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Radio Frequency (RF) sputtered germanium (Ge) thin films were deposited on glass substrate at in situ annealing temperatures of 400, 450, 500, 550, and 600 °C. X‐ray diffraction (XRD) and Raman spectroscopy revealed that the Ge films were initially amorphous but transformed to polycrystalline after annealing at 450 °C. Further annealing up to 600 °C resulted in improved crystallinity. Strain studies of the films using XRD and Raman showed compressive (out‐of‐plane) and tensile (in‐plane) strains, respectively, throughout all the annealing temperatures. The surface morphology of the films was recorded using atomic force microscopy (AFM) and field emission scanning electron microscopy (FESEM), which showed grain growth with annealing temperatures. The optical energy gap evaluated from absorption spectra for crystalline films decreased with annealing temperature, indicating improvement in crystallinity of films. The resistivity of the films deduced using current‐voltage measurements was found to decrease with annealing temperature, which can be attributed to enhancement in grain size. This study establishes a correlation between strain, grain size, optical energy gap, and electrical resistivity with temperature for Ge films deposited on glass substrates. Thus, the present study provides insights into variation in physical and electrical properties of films with in situ annealing temperature for their applicability in optoelectronic devices. [ABSTRACT FROM AUTHOR]

Mouth cancer is the most frequent cancer of the head and neck in both older and younger people. Achyranthes aspera L. has been used in ethnotraditional and pharmacological applications since ancient times for a variety of disorders. This study was formulated to examine bioactive phenolic and flavonoid compounds from the ethanolic extract of Achyranthes aspera and their binding efficacy targeting growth factor receptors (GFRs) against mouth cancer through in silico molecular docking and simulation studies. Phytochemicals were investigated through the UHPLC technique. A molecular docking study was accomplished using docking software AutoDock 4.2, and MD simulation was executed through GROMACS software. Drug‐likeness, pharmacokinetics, and toxicity profiles of phytocompounds were evaluated using Molinspiration, Swiss ADME, OSIRIS Data Warrior tools, respectively. UHPLC analysis detected phenolics and flavonoids, viz., fisetin, rutin, and fumaric acid, which satisfied Lipinski's rule of five and pharmacokinetic properties. In molecular docking assessment, fisetin exhibited promising interactions with core targeted proteins VEGFR‐2 (B.E. = −8.30 kcal mol−1) and FGFR‐2 (B.E. = −7.64 kcal mol−1) of mouth cancer. Moreover, molecular dynamics simulation data demonstrated stable interactions with both VEGFR‐2 and FGFR‐2 proteins. This binding interaction and stability of A. aspera phytocompounds with therapeutic proteins might contribute to their therapeutic potential in mouth cancer management. [ABSTRACT FROM AUTHOR]

Acrylamide (AA) is a carcinogenic compound that affects people due to its frequent use in laboratories and industry as well as the high‐temperature cooking of foods with high hydrocarbon content. AA is known to cause severe reproductive abnormalities. The main aim of this study is to evaluate the protective effect of rutin (RU), a phytoactive compound, against AA‐induced reproductive toxicity in female rats. Initially, rats were exposed to AA (40 mg/kg for 10 days). Therapy of RU was given after AA intoxication consecutively for 3 days. After 24 h of the last treatment, all the animals were sacrificed. The study evaluated reproductive hormones, oxidative stress markers, membrane‐bound enzymes, DNA damage, histological findings, and an in silico approach to determine the protective efficacy of RU. The results indicated that RU significantly protected against inflammation, oxidative stress, and DNA damage induced by AA, likely due to its antioxidant properties. [ABSTRACT FROM AUTHOR]

Climate change has become increasingly intertwined with the occurrence and severity of droughts. As global temperatures rise due to greenhouse gas emissions, weather patterns are altered, leading to shifts in precipitation levels and distribution. These exacerbate the risk of drought in many regions, with potentially devastating consequences. A comprehensive transcriptome analysis was performed on Keteki Joha, an aromatic rice from North East India, with the aim of elucidating molecular responses to drought. Numerous genes linked to drought were activated, with both ABA‐dependent and ABA‐independent pathways playing crucial roles. Upregulated genes were enriched with gene ontology terms with response to abscisic acid and abscisic acid‐activated signalling pathway, suggesting the existence of an ABA‐dependent pathway for drought mitigation. The upregulated genes were also enriched with responses to stress, water, heat, jasmonic acid, and hydrogen peroxide, indicating the presence of an ABA‐independent pathway alongside the ABA‐dependent mechanism. Weighted Correlation Network Analysis (WGCNA) identified 267 genes that specifically govern drought mitigation in Keteki Joha. The late embryogenesis abundant (LEA) gene family emerges as the most overrepresented in both RNA sequencing data and WGCNA analysis, suggesting their dominant role in mitigating drought. Notably, 31 LEA genes were induced in seedlings and 32 in mature stages under drought stress. The LEA3‐1, LEA14/WSI18, RAB16A, RAB16B, DHN1, DHN6, LEA1, LEA3, LEA17, and LEA33 exhibited and established co‐expression with numerous other drought stress‐related genes, indicating their inseparable role in alleviating drought. Consequently, LEA genes have been proposed to be primary and crucial responders to drought in Keteki Joha. [ABSTRACT FROM AUTHOR]

Introduction: Cardiac allograft vasculopathy (CAV) limits long‐term survival in heart transplant (HTx) recipients. The use of biomarkers in CAV surveillance has been studied, but none are used in clinical practice. The predictive value of high‐sensitivity troponin I (hsTnI) has not been extensively investigated in HTx recipients. Methods: HTx patients undergoing surveillance coronary angiograms and enrolled in the Emory Cardiovascular Biobank had plasma hsTnI measured. CAV grade was assessed using ISHLT nomenclature. Multivariable cumulative link mixed modeling was performed to determine association between hsTnI level and CAV grade. Patients were followed for adverse outcomes over a median 10‐year period. Kaplan‐Meier survival analysis and Cox proportional hazard modeling were performed. Results: Three hundred and seventy‐two angiograms were analyzed in 156 patients at a median 8.9 years after transplant. hsTnI levels were positively correlated with concurrent CAV grade after adjustment for age, age at transplant, sex, BMI, hypertension, diabetes, hyperlipidemia, estimated glomerular filtration rate, and history of acute cellular rejection (p =.016). In an adjusted Cox proportional hazard model, initial hsTnI level above the median (4.9 pg/mL) remained a predictor of re‐transplantation or death (hazard ratio 1.82; 95% confidence interval 1.16–2.90; p =.01). Conclusion: An elevated hsTnI level reflects severity of CAV and is associated with poor long‐term outcomes in patients with HTx. [ABSTRACT FROM AUTHOR]

Membrane receptors, attachment factors and various other membrane factors play a critical role in the specific attachment of virus particles to a cell surface. Researchers have been employing a range of model systems starting from receptor‐reconstituted lipid membranes to live cells for quantitative evaluation of virus‐receptor/attachment factor interactions. In this work, we show that giant plasma membrane vesicles (GPMVs) derived from adherent cells are a suitable cell‐mimicking model system to examine the binding of SARS‐CoV‐2 to cellular receptors. We evaluated the binding of cell‐cultured SARS‐CoV‐2 to GPMVs by imaging single virus particles with the wide‐field fluorescence microscopy technique. The GPMVs were derived from three different cell lines, i. e., Vero, HEK293T and A549. We compared the number of bound virus particles per cell, cell‐attached GPMV, and cell‐free GPMV of three different cell lines. We explain the observed trend in the data from the expression level of endogenous ACE2 protein and also, conclude that the protein is functional in GPMVs for virus and antibody binding. [ABSTRACT FROM AUTHOR]

Background: Little is understood about the risk factors and outcomes from candidemia in thoracic solid organ transplant recipients. Methods: This is a single‐center retrospective cohort study of patients undergoing heart or lung transplant between January 1, 2013 and December 31, 2022. We performed two comparisons among heart and lung transplant recipients: (1) recipients with candidemia versus matched, uninfected recipients, and (2) recipients with candidemia versus recipients with bacteremia. Results: During the study 384 heart and 194 lung transplants were performed. Twenty‐one (5.5%) heart and six (3.1%) lung recipients developed candidemia. Heart recipients with candidemia were more likely to have had delayed chest closure (38.1% vs. 0%, p <.0001), temporary mechanical circulatory support (57.1% vs. 11.9%, p =.0003), and repeat surgical chest exploration 76.2% vs. 16.7%, p <.0001) than uninfected controls. Heart and lung recipients who developed candidemia were more likely to have been on renal replacement therapy prior to infection relative to uninfected controls (57.1% vs. 11.9%, p =.0003 and 66.7% vs. 0%, p =.0041, respectively). Heart recipients with candidemia had significantly lower post‐transplant survival and lower post‐infection survival relative to matched uninfected controls and heart recipients with bacteremia, respectively (p <.0001 and p =.0002, respectively). Conclusions: Candidemia following heart and lung transplantation is associated with significant morbidity and mortality. Further research is needed to understand if heart recipients with delayed chest closure, temporary mechanical circulatory support, renal replacement therapy, and repeat surgical chest exploration may benefit from targeted antifungal prophylaxis. [ABSTRACT FROM AUTHOR]

The distinct disease progression patterns of severe acute respiratory syndrome coronavirus clade 2 (SARS‐CoV‐2) indicate diverse host immune responses. SARS‐CoV‐2 severely impairs type I interferon (IFN) cell signaling, resulting in uncontrolled late‐phase lung damage in patients. For better pharmacological properties, cytokine modifications may sometimes result in a loss of biological activity against the virus. Here, we employed the genetic code expansion and engineered IFN‐β, a phase II clinical cytokine with 3‐amino tyrosine (IFN‐β‐A) that reactivates STAT2 expression in virus‐infected human cells through JAK/STAT cell signaling without affecting signal activation and serum half‐life. This study identified that genetically encoded IFN‐β‐A might stabilize the protein‐receptor complex and trigger JAK‐STAT cell signaling, which is a promising modality for controlling SARS‐CoV‐2 infection. [ABSTRACT FROM AUTHOR]

Background: The PRIMA/ENGOT‐OV26/GOG‐3012 (NCT02655016) trial was amended to prospectively evaluate the safety and efficacy of an individualized starting dose (ISD) regimen of niraparib for first‐line maintenance therapy in patients with newly diagnosed advanced ovarian cancer. Methods: In the phase 3 PRIMA trial, patients with newly diagnosed advanced ovarian cancer with a complete/partial response to first‐line platinum‐based chemotherapy (N = 733) were initially treated with a fixed starting dose (FSD) regimen of 300 mg once daily. Subsequently, the protocol was amended so newly enrolled patients received an ISD: 200 mg once daily in patients with baseline body weight < 77 kg or baseline platelet count < 150,000/µL, and 300 mg once daily in all other patients. Efficacy and safety outcomes were assessed by starting dose. Results: Overall, 475 (64.8%) patients were assigned to an FSD (niraparib, n = 317; placebo, n = 158) and 258 (35.2%) were assigned to an ISD (niraparib, n = 170; placebo, n = 88). Efficacy in patients who received FSD or ISD was similar for the overall (FSD hazard ratio [HR], 0.59 [95% CI, 0.46–0.76] vs. ISD HR, 0.69 [95% CI, 0.48–0.98]) and the homologous recombination–deficient (FSD HR, 0.44 [95% CI, 0.30–0.64] vs. ISD HR, 0.39 [95% CI, 0.22–0.72]) populations. In patients with low body weight/platelet count, rates of grades ≥3 and 4 hematologic treatment‐emergent adverse events, dose interruptions, and dose reductions were lower for those who received ISD than for those who received FSD. Conclusions: In PRIMA, similar dose intensity, similar efficacy, and improved safety were observed with the ISD compared with the FSD regimen. Results from the phase 3 PRIMA trial of niraparib first‐line maintenance therapy that prospectively evaluated fixed versus individualized dosing support the selection of a niraparib starting dose based on an individual's body weight and platelet count. In prespecified analyses, patients who received the individualized starting dose of niraparib experienced similar progression‐free survival and improved safety outcomes compared with patients who received the fixed starting dose of niraparib. [ABSTRACT FROM AUTHOR]

Chronic exposure to Ultraviolet B radiation (UV‐B) evokes a myriad of toxic signalling events in the irradiated skin. One of such response is ER stress, which is known to exacerbate photodamage responses. Also, recent literature has highlighted the adverse impact of environmental toxicants on mitochondrial dynamics and mitophagy. Impaired mitochondrial dynamics escalates oxidative damage and causes apoptosis. There have been evidences that support crosstalk between ER stress and mitochondrial dysfunction. However, mechanistic clarification is still needed to verify the interactions between UPR responses and mitochondrial dynamics impairment in UV‐B‐induced photodamage models. Lastly, plant‐based natural agents have garnered attention as therapeutic agents against skin photodamage. Thus, gaining mechanistic insights of plant‐based natural agents is required for their application and feasibility in clinical settings. With this aim in view, this study was performed in primary human dermal fibroblasts (HDFs) and Balb/C mice. Different parameters regarding mitochondrial dynamics, ER stress, intracellular damage and histological damage were analyzed using western blot, rt‐PCR and microscopy. We demonstrated that UV‐B exposure leads to induction of UPR responses, upregulation of Drp‐1 and inhibition of mitophagy. Further, 4‐PBA treatment leads to reversal of these noxious stimuli in irradiated HDF cells, thereby, indicating an upstream role of UPR induction in mitophagy inhibition. Also, we explored the therapeutic effect of Rosmarinic acid (RA) against ER stress and impaired mitophagy in photodamage models. RA prevents intracellular damage via alleviation of ER stress and mitophagic responses in HDFs and irradiated Balb/C mice skin. The current study summarizes the mechanistic insights into UVB‐mediated intracellular damage and role of natural plant‐based agent (RA) in ameliorating these toxic responses. [ABSTRACT FROM AUTHOR]

Little is known about the post heart transplantation management of extra cardiac manifestations in patients with hereditary transthyretin amyloid cardiomyopathy (hATTR‐CM) in the new era of disease modifying treatment for ATTR amyloidosis. This is a retrospective study of all patients with hATTR‐CM associated with the Val142Ile variant who underwent heart transplantation (HT) from January 2014 to February 2022. All 10 patients with the Val142Ile mutation were successfully transplanted, with a 1 year survival post heart transplantation (HT) of 90%, comparable to an age, sex, and race matched cohort of patients transplanted for non‐amyloid indications. However, 4 (40%) of these patients developed progressive extracardiac manifestations requiring initiation of TTR silencer therapy with the small interfering RNA (siRNA) drug patisiran, which was well tolerated with no significant side effects in this population. We recommend formal neurologic evaluation and assessment of extracardiac manifestations annually as part of routine post‐transplant care, and disease modifying therapy, aimed at TTR stabilization or silencing, should be initiated in the context of previously untreated extracardiac manifestations or evidence of subclinical neuropathy to prevent progression. [ABSTRACT FROM AUTHOR]

Understanding estimated survival times in discrete groups according to race-ethnicity and age might allow for more accurate patient counseling, to set appropriate expectations for patients who are being considered for HT. Racial disparities in long-term survival after heart transplantation: What should we be telling patients? Black heart transplant (HT) recipients continue to have inferior outcomes compared to other race-ethnic groups, including a higher risk of rejection and allograft failure contributing to lower rates of long-term survival in this population.1-4 It is important for clinicians to understand race-ethnic differences in post-HT survival, so that patients can be counseled accurately. [Extracted from the article]

Epidermolysis bullosa simplex (EBS) with plectin mutations is a very rare subtype of EB usually associated with pyloric atresia (PA) or muscular dystrophy (MD). We report six unrelated children between ages 4 and 14 years from India with varied clinical manifestations. Only one had PA, and none has developed MD to date. All except the one with PA presented with early onset blistering along with laryngeal involvement in the form of hoarseness of voice and nail involvement. Patient with PA presented with aplasia cutis and died in the first week. Two patients had predominantly respiratory and gastrointestinal involvement with varying severity while two had features of myasthenic syndrome but no limb‐girdle involvement and one patient phenocopied laryngo‐onycho‐cutaneous (LOC) syndrome. Using whole‐exome sequencing, we identified novel mutations in PLEC. Histopathological analysis (Immunofluorescence antigen mapping) showed absence of staining to plectin antibodies. Our observations propose to append a phenotype of EBS, hoarseness of voice and nail dystrophy or LOC‐like phenotype with plectin mutations. Long‐term follow up is necessary to monitor for the development of muscular dystrophy. [ABSTRACT FROM AUTHOR]

Ultraviolet B (UVB) radiation is the leading cause of premature skin aging and skin cancer. UVB mediated mitochondrial dysfunction has been identified as one of the causative factors of UVB induced oxidative imbalance and apoptosis. Here, we report that UVB leads to mitochondrial fragmentation by causing imbalance in the markers regulating mitochondrial dynamics, which further contributes to ROS imbalance and activation of mitochondrial apoptotic signals. Several studies have demonstrated natural products as inhibitors of mitochondrial fission. However, to our knowledge, not much evidence has been gathered regarding utilization of Rosmarinic acid (RA) against UVB orchestrated mitochondrial fragmentation responses. Thus, in our study, we present the evidence of the efficacy of RA as a modulator of mitochondrial dynamics in UVB irradiated skin cells to prevent oxidative imbalance and apoptosis thereby preventing UVB induced photodamage. [ABSTRACT FROM AUTHOR]

Skin is a dynamic interface between the external environment and internal organs. It has high turnover that allows the renewal of dead skin cells, thus maintaining a healthy skin homeostasis. Mitochondria fulfills all the energy needs for these cells. In addition, mitochondria are an active source of free radicals that have been determined as crucially important in skin health and disease. The common notion of limited role of mitochondria as merely the cellular powerhouse has drastically changed. Several extracellular stressors have proved to induce impairment in the dynamic properties of mitochondria such as fusion and fission, which further leads to an activation of selective autophagic response known as mitophagy. Altered mitochondrial dynamics have been lately associated with skin photodamage and cutaneous manifestations of several diseased states, thereby suggesting it to be an effective therapeutic target. This review summarizes the molecular mechanisms involved with impaired mitochondrial dynamics and its potential role in skin health and disease. [ABSTRACT FROM AUTHOR]

Background: Caregiver support is considered necessary after heart transplant (HT) and left ventricular assist device (LVAD) for patients with end‐stage heart failure (HF). Few studies have demonstrated how caregivers differ by gender and race, and whether that impacts therapy eligibility. Methods: We examined caregiver relationships among 674 patients (32% women, 55% Black) evaluated at Emory University from 2011 to 2017. Therapy readiness was assessed using the Stanford Integrated Assessment for Transplant (SIPAT). Evaluation outcome according to caregiver relationship was compared using χ2 analysis. Multivariable logistic regression determined the association between caregiver and eligibility according to gender and race. Results: Women and Black patients were less likely to have spouses as their support person (P <.001). Women were less likely to be considered eligible for advanced therapies (adjusted odds ratio [aOR].64, 95% confidence interval [CI].46–.89; P =.008), with Black women having lower eligibility than White women (aOR.28, 95% CI.11–.72; P =.008). Social support and SIPAT scores did not significantly influence eligibility by gender or race. Conclusion: Lack of caregiver support is considered a relative contraindication to advanced therapies. Type of caregiver in our cohort varied according to race and gender but did not explain differences in eligibility for advanced therapies. [ABSTRACT FROM AUTHOR]

Objectives: We investigated sex‐based differences in eligibility for and outcomes after receipt of advanced heart failure (HF) therapies. Background: Although women are more likely to die from HF than men, registry data suggest that women are less likely to receive heart transplant (HT) or left ventricular assist device (LVAD) for largely unknown reasons. Methods: We performed a single‐center retrospective cohort study of patients evaluated for advanced HF therapies from 2012 to 2016. Logistic regression was used to determine the association of sex with eligibility for HT/LVAD. Competing risks and Kaplan‐Meier analysis were used to examine survival. Results: Of 569 patients (31% women) evaluated, 223 (39.2%) were listed for HT and 81 (14.2%) received destination (DT) LVAD. Women were less likely to be listed for HT (adjusted odds ratio [OR] 0.36, 95% confidence interval [CI] 0.21‐0.61; P <.0001), based on allosensitization (P <.0001) and obesity (P =.02). Women were more likely to receive DT LVAD (adjusted OR 2.29, 95% CI 1.23‐4.29; P =.01). Survival was similar between men and women regardless of whether they received HT and DT LVAD or were ineligible for therapy. Conclusion: Women are less likely to be HT candidates, but more likely to receive DT LVAD. [ABSTRACT FROM AUTHOR]

The 2018 Revised United Network for Organ Sharing Heart Allocation System (HAS) was proposed to reclassify status 1A candidates into groups of decreasing acuity; however, it does not take into account factors such as body mass index (BMI) and blood group which influence waitlist (WL) outcomes. We sought to validate patient prioritization in the new HAS at our center. We retrospectively evaluated patients listed for heart transplantation (n = 214) at Emory University Hospital from 2011 to 2017. Patients were reclassified into the 6‐tier HAS. Multistate modeling and competing risk analysis were used to compare outcomes of transplantation and WL death/deterioration between new tiers. Additionally, a stratified sensitivity analysis by BMI and blood group was performed. Compared with tier 4 patients, there was progressively increasing hazard of WL death/deterioration in tier 3 (HR: 2.52, 95% CI: 1.37‐4.63, P =.003) and tier 2 (HR: 5.03, 95% CI: 1.99‐12.70, P <.001), without a difference in transplantation outcome. When stratified by BMI and blood group, this hierarchical association was not valid in patients with BMI ≥30 kg/m2 and non‐O blood groups in our cohort. Therefore, the 2018 HAS accurately prioritizes the sickest patients in our cohort. Factors such as BMI and blood group influence this relationship and iterate that the system can be further refined. [ABSTRACT FROM AUTHOR]

Background Antibody-mediated rejection ( AMR) resulting from de novo donor-specific antibodies (dn DSA) leads to adverse outcomes following heart transplantation ( HTx). It remains unclear what role dn DSA to specific HLA antigens play in adverse outcomes. This study compares outcomes in patients developing dn DSA to DQ antigens with those developing non- DQ dn DSA and those free from dn DSA. Methods The present study was a single-center, retrospective analysis of 122 consecutive HTx recipients. The primary outcome was a composite of death or graft dysfunction. Results After 3.3 years of follow-up, 31 (28%) patients developed dn DSA. Mean time to dn DSA was 539 days. Of 31 patients, 19 developed DQ antibodies and 12 developed non- DQ antibodies. Compared to non- DQ dn DSA, DQ antibodies presented with higher MFI values ( P=.001) were more likely persistent ( P=.001) and appeared later post- HTx (654 vs 359 days, P=.035). In a multivariable analysis, DQ dn DSA was associated with increased risk of the primary endpoint ( HR 6.15, 95% CI 2.57-14.75, P=.001), whereas no increased risk was seen with non- DQ dn DSA ( P=.749). Conclusions dn DSA to DQ antigens following HTx are associated with increased risk of death and graft dysfunction. [ABSTRACT FROM AUTHOR]

Background Familial lentiginosis syndromes are characterized by a wide array of manifestations resulting from activation of molecular pathways which control growth, proliferation, and differentiation of a broad range of tissues. Familial gastrointestinal stromal tumors ( GISTs) are often accompanied by additional features like hyperpigmentation, mastocytosis, and dysphagia. They have been described with mutations in c-kit (most commonly), platelet-derived growth factor receptor A, neurofibromatosis-1, and succinate dehydrogenase genes. Materials and Methods We report on molecular characterization and tumor histopathology of two siblings in whom lentigines and café-au-lait macules were present along with multifocal GIST. Immuhistochemical analysis of CD34 and CD117 was performed on GIST biopsy samples from both siblings, while c-kit mutational analysis was done by PCR and direct sequencing on DNA from peripheral blood leukocytes of all family members and from paraffin-embedded gastric biopsy specimens of affected siblings. Results Histopathology revealed positive expression of CD117 and CD34. Mutational analysis showed the germline c.1676T>C mutation in c-kit exon 11, (p.(Val559Ala)), in the peripheral blood of both siblings and a second exon 11 mutation, c.1669T>A (p.(Trp557Arg)) in the tumor biopsy of one of them. Initiation of imatinib treatment resulted in striking resolution of their hyperpigmentation and a stable gastrointestinal disease in one of them. Conclusions A c-kit mutational test in familial GISTs is indicated before initiation of imatinib therapy, as it can help predict tumor response to treatment. [ABSTRACT FROM AUTHOR]

Background Pyogenic granuloma ( PG) is a benign vascular tumor that can be treated by cautery (chemical or thermal), laser, excision, curettage, sclerotherapy, and cryotherapy. Topical timolol is emerging as a non-invasive modality for the treatment of PGs. Methods We recruited a series of 10 patients with PG, who received treatment with 0.5% timolol maleate ophthalmic solution applied 4 times a day, 2 drops per dose. No other medication, topical or systemic, was given. Pulse rate, blood pressure, and blood glucose were monitored at baseline and weekly thereafter for the duration of treatment. ECG was done at baseline. The efficacy of the treatment was evaluated by considering a complete response, a partial response, and no response. Results Of 10 patients, four showed complete response within 3-24 days, with no recurrence at 3-month follow-up. Three patients each showed partial or no response. No local or systemic side effects were reported in any of the patients. Conclusions The response of PGs to β blockers seems to be variable. Although topical timolol has the advantage of minimal adverse events, ease of administration, and better cosmetic outcomes, it's efficacy in PG may not be universal unlike in infantile hemangiomas. Topical timolol may be a treatment option in young children, incapacitated elderly, and over delicate areas like face, nails, and gums where invasive modalities are not desirable. [ABSTRACT FROM AUTHOR]

Inhibition of autophagy is a characteristic of ovarian cancer. We determined whether inhibition of autophagy by vaginal fluid could provide a non-invasive test for cancer risk stratification in women presenting with an adnexal mass. Vaginal fluid supernatants from 90 women undergoing evaluation for a suspicious adnexal mass were incubated with peripheral blood mononuclear cells (PBMCs) obtained from healthy women under conditions that induce autophagy. Rapamycin, an autophagy inducer, was added to some cultures. After 48 hr the cells were collected, lysed and assayed by ELISA for intracellular p62 concentration. p62 is a cytoplasmic protein that is consumed during autophagy induction. Its concentration is inversely proportional to the extent of autophagy induction. Clinical information including pathological diagnoses was obtained after completion of laboratory studies. Mean p62 levels were 9.4 ng/ml in the 21 women with a subsequent malignant diagnosis, 4.5 ng/ml in the eight women with a borderline tumor diagnosis and 3.6 ng/ml in the 61 women with benign disease ( p < 0.0001, malignant vs. others). When rapamycin was added to the vaginal fluid-PBMC co-incubation, p62 levels in samples from women with a malignant diagnosis decreased to 3.3 ng/ml, a level comparable to what was observed with the nonmalignant samples. Vaginal fluid inhibition of autophagy can differentiate between women with malignant and benign adnexal masses. [ABSTRACT FROM AUTHOR]

Objectives Lepra reaction in histoid leprosy (HL) is rare; there are few reports of type 2 lepra reaction in HL. We report a 42-year-old woman with HL in type 1 lepra reaction after 10 weeks of multibacillary multi-drug therapy (MBMDT). Case report A 42-year-old woman presented with asymptomatic multiple papules, plaques, and nodules over the face, trunk, and extremities and no history of prior treatment with anti-leprosy drugs. A biopsy of a skin nodule on the forearm revealed spindle-shaped, nonvacuolated histiocytes in a whorled pattern with abundant acid-fast bacilli (AFB). The patient was diagnosed with HL and started on MBMDT. Ten weeks later, she developed pruritic, painful, erythematous, and edematous papules, plaques, and nodules over the face, trunk, and extremities, without constitutional symptoms. Histopathology revealed an atrophic epidermis, preserved grenz zone, and papillary dermal edema. Elongated AFB were visible on Fite's stain. The MBMDT was continued, along with nonsteroidal antiinflammatory drugs and antihistamines, but pruritus, pain, erythema, and edema persisted, and new skin lesions appeared. The patient was started on prednisolone at 0.75 mg/kg body weight/day. Prednisolone resulted in symptomatic relief and the healing of ulcerated papules within four weeks. Treatment was tapered and stopped after 20 weeks. Conclusions Histoid leprosy is considered a variant of lepromatous leprosy, which rarely involves a lepra reaction. Pruritus and ulceration of skin lesions as manifestations of type 1 lepra reaction in HL have not been reported previously. These symptoms manifested after 10 weeks of MBMDT and responded well to oral prednisolone. [ABSTRACT FROM AUTHOR]

To determine the frequency and clinical presentation of Mongolian spots ( MS) and assess their evolution with age, this study was conducted in three phases. The first phase examined 2,313 babies born at Jawaharlal Institute of Postgraduate Medical Education and Research between October and December 2010 for the number, size, shape, color, and distribution of MS. Babies with MS were followed up at 6 months and 1 year, in the second and third phases, respectively, to note the evolution of the patches. Of 2,313 babies, 1,524 (65.9%) had MS. The majority had a single patch ( n = 790), measuring less than 5 cm ( n = 932), with an irregular shape ( n = 981) and a blue-green color ( n = 577). The most common site was sacral ( n = 1,203), and the most common extrasacral site was a lower extremity ( n = 156). A single case of superimposed MS was recorded. Male sex and prematurity were significantly associated with MS (p < 0.05). At 6 months, 73 of 634 babies (11.5%) showed fading and 83 (13.1%) showed complete disappearance. At 1 year, 90 (14.2%) showed fading and 268 (42.3%) showed complete disappearance. Multiple MS (p < 0.05), extrasacral position (p < 0.05), size larger than 10 cm (p < 0.05), and dark-colored lesions (blue/blue-black) (p < 0.05) were significantly associated with persistence beyond 1 year. Seven hundred ninety babies (51.8%) had a single MS. More than 40% of MS disappeared by 1 year. Multiple patches, extrasacral position, size larger than 10 cm, and dark-colored lesions were markers of persistence beyond 1 year. [ABSTRACT FROM AUTHOR]

We report on two brothers (born to nonconsanguineous parents) with short stature, hypospadias, scoliosis, vertebral segmentation defects of 'spondylocostal dysostosis' type, and intellectual disability. Results of cytogenetic and molecular genetic tests performed, including routine karyotype, MLPA (multiplex ligation-dependent probe amplification) for common microdeletions and subtelomeric copy number variants, microarray-CGH analysis, and sequencing of four Notch signaling pathway genes ( DLL3, MESP2, LFNG, and HES7), were all normal. We present a comparison of the condition in the two boys with known syndromes and suggest that they may represent a hitherto unreported syndrome, most likely following autosomal recessive inheritance, though X-linked inheritance is not excluded. © 2012 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Cocaine is a common drug of abuse in the United States. Although long-term cocaine use has been associated with premature coronary artery disease (CAD), the relationship between cocaine use and the presence of angiographically significant CAD (≥70%) is not clear. A retrospective analysis of all patients who had undergone cardiac catheterization at an urban medical center over a 1-year period was performed. Five hundred twelve patients were enrolled in the study; 84 (16.4%) had evidence of cocaine use, and 111 (21.7%) were admitted with a myocardial infarction. At the time of cardiac catheterization, 31 (36.9%) cocaine-positive patients had ≥70% stenosis in at least one epicardial vessel, compared with 200 (46.7%) cocaine-negative patients (p =0.09). Although a trend toward an association was noted on unadjusted analysis, after adjusting for CAD risk factors, cocaine use was not associated with angiographically significant CAD (odds ratio, 0.9; 95% confidence interval, 0.55-1.5; p =0.7). [ABSTRACT FROM AUTHOR]

The article reports on the practice of cultural dermatology in India. Topics covered include skin problems that result from the presence of various socio-religious and cultural habits and the use of alternative medicine systems, reasons for the popularity of alternative medicine system in India, also known as ayurveda, yoga, and naturopathy, Unani, Siddha, homeopathy (AYUSH), as well as the adverse effects of AYUSH.