Routine pelvic examinations in women prescribed oral contraceptive pills (OCPs) for acne management are scrutinized to assess their impact on dermatological outcomes versus gynecological health. A synthesis of clinica...Routine pelvic examinations in women prescribed oral contraceptive pills (OCPs) for acne management are scrutinized to assess their impact on dermatological outcomes versus gynecological health. A synthesis of clinical trials, patient surveys, and medical guidelines reveals that these routine exams do not significantly enhance the effectiveness of acne treatment with OCPs but are linked to increased patient discomfort and false-positive results. Evidence suggests that routine pelvic examinations do not significantly impact the effectiveness of acne management with OCPs but are associated with increased patient discomfort and higher rates of false-positive results. The analysis indicates that a more personalized approach, focusing on selective pelvic examinations based on individual risk factors and clinical symptoms, may offer a more practical and patient-centered alternative. The review advocates for a reexamination of existing guidelines to better align with a model of individualized care, emphasizing the need for further research to optimize best practices at the intersection of dermatological and gynecological care. Adopting a personalized approach to pelvic examinations could substantially improve patient care by minimizing unnecessary interventions and discomfort while maintaining the efficacy of acne treatment with oral contraceptive pills.展开更多
BACKGROUND During the peak of the coronavirus diseases 2019(COVID-19)pandemic,clinicians actively studied the utility of various epidemiologic-clinical parameters to determine the prognosis for patients hospitalized w...BACKGROUND During the peak of the coronavirus diseases 2019(COVID-19)pandemic,clinicians actively studied the utility of various epidemiologic-clinical parameters to determine the prognosis for patients hospitalized with severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection.Serum IgG antibody level,DDimer,C-reactive protein and neutrophil to lymphocyte ratio,etc.were studied to assess their association with the clinical course in hospitalized patients and predict who may be at increased risk for poor clinical outcome.However,the influence of SARS-CoV-2-anti-nucleocapsid-IgG antibody(IgG-N)sero-positivity on the clinical outcome of patients with COVID-19 is largely unknown.AIM To study the influence of SARS-CoV-2 anti-nucleocapsid-IgG seropositivity on clinical course and diseases severity in hospitalized COVID-19 patients.METHODS We conducted a retrospective study of adults admitted to a tertiary care community hospital in North Dakota with COVID-19.Included patients had severeCOVID-19 disease or worse and so required supplemental oxygen on admission.They were serologically tested for SARS-CoV-2-anti-nuceocapsid-IgG(IgG-N).The IgG-N positive group were 26 patients and the IgG-N negative group had 33 patients.The groups received similar treatment for COVID-19 as approved by our healthcare system from Day 1 of admission until discharge or death.Measurable parameters for monitoring the patients’clinical course included the following:Length of hospitalization(LOS),use of high flow nasal canula(HFNC),use of noninvasive bilevel positive pressure ventilation(BiPAP),admission into the intensive care unit,need for mechanical ventilation(VENT);and the patient outcome/discharge or death.Other variables included were age,gender and body-mass-index,and duration of symptoms before presentation.For each variable,the outcome was modeled as a function of SARS-CoV-2-IgG-N status(positive or negative)using a generalized linear model.For LOS-days,a negative binomial distribution was used as it had a better fit than a Poisson or Gaussian distribution as evidenced by a Pearson chi-square/df value closer to 1.0.All other outcomes utilized a binary logistic regression model.RESULTS After a thorough examination of patient data,it was found that admission rates to the Intensive Care Unit,as well as the usage of BiPAP,HFNC and VENT support,in conjunction with patient outcomes,were not significantly different across IgG-N status.However,the LOS variable when assessed by IgG-N status was found to be significant(t value=2.16,P value=0.0349).IgG-N negative patients had higher than average LOS in comparison to IgG-N positive patients(15.12 vs 9.35 d).Even when removing the extreme value(an LOS of 158 d),IgG-N negative patients still had slightly higher than average stays(10.66 vs 9.35 d)but the relationship was no longer significant.For patient outcome/death,only age(numerical)was a significant predictor(F value=4.66,P value=0.0352).No other variables for any of the outcomes were significant predictors of clinical course or disease severity.CONCLUSION Our study demonstrated that IgG-N seroconversion had no significant association with clinical outcomes in hospitalized COVID-19 patients.展开更多
Emerging evidence indicates that childhood stressors, such as familial conflict, bullying, academic pressure, and traumatic events, can significantly worsen inflammatory skin conditions like atopic dermatitis (AD) and...Emerging evidence indicates that childhood stressors, such as familial conflict, bullying, academic pressure, and traumatic events, can significantly worsen inflammatory skin conditions like atopic dermatitis (AD) and psoriasis. This review explores the underlying neuroimmune pathways that link stress to skin inflammation in children, focusing on the role of the hypothalamic-pituitary-adrenal (HPA) axis and stress-induced cytokine production. Studies have shown that chronic psychological stress leads to dysregulation of the HPA axis, resulting in elevated cortisol levels, which paradoxically impair skin barrier function and upregulate pro-inflammatory cytokines such as IL-6, TNF-α, and IL-1β. Specific stressors, such as bullying, have been associated with heightened immune responses, increasing inflammation in the skin. For example, research has demonstrated that children who experience social stressors show elevated levels of C-reactive protein (CRP) and other markers of systemic inflammation, which directly correlate with skin condition flare-ups. Furthermore, exposure to early life stress has been linked to long-term alterations in immune function, perpetuating chronic inflammation even in the absence of ongoing stress. Future research should focus on longitudinal studies assessing how the timing, duration, and type of stressors influence skin condition severity, alongside evaluating interventions like cognitive-behavioral therapy (CBT) and stress management techniques. By addressing these childhood stressors, there is potential to not only mitigate skin condition flares but also reduce the long-term health consequences of chronic inflammation leading to therapeutic strategies that emphasize mental health alongside traditional dermatological treatments.展开更多
Dear Editor:I have read the paper“A Study of Normal Epidermal Melanocyte Distribution”by Sun et al.1 in the International Journal of Dermatology and Venereology(October 2020).I would like to congratulate the authors...Dear Editor:I have read the paper“A Study of Normal Epidermal Melanocyte Distribution”by Sun et al.1 in the International Journal of Dermatology and Venereology(October 2020).I would like to congratulate the authors on their interesting findings.It is intriguing to learn that the melanocyte density differs among specific areas of the body and that the skin thickness is not associated with the melanocyte density.展开更多
文摘Routine pelvic examinations in women prescribed oral contraceptive pills (OCPs) for acne management are scrutinized to assess their impact on dermatological outcomes versus gynecological health. A synthesis of clinical trials, patient surveys, and medical guidelines reveals that these routine exams do not significantly enhance the effectiveness of acne treatment with OCPs but are linked to increased patient discomfort and false-positive results. Evidence suggests that routine pelvic examinations do not significantly impact the effectiveness of acne management with OCPs but are associated with increased patient discomfort and higher rates of false-positive results. The analysis indicates that a more personalized approach, focusing on selective pelvic examinations based on individual risk factors and clinical symptoms, may offer a more practical and patient-centered alternative. The review advocates for a reexamination of existing guidelines to better align with a model of individualized care, emphasizing the need for further research to optimize best practices at the intersection of dermatological and gynecological care. Adopting a personalized approach to pelvic examinations could substantially improve patient care by minimizing unnecessary interventions and discomfort while maintaining the efficacy of acne treatment with oral contraceptive pills.
基金the National Institute of General Medical Sciences of the National Institutes of Health under Award,No.U54GM128729.
文摘BACKGROUND During the peak of the coronavirus diseases 2019(COVID-19)pandemic,clinicians actively studied the utility of various epidemiologic-clinical parameters to determine the prognosis for patients hospitalized with severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection.Serum IgG antibody level,DDimer,C-reactive protein and neutrophil to lymphocyte ratio,etc.were studied to assess their association with the clinical course in hospitalized patients and predict who may be at increased risk for poor clinical outcome.However,the influence of SARS-CoV-2-anti-nucleocapsid-IgG antibody(IgG-N)sero-positivity on the clinical outcome of patients with COVID-19 is largely unknown.AIM To study the influence of SARS-CoV-2 anti-nucleocapsid-IgG seropositivity on clinical course and diseases severity in hospitalized COVID-19 patients.METHODS We conducted a retrospective study of adults admitted to a tertiary care community hospital in North Dakota with COVID-19.Included patients had severeCOVID-19 disease or worse and so required supplemental oxygen on admission.They were serologically tested for SARS-CoV-2-anti-nuceocapsid-IgG(IgG-N).The IgG-N positive group were 26 patients and the IgG-N negative group had 33 patients.The groups received similar treatment for COVID-19 as approved by our healthcare system from Day 1 of admission until discharge or death.Measurable parameters for monitoring the patients’clinical course included the following:Length of hospitalization(LOS),use of high flow nasal canula(HFNC),use of noninvasive bilevel positive pressure ventilation(BiPAP),admission into the intensive care unit,need for mechanical ventilation(VENT);and the patient outcome/discharge or death.Other variables included were age,gender and body-mass-index,and duration of symptoms before presentation.For each variable,the outcome was modeled as a function of SARS-CoV-2-IgG-N status(positive or negative)using a generalized linear model.For LOS-days,a negative binomial distribution was used as it had a better fit than a Poisson or Gaussian distribution as evidenced by a Pearson chi-square/df value closer to 1.0.All other outcomes utilized a binary logistic regression model.RESULTS After a thorough examination of patient data,it was found that admission rates to the Intensive Care Unit,as well as the usage of BiPAP,HFNC and VENT support,in conjunction with patient outcomes,were not significantly different across IgG-N status.However,the LOS variable when assessed by IgG-N status was found to be significant(t value=2.16,P value=0.0349).IgG-N negative patients had higher than average LOS in comparison to IgG-N positive patients(15.12 vs 9.35 d).Even when removing the extreme value(an LOS of 158 d),IgG-N negative patients still had slightly higher than average stays(10.66 vs 9.35 d)but the relationship was no longer significant.For patient outcome/death,only age(numerical)was a significant predictor(F value=4.66,P value=0.0352).No other variables for any of the outcomes were significant predictors of clinical course or disease severity.CONCLUSION Our study demonstrated that IgG-N seroconversion had no significant association with clinical outcomes in hospitalized COVID-19 patients.
文摘Emerging evidence indicates that childhood stressors, such as familial conflict, bullying, academic pressure, and traumatic events, can significantly worsen inflammatory skin conditions like atopic dermatitis (AD) and psoriasis. This review explores the underlying neuroimmune pathways that link stress to skin inflammation in children, focusing on the role of the hypothalamic-pituitary-adrenal (HPA) axis and stress-induced cytokine production. Studies have shown that chronic psychological stress leads to dysregulation of the HPA axis, resulting in elevated cortisol levels, which paradoxically impair skin barrier function and upregulate pro-inflammatory cytokines such as IL-6, TNF-α, and IL-1β. Specific stressors, such as bullying, have been associated with heightened immune responses, increasing inflammation in the skin. For example, research has demonstrated that children who experience social stressors show elevated levels of C-reactive protein (CRP) and other markers of systemic inflammation, which directly correlate with skin condition flare-ups. Furthermore, exposure to early life stress has been linked to long-term alterations in immune function, perpetuating chronic inflammation even in the absence of ongoing stress. Future research should focus on longitudinal studies assessing how the timing, duration, and type of stressors influence skin condition severity, alongside evaluating interventions like cognitive-behavioral therapy (CBT) and stress management techniques. By addressing these childhood stressors, there is potential to not only mitigate skin condition flares but also reduce the long-term health consequences of chronic inflammation leading to therapeutic strategies that emphasize mental health alongside traditional dermatological treatments.
文摘Dear Editor:I have read the paper“A Study of Normal Epidermal Melanocyte Distribution”by Sun et al.1 in the International Journal of Dermatology and Venereology(October 2020).I would like to congratulate the authors on their interesting findings.It is intriguing to learn that the melanocyte density differs among specific areas of the body and that the skin thickness is not associated with the melanocyte density.
