8.44-10.33) for biologics and 19.67 (95%CI:17.9-21.6) events/100PY for classics (p< 0.001). Of 810 discontinuation-related AEs, 117 (14%) were serious. The highest IRs were for cyclosporine [49.18/100PY (95%CI:41.91-57.72)] and infliximab [26.52/100PY (95%CI:20.98-33.51). Ustekinumab presented the lowest IR (2.6/100PY (95%CI:1.83-3.69). Limitations Observational study with potential selection bias. Conclusion Biologic therapies are associated with a lower rate of discontinuation-related AEs than are classic therapies in real clinical practice. Ustekinumab showed the lowest incidence. This article is protected by copyright. All rights reserved.

BACKGROUND: There are a limited number of studies comparing psoriasis patients without psoriatic arthritis (PsA) to those with arthritis. Previous results are controversial. OBJECTIVES: To perform a comparative analysis of the phenotype, baseline comorbidities, therapeutic profile and incidence of adverse events (particularly overall adverse events, infections and infestations, malignancies and psychiatric disorders) among psoriatic patients with/without PsA. METHODS: All the patients on the Biobadaderm registry, a prospective inception cohort of psoriasis patients on systemic therapy, were included. Patients were divided into two groups: those with psoriasis without arthritis at the time of entry into the cohort (Pso group) and those with psoriasis and psoriatic arthritis (PsA group) at entry. Patients were followed until the censorship date (last visit in a lost-to-follow-up patient, or 10 November 2015, whichever occurred first). We excluded all the patients who developed any kind of signs and/or symptoms of joint involvement during the follow-up. A descriptive analysis was performed. We estimated incidence ratios (IRR) of adverse events during systemic treatment using a mixed-effects Poisson regression. RESULTS: We included 2120 patients: 1871 (88%) patients with psoriasis without arthritis and 249 (12%) with psoriasis and PsA. The follow-up time was 5020 patients-year in the Pso group and 762 patients-year in the PsA group. Patients with PsA had more comorbidities, particularly hypertension and liver disease; used a higher number of systemic therapies, particularly anti-TNFa drugs and combination therapy; and presented more adverse events (IRR adjusted = 1.29; 95% CI: [1.05-1.58]), particularly serious adverse events (IRR adjusted = 1.51; 95% CI: [1.01-2.26]) and infections/infestations (IRR adjusted = 1.88; 95% CI: [1.27-2.79]), independently of the associated comorbidities and present/past therapies. CONCLUSIONS: Given the differences between patients with psoriasis alone or with psoriasis associated with PsA, patients with psoriasis and PsA should be followed and managed more closely and with specific attention.

Resumen Introduccion y objetivo Disponemos de una gran experiencia en el uso de los farmacos biologicos para el tratamiento de los pacientes con psoriasis, sin embargo, existen situaciones concretas, como la cirugia, en las que pueden surgir dudas sobre su manejo. Aunque las guias de tratamiento aconsejan su suspension programada previamente a los procedimientos de cirugia mayor, no existe evidencia de cual es la actitud habitual en la practica clinica y su asociacion a complicaciones. Nuestro objetivo fue analizar el manejo actual de esta situacion en la practica clinica habitual. Metodos A traves de un estudio retrospectivo de la base de datos Biobadaderm se analizo el manejo practico de pacientes con psoriasis en tratamiento biologico que fueron intervenidos mediante algun procedimiento quirurgico. Resultados De los 2.113 pacientes incluidos en Biobadaderm, 48 fueron tratados con una intervencion quirurgica, de las que fueron mayoritarias las de tipo cutaneo (31%). El tratamiento biologico se suspendio en el 42% de los casos. No se observaron asociaciones estadisticamente significativas entre la aparicion de complicaciones posquirurgicas y la interrupcion del farmaco. Tampoco se detecto asociacion entre la interrupcion del tratamiento con otras variables como el sexo, la edad, la duracion de la enfermedad y la gravedad de la psoriasis. Conclusion No se ha encontrado asociacion entre la continuidad del tratamiento biologico y el riesgo de complicaciones posquirurgicas, aunque el estudio presenta la limitacion de tener un tamano muestral escaso.

Anisotropic mechanical properties related to build orientation is a characteristic of parts fabricated with 3D printing technologies. In the development of new materials for 3D printing processes, understanding the effects of 3D printer build orientation and raster pattern on physical property and failure mode differences is extremely important. While there is currently no standard for the evaluation of build orientation-based mechanical performance, such analysis has typically been achieved through the fabrication and scrutiny of tensile and other test coupons which were printed in different build orientations. In some cases, printing specimens in the ZXY (or vertical) build orientation can be difficult due to the capability of a given 3D printer platform. There are also multiple tensile test specimen geometries specified in the ASTM D638 standard for the tensile testing of polymer materials and understanding which specimen geometry works best for 3D printing is not currently well understood. The work presented here explores the effect of tensile test specimen geometry on the anisotropy of mechanical properties related to the build orientation of tensile test specimens. The test coupons were fabricated using a material extrusion 3D printing platform based on fused deposition modeling technology using a grade of acrylonitrile butadiene styrene not typically used in 3D printing in order to simulate the testing of a new material. The effects of raster pattern and the geometric dependence of mechanical property anisotropy were explored, and validation of the use of “faux vertical” specimens in lieu of ZXY-printed specimens was demonstrated. Finally, scanning electron microscopy was used to perform fractography on the various versions of the printed tensile test specimens in order to determine the effect of raster pattern on failure mode.

Introduction and objectives A 5% risk of reactivation of hepatitis B virus (HBV) infection has been reported in patients with diseases other than psoriasis treated with tumor necrosis factor inhibitors. The aim of this study was to investigate the risk of HBV reactivation in patients with a past history of HBV infection who were receiving biologic therapy for psoriasis. Material and methods This was a multicenter study of 20 patients with psoriasis who were treated with at least 1 biologic agent. All the patients had serologic evidence of past HBV infection (positive total hepatitis B core antibody and negative hepatitis B surface antibody). We analyzed the clinical, serological, and liver function variables recorded before, during, and at the end of follow-up. The viral load at the end of follow-up was also analyzed for all patients. Results None of the patients fulfilled the criteria for HBV reactivation at the end of a median follow-up period of 40 months. Combining our data with data from other studies of psoriasis patients with a past history of HBV infection who were treated with a biologic, we calculated a maximum estimated risk of HBV reactivation for a mean follow-up period of 30 months of 2.7 reactivations per 100 patients. Conclusions Biologic therapy did not cause HBV reactivation in our series of patients. Nonetheless, because of the potentially serious complications associated with HBV reactivation, it is important to measure viral load in patients with a history of HBV infection prior to initiation of biologic therapy to rule out occult carriage. These patients should also be monitored regularly in conjunction with a hepatologist.

Izod impact test specimens were fabricated via a desktop grade material extrusion 3D printer process using ABS in four build orientations. The 3D printed impact test specimens were examined in order to compare the effect of stress concentrator fabrication on impact test data where two methods were used to fabricate the stress concentrating notch: (1) printing the stress concentrator; and (2) machining the stress concentrator where the dimensions of the notch matched those specified in the ASTM standard D256-10. In both test cases, sensitivity to build orientation was also observed. The sample sets with printed stress concentrators were found to be statistically similar to their counterparts with milled stress concentrators. The experiment was repeated again on a commercial grade material extrusion 3D printer using ABS, PC, PC-ABS, and Ultem 9085 and differences in impact test results were observed most notably when Ultem 9085 was tested. Scanning electron microscopy was utilized to perform fractograpy on impact test specimens to explore the effect of stress concentrator fabrication on the fracture surface morphology of the failed specimens. The work here demonstrates the need for materials testing standards that are specific to additive manufacturing technologies; as well as concluding that all-printed impact test specimens may offer the best representation of the impact characteristics of 3D printed structures.

Resumen Introduccion y objetivos Se ha reportado un riesgo de reactivacion de hepatitis B pasada de hasta el 5% en pacientes tratados con farmacos dirigidos contra el factor de necrosis tumoral para enfermedades distintas a la psoriasis. Nuestro objetivo es investigar el riesgo de reactivacion del virus de la hepatitis B en pacientes con hepatitis B pasada y psoriasis tratada con biologicos. Material y metodos Estudio multicentrico en el que se incluyeron 20 pacientes con serologia sugestiva de hepatitis B pasada (antiHBc+, antigeno HBs–) y diagnostico de psoriasis tratada con al menos un biologico. Se recogieron variables clinicas, serologicas y de funcion hepatica antes, durante y al final del seguimiento. Se obtuvo una carga viral al final del seguimiento en todos los pacientes. Resultados Ningun paciente mostro criterios de reactivacion de hepatitis B al final del estudio, con una mediana de seguimiento de 40 meses. Sumando los datos de otras series publicadas de pacientes con psoriasis y hepatitis B pasada tratados con biologicos, el riesgo maximo seria de 2,7 reactivaciones por 100 pacientes tratados con un seguimiento medio de unos 30 meses. Conclusiones En nuestro estudio el tratamiento con biologicos no provoco ninguna reactivacion de hepatitis B. Sin embargo, debido a las graves complicaciones asociadas a la misma, se aconseja descartar portadores ocultos en pacientes con hepatitis B pasada antes de iniciar tratamiento biologico (solicitando una carga viral al inicio del mismo), asi como un seguimiento conjunto con un hepatologo.

Material extrusion 3D printing (ME3DP), based on fused deposition modeling (FDM) technology is currently the most widely available 3D printing platform. As is the case with other 3D printing methods, parts fabricated from ME3DP will exhibit physical property anisotropy where build direction has an effect on the mechanical properties of a given part. The work presented in this paper analyzes the effect of physical property-altering additives to acrylonitrile butadiene styrene (ABS) on mechanical property anisotropy. A total of six ABS-based polymer matrix composites and four polymer blends were created and evaluated. Tensile test specimens were printed in two build orientations and the differences in ultimate tensile strength and % elongation at break were compared between the two test sample versions. Fracture surface analysis was performed via scanning electron microscopy (SEM) which gave insight to the failure modes and rheology of the novel material systems as compared to specimens fabricated from the same ABS base resin. Here it was found that a ternary blend of ABS combined with styrene ethylene butadiene styrene (SEBS) and ultra high molecular weight polyethylene (UHMWPE) lowered the mechanical property anisotropy in terms of relative UTS to a difference of 22 ± 2.07% as compared to 47 ± 7.23% for samples printed from ABS. The work here demonstrates the mitigation of a problem associated with 3D printing as a whole through novel materials development and analyzes the effects of adding a wide variety of materials on the physical properties of a thermoplastic base resin.

Material-extrusion three-dimensional (3D) printing has recently attracted much interest because of its process flexibility, rapid response to design alterations, and ability to create structures ‘‘on-the-go’’. For this reason, 3D printing has possible applications in rapid creation of space-based devices, for example cube satellites (CubeSat). This work focused on fabrication and characterization of tungsten-doped polycarbonate polymer matrix composites specifically designed for x-ray radiation-shielding applications. The polycarbonate–tungsten polymer composite obtained intentionally utilizes low loading levels to provide x-ray shielding while limiting effects on other properties of the material, for example weight, electromagnetic functionality, and mechanical strength. The fabrication process, from tungsten functionalization to filament extrusion and material characterization, is described, including printability, determination of x-ray attenuation, tensile strength, impact resistance, and gigahertz permittivity, and failure analysis. The proposed materials are uniquely advantageous when implemented in 3D printed structures, because even a small volume fraction of tungsten has been shown to substantially alter the properties of the resulting composite.

Background Psoriasis patients over 65 years-old (elderly) constitute a growing group, underrepresented in clinical trials, and likely to be more prone to adverse events. Objective To describe safety of systemic psoriasis therapy in patients over 65 years-old compared to younger patients. Methods Patients registered in Biobadaderm, a Spanish national registry of psoriasis patients treated with systemic therapy, were grouped in elderly (≥ 65 years old) and younger patients. Rates of adverse events were described by severity and type, and the risks compared in both groups, taking into account exposure to classic or biologic drugs, using Cox regression. Results 175 (9.8%) of 1793 patients were elderly. Overall risk of adverse events was not higher in elderly (drug group adjusted HR 1.09 (95%CI: 0.93-1.3)). Serious adverse events were more common in elderly (drug group adjusted HR 3.2 (95%CI: 2.0-5.1)). Age adjusted HR of all adverse events was lower for patients exposed to biologics compared to classic drugs in the whole sample (HR 0.7 (95%CI: 0.6-0.7)). Age did not seem to modify the effect of therapy (biologic vs. classic) in the risk of adverse events (likelihood ratio test for interaction, p = 0.12 for all adverse events, p = 0-09 for serious adverse events). Conclusions Serious adverse events are more common in elderly patients, although they may be related to other variants that are associated with this age group and not due to the treatment itself. Use of biologics was associated with lower risk of adverse events in the whole group. We found no differences in this association between young and elderly. These results are reassuring, although uncontrolled confounding could not be excluded as an explanation for these findings, and the power of the study to detect differences was low.

Material extrusion 3D printing (ME3DP) based on fused deposition modeling (FDM) technology is currently the most commonly used additive manufacturing method. However, ME3DP suffers from a limitation of compatible materials and typically relies upon amorphous thermoplastics, such as acrylonitrile butadiene styrene (ABS). The work presented here demonstrates the development and implementation of binary and ternary polymeric blends for ME3DP. Multiple blends of acrylonitrile butadiene styrene (ABS), styrene ethylene butadiene styrene (SEBS), and ultrahigh molecular weight polyethylene (UHMWPE) were created through a twin screw compounding process to produce novel polymer blends compatible with ME3DP platforms. Mechanical testing and fractography were used to characterize the different physical properties of these new blends. Though the new blends possessed different physical properties, compatibility with ME3DP platforms was maintained. Also, a decrease in surface roughness of a standard test piece was observed for some blends as compared with ABS.

Background Biobadaderm is the Spanish registry of psoriasis patients receiving systemic treatment in clinical practice. Objective To compare the safety of biologics and classic systemic treatment. Methods Prospective cohort of patients receiving biologics and classic systemic therapies between 2008 and 2013 in 12 hospitals are included. We registered demographic data, diagnoses, comorbidities, treatments and adverse events (AE). We obtained raw relative risks (RR) for specific AE. Multivariate analysis consisted of Cox models adjusting for age, gender, chronic hepatic disease and previous cancer. Results A total of 1030 patients received biologics (2061 AE in 3681 person-years), 926 patients classic systemic drugs (1015 AE in 1517 person-years). Ninety-three per cent of AE in both groups were non-serious, 6% serious and 0.003% fatal. The age- and gender-adjusted hazard ratio of AE was lower in the biologics group [hazard ratio 0.6 (95% CI: 0.5–0.7)].We found no differences in rates of serious and mortal AE. Some system organ class AE rates differed between both groups. As limitations: Prescription bias might affect the incidence of AE in both groups. Association of drug and AE was based on timing: associations might not be causal. Conclusion Patients receiving biologics had lower risk of AE. We did not find differences in the risk of serious or fatal AE.

One of the most common materials utilized by material extrusion 3D printing is acrylonitrile butadiene styrene (ABS). The work presented in this research explored the effect of the addition of reinforcing materials on the mechanical properties of ABS in an effort to create materials with enhanced physical properties. A comparison was made between pure ABS, two ABS matrix composites, and one ABS/elastomer blend with the purpose of characterizing the effect of additives on the mechanical properties. Tensile test results of specimens built in different orientations showed that ABS reinforced with 5% by weight TiO2 exhibited the highest ultimate tensile strength for specimens built in both horizontal and vertical directions with 32.2 and 18.4 MPa, respectively. The compounding of an elastomeric material with ABS improved the surface finish of parts as they were visibly smoother compared to those printed from the ABS baseline material, though there was an observable decrease in the ductility of tensile specimens. Analysis was performed on the fracture surface of the tensile specimens through the use of scanning electron microscopy. Fractography revealed different modes of failure related to the different additives. The effects of additives on the anisotropy associated with the mechanical properties of 3D-printed parts were also analyzed.

Background There are few data on the prevalence of obesity in the general psoriasis population and on the real impact of obesity on the management of psoriasis patients in the clinical setting. Objectives To evaluate the prevalence of overweight and obesity in patients with moderate-to-severe psoriasis compared to the general population and to assess the relationship between Body Mass Index (BMI) and the risk of discontinuing treatment. Methods Patients registered on Biobadaderm, a prospective registry, were grouped according the different categories of BMI and compared to the general Spanish population. Drug survival was analysed considering only drug withdrawal due to lack of effectiveness, remission and adverse events. Results A total of 1162 moderate-to-severe psoriasis patients on systemic conventional or biological treatment were recruited. The prevalence of obesity was found to be significantly higher in psoriasis patients than in the general Spanish population (P

Background and objective: We now have considerable experience in the use of biologic agents to treat psoriasis, but doubts about management arise in certain clinical settings. Surgery is one of them. Although treatment guidelines advise that biologics be suspended before major surgery, data about actual clinical practices and associated complications are lacking. We aimed to analyze current practice in the clinical management of these cases. Methods: Retrospective study of cases in the Biobadaderm database. We analyzed the management of biologic therapy in patients with psoriasis who underwent surgical procedures. Results: Forty-eight of the 2113 patients registered in Biobadaderm underwent surgery. The largest percentage of procedures (31%) involved skin lesions. Biologic treatment was interrupted in 42% of the cases. No postsurgical complications were significantly related to treatment interruption. Likewise we detected no associations between treatment interruption and other variables, such as sex, age, or duration or severity of psoriasis. Conclusion: Continuity of biologic treatment and the risk of postsurgical complications were not associated in this study, although conclusions are limited by the small sample size. (C) 2016 AEDV. Published by Elsevier Espana, S.L.U. All rights reserved.

Information regarding the safety of biological drugs prescribed to psoriasis patients on daily and long-term bases is insufficient. We used data from the BIOBADADERM registry (Spanish Registry of Adverse Events for Biological Therapy in Dermatological Diseases) to generate crude rates of infection during therapy with systemic drugs, including biological drugs (infliximab, etanercept, adalimumab, and ustekinumab) and nonbiological drugs (acitretin, cyclosporine, and methotrexate). We also calculated unadjusted and adjusted risk ratios (RRs) (with propensity score adjustment) of infection, serious infections, and recurrent infections of systemic therapies compared with methotrexate, using Poisson regression. Our study included records of 2,153 patients (7,867.5 person-years). The adjusted RR of overall infection was significantly increased in the groups treated with adalimumab with methotrexate (adjusted RR = 2.13, 95% confidence interval [CI] = 1.2-3.7), infliximab (adjusted RR = 1.71, 95% CI = 1.1-2.65), cyclosporine (adjusted RR = 1.58, 95% CI = 1.17-2.15), ustekinumab with methotrexate (adjusted RR = 1.56, 95% CI = 1.08-2.25), and etanercept (adjusted RR = 1.34, 95% CI: 1.02-1.76) compared with methotrexate alone. Cyclosporine had a significant risk of serious infection (adjusted RR = 3.12, 95% CI = 1.1-8.8), followed by adalimumab combined with methotrexate (adjusted RR = 3.28, 95% CI = 0.8-13.5). Adalimumab in combination with methotrexate had the highest risk of infection recurrence (adjusted RR = 4.33, 95% CI = 2.27-8.24).

We now have considerable experience in the use of biologic agents to treat psoriasis, but doubts about management arise in certain clinical settings. Surgery is one of them. Although treatment guidelines advise that biologics be suspended before major surgery, data about actual clinical practices and associated complications are lacking. We aimed to analyze current practice in the clinical management of these cases.Retrospective study of cases in the Biobadaderm database. We analyzed the management of biologic therapy in patients with psoriasis who underwent surgical procedures.Forty-eight of the 2113 patients registered in Biobadaderm underwent surgery. The largest percentage of procedures (31%) involved skin lesions. Biologic treatment was interrupted in 42% of the cases. No postsurgical complications were significantly related to treatment interruption. Likewise we detected no associations between treatment interruption and other variables, such as sex, age, or duration or severity of psoriasis.Continuity of biologic treatment and the risk of postsurgical complications were not associated in this study, although conclusions are limited by the small sample size.

BackgroundFew reported studies compare drug survival in moderate-to-severe psoriasis vulgaris. ObjectivesTo describe and compare drug survival of systemic drugs, including biologic agents (infliximab, etanercept, adalimumab and ustekinumab) and classical drugs (acitretin, ciclosporin and methotrexate) in moderate-to-severe psoriasis. MethodsThis was a multicenter, prospective, cohort study of patients receiving systemic therapies between 2008 and 2013 in 12 hospitals in Spain. Baseline data and drug discontinuation were collected. Drug survival is presented using Kaplan-Meier survival curves. We compared adjusted risk ratios of serious adverse events (AEs) with results of survival analysis for AEs. ResultsA total of 1956 patients were included for analysis (1240 exposed to biologics during follow-up and 1076 to classic therapies). Median follow-up time was 3.3 years (0.0-5.1 years). There were 2209 discontinuations out of 3640 therapy cycles started. The main reason for discontinuation was lack of efficacy (36.4%) and remission (27.2%). Biologics showed a higher drug survival than classics and the pattern of survival results for all outcomes (positive or negative) were very similar. Adjusted risk ratios of serious AEs did not agree with results of survival analysis. LimitationsA limitation is that this is an observational study with potential selection bias. ConclusionSurvival as a proxy measure of drug safety in psoriasis is inadequate.

Biologic medications increase dramatically the burden of a chronic and high prevalent disease like psoriasis. The objective of the study was to quantify the use of dose reduction or dose escalation strategies, not reflected in the drug summary of product characteristics, in clinical practice.An observational, cross-sectional study of a subset of patients from the Spanish Registry for Systemic Treatments in Psoriasis (BIOBADADERM) treated for over six consecutive months with the same biologic agent.The study included 637 patients. At the cut-off date, the initial dose had been reduced in 223 patients (35%; 95% CI: 31.3-38.9%) and escalated in 46 (7.2%; 95% CI: 5.3-9.5%). When compared with the patients treated with standard doses, the patients on reduced doses had a lower PASI score at the cut-off date (a mean 2.6 versus 1; -1.6 points) and exhibited greater improvement in PASI since the start of biologic therapy (mean reduction over baseline 75% versus 87%). By contrast, the patients receiving an escalated dose had higher PASI scores (2.6 versus 8.0) and showed less improvement in PASI (75% versus 46.8%).Off-label doses of biologic agents for psoriasis are frequent in clinical practice. This information is especially relevant for pharmacoeconomic models.

A 5% risk of reactivation of hepatitis B virus (HBV) infection has been reported in patients with diseases other than psoriasis treated with tumor necrosis factor inhibitors. The aim of this study was to investigate the risk of HBV reactivation in patients with a past history of HBV infection who were receiving biologic therapy for psoriasis.This was a multicenter study of 20 patients with psoriasis who were treated with at least 1 biologic agent. All the patients had serologic evidence of past HBV infection (positive total hepatitis B core antibody and negative hepatitis B surface antibody). We analyzed the clinical, serological, and liver function variables recorded before, during, and at the end of follow-up. The viral load at the end of follow-up was also analyzed for all patients.None of the patients fulfilled the criteria for HBV reactivation at the end of a median follow-up period of 40 months. Combining our data with data from other studies of psoriasis patients with a past history of HBV infection who were treated with a biologic, we calculated a maximum estimated risk of HBV reactivation for a mean follow-up period of 30 months of 2.7 reactivations per 100 patients.Biologic therapy did not cause HBV reactivation in our series of patients. Nonetheless, because of the potentially serious complications associated with HBV reactivation, it is important to measure viral load in patients with a history of HBV infection prior to initiation of biologic therapy to rule out occult carriage. These patients should also be monitored regularly in conjunction with a hepatologist.

The correct address for Materials Science, University of Texas at El Paso is 500 W. University Avenue, El Paso, TX 79968, USA. As specified in the original article, the data for UTS, elongation to break and Young’s modulus for the ABS loaded with TiO2, jute fiber and TP elastomer were based on three specimens instead of five specimens. Tables 3 and 4 are updated with the correct data. The data for ABS remains the same. Table 3 Values of UTS and UFS for XYZ specimens

A patient who consulted because of diarrhea was diagnosed of thyroid medullar carcinoma (TMC) associated to pheochromocytoma. All members of his family were studied for a possible family variety of TMC with a genetic origin. In the 21 family members studied basal and calcium-pentagastrin stimulated calcitonin levels were determined and parathyroid and adrenal gland function were explored to rule out pheochromocytoma. Elevated levels of calcitonin agreed with pathological findings of TMC. Pheochromocytoma carriers had altered catecholamines and an abnormal abdominal CT scan. The clinical, analytical and radiologic findings in the four affected family members are described. The histopathological study revealed a pheochromocytoma in one case and bilateral TMC in two cases. The cytology of aspiration biopsy samples was positive for TMC in three cases. The importance of calcitonin determinations is emphasized as well as the obligatory determination of catecholamines and adrenal CT scan in order to rule out the coexistance of pheochromocytoma. The reasons for not utilizing gammagraphy with meta-iodine benzyl guanidine in these four cases are also explained.