Morphea-like discoid lupus erythematosus in a patient with a history of polyacrylamide gel injection: A case report

BACKGROUND

Discoid lupus erythematosus (DLE) is an autoimmune disease with multifactor etiology which develops in genetically susceptible patients. Rarely, DLE lesions can mimic other connective tissue disorders such as morphea. The growing application of soft tissue fillers is associated with increasing complications. Some substances used for soft tissue augmentation such as silicon implants may trigger lupus erythematosus diseases.

CASE REPORT

Here we report a case of morphea-like discoid lupus erythematosus developed several years after polyacrylamide dermal filler (PAAG) injection for facial rejuvenation.

CONCLUSION

As noninvasive procedures like dermal filler injections are increasing worldwide, physicians may consider the long-term probable side effects of these compounds.

Iranian psoriasis registry: Research protocol and preliminary results of a pilot study

BACKGROUND

Psoriasis as a common cutaneous inflammatory disease affect many aspects of patients' life. Disease registries render it possible to collect valuable data regarding a disease prevalence and burden as well as long-term observations concerning possible therapeutic regimens.

METHODS

This registry was designed for the ongoing systematic data collection on patients with psoriasis at two referral dermatology centers in Iran. The pilot phase of the registry was used to identify possible obstacles in the application and execution of systematic registration.

RESULTS

A total of 281 patients were registered with the mean age of 42.02 years. The disease duration was 12.06 ± 10.90 years with the variety of clinical presentations. There was no significant difference between males and females in the age of disease onset (p = 0.53). Notably, 167 patients had children. Among them, 13 had children with psoriasis. The gender of the affected parent did not affect the possibility of psoriasis transmission to the child, and no significant difference was seen between the two sexes (P = 0.569). Regarding treatment, 99.4% of patients (n = 280) had used topical agents, 52.3% (n = 147) biologics, and 60.9% (n = 171) nonbiologic medications.

CONCLUSION

Clinical trials report the efficacy and safety data regarding limited study populations in a restricted time window, and the results may differ from the general population. This highlights the importance of registry-based studies for collecting and analyzing longitudinal information. In terms of long-term disease complications such as malignancies, cardiovascular events, and serious adverse events, registry-based studies will help clinicians better recognize and manage each disease.

Presentation of vitiligo in a case of COVID-19 infection concomitant with receiving remdesivir

The occurrence of vitiligo following COVID-19 infection and vaccination is well-documented. The mitochondrial dysfunction of melanocytes in vitiligo and the potential impact of RDV on mitochondria raise concerns about RDV possibly causing vitiligo.

Botulinium toxin applications in the lower face and neck: A comprehensive review

BACKGROUND

Botulinum toxin has been widely and mainly used for the treatment of conditions affecting the upper and middle face; however, recent efforts have expanded the indications of botulinum toxin injection to the lower face and neck areas for cosmetic and medical purposes.

AIMS

We have reviewed the latest updates on using botulinum toxin in the lower face and neck focusing on cosmetic purposes and have discussed the existing concerns as well as the adverse sequelae of these newer indications.

PATIENTS/METHODS

A comprehensive literature search was performed using the following keywords [[botulinum] AND [[Toxin] OR [Neurotoxin]]] AND [[Lower AND Face] AND/OR [Neck]] within the main databases including Web of Science, PubMed, Embase and gray literature on and before February 2023. The data were screened using titles and abstracts and those relevant to the topic were included in the paper.

RESULTS

Botulinum toxin injection has considerable cosmetic and therapeutic effect on facial contouring, masseteric hypertrophy, lower face and neck scars, gummy smile, drooping lip corner and even skin rejuvenation.

CONCLUSION

BNT injection has been widely used for the treatment of different medical and cosmetic purposes. Low rates of side effects, which were self-limited in most cases, have been reported in the literature, making BNT a safe therapeutic medication in most cases. However, regulatory status needs to be updated and more accurately revised in many countries and more comprehensive research is required to address the existing gaps in this area including the site, dosage, and method of injection in each case.

Economic, social, and cultural capital and ESQ in academic achievement: A comparison of Afghan and Iranian students

The present study aimed to investigate the role of different types of capital, including economic, social, and cultural, as well as emo-sensory intelligence (ESI) in the academic achievement of students in the two contexts of Afghanistan and Iran. For this purpose, 317 students from both countries participated in the study. They were asked to fill out the Social and Cultural Capital Questionnaire (SCCQ) and the Emo-sensory Intelligence Questionnaire (ESI-Q). Their grade point average (GPA) was taken as the indicator of their academic achievement. The findings revealed that students' level of cultural capital and emo-sensory quotient (ESQ) had a significantly positive role in their academic achievement (p < 0.05). Moreover, significant differences were found between the two contexts in terms of the level of capital, with Afghan students having significantly more cultural capital, and Iranian students having significantly higher economic capital (p < 0.05). Iranian students were also found to have a significantly higher level of ESQ compared to Afghan students (p < 0.05). Finally, the results were discussed, and implications and suggestions for further research were provided.

COVID-19 Clinical Characteristics, and Sex-Specific Risk of Mortality: Systematic Review and Meta-Analysis

Background: The rapidly evolving coronavirus disease 2019 (COVID-19), was declared a pandemic by the World Health Organization on March 11, 2020. It was first detected in the Wuhan city of China and has spread globally resulting in a substantial health and economic crisis in many countries. Observational studies have partially identified different aspects of this disease. There have been no published systematic reviews that combine clinical, laboratory, epidemiologic, and mortality findings. Also, the effect of gender on the outcomes of COVID-19 has not been well-defined.

Methods: We reviewed the scientific literature published from January 1, 2019 to May 29, 2020. Statistical analyses were performed with STATA (version 14, IC; Stata Corporation, College Station, TX, USA). The pooled frequency with 95% confidence intervals (CI) was assessed using random effect model. P < 0.05 was considered a statistically significant publication bias.

Results: Out of 1,223 studies, 34 satisfied the inclusion criteria. A total of 5,057 patients with a mean age of 49 years were evaluated. Fever (83.0%, CI 77.5–87.6) and cough (65.2%, CI 58.6–71.2) were the most common symptoms. The most prevalent comorbidities were hypertension (18.5%, CI 12.7–24.4) and Cardiovascular disease (14.9%, CI 6.0–23.8). Among the laboratory abnormalities, elevated C-Reactive Protein (CRP) (72.0%, CI 54.3–84.6) and lymphopenia (50.1%, CI 38.0–62.4) were the most common. Bilateral ground-glass opacities (66.0%, CI 51.1–78.0) was the most common CT scan presentation. The pooled mortality rate was 6.6%, with males having significantly higher mortality compared to females (OR 3.4; 95% CI 1.2–9.1, P = 0.01).

Conclusion: COVID-19 has caused a significant number of hospitalization and mortality worldwide. Mortality associated with COVID-19 was higher in our study compared to the previous reports from China. The mortality was significantly higher among the hospitalized male group. Further studies are required to evaluate the effect of different variables resulting in sex disparity in COVID-19 mortality.

Clinical Features, Diagnosis, and Treatment of COVID-19 in Hospitalized Patients: A Systematic Review of Case Reports and Case Series

Introduction: The 2019 novel coronavirus (COVID-19) has been declared a public health emergency worldwide. The objective of this systematic review was to characterize the clinical, diagnostic, and treatment characteristics of hospitalized patients presenting with COVID-19.

Methods: We conducted a structured search using PubMed/Medline, Embase, and Web of Science to collect both case reports and case series on COVID-19 published up to April 24, 2020. There were no restrictions regarding publication language.

Results: Eighty articles were included analyzing a total of 417 patients with a mean age of 48 years. The most common presenting symptom in patients who tested positive for COVID-19 was fever, reported in up to 62% of patients from 82% of the analyzed studies. Other symptoms including rhinorrhea, dizziness, and chills were less frequently reported. Additionally, in studies that reported C-reactive protein (CRP) measurements, a large majority of patients displayed an elevated CRP (60%). Progression to acute respiratory distress syndrome (ARDS) was the most common complication of patients testing positive for COVID-19 (21%). CT images displayed ground-glass opacification (GGO) patterns (80%) as well as bilateral lung involvement (69%). The most commonly used antiviral treatment modalities included, lopinavir (HIV protease inhibitor), arbidiol hydrochloride (influenza fusion inhibitor), and oseltamivir (neuraminidase inhibitor).

Conclusions: Development of ARDS may play a role in estimating disease progression and mortality risk. Early detection of elevations in serum CRP, combined with a clinical COVID-19 symptom presentation may be used as a surrogate marker for the presence and severity of the disease. There is a paucity of data surrounding the efficacy of treatments. There is currently not a well-established gold standard therapy for the treatment of diagnosed COVID-19. Further prospective investigations are necessary.

Is there any association between gut microbiota and type 1 diabetes? A systematic review

Introduction

Type 1 diabetes (T1D) is the second most common autoimmune disease among children. There is evidence suggesting that dysbiosis of some gut colonizing bacteria are associated with the pathogenesis of T1D. However, these studies are still controversial and a systematic review was conducted to evaluate the association between gut microbiota and T1D.

Methods

A systematic search was carried out in Medline (Via Pubmed) and Embase from January 2000 to January 2019 for all original cross-sectional, cohort, case–control or nested case–control studies investigating the association between gut microbiota and T1D.

Results

Of 568 articles identified, 26 studies met the inclusion criteria. The total population study of these articles consists of 2600 children (under 18 years old) and 189 adults. Among the included studies, 24 articles confirmed the association between gut microbiota dysbiosis and T1D. The most common bacterial alterations in T1D patients included Bacteroides spp., Streptococcus spp., Clostridium spp., Bifidobacterium spp., Prevotella spp., Staphylococcus spp., Blautia spp., Faecalibacterium spp., Roseburia spp., and Lactobacillus spp.

Conclusion

Our study showed a significant association between alterations in intestinal microbial composition and T1D; however, in some articles, it is not clear which one happens first. Investigation of altered gut microbiota can help in the early detection of T1D before seropositivity. Targeted microbiome modulation can be a novel potential therapeutic strategy.

Cyclopiazonic acid decreases sperm quality and in vitro fertilisation rate in mice

The presence of cyclopiazonic acid (CPA) as a mycotoxin has been reported in feed and foodstuffs. The aim of this investigation was to determine the effects of CPA on reproductive functions of male mice. In this experiment, 40 mature male mice were randomly assigned into five groups (n=8): control, control-sham, CPA (0.03 mg/kg, body weight (BW)), CPA (0.06 mg/kg, BW) and CPA (0.12 mg/kg, BW). Following 28 days exposure to CPA, sperm quality parameters, in vitro fertilisation (IVF) capacity of sperms, serum testosterone level, Leydig cells number and serum total antioxidant capacity (TAC) were analysed. The results revealed a significant (P<0.05) reduction in sperm count, sperm viability, sperm motility, chromatin quality of sperm, sperms with intact DNA, IVF rate, testosterone level, Leydig cell distribution and TAC in comparison to the control group. The most prominent detrimental effects of CPA were found at the highest given dose level. Our results suggest that CPA at higher dose levels exerts detrimental effects on the male reproductive system. Moreover, these descriptive warrant further investigations into the specific mechanisms of action and the effects of CPA on spermatogenesis.

Three-dimensional scanning transmission electron microscopy of dislocation loops in tungsten

Scanning transmission electron microscopy (STEM) imaging using diffraction contrast is a powerful technique to assess crystal defects. In this work it is used to assess the spatial distribution of radiation induced defect in tungsten. In effect, its irradiation leads to the formation of nanometric dislocation loops that under certain conditions may form intriguing 3-D rafts. In this study, we have irradiated thin tungsten samples in situ in a TEM with 1.2 MeV W ions to 0.017 dpa at room temperature (RT) and at 700 °C. Besides the Burgers vector analysis, the number density and size of the dislocation loops with their spatial arrangement were quantitatively characterized by stereo imaging in STEM mode. Most of the loops have a Burgers vector ½ a₀ 〈111〉, with some a₀ 〈100〉 at room temperature. Loops are located mainly in the simulated damage profile but there is also a significant portion in deeper regions of the sample, indicating that loops in W diffuse easily, even at RT. At 700 °C, loops form elongated rafts that contain dislocation segments having a Burgers vector ½ a₀ 〈111〉. The rafts are narrow and reside on {111} planes; they are elongated along 〈110〉 directions, which correspond, when combined to the rafts' Burgers vector, to the lines of edge dislocations. Compared to conventional TEM, 3-D analysis in STEM appears thus as a powerful technique for quantitative analyses of defects in tungsten, as it allows reducing the background diffraction contrast and reaching thicker areas of the electron transparent foil, here 0.5 μm of tungsten at 200 kV.

Auditory electrical tinnitus suppression in patients with and without implants

The aim of this study was to evaluate the effectiveness of electrical tinnitus suppression in two groups of chronic severe tinnitus sufferers. Through standard tinnitus questionnaires, we compared the effectiveness of extratympanic and intratympanic auditory electrical stimulation (AES) by cochlear implants (CI) for the suppression or abolition of the perception of tinnitus and the decrease of its associated complaints. We made otolaryngological and comprehensive audiological assessment and also tinnitus measurement in each group of patients before and after AES and 50 days later. We investigated the dimensions of psychological complaints due to chronic and disabling tinnitus by means of the tinnitus questionnaire (TQ). The control examination during at least seven sessions (50 days) after AES in the group of patients without implants showed improvement in 20 of 32 patients (62.5%); 12 (37.5%) did not notice any change. In the comparative group of patients with implants, improvement occurred in 16 of 20 patients (75%); during the switch-on of the speech processor, these patients reported significant attenuation or complete suppression of their tinnitus. Complete suppression of the tinnitus after CI was observed for 11 patients (55%), and 5 patients (25%) demonstrated significant attenuation of tinnitus. Nonsuppression of tinnitus was observed for only 4 patients (25%). None of our patients was affected by an increment in the tinnitus owing to CI. The differences of means of scores in the standard TQ were significant in both groups of patients. A comparison of TQ score differences between patients with and without implants showed no significance. We concluded that AES is a useful and effective therapeutic intervention in patients with tinnitus. Extratympanic AES reduces the effects of the tinnitus but presents limitations, mainly owing to the short duration of the electrical residual inhibition of the tinnitus. CI is shown to be more efficient for the treatment of tinnitus, mainly because the electrical stimulation affects a wider area of the cochlea and is presented for longer sessions. Therefore, patients affected by incapacitating tinnitus should be considered for continuous use of electrical stimulation.