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Find video protocols related to scientific articles indexed in Pubmed.
Purse-String Suture vs Second Intention Healing: Results of a Randomized, Blind Clinical Trial.
JAMA Dermatol
PUBLISHED: 11-06-2014
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Purse-string suture is a closure method that purportedly reduces the scar area compared with second intention healing. Randomized clinical trials comparing these 2 methods appear to be limited or absent.
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Treatments for Nail Psoriasis: A Systematic Review by the GRAPPA Nail Psoriasis Work Group.
J. Rheumatol.
PUBLISHED: 11-03-2014
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Nail involvement in psoriatic diseases causes significant physical and functional disabilities. Evaluating, measuring, and treating nail involvement is important in improving the health outcomes and quality of life among patients with psoriasis and psoriatic arthritis (PsA). We performed a systematic analysis of the literature on nail psoriasis to help inform an update of treatment recommendations by the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA).
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Patient-Centered, Direct-Access Online Care for Management of Atopic Dermatitis: A Randomized Clinical Trial.
JAMA Dermatol
PUBLISHED: 10-23-2014
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New models of health care delivery for dermatological care have the potential to increase access and improve patient-centered outcomes.
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Public perception of dermatologists and comparison with other medical specialties: Results from a national survey.
J. Am. Acad. Dermatol.
PUBLISHED: 08-27-2014
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The public's perception of dermatologists in the United States is unknown.
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Efficacy of Photodynamic Therapy vs Other Interventions in Randomized Clinical Trials for the Treatment of Actinic Keratoses: A Systematic Review and Meta-analysis.
JAMA Dermatol
PUBLISHED: 08-27-2014
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Photodynamic therapy (PDT) is used extensively to treat actinic keratoses (AKs). An analysis of the effectiveness of PDT compared with other treatments may help physicians decide what role it should play in their own clinical practices.
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Set-back versus buried vertical mattress suturing: Results of a randomized blinded trial.
J. Am. Acad. Dermatol.
PUBLISHED: 08-14-2014
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The set-back suture, an absorbable dermal suturing technique, purportedly improves wound eversion and cosmetic outcomes.
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Pre-bisection of a single skin biopsy does not produce technically inadequate specimens for direct immunofluorescence: a review of 3450 specimens.
J. Cutan. Pathol.
PUBLISHED: 08-05-2014
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Evaluation of a potential immunobullous disorder typically requires two pieces of tissue obtained by skin biopsy: one placed in formalin for conventional microscopy and a second placed in a different transport medium suitable for direct immunofluorescence (DIF) testing. Clinical practice in this area is not standardized, with dermatologists either obtaining two biopsies or dividing (pre-bisecting) a single biopsy. Some DIF specimens are technically inadequate for interpretation of subepidermal imunobullous disorders because the basement membrane zone is not intact, but it is unknown whether pre-bisecting the tissue increases the risk of compromising the specimen.
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Strategies to maximize treatment success in moderate to severe psoriasis: establishing treatment goals and tailoring of biologic therapies.
Semin Cutan Med Surg
PUBLISHED: 08-03-2014
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Achieving treatment success among patients with moderate to severe psoriasis is a clinically relevant and important issue facing clinicians and patients. Despite advances in systemic therapy, most patients with moderate to severe psoriasis are not satisfied with their treatment. We will discuss strategies to maximize treatment success through the establishment of treatment goals and tailoring of biologic therapy for patients with difficult-to-treat psoriasis. Specifically, we provide evidence-based highlights on the development of biologics, recommendations by psoriasis expert groups on treatment goals, approaches to achieve treatment to defined targets, and therapeutic strategies to customize biologic treatment for nonresponders. The discussion on nonresponders focuses on subpopulations of interest including patients with significant obesity, antidrug antibody formation, personal preferences for medication administration, and treatment nonadherence. We also highlight circumstances where the selection of the systemic medication is driven by safety considerations. As expectation for efficacy and safety increases with continued biologic development for psoriasis, devising real-world treatment strategies to maximize treatment success is critical to improve the overall physical and psychosocial wellbeing of psoriasis patients.
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Metabolomic analysis using porcine skin: a pilot study of analytical techniques.
Dermatol. Online J.
PUBLISHED: 06-13-2014
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Metabolic byproducts serve as indicators of the chemical processes and can provide valuable information on pathogenesis by measuring the amplified output. Standardized techniques for metabolome extraction of skin samples serve as a critical foundation to this field but have not been developed.
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Psoriasis and psoriatic arthritis educational initiatives: an update from the 2013 GRAPPA Annual Meeting.
J. Rheumatol.
PUBLISHED: 06-03-2014
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At the 2013 annual meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA), members were updated on educational areas in psoriasis and psoriatic arthritis (PsA). Discussions included (1) the psoriasis and PsA GRAPPA video project, comprising a set of educational online videos that provide standardized psoriatic disease endpoint training to clinicians and researchers; (2) the GRAPPA Educational Outreach Project, focused on cross-disciplinary education for rheumatologists and dermatologists and including several collaborations to expand educational sessions globally; (3) the Dermatology and Rheumatology Trainee Educational Initiative, that provides psoriatic disease education to medical students, residents, and fellows training in dermatology and/or rheumatology; and (4) the GRAPPA Educational Slide Library, developed as a resource for GRAPPA members for their own educational presentations.
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Outcomes research in psoriasis and psoriatic arthritis using large databases and research networks: a report from the GRAPPA 2013 Annual Meeting.
J. Rheumatol.
PUBLISHED: 06-03-2014
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Advances in healthcare informatics have increased the ability to address real-world, clinically relevant questions using large databases. When examining data sources, researchers and clinicians need to consider data validity, potential sources of misclassification, whether the source is sufficiently powered to detect clinically relevant differences, ability to obtain longitudinal data, containment of patients within a database, and ability to obtain structured point-of-care data. Population-based databases create opportunities for characterizing natural history of psoriatic diseases, conducting comparative effectiveness research, determining comorbidities, and providing epidemiology-based rational approaches to mechanistic investigations. Herein, we discuss the major data sources for clinical research in psoriasis, including electronic medical records, research networks, disease registries, and others.
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The International Dermatology Outcome Measures initiative as applied to psoriatic disease outcomes: a report from the GRAPPA 2013 meeting.
J. Rheumatol.
PUBLISHED: 06-03-2014
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In the United States, access to care is the number one issue facing our patients with dermatological conditions. In part, this is because we do not have outcome measures that are useful in clinical practice and available in databases where payers and governmental agencies can compare the performance of physicians and treatments. There is a growing recognition that insufficient attention has been paid to the outcomes measured in clinical trials and subsequently in clinical practice. The International Dermatology Outcome Measures group includes all willing stakeholders: patients, physicians, payers, and pharmaceutical scientists. As reported herein, the group's goal is to develop outcome measures in dermatology that address the needs of all involved.
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Who do you prefer? A study of public preferences for health care provider type in performing cutaneous surgery and cosmetic procedures in the United States.
Dermatol Surg
PUBLISHED: 05-24-2014
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The public preference for provider type in performing cutaneous surgery and cosmetic procedures is unknown in the United States.
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Evaluation and management of adult shoulder pain: a focus on rotator cuff disorders, acromioclavicular joint arthritis, and glenohumeral arthritis.
Med. Clin. North Am.
PUBLISHED: 04-19-2014
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Shoulder pain is a common reason for a patient to see their primary care physician. This article focuses on the evaluation and management of 3 common shoulder disorders; rotator cuff disorders, acromioclavicular joint arthritis, and glenohumeral joint arthritis. The typical history and physical examination findings for each of these entities are highlighted, in addition to treatment options.
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Managing patients with psoriatic disease: the diagnosis and pharmacologic treatment of psoriatic arthritis in patients with psoriasis.
Drugs
PUBLISHED: 02-26-2014
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Psoriatic arthritis (PsA) is a chronic, systemic inflammatory disease. Up to 40 % of patients with psoriasis will go on to develop PsA, usually within 5-10 years of cutaneous disease onset. Both conditions share common pathogenic mechanisms involving genetic and environmental factors. Because psoriasis is typically present for years before PsA-related joint symptoms emerge, dermatologists are in a unique position to detect PsA earlier in the disease process through regular, routine screening of psoriasis patients. Distinguishing clinical features of PsA include co-occurrence of psoriatic skin lesions and nail dystrophy, as well as dactylitis and enthesitis. Patients with PsA are usually seronegative for rheumatoid factor, and radiographs may reveal unique features such as juxta-articular new bone formation and pencil-in-cup deformity. Early treatment of PsA with disease-modifying anti-rheumatic drugs has the potential to slow disease progression and maintain patient quality of life. Optimally, a single therapeutic agent will control both the skin and joint psoriatic symptoms. A number of traditional treatments used to manage psoriasis, such as methotrexate and cyclosporine, are also effective for PsA, but these agents are often inadequately effective, temporary in benefit and associated with significant safety concerns. Biologic anti-tumour necrosis factor agents, such as etanercept, infliximab and adalimumab, are effective for treating patients who have both psoriasis and PsA. However, a substantial number of patients may lose efficacy, have adverse effects or find intravenous or subcutaneous administration inconvenient. Emerging oral treatments, including phosphodiesterase 4 inhibitors, such as apremilast, and new biologics targeting interleukin-17, such as secukinumab, brodalumab and ixekizumab, have shown encouraging clinical results in the treatment of psoriasis and/or PsA. Active and regular collaboration of dermatologists with rheumatologists in managing patients who have psoriasis and PsA is likely to yield more optimal control of psoriatic dermal and joint symptoms, and improve long-term patient outcomes.
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Effect of appearance-based education compared with health-based education on sunscreen use and knowledge: a randomized controlled trial.
J. Am. Acad. Dermatol.
PUBLISHED: 02-05-2014
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Appearance-based education shows promise in promoting sunscreen use although resource-intensive methods used in prior studies preclude wide dissemination. Appearance-based video education can be made easily accessible.
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JAK inhibitors: treatment efficacy and safety profile in patients with psoriasis.
J Immunol Res
PUBLISHED: 02-01-2014
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Janus kinase (JAK) pathways are key mediators in the immunopathogenesis of psoriasis. Psoriasis treatment has evolved with the advent of targeted therapies, which inhibit specific components of the psoriasis proinflammatory cascade. JAK inhibitors have been studied in early phase trials for psoriasis patients, and the data are promising for these agents as potential treatment options. Tofacitinib, an oral or topically administered JAK1 and JAK3 inhibitor, and ruxolitinib, a topical JAK1 and JAK2 inhibitor, have been most extensively studied in psoriasis, and both improved clinical symptoms of psoriasis. Additional JAK1 or JAK3 inhibitors are being studied in clinical trials. In phase III trials for rheumatoid arthritis, tofacitinib was efficacious in patients with inadequate responses to tumor necrosis factor inhibitors, methotrexate monotherapy, or disease-modifying antirheumatic drugs. The results of phase III trials are pending for these therapies in psoriasis, and these agents may represent important alternatives for patients with inadequate responses to currently available agents. Further investigations with long-term clinical trials are necessary to verify their utility in psoriasis treatment and assess their safety in this patient population.
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Psoriasis prevalence among adults in the United States.
J. Am. Acad. Dermatol.
PUBLISHED: 01-02-2014
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Psoriasis is a chronic inflammatory disorder associated with significant morbidity and mortality. Up-to-date prevalence data on psoriasis provide the foundation for informing population research, education, and health policy.
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Immunology of atopic dermatitis: novel insights into mechanisms and immunomodulatory therapies.
Semin Cutan Med Surg
PUBLISHED: 11-02-2013
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Atopic dermatitis (AD) is a chronic, pruritic, inflammatory skin condition that is associated with immune dysregulation and epidermal barrier dysfunction. The imbalance of the Th2 and Th1 pathways and their associated cytokines in AD presents as one facet of the pathogenic mechanisms. Changes in the T-cell populations and the associated cytokines during the acute and chronic phases of AD can cause variations in disease presentations and treatment responses. Continued discoveries in the immunopathogenesis of AD provide optimism for the development of efficacious therapeutic agents. Novel immunomodulatory therapies include apremilast, dupilumab, IL-37, omalizumab, rituximab, mepolizumab, infliximab, allergen-specific immunotherapy, Mycobacterium vaccae, and leflunomide. These agents serve as examples of how modulation in immunopathogenesis of AD can lead to therapeutic discoveries.
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Anti-drug antibodies in psoriasis: a critical evaluation of clinical significance and impact on treatment response.
Expert Rev Clin Immunol
PUBLISHED: 10-17-2013
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TNF inhibitors and anti-p40IL12/23 monoclonal antibodies are efficacious treatments for moderate-to-severe psoriasis. However, the formation of anti-drug antibodies (ADA) with biologics may prevent patients from achieving a full clinical response. ADA have been reported in patients treated with etanercept, infliximab, adalimumab or ustekinumab at rates of 0-18.3%, 5.4-43.6%, 8.8-44.8% and 3.8-5.4%, respectively. Antibodies against etanercept have no apparent effects on clinical response, whereas antibodies against infliximab or adalimumab have been associated with diminished clinical response. The significance of ADA against ustekinumab is yet to be determined. Data regarding management strategies to counteract ADA formation and their effects are limited in psoriasis patients. However, some evidence suggests that concomitant immunomodulators such as methotrexate may suppress ADA development in psoriasis. ADA specific to one biologic do not appear to carry cross-linking potential with other biologic agents. ADA formation needs to be considered as a possible factor contributing to diminished response from biologic agents.
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The association between psoriasis and hypertension: a systematic review and meta-analysis of observational studies.
J. Hypertens.
PUBLISHED: 09-17-2013
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Population-based observational studies have suggested a relationship between psoriasis and hypertension. We performed a systematic review and meta-analysis to better understand the association between psoriasis and hypertension. We systematically searched MEDLINE, EMBASE, and the Cochrane Central Register from 1 January 1980 to 1 January 2012. Two authors independently assessed trial eligibility and quality. We applied the Meta-Analysis of Observational Studies in Epidemiology guidelines in the conduct of this study. We identified 24 observational studies with a total of approximately 2.7 million study participants fulfilling our inclusion criteria. Among them, 309?469 were patients with psoriasis. On the basis of random effects modeling of case-control and cross-sectional studies, the odds ratio (OR) for hypertension among patients with psoriasis was 1.58 [95% confidence interval (CI) 1.42-1.76] compared with the controls. The OR for hypertension among patients with mild psoriasis was 1.30 (95% CI 1.15-1.47) and the OR for hypertension among patients with severe psoriasis was 1.49 (95% CI 1.20-1.86) compared with the controls. Two cohort studies examining incidence of hypertension found that psoriasis was associated with a hazard ratio of 1.09 (95% CI 1.05-1.14) and 1.17 (95% CI 1.06-1.30) for development of hypertension. In a subgroup analysis, patients with psoriatic arthritis also had an increased prevalence of hypertension (OR 2.07, 95% CI 1.41-3.04). Psoriasis and psoriatic arthritis are associated with greater prevalence of hypertension. Patients with severe psoriasis have greater odds of hypertension than those with mild psoriasis.
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Clinical and histologic diagnostic guidelines for psoriasis: a critical review.
Clin Rev Allergy Immunol
PUBLISHED: 09-10-2013
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Psoriasis is a common inflammatory skin disease that is associated with joint, psychiatric, and cardiovascular comorbidities. Diagnosis of plaque psoriasis is dependent primarily on characteristic physical findings and history. Given the varied clinical presentations of psoriasis and its mimicry to other papulosquamous skin diseases, it may be difficult for nondermatologists to diagnose psoriasis. Currently, no diagnostic criteria for plaque psoriasis have been validated in clinical studies. In this paper, we provide diagnostic guidelines for the nondermatologist to aid them in recognizing psoriasis.
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Multipotent mesenchymal stem cells from human subacromial bursa: potential for cell based tendon tissue engineering.
Tissue Eng Part A
PUBLISHED: 08-21-2013
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Rotator cuff injuries are a common clinical problem either as a result of overuse or aging. Biological approaches to tendon repair that involve use of scaffolding materials or cell-based approaches are currently being investigated. The cell-based approaches are focused on applying multipotent mesenchymal stem cells (MSCs) mostly harvested from bone marrow. In the present study, we focused on characterizing cells harvested from tissues associated with rotator cuff tendons based on an assumption that these cells would be more appropriate for tendon repair. We isolated MSCs from bursa tissue associated with rotator cuff tendons and characterized them for multilineage differentiation in vitro and in vivo. Human bursa was obtained from patients undergoing rotator cuff surgery and cells within were isolated using collagenase and dispase digestion. The cells isolated from the tissues were characterized for osteoblastic, adipogenic, chondrogenic, and tenogenic differentiation in vitro and in vivo. The results showed that the cells isolated from bursa tissue exhibited MSCs characteristics as evidenced by the expression of putative cell surface markers attributed to MSCs. The cells exhibited high proliferative capacity and differentiated toward cells of mesenchymal lineages with high efficiency. Bursa-derived cells expressed markers of tenocytes when treated with bone morphogenetic protein-12 (BMP-12) and assumed aligned morphology in culture. Bursa cells pretreated with BMP-12 and seeded in ceramic scaffolds formed extensive bone, as well as tendon-like tissue in vivo. Bone formation was demonstrated by histological analysis and immunofluorescence for DMP-1 in tissue sections made from the scaffolds seeded with the cells. Tendon-like tissue formed in vivo consisted of parallel collagen fibres typical of tendon tissues. Bursa-derived cells also formed a fibrocartilagenous tissue in the ceramic scaffolds. Taken together, the results demonstrate a new source of MSCs with a high potential for application in tendon repair.
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Undertreatment, treatment trends, and treatment dissatisfaction among patients with psoriasis and psoriatic arthritis in the United States: findings from the National Psoriasis Foundation surveys, 2003-2011.
JAMA Dermatol
PUBLISHED: 08-16-2013
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Psoriasis and psoriatic arthritis inflict significant morbidity. Data on undertreatment, treatment use, and treatment satisfaction are paramount to identify priority areas for advocacy, education, and research to improve patient outcomes.
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Psoriasis and psoriatic arthritis video project: an update from the 2012 GRAPPA annual meeting.
J. Rheumatol.
PUBLISHED: 08-03-2013
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The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) has developed online videos intended to provide training on the most commonly used physical examination measures for psoriasis and psoriatic arthritis (PsA). At the 2012 GRAPPA annual meeting, attendees were updated on the development, availability, use, and validation of these video modules. To date, 1300 users from 45 different countries have used the Psoriasis Area and Severity Index (PASI) module at least once. Results were presented from a recently completed study of pre- and post-video scoring of the PASI by experienced and naive physicians and patient assessors. Future modifications of the video collection were also discussed.
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Infectious, oncologic, and autoimmune comorbidities of psoriasis and psoriatic arthritis: a report from the GRAPPA 2012 annual meeting.
J. Rheumatol.
PUBLISHED: 08-03-2013
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At the 2012 annual meeting of the Group for Research and Assessment of Psoriasis and PsA (GRAPPA) in Stockholm, Sweden, members addressed the infectious, oncologic, and autoimmune comorbidities of psoriasis and psoriatic arthritis (PsA). Members discussing infectious comorbidities asked whether patients with psoriasis or PsA are predisposed to particular types of infections, and whether the use of biologic agents is advisable in patients with certain preexisting infections. Regarding the oncologic comorbidities of psoriasis and PsA, members addressed cutaneous malignancy screening, lymphoproliferative malignancy risk and the need for screening, and treatment of patients with preexisting oncologic history requiring systemic therapy. Finally, GRAPPA members discussed autoimmune comorbidities associated with psoriasis and PsA; they agreed that research is nascent in this field and larger studies are necessary to determine the precise magnitude of these associations.
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Cardiovascular comorbidities of psoriasis and psoriatic arthritis: a report from the GRAPPA 2012 annual meeting.
J. Rheumatol.
PUBLISHED: 08-03-2013
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At the 2012 annual meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) in Stockholm, Sweden, several GRAPPA members led a panel discussion on cardiovascular (CV) comorbidities of psoriasis and psoriatic arthritis (PsA). The panelists discussed the role of insulin resistance in the pathophysiology of psoriasis, the possible effect of tumor necrosis factor inhibitors on CV comorbidities, and the effect of 12/23 monoclonal antibodies on CV outcomes. The panelists also addressed how lessons from CV comorbidity research could be applied to other areas of comorbidity research in psoriasis and PsA and identified future research directions in this area.
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Psoriasis outcome measures: a report from the GRAPPA 2012 annual meeting.
J. Rheumatol.
PUBLISHED: 08-03-2013
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Psoriasis is a multisystem disease. The cutaneous and musculoskeletal manifestations (psoriatic arthritis) are well recognized. However, the other manifestations of psoriatic disease including metabolic syndrome, atherosclerotic cardiovascular disease, depression, poor self-esteem, and self-destructive habits including obesity, smoking and excess alcohol consumption are underappreciated. At the 2012 annual meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA), members addressed the need to develop uniform, validated, standardized outcome measures for psoriatic disease, measures that are useful to all stakeholders including patients, physicians, regulators, and payers.
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Severe adverse events from the treatment of advanced melanoma: a systematic review of severe side effects associated with ipilimumab, vemurafenib, interferon alfa-2b, dacarbazine and interleukin-2.
J Dermatolog Treat
PUBLISHED: 07-03-2013
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Background: Current immunomodulatory agents for stage III and IV melanoma exert different mechanisms of action that manifest in distinct adverse events. Objective: This systematic review aims to synthesize safety data from clinical trials on ipilimumab, vemurafenib, interferon (IFN) alfa-2b, dacarbazine and interleukin (IL)-2 to elucidate the severe adverse events associated with each melanoma therapy. Methods: Through a systematic search using MEDLINE, EMBASE and the Cochrane Central Register between January 1, 2010 and June 1, 2012, we identified 32 clinical trials with 5802 subjects that met the inclusion criteria. Results:Ipilimumab was associated with immune-mediated diarrhea and colitis, with an incidence rate of 0.0017 cases per 100 person-years. Patients receiving vemurafenib developed keratoacanthomas and cutaneous squamous cell carcinoma at an incidence rate of 0.0025 cases per 100 person-years. Treatment with IFN alfa-2b precipitated depression at an incidence rate of 0.0002 cases per 100 person-years. Dacarbazine was associated with respiratory toxicity and dyspnea, with incidence rates of 0.0001 and 0.00008 cases per 100 person-years, respectively. IL-2 treatment induced vascular leak syndrome (VLS), with symptoms of hypotension and oliguria, was observed at incidence rates of 0.17 and 0.15 cases per 100 person-years, respectively. Findings may serve as a foundation for future research in this area and guide clinical recommendations.
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Evaluation criteria for mobile teledermatology applications and comparison of major mobile teledermatology applications.
Telemed J E Health
PUBLISHED: 06-28-2013
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Mobile teledermatology applications have enabled increased patient access to dermatologic care. For groups interested in starting a mobile teledermatology program, selection of the appropriate application can be challenging. Having pretested evaluation criteria allows for efficient, systematic assessment of mobile teledermatology applications and identification of features important for comparison. The primary aim of this study is to determine a framework for evaluation of mobile teledermatology applications and to compare two major mobile teledermatology applications available in the United States using the proposed criteria.
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Access to health care in patients with psoriasis and psoriatic arthritis: data from National Psoriasis Foundation survey panels.
JAMA Dermatol
PUBLISHED: 06-21-2013
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This article represents a real-world perspective on access to health care including the number and types of physicians seen by patients with psoriasis. It is important for practicing dermatologists to recognize patients who may be less likely to seek care for this multifaceted systemic disease as well as to be aware of reasons for not seeing physicians.
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Corticosteroids and wound healing: clinical considerations in the perioperative period.
Am. J. Surg.
PUBLISHED: 06-04-2013
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Determining whether systemic corticosteroids impair wound healing is a clinically relevant topic that has important management implications.
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Effect of nutrient supplementation on atopic dermatitis in children: a systematic review of probiotics, prebiotics, formula, and fatty acids.
JAMA Dermatol
PUBLISHED: 05-18-2013
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To identify whether nutrient supplementation with probiotics, prebiotics, formula, or fatty acids prevents the development of atopic dermatitis (AD) or reduces the severity of AD in newborns to children younger than 3 years.
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Do TNF inhibitors reduce the risk of myocardial infarction in psoriasis patients?
JAMA
PUBLISHED: 05-17-2013
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To assess whether patients with psoriasis treated with tumor necrosis factor (TNF) inhibitors have a decreased risk of myocardial infarction (MI) compared with those not treated with TNF inhibitors.
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Psoriasis and Sexual Behavior in Men: Examination of the National Health and Nutrition Examination Survey (NHANES) in the United States.
J Sex Med
PUBLISHED: 05-16-2013
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INTRODUCTION: Epidemiologic data on sexual behavior in psoriasis patients are lacking. AIM: We aim to examine and compare the sexual behaviors between men with and without psoriasis in the United States. METHODS: We analyzed data from the National Health and Nutrition Examination Survey (NHANES) from 2003 to 2006 and 2009 to 2010. Responses from male participants to the dermatology and sexual behavior questionnaires of the NHANES were collated and analyzed. MAIN OUTCOME MEASURES: Outcome measures included sexual orientation, age of first sexual encounter, number of oral and non-oral sexual partners, and frequency of unprotected sex. RESULTS: Among 6,444 U.S. men that responded to the psoriasis question, 170 (2.6%) reported a physician-given diagnosis of psoriasis. Heterosexual men accounted for 95.5% and nonheterosexual men 4.5% of the overall study population. On multivariate analysis, psoriasis was not associated with differences in sexual orientation (odds ratio 1.78, 95% confidence interval [CI] 0.75-4.15). Heterosexual men with psoriasis experienced first sexual encounter at an earlier age than those without psoriasis (weighted difference -0.9 years, P?=?0.002). Heterosexual men with psoriasis had significantly fewer female oral sexual partners compared with heterosexual men without psoriasis on multivariate analysis (lifetime partner number: rate ratio [RR] 0.65, 95% CI 0.45-0.95; past-year partner number: RR 0.64, 95% CI 0.42-0.97). No significant differences existed between heterosexual men with and without psoriasis regarding frequency of unprotected sex (RR 0.96, 95% CI 0.85-1.09). Among nonheterosexual men with and without psoriasis, no significant differences existed in age first had sex, number of sexual partners, or frequency of unprotected sex. CONCLUSION: Heterosexual men with psoriasis have significantly fewer lifetime female oral sexual partners compared with those without psoriasis. Dermatologists and other healthcare providers need to examine the genital region routinely and initiate appropriate therapy to improve patients sexual health. Armstrong AW, Harskamp CT, and Schupp CW. Psoriasis and sexual behavior in men: Examination of the National Health and Nutrition Examination Survey (NHANES) in the United States. J Sex Med **;**:**-**.
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Psoriasis and major adverse cardiovascular events: a systematic review and meta-analysis of observational studies.
J Am Heart Assoc
PUBLISHED: 04-06-2013
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Psoriasis is a chronic inflammatory disease that may be associated with increased risk of cardiovascular events, including cardiovascular mortality, myocardial infarction, and stroke.
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Psoriasis, electrocardiographic characteristics, and incidence of atrial fibrillation.
Arch. Dermatol. Res.
PUBLISHED: 03-12-2013
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Psoriasis patients have an increased incidence of cardiovascular disease. Atrial fibrillation is the most common cardiac arrhythmia and is associated with increased morbidity and risk of stroke. In this study, we assessed the association between psoriasis, electrocardiographic characteristics, and incident atrial fibrillation. Two cohorts were studied to address this question. First, the electrocardiograms of 169 subjects with psoriasis and coronary heart disease were reviewed and matched to patients without psoriasis. The Framingham risk score for atrial fibrillation was calculated to predict incident atrial fibrillation. Second, a larger cohort of 2,078 patients with psoriasis was matched to 6,234 patients without psoriasis. In the first group, psoriasis patients had no significantly different electrocardiographic characteristics, but a trend towards a decreased predicted incidence of atrial fibrillation using the Framingham risk score (12.8 vs. 14.6 % over a 10-year period, P = 0.06), suggesting that patients with psoriasis do not have a higher prevalence of risk factors for atrial fibrillation based on established risk scores. In the second group, the 5-year incidence of atrial fibrillation among patients with psoriasis was 2.5, vs. 3.3 % for matched controls (P = 0.4). The rates of atrial fibrillation per 1,000 person-years ranged from 4.8 events/1,000 person-years for mild psoriasis to 5.4 for patients with moderate/severe psoriasis. On multivariable analysis, there remained no association between mild psoriasis (adjusted HR 1.32, 95 % CI 0.91-1.89) or moderate-to-severe psoriasis (adjusted HR 1.27, 95 % CI 0.54-3.03) and incident atrial fibrillation.
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Postoperative preferences in cutaneous surgery: a patient-centered investigation from an academic dermatologic surgery practice.
Dermatol Surg
PUBLISHED: 02-22-2013
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Little is known about postoperative preferences regarding dermatologic surgery.
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Standardizing training for psoriasis measures: effectiveness of an online training video on Psoriasis Area and Severity Index assessment by physician and patient raters.
JAMA Dermatol
PUBLISHED: 02-22-2013
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Because the Psoriasis Area and Severity Index (PASI) is the most commonly used and validated disease severity measure for clinical trials, it is imperative to standardize training to ensure reliability in PASI scoring for accurate assessment of disease severity.
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Prevalence of pilomatricoma in Turner syndrome: findings from a multicenter study.
JAMA Dermatol
PUBLISHED: 02-22-2013
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The absence of data on the prevalence of pilomatricoma among patients with Turner syndrome served as the catalyst for this multicenter investigation.
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Psoriasis and the risk of diabetes mellitus: a systematic review and meta-analysis.
JAMA Dermatol
PUBLISHED: 02-15-2013
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To compare the prevalence and incidence of type 2 diabetes mellitus between patients with psoriasis and those without psoriasis.
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Surgeon error and slide quality during Mohs micrographic surgery: is there a relationship with tumor recurrence?
J. Am. Acad. Dermatol.
PUBLISHED: 02-14-2013
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Recurrences after Mohs micrographic surgery (MMS) have been associated in the past with aggressive tumor type, large tumor size, and location within certain anatomic subunits. These factors are beyond the control of the treating physician and not subject to quality improvement efforts.
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I feel disconnected: learning technologies in resident education.
Instr Course Lect
PUBLISHED: 02-12-2013
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With the rapid development of technology in medical education, orthopaedic educators are recognizing that the way residents learn and access information is profoundly changing. Residency programs are faced with the challenging problem that current educational methods are not designed to take full advantage of the information explosion and rapid technologic changes. This disconnection is often seen in the potentially separate approaches to education preferred by residents and orthopaedic educators. Becoming connected with residents requires understanding the possible learning technologies available and the learners abilities, needs, and expectations. It is often assumed that approaches to strategic lifelong learning are developed by residents during their training; however, without the incorporation of technology into the learning environment, residents will not be taught the digital literacy and information management strategies that will be needed in the future. To improve learning, it is important to highlight and discuss current technologic trends in education, the possible technologic disconnection between educators and learners, the types of learning technologies available, and the potential opportunities for getting connected.
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Clinical manifestations of pediatric psoriasis: results of a multicenter study in the United States.
Pediatr Dermatol
PUBLISHED: 01-30-2013
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The clinical features of pediatric psoriasis warrant further attention. A national study was conducted to determine the prevalence of scalp and nail involvement and a history of guttate psoriasis at onset according to age, sex, and disease severity. One hundred eighty-one children ages 5 to 17 years with plaque psoriasis were enrolled in a multicenter, cross-sectional study. Subjects and guardians were asked about a history of scalp and nail involvement and whether the initial presentation was guttate. Peak psoriasis severity was assessed and defined historically as mild psoriasis (MP) or severe psoriasis (SP) according to the Physicians Global Assessment and body surface area measures. One hundred forty-three (79.0%) subjects reported a history of scalp involvement, and 71 (39.2%) described a history of nail involvement. Boys were less likely than girls to report a history of scalp involvement (odds ratio [OR] = 0.40, 95% confidence interval [CI] = 0.19-0.84) but more likely to have had nail involvement (OR = 3.01, 95% CI = 1.62-5.60). Scalp and nail involvement was not related to psoriasis severity. In contrast, subjects with SP (35.9%) more often reported a history of guttate lesions than did those with MP (21.8%) (p = .02). Antecedent streptococcal infection was more common in children with guttate than those with plaque psoriasis at onset (p = .02) but did not correlate with severity. Sex-related differences in scalp and nail involvement suggest koebnerization. Preceding streptococcal infection predicts guttate morphology but not severity, and initial guttate morphology is associated with eventual greater severity of disease. More aggressive monitoring and management should be considered for guttate psoriasis, given its later association with more severe disease.
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Psoriasis and metabolic syndrome: a systematic review and meta-analysis of observational studies.
J. Am. Acad. Dermatol.
PUBLISHED: 01-27-2013
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Increasing population-based studies have suggested a relationship between psoriasis and metabolic syndrome.
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Combination treatments for psoriasis: a systematic review and meta-analysis.
Arch Dermatol
PUBLISHED: 12-19-2011
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To summarize the current state of evidence for combination topical and systemic therapies for mild to severe psoriasis.
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Nonmelanoma skin cancer.
Dermatol Clin
PUBLISHED: 10-21-2011
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Nonmelanoma skin cancers (NMSCs) represent the most common cancer in the United States, accounting for more than 2 million cases per year. Despite the magnitude of health burden on the US population, there remain many questions regarding the epidemiology, health outcomes, and treatments of NMSCs. This article highlights these areas of clinical and research need. The article focuses on the recent epidemiologic trends as well as health outcomes of NMSCs in the United States. In addition, current national guidelines, available treatments and care pathways, and clinical trials are discussed.
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Melanoma: epidemiology, diagnosis, treatment, and outcomes.
Dermatol Clin
PUBLISHED: 10-19-2011
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Melanoma is a skin cancer that arises from the malignant transformation of melanocytes. Although it is typically considered a pigmented lesion, the clinical presentation of melanoma can vary greatly. With increased efforts in screening and detection of early-stage melanoma, researchers and clinicians hope to improve clinical outcomes for patients with melanoma. Novel immunotherapies directed at specific molecular targets in the pathogenesis of melanoma usher in a new era of treatment of advanced melanoma.
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A review of health outcomes in patients with psoriasis.
Dermatol Clin
PUBLISHED: 10-19-2011
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Psoriasis, a chronic inflammatory skin condition, is a complex disease in terms of its significant comorbidities and impact on patients quality of life. The objective of this article is to elucidate the health outcomes of the disease, including its economic and psychosocial burden on the patient. Current treatments options and the economic considerations of treatment costs are reviewed. Psoriasis is a multidimensional disease, so patients benefit from having a multidisciplinary team of dermatologists and other physicians for management of it and of associated comorbid conditions.
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Practice models and challenges in teledermatology: a study of collective experiences from teledermatologists.
PLoS ONE
PUBLISHED: 09-29-2011
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Despite increasing practice of teledermatology in the U.S., teledermatology practice models and real-world challenges are rarely studied.
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Are patients with psoriasis being screened for cardiovascular risk factors? A study of screening practices and awareness among primary care physicians and cardiologists.
J. Am. Acad. Dermatol.
PUBLISHED: 07-21-2011
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Increasing literature suggests that patients with psoriasis who have severe disease appear to have increased frequency of cardiovascular (CV) diseases. The National Psoriasis Foundation recommends screening for CV risk factors as early as 20 years of age. The extent to which these screening guidelines are implemented in practice is unclear.
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A tale of two plaques: convergent mechanisms of T-cell-mediated inflammation in psoriasis and atherosclerosis.
Exp. Dermatol.
PUBLISHED: 06-23-2011
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Psoriasis and atherosclerosis are diseases in which effector T lymphocytes such as Helper T cells type 1 (Th1) and 17 (Th17) play integral roles in disease pathogenesis and progression. Regulatory T cells (Treg) also exert clinically important anti-inflammatory effects that are pathologically altered in psoriasis and atherosclerosis. We review the immunological pathways involving Th1, Th17 and Treg cells that are common to psoriasis and atherosclerosis. These shared pathways provide the basis for mechanisms that may explain the epidemiologic observation that patients with psoriasis have an increased risk of heart disease. Improved understanding of these pathways will guide future experiments and may lead to the development of therapeutics that prevent or treat cardiovascular complications in patients with psoriasis.
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Patient-centered online management of psoriasis: a randomized controlled equivalency trial.
J. Am. Acad. Dermatol.
PUBLISHED: 05-24-2011
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Previous research suggests that technology-enabled health care delivery may improve access to dermatologic specialty care. Outcomes research using validated outcomes measures is necessary for evaluation of novel health care delivery models.
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The recurrent unstable elbow: diagnosis and treatment.
Instr Course Lect
PUBLISHED: 05-11-2011
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The elbow is a difficult joint to treat because of the subtle nuances involved in pathology, examination, and treatment. Patients experiencing the sequelae of recurrent elbow instability can lose substantial function in the affected upper extremity. Elbow instability comprises a wide spectrum of diseases, ranging from valgus instability in the throwing athlete to traumatic recurrent rotatory instability to iatrogenic damage. For the orthopaedic surgeon to develop a systematic algorithm for treating elbow instability disorders, it is necessary to understand the basic elbow biomechanics and the alterations that occur in the unstable elbow. A thorough knowledge of the history, physical examination techniques, and imaging studies necessary to diagnose these injury patterns is also needed. Cutting-edge advances in the surgical reconstruction of the unstable elbow will allow those caring for patients with these difficult injuries to make the proper management decisions.
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Angiogenesis and oxidative stress: common mechanisms linking psoriasis with atherosclerosis.
J. Dermatol. Sci.
PUBLISHED: 03-30-2011
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Shared angiogenic and oxidative mechanisms underlie the pathophysiology of psoriasis and atherosclerosis. During the pathogenesis of both diseases, stimuli such as injury or local hypoxia trigger the release of pro-angiogenic factors including IL-8, HIF-1?, ETS-1, and VEGF. These factors stimulate increased permeability and encourage leukocyte transmigration into areas of inflammation by enhanced expression of cell adhesion molecules. Psoriasis and atherosclerosis also share common enzymatic sources of reactive oxygen species (ROS), and these ROS influence several cellular signaling pathways implicated in the pathogenesis of both diseases. Pharmacologic and genetic therapies that target key factors in these pathways could provide innovative approaches to the management of psoriasis and potentially mitigate the cardiovascular complications suffered by psoriasis patients.
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Current state of acne treatment: highlighting lasers, photodynamic therapy, and chemical peels.
Dermatol. Online J.
PUBLISHED: 03-24-2011
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Acne vulgaris continues to be a challenge to dermatologists and primary care physicians alike. The available treatments reflect the complex and multifactorial contributors to acne pathogenesis, with topical retinoids as first-line therapy for mild acne, topical retinoids in combination with anti-microbials for moderate acne, and isotretinoin for severe nodular acne. Unfortunately, these conventional therapies may not be effective against refractory acne, can lead to antibiotic resistance, and is associated with adverse effects. With the rise of new technologies and in-office procedures, light and laser therapy, photodynamic therapy, chemical peels, and comedo extraction are growing in popularity as adjunctive treatments and may offer alternatives to those who desire better efficacy, quicker onset of action, improved safety profile, reduced risk of antibiotic resistance, and non-systemic administration. Whereas adjunctive therapies are generally well-tolerated, the number of randomized controlled trials are few and limited by small sample sizes. Furthermore, results demonstrating efficacy of certain light therapies are mixed and studies involving photodynamic therapy and chemical peels have yet to standardize and optimize application, formulation, and exposure times. Nevertheless, adjunctive therapies, particularly blue light and photodynamic therapy, show promise as these treatments also target factors of acne pathogenesis and may potentially complement current conventional therapy.
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Mechanical characteristics of a novel posterior-step prosthesis for biconcave glenoid defects.
J Shoulder Elbow Surg
PUBLISHED: 03-21-2011
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Posterior glenoid defects increase the risk of glenoid component loosening after total shoulder arthroplasty (TSA). The goal of this work was to evaluate the mechanical performance of a novel posterior-step glenoid prosthesis, designed to compensate for biconcave (type B2) glenoid defects. Two prototypes ("Poly-step" and "Ti-step") were constructed by attaching polyethylene or titanium step-blocks onto standard (STD) glenoid prostheses. We hypothesized that the mechanical performance of the experimental prostheses in the presence of a B2 defect would be similar to that of an STD prosthesis in the absence of a defect.
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Comparison of standard two-dimensional and three-dimensional corrected glenoid version measurements.
J Shoulder Elbow Surg
PUBLISHED: 02-16-2011
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There is concern regarding the accuracy of 2-dimensional (2D) computed tomography (CT) for measuring glenoid version. Three-dimensional (3D) CT scan reconstructions can properly orient the glenoid to the plane of the scapula and have been reported to accurately measure glenoid version in cadaver models. We hypothesized that glenoid version measured by correcting 2D CT scans to the plane of the scapula by 3D reconstruction would be significantly different compared with standard 2D CT scan measurement of the glenoid in a clinical patient population.
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Cost-effectiveness analysis of a patient-centered care model for management of psoriasis.
J. Am. Acad. Dermatol.
PUBLISHED: 02-12-2011
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Cost-effectiveness analyses help policymakers make informed decisions regarding funding allocation of health care resources. Cost-effectiveness analysis of technology-enabled models of health care delivery is necessary to assess sustainability of novel online, patient-centered health care models.
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Health outcome measures in atopic dermatitis: a systematic review of trends in disease severity and quality-of-life instruments 1985-2010.
PLoS ONE
PUBLISHED: 02-04-2011
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A number of disease-severity and quality-of-life (QoL) instruments have emerged in atopic dermatitis (AD) in the last decade.
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Online video improves clinical outcomes in adults with atopic dermatitis: a randomized controlled trial.
J. Am. Acad. Dermatol.
PUBLISHED: 01-13-2011
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Atopic dermatitis (AD) is a chronic inflammatory skin disorder characterized by intense pruritus that causes significant disease and psychosocial burden in patients. Patient education has the potential to improve clinical outcomes and patient knowledge of this condition.
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Psoriasis and hypertension severity: results from a case-control study.
PLoS ONE
PUBLISHED: 01-03-2011
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Epidemiologic studies have provided new insights into the association between psoriasis and cardiovascular diseases. Previous population studies have examined hypertension frequency in psoriasis patients. However, the relationship between severity of hypertension and psoriasis has not been characterized.
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Combination systemic therapies in psoriatic arthritis.
J Dermatolog Treat
PUBLISHED: 07-28-2010
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Psoriatic arthritis (PsA) is a chronic, progressive, and debilitating disorder. When monotherapy fails, combination therapy is necessary for the long-term management of these patients. There is currently no review on this subject, and the purpose of this study was to investigate and describe the current literature on combination therapy in PsA. A PubMed MeSH search was performed for psoriatic arthritis and combination therapy, which yielded at total of 83 articles. After excluding reviews and commentaries, and pursuing relevant citations, a total of 21 articles on the subject were found: one study of NSAIDs and methotrexate, three studies of cyclosporine and methotrexate, three studies of non-TNF biologic inhibitors (alefacept, ustekinumab) and methotrexate, and 14 studies of anti-TNF-inhibitors (etanercept, adalimumab, infliximab, golimumab) and methotrexate. The combination of cyclosporine and methotrexate reduces the dosages and also the side effects of each agent, allowing better disease control with less toxicity. Methotrexate in combination with biologic agents, either non-TNF inhibitors or anti-TNF inhibitors, may have a role in decreasing side effects, but it does not appear to improve clinical symptoms beyond those attained by biologic monotherapy.
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Glenoid spherical orientation and version.
J Shoulder Elbow Surg
PUBLISHED: 05-25-2010
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Glenoid orientation likely plays an important role in shoulder mechanics and has been associated with glenohumeral instability, rotator cuff tears, and total shoulder arthroplasty outcome. Glenoid version and inclination measurements are widely used, but these measurements are 2-dimensional, and orientation of the central face must be inferred from 2 points on the outer rim. This study tested the hypothesis that sphere fitting provides an optimal assessment of glenoid face 3-dimensional orientation, and clinically important differences will exist in some individuals between sphere fit orientation and traditional version measurement.
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Location of the optimized centerline of the glenoid vault: a comparison of two operative techniques with use of three-dimensional computer modeling.
J Bone Joint Surg Am
PUBLISHED: 05-05-2010
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The three-dimensional vault geometry beneath the glenoid face reduces to a narrow width in many individuals, creating a risk of perforation of the glenoid component pegs or keel in total shoulder arthroplasty. The purpose of this study was to introduce the concept of a centerline of the glenoid vault determined by computed optimization and to compare this centerline geometry against two existing surgical methods for orienting the glenoid component.
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Evaluation and comparison of store-and-forward teledermatology applications.
Telemed J E Health
PUBLISHED: 05-05-2010
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Store-and-forward (S&F) teledermatology has been used to increase patient access to dermatologic care. A major challenge to implementing S&F teledermatology is selecting secure and cost-saving applications for data capture and transmission. Detailed analyses and comparison of the major S&F teledermatology applications do not exist in the current peer-reviewed literature. The objectives of this study were to identify, evaluate, and compare the major S&F teledermatology applications in the United States to help referral and consultant sites select applications responsive to their needs.
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Erythema induratum of Bazin.
Dermatol. Online J.
PUBLISHED: 04-23-2010
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An 81-year-old woman with a history of renal cell carcinoma and years of slowly, progressively enlarging pulmonary nodules of uncertain etiology presented with several weeks of painful lower extremity nodules. A biopsy revealed changes consistent with nodular vasculitis. A purified protein derivative and QuantiFERON test were positive, favoring the diagnosis of erythema induratum of Bazin. Treatment with a standard four-drug antituberculous regimen resulted in radiographic and clinical improvement. This case emphasizes the importance of dermatologic manifestations in the detection of systemic disease.
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A biomechanical study of posterior glenoid bone loss and humeral head translation.
J Shoulder Elbow Surg
PUBLISHED: 04-12-2010
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Results of shoulder arthroplasty have been reported to be inferior with posterior glenoid wear and accompanying subluxation of the humeral head. The purpose of this study was to examine the effect of posterior glenoid wear on posterior subluxation of the humeral head.
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Effects of video-based, online education on behavioral and knowledge outcomes in sunscreen use: a randomized controlled trial.
Patient Educ Couns
PUBLISHED: 03-15-2010
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To compare online video and pamphlet education at improving patient comprehension and adherence to sunscreen use, and to assess patient satisfaction with the two educational approaches.
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What is Visualize?

JoVE Visualize is a tool created to match the last 5 years of PubMed publications to methods in JoVE's video library.

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We use abstracts found on PubMed and match them to JoVE videos to create a list of 10 to 30 related methods videos.

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In developing our video relationships, we compare around 5 million PubMed articles to our library of over 4,500 methods videos. In some cases the language used in the PubMed abstracts makes matching that content to a JoVE video difficult. In other cases, there happens not to be any content in our video library that is relevant to the topic of a given abstract. In these cases, our algorithms are trying their best to display videos with relevant content, which can sometimes result in matched videos with only a slight relation.