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Summary: Background: A temporal relationship between hidradenitis suppurativa (HS) and obesity has not been established. Objectives: To compare baseline body mass index (BMI) and change in BMI for patients with HS and controls before and after diagnosis. Methods: We performed a retrospective case–control analysis of 1284 patients with HS and controls matched for age, sex, race and calendar year between 1 January 1999 and 9 September 2019. BMI 7 years prior to first HS diagnosis, and rate of BMI change, were compared for patients with HS and controls using linear mixed effects models. Results: Baseline BMI was higher among patients with HS than controls [mean difference 3·03 kg m−2, 95% confidence interval (CI) 2·44–3·62; P < 0·001)]. This difference was larger for women [mean difference 3·37 kg m−2 (95% CI 2·73–4·01)] than men [mean difference 1·27 kg m−2 (95% CI − 0·20–2·73; interaction P = 0·01)], and for patients with HS diagnosed before age 40 years [mean difference 4·10 kg m−2 (95% CI 3·15–5·06)] than those diagnosed after age 40 years [mean difference 2·38 kg m−2 (95% CI 1·63–3·12; interaction P < 0·001)]. Prior to diagnosis, average annual increase in BMI among patients with HS was slightly higher than controls. There was no statistically significant change in annual BMI among patients with HS following diagnosis. Conclusions: Baseline BMI and, to a lesser extent, rate of BMI change appear to be risk factors for developing HS. The influence of BMI may play a larger role among female patients and younger patients. What is already known about this topic? The association between hidradenitis suppurativa (HS) and obesity is well established.However, whether obesity influences the development of HS or is a consequence of having HS is unknown. What does this study add? We have observed that obesity and, to a lesser extent, rate of change in body mass index appear to be risk factors for developing HS. Linked Comment: L.A.V. Orenstein. Br J Dermatol 2021; 185:6–7. [ABSTRACT FROM AUTHOR]

A Thomson Web of Science search for the topic "leaf age" AND potassium AND tropic* identified just one similar study, which reported a similar strong decline in foliar K with leaf age ([16]). This scientific commentary refers to 'Changes in leaf functional traits with leaf age: When do leaves decrease their photosynthetic capacity in Amazonian forests? Google Scholar Crossref Search ADS WorldCat 6 Kitajima K, Mulkey SS, Wright SJ (1997 a) Decline of photosynthetic capacity with leaf age in relation to leaf longevities for five tropical canopy tree species. The LDO model integrates seasonality in the timing of leaf production and abscission, total leaf area present and the contribution of expanding, mature and old leaves to successfully explain seasonality in gross ecosystem production. [Extracted from the article]

Introduction: The risk of miscommunication and unintended changes to medicines is a significant problem when patients transfer between care settings.1 Medicines reconciliation is recommended at each transfer of care to reduce the risk of these errors occurring.2 Whilst common practice on admission to hospital, medicines reconciliation was not routinely undertaken for patients after discharge. One local pharmaceutical committee piloted a discharge medicines service (DMS) provided by community pharmacists within the area. The pilot took place prior to commissioning of the essential service, NHS DMS3 . It involved a person-centred consultation with each patient and reconciliation of the patient’s post-discharge medicines using the electronic discharge summary received via PharmOutcomes. Any issues were resolved by the community pharmacist where possible, or the GP surgery if necessary. Aim: This study aimed to evaluate the impact of the pilot DMS. Methods: A mixed-methods approach was taken to comprehensively evaluate the service. Nine community pharmacies provided DMS for patients discharged from hospital. Quantitative data were collected by community pharmacists for each DMS, then collated and analysed using descriptive statistics by an independent researcher. Qualitative, semi-structured telephone interviews based on the quantitative findings were conducted after the pilot with pharmacists from each of the pilot pharmacies. Interview recordings were transcribed and used to contextualise the quantitative findings. Ethical approval was granted by LJMU research ethics committee. Results: 56 DMS were carried out a four-month period. 43% (24/56) of patients had at least one medicines-related discrepancy. A total of 40 discrepancies were identified by community pharmacists, 50% (20/40) of which involved high-risk medicines known to cause hospital readmission. 63% (25/40) of the discrepancies identified prevented the dispensing of unnecessary medicines requested, and consequently reduced medicines wastage with an estimated cost saving of £229.06. Community pharmacists from each of the pilot pharmacies found the service worthwhile, perceiving that it helped to improve communication between healthcare professionals, increase patient involvement in their care and cut the medicines waste associated with unnecessary dispensing and returned medicines. Whilst overall beneficial, community pharmacists did report some difficulties, including examples of unclear discharge information documented by hospitals and the time spent trying to contact GP surgeries to resolve some prescribing discrepancies. Discussion/Conclusion: This small-scale pilot demonstrated that the impact of DMS could be wide-reaching. A reduction in medicines waste was seen, resulting in a positive impact on sustainability and cost savings for the NHS. The savings reported are due to medicines waste alone and do not take into account any other potential cost savings incurred, for example preventing the costs associated patient harm from medication errors, re-admission to hospital or wasted healthcare professionals’ time. Whilst lessons can be learned from the pharmacists’ feedback to improve efficiency, DMS has a positive impact on various healthcare providers in terms of efficiency and cost savings: GPs, hospitals and pharmacists. Patients will benefit from the efficient provision of appropriate post-discharge medicines and reduced risk of medicines-related issues or hospital readmission. The person-centred approach involves patients throughout to highlight any issues and supports them to more effectively manage their own care. [ABSTRACT FROM AUTHOR]

Chinese tallowtree, Triadica sebifera (L.) Small (Euphoriaceae), is one of the most aggressive weeds of coastal wetlands and forests of the southeastern United States. The lack of specialist herbivores in the invaded range may be one of the factors that contribute to the invasive nature of this weed. Chinese tallowtree has been the target of a classical biological control project since 2006. Several herbivore species are being tested for biological control of Chinese tallowtree. Concurrently, an adventive herbivore, Caloptilia triadicae Davis (Lepidoptera: Gracillariidae), was found feeding on Chinese tallowtree in the southeastern United States in 2004 and now occurs throughout the invaded range. Field populations of C. triadicae from two sites caused extensive mining damage to the Chinese tallowtree leaves. The greatest damage occurred after 30 d of exposure to C. triadicae in the herbivory treatment and amounted to about 25-30 leaf mines (early instars) and leaf rolls (late instars) per plant. Insecticide-treated plants had atmost 5-10 leaf mines and rolls per plant. Despite this difference, plant growth in height, number of new branches, and leaves did not differ significantly from plants protected from herbivory. Analysis of harvested plant results suggested that, in general, herbivory had little impact on biomass. However, there was a slight reduction in trunk weights in the unrestriced herbivory treatment compared with the insecticide-treated plants. Although this study exposed experimental plants to only 60 d of herbivory, these results suggested that C. triadicae alone will not exert sufficient control of invasive populations of Chinese tallowtree. Furthermore, they indicated that continued development of biological control agents that target Chinese tallowtree are needed. [ABSTRACT FROM AUTHOR]

Strong gravitational lensing provides a powerful test of cold dark matter (CDM) as it enables the detection and mass measurement of low-mass haloes even if they do not contain baryons. Compact lensed sources such as active galactic nuclei (AGNs) are particularly sensitive to perturbing subhaloes, but their use as a test of CDM has been limited by the small number of systems which have significant radio emission that is extended enough to avoid significant lensing by stars in the plane of the lens galaxy, and red enough to be minimally affected by differential dust extinction. Narrow-line emission is a promising alternative as it is also extended and, unlike radio, detectable in virtually all optically selected AGN lenses. We present first results from a Wide Field Camera 3 (WFC3) grism narrow-line survey of lensed quasars, for the quadruply lensed AGN HE 0435–1223. Using a forward modelling pipeline that enables us to robustly account for spatial blending, we measure the [O III] 5007 Å flux ratios of the four images. We find that the [O III] fluxes and positions are well fit by a simple smooth mass model for the main lens. Our data rule out a M600 > 108(107.2)M⊙ Navarro–Frenk–White perturber projected within ~1.0 (0.1) arcsec of each of the lensed images, where M600 is the perturber mass within its central 600 pc. The non-detection is broadly consistent with the expectations of ΛCDM for a single system. The sensitivity achieved demonstrates that powerful limits on the nature of dark matter can be obtained with the analysis of ~20 narrow-line lenses. [ABSTRACT FROM AUTHOR]

Strong gravitational lenses can be used to detect low-mass subhaloes, based on deviations in image fluxes and positions from what can be achieved with a smooth mass distribution. So far, this method has been limited by the small number of (radio-loud, microlensing-free) systems which can be analysed for the presence of substructure. Using the gravitational lens B1422+231, we demonstrate that adaptive optics integral field spectroscopy can also be used to detect dark substructures. We analyse data obtained with OH Suppressing Infra-Red Imaging Spectrograph on the Keck i Telescope, using a Bayesian method that accounts for uncertainties relating to the point spread function and image positions in the separate exposures. The narrow-line [O iii] fluxes measured for the lensed images are consistent with those measured in the radio, and show a significant deviation from what would be expected in a smooth mass distribution, consistent with the presence of a perturbing low-mass halo. Detailed lens modelling shows that image fluxes and positions are fitted significantly better when the lens is modelled as a system containing a single perturbing subhalo in addition to the main halo, rather than by the main halo on its own, indicating the significant detection of substructure. The inferred mass of the subhalo depends on the subhalo mass density profile: the 68 per cent confidence intervals for the perturber mass within 600 pc are 8.2$^{+0.6}_{-0.8}$, 8.2$^{+0.6}_{-1}$ and 7.6 ± 0.3 log10[Msub/M⊙], respectively, for a singular isothermal sphere, a pseudo-Jaffe and a Navarro–Frenk–White mass profile. This method can extend the study of flux ratio anomalies to virtually all quadruply imaged quasars, and therefore offers great potential to improve the determination of the subhalo mass function in the near future. [ABSTRACT FROM AUTHOR]

Highly selfing species often show reduced effective population sizes and reduced selection efficacy. Whether mixed mating species, which produce both self and outcross progeny, show similar patterns of diversity and selection remains less clear. Examination of patterns of molecular evolution and levels of diversity in species with mixed mating systems can be particularly useful for investigating the relative importance of linked selection and demographic effects on diversity and the efficacy of selection, as the effects of linked selection should be minimal in mixed mating populations, although severe bottlenecks tied to founder events could still be frequent. To begin to address this gap, we assembled and analysed the transcriptomes of individuals from a recently diverged mixed mating sister species pair in the self-compatible genus, Collinsia. The de novo assembly of 52 and 37 Mbp C. concolor and C. parryi transcriptomes resulted in ~40 000 and ~55 000 contigs, respectively, both with an average contig size ~945. We observed a high ratio of shared polymorphisms to fixed differences in the species pair and minimal differences between species in the ratio of synonymous to replacement substitutions or codon usage bias implying comparable effective population sizes throughout species divergence. Our results suggest that differences in effective population size and selection efficacy in mixed mating taxa shortly after their divergence may be minimal and are likely influenced by fluctuating mating systems and population sizes. [ABSTRACT FROM AUTHOR]

Background and Aims Leaf life span is widely recognized as a key life history trait associated with herbivory resistance, but rigorous comparative data are rare for seedlings. The goal of this study was to examine how light environment affects leaf life span, and how ontogenetic development during the first year may influence leaf fracture toughness, lamina density and stem density that are relevant for herbivory resistance, leaf life span and seedling survival. Methods Data from three experiments encompassing 104 neotropical woody species were combined. Leaf life span, lamina and vein fracture toughness, leaf and stem tissue density and seedling survival were quantified for the first-year seedlings at standardized ontogenetic stages in shade houses and common gardens established in gaps and shaded understorey in a moist tropical forest in Panama. Mortality of naturally recruited seedlings till 1 year later was quantified in 800 1-m2 plots from 1994 to 2011. Key Results Median leaf life span ranged widely among species, always greater in shade (ranging from 151 to >1790 d in the understorey and shade houses) than in gaps (115–867 d), but with strong correlation between gaps and shade. Leaf and stem tissue density increased with seedling age, whereas leaf fracture toughness showed only a weak increase. All these traits were positively correlated with leaf life span. Leaf life span and stem density were negatively correlated with seedling mortality in shade, while gap mortality showed no correlation with these traits. Conclusions The wide spectrum of leaf life span and associated functional traits reflects variation in shade tolerance of first-year seedlings among coexisting trees, shrubs and lianas in this neotropical forest. High leaf tissue density is important in enhancing leaf toughness, a known physical defence, and leaf life span. Both seedling leaf life span and stem density should be considered as key functional traits that contribute to seedling survival in tropical forest understoreys. [ABSTRACT FROM AUTHOR]

Background Many tropical forest tree species delay greening their leaves until full expansion. This strategy is thought to provide newly flushing leaves with protection against damage by herbivores by keeping young leaves devoid of nutritive value. Because young leaves suffer the greatest predation from invertebrate herbivores, delayed greening could prevent costly tissue loss. Many species that delay greening also produce anthocyanin pigments in their new leaves, giving them a reddish tint. These anthocyanins may be fungicidal, protect leaves against UV damage or make leaves cryptic to herbivores blind to the red part of the spectrum. Methods A comprehensive survey was undertaken of seedlings, saplings and mature trees in two diverse tropical forests: a rain forest in western Amazonia (Yasuní National Park, Ecuador) and a deciduous forest in Central America (Barro Colorado Island, Panamá). A test was made of whether individuals and species with delayed greening or red-coloured young leaves showed lower mortality or higher relative growth rates than species that did not. Key results At both Yasuní and Barro Colorado Island, species with delayed greening or red young leaves comprised significant proportions of the seedling and tree communities. At both sites, significantly lower mortality was found in seedlings and trees with delayed greening and red-coloured young leaves. While there was little effect of leaf colour on the production of new leaves of seedlings, diameter relative growth rates of small trees were lower in species with delayed greening and red-coloured young leaves than in species with regular green leaves, and this effect remained when the trade-off between mortality and growth was accounted for. Conclusions Herbivores exert strong selection pressure on seedlings for the expression of defence traits. A delayed greening or red-coloured young leaf strategy in seedlings appears to be associated with higher survival for a given growth rate, and may thus influence the species composition of later life stages. [ABSTRACT FROM AUTHOR]

The Australian tree Melaleuca quinquenervia (Cavanilles) Blake is an invasive weed in wetland systems of Florida. A biological control program targeting M. quinquenervia has resulted in the release of the gall forming midge Lophodiplosis trifida Gagne (Diptera: Cecidomyiidae). Populations of the introduced herbivore readily established at all 24 release sites across the weed's range in Florida, and there was no evidence that founding colony size (100,2,000, or 6,000 adults) influenced herbivore establishment or local population growth rates. Landscape level spread of L. trifida from release sites averaged nearly 6 km/yr, ranging as high as 14.4 km/yr. Prerelease host range testing predicted that L. trifida oviposits indiscriminately on test plant species but does not complete development on any of the test species, including congeners present in Florida. To test the predictability of these host range tests, L. trifida was released in a common garden consisting of 18 test plant species that were interplanted with M. quinquenervia. Plant species postulated to be at risk experienced no gall development by L. trifida while intermingled M. quinquenervia trees supported 704.8 (±158.5) galls per plant. Historically, many introduced Cecidomyiidae have limited effect on plant performance of target weeds because of recruitment of native parasitoids that disrupt biological control efficacy. In contrast to this trend, there has been no evidence to date that parasitoids are exploiting L. trifida in Florida. [ABSTRACT FROM AUTHOR]

Leaf dark respiration (R) and its temperature sensitivity are essential for efforts to model carbon fluxes in tropical forests under current and future temperature regimes, but insufficient data exist to generalize patterns of R in species-rich tropical forests. Here, we tested the hypothesis that R and its temperature sensitivity (expressed as Q10, the proportional increase in R with a 10 °C rise in temperature) vary in relation to leaf functional traits, and among plant functional types (PFTs). We conducted in situ measurements of R of 461 leaves of 26 species of tree and liana in the upper canopy of a tropical forest in Panama. A construction crane allowed repeated non-destructive access to measure leaves kept in the dark since the previous night and equilibrated to the ambient temperature of 23–31 °C in the morning. R at 25 °C (R25) varied among species (mean 1.11 μmol m−2 s−1; range 0.72–1.79 μmol m−2 s−1) but did not differ significantly among PFTs. R25 correlated positively with photosynthetic capacity, leaf mass per unit area, concentrations of nitrogen and phosphorus, and negatively with leaf lifespan. Q10 estimated for each species was on average higher than the 2.0 often assumed in coupled climate–vegetation models (mean 2.19; range 1.24–3.66). Early-successional tree species had higher Q10 values than other functional types, but interspecific variation in Q10 values was not correlated with other leaf traits. Similarity in respiration characteristics across PFTs, and relatively strong correlations of R with other leaf functional traits offer potential for trait-based vegetation modeling in species-rich tropical forests. [ABSTRACT FROM PUBLISHER]

A faster rate of nuclear DNA evolution has recently been found for plants occupying warmer low latitudes relative to those in cooler high latitudes. That earlier study by our research group compared substitution rates within the variable internal transcribed spacer (ITS) region of the ribosomal gene complex amongst 45 congeneric species pairs, each member of which differed in their latitudinal distributions. To determine whether this rate differential might also occur within highly conserved DNA, we sequenced the 18S ribosomal gene in the same 45 pairs of plants. We found that the rate of evolution in 18S was 51% faster in the tropical plant species relative to their temperate sisters and that the substitution rate in 18S correlated positively with that in the more variable ITS. This result, with a gene coding for ribosomal structure, suggests that climatic influences on evolution extend to functionally important regions of the genome. [ABSTRACT FROM AUTHOR]

Background: Osteoporosis (OP) is a major and increasing health problem worldwide, especially in European countries, where the modern, sedentary lifestyle from an early age leads to brittle bones later in life. Patients affected by OP tend to move less and have a lower quality of life (QoL). This study aims to evaluate how OP affects individual markers for QoL in postmenopausal women and assess the influence of exercise on these markers. Methods: The EQ-5D questionnaire was administered to evaluate Mobility, Self-care, Usual Activities, Pain/Discomfort and Anxiety/Depression in a sample of Italian women with osteoporotic vertebral fractures, aged 60-75. Markers linked to QoL were compared for these women with those of an average female Italian population (AFIP) of similar age. Concurrently, a 6-month exercise trial was conducted, in which the OP patients were divided into two groups: an exercise group (EG) and a control group (CG). The QoL was assessed for both groups at the end of the trial. Results: A larger proportion of OP patients reported some problems with Mobility as compared to the AFIP (37.5% versus 31.2% respectively, p = 0.001) and in performing Usual Activities (45% versus 23.9%, p = 0.002). OP patients (77.5%) experienced some Pain/Discomfort, compared to 48.1% of the AFIP (p = 0.001). Anxiety/Depression was reported by 40% of OP patients and 18.8% of the AFIP (p = 0.001). Concerning the exercise trial, the results indicated a positive trend for Mobility and Usual Activities in the EG, while the CG markers remained unchanged. Conclusions: Overall, results confirm that OP significantly affected QoL in postmenopausal women. In particular, OP negatively influenced the markers Mobility, Usual Activities, Pain/Discomfort and Anxiety/Depression. Exercise programs tailored to OP patients can improve some markers linked to QoL. Evidence suggests that health policy makers in Europe can consider including OP-adapted exercise programmes in guidelines for OP management. Key messages: Osteoporosis negatively affects the quality of life for postmenopausal women. In particular, Mobility, Usual Activities, Pain/Discomfort and Anxiety/Depression markers were affected. Exercise can improve some markers linked to quality of life (Mobility and Usual Activities). Thus, it could be proposed as a treatment for osteoporosis in postmenopausal women. [ABSTRACT FROM AUTHOR]

Heterostyly is a genetic polymorphism in which plant populations are composed of two or more morphs that differ in stigma and anther heights. The polymorphism promotes intermorph pollen transfer, thus outcrossing. Heterostyly has been reported in 28 angiosperm families and is frequently lost in heterostylous lineages. To assess ecological factors related to shifts from heterostyly to monomorphy, we examined the reproductive ecology of heterostylous tropical shrubs of Psychotria. Among 21 species at Barro Colorado Island and the nearby Parque Nacional Soberania, Panama, 14 species were heterostylous while seven were monomorphic. A molecular phylogeny and the existence elsewhere of heterostylous populations indicated that the breakdown of heterostyly had occurred independently. Heterostylous and monomorphic species were visited by the same bee species, although visit frequencies were lower in monomorphic species. Monomorphic species had significantly lower population density and greater fruit set than did heterostylous species. Autonomous autogamy made a large contribution to fruit set in monomorphic species and was only rarely observed in heterostylous species. The results indicate monomorphic and heterostylous species produce more seeds through selfing and outcrossing, respectively. The limitation of outcrossing as a result of low population density may be related to the breakdown of heterostyly and the evolution of selfing. © 2008 The Linnean Society of London, Biological Journal of the Linnean Society, 2008, 93, 125–134. [ABSTRACT FROM AUTHOR]

• Background and Aims Light extinction through crowns of canopy trees determines light availability at lower levels within forests. The goal of this paper is the exploration of foliage distribution and light extinction in crowns of five canopy tree species in relation to their shoot architecture, leaf traits (mean leaf angle, life span, photosynthetic characteristics) and successional status (from pioneers to persistent). [ABSTRACT FROM PUBLISHER]

Despite the potential for changes during transit or preservation, the physicochemical properties of leaves are typically measured in a laboratory setting. A suite of laboratory methods adapted for use in the field is described here. The equipment is portable and operable in remote environments. Each technique has been validated against laboratory standards and has been tested throughout the tropics in a variety of ecological contexts. The properties of canopy and understorey leaves from Central Panama are reported here. The results show clear differences between leaves growing in different light regimes. Canopy leaves are tougher and possess greater concentrations of protein, phenols, and tannins. The implication of these results to the resource availability hypothesis, which proposes trade‐offs between physiology and defences against herbivory, is discussed. [ABSTRACT FROM PUBLISHER]

Presents a study which evaluated the effects of the immunization of gilts against ovarian steroids on ovulation rate and litter size. Materials and methods; Reproductive responses of gilts immunized against androstenedione; Implication of the observed increase in serum binding of hydrogen-labeled steroids on the immunization procedure.

Examines the ecosystem integrity of the Panama Canal, and challenges for conservation in a biologically diverse watershed area adjacent to canal. Description of watershed area; Determination of how much land remains forested in an area; Tree species diversity; Identification of bird species in an area; Activity which affects the area, including hunting, human population, canal's water supply, and greenhouse gases.

Aims To examine the acute effect of red wine and de-alcoholized red wine on endothelial function.Methods and Results High frequency ultrasound was used to measure blood flow and percentage brachial artery dilatation after reactive hyperaemia induced by forearm cuff occlusion in 12 healthy subjects, less than 40 years of age, without known cardiovascular risk factors. The subjects drank 250ml of red wine with or without alcohol over 10min according to a randomized procedure. Brachial artery dilatation was measured again 30 and 60min after the subjects had finished drinking. The subjects were studied a second time within a week of the first study in a cross-over design. After the red wine with alcohol the resting brachial artery diameter, resting blood flow, heart rate and plasma–ethanol increased significantly. After the de-alcoholized red wine these parameters were unchanged. Flow-mediated dilatation of the brachial artery was significantly higher (P<0·05) after drinking de-alcoholized red wine (5·6±3·2%) than after drinking red wine with alcohol (3·6±2·2%) and before drinking (3·9±2·5%).Conclusion After ingestion of red wine with alcohol the brachial artery dilated and the blood flow increased. These changes were not observed following the de-alcoholized red wine and were thus attributable to ethanol. These haemodynamic changes may have concealed an effect on flow-mediated brachial artery dilatation which did not increase after drinking red wine with alcohol. Flow-mediated dilatation of the brachial artery increased significantly after de-alcoholized red wine and this finding may support the hypothesis that antioxidant qualities of red wine, rather than ethanol in itself, may protect against cardiovascular disease. [ABSTRACT FROM PUBLISHER]

We have evaluated the effect of brief intervention by an alcohol health worker on alcohol consumption by 202 alcohol misusing patients. For 71 patients where questionnaires were successfully completed, 46 (65%) reported drinking less alcohol at 6 months as opposed to six (8.5%) who reported drinking more. The overall reduction was statistically significant (P<0.001), with a mean reduction of 43%. [ABSTRACT FROM PUBLISHER]

The intraepithelial lymphocytes of the jejunal mucosa from patients with giardiasis and from control patients were counted in coded serial sections. Patients with giardiasis and normal intestinal absorption and control patients who had lived and travelled in tropical areas had similar counts, which were higher than those reported for controls from temperate areas. Where giardiasis was accompanied by malabsorption of one substance the mean count was significantly higher than that of controls (P < 0.02). In those patients with giardiasis and malabsorption of two or three substances the mean count was significantly higher than that of controls (P < 0.02) and that of patients with giardiasis and normal absorption (P < 0.05). After treatment, intraepithelial lymphocyte counts declined consistently in patients with malabsorption. An association between raised intraepithelial lymphocyte counts and malabsorption is indicated. The possible significance of this finding is discussed. [ABSTRACT FROM AUTHOR]

A study of the prevalence of tinea capitis at a residential school for physically handicapped children in Harare, Zimbabwe is reported. In the 7-12 year old age group the prevalence of mycologically proven fungus infection was 39%. It is suggested that this can be explained by their hygiene. Two species of dermatophyte were isolated: Trichophyton violaceum from 88% and Microsporum audouimi from 38% of cases which were positive following culture. Twenty-six per cent of these cases were mixed infections. There was a slightly higher rate of infection amongst boys. The effectiveness of the clinical and mycological examination was assessed. Affect5ed children were treated with a 6-weed course of either Whitefield's ointment or miconazole cream. Results are presented to show that neither treatment is fully effective. [ABSTRACT FROM AUTHOR]

A single blind comparison of 0.1%, dithranol in a 17% urea cream base (Psoradrate®) with a coal tar and salicyclic acid pomade in the treatment of scalp psoriasis is described. Both treatments were equally effective, though Psoradrate caused significantly more side-effects. We concluded that Psoradrate is effective in the treatment of scalp psoriasis. [ABSTRACT FROM AUTHOR]

Discusses the role of essential fatty acids (EFA) in the structure and physiology of the skin. Definition of EFAs; Consequences of EFA dificiency; Effect of saturated fatty acids on the cell membranes.

Gamma-linolenic acid in the form of a particular variety of evening primrose oil (Epogam) has been reported of value in the treatment of atopic eczema. Nine controlled trials of evening primrose oil were performed in eight centres. Four of the trials were parallel and five cross-over. Doctors and patients assessed the severity of eczema by scoring measures of inflammation, dryness, scaliness, pruritus and overall skin involvement. Individual symptom scores were combined to give a single global score at each assessment point. In the analysis of the parallel studies, both patient and doctor scores showed a highly significant improvement over baseline (P < 0·0001) due to Epogam: for both scores the effect of Epogam was significantly better than placebo. Similar results were obtained on analysis of the cross-over trials, but in this case the difference between Epogam and placebo in the doctors' global score, although in favour of Epogam, failed to reach significance. The effects on itch were particularly striking. There was no placebo response to this symptom, whereas there was a substantial and highly significant response to Epogam (P < 0·000l). When the improvements, or otherwise, in clinical condition were related to changes in plasma levels of dihomogammalinolenic and arachidonic acids, it was found that there was a positive correlation between an improvement in clinical score and a rise in the fatty acid levels. [ABSTRACT FROM AUTHOR]

We report the association of an intra-epidermal blistering disease of the skin with colitis. Both the skin and large bowel epithelium were infiltrated by neutrophils and eosinophils, and showed intra-epithelial deposition of IgA in an intercellular pattern. The colitis and the blisters responded well to treatment with dapsone. [ABSTRACT FROM AUTHOR]

The article presents information on a study which reports that a radioactive organophosphorus compound, 32P-diphenyl phosphinothioic chloride was synthesized from commercially available radioactive phosphorus pentasulphide of high specific activity and conjugated to an immunoglobulin. Goat anti-human-globulin was used and the conjugation had no material effect on its antibody titre. The conjugate was highly radioactive and contained on average twenty-eight phosphorus atoms per globulin molecule. The chemical combination was stable and permitted specific immunodiffusion and immunohistological localization of the antibody as judged by autoradiography.

Dear Editor, Within the U.K., Wales has some of the highest rates of skin cancer annually, and skin cancer diagnosis rates have increased 63% in 10 years.[1] The charity Skin Care Cymru (SCCym) provides a voice for skin health in Wales. This novel campaign promoted the importance of sun protection to reduce skin cancer rates in Wales and, by extension, the U.K. Using the extensive support and coverage of #DontBeALobster, SCCym will further expand and develop the campaign to measure its effect on skin cancer knowledge and sun-protection behaviour. While more evidence is needed to show that mass media campaigns are as effective as multicomponent campaigns in increasing sun-safe behaviour,[2] social media can improve knowledge and attitudes toward skin cancer.[3]. [Extracted from the article]

Basal cell epithelioma with eccrine differentiation is a turnout that has previously been characterized as a rare turnout in which the histological and histochemical differentiation towards eccrine epithelium has been taken to indicate a more aggressive clinical course. We present a further ease of this tumour with studies of its pattern of keratin expression using a battery of antikeratin monoclonal antibodies and conclude that the presence of simple epithelial markers within the turnout confirm the differentiation towards eccrine epithelium. [ABSTRACT FROM AUTHOR]

The pathogenesis of pruritus in patients undergoing chronic haemodialysis is unknown. Dryness of the skin is common in uraemic patients, and a correlation between xerosis and pruritus has been reported. Transepidermal water loss (TEWL) is a measure of cutaneous barrier function and also reflects skin water content. In this study the transepidermal water loss was measured at four sites pre- and postdialysis in 20 subjects undergoing chronic haemodialysis and in 16 healthy controls. Patients were weighed before and after dialysis and blood was taken for measurement of urea, creatinine, calcium, magnesium, phosphate and haemoglobin. All patients had parathyroid hormone measured within 3 months of the assessment. There was no significant difference in TEWL between patients and controls, with control values in general being between pre- and postdialysis rates of TEWL, and no correlation between TEWL and the presence or absence of pruritus. There was no significant differences between the pruritic and non-pruritic patients for any of the biochemical markers measured. Finally there was no significant correlation between the percentage water loss and TEWL. These findings indicate that pruritus of chronic haemodialysis is not related to abnormalities of cutaneous permeability. [ABSTRACT FROM PUBLISHER]

We have reviewed the clinical presentation of 100 consecutive culture positive cases of brucellosis which came under our care during the last two years. Of these, six had atypical presentations and but for the routine practice of sending blood for brucella culture, the diagnosis would have been missed. The unusual presentations included a 19 year old boy presenting as an acute abdomen ending in laparotomy, a 52 year old man presenting with a psoas abscess, a 29 year old woman presenting with a transient perinephric mass, a 75 year old man with an acute flare up of his osteoarthritis, a 65 year old diabetic man presenting in an insulin-resistant diabetic state and a 35 year old man presenting with a cauda equina syndrome. [ABSTRACT FROM PUBLISHER]

The precise mode of action of topically applied steroids is unknown. We have applied clobetasol propionate 0.05% ointment (Dermovate®; Glaxo Pharmaceuticals) under occlusion to the forearm skin of 10 healthy volunteers for 6 h and monitored transcutaneous oxygen tension at the site for 19 h after its removal. Compared to the ointment base, the steroid-treated area was significantly hypoxic up to 1.3 h after application. The profound hypoxia present at the site of application of clobetasol propionate 0.05% ointment may account for some of its anti-inflammatory effects, and its atrophogenicity. [ABSTRACT FROM AUTHOR]

We report a case of necrolytic migratory erythema without a glucagonoma and which responded to treatment with essential fatty acids and zinc. [ABSTRACT FROM AUTHOR]