Platelet-rich plasma for genital lichen sclerosus: analysis and results of 94 patients. Are there gender-related differences in symptoms and therapeutic response to PRP?

BACKGROUND: Lichen sclerosus is a chronic relapsing inflammatory dermatosis with a predilection for anogenital skin in 85%-98% of cases and is more prevalent in women (3%) than in men (> 0.07%). OBJECTIVES: The purpose of this study was to investigate gender differences in clinical presentation and therapeutic response to treatment with platelet-rich plasma (PRP), an emerging innovative strategy for LS. METHODS: Forty-three male and 51 female patients affected by LS were evaluated. Each patient was subjected to PRP treatment (1 infiltration every 15 days, for 3 times). RESULTS: The PRP procedure was well tolerated by all patients and an overall significant decrease in symptoms was reported 6 months after PRP infiltration. Reduction in pain and burning sensation was significant in both gender but more accentuated in women than in men, whereas reduction of itching was similar. On the contrary, dyspareunia evidenced sex-related difference since a significant diminution was observed only in male. CONCLUSIONS: This study demonstrates that PRP based therapy may exert a relevant role in LS patient management due to its effect on Quality of Life (QoL) and sexual function in both gender. In addition, the study underlined gender-related differences in severity of symptoms and disease age onset.

Environment or beekeeping management: What explains better the prevalence of honey bee colonies with high levels of Varroa destructor?

Varroa destructor is one of the major threats to honey bee colonies. The mite abundance in the colonies is affected by environmental conditions as well as by beekeeping management. The aim of this study was to recognize the main drivers associated with autumn V. destructor infestation in honey bee colonies when different regions from Argentina are compared. A total of 361 colonies distributed in five Argentinean eco-regions were examined to evaluate Varroa mite infestation rate during autumn and Nosema sp. presence. Regions were different regarding annual temperature, precipitation and especially vegetation landscape. In addition, beekeeping management practices were obtained from a checklist questionnaire answered by the beekeepers. The prevalence of colonies with high infestation level was lower in semi-arid Chaco followed by humid and transition Chaco regions. Also, colonies that were positive for Nosema sp. showed a higher Varroa infestation rate. The "environmental" effect was stronger compared with the influence of secondary drivers associated with beekeeping activities. As well, a significant association between V. destructor infestation rates and Nosema presence was identified. Under contrasting natural conditions, environment seems a predominant driver on Varroa destructor infestation level in honey bee colonies.

Risk factors associated with the presence of Varroa destructor in honey bee colonies from east-central Argentina.

Varroa destructor is considered one of the major threats for worldwide apiculture. Damage caused by varroa mite includes body weight loss, malformation and weakening of the bees. It was also suggested as the main cause associated with colony winter mortality and as an important vector for several honey bee viruses. Little is known about multiple factors and their interaction affecting V. destructor prevalence in apiaries from South America. The aim of this study was to identify risk factors associated with V. destructor prevalence in east-central Argentina. Parasitic mite infestation level and colony strength measures were evaluated in 63 apiaries distributed in 4 different regions in east-central Argentina in a cross sectional study. Data regarding management practices in each apiary were collected by means of a questionnaire. A mixed-effects logistic regression model was constructed to associate management variables with the risk of achieving mite infestation higher than 3%. Colonies owned by beekeepers who indicated that they did not monitor colonies after mite treatment (OR=2.305; 95% CI: 0.944-5.629) nor disinfect hives woodenware material (OR=2.722; 95% CI: 1.380-5.565) were associated with an increased risk of presenting high intensity infestation with V. destructor (>3%). On the other hand, beekeepers who reported replacing more than 50% of the queens in their operation (OR=0.305; 95% CI: 0.107-0.872), feeding colonies protein substitute containing natural pollen (OR=0.348; 95% CI: 0.129-0.941) and feeding colonies High Fructose Corn Syrup (HFCS) (OR=0.108; 95% CI: 0.032-0.364), had colonies that were less likely to have V. destructor infestations above 3%, than beekeepers who did not report using these management practices. Further research should be conducted considering that certain management practices were associated to mite infestation level in order to improve the sanitary condition in the colonies. Epidemiological studies provide key information to design surveillance programs against one the major threat to worldwide beekeeping.

Clinical use of a new axial chondro-mucosal flap in wide full-thickness eyelid reconstructions.

BACKGROUND AND OBJECTIVE: Full thickness reconstruction of more than half of an eyelid, mainly of the upper one, is a challenge for the surgeon. In 1992, for the first time, the authors reported the use of an axial chondro-mucosal flap from the nose for reconstruction of the tarsoconjunctival plane of a full thickness defect of an eyelid. This article reports and discusses the results of the follow-up of 18 patients operated on using the above technique during the period June 1991-March 1997. PATIENTS AND METHODS: Apart from the oncological evaluation, the following parameters were assessed: position, closure, the presence of epiphora, length of the palpebral rim, rim opening, levator function, an aesthetic balance of the eyelids, and donor site morbidity. The follow-up ranged from 6 to 40 months. RESULTS: The axial chondro-mucosal flap was clinically viable in all patients. One patient showed a 2 mm lagophthalmos. Static parameters were within normal ranges. In upper eyelid reconstruction, an 8 to 18 mm. levator function (mean 13 mm) was shown. CONCLUSION: The authors discuss their complications and results and feel that this flap, associated with full thickness skin grafts, may be considered a first choice technique, in expert hands, in complex full thickness upper eyelid reconstruction, and a possible alternative in lower eyelid reconstruction, for wide defects when the use of other flaps is compromised.