Correlation of serum level of squamous cell carcinoma antigen with severity of cutaneous psoriasis, assessed using the simplified psoriasis index.

BACKGROUND: Squamous cell carcinoma antigen (SCCA) is a biomarker of disease progression in squamous cell carcinoma but also contributes to the pathogenesis of psoriasis. Eight previous studies have shown a correlation between psoriasis severity, assessed using the Psoriasis Assessment Severity Index or body surface area, and serum level of SCCA, mainly SCCA2, assessed by means of non-commercial tests. We examined the correlation between serum SCCA level, measured with a commercial kit, and psoriasis severity assessed using the Simplified Psoriasis Index (SPI). METHODS: We conducted a prospective, non-interventional, single-centre study at the University Hospital of Tours over 18 months. The primary endpoint was same-day measurement of serum SCCA level and the psoriasis severity score on the professional version of the SPI (proSPI-s) at both baseline and follow-up. Secondary endpoints were same-day measurement of serum SCCA level and the proSPI psychosocial score (proSPI-p), proSPI treatment score, Dermatology Life Quality Index (DLQI), and inflammation parameters (C-reactive protein level, neutrophil-to-lymphocyte ratio). RESULTS: We included 50 psoriasis patients. Serum SCCA level was correlated with the proSPI-s at baseline and follow-up (Spearman r = 0.686 and r = 0.674, p < 0.0001) for both. It was correlated with the proSPI-p and DLQI. Serum SCCA level was not correlated with either neutrophil-to-lymphocyte ratio (r = 0.083) or C-reactive protein level (r = 0.192). CONCLUSION: This study is the first to correlate serum SCCA level with proSPI-s. Moreover, SCCA was measured using a widely available kit. SCCA may be used to assess the severity of psoriasis.

Evaluation of medical and surgical treatments for hidradenitis suppurativa using real-life data from the Scandinavian registry (HISREG).

BACKGROUND: Hidradenitis suppurativa (HS) substantially affects health-related quality-of-life outcomes. Most treatment options are supported by low quality of evidence without validated outcomes. OBJECTIVE: The aim of this study was to evaluate the efficacy of surgical and medical interventions using physician- and patient-reported outcomes registered in HISREG. METHODS: Data were extracted for all adult patients registered in HISREG between January 2013 and April 2016. Primary endpoints included Dermatology Life Quality Index (DLQI) scores, pain as measured using a numeric rating scale (NRS), Sartorius score and Hurley classification. Minimum clinically important differences (MCIDs) for DLQI and NRS pain were analysed. Secondary endpoints included comparisons among different treatment groups, safety and complications of various treatments. RESULTS: Two hundred and fifty-five patients were included in the study: 31, 188, and 36 patients had Hurley stages I, II and III disease, respectively. Treatment with CO2 lasers was the most common treatment modality. One hundred and forty-nine patients (58.4%) were treated with surgical intervention, 87 (34.1%) received antibiotics and/or anti-inflammatory treatments, and 19 (7.5%) were treated with both surgery and medical intervention. No patients received biologic treatment. In patients with surgical treatments, Sartorius scores were significantly improved compared with baseline (P = 0.001), 83 patients (55%) achieved a DLQI MCID, and 75 patients (49.7%) achieved an NRS pain MCID. In patients with medical treatments, Sartorius scores were not significantly improved compared with baseline (P = 0.582); 25 patients (28%) achieved a DLQI MCID and 28 patients (31%) achieved an NRS pain MCID. In patients treated with surgical and medical combination, 9 (48%) achieved DLQI and NRS pain MCIDs and Sartorius scores were significantly improved. CONCLUSIONS: CO2 laser treatment is more effective than the non-biologic medical treatments in this analysis based on physician- and patient-derived outcomes. The study provides limited evidence for the combination of medical and surgical therapies in patients with HS.

[Home and recreational injuries in children under 1year: 10years of experience]. / Accidents de la vie courante chez les enfants âgés de moins d'un an : expérience sur 10 ans.

BACKGROUND: There is little research on the prevalence and characteristics of home and recreational injuries in infants under 12months of age. However, domestic accidents result in an average of 50 infant deaths in France every year. METHODS: A descriptive and retrospective study was conducted, based on data from the permanent investigation on home and recreational injuries in infants under 12months of age (EPAC) published by the Institute for Public Health. Data were collected from 2004 to 2013 in the pediatric emergency department of Le Havre hospital. A global quantitative analysis was carried out, as well as age-group-based analyses (groups of infants of similar age within a specific range of 3months of age). RESULTS: A total of 3708 infants under 1year of age were victims of home and recreational injuries. The incidence of domestic accidents was found to be an average of one case per day (gender ratio, 1.12). Up to 85% of reported injuries were found to occur in the home. Falls were the leading cause of home accidents or injuries (73% of the total number of reported accidents), 7% of which resulted from a fall from stairs. Children frequently suffered from concussion or contusions (65%). The neck and head were affected in 73% of cases. A higher proportion of foreign body injuries occurred after 6months of age (RR=2.9, p<0.001). The number of hospitalizations decreased with age: 21% of accidents occurred before 3 months of age; 7% occurred between 9 and 11 months of age (RR=0.32, p<0.001). Falling from a changing table accounted for 9% of fall-related hospitalizations. CONCLUSIONS: This survey characterized for the first time the occurrence of home and recreational injuries in infants under 12months of age in France.

Starch gelatinization and in vitro digestibility behaviour after heat treatment: Comparison between plantain paste and piece of pulp.

Over the 65-100°C range and at a water content of 1.6kgkg(-1)db, a comparison was conducted between plantain paste (dispersion made of flour and water) and pulp pieces after cooking to evaluate their respective degree of starch gelatinization (α) and in vitro digestibility. Below 76°C and at 100°C, the gelatinization behaviour of starch into pulp pieces and paste was similar, whereas at 85°C a significant mean relative difference was observed in between. For α in the 0-1 range, pieces of plantain pulp exhibited a lower rapidly digestible starch fraction (30%) and a higher resistant starch fraction (33%) than the flour paste, suggesting some structural effects. Both Weibull and exponential models showed a good fit for α over temperature range and starch digestibility fractions over α. Although no explicit relationship was established between the intact pulp structure and grinded flour state of plantain, the evaluation of the degree of starch gelatinization and digestibility of a plantain flour paste, could be used to predict the gelatinization and digestibility behaviour of plantain starch in entire pieces of pulp.

Escape from the competence state in Streptococcus mutans is governed by the bacterial population density.

Horizontal gene transfer through natural DNA transformation is an important evolutionary mechanism among bacteria. Transformation requires that the bacteria are physiologically competent to take and incorporate free DNA directly from the environment. Although natural genetic transformation is a remarkable feature of many naturally competent bacteria, the process is energetically expensive for the cells. Consequently, a tight control of the competence state is necessary. The objective of the present work was to help decipher the molecular mechanisms regulating the escape from the competence state in Streptococcus mutans, the principal etiological agent responsible for tooth decay in humans. Our results showed that the cessation of competence in S. mutans was abrupt, and did not involve the accumulation of a competence inhibitor nor the depletion of a competence activator in the extracellular environment. The competence state was repressed at high cell population density via concomitant repression of sigX gene encoding the master regulator of the competence regulon. Co-culture experiments performed with oral and non-oral bacteria showed that S. mutans assesses its own population density and also the microbial density of its surroundings to regulate its competence escape. Interestingly, neither the intra-species and extra-species quorum-sensing systems nor the other 13 two-component regulatory systems identified in S. mutans were involved in the cell-density-dependent escape of the competence state. Altogether, our results suggest a complex mechanism regulating the competence shut-off involving cell-density-dependent repression of sigX through an as yet undefined system, and possibly SigX protein stability.

Cost-effectiveness of strategies for testing current hepatitis C virus infection.

UNLABELLED: Six strategies for identifying hepatitis C virus (HCV) viremia, involving testing for HCV antibody (HCVAb) followed by a nucleic acid test (NAT) for HCV RNA when the antibody test is positive, are compared. Decision analysis was used to determine mean relative cost per person tested and outcomes of HCV viremia detection. Parameters included proportions of test population with HCVAb and viremia plus specificity, sensitivity, and cost of individual tests. For testing a population with an HCVAb seroprevalence of 3.25%, all strategies when adopting quantitative NAT vary little in cost (range, $29.50-$30.70) and are highly viremia specific (≥0.9997). Four of the strategies using venipuncture blood for HCVAb testing (whether laboratory conducted or employing a rapid, point-of-care assay) and for NAT (whether done by reflex or using separately drawn blood) achieve the highest viremia sensitivities (range, 0.9950-0.9954). Point-of-care HCVAb testing in fingerstick blood followed by NAT in venipuncture blood yields relatively lower viremia sensitivity (0.9301). The strategy that requires returning for NAT is even less viremia sensitive (<0.9000) because of follow-up loss. Strategies adopting qualitative rather than quantitative NAT are slightly cheaper (range, $28.90-$29.99), similarly viremia specific (≥0.9997), but less viremia sensitive (≤0.9456). Viremia sensitivity and specificity remain the same regardless of the proportion of HCVAb-seropositive persons in the cohort being tested. CONCLUSIONS: Strategies involving HCVAb testing in venipuncture blood, whether laboratory conducted or using a point-of-care assay, when followed by quantitative NAT done reflexively or in separately drawn blood, are comparably economical and suitably viremia sensitive. Less cost-effective is point-of-care HCVAb testing in fingerstick blood followed by NAT in venipuncture blood. Least cost-effective is the strategy requiring the tested person to return for NAT.

Digestibility prediction of cooked plantain flour as a function of water content and temperature.

The effect of temperature (T=55-120°C) and water content (X1=1.4-2.0 kg kg(-1) dry basis) on the gelatinization and digestibility of plantain flour (Dominico Harton genotype) were investigated. The degree of plantain starch gelatinization (α) was measured by DSC and modelled as a function of T and X1, using the Weibull model. Rapidly digestible starch (RDS) and resistant starch (RS) fractions were evaluated for different α values. An appropriate dimensionless variable was introduced to the analyzed and modelled RDS and RS as a function of α. Starch gelatinization begins at a temperature above 59.6 ± 0.5°C and α is strongly dependent on T in non-limiting water conditions. The combined effects of T and X1 on the RDS and RS can be explained by α. We demonstrate that various heat treatments and water contents lead to the same α, with the same RDS and RS values.

Prediction of carotenoids, cyanide and dry matter contents in fresh cassava root using NIRS and Hunter color techniques.

Efforts are currently underway to improve carotenoids content in cassava roots through conventional breeding as a strategy to reduce vitamin A deficiency. However, only few samples can be quantified each day for total carotenoids (TCC) and ß-carotene (TBC) contents, limiting the gains from breeding. A database with >3000 samples was used to evaluate the potential of NIRS and chromameter devices to predict root quality traits. Maximum TTC and TBC were up to 25.5 and 16.6 µg/g (fresh weight basis), respectively. NIRS predictions were highly satisfactory for dry matter content (DMC, R(2): 0.96), TCC (R(2): 0.92) and TBC (R(2): 0.93). NIRS could also distinguish roots with high or low cyanogenic potential (R(2): 0.86). Hunter color parameters could also be used for predictions, but with lower accuracy than NIRS. NIRS or chromameter improve selection protocols, allowing faster gains from breeding. Results also demonstrate that TBC and DMC can be improved simultaneously (required for the adoption of biofortified cassava).

Lab Tests Online and consumer understanding of laboratory testing.

Lab Tests Online is a "peer-reviewed, non-commercial, patient-centered" resource where patients and their relatives and caregivers can learn about the tests used to screen for, diagnose, and manage disease. Consumers are becoming increasingly involved in the management of their own health care and increasingly have access to their laboratory results through electronic health records. Research has shown that consumers have difficulty with health literacy in general and with numerical data in particular. The Lab Tests Online global websites are an important step toward helping consumers understand the complexity of the pathology process, the expertise of the people involved and the meaning of the results provided to them and their healthcare professionals.

Depression in patients with hidradenitis suppurativa.

BACKGROUND: Hidradenitis suppurativa (HS) is a chronic recurrent inflammatory skin disease with abscess formation and scarring predominantly in the inverse areas. The disease is often difficult to treat and patients experience a decreased quality of life (QoL). It is hypothesized that depression is more common in HS patients than among other dermatological patients. OBJECTIVES: To evaluate the prevalence of depression in patients with HS. METHODS: In total 211 HS patients were included in the study and 233 were dermatological control patients. Their QoL and depression scores were assessed using the Dermatology Life Quality Index (DLQI) and the Major Depression Inventory (MDI) questionnaires. HS severity was recorded with a questionnaire and Hurley stages were extracted from the case records. RESULTS: The DLQI was significantly higher for HS patients than for the control patients, 8.4 ± 7.5 vs. 4.3 ± 5.6 (P < 0.0001) and correlated with Hurley stage severity scores. Mean MDI scores were significantly higher for HS patients, 11.0 vs. 7.2 (P < 0.0001). However, clinically defined depression rates according to the International Classification of Diseases, 10th edition (ICD-10) criteria were not significantly higher in HS patients compared to controls (9% vs. 6%). CONCLUSIONS: HS is a chronic skin disease with major impact on QoL even when compared to other dermatological diseases. MDI scores in HS patients correlate with disease severity. This correlation could indicate that the MDI represents a valid measure of disease related morbidity that may serve as an outcome measure in future studies and a relevant point of intervention for individual patients.

Comparison of serial Hepatitis C virus detection in samples submitted through serology for reflex confirmation versus samples directly submitted for quantitation.

Using real-time technology, we reliably identified chronic hepatitis C virus (HCV) infection and quantified virus from reflex samples originally submitted for serologic testing. There was no need to process specimens obtained directly for quantitation separately. Whether the initial source is a reflex sample or one obtained directly, a repeat HCV RNA test is needed before starting treatment.

First evidence of the presence of genomic islands in Escherichia coli P4, a mammary pathogen frequently used to induce experimental mastitis.

Mastitis pathogens belonging to Escherichia coli species are often considered as environmental opportunistic pathogens that invade the udder and are rapidly killed by the immune system of cows. However, several studies have reported that some of these strains are able to persist in the udder for prolonged periods or to adhere and invade mammary epithelial cells, suggesting that they might possess some specific properties or genes that could be involved in their capacity to provoke mastitis. The aim of this work was to search for such specific genes in the E. coli strain P4, which was isolated from a case of severe mastitis and is often used to induce experimental mastitis. We established that this strain belongs to phylogenetic group A of the E. coli species, and that its core genome is very similar to that of the commensal nonpathogenic strain E. coli K-12 MG1655. Seventeen transfer RNA loci, known to be frequently associated with genomic islands, were screened and an altered structure was detected for 7 of them. The partial characterization of 5 of these loci (asnT, leuX, pheV, serU, and thrW) and the complete characterization of 1 (argW) revealed the presence of genomic islands that differ from those already described in pathogenic or nonpathogenic E. coli strains.