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Introduction: Few studies analysed the impact of COVID-19 on supported accommodations (SAs) for people with serious mental disorders. This study aimed to analyse staff's assessments of work challenges in SAs during COVID-19, the impact of the pandemic on staff, their perception of the impact on residents, and associated factors. Methods: To assess work challenges and the impact of the pandemic on staff and their perception of the impact on residents, a questionnaire was administered to the staff of SAs. Multilevel logistic regression analyses were conducted, involving work challenges and staff's sociodemographic characteristics, and impact on staff. Results: In total, 117 staff from 32 SAs responded. A challenging environment was felt by most participants (68.4%). There were significant differences in work challenges experienced by staff, namely, according to profession and years working in mental health. A negative impact of COVID-19 was reported by 26.5% of staff, which was associated with their feeling that residents were no longer getting an acceptable service (OR = 7.04, 95% CI [1.43, 34.65], p = 0.016) and with staff feeling at risk of infection at work (OR = 7.99, 95% CI [1.39, 45.86], p = 0.020). Relapse and deterioration of residents' mental health were perceived by 43.6% of staff. Conclusions: Several work challenges occurred in SAs during COVID-19, which had a negative impact on staff and reportedly on residents. Implications range from the organisational to the clinical levels and may apply internationally and in similarly challenging situations. [ABSTRACT FROM AUTHOR]

Chronic inducible urticaria (CIndU) is a condition characterized by the formation of itchy wheals and/or angioedema in response to specific triggers. It accounts for 20-30% of all cases of chronic urticaria. The triggers for CIndU can be physical or non-physical, such as mechanical friction, exposure to cold or heat, pressure, or specific agents. The diagnosis of CIndU is based on a thorough patient history and provocation testing. Treatment options include antihistamines and, in some cases, off-label use of omalizumab. Managing CIndU involves measuring and monitoring disease activity, mitigating triggers, and using medication. [Extracted from the article]

Chronic spontaneous urticaria (CSU) is a debilitating, inflammatory skin condition characterized by infiltrating immune cells. Available treatments are limited to improving the signs and symptoms. There is an unmet need to develop therapies that target disease‐driving pathways upstream of mast cell activation to inhibit or delay the progression of CSU and associated comorbidities. Here, we aim to define disease modification due to a treatment intervention and criteria that disease‐modifying treatments (DMTs) must meet in CSU. We have defined disease modification in CSU as a favorable treatment‐induced change in the underlying pathophysiology and, therefore, the disease course, which is clinically beneficial and enduring. A DMT must fulfil the following criteria: (1) prevents or delays the progression of CSU, (2) induces long‐term, therapy‐free clinical remission, which is the sustained absence of CSU signs and symptoms without the need for treatment, and (3) affects the underlying mechanism of CSU, as demonstrated by an effect on disease‐driving signals and/or a biomarker. DMTs in CSU should slow disease progression, achieve long‐lasting disease remission, target disease‐driving mechanisms, reduce mast cell‐activating IgE autoantibodies, target cytokine profile polarization, and normalize the gut microbiome and barrier. Treating CSU at the immune system level could provide valuable alternatives to pharmacotherapy in CSU management. Specific DMTs in CSU are yet to be developed, but some show potential benefits, such as inhibitors of Bruton's Tyrosine Kinase, IL‐4 and IL‐13. Future therapies could prevent CSU signs and symptoms, achieve long‐term clinical benefits after discontinuing treatment, and prevent associated concomitant disorders. [ABSTRACT FROM AUTHOR]

The occurrence of pruritus in psoriasis was previously underestimated but is a significant burden. Secukinumab (SEC), a monoclonal anti-interleukin-17A antibody, efficiently controls signs of psoriasis, but the effect on pruritus and cutaneous neuroanatomy remained unknown. The primary objective of this study (NCT02362789) was to evaluate the superiority of SEC treatment vs placebo on pruritus intensity (visual analogue scale; VAS). Furthermore, the treatment-dependent course of pruritus in association with absolute Psoriasis Area Severity Index (PASI) score, as well as cutaneous histopathology and neuroanatomy, was assessed. Open-label SEC 300 mg s.c. was administered regularly until week 16. Patients who reached a ≥ 98% PASI reduction (PASI ≥ 98) were randomized to receive either placebo or SEC up to week 32. Punch biopsies were collected from lesional psoriatic (baseline, weeks 16 and 32) and non-lesional (baseline) skin for histopathological and neuroanatomical analyses. VAS scores improved significantly after open-label SEC treatment but relapsed upon placebo (29.92 ± 33.8) compared with SEC (12.30 ± 22.6; p = 0.036). After SEC-dependent improvement in PASI, histopathology, marker expression and neuroanatomy, relapse was observed with treatment discontinuation in all parameters except neuroanatomy. SEC was superior to placebo by efficiently controlling reduced pruritus intensity, clinically normalizing skin lesions, and reversing histopathological abnormalities. The neuroanatomy recovered upon SEC and remained stable even after withdrawal. [ABSTRACT FROM AUTHOR]

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