Individual and combined effects of contact insecticides and high temperatures on Mediterranean flour moth, Ephestia kuehniella Zeller (Lepidoptera: Pyralidae).

BACKGROUND: Mediterranean flour moth or mill moth Ephestia kuehniella Zeller (Lepidoptera: Pyralidae) is a common pest of cereals and flour throughout the world. In this study, eggs, third instar larvae, pupae and adults of E. kuehniella were exposed to five elevated temperatures at a range of 45 to 65 °C for 5, 8, 10, 14, 18, 23 and 30 min. The effect of cypermethrin and dichlorvos was assessed on third instar larvae. The larvae were exposed to the insecticides on glass and concrete arenas and their mortality was recorded 24 h after treatment. To determine combination effects, the third instar larvae were transferred into the Petri dishes treated with LC25 (lethal concentration that kills 25%) of each insecticide and exposed to high temperatures for the period of time equal to LTi25 values (time needed for killing 25% of tested insects). RESULTS: Exposing the eggs, third instar larvae and adults of E. kuehniella to 55 °C for 30, 18 and 30 min respectively, resulted in 100% mortality. In the pupa, exposure to 65 °C caused 100% mortality after 23 min. Based on the LTe50 values (temperature needed to cause 50% mortality in the tested population), pupa was the most tolerant life stage to the temperatures tested. The LC50 values of cypermethrin and dichlorvos were 423.1 and 2608.5 mg active ingredient (a.i.) L-l on glass, and 2525.0 and 13502.8 mg a.i. L-l on concrete, respectively. The effect of cypermethrin was synergized by high temperatures. CONCLUSION: High temperatures, cypermethrin and dichlorvos were effective against E. kuehniella. Exposure to combination of lower doses of cypermethrin and high temperatures at short time intervals may have potential in managing this pest. © 2021 Society of Chemical Industry.

COVID-19 related treatment and outcomes among COVID-19 ICU patients: A retrospective cohort study.

BACKGROUND: The COVID-19 pandemic remains an immediate and present concern, yet as of now there is still no approved therapeutic available for the treatment of COVID-19.This study aimed to investigate and report evidence concerning demographic characteristics and currently-used medications that contribute to the ultimate outcomes of COVID-19 ICU patients. METHODS: A retrospective cohort study was conducted among all COVID-19 patients in the Intensive Care Unit (ICU) of Asir Central Hospital in Saudi Arabia between the 1st and 30th of June 2020. Data extracted from patients' medical records included their demographics, home medications, medications used to treat COVID-19, treatment durations, ICU stay, hospital stay, and ultimate outcome (recovery or death).Descriptive statistics and regression modelling were used to analyze and compare the results. The study was approved by the Institutional Ethics Committees at both Asir Central Hospital and King Khalid University. RESULTS: A total of 118 patients with median age of 57 years having definite clinical and disease outcomes were included in the study. Male patients accounted for 87% of the study population, and more than 65% experienced at least one comorbidity. The mean hospital and ICU stay was 11.4 and 9.8 days, respectively. The most common drugs used were tocilizumab (31.4%), triple combination therapy (45.8%), favipiravir (56.8%), dexamethasone (86.7%), and enoxaparin (83%). Treatment with enoxaparin significantly reduced the length of ICU stay (p = 0.04) and was found to be associated with mortality reduction in patients aged 50-75 (p = 0.03), whereas the triple regimen therapy and tocilizumab significantly increased the length of ICU stay in all patients (p = 0.01, p = 0.02 respectively). CONCLUSION: COVID-19 tends to affect males more significantly than females. The use of enoxaparin is an important part of COVID-19 treatment, especially for those above 50 years of age, while the use of triple combination therapy and tocilizumab in COVID-19 protocols should be reevaluated and restricted to patients who have high likelihood of benefit.

A Nonclinical Spectroscopic Approach for Diagnosing Covid-19: A Concise Perspective.

With the COVID-19 outbreak, many challenges are posed before the scientific world to curb this pandemic. The diagnostic testing, treatment, and vaccine development for this infection caught the scientific community's immediate attention. Currently, despite the global proliferation of COVID-19 vaccination, the specific treatment for this disease is yet unknown. Meanwhile, COVID-19 detection or diagnosis using polymerase chain reaction (PCR)-based me hods is expensive and less reliable. Moreover, this technique needs much time to furnish the results. Thus, the elaboration of a highly sensitive and fast method of COVID-19 diagnostics is of great importance. The spectroscopic approach is herein suggested as an efficient detection methodology for COVID-19 diagnosis, particularly Raman spectroscopy, infrared spectroscopy, and mass spectrometry.

Immune Cell-Stromal Circuitry in Lupus Photosensitivity.

Photosensitivity is a sensitivity to UV radiation (UVR) commonly found in systemic lupus erythematosus (SLE) patients who have cutaneous disease. Upon even ambient UVR exposure, patients can develop inflammatory skin lesions that can reduce the quality of life. Additionally, UVR-exposed skin lesions can be associated with systemic disease flares marked by rising autoantibody titers and worsening kidney disease. Why SLE patients are photosensitive and how skin sensitivity leads to systemic disease flares are not well understood, and treatment options are limited. In recent years, the importance of immune cell-stromal interactions in tissue function and maintenance is being increasingly recognized. In this review, we discuss SLE as an anatomic circuit and review recent findings in the pathogenesis of photosensitivity with a focus on immune cell-stromal circuitry in tissue health and disease.

Cutaneous malignant melanoma mortality in Spain from 1979 to 2018. Trends and new perspectives in the immunotherapy era.

BACKGROUND: Recent studies suggest that cutaneous melanoma mortality rates in Spain are stabilizing and even decreasing in younger cohorts. OBJECTIVES: To analyse mortality rates of melanoma from the last 40 years, focusing on changes related with the development of new therapeutic approaches. METHODS: Death records and mid-year population data were collected from the National Statistics Institute. By using the direct method, age-standardized mortality rates were calculated for overall population and for each sex and age group. Significant changes in mortality trends were identified by Joinpoint regressions. The independent effects of age, period and cohort (APC) and potential years of life lost (PYLL) due to melanoma were also analysed. RESULTS: Age-standardized melanoma mortality rates rose in Spain from 0.78 to 2.13 deaths per 100 000 from the first to the last quinquennium of the study (1979-1983 to 2014-2018) for the overall population. After a marked increase until 1995, mortality rates levelled off. Following this stabilization, from 2015 to 2018 there was a decrease in mortality rates for the overall population (average annual per cent change (AAPC): -4.3, not significant), more accused in males over 64 years old (yo). A period effect was observed from the beginning of 21st century, with mortality rates dropping to date. CONCLUSIONS: There is a decrease in melanoma mortality rates from 2015 in all age groups that confirms previous trends in mortality in younger cohorts. Improvement in diagnosis and development of new therapies for advanced melanoma may have a crucial role in this event. Close monitoring of melanoma mortality rates is necessary to confirm these trends.

Calidad de vida en pacientes con linfomas cutáneos de células T / Quality of Life in Patients with Cutaneous T-Cell Lymphoma

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Características clínico-epidemiológicas del carcinoma de células de Merkel en una serie de 38 pacientes / Clinical and Epidemiological Characteristics of Merkel Cell Carcinoma in a Series of 38 Patients

Introducción: El carcinoma de células de Merkel (CCM) es un tumor cutáneo muy agresivo y de mal pronóstico, aunque la incidencia es muy baja. Existen pocas series que analicen la experiencia en un mismo centro. Metodología: Estudio observacional, descriptivo y retrospectivo de todos los pacientes diagnosticados en un hospital de tercer nivel entre 2002 y 2017. Se recogieron las características epidemiológicas, clínicas, histológicas, el tratamiento y la supervivencia, y se dividió la muestra en 2 períodos para el análisis (2002-2009 y 2010-2017). Se realizó un análisis de supervivencia mediante el modelo de Kaplan-Meier y un análisis multivariante mediante el modelo de riesgos proporcionales de Cox. Resultados: Se incluyó a 38 pacientes, 24 hombres y 14 mujeres, con una edad media 77,76 años. El período medio de seguimiento fue de 30,11 meses. Se observó un aumento del 116% (12 vs. 26) entre los años 2002-2009 y 2010-2017, así como una edad media más avanzada (70,92 vs. 80,92; p < 0,05) y un incremento de lesiones en tronco y miembros inferiores (34,62% vs. 0%). Once pacientes fallecieron debido al CCM. La supervivencia global a los 12 meses en la serie fue del 78,2% y a los 24 meses del 69,3%. Los factores asociados a mortalidad fueron la edad mayor de 70 años y la afectación ganglionar, mientras que la localización en miembros superiores y la realización de ampliación de márgenes aumentó la supervivencia. Al realizar el análisis multivariante, solo la afectación de ganglios permaneció como factor pronóstico. Conclusiones: Se ha observado un aumento de la frecuencia en los últimos años y un cambio en la forma de presentación a edades más avanzadas y en otras localizaciones diferentes a las clásicas

Background: Merkel cell carcinoma is a rare yet aggressive cutaneous tumor with a poor prognosis. Few studies have analyzed series of patients from the same hospital. Methodology: We performed a retrospective, descriptive, observational study of all patients diagnosed with Merkel cell carcinoma at a tertiary care hospital between 2002 and 2017. We recorded epidemiological, clinical, and histologic data and information on treatments and survival. For analysis, the sample was divided into 2 groups from different periods: 2002-2009 and 2010-2017. We performed survival analysis using Kaplan-Meier curves and multivariate analysis using a Cox proportional hazards model. Results: Thirty-eight patients (24 men and 14 women) with a mean age of 77.76 years were included. Mean follow-up time was 30.11 months. On comparing 2010-2017 with 2002-2009, we observed a 116% increase in the number of Merkel cell carcinoma cases (26 vs. 12), an older mean age at diagnosis (80.92 vs. 70.92 years, P<.05), and an increase in lesions located on the trunk and lower limbs (0% vs. 34.62%). Eleven patients died of Merkel cell carcinoma. Overall survival was 78.2% at 12 months and 69.3% at 24 months. In the univariate analysis, age over 70 years and lymph node involvement were associated with mortality, while tumor location on the upper extremities and wide surgical excision were associated with improved survival. Only lymph node involvement retained its prognostic significance in the multivariate analysis. Conclusions: In this series, we observed that Merkel cell carcinoma has become more common in recent years and is now diagnosed at an older age and found in new anatomic locations

Clinical and Epidemiological Characteristics of Merkel Cell Carcinoma in a Series of 38 Patients. / Características clínico-epidemiológicas del carcinoma de células de Merkel en una serie de 38 pacientes.

BACKGROUND: Merkel cell carcinoma is a rare yet aggressive cutaneous tumor with a poor prognosis. Few studies have analyzed series of patients from the same hospital. METHODOLOGY: We performed a retrospective, descriptive, observational study of all patients diagnosed with Merkel cell carcinoma at a tertiary care hospital between 2002 and 2017. We recorded epidemiological, clinical, and histologic data and information on treatments and survival. For analysis, the sample was divided into 2 groups from different periods: 2002-2009 and 2010-2017. We performed survival analysis using Kaplan-Meier curves and multivariate analysis using a Cox proportional hazards model. RESULTS: Thirty-eight patients (24 men and 14 women) with a mean age of 77.76 years were included. Mean follow-up time was 30.11 months. On comparing 2010-2017 with 2002-2009, we observed a 116% increase in the number of Merkel cell carcinoma cases (26 vs. 12), an older mean age at diagnosis (80.92 vs. 70.92 years, P<.05), and an increase in lesions located on the trunk and lower limbs (0% vs. 34.62%). Eleven patients died of Merkel cell carcinoma. Overall survival was 78.2% at 12 months and 69.3% at 24 months. In the univariate analysis, age over 70 years and lymph node involvement were associated with mortality, while tumor location on the upper extremities and wide surgical excision were associated with improved survival. Only lymph node involvement retained its prognostic significance in the multivariate analysis. CONCLUSIONS: In this series, we observed that Merkel cell carcinoma has become more common in recent years and is now diagnosed at an older age and found in new anatomic locations.

Extirpación eco-guiada mínimamente invasiva del tumor glómico digital / Ultrasound-Guided, Minimally Invasive Resection of a Digital Glomus Tumor

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BCN Checkpoint: same-day confirmation of reactive HIV rapid test with Point Of Care HIV-RNA accelerates linkage to care and reduces anxiety.

BACKGROUND: The introduction in 2006 of the rapid HIV test by BCN Checkpoint in a non-clinical setting has been a successful step forwards in the uptake of testing. Nevertheless, HIV serostatus should be reported as HIV positive only when a reactive result has been tested again using a different assay (WHO guidelines 2015). The standard confirmation test has been the Western Blot (WB) test. However confirmation results take around 7 days to come back. AIMS: This study explores the possibility of Point of Care PCR testing for a same-day confirmation. MATERIALS AND METHODS: Between March 2015 and September 2016 a POC PCR test (Xpert® HIV-1 Qual) was performed in parallel to the Western Blot test after a reactive HIV rapid test (Alere Determine™ HIV-1/2 Ag/Ab Combo and Alere™ HIV Combo). HIV confirmed positive cases received emotional support by peers, were informed and prepared for treatment initiation and rapidly linked to HIV clinic. RESULTS: During the study period 11 455 tests were performed to 7163 clients. A total of 249 reactive rapid HIV tests were found. For analysis a total of 33 cases were excluded due to the lack of PCR and/or WB test. Results of comparison of the 216 cases showed 194 concordant positive confirmations and 14 concordant negative results. In three cases PCR was positive and WB negative. In five cases PCR was negative and WB positive. CONCLUSION: The POC PCR assay is easy to use and feasible in a community-based center. Reducing time for confirmation to 90 min has been possible in 91.2% (197/216) of cases with positive PCR result. In cases of a negative PCR result an additional test (WB, Elisa or PCR quantitative) was needed to distinguish false positive results (6.5%) from viral load results below level of detection (2.3%). Clients expressed satisfaction with same-day confirmation and less anxiety.

Impact of weight loss on sperm DNA integrity in obese men.

The objective of the study was to determine whether weight loss in obese men improves their fertility with respect to DNA fragmentation index and morphology. Collected fertility parameters included DFI and morphology. Body mass index (BMI) was calculated for all patients with comparisons to their fertility parameters before and after weight loss using paired t test and chi-square tests. The mean BMI was significantly higher in group 1, before weight loss (33.18 kg/m2 ), than in group 2, after weight loss (30.43 kg/m2 ). Overall, 53.3% of men had DFI <20% while 43.8% had a DFI between 20% and 40%, and 2.9% of men had DFI >40%. The mean DFI of participants was higher before weight loss (20.2%) and had improved significantly after weight loss (17.5%) (p = <.001). The weight loss had significant positive correlation with percentage of DFI. There was a significant improvement in morphology after weight loss (p = <.05). In one of the largest cohorts of male fertility and obesity, DFI and morphology demonstrated significant relationship with adiposity, possibly contributing to subfertility in this population.

¿Qué haría usted ante un paciente musulmán con trastorno conversivo? / What would you do when faced with a Muslim patient with a conversational disorder?

El propósito de este trabajo es reflexionar sobre el abordaje de los desórdenes mentales en pacientes marroquíes desde una perspectiva sociocultural. La antropología de la salud y la etnopsiquiatría permitirán analizar los conceptos de salud y enfermedad. Desde la cosmovisión marroquí analizaremos los tratamientos alternativos a la psiquiatría y su articulación con otros modelos terapéuticos (AU)

The purpose of this work is to present the approach to mental disorders in Moroccan patients from a sociocultural perspective. The anthropology of health and ethno-psychiatry will allow us to analyze the concepts of health and disease. From the Moroccan cosmovision we will analyze the alternative treatments and their association with other therapeutic models (AU)

Fluticasone in mild to moderate atopic dermatitis relapse: A randomized controlled trial.

BACKGROUND: The long-term efficacy of corticosteroids to prevent atopic dermatitis (AD) relapses has partially been addressed in children. This study compared an intermittent dosing regimen of fluticasone propionate (FP) cream 0.05% with its vehicle base in reducing the risk of relapse in children with stabilized AD. METHODS: A randomized controlled, multicentric, double-blind trial was conducted. Children (2-10 years) with mild/moderate AD (exclusion criteria: >30% affected body surface area and/or head) were enrolled into an Open-label Stabilization Phase (OSP) of up to 2 weeks on twice daily FP. Those who achieved treatment success entered the Double-blind Maintenance Phase (DMP). They were randomly allocated to receive FP or vehicle twice-weekly on consecutive days for 16 weeks. The primary study endpoint was relapse rate; time to relapse and severity of disease were also studied. Kaplan-Meier estimates were calculated. RESULTS: Fifty-four patients (29 girls) entered the OSP (23 mild AD) and 49 (26 girls) continued into the DMP. Mean age was 5.5 (SD: 2.8) and 5.1 (SD: 2.3) yrs for FP and vehicle groups, respectively. Four patients withdrew from the DMP (two in every group). Patients treated with FP twice weekly had a 2.7 fold lower risk of experiencing a relapse than patients treated with vehicle (relative risk 2.72, SD: 1.28; p=0.034). FP was also superior to vehicle for delaying time to relapse. Both treatment therapies were well tolerated. CONCLUSION: This long-term study shows that twice weekly FP provides an effective maintenance treatment to control the risk of relapse in children with AD.

[What would you do when faced with a Muslim patient with a conversational disorder?] / ¿Qué haría usted ante un paciente musulmán con trastorno conversivo?

The purpose of this work is to present the approach to mental disorders in Moroccan patients from a sociocultural perspective. The anthropology of health and ethno-psychiatry will allow us to analyze the concepts of health and disease. From the Moroccan cosmovision we will analyze the alternative treatments and their association with other therapeutic models.