While the effectiveness of narrowband UVB phototherapy (NB-UVB) has been demonstrated in clinical trials, opinions on the value of offering this treatment in routine practice vary due to the need for treatment attendance and required infrastructure.
In order to assist in management decisions, scientists examined large-scale and long-term data on the efficacy of NB-UVB for psoriasis under real-world conditions in a new study published in PLoS One.
They found NB-UVB treatment leads to both a major sustained improvement as well as significant reduction in topical treatments in approximately 75 per cent of patients treated for psoriasis, with almost one-third of patients no longer requiring psoriasis-specific topicals and one-quarter of patients no longer needing steroid creams. Results were highly similar between four geographically separate locations.
A statistically significant reduction in anti-histamine prescriptions was also seen and the authors said the reduction in the use of anti-histamines indicates that NB-UVB ameliorates this symptom. “In a wider sense, these data therefore support the use of NB-UVB in non-psoriasis associated pruritus, which is often employed in clinical contexts not favourable to drug treatment,” the authors said.
Sin unos correctos hábitos dietéticos, inevitablemente se producen desajustes en el peso corporal, tanto por exceso como por defecto.
Las dietas que incluyen carbohidratos refinados, azúcares, grasas saturadas o trans han demostrado ser perjudiciales para las enfermedades reumáticas, tanto que se las conoce como ‘pro-inflamatorias’, y frente a esto, la dieta mediterránea se ha posicionado como “la mejor opción” para este tipo de enfermedades, según el catedrático de medicina preventiva y Salud pública en la Universidad de Las Palmas de Gran Canaria, Lluís Serra.
“La dieta mediterránea emerge como la mejor opción en nuestro entorno geográfico sin ninguna duda, incorporando siempre frutas y hortalizas, cereales integrales, legumbres, pescado azul, frutos secos, vino con moderación y aceite de oliva virgen extra, entre otros”, ha concretado el Dr. Serra durante la celebración del XLIII Congreso Nacional de la Sociedad Española de Reumatología (SER), celebrado en Bilbao.
En este sentido, si el paciente no sigue unos correctos hábitos dietéticos, “inevitablemente” se producirán desajustes en su peso corporal, tanto por exceso como por defecto, una situación que repercutirá de forma directa en sus articulaciones (sobrecarga o falta de estructuras de soporte), “llegando incluso a presentar, en ocasiones, déficit de nutrientes (como la vitamina D) que juegan un papel muy importante, tanto desde el punto de vista inmunológico como en la formación del hueso”, según el enfermero en consulta de reumatología en el Hospital Universitario Ramón y Cajal, Eduardo Fernández Ulloa.
Además, la prevención juega también un papel importante, ya que esta (secundaria o terciaria) continúa después del diagnóstico y de los beneficios de la dieta mediterránea, por lo que, como ha señalado el Dr. Serra, “nunca es tarde para disfrutar de los beneficios que nos puede aportar esta dieta, aunque sus efectos serán más precoces y mayores cuanto antes la adoptemos”.
“Es necesario saber que una mala alimentación incrementa en general el riesgo de este tipo de enfermedades o puede empeorar su pronóstico en el caso de personas ya diagnosticadas”, ha concluido.
Occupational status should be considered in diagnostics and in estimations of risk for rheumatoid arthritis (RA) in clinical practice, conclude the authors of a new study published in Arthritis Care & Research .
The recommendation follows new findings that certain occupations may put workers at an elevated risk of developing RA.
After examining data on 3,522 individuals with RA and 5,580 controls from the Swedish population-based EIRA (Epidemiological Investigation of Rheumatoid Arthritis) study, researchers found men working in the manufacturing sector had a higher risk of developing RA than workers within the professional, administrative, and technical sectors. Within this sector, male bricklayers and concrete workers had a threefold increased risk of RA than the reference group, while electrical and electronics workers and material handling operators had a twofold increased risk. Among women, assistant nurses and attendants had a slightly increased risk of RA. There was no increased risk amongst nurses.
“Our findings therefore indicate that work-related factors, such as airborne harmful exposures, may contribute to disease development,” said lead author, Anna Ilar. “It is important that findings on preventable risk factors are spread to employees, employers, and decision-makers in order to prevent disease by reducing or eliminating known risk factors,” she added.
New Antibiotic for ‘Superbug’ Gonorrhea
Theresa Bebbington August 07, 2017
Some types of the sexually transmitted infection known as gonorrhea have become resistant to several antibiotics – but laboratory research on a new drug is showing promise against this ‘superbug’.Without treatment, gonorrhea infection can lead to pelvic inflammatory disease and infertility in adults, and vision damage in babies when passed from the mother during childbirth.The organism that causes gonorrhea, Neisseria gonorrheae, can adapt and build up resistance to treatment. The first antibiotic it managed to beat was penicillin, which had been curing gonorrhea infections for the first 70 years from when the medicine was first introduced.Cases of gonorrhea resistant to the antibiotic azithromycin have occurred in England, with Public Health England (PHE) reporting 34 cases between November 2014 and April 2016. The cases have been confirmed in both heterosexual men and women, as well as in men who have sex with men. Although the strain of gonorrhea in that outbreak was treatable by a second antibiotic, ceftriaxone, resistance could build up to that drug, too.The World Health Organisation (WHO) currently recommends a combination of both ceftriaxone, which is given by injection, and azithromycin, which is taken by mouth.Antimicrobial resistance occurs when a strain of bacteria evolves to resist each consecutive treatment until no treatments are left, leaving these so-called ‘superbugs’ incurable. Some strains of N. gonorrheae are now currently untreatable due to the lack of alternative treatments. The first case of antibiotic-resistant gonorrhea was reported in Japan in 2011, and similar cases have since been found worldwide.Potential of a New AntibioticClosthioamide, a new class of natural antibiotics discovered in 2010, might eventually offer an alternative for current drugs that are becoming less effective against gonorrhea. For the first time, researchers from Imperial College London and the London School of Hygiene and Tropical Medicine have tested closthioamide on gonorrhea samples in the laboratory.
The researchers used 149 samples of N. gonorrheae taken from hospital patients with infections in the throat, urethra, cervix and rectum. They found that very low amounts (equal to or less than 0.125mg/L) of closthioamide was effective against 146 of the 149 samples – and against all of the samples provided to them by WHO that were known to be resistant to other antibiotics. The results of the study are published in the journal Antimicrobial Agents and Chemotherapy.This laboratory-based study is in an early stage of research. The drug has not yet been tested on animals and humans, but the researchers say the antibiotic shows tremendous promise and could be an exciting new step in the fight against gonorrhea. However, further research is necessary to assess the drug’s safety and effectiveness, and it will be a number of years before closthioamide can be used in real-life human cases.In reaction to the study, Dr Michael Brady, medical director at Terrence Higgins Trust, says: “We still have much to do to address the nation’s poor sexual health and the rates of STIs [sexually transmitted infections] in those most at risk. This research is an important contribution to our efforts, as it raises the hope that this new antibiotic, closthioamide, may be a novel and effective treatment for gonorrhea.
“It is early days and further research is needed to demonstrate the same effect in people that is seen in the laboratory, but this signals an important new step in fighting the infection.”
Prevention Is Key
Meanwhile, it remains important to try to prevent the spread of gonorrhea. According to statistics from the sexual health charity FPA ( Family Planning Association), there were 41,193 new cases of gonorrhea diagnosed in 2015, with men who have sex with men accounting for more than 55% of all gonorrhea diagnoses in 2015.
In his reaction, Dr Brady points out that between 2008 and 2015 gonorrhea rates in the UK rose by 175%. He says: “It is vital that we continue to educate people on how to protect themselves from STIs, including drug resistant gonorrhea, and encourage people to test regularly.”
PHE recommends that people help protect themselves by using condoms. They should use them correctly and consistently with new or casual partners until all partners have a sexual health screen. People should avoid overlapping relationships and get screened regularly if they belong in a higher risk group, such as men who have sex with men.
Although symptoms in men usually develop within two weeks, some men and women don’t have any symptoms.
In men, symptoms of gonorrhea noticeable in the penis include:
A yellowish, white or green discharge
A burning feeling, especially when urinating
Swelling of the foreskin
In women, gonorrhea in the vagina can cause:
A change in discharge
A burning feeling when urinating
Bleeding between periods
“In vitro susceptibility to closthioamide among clinical and reference strains of Neisseria gonorrheae”, published in Antimicrobial Agents and Chemotherapy
Imperial College London news release
Terrence Higgins Trust emailed statement
FPA (Family Planning Association)
In very rare cases – two in 10,000 people experts say – a chickenpox infection can trigger extremely dangerous brain inflammation. Until now, scientists didn’t know why this happened, and there was nothing they could do to predict or prevent it. Now, they’ve discovered a clue: a small mutation in the immune system’s DNA.
Chicken pox caused by the varicella zoster virus. Credit: BruceBlaus
The problem isn’t necessarily a failed attack on the chickenpox virus; rather, it’s that the immune system never realizes that the virus is there at all. Varicella zoster virus (VZV), which causes chickenpox, can sneak in undetected on rare occasions when there is a mutation in the “POL III” sensor. The immune system relies on this sensor to ring the alarm when VZV makes its way into the body. Researchers discovered the role of POL III after mapping genomes of people who experienced these rare infections.
VZV is unique in that it only infects humans. It comes from the same family of viruses that cause herpes, and it often remains in the body after an initial infection, resurfacing years later causing shingles. In addition to causing brain inflammation in rare instances, VZV can also lead to severe pneumonia (twenty out of 10,000 people), which is especially dangerous for pregnant women.
A vaccine to prevent chickenpox entered the world in 1995, and the Centers for Disease Control and Prevention (CDC) reports that “each year, more than 3.5 million cases of varicella, 9,000 hospitalizations, and 100 deaths are prevented by varicella vaccination in the United States.”
“We cannot yet put an exact figure on how much the risk of complications is increased when you have this new immunodeficiency, since we have looked at relatively few patients in our study. Neither do we know how large a proportion of all those who have inflammation of the brain and pneumonia have the defect,” clarified Trine Hyrup Mogensen. “But we do know that this applies to both children and adults.”
Further analysis of the individual cells invaded by VZV confirmed that no immune response was initiated because the virus was never detected. But when researchers manually repaired the mutation, the immune system was suddenly aware of VZV, like taking off a blindfold.
Chickenpox isn’t the only infection that can enter the body undetected if there’s a specific mutation in the immune system’s DNA. Now that scientists know they can identify the genes responsible and even fix mutations to activate the immune system, this knowledge could spread to treat other diseases.
“We are now slowly becoming able to understand the individual differences in susceptibility to infections at both the genetic and molecular level,” said Soren Riis Paludan. He and the other researchers on the project see their study as a unique contribution to the advancement of personalized medicine, where treatments and diagnostics are based on individual cases and needs.
The present study was published in The Journal of Clinical Investigation.
Sources: Aarhus University, American Journal of Transplantation, CDC
Allergy specialists in the US and Canada have described as a “tragedy” the death of a toddler during an oral food challenge at a US hospital. It’s reported three-year-old Alastair Watson died last month during a routine challenge to see if he could tolerate foods containing baked milk.
In a joint statement , The American Academy of Allergy, Asthma & Immunology , American College of Allergy, Asthma & Immunology and the Canadian Society of Allergy and Clinical Immunology said diagnosing food allergy is not always simple and multiple aspects of a person’s history must be considered in determining if a patient is a candidate for an oral food challenge, including recent or concurrent illness.
“This is the first reported fatality associated with an oral food allergy challenge. While even one death is too many, oral food challenges are considered the ‘gold standard’ test to determine if someone is allergic to a food,” the statement said.
They said to ensure patient safety, challenges should only take place in an office or hospital setting, with appropriate staff, and with documentation of informed consent which details that the risks and benefits of the procedure were explained to the patient or caregiver.
Smell Your Food, Live Longer
WRITTEN BY: Kara Marker
An intricate relationship between the gastrointestinal (GI) tract and the part of the brain that senses smell contributes to human longevity, a new study shows. The middleman that facilitates this relationship? Autophagy.
When you decrease autophagy the disease process is exacerbated and when you increase it you get the opposite effect. Aggregation of polyglutamine expansion protein is a hallmark of Huntington’s disease and other neurodegenerative diseases. The picture shows that there are more aggregates of green fluorescence protein-labelled polyglutamine expansion protein in autophagy deficient worms (bottom) compared to normal animals (top). Credit: Florida Atlantic University
Autophagy is the cellular process of removing debris and delivering it to an organelle called a lysosome to be degraded, like recycling or taking out the trash to keep your house clean of things you don’t need anymore. The goal of autophagy is simple, but its effects are complicated and diverse. Many studies on autophagy have shown that the process is vital for tumor suppression, targeting microorganisms in the body, and inhibiting the aging process.
In a new study from Florida Atlantic University published in the journal PLOS Genetics, researchers unveil how autophagy, nutrient absorption, and olfactory neurons are intertwined to influence natural human aging.
“If you want to extend the lifespan of any animal, after limiting their diet, you have to have functional autophagy in this animal otherwise you won’t see this lifespan extending effect,” explained corresponding author Kailiang Jia, PhD. In the new study, Jia and the other study authors found that autophagy is closely linked to lifespan because of its influence over nutrient absorption and olfaction.
“Autophagy can be activated and enhanced when you restrict calories, and we can actually see the autophagy process activated through caloric restriction,” Jia explained. “With disease, when you decrease autophagy the disease process is exacerbated, and when you increase it you get the opposite effect.”
Jia and the research team first realized the anti-aging role of smelling food in an experiment with fruit flies. Put simply, the flies on a restricted diet who were allowed to smell their food lived longer than the flies who couldn’t smell their food. Now, the researchers turn to model organism C. elegans to learn more about how autophagy, both in the nervous system and the GI tract, is connected to the aging process.
They found that autophagy is required for a neuroendocrine pathway that facilitates the conversation between sensory neurons and nutrient levels in the GI tract. When olfactory neurons sense a food’s smell, they secrete neuron signals, which influence aging. This pathway is mediated by autophagy.
In the GI tract, autophagy is regulated by nutrients that are consumed through food and absorbed in the gut. Together, autophagy in the brain and in the GI tract influence aging.
This current study sets the groundwork for an intriguing cellular relationship between the food we eat, the food we smell, and how are body’s cells break down and recycle cellular debris. Along with continued work on the application to anti-aging, the study’s authors plan to apply these findings to potential treatments for cancer, obesity, and neurodegenerative diseases.
Sources: Genes & Development, Florida Atlantic University