bluuebunny/crossref_metadata_2025 huggingface dataset:
Treatment Satisfaction and Health-related Quality of Life among Individuals with Psoriasis: National Psoriasis Foundation Survey Findings
Authors: Horn Elizabeth J. , Fox Kathleen M. , Patel Vaishali , Kimball Alexa B. , Gordon Kenneth B. , Lebwohl Mark G.
Published: April 2018

Objective

To evaluate health-related quality of life (HRQoL) and treatment satisfaction among individuals with psoriasis.

Methods

Survey data from the National Psoriasis Foundation (2003–2006) were evaluated for >3,000 adult respondents. Psoriasis Quality of Life questionnaire (PQOL-12, lower scores = better HRQoL) assessed HRQoL. Respondents indicated satisfaction with psoriasis treatment on a scale of 1 (very unsatisfied) to 10 (very satisfied). Mean scores were compared by psoriasis severity using ANOVA. Multivariate linear regression evaluated the association of PQOL-12 scores and treatment satisfaction with demographic, clinical and treatment factors.

Results

Respondents with severe psoriasis had significantly higher PQOL-12 scores (mean= 7.0) than respondents with moderate (5.7) and mild (4.0) psoriasis, p<0.05. PQOL-12 scores were significantly associated with age, age at diagnosis, gender and psoriasis severity. Respondents with severe or moderate psoriasis reported lower (4.6 and 4.8, respectively) treatment satisfaction than respondents with mild psoriasis (6.1), p<0.0001. Psoriasis severity, psoriatic arthritis, therapy type, dermatologist and number of doctors seen were significantly associated with treatment satisfaction.

Conclusion

HRQoL and treatment satisfaction were significantly lower among respondents with severe and moderate psoriasis.
Mechanism behind Pruritus in Psoriasis
Authors: Hayashi Genki , Pang Mei-Lin
Published: April 2018

Background

A majority of psoriatic patients suffer from pruritus, but little is known about its mediator. Pruritus of psoriasis was thought to have been predominantly mediated by histamine, but the recent data suggest non-histamine mediators play the major role.

Objective

This paper reviews current published research on the mediators of pruritus in psoriatic patients.

Methods

English articles between 1980 and 2008, using the key words pruritus, psoriasis, itching, mechanism, and mediators, searched on MEDLINE and PubMed, were reviewed.

Results

Histamines appear to play little role in mediating pruritus in psoriatic patients, while other factors such as substance P (SP), nerve growth factor (NGF) and calcitonin gene-related peptide (CGRP) were shown to be more convincingly associated in mediating psoriatic pruritus.

Conclusion

The results indicate the possibility that there exist multiple mediators of pruritus with major involvement of the central nervous system (CNS).
The Appearance of a Cutaneous Anaplastic Lymphoma in a Psoriasis Patient Taking Methotrexate
Authors: Luber Adam , Patel Rita V.
Published: April 2018

The use of immunosuppressive therapies, including methotrexate (MTX) in the psoriasis population has been associated with the formation of lymphoproliferative disorders. We present a case of a 78-year-old patient with long-standing psoriasis who developed an anaplastic cutaneous lymphoma after approximately 16 months of treatment with 15 mg per week of MTX. Within a month of diagnosis, the MTX was tapered and acitretin was started. Ten weeks later, the patient's lymphoma was clinically resolved, and his psoriasis was well controlled with acitretin and topical therapy as needed. Until further investigation in the form of large prospective clinical trials are completed to substantiate the carcinogenic risk of this antipsoriatic therapy, physicians should be made aware of this plausible association and, along with regular blood work for hepatotoxicity, careful skin screening should be conducted regularly.
Assessing Newer Topical Treatment Options for Scalp Psoriasis
Authors: Kircik Leon H.
Published: April 2018

The scalp represents the most common site of involvement at the onset and throughout the course of psoriatic disease, yet it remains one of the most difficult anatomic areas to treat. Recent guidelines from the Medical Board of the National Psoriasis Foundation indicate the preeminence of topical corticosteroids in the management of scalp psoriasis while noting the benefits of various adjunctive agents, including vitamin D3 analogs and combination therapy. Although a number of topical treatment options are indicated for or have been used off-label to manage scalp psoriasis (short-contact tazarotene 0.05% or 0.1% gel, anthralin solution, keratolytics and clobetasol propionate 0.05% spray, among them), the newest agents approved by the U.S. Food and Drug Administration for the management of scalp psoriasis warrant consideration in light of these expert treatment recommendations.
The Role of CD8 T Cells and Their Antigen Receptors in Psoriasis
Authors: Gudjonsson Johann E. , Yost John , Johnston Andrew
Published: April 2018

Our knowledge of the pathogenesis and pathologic mechanisms involved in psoriasis has increased greatly over the past few years. Currently, 10 genetic susceptibility variants have been shown to predispose to psoriasis. Although work is being done to determine the biological function of these risk variants and how they predispose to psoriasis, there is no concise model that discusses the role of HLA-Cw6, the strongest risk variant identified to date, or CD8+ T cells, which are the predominant T-cell type in the epidermis of psoriatic lesions. Here, we discuss the relatively unexplored role of CD8+ T cells in psoriasis, their potential interaction with HLA-Cw6 and how this T-cell population may be the main culprit and driving force behind psoriasis. The evidence for involvement of the CD8+ T-cell subset is becoming increasingly convincing and may ultimately lead to better understanding of the autoimmune basis of psoriasis and eventual cure of this disease.
A Practical Approach to the Use of Cyclosporine for the Treatment of Psoriasis
Authors: Kamaria Monique , Liao Wilson , Koo John
Published: April 2018

Cyclosporine is an immunosuppressant that inhibits production of inflammatory cytokines involved in the pathogenesis of psoriasis. It is a rapid-acting agent that is highly effective for all types of psoriasis. It is intended for use at dosages of 2.5–5 mg/kg/day, either as acute short-term therapy or for continuous use for one to two years at a time in systemically healthy patients. The major adverse effects are nephrotoxicity and hypertension. Blood pressure, baseline creatinine, BUN, Mg2+, K+, Uric acid, CBC, fasting lipid profile, liver enzymes and bilirubin should be obtained before initiating therapy and should be monitored throughout therapy. There are many potential drug interactions, and a thorough drug history should also be obtained before initiating therapy.
Statin Use and Psoriasis Severity
Authors: Perry Adam , Kamalpour Loebat , Veledar Emir , Chen Suephy C.
Published: April 2018

Background

Inflammation plays a key role in psoriasis. Statins reduce inflammatory markers. However, data in the literature are limited regarding the effect of statins in psoriasis patients.

Objective

To examine the role of statin therapy in psoriasis.

Methods

We performed a retrospective chart review of 232 psoriasis patients. Psoriasis severity was measured by the percentage of body surface area covered by psoriatic lesions. It was recorded at two time points: (1) the last visit during which a new psoriasis medication was started and (2) the patient's most recent clinic visit. Subjects were divided according to statin use status.

Results

Although the statin users had a greater reduction in psoriasis severity, the difference did not reach statistical significance.

Conclusions

Our data suggest that future work regarding the impact of statin use on psoriasis severity is warranted.
A Review of the Efficacy and Safety of Combined Methotrexate and Ultraviolet B Phototherapy versus Ultraviolet B Phototherapy Alone in the Treatment of Psoriasis
Authors: Mudigonda Tejaswi , Levender Michelle M. , Feldman Steven R.
Published: April 2018

Background

Methotrexate (MTX) and ultraviolet light B (UVB) phototherapy are effective as single agents for psoriasis. By combining the two agents, it is proposed that the use of UVB-MTX can yield greater therapeutic efficacy than using MTX or UVB alone and limit the cumulative exposure of both UVB and MTX to the patient.

Objective

To review evidence on the clinical efficacy and safety of using combined UVB-MTX compared with using UVB alone.

Methods

We performed a PubMed search for studies involving the combination of UV therapy with MTX. The reported studies evaluate the clinical efficacy and safety of UVB-MTX therapy compared with UVB alone.

Results

Based on the studies we reviewed, combined UVB-MTX therapy is more effective than UVB alone in treating psoriasis. The mean cumulative MTX doses ranged from 112 to 196 mg, and no cases of MTX-related liver toxicity symptoms were reported in the three studies.

Discussion

Combination phototherapy involving UVB-MTX is more clinically effective than UVB alone for patients with plaque-type psoriasis. The current review is limited by the absence of studies comparing the efficacy of combined UVB-MTX therapy with MTX monotherapy. Combination UVB-MTX therapy appears to be safe and well tolerated.
C-Reactive Protein and Cardiovascular Disease in Psoriasis
Authors: Goldminz Ari M. , Gottlieb Alice B.
Published: April 2018

Psoriasis is often associated with an overproduction of C-reactive protein (CRP). Patients at increased risk for cardiovascular disease (CVD) also frequently have elevated CRP levels. This article reviews the latest data on the connection between CRP, CVD, and psoriasis. Patients with elevated CRP levels as well as those with psoriasis may be at increased risk for CVD, yet some controversy exists over the strength of these correlations. Several systemic treatments for psoriasis have CRP-lowering effects, although a connection between reductions in CRP levels and clinical clearance of psoriatic disease has not been studied extensively. Limited data are available on the relationship between psoriasis severity and CRP. While the articles included in this review begin to uncover the relationship between CRP and psoriasis, they also illustrate several confounding variables and an incomplete understanding of CRP's clinical application in psoriasis. A large-scale, detailed psoriasis patient database would provide a more accurate assessment of the association between CRP, CVD, and psoriasis.
Treatment of Psoriasis in the Setting of Excessive Alcohol Intake: From the Medical Board of the National Psoriasis Foundation
Authors: Pugliese Douglas J. , Gottlieb Alice B. , Hsu Sylvia , Korman Neil J. , Lebwohl Mark G. , Young Melodie , Bebo Bruce F. , Blauvelt Andrew , Van Voorhees Abby S. ,   for the National Psoriasis Foundation
Published: April 2018

A task force of the National Psoriasis Foundation Medical Board was convened to evaluate treatment options for psoriasis in the setting of excessive alcohol intake. Consensus on treatment algorithms was achieved.

Background

Psoriasis is a chronic, inflammatory, multisystem disease in which alcohol abuse is higher than in the general population. Alcohol may exacerbate psoriasis and can complicate the choices for therapy given the potential for the combined toxicity of ethanol and treatment. Evidence-based data to guide clinicians in managing these challenging patients are quite limited.

Objective

Our aim was to create treatment recommendations to help dermatologists manage patients with psoriasis in the setting of excessive alcohol intake.

Methods

A literature review was conducted to examine treatment options for psoriasis in the setting of excessive alcohol consumption.

Results

Treatment should be dictated by the severity of disease and any patient comorbidities. First-line choices for extensive disease include phototherapy with narrowband ultraviolet B and photochemotherapy with psoralen plus ultraviolet A, as well as the tumor necrosis factor-alpha inhibitors adalimumab and infliximab. Second-line choices are acitretin, alefacept, cyclosporine, etanercept, and ustekinumab. A third-line choice would be methotrexate. Physicians should be vigilant to check liver function tests regularly.

Limitations

There are few studies examining treatment options for psoriasis in the setting of excessive alcohol consumption. Thus, these recommendations are based on experience and expert opinions.

Conclusion

Management of psoriasis in the setting of excessive alcohol consumption requires a thorough understanding of the treatment options that are available. Therapy should be based on the extent of the disease balanced with patients' underlying comorbidities.
A Practical Approach to the use of Ustekinumab
Authors: Zitelli Kristine B. , Bhutani Tina
Published: April 2018

This clinical review outlines a practical approach for the use of ustekinumab in psoriasis treatment. Ustekinumab is a human immunoglobulin G (IgG)1-kappa monoclonal antibody antagonist of the p40 subunit of interleukin (IL)-12 and IL-23. Ustekinumab was approved by the Food and Drug Administration in September 2009 for treatment of patients aged 18 years and older with moderate to severe plaque psoriasis who are eligible for phototherapy or other systemic therapy. Its efficacy and safety have been evaluated in two large phase III clinical trials: PHOENIX 1 and PHOENIX 2. Proper dosing is based on a fixed dose determined by patient body weight and administered by a health care provider with two starter doses 4 weeks apart, followed by maintenance dosing every 12 weeks. Adverse events—including serious infections, malignancy, reversible posterior leukoencephalopathy syndrome, and cardiovascular events (e.g., sudden cardiac death, myocardial infarction, or stroke)—have been reported. Attention to warnings, precautions, and appropriate patient selection regarding ustekinumab can assist dermatologists in safely prescribing this new biologic agent for psoriasis patients.
Erythrodermic Psoriasis in a 13-Year-Old Girl
Authors: Guenin Sophie , Geller Lauren
Published: April 2018

Erythrodermic psoriasis is a rare yet severe form of psoriasis in children. The National Psoriasis Foundation recently published treatment guidelines for erythrodermic psoriasis in adults recommending systemic medications such as infliximab, cyclosporine, methotrexate, and acitretin as first-line agents for this disorder. However, the evidence on the safety and efficacy of these medications in children is limited, and the management of pediatric erythrodermic psoriasis remains a therapeutic challenge. We present a case of a 13-year-old girl with a 10-month history of severe refractory erythrodermic psoriasis. Initial treatment with cyclosporine was complicated by the development of H1N1 influenza infection and hospitalization in the intensive care unit. She was subsequently administered methotrexate, acitretin, and oral steroids, but her symptoms have persisted, with erythema and scaling involving nearly her entire body surface area.
The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) Composite Disease Index Project (GRACE)
Authors: Helliwell Philip
Published: April 2018

Composite disease outcome measures have been used in rheumatology for some time, but a disease-specific composite measure for psoriatic arthritis has not yet been validated. Currently, instruments developed for use in rheumatoid arthritis are employed in psoriatic arthritis and include the American College of Rheumatology (ACR) response criteria (ACR20, 50, and 70 criteria) and the disease activity score for 28 and 44 joints. However, none of these instruments covers the full spectrum of psoriatic disease and in particular they do not assess the dermatologic contribution. By definition, a composite measure incorporates several dimensions of disease status, often by combining these different domains into a single score, which in the case of psoriatic arthritis should include joints, skin, entheses, dactylitis, and axial disease. Although some indices combine these diverse clinical manifestations of psoriatic disease, the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) established the GRAPPA Composite Exercise (GRACE) project to develop a new index and to compare the existing composite measures.
The International Psoriasis Council Presents Top Five Psoriasis Research Articles for July 2010–December 2010
Authors: Tebbey Paul , Gordon Kenneth , Rajagopalan Murlidhar , van de Kerkhof Peter C. M.
Published: April 2018

The International Psoriasis Council (IPC) is a global nonprofit organization dedicated to advancing psoriasis research and treatment by providing a forum for education, collaboration, and innovation among physicians, researchers, and other professionals interested in psoriasis. Each year, the IPC identifies the top papers in the field of psoriasis. Those selected from the second half of 2010 are reviewed here.
Minimal Erythema Dose Testing Made Easy with Excimer Laser
Authors: Lee Eric S. , Park Kelly , Heller Misha M. , Kamangar Faranak , Lee Stephen S. , Koo John Y. M.
Published: April 2018

Phototherapy is one of the oldest therapeutic modalities for the treatment of generalized psoriasis. Optimal efficacy for phototherapy is based on achieving the minimal erythema dose (MED) as quickly as possible. MED testing on every patient would be ideal to determine each individual's most effective dose. Previous methods of determining MED are cumbersome; however, the excimer laser has made MED determination easy. The excimer laser is not only a treatment modality in itself, but it can also be used to provide the clinician with a quick and easy way of determining each individual patient's MED. In this way, the laser can also significantly enhance efficacy for patients undergoing traditional narrowband ultraviolet B phototherapy.
Psoriasis Patient–Physician Interactions
Authors: Uhlenhake Elizabeth E. , Feldman Steven R. , Kurkowski David
Published: April 2018

Background

Psoriasis patients are too frequently dissatisfied with the doctor–patient relationship.

Purpose

To explore how psoriasis patients and dermatologists view the doctor–patient relationship.

Methods

Separate discussion groups were held in which physicians and patients discussing their thoughts on interactions between psoriasis patients and their physicians. Four groups of six to eight dermatologists discussed patient expectations, observed psoriasis patients as they discussed their views on office visits, and finally discussed the patient encounter after observing the patient dialogues.

Results

Patients desired more information, quick treatments, clear therapeutic expectations, and recognition of emotional burden. After viewing patient discussions, dermatologists noted that patients often do not receive or internalize adequate information and therefore need further explanation of treatment regimens to increase compliance and patient satisfaction.

Conclusions

Dermatologists and patients had different impressions of key issues in the psoriasis patient–physician encounter. Patients' needs may be better met by providing more information on psoriasis treatments, even when the information may not change the treatment plan, and by providing information in writing.
Naphthalan Oil in the Treatment of Psoriasis and Psoriatic Arthritis
Authors: Krnjevic-Pezic Gordana , Alajbeg Ivan , Maricić Goran , Pašić Aida , Ćurković Božidar , Ceović Romana , Kostović Krešimir
Published: April 2018

Background

Naphthalan is a specific form of medicinal earth oil, and a number of subtypes are used in topical therapy for psoriasis and psoriatic arthritis. In the present study, yellow naphthalan oil that is enriched with steranes but that has a reduced content of polyaromatics was used.

Objective

The aim of the study was to assess the effect of naphthalan on psoriatic skin lesions, on painful and swollen joints, and on functional status of patients with psoriatic arthritis.

Methods

The study included 28 patients with chronic stationary psoriasis (psoriasis vulgaris) and 12 patients with psoriatic arthritis.

Results

In the psoriasis vulgaris study arm, the mean ± SD Psoriasis Area and Severity Index score was 23.1 ± 7.5 at baseline; it was 7.95 ± 4.08 after 3 weeks of naphthalan treatment. In the majority of patients, naphthalan treatment reduced articular pain and edema and improved mobility of affected joints.

Conclusion

Naphthalan provides efficacious therapy in the management of mild to moderate psoriasis and psoriatic arthritis.
Biomarkers to Diagnose Early Arthritis in Patients with Psoriasis
Authors: Grace Chiu Ya-Hui , Ritchlin Christopher T.
Published: April 2018

Background

Psoriatic arthritis is a potentially destructive, inflammatory joint disease that affects 20% to 30% of patients with psoriasis. Psoriasis precedes the onset of joint inflammation by approximately 10 years, providing a unique opportunity to intervene and prevent or delay onset of musculoskeletal manifestations. The emergence of sensitive imaging modalities and cellular biomarkers may facilitate early identification of patients with psoriasis who have subclinical joint disease and might help stratify patients with an early onset of arthritis.

Methods

The translational studies described herein are focused on the development of cellular biomarkers identified with flow cytometry and cell culture techniques in patients with psoriasis and psoriatic arthritis.

Results and Conclusion

The combination of power Doppler ultrasound imaging and cellular biomarkers (ie, CD16 and dendritic cell specific transmembrane protein) to diagnose early psoriatic arthritis and to stratify patients with established psoriatic arthritis provides a new opportunity to optimize treatment outcomes in this potentially disabling disease.
Compatibility Study Examining the Physical and Chemical Stability of Calcipotriene Ointment 0.005% with Three Topical Corticosteroids: Clobetasol Ointment 0.05%, Desoximetasone Ointment 0.25%, and Desoximetasone Ointment 0.05%
Authors: Frankel Amylynne , Patel Bikhu
Published: April 2018

Combination topical therapy with calcipotriene ointment and topical corticosteroids is a useful treatment strategy for plaque psoriasis. Combination therapies involve using several drugs at once to optimize their effectiveness while potentially reducing unwanted adverse effects of the corticosteroid. Clobetasol propionate ointment 0.05% and desoximetasone ointment 0.25% are high-potency corticosteroids that are used for their anti-inflammatory and antipruritic properties in a variety of skin disorders. Calcipotriene ointment is a synthetic derivative of calcitriol, or vitamin D, used in the treatment of plaque psoriasis, but it can be inactivated by certain topical medications. Clinical trials involving the combination calcipotriene with topical corticosteroids have demonstrated clinical benefit compared with corticosteroid monotherapy. This study evaluated the physical and chemical compatibility of combination of topical therapies with a new, generic formulation of calcipotriene. Calcipotriene ointment 0.005% was compatible both physically and chemically when compounded with the high-potency topical corticosteroids clobetasol ointment 0.05% and desoximetasone ointment 0.25% and 0.05%.
History of Methotrexate and Use in Psoriasis
Authors: Luber Adam , Lee David
Published: April 2018

Since the 1950s, methotrexate (MTX) has been an effective treatment for patients with psoriasis. Although initially used as an antineoplastic drug, in recent history, MTX has become useful for the treatment of a broad range of non-neoplastic proliferative dermatoses, particularly psoriasis. The guidelines for use of MTX in psoriasis patients provide a unique perspective of the discoveries and new information that we have learned about MTX over the years. In this historical review, we analyze the development of MTX and the circumstances that led to its use as an effective treatment for psoriasis.
Survey of Psoriasis Patient Awareness of Metabolic Syndrome Co-Morbidities
Authors: Adelzadeh Lily , Vangala Sitaram , Chiu Melvin W.
Published: April 2018

Background

Psoriasis patients are thought to be at increased risk of having metabolic syndrome.

Objective

To investigate if psoriasis patients are aware of their condition's association with metabolic syndrome, and whether they have been educated about and screened for metabolic syndrome by their dermatologists.

Methods

Written surveys distributed to psoriasis patients at a National Psoriasis Foundation fundraising event.

Results

Of 49 patients who completed the survey, 16 (32.7%), 17 (34.7%), 16 (32.7%), 20 (40.8%), and 16 (32.7%) were aware of the link between psoriasis and diabetes, hypertension, dyslipidemia, obesity, and myocardial infarction, respectively. Only 4.7% to 32.6% of the respondents reported being educated about the link between psoriasis and metabolic syndrome, and 19.6% to 39.1% reported having been screened by their dermatologist for metabolic syndrome components.

Limitations

Patients may not remember or be aware they are being taught or screened for metabolic syndrome. Conclusion: The majority of psoriasis patients in this survey were unaware of the association of psoriasis with metabolic syndrome and reported infrequent teaching and screening by their dermatologists.
Review of Oral Psoriasis
Authors: Moccia Robert , Zhang Lisa
Published: April 2018

Oral psoriasis is a subset of psoriasis that has many clinical presentations. Among the most common are geographic tongue, fissured tongue, and plaque psoriasis of the lips. Treatment options vary depending on the severity of the oral involvement as well as the extent of cutaneous involvement. Systemic treatments include infliximab, cyclosporine, and methotrexate. In cases with limited skin findings, topical treatments such as tacrolimus ointment, mometasone furoate ointment, fluocinolone acetonide cream, and retinoic acid mouthwash can be used. Direct steroid injections into the oral lesions also have been shown to aid in regression.
The Role of Interleukin-17 in Atherosclerosis and Psoriasis
Authors: Hegedus Fanni , Rose Sharon
Published: April 2018

Interleukin-17 (IL-17) has a complex, multifaceted role in the inflammatory and immune processes in both humans and mice. However, the research findings thus far on IL-17's role in the pathogenesis of atherosclerosis and psoriasis remain controversial. It is both atheroprotective and atherogenic in different studies. There are important clinical implications in the treatment of psoriasis with biologic therapies (i.e. IL-17 blockers and IL-12/23 blockers) and the occurrence of cardiac events. Further investigations are needed to elucidate the exact mechanisms of IL-17 and related cytokines, and the consequences of their inhibition.
ICD-10 for the Dermatologist and Psoriasis Care Provider
Authors: Algzlan Haitham , Varada Sowmya , Posnick Mark , Gottlieb Alice B.
Published: April 2018

On March 31, 2014, the U.S. Department of Health and Human Services announced an Oct. 1, 2015, deadline for the implementation of ICD-10. Importantly, the shift will be immediate, with no rollout or overlap period. This means that starting on Oct. 1, 2015, any claims filed using ICD-9 codes will be denied. This article hopes to provide an overview of ICD-10, the main differences between the 9th and 10th version, and its implications for the dermatology practice and those who manage psoriasis.
Patient Perspectives on Psoriasis Management: U.S. Results of the Population-Based Multinational Assessment of Psoriasis and Psoriatic Arthritis Survey
Authors: Lebwohl Mark G. , Kavanaugh Arthur , Armstrong April W. , Van Voorhees Abby S. , Kalb Robert E.
Published: April 2018

Background

Psoriasis and psoriatic arthritis are associated with a high disease burden, underdiagnosis, and undertreatment.

Objective

To further understand unmet needs in patients with psoriasis and psoriatic arthritis.

Methods

The population-based Multinational Assessment of Psoriasis and Psoriatic Arthritis (MAPP) survey included psoriasis and/or psoriatic arthritis patients selected by list-assisted random digit dialing. We report results from the United States.

Results

52,926 households in the United States were screened; 1,005 adults completed the survey. Of these, 73.1% of patients reported a psoriasis diagnosis alone and 26.9% reported psoriatic arthritis (with/without a separate psoriasis diagnosis). Approximately 22% of patients reported no current treatment; <10% of psoriasis and 50% of psoriatic arthritis patients were receiving systemic therapy. Perceived treatment burden, safety and tolerability concerns, and lack of effectiveness were commonly reported as reasons for treatment dissatisfaction and discontinuation.

Conclusions

Psoriasis and psoriatic arthritis remain undertreated in the United States, marked by high treatment dissatisfaction and discontinuation.
Safety and Efficacy of Combining Biologic with Nonbiologic Therapies for Moderate to Severe Psoriasis: A Review
Authors: Patel Viraat , Levin Ethan , Sorenson Eric , Malakouti Mona , Koo John Y.M.
Published: April 2018

Background

Some psoriasis patients respond inadequately to monotherapy and require combination therapy. Combining a biologic and nonbiologic agent may provide improvement.

Objective

To review the efficacy and safety of combination treatment with biologic and nonbiologic agents in the treatment of moderate to severe plaque psoriasis.

Methods

We searched Pubmed for English-language publications evaluating combination treatment with biologic and nonbiologic therapies through June 2014.

Results

Etancercept was the most commonly used biologic followed by ustekinumab, adalimumab, and infliximab. The majority of nonbiologic therapies reported were narrowband UVB (NBUVB) and methotrexate. Most cases reported increased efficacy with combination therapy with serious adverse events occurring in less than 3% of patients.

Conclusion

Combination biologic plus nonbiologic therapy, especially NBUVB with biologics is a viable clinical strategy in the treatment of psoriasis patients unresponsive to monotherapy, despite limitations in the data available. However, the long-term impact of these combinations has yet to be determined.
Prescription Medication Hoarding in Two Patients with Psoriasis
Authors: Peart Jenna M. , McLean Carmen P. , Masalaitis Jeannine , Van Voorhees Abby S.
Published: April 2018

We report two cases of patients who endorsed hoarding prescription medications for the treatment of their psoriasis, at times utilizing long-expired medications or starting a second course of a biologic without the guidance of a physician. These behaviors represent risk factors for possible adverse medication-related outcomes. Dermatologists should be aware that patients may be hoarding medications and counsel them accordingly.
How I treat T-cell chronic active Epstein-Barr virus disease
Authors: Bollard Catherine M. , Cohen Jeffrey I.
Published: April 2018

T-cell chronic active Epstein-Barr virus (CAEBV) is a rare disease in which EBV is present predominantly in T cells that infiltrate the tissues; patients have high levels of EBV in the blood. If untreated, patients often develop liver failure, hemophagocytic lymphohistiocytosis, coronary artery aneurysms, EBV infiltrating T cells impairing organ function, or T-cell lymphomas refractory to treatment. At present, hematopoietic stem-cell transplantation is the only curative therapy, and it is critical to make a proper diagnosis and initiate transplantation before the disease progresses to an irreversible stage. Specific medications such as high-dose systemic corticosteroids or ganciclovir combined with either histone deacetylase inhibitors or bortezomib may temporarily reduce systemic toxicity associated with T-cell CAEBV and allow the patient time to receive a transplant. Relapses of the disease after transplantation have also occurred, and the use of donor-derived virus-specific T cells may help to treat these relapses.
Randomized phase 2 trial of monthly vitamin D to prevent respiratory complications in children with sickle cell disease
Authors: Lee Margaret T. , Kattan Meyer , Fennoy Ilene , Arpadi Stephen M. , Miller Rachel L. , Cremers Serge , McMahon Donald J. , Nieves Jeri W. , Brittenham Gary M.
Published: April 2018

Key Points

Annual rates of respiratory illness in sickle cell disease decreased by >50% during the second year of monthly doses of oral vitamin D3. Reduction in rates was similar with high-dose (100 000 IU/mo) and standard-dose (12 000 IU/mo) treatment.
Introduction to this special section: Geomechanics
Authors: Li Yongyi , Foster Douglas , Sanchez-Nagel Marisela , Tingay Mark , Verdon James
Published: April 2018

Geomechanics is the study of the mechanical properties, conditions, and behavior of the subsurface. It can be applied at a range of scales, from tectonic to regional studies, through reservoir characterization, down to well studies, which can be vital for successful drilling, completion, and reservoir management. Geomechanics, therefore, plays an important role in the exploitation of hydrocarbons and especially in the development of unconventional resources.
Geomechanical investigation of microseismicity during hydraulic fracture interaction with a preexisting fault
Authors: Maxwell Shawn C. , Hazzard Jim , Pettitt Will
Published: April 2018

We discuss characteristics of geomechanically modeled microseismicity in a scenario of hydraulic fracture activation of a preexisting fault. This modeling example represents a geomechanical tutorial of the fault activation in a relatively simple scenario, which may be of use when interpreting microseismic imaging and induced seismicity field data. The model confirms the expected result of induced shear slip when the hydraulic fracture intersects the fault. However, a subtle asymmetry in fault slip and associated onset of the microseismicity occurs due to stress shadowing around the hydraulic fracture. Although the modeled microseismicity along the fault is predominantly associated with a shear mechanism, localized dilation of the fault introduces a relatively small fault-opening component for small-magnitude microseismicity. Finally, episodic clusters of microseismicity were found as the area of fault activation grew. This was associated with an initial slip event and subsequent redistributions on localized segments of the fault.
Spatial regulation of microtubule disruption during dendrite pruning in Drosophila
Authors: Herzmann Svende , Götzelmann Ina , Reekers Lea-Franziska , Rumpf Sebastian
Published: April 2018

Large scale neurite pruning is an important specificity mechanism during neuronal morphogenesis. Drosophila sensory neurons prune their larval dendrites during metamorphosis. Pruning dendrites are severed in their proximal regions, but how this spatial information is encoded is not clear. Dendrite severing is preceded by local breakdown of dendritic microtubules through PAR-1-mediated inhibition of Tau. Here, we investigated spatial aspects of microtubule breakdown during dendrite pruning. Live imaging of fluorescently tagged tubulin shows that microtubule breakdown first occurs at proximal dendritic branchpoints, followed by breakdown at more distal branchpoints, suggesting that the process is triggered by a signal emanating from the soma. In fly dendrites, microtubules are arranged in uniformly oriented arrays where all plus ends face towards the soma. Mutants in kinesin-1 and -2, which are required for uniform microtubule orientation, cause defects in microtubule breakdown and dendrite pruning. Our data suggest that the local microtubule organization at branch points determines where microtubule breakdown occurs. Local microtubule organization may therefore contribute spatial information for severing sites during dendrite pruning.
Bone marrow transplantation corrects haemolytic anaemia in novel ENU mutagenesis mouse model of TPI deficiency
Authors: Conway Ashlee J. , Brown Fiona C. , Hortle Elinor J. , Burgio Gaetan , Foote Simon J. , Morton Craig J. , Jane Stephen M. , Curtis David J.
Published: April 2018

We have performed a genome-wide ENU mutagenesis screen in mice to identify novel genes or alleles that regulate erythropoiesis. Here we describe a recessive mouse strain, called RBC19, harbouring a point mutation within the housekeeping gene, Tpi1, which encodes for the glycolysis enzyme, triosephosphate isomerase (TPI). A serine in place of a phenylalanine at amino acid 57 severely diminishes enzyme activity in red cells and other tissues, resulting in a macrocytic haemolytic phenotype in homozygous mice that closely resembles human TPI deficiency. A rescue study was performed using bone marrow transplantation of wildtype donor cells, which restored all haematological parameters and increased red cell enzyme function to wildtype levels after 7 weeks. This is the first study performed in a mammalian model of TPI deficiency demonstrating that the haematological phenotype can be rescued.
Βιβλιοκριτική Μαραβέγιας, Ν. (2016) (επιμ.)Ευρωπαϊκή Ένωση. Δημιουργία, εξέλιξη, προοπτικές. Αθήνα: Κριτική
Authors: Χάρδας Αναστάσιος
Published: April 2018

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Ασύμμετρη ισχύς, ευρωπαϊκή ολοκλήρωση και εθνική κυριαρχία: Η περίπτωση της ευρωζώνης
Authors: Μαρής Γεώργιος
Published: April 2018

Κύριος σκοπός αυτής της μελέτης είναι να προσφέρει μια διαφορετική ερμηνεία της διαδικασίας της ευρωπαϊκής ολοκλήρωσης, με την παράθεση ενός  εναλλακτικού προτύπου συστηματικής εξέτασης του φαινομένου στο οποίο τονίζεται η σημασία της ασυμμετρίας ως προσδιοριστικού της παράγοντα. Εξετάζεται κυρίως πως η ανάπτυξη ασύμμετρων δυναμικών σχέσεων ανάμεσα στους κύριους δρώντες επηρεάζει τη διαδικασία της ευρωπαϊκής ολοκλήρωσης. Στο ιδιότυπο σύστημα της Ευρωπαϊκής Ένωσης η ασυμμετρία αποκτά τελείως διαφορετικά χαρακτηριστικά σε σχέση με την ασυμμετρία που παρατηρείται στο διεθνές πλαίσιο, συνθήκη η οποία αλλάζει τη φύση της ενοποιητικής διαδικασίας και του προτύπου διακυβέρνησης. Η σημασία της ασυμμετρίας γίνεται εντονότερη στην τρέχουσα περίοδο στην οποία η διαχείριση των ποικίλων κρίσεων και προκλήσεων που αντιμετωπίζει η ΕΕ αποτελεί πεδίο έντονου προβληματισμού και αντιπαράθεσης.
Current Perspectives on Transport Medicine in Pediatric Hospital Medicine Fellowships
Authors: Corden Mark H. , Huynh Thanh , Mandal Purnima , Chand Sanjay , Maniscalco Jennifer
Published: April 2018

Transport medicine (TM) is a Pediatric Hospital Medicine (PHM) Core Competency and part of the proposed PHM fellowship curricular framework. No published TM curricula are available. This cross‐sectional study was designed to determine attitudes toward TM training among PHM fellowship stakeholders and conduct a TM curriculum needs assessment. Unique, web‐based, anonymous surveys for PHM fellows, graduates, and program directors (PDs) were administered, with response rates of 57%, 37%, and 44%, respectively. Fellows' interest in completing a TM rotation is greater than their perceived interest by PDs (P = .06). Graduates who completed a TM rotation were more likely to recommend a TM rotation than those who did not (P = .001). Perceived barriers included lack of a formal TM curriculum and time constraints. Stabilizing patients and triage of referrals were deemed important learning objectives, and active learning strategies were prioritized. Curriculum design should focus on topics specific to the transport process and environment.
Hospital Readmissions in Patients with Cirrhosis: A Systematic Review
Authors: Orman Eric S. , Ghabril Marwan , Emmett Thomas W. , Chalasani Naga
Published: April 2018

BACKGROUND

Hospital readmission is a significant problem for patients with complex chronic illnesses such as liver cirrhosis.

PURPOSE

We aimed to describe the range of readmission risk in patients with cirrhosis and the impact of the model for end‐stage liver disease (MELD) score.

DATA SOURCES

We conducted a systematic review of studies identified in Ovid MEDLINE, PubMed, EMBASE, CINAHL, the Cochrane Library, Scopus, Google Scholar, and ClinicalTrials.gov from 2000 to May 2017.

STUDY SELECTION

We examined studies that reported early readmissions (up to 90 days) in patients with cirrhosis. Studies were excluded if they did not examine the association between readmission and at least 1 variable or intervention.

DATA EXTRACTION

Two reviewers independently extracted data on study design, setting, population, interventions, comparisons, and detailed information on readmissions.

DATA SYNTHESIS

Of the 1363 records reviewed, 26 studies met the inclusion and exclusion criteria. Of these studies, 21 were retrospective, and there was significant variation in the inclusion and exclusion criteria. The pooled estimate of 30‐day readmissions was 26%(95% confidence interval [CI], 22%‐30%). Few studies examined readmission preventability or the relationship between readmissions and social determinants of health. Reasons for readmission were highly variable. An increased MELD score was associated with readmissions in most studies. Readmission was associated with increased mortality.

CONCLUSION

Hospital readmissions frequently occur in patients with cirrhosis and are associated with liver disease severity. The impact of functional and social factors on readmissions is unclear.
Conocimiento experto y autorregulación en adultos mayores jubilados profesionales y no profesionales
Authors: Krzemien Deisy , Richard´s María M , Biscarra María Ayelén
Published: April 2018

Si bien se han investigado variables psicosociales implicadas en la adaptación posjubilatoria, existe escaso interés en el factor del conocimiento experto. Este estudio propone comparar las metas de vida a partir del retiro jubilatorio en adultos mayores profesionales y no profesionales, y analizar la relación entre el conocimiento experto y las estrategias de autorregulación, con el fin de contrastar empíricamente el modelo del Grupo de Berlín. Se utilizó un diseño correlacional transversal en una muestra de 258 jubilados distribuidos en dos grupos: profesionales y no profesionales. Se hallaron diferencias en la selección de metas entre ambos grupos y se evidenció que el conocimiento experto se relacionó con un mayor uso de estrategias de optimización y compensación. El grupo no profesional utilizó la estrategia compensación en mayor medida, y el grupo profesional presentó un desempeño significativamente mayor en conocimiento experto. Los datos obtenidos sirven al diseño de programas de asistencia prejubilatoria.
La habitabilidad del espacio público en las ciudades de América Latina
Authors: Páramo Pablo , Burbano Andrea Milena , Jiménez Domínguez Bernardo , Barrios Veronica , Pasquali Carlota , Vivas Fabiola , Moros Oscar , Alzate Mónica , Jaramillo Fayad Juan Carlos , Moyano Emilio
Published: April 2018

Este artículo presenta los resultados de un estudio descriptivo correlacional que investiga la evaluación personal de las condiciones que caracterizan la habitabilidad del espacio público en 11 ciudades de 7 países de Amé- rica Latina: México, Colombia, Venezuela, Perú, Brasil, Chile y Argentina. En la investigación participaron un total de 1823 personas de ambos sexos y diferentes grupos de edad, que evaluaron la importancia y la satisfacción de diferentes características y condiciones del espacio público a través de un cuestionario ad hoc de 48 reactivos. Un análisis de escalamiento multidimensional de distancias mínimas (ssa) y de coordenadas de ordenamiento parcial (posac) indican que las personas evalúan las condiciones exploradas con base en la función que le atribuyen al espacio público de la ciudad. A pesar de las diferencias importantes entre las ciudades, hay coincidencias en varias condiciones del espacio público que, aunque se consideran importantes, no son reportadas como satisfactorias. Aparte de la importancia del conocimiento de la habitabilidad del espacio público en Latinoamérica, los resultados se discuten a partir de las consecuencias para la calidad de vida urbana y para la formulación de la política pública en la planificación y la gestión urbana
Procedimientos de subjetivación de trabajadores y usuarios en las relaciones micropolíticas del modo de atención psicosocial
Authors: Argiles Carmen Terezinha Leal , Andrade Ana Paula Müller de , Kantorski Luciane Prado , Willrich Janaína Quinzen
Published: April 2018

El artículo tiene como objetivo problematizar las relaciones micropolíticas producidas en el Centro de Atención Psicosocial (caps) de Alegrete-RS, enfoncando los principios éticos de las relaciones de los trabajadores con la clientela y en el trabajo en equipo, identificando las aproximaciones y los distanciamientos con las propuestas de atención psicosocial. Se trata de un estudio de abordaje cualitativo, descriptivo y analítico. Se realizaron entrevistas con los usuarios y trabajadores, y observación participante. Se encontraron aspectos de movilización subjetiva, innovación y creación de relaciones que producen rupturas en las prácticas institucionales, potencializando la subjetivación, los agenciamientos, las resistencias y la invención de diversos dispositivos de relación e interacción en la sociedad, produciendo territorios existenciales en la perspectiva de la atención psicosocial. Las relaciones micropolíticas trabajan para agenciar procesos de producción de sentido y valorización de los saberes, caracterizando una postura ética en el ámbito de las relaciones
Learning from Online Social Ties
Authors: Zhang Yuchi , Godes David
Published: April 2018

We ask whether online opinions impact consumers’ decision quality and assess whether this impact occurs immediately or requires one to undergo learning first. We focus on a setting where consumers have multiple learning experiences using opinions from both uni- and bidirectional network ties. This allows us to investigate the impact of learning from both weak and strong ties. We find that, with sufficient experience, having more ties may lead to better decisions. However, the dynamic effects are dependent on the strength of the tie. Additional strong ties (operationalized as bidirectional links) lead to immediate positive effects on decision quality. However, additional weak ties (unidirectional, follower relationships) initially lead to lower decision quality. We find beneficial learning effects, however: adding more weak ties improves decision quality once one has sufficient experience in the community. Indeed, more-experienced consumers receive, ultimately, higher positive effects on decision quality from weak ties compared with strong ties. We interpret this as demonstrating that one needs to learn the norms of a new community before using the available information to improve decisions.

Data and the online appendix are available at https://doi.org/10.1287/mksc.2017.1076 .