Ixekizumab and herpes zoster in an erythrodermic patient.

Ixekizumab is an injectable monoclonal antibody against IL-17A approved by the US Food and Drug Administration for the treatment of plaque psoriasis, psoriatic arthritis, and ankylosing spondylitis. We present what we believe is the first case of herpes zoster (shingles) in a patient 12 weeks after starting ixekizumab for presumed erythrodermic psoriasis. It is important to be aware of potential side effects of immunomodulatory medications, particularly those that are new to the market.

Genetic mapping of QTLs controlling fatty acids provided insights into the genetic control of fatty acid synthesis pathway in peanut (Arachis hypogaea L.).

Peanut, a high-oil crop with about 50% oil content, is either crushed for oil or used as edible products. Fatty acid composition determines the oil quality which has high relevance to consumer health, flavor, and shelf life of commercial products. In addition to the major fatty acids, oleic acid (C18:1) and linoleic acid (C18:2) accounting for about 80% of peanut oil, the six other fatty acids namely palmitic acid (C16:0), stearic acid (C18:0), arachidic acid (C20:0), gadoleic acid (C20:1), behenic acid (C22:0), and lignoceric acid (C24:0) are accounted for the rest 20%. To determine the genetic basis and to improve further understanding on effect of FAD2 genes on these fatty acids, two recombinant inbred line (RIL) populations namely S-population (high oleic line 'SunOleic 97R' × low oleic line 'NC94022') and T-population (normal oleic line 'Tifrunner' × low oleic line 'GT-C20') were developed. Genetic maps with 206 and 378 marker loci for the S- and the T-population, respectively were used for quantitative trait locus (QTL) analysis. As a result, a total of 164 main-effect (M-QTLs) and 27 epistatic (E-QTLs) QTLs associated with the minor fatty acids were identified with 0.16% to 40.56% phenotypic variation explained (PVE). Thirty four major QTLs (>10% of PVE) mapped on five linkage groups and 28 clusters containing more than three QTLs were also identified. These results suggest that the major QTLs with large additive effects would play an important role in controlling composition of these minor fatty acids in addition to the oleic and linoleic acids in peanut oil. The interrelationship among these fatty acids should be considered while breeding for improved peanut genotypes with good oil quality and desired fatty acid composition.

An overview of internet biosurveillance.

Internet biosurveillance utilizes unstructured data from diverse web-based sources to provide early warning and situational awareness of public health threats. The scope of source coverage ranges from local media in the vernacular to international media in widely read languages. Internet biosurveillance is a timely modality that is available to government and public health officials, healthcare workers, and the public and private sector, serving as a real-time complementary approach to traditional indicator-based public health disease surveillance methods. Internet biosurveillance also supports the broader activity of epidemic intelligence. This overview covers the current state of the field of Internet biosurveillance, and provides a perspective on the future of the field.

Genetic diversity of cultivated and wild-type peanuts evaluated with M13-tailed SSR markers and sequencing.

Thirty-one genomic SSR markers with a M13 tail attached were used to assess the genetic diversity of the peanut mini core collection. The M13-tailed method was effective in discriminating almost all the cultivated and wild accessions. A total of 477 alleles were detected with an average of 15.4 alleles per locus. The mean polymorphic information content (PIC) score was 0.687. The cultivated peanut (Arachis hypogaea L.) mini core produced a total of 312 alleles with an average of 10.1 alleles per locus. A neighbour-joining tree was constructed to determine the interspecific and intraspecific relationships in this data set. Almost all the peanut accessions in this data set classified into subspecies and botanical varieties such as subsp. hypogaea var. hypogaea, subsp. fastigiata var. fastigiata, and subsp. fastigiata var. vulgaris clustered with other accessions with the same classification, which lends further support to their current taxonomy. Alleles were sequenced from one of the SSR markers used in this study, which demonstrated that the repeat motif is conserved when transferring the marker across species borders. This study allowed the examination of the diversity and phylogenetic relationships in the peanut mini core which has not been previously reported.

Effect of gelation on the chemical stability and conformation of leuprolide.

PURPOSE: The purpose of this study was to characterize the conformation, aggregation, and stability of leuprolide on gelation. METHODS: Infrared spectra (FTIR) of leuprolide solutions and gels were collected in water, propylene glycol (PG), dimethyl sulfoxide (DMSO), and trifluoroethanol (TFE). Leuprolide solution and gel stability data were obtained by SEC and RP-HPLC. RESULTS: Leuprolide was induced to gel with increasing peptide concentration, introduction of salts, and gentle agitation. Leuprolide dissolved in water (400 mg/ml) demonstrated FTIR spectra consisting of two major bands of equal intensity at 1615 cm(-1) and 1630 cm(-1), similar to inter- and intra-molecular beta-sheet structure in proteins. When samples were gently agitated for 24 hours at 25 degrees C, the formulation was observed to change from a viscous liquid to an opaque gel with a concomitant shift in infrared spectra from the equal intensity bands to mostly 1630 cm(-1), indicating a shift to a preferred beta-sheet structure. Incubation of leuprolide with 20-200 mM salts at 25 degrees C and 37 degrees C also produced gels ranging from clear to cloudy and stringy white precipitates. The gel and precipitate were marked by a shift of the predominant beta-sheet band to 1630 cm(-1) and 1615 cm(-1), respectively. Leuprolide was also observed to gel and/or precipitate in mixtures of water, PG or TFE, but not in DMSO. CONCLUSIONS: Birefringence was noted in many of the firmer gels. Both solutions and gels demonstrated minimal dimer or trimer formation, with no larger order aggregates detected. The chemical stability profile of gelled leuprolide was similar to that of the non-gelled water formulation by RP-HPLC.

Case report: interaction of rifampin and nortriptyline.

Rifampin is well documented to cause numerous clinically significant drug interactions because of its induction of the hepatic cytochrome P450 system. The metabolism of nortriptyline and other tricyclic antidepressants is induced and inhibited by this enzyme system. To the authors' knowledge, this is only the second case report in the literature regarding a possible interaction between rifampin and a tricyclic antidepressant. Nortriptyline serum concentrations were not detectable while rifampin was given concurrently. Two weeks after discontinuation of rifampin, nortriptyline concentrations increased dramatically. Further study of this possible interaction is warranted.

Quinolones: a practical review of clinical uses, dosing considerations, and drug interactions.

A review of the literature on quinolones reveals numerous clinically relevant points regarding indications, dosing considerations, and drug interactions. Quinolones are useful in the treatment of several infectious diseases. Unfortunately, indiscriminate use of these valuable antimicrobials has resulted in increased patterns of resistance. It is important to consider carefully the site of infection and the potential pathogens in each patient before dosing. Quinolones have excellent oral absorption, with peak serum concentrations approaching those achieved with intravenous administration. When prescribing quinolones, the dose should be based on estimated creatinine clearance. Quinolones are associated with several clinically significant drug interactions. Some of these agents are well-documented inhibitors of hepatic metabolism of theophylline, caffeine, and warfarin. It has been well documented that divalent and trivalent cations in antacids, sucralfate, and some other products significantly reduce the absorption of quinolones. Avoidance or proper management of these interactions is required to ensure optimal safety and efficacy.

Malignant angioendotheliomatosis presenting as disseminated intravascular coagulopathy.

Disseminated intravascular coagulopathy (DIC) occurred in a patient with hemolytic anemia and anasarca. Skin and muscle biopsy showed intravascular lymphomatosis (malignant angioendotheliomatosis). Combination chemotherapy resulted in resolution of the DIC and anasarca. After an unmaintained 8-month clinical remission, the patient had central nervous system relapse and died. Malignant angioendotheliomatosis is a rare disorder that should be considered among the occult causes of DIC.

Socioeconomic, sociodemographic and attitudinal correlates of the tempo of divorce.

PIP: The association between sociodemographic, demographic, and attitudinal measures and the timing or tempo of marital dissolution over a 14-year time span is examined. Separation is considered equivalent to divorce. Early and late divorce are differentiated by whether the event occurred before or after the average number of years married prior to divorce. Data were obtained on husbands and wives within childbearing years (up to 39 years) in the 1st years of the 1st marriage. A random stratified sample of 610 couples was drawn from records of marriages in a midwestern county between 1972-77. Reinterviews were conducted on 544 couples in April 1985. socioeconomic variables included educational attainment, occupational prestige, wife's employment status, wife's future work plans, husband's attitude to wife's future work plans, total family income, and level of satisfaction with current financial status. Demographic variables are age at marriage, number of children in 1985, marital duration, and desired family size. Attitudinal items were religiosity and gender role orientations (traditionalism, modernism, egalitarianism). Exposure to divorce was not equitably distributed for the 108 who divorced, but this was not statistically significant. The results indicate that those divorced earlier were wives who worked outside the home, worked at more prestigious jobs, planned to be employed throughout married life, and whose father had a higher level of educational attainment. This finding is not consistent with prior research which has shown that favorable socioeconomic conditions lower the probability of divorce. The timing of divorce was affected by the presence of children. Those married at younger ages divorced earlier and couples with children delayed divorcing longer than couples without children. These findings were consistent with earlier research. Catholic wives delayed divorce longer than non-Catholic wives. Males lower in sexual satisfaction divorced earlier. Divorce was postponed longer for husbands with traditional values and wives who had higher scores on egalitarianism. Wives with scores on modernism had earlier divorces than wives scoring lower on modernism. The tempo of divorce was in multiple classification analysis predicted best by wife's employment status and number of children. Cross-classification was not possible.^ieng

Posterior fossa subdural hematoma in a hemophiliac.

A successfully managed case of posterior fossa subdural hematoma occurring in a hemophiliac is reported, and the rarity of this lesion is mentioned. The management of the hemophiliac who is a victim of craniocerebral trauma is discussed, with emphasis on the use of computerized tomographic scanning to obtain rapid diagnosis. The importance of prophylactic Factor VIII replacement is emphasized, and appropriate methods of Factor VIII administration are outlined.

Thalassemia intermedia caused by heterozygosity for both beta-thalassemia and hemoglobin Saki [beta 14 (A11) Leu replaced by Pro].

The syndrome thalassemia intermedia can be the clinical expression of heterozygosity for different tyes of thalassemia, beta-thalassemia and hereditary persistence of fetal hemoglobin, beta-thalassemia and Hb-Lepore, and in blacks it may even represent a true beta-thalassemia homozygote. This report describes thalassemia intermedia in a white male due to beta-thalassemia and an unstable hemoglobin. Chain-synthesis studies showed an excess of alpha-chain production over beta-chain production in the propositus and his mother but balanced chain synthesis in the clinically normal father, who is heterozygous for the unstable hemoglobin. The unstable hemoglobin was found to be beta14 (A11) Leu leads to Pro, which has previously been described in a clinically normal African woman, and named Hb-Saki. This hemoglobin is not distinguishable from Hb-A on routine electrophoresis at alkaline or acid pH and tests for unstable hemoglobins are necessary for its detection. The increasing list of such hemoglobin variants and previous cases of heterozygosity for beta-thalassemia and unstable hemoglobins are reviewed.