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Primitive melanoma and covid-19: are we still paying the price of the pandemic? Here, we evaluated if the COVID-19 pandemic has had any detrimental effect on melanoma diagnoses also in the year 2021. Delayed melanoma diagnosis in the COVID-19 era: increased breslow thickness in primary melanomas seen after the COVID-19 lockdown. [Extracted from the article]

The article talks about bullous pemphigoid (BP) is a major autoimmune blistering skin disorder. It is mentioned that in BP majority of the autoantibodies (autoAbs) target the juxtamembranous extracellular NC16A domain of hemidesmosomal collagen XVII (COL17). The article discusses the connection between between BP and diabetes mellitus (DM) and how Dipeptidyl peptidase (DPP)-IV inhibitors causes BP.

We evaluated the impact of bariatric surgery on bone mineral density (BMD) and microarchitecture over one year using dual-energy X-ray absorptiometry (DXA), the trabecular bone score (TBS), and 3D-DXA to assess changes after different surgical techniques. This prospective, single-center study of 153 patients with severe obesity contrasts the effects on bone health of sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and duodenal switch/single anastomosis duodeno-ileostomy with sleeve gastrectomy (DS/SADIS). To our knowledge, this is the first study to evaluate patients undergoing DS/SADIS and to incorporate 3D-DXA analysis in the assessment of bone loss. Patients were 81 % female with a mean age of 50 ± 9 years. Fifty-four per cent underwent SG; 16 %, RYGB; and 30 %, DS/SADIS. Our findings revealed a significant decrease in areal BMD at the LS (-3.49 ± 5.44 %), FN (-5.24 ± 5.86 %), and TH (-8.06 ± 5.14 %) one year after bariatric surgery. Bone microarchitecture at the LS assessed by TBS was degraded in 30 % of patients. Proximal femur 3D-DXA analysis showed that surgery-induced bone loss predominantly affects the trabecular compartment (Trabecular volumetric (v) BMD: -8.00 ± 6.57 %) rather than the cortical compartment (Cortical vBMD: -1.37 ± 2.79 %). These results suggest hypoabsorptive and mixed techniques (DS/SADIS and RYGB) were associated with greater BMD loss and deterioration of microarchitecture than restrictive techniques (SG). The primary determinants of bone density and impairment of microarchitecture were the extent of weight loss and the type of surgical procedure. Despite overall bone loss, Z-score assessments indicated that post-surgical bone status remained within or above the average ranges compared to a healthy population, except for TH following DS/SADIS. In conclusion, our research shows differences in the impact of bariatric surgery techniques on bone density and microarchitecture, emphasizing the need for careful postoperative monitoring of bone health, particularly in patients undergoing hypoabsorptive and mixed procedures., Competing Interests: Declaration of competing interest Ludovic Humbert is an employee and shareholder of 3D-Shaper Medical. Mirella López Picazo is an employee of 3D-Shaper Medical. The remaining authors have no competing interests to disclose., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Introduction: One Anastomosis Duodenal Switch (OADS/SADI-S) is used both as a one stage and a second-step procedure, either planned or revisional after a failed sleeve gastrectomy. However, there is lack of adjusted comparative evidence validating its use., Material and Methods: Propensity-score matched comparison between patients submitted to one-stage vs. two-step OADS, adjusted by age, gender, and initial body mass index (BMI)., Results: One hundred ninety-five patients (130 one-stage and 65 two-step OADS) were included, with mean initial BMI 52.4 kg/m 2 . Overall complication rate was 6.6% in the short-term (3.3% Clavien-Dindo ≥ III), and 7.3% in the long-term, with no differences between groups. Follow-up at 1 and 3 years was 83.6% and 61.5%. After one-stage OADS, total weight loss was 36.6 ± 8.2% at 1 year and 30.4 ± 10.3% at 3 years, vs. 30.2 ± 9.4% and 25.6 ± 10.2% after two-steps OADS (p = 0.021). Resolution rates of diabetes mellitus, hypertension, dyslipidemia, and obstructive sleep apnea were 86.4%, 80.4%, 78.0%, and 73.3%, with no differences between groups., Conclusion: One-stage OADS is a safe and effective bariatric technique for patients with grade III and IV obesity. The two-step strategy does not reduce postoperative risks and may compromise weight loss results at mid-term., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Objective: To determine changes in incretins, systemic inflammation, intestinal permeability and microbiome modifications 12 months after metabolic RYGB (mRYGB) in patients with type 2 diabetes (T2D) and their relationship with metabolic improvement., Materials and Methods: Prospective single-center non-randomized controlled study, including patients with class II-III obesity and T2D undergoing mRYGB. At baseline and one year after surgery we performed body composition measurements, biochemical analysis, a meal tolerance test (MTT) and lipid test (LT) with determination of the area under the curve (AUC) for insulin, C-peptide, GLP-1, GLP-2, and fasting determinations of succinate, zonulin, IL-6 and study of gut microbiota., Results: Thirteen patients aged 52.6 ± 6.5 years, BMI 39.3 ± 1.4 kg/m 2 , HbA 1c 7.62 ± 1.5% were evaluated. After mRYGB, zonulin decreased and an increase in AUC after MTT was observed for GLP-1 (pre 9371 ± 5973 vs post 15788 ± 8021 pM, P <0.05), GLP-2 (pre 732 ± 182 vs post 1190 ± 447 ng/ml, P <0.001) and C- peptide, as well as after LT. Species belonging to Streptococaceae, Akkermansiacea, Rickenellaceae, Sutterellaceae, Enterobacteriaceae, Oscillospiraceae, Veillonellaceae, Enterobacterales&#95;uc, and Fusobacteriaceae families increased after intervention and correlated positively with AUC of GLP-1 and GLP-2, and negatively with glucose, HbA 1c , triglycerides and adiposity markers. Clostridium perfringens and Roseburia sp. 40&#95;7 behaved similarly. In contrast, some species belonging to Lachnospiraceae, Erysipelotricaceae, and Rumnicocaceae families decreased and showed opposite correlations. Higher initial C-peptide was the only predictor for T2D remission, which was achieved in 69% of patients., Conclusions: Patients with obesity and T2D submitted to mRYGB show an enhanced incretin response, a reduced gut permeability and a metabolic improvement, associated with a specific microbiota signature., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Hernández-Montoliu, Rodríguez-Peña, Puig, Astiarraga, Guerrero-Pérez, Virgili, López-Urdiales, Osorio, Monseny, Lazzara, Sobrino, Pérez-Maraver, Pérez-Prieto, Pellitero, Fernández-Veledo, Vendrell and Vilarrasa.)

Introduction: Single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) is a safe and effective technique with good short- and mid-term weight control and associated medical problems remission for patients with a body mass index (BMI) > 45 kg/m 2 . The aim of this study was to analyze patient-reported symptoms, specifically symptomatic gastroesophageal reflux disease symptoms (GERD), depositional habit, and quality of life (QOL) following SADI-S, using telemedicine and validated tests., Methods: A prospective unicentric cross-sectional study was conducted including all patients submitted to SADI-S in the University Hospital of Bellvitge from May 2014 to September 2019. A baseline control group was composed of 67 patients who were planning to undergo SADI-S in the following 4 months. Patients were divided into four groups: pre-SADIS, < 2 years, 2-3 years, and > 3 years after surgery. The information gathered via a telematic questionnaire was analyzed and compared with its presence in patients' clinical history derived from the last presential visit., Results: The response rate to telematic tests was 86.9%. The mean BMI exhibited significant differences depending on the moment of evaluation: 50.8 kg/m 2 , 30.0 kg/m 2 , 31.1 kg/m 2 , and 32.7 kg/m 2 at pre-SADIS, < 2, 2-3, and > 3 years follow-up, respectively (p < 0.001). The proportion of GERD symptoms increased over time (17.9%, 18.8%, 26.9%, and 30.2%, p = 0.320). After SADIS, the percentage of patients with loose stools was progressively higher (17.4% vs 25.4% vs 30.2%, p = 0.04). Patients with < 2-year follow-up presented an improvement in both physical component (PCS) and mental component (MCS) summaries compared to the baseline group (PCS = 51.3, and MCS = 49.4). The mean BMI of patients with PCS ≥ 50 was 31.9 kg/m 2 , compared with 41.7 kg/m 2 in the PCS < 50 group (p < 0.001). In the MCS ≥ 50 group, there were more patients with a BMI < 35 kg/m 2 than the MCS < 50 group (66.7% vs 48.7%, p = 0.004). Telematic follow-up offered a more systemic and detailed information: in the last presential visit only, 13.9% of patients had complete data regarding weight evolution, remission of associated medical problems, GERD symptoms, and depositional habit in comparison with the 82.9% of patients with telematic follow-up (p < 0.001)., Conclusion: Weight control is the main factor related to long-term QOL after SADI-S. The incidence of GERD symptoms and diarrhea was up to 30% in patients with > 3-year follow-up. Monitoring postoperative patient-related symptoms with validated objective tests seems a feasible and useful resource for the long-term follow-up of patients submitted to SADI-S., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Purpose: The aims were to compare the 5-year outcomes of duodenal switch (DS) and single-anastomosis duodenal switch (SADI-S) in terms of weight loss; remission of comorbidities; nutritional status short- and long-term complications; postoperative mortality; and need for revisional surgery., Materials and Methods: Multicenter prospective observational study of all consecutive patients undergoing DS or SADI-S in three high-volume hospitals., Results: A total of 87 patients were included in the study, 43 submitted to DS and 44 to SADI-S, with similar basal characteristics, nutritional parameters, and BMI (52.9 kg/m 2 DS vs. 52.5 kg/m 2 SADI-S). Operative time was 152 min (± 32.6) in DS vs. 116 min (± 21.9) in SADI-S (p = 0.043). Short-term complications were similar for DS and SADI-S, both overall (11.8% vs. 11.6%), and ranged as Clavien-Dindo > II (4.5% vs. 4.7%), with no mortality. At 5 years, DS and SADI-S results were as follows: BMI 30.6 vs. 33.3 kg/m 2 (p = 0.023); %EWL 80.5% vs. 68.6% (p = 0.006); and %TWL 42.1 vs. 36.0 (p = 0.006). Comorbidity remission rates for DS and SADI-S were as follows: for diabetes, 92.8% vs. 85.7% (n.s.); for hypertension, 95.2% vs. 85.1% (n.s.); for sleep apnea, 75% vs. 73.3% (n.s.); and for dyslipidemia, 76.4% vs. 73.3% (n.s.). DS showed lower levels of vitamin B 12 , iron, vitamin E, and zinc than SADI-S (p =  < 0.005). In the long term, there were 4 surgical reinterventions (due to 1 internal hernia in the DS group and 1 internal hernia and 2 biliary refluxes in the SADI-S group) with no cases of persistent diarrhea or malnutrition., Conclusion: Both DS and SADI-S allowed good weight control and resolution of comorbidities. DS achieved a greater weight loss compared to SADI-S, at the expense of longer operative time and lower vitamin and mineral levels., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Purpose: Describe and analyze the safety and weight loss performance of biliopancreatic diversion and duodenal switch (BPD-DS) and single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S), verifying any possible superiority according to preoperative BMI., Methods: Retrospective review of patients who underwent primary SADI-S or BPD-DS in three bariatric centers. Study groups were further stratified according to preoperative BMI (subgroup 1: BMI < 50; subgroup 2: 50 ≤ BMI < 55; subgroup 3: BMI ≥ 55)., Results: Four hundred and sixty patients underwent BPD-DS (n = 220) or SADI-S (n = 240). The mean LOS was 3.48 ± 3.7 and 3.13 ± 2.3 days for BPD-DS and SADI-S respectively (p = 0.235). The mean operative time was shorter in the SADI-S group (167.25 ± 33.6 vs 140.85 ± 56.7 min) (p < 0.00). The mean %EWL was 44.2, 62.4, and 69.4 for the BPD-DS group and 48.4, 64.5, and 67.1 for the SADI-S group at 6, 12, and 24 months respectively. The mean %TBWL was 25, 35.9, and 40.3 for the BPD-DS group, and 26.2, 35, and 36.9 for the SADI-S group at 6, 12, and 24 months respectively. Overall complication rates were comparable between BPD-DS and SADI-S groups (14% vs 18%) (p = 0.219). SADI-S showed greater emergency department visits (17% vs 7%) (p = 0.005); similar readmission rates (6% vs 7%) (p = 0.80); similar reoperation rates (3% vs 7%) (p = 0.102); and similar mortality rate (0.9% vs 0.4%), after BPD-DS and SADI-S respectively., Conclusion: BPD-DS achieved greater %TBWL at 2 years, but no superiority was perceived among study subgroups. SADI-S and BPD-DS showed similar overall complication rates., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Sleeve gastrectomy (SG) is the most performed bariatric surgery worldwide but approximately 50% of patients will present insufficient weight loss or weight regain after surgery. In 2004, Santoro et al. described an alternative revisional technique other than DS and RYGBP called intestinal bipartition (IB). It involves a pre-pyloric gastro-ileal and an ileo-ileal anastomosis without exclusion of intestinal segments. Duodenal dissection is not necessary, making it an easier and more reproducible technical alternative to DS. its preliminary reports show good weight control with resolution of obesity related comorbidities. We present our technical suggestions to perform a safe IB in a patient with a failed SG in whom revisional DS or RYGBP were not feasible due to a vascular anomaly., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Introduction: Duodenal switch (DS) is considered one of the most effective techniques to achieve weight loss and reduce comorbidities in patients with morbidly obesity., Material and Methods: Descriptive single-center study. 224 patients were analyzed who underwent direct laparoscopic DS in our center. The objective was to describe the results of weight, resolution of comorbidities, nutritional supplementation and postoperative complications at 2, 5 and 10 years., Results: The mean age of the cohort was 49.3 [23-65] years and the mean weight and BMI were 131.8 [20] kg and 49.8 [5] kg/m 2 . The excess weight lost percentage at 2, 5 and 10 years was 80.6[15]%, 69.3[18]%, 67.4[18]%, respectively. Complete remission of diabetes was evidenced at 2 and 5 years in 35 (85.4%) and 27 (70.4%) patients. In the immediate postoperative period, the complication rate for Clavien-Dindo ≥ III was 15 patients (6.7%) and mortality at 30 and 90 days was 1 (0.4%) and 2 (0.9%) patients. Revisional surgery was performed in 2 patients (0.9%). 80% of the patients required an extra nutritional supplement up to 10 years after surgery., Conclusions: Direct DS is a safe and effective technique in patients with a BMI between 45 and 55 kg/m 2 . Weight loss is maintained with a low rate of revision surgery. It is a metabolically effective technique that entails the need for a close postoperative follow-up to assess nutritional supplementation., (Copyright © 2021 AEC. Published by Elsevier España, S.L.U. All rights reserved.)

Introduction: The "Single Anastomosis Duodeno-Ileal bypass with Sleeve gastrectomy" (SADI-S) is a bariatric surgery conceived to simplify the duodenal switch in order to reduce its postoperative complications. The objective of this study is to assess the safety and efficacy of SADI-S, comparing its results in both direct and two-step procedure., Methods: Unicentric cohort study that includes patients submitted to SADI-S, both direct or in two-step, between 2014 and 2019., Results: Two hundred thirty-two patients were included, 192 were submitted to direct SADI-S and 40 had previously undergone a sleeve gastrectomy. The severe complications rate (Clavien-Dindo ≥ IIIA) was 7.8%, being hemoperitoneum and duodenal stump leak the most frequent ones. One patient was exitus between the first 90 days after surgery (0.4%). Patients submitted to direct SADI-S had an initial body mass index (BMI) of 49.6 kg/m 2 in comparison of 56.2 kg/m 2 in the two-step SADI-S (P < .001). The mean excess weight loss (EWL) at two years was higher in direct SADI-S (77.3 vs. 59.3%, P < .05). Rate of comorbidities resolution was 88.5% for diabetes, 73.0% for hypertension, 77.0% for dyslipidemia and 85.7% for sleep apnea, with no differences between both techniques., Conclusion: In medium term, SADI-S is a safe and effective technique that offers a satisfactory weight loss and remission of comorbidities. Patients submitted to two-step SADI-S had a higher initial BMI and presented a lower EWL than direct SADI-S., (Copyright © 2020 AEC. Published by Elsevier España, S.L.U. All rights reserved.)

Background: Patients with a history of non-melanoma skin cancer (NMSC) are at increased risk for other primary cancers, in particular for cutaneous melanoma. However, rarely such studies are able to identify age-specific risks due to the lack of statistical power. The aim of this study was to compare the risk of melanoma development within age groups in a large cohort of NMSC patients and in a control group of non-dermatological patients., Methods: A retrospective linkage analysis was performed between records of hospitalizations and the occurrence of melanoma was compared within 10-year age group by computing the relative risk (RR) and modeled using multiple logistic regression., Results: The linkage procedures identified 30,929 individuals with NMSC and 25,956 control patients. Overall, NMSC patients had RR for melanoma of 6.2 compared to controls. Patients with NMSC and less than 40 years of age have a RR of melanoma of 25.1 compared to controls. Our study is a retrospective analysis, and our ICD-9 codes do not distinguish between basal cell carcinoma and squamous cell carcinoma, nor between subtypes of melanoma., Conclusions: Our large study suggests that prevention of melanoma in NMSC patients is mandatory, especially for patients which develop a NMSC under 40 years of age.

Introduction: Duodenal switch (DS) is considered one of the most effective techniques to achieve weight loss and reduce comorbidities in patients with morbidly obesity., Material and Methods: Descriptive single-center study. 224 patients were analyzed who underwent direct laparoscopic DS in our center. The objective was to describe the results of weight, resolution of comorbidities, nutritional supplementation and postoperative complications at 2, 5 and 10 years., Results: The mean age of the cohort was 49.3 [23-65] years and the mean weight and BMI were 131.8 [20]kg and 49.8 [5]kg/m 2 . The excess weight lost percentage at 2, 5 and 10 years was 80.6[15]%, 69.3[18]%, 67.4[18]%, respectively. Complete remission of diabetes was evidenced at 2 and 5 years in 35 (85.4%) and 27 (70.4%) patients. In the immediate postoperative period, the complication rate for Clavien-Dindo ≥ III was 15 patients (6.7%) and mortality at 30 and 90 days was 1 (0.4%) and 2 (0.9%) patients. Revisional surgery was performed in 2 patients (0.9%). 80% of the patients required an extra nutritional supplement up to 10 years after surgery., Conclusions: Direct DS is a safe and effective technique in patients with a BMI between 45 and 55 kg/m 2 . Weight loss is maintained with a low rate of revision surgery. It is a metabolically effective technique that entails the need for a close postoperative follow-up to assess nutritional supplementation., (Copyright © 2021 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.)

Background: Anastomotic leak (AL) after ileocolic anastomosis influences morbidity, mortality, length of hospitalization and costs. This study analyzes risk and protective factors for AL on ileocolic anastomoses., Methods: We retrospectively analyzed our single institution patients' series undergoing elective ileocolic anastomosis for AL between 1/2008-12/2017. AL grade A/B (antibiotic treatment and/or radiological drainage) were summarized as mild, grade C (surgical re-intervention) corresponds to severe AL., Results: We included 470 patients (mean age 70.8 years, 43.2% females). Overall AL rate was 9.4% (44 patients) with 6.0% severe and 3.4% mild AL. There was no difference in AL between hand sewn and stapled anastomoses. Multivariate analysis revealed preoperative serum albumin (p = 0.004), smoking habits (p = 0.005) and perioperative blood transfusion (p = 0.038) as risk factors for AL. Suture oversewing as anastomotic reinforcement resulted as independent protective factor (p < 0.001)., Conclusion: Poor nutritional status, smoking habits and perioperative blood transfusion are negative factors influencing on AL. Suture oversewing as anastomotic reinforcement associates with significantly less AL., Competing Interests: Declaration of competing interest All authors disclose no conflicts., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Background: The psychosocial impact of skin conditions is usually evaluated in research settings., Objectives: To define predictors that can be used by dermatologists to refer patients for psychological consultation or psychotherapy using a simple screening instrument., Materials & Methods: A questionnaire to evaluate possible anxiety and depression (12-item General Health Questionnaire [GHQ-12]) was routinely used over a period of two months in an Italian dermatological reference centre., Results: Of 651 patients, 508 (78%) completed the GHQ-12. Of the total sample, 35.2% scored 4 or more (psychological consultation suggested), and 15.7% scored 7 or more (psychological consultation recommended). Probable depression or anxiety was more frequent in women than in men, in patients born in foreign countries, and in patients with leg ulcers, pemphigoid, and psoriasis., Conclusion: Our results indicate that a simple instrument may be useful for dermatologists to detect patients at risk of psychological problems and subsequently refer them for psychological consultation.

Chronic inflammatory conditions, such as psoriasis, may pose an increased risk of cancer due to impaired immunosurveillance resulting from chronic inflammation and immunosuppressive medications. To compare the risk of non-melanoma skin cancer (NMSC) in a retrospective cohort of 72,739 psoriasis patients and 25,956 non-dermatological patients. A record linkage was performed for data on hospitalizations, and the occurrence of NMSC was compared by computing the relative risk (RR) and modelled using multiple logistic regression. Overall, the occurrence of NMSC was 9.6‰ (95% CI: 8.9-10.3‰) in psoriasis patients and 19.6‰ (95% CI: 18.0-21.4‰) in non-dermatological patients (RR = 0.49; 95% CI: 0.44-0.55). The simultaneous adjustment for gender, age, and phototherapy yielded a RR of 0.84 (95% CI: 0.75-0.95). With regards to phototherapy, the occurrence of NMSC was significantly higher among psoriasis patients who underwent phototherapy relative to those who did not (27.0‰ vs. 9.3‰). In this large retrospective study, we found that patients with psoriasis had a 16% lower probability of having NMSC when compared to a group of non-dermatological patients. Further studies, preferably with a prospective longitudinal design to collect more precise data, are needed to corroborate our findings.

Background: Chronic inflammatory conditions such as psoriasis may pose an increased risk of cancer due to impaired immunosurveillance resulting from the chronic inflammation and immunosuppressive medications. However, the relationship between psoriasis and the risk of melanoma is still controversial., Objective: To compare the occurrence of melanoma in a cohort of 72,739 psoriasis patients and in 25,956 non-dermatological patients., Methods: A record-linkage was performed between records of hospitalizations and access to day-hospital and day-surgery clinics and outpatient clinics. The frequency of melanoma was compared between psoriasis patients and vascular surgery patients. Occurrence of melanoma was compared by computing the relative risk (RR) and modelled using multiple logistic regression., Results: Overall, occurrence of melanoma was 1.8% (95% CI 1.5-2.2%) in psoriasis patients and 4.5% (95% CI 3.8-5.4%) in non-dermatological patients (RR = 0.40, 95% CI 0.31-0.51). The simultaneous adjustment for gender, age, and phototherapy yielded a RRadj = 0.54(95% CI 0.41-0.70. For patients who underwent phototherapy, vs. those who did not, the RRadj was 1.50 (95% CI 0.56-4.15)., Conclusions: In this large retrospective study, patients with psoriasis had a significantly lower probability of having melanoma when compared to a group of non-dermatological patients. Further studies, preferably with a concurrent longitudinal design to estimate incidence with more complete information, are needed to corroborate our findings.

Background: Genetic findings suggesting a lower susceptibility to melanoma in patients with vitiligo are supported by recent clinical studies. Nonmelanoma skin cancer (NMSC) has also been studied, but mainly in small samples, and with conflicting results., Objective: We sought to study the relative risk (RR) of melanoma and NMSC in patients with vitiligo compared with that in patients seen for vascular surgery., Methods: The frequency of melanoma and NMSC was compared between patients with vitiligo and patients seen for vascular surgery. Occurrence of skin cancer was compared by computing RR and modeled using multiple logistic regression., Results: Overall, the crude RR for melanoma was 0.24 (95% confidence interval [CI] 0.13-0.45) in patients with vitiligo compared with those with a nondermatologic condition (occurrence 1.1‰, 95% CI 0.5‰-2.0‰ in patients with vitiligo and occurrence 4.5‰, 95% CI 3.8‰-5.4‰ in the control cohort). The crude RR for NMSC was 0.19 (95% CI 0.14-0.17) and the occurrence was 3.8‰ (95% CI 2.7‰-5.2‰) among patients with vitiligo and 19.6‰ (95% CI 18.0‰-21.4‰) in control subjects. Patients with vitiligo who underwent phototherapy had a markedly higher risk of both cancers., Conclusions: In our large study, patients with vitiligo have a decreased risk of developing skin neoplasms, even considering that a larger proportion in this patient group is exposed to higher levels of ultraviolet radiation., (Copyright © 2014 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)

Previous epidemiological studies have observed that adherence to Mediterranean Diet is associated with reduced cardiovascular risk, but also evident in literature are the changes in the dietary habits of the Mediterranean countries which show a departure from Mediterranean patterns. The objective of this work was to estimate the variations of the diet of Galician university students (Ourense Campus), between 2011 and 2013, in relation to the pattern of the cardioprotective Mediterranean diet. A total of 726 university students participated (344 at 2011 and 382 at 2013). A short questionnaire of adherence to a cardioprotective Mediterranean diet was used and the height and weight of each participant was recorded and BMI (Body Mass Index) was calculated. The majority of participants were normal weight. In 2013 there was an increase in low weight and obesity in women and a decrease in the prevalence of normal and overweight. In men an increase of a low weight and normal weight was observed and a decrease in the prevalence of overweight/obesity in men. In the two years studied, it was observed that there is low to intermediate adherence of students to the cardioprotective Mediterranean diet, with less adherence observed in 2013 to the Mediterranean diet, for both sexes. The dietary habits observed in 2013 have shown that the population is distancing its diet from the cardioprotective pattern of the Mediterranean diet, a decrease in the consumption of vegetables, fish, wholegrain cereals and olive oil and an increase consumption of meat. 90% of these university students need to modify their eating habits to conform to a heart-healthy diet., (Copyright AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.)

Cryptococcus neoformans is an encapsulated yeast that causes a life-threatening meningoencephalitis in immunocompromised individuals. The ability to survive and proliferate at the human body temperature is an essential virulence attribute of this pathogen. This trait is controlled in part by the Ca²(+)-calcineurin pathway, which senses and utilizes cytosolic calcium for signaling. In the present study, the identification of the C. neoformans gene VCX1, which encodes a vacuolar calcium exchanger, is reported. The VCX1 knockout results in hypersensitivity to the calcineurin inhibitor cyclosporine A at 35°C, but not at 30°C. Furthermore, high concentrations of CaCl₂ lead to growth inhibition of the vcx1 mutant strain only in the presence of cyclosporine A, indicating that Vcx1 acts in parallel with calcineurin. The loss of VCX1 does not influence cell wall integrity or capsule size but decreases secretion of the major capsular polysaccharide glucuronoxylomannan (GXM) in culture supernatants.Vcx1 also influences C. neoformans phagocytosis by murine macrophages and is required for full virulence in mice. Analysis of cellular distribution by confocal microscopy confirmed the vacuolar localization of Vcx1 in C. neoformans cells.