Search

Starting from the well known stable free radical DPPH (or its reduced counterpart, 2,2-diphenyl-1-picryl-hydrazine) and several amino derivatives, novel zwitterionic compounds (diazenium betaines) were obtained and characterized by different means, like NMR, IR, MS, and UV–Vis. These betaines are highly intense blue-colored compounds that can be easily reduced by ascorbic acid (vitamin C) or sodium ascorbate to their corresponding para-phenyl substituted derivatives of DPPH, which have a yellow color. Most of such redox processes were found to be reversible. However, the oxidation of 2-p-aminophenyl-2-phenyl-1-picryl-hydrazine led to an azo-derivative of DPPH diradical, and its structure was unveiled by X-ray monocrystal diffraction. Possible diradicaloid behavior is also discussed.

Bromination of the 2,2-diphenyl-1-picrylhydrazyl (DPPH) free radical with bromine or N-bromo-succinimide (NBS) affords a complex mixture of bromo- and nitro-derivatives of the starting material. In this study, by chromatographic separation, most of the reaction products were isolated. Suitable crystals for X-ray measurements were obtained and characterized for the compounds 2-p-bromophenyl-2-phenyl-1-picrylhydrazyl free radical (Br-DPPH), 2-p-bromophenyl-2-phenyl-1-picrylhydrazine (Br-DPPH-H), and 2,2-(p-bromophenyl)-1-(2-bromo-4,6-dinitrophenyl)hydrazine (Br2-DPPBr-H).

María José Valencia López,1,* Brigitte Stephan,1,* Anna Meineke,1 Sandra Wolf,1 Diamant Thaci,2 Ulrich Mrowietz,3 Valerie Andrees,1 Stephan Jeff Rustenbach,1 Kristian Reich,1 Linus Thalmann,1 Henriette Bogena,1 Petra Staubach,4 Ralph Michael von Kiedrowski,5 Matthias Augustin1 1Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany; 2Institute and Comprehensive Center for Inflammation Medicine, University of Lübeck, Lübeck, Germany; 3Psoriasis-Center, Department of Dermatology, University Medical Center Schleswig-Holstein, Kiel, Germany; 4Department of Dermatology and Allergy, University Medical Center Mainz, Mainz, Germany; 5Dermatological Practice Selters, Selters, Germany*These authors contributed equally to this workCorrespondence: Matthias Augustin, Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, Hamburg, 20246, Germany, Tel +49 040 7410 55428, Fax +49 040 7410 55348, Email m.augustin@uke.deBackground: Limited data are available characterizing the impact of the SARS-CoV-2 pandemic on psoriasis care for patients in Germany.Objective: To analyze patient perception and impact of the pandemic on well-being and psoriasis management of German patients with moderate-to-severe psoriasis or psoriasis arthritis under systemic therapies.Methods: The CoronaBest registry captures events of SARS-CoV-2 infections and analyzes the impact of the pandemic on patients with psoriasis or psoriasis arthritis. In June 2020, and independently in February 2022, patients with psoriasis or psoriasis arthritis received a standardized questionnaire for current treatment, protective measures, well-being, and individual risks for COVID-19, among others.Results: Included were 4,194 patients in 2020 (mean age of 47.7 years and 41.8% women) and 4,818 patients in 2022 (mean age of 56.4 and 42.9% women). Treatment discontinuations were observed in 2.7% and 1.7% of patients in 2020 and 2022, respectively. In the vast majority of the cases (> 92%), no additional measures were taken concerning the management of psoriasis treatments in either 2020 or 2022. Those patients with changes reported most frequently: telephone calls instead of face-to-face visits (80.2%, in 2020 vs 40.5% in 2022) or more frequent controls (27.1%, 2020 vs 22.0%, 2022). A majority (66.7%, 2020, and 70.6%, 2022) did not perceive the virus as a considerable threat. The proportion of patients feeling well informed about COVID-19 by physicians increased from 42.6% in 2020 to 51.8% in 2022. About 81.1% of patients in 2020 and 67.5% in 2022 stated that their overall personal condition was not affected due to the pandemic. Physicians attributed no special risk of contracting SARS-CoV-2 in most of the patients.Conclusion: A high rate of systemic treatment persistence and awareness of risks and protective measures indicate that health care for psoriasis largely followed current national and international recommendations during the COVID-19 pandemic.Keywords: psoriasis, COVID-19, SARS-CoV-2, pandemic, patient perception, risk factors

Lorenz Julius Kuhls,1 Jeta Demiri,1 Adam Weidlich,1 Susanne Weidlich,1 Janin Trinkaus,1 Kerstin Steinbrink,2 Matthias Augustin,3 Athanasios Tsianakas1 1Department of Dermatology and Allergology, Fachklinik Bad Bentheim, Bad Bentheim, Germany; 2Department of Dermatology, University Hospital Münster, Münster, Germany; 3Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, GermanyCorrespondence: Athanasios Tsianakas; Lorenz Julius Kuhls, Department of Dermatology and Allergology, Fachklinik Bad Bentheim, Bad Bentheim, 48455, Germany, Tel/Fax +49 5922 74-52 10, Email A.tsianakas@fk-bentheim.de; L.Kuhls@fk-bentheim.dePurpose: During the COVID-19 pandemic, infections could also be detected among the staff and patients of the dermatological hospital Bad Bentheim (Germany). This retrospective analysis aims to better understand the impact of the pandemic on health care workers. The results could help improve future pandemic plans and measures to protect health care workers.Patients and Methods: In 2020, the whole staff (460 participants) of the dermatological hospital Bad Bentheim had been offered the option to be tested with respect to the antibody status on SARS-CoV-2 (IgG, IgM). The data were collected by means of a blood sample and subsequent questionnaires (22 questions for employees with positive SARS-CoV-2 serology) regarding disease severity, symptoms, disease duration, chains of infection, psychological and physical burden. Both groups were divided by positive or negative serology and data analysis was performed using an independent t-test.Results: It was shown that a COVID-19 Infection clinically presented itself as a respiratory tract infection, differed significantly in severity and duration, but also the long-term consequences in employees with proven COVID-19 disease (n=14, 3.7%) from the employees with non-COVID-19 respiratory diseases (33.6% of the seronegative employees). In addition, there was a significant psychological impairment and burden of COVID-19-affected employees. Our study showed unique insights into infection chains, disease courses, disease severity, symptoms and a significant psychological impairment and burden of COVID-19-affected employees among the COVID-19 positive staff.Conclusion: Our study shows deep insights into infection chains, disease courses, disease severity and symptoms among the COVID-19 positive staff and led to change of behavior with the disease itself and among the health care professionals. This knowledge has the potential to positively influence the handling of similar future events.Plain Language Summary: Due to the nature of the Corona pandemic with massive effects, especially in the environment of health care facilities, we provide a detailed insight into the stresses on employees in a dermatological acute and rehabilitation clinic. To recognize their stress and to monitor the maintenance and quality of patient care, it is important to focus especially on the effects of an infection with SARS-CoV-2 of these employees and to analyze them. This revealed insights into the disease trajectories of staff infected with COVID-19 with significant differences compared to healthy individuals. Starting with physical symptoms and ending with psychological stress.Keywords: COVID-19, SARS-CoV-2, immunoassay, infection chain, hospital staff

Matthias Augustin, Rachel Sommer, Christine Blome, Natalia Kirsten, Anna Langenbruch German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, GermanyCorrespondence: Matthias Augustin, German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, Hamburg, 20246, Germany, Tel +49 40 7410 55428, Fax +49 40 7410 55348, Email m.augustin@uke.deIntroduction: Evaluation of patient-reported outcomes including health-related quality of life (HRQoL) and perceived benefits from treatment has become a fundamental component of medical decision-making. Standardized evaluation of treatment benefits in rosacea based on patient preferences is still lacking.Objective: Development and validation of an instrument for recording patient-defined benefits in rosacea therapy based on the Patient Benefit Index (PBI) methodology.Patients and Methods: In an open survey of n = 50 patients, potential benefits of therapy from the patient’s perspective were examined. The generated item pool was combined with pre-existing PBI items for other skin conditions and reviewed by an expert panel of dermatologists, psychologists and patients. Items were condensed to n = 25 and converted into a Likert-scaled questionnaire. The validity and feasibility of the resulting Patient Benefit Index for rosacea (PBI-RO) were tested on individuals with rosacea recruited from a German rosacea patient organization.Results: N = 446 patients with rosacea completed the PBI-RO. The internal consistencies measured by Cronbach’s alpha were high (Patient Needs Questionnaire [PNQ] 0.94). Mean PBI-RO was 1.9 ± 1.2 (scale from 0 = no benefit to 4 = maximum benefit), 23.5% of the patients experienced a PBI-RO < 1 (no clinically relevant benefit). The PBI-RO correlated with HRQoL, health state, current extent of rosacea lesions and treatment satisfaction. The highest correlation was found between PBI-RO and satisfaction with previous treatment (r = − 0.59, p < 0.001); correlation with the extent of rosacea lesions was low (r = 0.16, p < 0.001).Conclusion: The PBI-RO shows satisfying internal consistency and construct validity. It offers the option of a patient-weighted evaluation of the therapeutic benefit of rosacea therapy and may add to more stringent goal orientation in therapy.Keywords: patient needs, treatment goals, disease burden, health-related quality of life, Patient Benefit Index, rosacea

Anna Langenbruch,1 Eike Wüstenberg,2,3 Hendrik Wolf,2 Matthias Augustin1 1German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany; 2ALK-Abelló Arzneimittel GmbH, Hamburg, Germany; 3Clinic for Otorhinolaryngology, University Hospital Dresden, Dresden, GermanyCorrespondence: Anna Langenbruch, German Center for Health Services Research in Dermatology (CVderm) Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, Hamburg, 20246, Germany, Tel +49 40 7410-53942, Fax +49 40 7410-55348, Email a.langenbruch@uke.dePurpose: Allergic rhinoconjunctivitis (ARC) is one of the most common diseases worldwide. Allergen immunotherapy (AIT) is the only causal treatment available so far. Due to health policy provisions, the assessment of treatment benefit from the patient’s perspective is of high relevance. To date, no instrument for assessing treatment needs and benefits of patients with ARC who receive AIT has been published. The aim of the study was to validate an instrument to assess the patient-relevant treatment benefit of patients with ARC who receive AIT.Methods: We developed the Patient Benefit Index questionnaire for AIT (PBI-AIT), consisting of 33 items. Longitudinal data of patients with ARC were used to test feasibility, reliability and validity. The PBI was compared between the beginning of the study (t1) and the end of the study (t5).Results: N = 279 patients with AIT completed the PBI-AIT at t1, n = 333 at t5; n = 226 at both timepoints. Mean number of missing values per patient was 0.7 in the Patient Needs Questionnaire (PNQ) at t1 and 1.2 in the Patient Benefit Questionnaire (PBQ) at t5. The internal consistencies measured by Cronbach’s alpha were 0.98 (PNQ) and 0.99 (PBQ). The mean PBI of the patients with AIT was significantly lower at t1 and improved at t5. The PBI-AIT correlated with all tested external criteria at t5. The correlation between PBI-AIT and satisfaction with previous treatment (r = − 0.57, p < 0.001) was higher than the correlation between PBI-AIT and current disease severity (r = − 0.26, p < 0.001).Conclusion: The results indicate feasibility, reliability, convergent and discriminant validity as well as sensitivity to change of the PBI-AIT.Keywords: allergy treatment, immunotherapy and tolerance induction, patient reported outcome, prevention, quality of life

Chalcones are α,β-unsaturated ketones with great structural diversity and various applications. A chalcone produced by condensation of 2-acetylpyridine with 2-naphthaldehyde (L) was employed for synthesis of two mononuclear complexes: [Eu(L)(hfac)3(H2O)]·0.5CHCl3 and [Tb(L)(hfac)3], where hfac is the hexafluoroacetylacetonate anion. The chalcone and complexes were structurally characterized by single-crystal X-ray diffraction. The chalcone acts as a chelating bidentate ligand. Luminescent properties of the ligand L and the complexes were investigated in the solid state. For these heteroleptic mononuclear complexes, the emission of the Eu(III) and Tb(III) ions was influenced by the excitation wavelength.

Philip Hampton,1 Emma Borg,2 Jes Birger Hansen,2 Matthias Augustin3 1Department of Dermatology, The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK; 2LEO Pharma A/S, Ballerup, Denmark; 3Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, GermanyCorrespondence: Philip HamptonDepartment of Dermatology, The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle, NE7 7DN, UKEmail philip.hampton@nhs.netPurpose: Both brodalumab and guselkumab improve skin clearance in patients with moderate-to-severe plaque psoriasis after inadequate response to ustekinumab. In the absence of a direct head-to-head comparison, the relative efficacy of brodalumab and guselkumab in non-responders to ustekinumab were compared using a matching-adjusted indirect comparison (MAIC).Patients and Methods: Individual patient data for brodalumab (n = 121) were pooled from the AMAGINE-2 and -3 trials and adjusted using a propensity score reweighting method, so that baseline and week 16 characteristics matched the aggregate published data of patients with an inadequate response to ustekinumab who switched to guselkumab (n = 135) in the NAVIGATE trial.Results: After inadequate response to ustekinumab, brodalumab resulted in significantly higher psoriasis area and severity index (PASI) 90 rates versus guselkumab at post-treatment switch week 12 (62.7% vs 48.1%, relative difference 14.6% [95% confidence interval [CI] 5.3– 23.9], p = 0.002 [number needed to treat [NNT] = 6.8]) and week 36 (63.7% vs 51.1%; relative difference 12.6% [95% CI 4.1– 21.0]; p = 0.004 [NNT = 7.9]) and PASI 100 rate at week 36 (40.3% vs 20.0%; relative difference 20.3% [95% CI 11.8– 28.7]; p < 0.001 [NNT = 4.9]).Conclusion: In this MAIC, brodalumab was associated with greater improvements than guselkumab in inadequate responders to ustekinumab. Switching to brodalumab in such patients may be a more effective strategy than switching to guselkumab.Keywords: brodalumab, guselkumab, psoriasis

Natalia Kirsten, Nicole Mohr, Matthias Augustin Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, GermanyCorrespondence: Natalia KirstenInstitute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, 20246, GermanyTel +49-40-7410-55428Fax +49-40-7410-5348Email n.kirsten@uke.dePurpose: Although acne vulgaris (AV) is a common disease and can persist into adulthood, there are few large-scale epidemiological studies on the prevalence of acne vulgaris in adults. The aim of our study was to characterise the epidemiology and comorbidity of acne vulgaris in working adults in Germany.Patients and Methods: Within the framework of a cross-sectional study, a total of 161,269 employees underwent dermatological whole-body examinations in more than 500 German companies between 2001 and 2016. Point prevalence rates for acne vulgaris and further skin diseases and their 95% confidence intervals were calculated and differences between participants with and without acne vulgaris were tested with chi-squared tests.Results: Mean age was 43.2 years ± 10.9, 55.5% were male. In total, n = 5311 people (3.3%) with acne vulgaris were identified. Prevalence decreased by age. Controlling for age and gender, acne was significantly associated with folliculitis (OR = 1.91; CI: 1.76– 2.07), contact dermatitis (OR = 1.74; CI: 1.08– 2.81), rosacea (OR = 1.74; CI: 1.40– 2.15), pyoderma (OR = 1.58; 1.22– 2.06), seborrheic dermatitis (OR = 1.47; CI: 1.27– 1.71), hand eczema (OR = 1.34; CI: 1.00– 1.76), verruca vulgaris plantaris (OR = 1.29; CI: 1.09– 1.51), tinea pedis (OR = 1.27; CI: 1.10– 1.47), spider veins (OR = 1.26; CI: 1.16– 1.38) and telangiectasia (OR = 1.15; CI: 1.02– 1.30).Conclusion: These data underline the importance of acne vulgaris in the adult population. Further studies to better understand the pathophysiology of AV and its comorbidity in different phases of adulthood would be desirable to develop appropriate guidelines and therapy concepts.Keywords: acne vulgaris, comorbidities, epidemiology, inflammation

Natalia Kirsten,1 Nicole Mohr,1 Franziska Gensel,1 Aminah Alhumam,1,2 Guido Bruning,3 Matthias Augustin1 1Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany; 2Department of Dermatology, College of Medicine, King Faisal University, Hofuf, Al Ahsa, Saudi Arabia; 3Department of Vein and Dermatosurgery, Tabea Hospital GmbH and Co KG, Hamburg, GermanyCorrespondence: Natalia KirstenInstitute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Martinistr. 52, Hamburg, D-20246, GermanyTel +49-40-7410-55428Fax +49-40-7410-55348Email n.kirsten@uke.deIntroduction: Data on the prevalence of chronic venous disorders (CVD) at the national level in Germany are scarce.Methods: We performed a population-based observational study based on clinical examinations, personal history, and technical examinations. Data were collected from 2006 to 2015. Descriptive data analysis was done to determine CVD and chronic venous insufficiency (CVI) prevalence and occurrence of potential risk factors. Chi-squared tests were performed to estimate the influence of risk factors on the prevalence of CVD.Results: In total, 19,104 employees from different branches were included. The majority of the examined people were doing office work (n = 8157; 80.2%). A total of 4038 persons (21.1%) show at least one sign of CVD. At least one sign of CVI could be found in 679 persons (3.6%). Being female was found to be protective with an odds ratio of 0.66 (95% CI 0.59– 0.73).Conclusion: There is clear indication for active venous treatment in 22.3% of the adult working population in Germany.Keywords: venous insufficiency, epidemiology, prevalence

Natalia Kirsten,1 Nicole Mohr,1 Aminah Alhumam,1,2 Matthias Augustin1 1Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany; 2Department of Dermatology, College of Medicine, King Faisal University, Hofuf, Al Ahsa, Saudi ArabiaCorrespondence: Natalia KirstenInstitute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), 20246 Hamburg, GermanyTel +49-40-7410-55428Fax +49-40-7410-5348Email n.kirsten@uke.deBackground: Seborrhea is a skin condition characterized by abundant production of sebum associated with typical dermatological conditions such as rosacea and acne. Little is known about the prevalence of seborrhea and the frequency of concurrent skin diseases in the general population.Objective: To investigate the epidemiology and comorbidity of seborrhea in the adolescent and adult working population.Methods: In large-scale examinations by dermatologists in 343 German companies, the seborrheic skin type and the occurrence of skin findings were documented electronically. Odds ratios (OR) and their 95% confidence intervals (95% CI) of further skin diseases were computed. Logistic regression analyses were conducted for each disease using seborrhea as dependent variable.Results: A total of 48,630 employees were examined. About 6.0% showed seborrhea (6.6% in men, 5.4% in women). Seborrhea strongly predicted acne (OR 3.59; CI 3.18– 4.05), trichilemmal cysts (OR 1.99; CI 1.25– 3.18) and rosacea (OR 1.45; CI 1.17– 1.81). Regression analyses controlling for age, gender and phototype confirmed significant associations of seborrhea with acne and rosacea.Conclusion: Only a minor proportion of the working population shows meaningful seborrheic skin. However, this condition predicts distinct skin diseases and thus needs attention, in particular, with respect to consulting and secondary prevention.Keywords: seborrhea, seborrheic skin, epidemiology, comorbidities

Five new derivatives were obtained utilizing 4-chloro-7-nitrobenzofurazan (NBD-chloride) in combination with furfurylamine, adamantylamine, aminohippuric acid, phenylalanine, and dehydroabietylamine. These derivatives were then subjected to a comparative analysis of their physical, chemical, and certain biological properties alongside two analogous and known compounds derived from the glycine and 4-amino-TEMPO free radical.

Janine Topp,1 Christine Blome,1 Matthias Augustin,1 Nicole Mohr,1 Eike Sebastian Debus,2 Holger Diener,2 Rachel Sommer1 1Institute for Health Services Research in Dermatology and Nursing (IVDP), German Center for Health Services Research in Dermatology (CVderm), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany; 2Department of Vascular Medicine, University Medical Center Hamburg‐Eppendorf (UKE), Hamburg, GermanyCorrespondence: Rachel SommerInstitute for Health Services Research in Dermatology and Nursing (IVDP), German Center for Health Services Research in Dermatology (CVderm), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, GermanyTel +49 (0) 40 7410 24724Fax +49 (0) 40 7410 40160Email r.sommer@uke.deBackground: The questionnaire for the quality of life with chronic wounds (Wound-QoL) is a valid and reliable instrument to determine the disease-specific health-related QoL of patients with chronic wounds. For the interpretation of HRQoL scores, it is additionally important to know which differences in scores are considered meaningful. The minimal important difference (MID) is defined as a change in HRQoL that a patient would consider meaningful, such that the patient would judge a treatment to be beneficial and worthy of repeating.Objective: To interpret changes in the Wound-QoL scores and draw conclusions regarding the relevance of detected changes; the purpose of this study was to estimate the MID of the Wound-QoL global score and its subscales for patients with chronic wounds.Patients and Methods: Patients completed the Wound-QoL before and four to six weeks after treatment and additionally gave a global rating of wound status change after treatment. The global rating of change served as an anchor question. MIDs were calculated based on an anchor-based and a distribution-based method.Results: In total, 227 patients participated in the study. The mean age of the study population was 66.9 (± 12.7) median was 69.5, and 51.5% of the patients were female. MIDs for the Wound-QoL global score ranged from 0.47 to 0.52, proposing an overall estimation of 0.50.Conclusion: The results can be used to measure and interpret changes in wound-specific QoL over time.Keywords: MID, minimal important difference, health-related quality of life, chronic wounds

Abstract Background Urolithiasis is increasingly diagnosed worldwide. Stone analysis is an important part in the assessment of patients with urolithiasis. However, in sub-Saharan Africa, data on the composition of urinary stones are limited. This study aimed to describe the composition and sites of urinary stones and to investigate relationship between socio-demographic characteristics, clinical profile of patients, and the composition of urinary stones. Methods A retrospective analysis of 132 patients with urolithiasis who visited one of the seven hospitals in the Democratic Republic of Congo during eight years of study period (January 2010 to January 2018) was conducted. Stones were analyzed by infrared spectrophotometry. Results Most of stones analyzed (n = 82, 62.1%) originated from the upper urinary tract with a difference across gender (58.5% males vs. 41.5% females, p = 0.001). Only three stones (two from whewellite and one from anhydrous uric acid) were considered pure (2.3%), excluding the protein frame (less than 5%). Whewellite, proteins, and carbapatite were identified in 97.7%, 96.2%, and 80.3% of the stones analyzed, respectively; and in 91.7%, 89.4%, and 67.7% of the nuclei of the stones analyzed, respectively. Taking into account the proportion of each constituent in the stones analyzed, whewellite (68.9%), anhydrous uric acid (10.6%), and carbapatite (8.3%) were the main constituents in respectively 68, 9%, 10.6%, and 8.3% of the stones analyzed. Conclusion Whewellite, anhydrous uric acid, and carbapatite represented the most frequent main components of stones identified, suggesting that dietary hyperoxaluria could be an important factor in lithogenesis in the Democratic Republic of Congo.

Kristina Hagenström,1 Kristin Sauer,1 Nicole Mohr,1 Marleen Dettmann,1 Gerd Glaeske,2 Jana Petersen,1 Claudia Garbe,1 Tim Steimle,3 Matthias Augustin1 1German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany; 2Research Center on Inequality and Social Policy, University of Bremen, Bremen, Germany; 3Techniker Krankenkasse, Hamburg, GermanyCorrespondence: Kristina HagenströmGerman Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, Hamburg, 20246, GermanyTel +49 (0) 40 7410 554 28Fax +49 (0) 40 7410 553 48Email k.hagenstroem@uke.deBackground: Information on the prevalence of atopic dermatitis (AD) varies greatly, and so far, only a few studies describe the healthcare of patients with AD in Germany.Objective: The aim of the study is to describe the prevalence and medications of people with AD in Germany.Methods: Health insurance data for the year 2019 were examined. Prevalence rates, the severity of disease, comorbidities and pharmaceutical supply were analyzed. Insured persons with AD were identified with at least one outpatient or inpatient International Classification Code of Diseases (L20).Results: In 2019, 4.21% [95% CI 4.21− 4.22%] of insured persons had AD (3.6 million). Women were affected slightly more frequently than men (4.74% [95% CI 4.73− 4.74%] and 3.64% [95% CI 3.64− 3.65%]). Adolescents and children under the age of 15 had the highest prevalence of AD compared to other age groups (9.44% [95% CI 9.42− 9.46%]). Majority of the insured persons with AD were affected by a mild to moderate form of the disease. The most common co-morbidity was infections of the skin (RR 5.00 [95% CI 4.97− 5.02%]). Some patients were treated by a dermatologist, while others by a general practitioner, 39.10% and 36.74%, respectively. Of the anti-inflammatory drugs, systemic glucocorticosteroids preparations were used most frequently and were most frequently prescribed by the general practitioner. With a total of 42,841 prescriptions (1.53%), methotrexate (third-line treatment option) was prescribed more frequently than ciclosporin with 19,628 prescriptions (0.70%) or azathioprine with 25,696 prescriptions (0.92%). Ciclosporin (first-line treatment option) was prescribed much more frequently by a dermatologist (44.00% versus 14.32% by general practitioner). The biological dupilumab was prescribed 30,801 times (1,10%) and was also primarily prescribed by a dermatologist (66.67%).Conclusion: The present results reveal that a specialist treats approximately one-third of the patients with AD and that there is still a drug undersupply in some cases, especially concerning innovative drugs.Keywords: epidemiology, frequency of illness, pharmaceutical supply, neurodermatitis, statutory health insurance

Marina Otten, Matthias Augustin German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, GermanyCorrespondence: Marina OttenGerman Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, Hamburg, 20246, GermanyTel +49 40 7410 55428Fax +49 40 7410 55348Email m.otten@uke.deBackground and Objectives: This article presents patients’ attitudes about documenting patient data and outcome measures in psoriasis clinical practice to support a Delphi approach of psoriasis experts to develop a standard data set.Patients and Methods: We conducted three focus groups with 14 patients in a German outpatient unit for psoriasis. The focus was to explore reasons for and against the documentation of single variables concerning personal, anamnesis, clinical, patient-reported outcomes, and other data.Results: The patients mainly discussed if a variable has an impact on the disease or treatment decision, or if there might be a practical value from experiences with treatments when documented. In addition, in their point of view, patient-reported outcome data are important to document as it enables physicians to learn about a patient’s subjective burden of disease. Patient education and the involvement of other physicians in the treatment process also emerged as relevant aspects.Conclusion: The results help to understand patients’ preferences on documenting patient data and their idea of an exhaustive doctor–patient consultation to improve doctor–patient communication, disease monitoring, and quality of care.Keywords: psoriasis, patient involvement, focus groups, documentation, patient data

4-Aminodiphenylamino derivatives were investigated for their antioxidant and hydrophobicity character, together with other biological measurements, such as antimicrobial and antibiofilm activity. Among these nine compounds used, we obtained novel derivatives via reaction of the starting material with NBD-chloride. Therefore, we performed a full structural analysis for these compounds, i.e., elemental analysis, IR, UV-Vis, 1H- and 13C-NMR, ESI-MS, X-ray diffraction on single crystal, etc. The hydrophobicity of all the compounds was measured either experimentally using the RP-TLC technique, or via calculation using the fragments method. The other structural characteristics were analyzed, and a correlation between the experimental and computed properties was found. Moreover, the results of the biological evaluation showed that some of the synthesized compounds have antimicrobial and antibiofilm activity.

The contamination of freshwater resource by heavy metals is still a major environmental and human health concern globally. The release of these contaminants into the aquatic environment can lead to the pollution of water resources and generate risks for aquatic living organisms and human health. The sediments can act as reservoir for heavy metals, thereby they are used to assess the pollution status of the rivers. In the present investigation, surface sediments collected from two urban rivers named, N’djili and Lukaya draining through the city of Kinshasa, Democratic Republic of the Congo were characterized for grain size, organic matter (OM) and heavy metals. Additionally, Sediment Quality Guidelines for the protection of aquatic life (SQGs), enrichment factor (EF) and geoaccumulation index (Igeo) were performed to determine the river pollution status. The results highlight high concentrations of heavy metals in sediment samples mainly from N’djili River, reaching the values (mg kg−1) of 180.3 (Cu), 451.5 (Zn), 185.8 (Pb) and 4.1 (Hg). These values exceed the SQGs. Based on EF and Igeo values, the sediments from the two rivers have severe enrichment and polluted with Cu, Zn and Pb, and moderate enrichment of Cr and As. In general, the positive correlation was observed between some heavy metals and OM suggesting that these contaminants could have originated from common sources with a similar transport pathway. Based on the SQGs, EF and Igeo, N’djili River is considered as highly polluted with heavy metals indicating environmental and human health potential risks. The results of this study clearly indicate that the pollution of urban rivers in developing countries can be explained by several anthropogenic activities such as urban runoff, uncontrolled landfills in riverbanks, untreated wastewater from densely populated areas, anarchic commercial and industrial settlements, and heavy road traffic. The approaches used in this study represent a useful tool to assess the river sediment quality of urban river which can be applied to similar environment.

A heteroleptic homotrinuclear complex, [Zn3(valhydr)2(RhB)2(EtOH)2](ClO4)2 (H2valhydr = 1,2-bis(2-hydroxy-3-methoxybenzylidene)hydrazine, RhB = rhodamine B), was synthesized and structurally characterized by X-ray diffraction on single crystal. In the centrosymmetric complex, the zinc ions are positioned in a linear manner. The external zinc ions are pentacoordinated with a distorted square pyramidal stereochemistry, while the central zinc ion presents an elongated octahedral geometry. Luminescent properties of the complex were investigated in solid state and solution.

Mandy Gutknecht,1 Marthe-Lisa Schaarschmidt,1,2 Marion Danner,3 Christine Blome,1 Matthias Augustin1 1German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany; 2Department of Dermatology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany; 3Institute for Health Economics and Clinical Epidemiology (IGKE), University Hospital of Cologne, Cologne, Germany Background: Psoriasis affects different aspects of health-related quality of life (eg, physical, psychological, and social impairments); these health domains can be of different importance for patients. The importance of domains can be measured with the Patient Benefit Index (PBI). This questionnaire weights the achievement of treatment goals by Likert scales (0, “not important at all” to 4, “very important”) using the Patient Needs Questionnaire (PNQ). Treatment goals assessed with the PBI have been assigned to five health domains; the importance of each domain can be calculated as the average importance of the respective treatment goals. In this study, the PBI approach of deriving importance weights is contrasted to a discrete choice experiment (DCE), in order to determine the importance of health domains in psoriasis, and to find if the resulting weights will differ when derived from these two methods.Methods: Adult patients with psoriasis completed both questionnaires (PNQ, DCE). The PBI domains were used as attributes in the DCE with the levels “did not help at all”, “helped moderately”, and “helped a lot”.Results: Using DCE, “improving physical functioning” was the most important health domain, followed by “improving psychological well-being”. Using PNQ, these domains were ranked in position two and three following “strengthening confidence in the therapy and in a possible healing”. The latter was least important using DCE. The only agreement of ranking was shown in “reducing impairments due to therapy” (position four). “Improving social functioning” was ranked in position three (DCE) and five (PNQ).Conclusion: Health domains have different importance to patients with psoriasis. Using PNQ or DCE to determine the importance of domains results in markedly different rankings; both approaches can thus not be considered equivalent. However, in this study, importance was assessed at the domain level in DCE and at the single item level in PNQ, which may have added to the differences. Keywords: conjoint analysis, Patient Benefit Index, patient-reported outcomes, preferences

Spontaneous atmospheric CO2 capture as carbonate anion occurred in the synthesis of a trinuclear Cd(II) complex with tris(2-aminoethyl)amine ligand. In reaction two types of compounds were obtained and structurally characterized by X-ray diffraction on a single crystal: initially [{Cd(tren)}3(tren)](ClO4)6·2H2O (1) and subsequently [{Cd(tren)}3(tren)][{Cd(tren)}3(µ3-ηCO3)](ClO4)10 (2). The carbonate anion replaces partially the bridging tren molecule and coordinates in a µ3 fashion. The luminescent properties of the compounds were investigated.

A series of nitrogen-containing organic molecules (4,4’-bipyridyl; trans-1,2-bis(4-pyridyl)ethylene; 1,2-bis(4-pyridyl)ethane; 4-aminopyridine and trans-1,4-diaminocyclohexane) was envisaged for cocrystallization experiments together with fluorescein. These compounds, containing pyridyl or/and amino nitrogen atoms, can act either as hydrogen bond acceptors for the phenol groups of fluorescein-generating cocrystals or as proton acceptors forming organic salts. Five cocrystals were obtained with the partners containing only pyridyl groups: {(H2Fl)2(bipy)} (1); {(H2Fl)2(bipy)(MeOH)2} (2); {(H2Fl)2(bpete)(EtOH)2} (3); {(H2Fl)(bpete)} (4); {(H2Fl)(bpeta)} (5). The compounds bearing amino groups deprotonate fluorescein producing salts: [(HFl)(Hampy)]∙2H2O (6); [(HFl)(Hampy)] (7); [(Fl)(H2diach)]∙3H2O (8); [(HFl)2(H2diach)]∙2H2O∙EtOH (9); and [(HFl)2(Fl)2(H2diach)3]∙4H2O (10). Optical properties of the cocrystals and salts were investigated.

Matthias Augustin,1 Lisa Goepel,2 Arnd Jacobi,2 Bjoern Bosse,3 Stefan Mueller,3 Michael Hopp3 1Department of Dermatology, University-Hospital Freiburg, Freiburg, 2Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, University of Hamburg, Hamburg, 3Mundipharma Research GmbH & Co.KG, Limburg (Lahn), Germany Abstract: Infection is common in many chronic, inflammatory skin conditions but is often difficult to treat, in part due to growing bacterial resistance to antibiotics. Liposomal polyvinylpyrrolidone (PVP)-iodine hydrogel has a unique mode of action, combining the antiseptic and anti-inflammatory actions of PVP-iodine with the drug delivery and moisturizing properties of liposomes. We investigated the utility of liposomal PVP-iodine to treat infective dermatoses. In this prospective, single-arm (uncontrolled), open-label Phase II pilot study, patients with acne vulgaris (n=30), atopic dermatitis (n=20), impetigo contagiosa (n=10), and rosacea (n=10) received PVP-iodine (3%) hydrogel for ≤4 weeks. Global Clinical Severity score improved for all dermatoses (range: 0.5 for acne vulgaris [p

Three new 1D cyanido-bridged 3d-4f coordination polymers, {[Gd(L)(H2O)2Fe(CN)6]·H2O}n (1GdFe), {[Dy(L)(H2O)2Fe(CN)6]·3H2O}n (2DyFe), and {[Dy(L)(H2O)2Co(CN)6]·H2O}n (3DyCo), were assembled following the building-block approach (L = pentadentate bis-semicarbazone ligand resulting from the condensation reaction between 2,6-diacetyl-pyridine and semicarbazide). The crystal structures consist of crenel-like LnIII-MIII alternate chains, with the LnIII ions connected by the hexacyanido metalloligands through two cis cyanido groups. The magnetic properties of the three complexes have been investigated. Field-induced slow relaxation of the magnetization was observed for compounds 2DyFe and 3DyCo. Compound 3DyCo is a new example of chain of Single Ion Magnets.

4′-Azulenyl-substituted terpyridines were efficiently synthesized following the Kröhnke methodology via azulenylchalcone intermediates. These azulenyl-containing terpyridines showed fluorescent emission with a fluorescence quantum yield varying from 0.14, in the case of parent terpyridine, to 0.64 when methyl groups are grafted on the azulenyl seven-membered ring. According to the crystal structures and TDDFT calculations, different twisting of the aromatic constituents is responsible for the observed fluorescent behavior. The electrochemical profile contains one-electron oxidation/reduction steps, which can only be explained on the basis of the redox behavior of the azulene unit. The ability of the 4′-azulenyl 2,2′:6′,2″-terpyridine to bind poisoning metal cations was studied by UV–vis titrations using aqueous solutions of Hg(II) and Cd(II) chlorides as illustrative examples.

Potency assays are critical for regenerative medicine, addressing the known challenge of functional heterogeneity among human multipotent stromal cells (hMSC). Necessary laboratory cell expansion allows analysis before implantation in the patient. Levels of induction of five signature gene biomarkers, ALPL, COL1A2, DCN, ELN and RUNX2, constituted a previously reported proof-of-principle osteogenic potency assay. We tested assay modification to enhance reproducibility using six consistent bone marrow derived hBM-MSC and explored applicability to three adipose tissue derived hAT-MSC. Using a potent proprietary osteogenic induction factor, the GUSB/YWAHZ reference gene pair provided real time PCR consistency. The novel assay conditions supported the concept that genes encoding extracellular matrix proteins one week after osteogenic induction were informative. Nonetheless, relatively low induction of COL1A2 and ELN encouraged search for additional biomarkers. TGFB2 mRNA induction, important for osteogenic commitment, was readily quantifiable in both hBM-MSC and hAT-MSC. Combined with DCN, TGFB2 mRNA induction data provided discriminatory power for resolving donor-specific heterogeneity. Histomorphometric decorin and TGF-β2 protein expression patterns in eight-week heterotopic bone implants also discriminated the two non-bone-forming hMSC. We highlight progress towards prompt osteogenic potency assays, needed by current clinical trials to accelerate improved intervention with enhanced stem cell therapy for serious bone fractures.

Starting from dansyl-chloride, in reaction with 1,1-diphenylhydrazine and methoxyamine, two new fluorescent derivatives 1 and 2 were obtained and characterized by NMR, IR, UV-Vis, HR-MS, and fluorescence spectroscopy. The single-crystal X-ray structure was obtained for compound 2. Both compounds generate free radicals by oxidation, as demonstrated by ESR spectroscopy. Compound 1 generates the corresponding hydrazyl-persistent free radical, evidenced directly by ESR spectroscopy, while compound 2 generates in the first instance the methoxyaminyl short-lived free radical, which decomposes rapidly with the formation of the methoxy radical, evidenced by the ESR spin-trapping technique. By oxidation of compounds 1 and 2, their fluorescence is quenched.

Green tea extracts (GTEs) as well as their main component, the polyphenol epigallocatechin gallate (EGCG), are known for their versatile antioxidant, antimicrobial, antitumoral or anti-inflammatory effects. In spite of the huge beneficial action, there is increasing evidence that under certain conditions green tea and its components can be detrimental to living organisms. Using Saccharomyces cerevisiae strains with various defects in the response to oxidative stress, we found that GTEs or EGCG act in synergy with visible light, exhibiting either deleterious or protective effects depending on the solvent employed. Similar synergistic effects could be observed under singlet oxygen-generating conditions, such as light exposure in the presence of photosensitizers or UV-A irradiation, therefore solvent variance may represent a powerful tool to modulate the preparation of green tea extracts, depending on the intended target.

BackgroundCertolizumab pegol (CZP) is an Fc-free, PEGylated anti-tumor necrosis factor biologic.ObjectivesTo report 3-year outcomes from the CIMPACT (NCT02346240) phase 3, CZP in moderate to severe plaque psoriasis, randomized controlled trial.MethodsAdults were randomized 3:3:3:1 to CZP 200 mg every other week (Q2W), CZP 400 mg Q2W, etanercept biweekly or placebo. At Week 16, CZP- and etanercept-treated PASI 75 responders were re-randomized to CZP 200 mg Q2W, CZP 400 mg Q4W, CZP 400 mg Q2W or placebo for maintenance treatment; PASI 75 non-responders entered an open-label escape CZP 400 mg Q2W arm. Patients entering the open-label extension (OLE; Weeks 48-144) from blinded treatment received CZP 200 mg Q2W.ResultsDouble-blinded results have been reported previously. 261 patients received 200 mg Q2W upon OLE entry. PASI 75 response was maintained in patients continuing 200 mg Q2W treatment through Weeks 16-144 (Week 144: 96.2%). In patients dosed down at Week 48 (double-blinded 400 mg to 200 mg Q2W), PASI 75 decreased (Week 48: 98.7%; Week 144: 85.9%). In patients who received placebo through Weeks 16-48, PASI 75 response decreased (Week 48: 60.4%), then increased following Week 48 switch to 200 mg Q2W (Week 144: 95.1%). 48 and 36 patients initially randomized to 200 and 400 mg Q2W, respectively, were Week 16 PASI 75 non-responders and entered the escape arm; at Week 144, 71.8% and 78.2% achieved PASI 75. No new safety signals were identified.ConclusionsResponse to CZP was durable over three years; no new safety signals were identified.

The study published in the Journal of the European Academy of Dermatology & Venereology explores the association between comorbidities, itch intensity, and quality of life in patients with Chronic Nodular Prurigo (CNPG). The research involved 513 adult CNPG patients from 12 European countries and found that hypertension was significantly associated with itch intensity, while depression was significantly associated with impaired quality of life. The study suggests that conditions like diabetes, hypertension, and arthritis may impact itch perception, highlighting the need for further investigation into the pathophysiological significance of these associations. [Extracted from the article]

Background: Brodalumab, a fully human monoclonal immunoglobulin IgG2 antibody that binds the human interleukin 17 receptor subunit A, is available for the treatment of moderate‐to‐severe plaque psoriasis in Europe since September 2017, but so far there are only a few studies on its use in real‐world conditions. Objectives: To assess the management of moderate‐to‐severe psoriasis with brodalumab 210 mg in daily practice after 12 and 52 weeks (W). In addition, patient profiles and treatment pathways are described. Methods: LIBERO is a prospective, multicenter, non‐interventional study including adult patients with plaque psoriasis treated with brodalumab 210 mg. Results: In total, 638 patients (65% male, mean age: 49.3 ± 14.4 years) from 148 sites in Germany were enrolled. The majority suffered from severe (51.1%) or very severe (13.1%) psoriasis according to physician global assessment (PGA0‐5). When starting with brodalumab, 58.5% were biologic naïve and 41.5% were previously treated with another biologic, mainly adalimumab (18.5%) and secukinumab (17.9%). About 74.0% of patients met the primary endpoint of an absolute PASI ≤3 at ~W12 (n = 618, LOCF). The mean PASI was reduced significantly as of ~W2 from 17.2 (±11.7) to 9.7 (±8.8) and improved further to 3.3 (±6.3) at ~W12 (p < 0.001). At ~W52 85.5% of patients reached a PGA0/1‐response (primary endpoint) and 54.1% patients were assessed as completely clear (PGA0) (both n = 399, as observed). Effectiveness of brodalumab was confirmed in relevant subgroup analysis by previous treatment regimen. Most frequently reported adverse events were nasopharyngitis (4.6%), psoriasis (4.6%) and arthralgia (4.1%), new safety signals were not detected. Conclusions: This representative, non‐interventional study confirms the short‐ and long‐term effectiveness and safety profile of brodalumab in the management of psoriasis in daily practice as well as in relevant treatment pathways. [ABSTRACT FROM AUTHOR]