Inhibition of UVB radiation-induced tissue swelling and immune suppression by nicotinamide riboside and pterostilbene.

BACKGROUND: Environmental ultraviolet radiation has deleterious effects on humans, including sunburn and immune perturbations. These immune changes are involved in skin carcinogenesis. OBJECTIVES: To determine whether nicotinamide riboside and/or pterostilbene administered systemically inhibits inflammatory and immune effects of exposure to mid-range ultraviolet radiation. METHODS: To examine UVB radiation-induced inflammatory effects, mice were fed standard chow/water, 0.04% pterostilbene in chow and 0.2% nicotinamide riboside in drinking water, diet with nicotinamide riboside alone, or diet with pterostilbene alone. After 4 weeks, mice were exposed to UVB radiation (3500 J/m2), and 24-/48-h ear swelling was assessed. We also asked if each agent or the combination inhibits UVB radiation suppression of contact hypersensitivity in two models. Mice were fed standard diet/water or chow containing 0.08% pterostilbene, water with 0.4% nicotinamide riboside, or both for 4 weeks. Low-dose: Half the mice in each group were exposed on the depilated dorsum to UVB radiation (1700 J/m2) daily for 4 days, whereas half were mock-irradiated. Mice were immunized on the exposed dorsum to dinitrofluorobenzene 4 h after the last irradiation, challenged 7 days later on the ears with dinitrofluorobenzene, and 24-h ear swelling assessed. High dose: Mice were treated similarly except that a single dose of 10,000 J/m2 of radiation was administered and immunization was performed on the unirradiated shaved abdomen 3 days later. RESULTS: Nicotinamide riboside and pterostilbene together inhibited UVB-induced skin swelling more than either alone. Pterostilbene alone and both given together could inhibit UVB-induced immune suppression in both the low-dose and high-dose models while nicotinamide riboside alone was more effective in the low-dose model than the high-dose model. CONCLUSION: Nicotinamide riboside and pterostilbene have protective effects against UVB radiation-induced tissue swelling and immune suppression.

A Rare Case of Localized Argyria on the Face.

Due to its antibacterial actions, silver sulfadiazine is widely used as a topical agent in the treatment of wounds, including burns. Widespread or prolonged topical application of silver sulfadiazine dressings can lead to argyria including systemic symptoms due to the resorption of silver. Here, we report a patient experiencing localized argyria due to sunlight exposure after topical use of silver sulfadiazine cream on his face.

Distal femoral varus osteotomy: results of the lateral open-wedge technique without bone grafting.

BACKGROUND: The lateral opening wedge distal femoral osteotomy (LOWDFO) to reconstruct knee alignment in patients with genu valgum originating in the distal femur has gained importance within the last years. PURPOSE: To analyze clinical and radiographic outcome of patients treated with LOWDFO with respect to bone healing without grafting and patient age. MATERIAL AND METHODS: Twenty-two consecutive patients with genu valgum corrected with 23 LOWDFOs using a Tomofix-locking plate were retrospectively analyzed (mean age 23.7 years). Clinical evaluation was based on pre- and post-operative KOOS scores. A pre- and post-operative radiographic assessment, including MAD, mLDFA, LLD, bone healing, and patella parameters, was performed. Differences between subgroups (age, bone grafting) were analyzed. RESULTS: The restoration of MAD and mLDFA resulted in significantly improved post-operative KOOS5 scores in younger and older patients (p = 0.001). Bone healing without bone grafting was reliable in all patients. The leg length was significantly increased post-operatively (p = 0.001). The Blackburne-Peel ratio was significantly reduced to more normal values post-operatively (p < 0.001). CONCLUSION: LOWDFO without bone grafting is a reliable procedure representing a promising treatment option particularly in young patients with genu valgum. Besides correction of the MAD, a significant leg length increase and additional patella stability can be expected.

Recent developments on treatment strategies and the prognosis of dermatomyositis: a review.

Dermatomyositis is an autoimmune disease affecting both skin and muscle. Steroids are the first line treatment. However, no consensus regarding dosing, length of treatment, tapering speed, or when to add which immunosuppressant in case of steroid resistance, has been reached, as randomized-controlled trials are scarce. Especially data on long-term treatment is lacking in order to decide on the most effective treatment for long-term remission. Empiric evidence suggests that with an initially aggressive treatment with oral steroids followed by a slow taper, during which disease activity is adequately controlled, patients can be off therapy within typically 24-48 months, and remain disease-free without medication for over 20 years. Biologics such as rituximab have shown good results in the treatment of refractory DM. New, targeted therapies have been reported to improve DM in single cases or case series, but have to be evaluated for efficacy in randomized controlled trials.