This article reports on a prevalence study of dementia and Alzheimer's disease among two groups of subjects with the same ethnic background but widely differing environments.
The study was conducted ...among residents aged 65 years and older in two communities: Yorubas (N = 2,494) living in Ibadan, Nigeria, and African Americans (N = 2,212 in the community and N = 106 in nursing homes) living in Indianapolis, Indiana. The study design consisted of a screening stage followed by a clinical assessment stage for selected subjects on the basis of their performance on the screening tests.
The age-adjusted prevalence rates of dementia (2.29%) and Alzheimer's disease (1.41%) in the Ibadan sample were significantly lower than those in the Indianapolis sample, both in the community-dwelling subjects alone (4.82% and 3.69%, respectively) and in the combined nursing home and community samples (8.24% and 6.24%, respectively). The prevalence rates of dementia and Alzheimer's disease increased consistently with advancing age in both study groups.
To the authors' knowledge, this is the first study, using the same research method at the two sites, to report significant differences in rates of dementia and Alzheimer's disease in two different communities with similar ethnic origins.
In three phase 3 trials, ixekizumab, an anti–IL-17A monoclonal antibody, was effective in the treatment of patients with moderate-to-severe plaque psoriasis. Adverse events included neutropenia, ...candida infections, and inflammatory bowel disease.
Psoriasis is a chronic inflammatory disease that is mediated by aberrant immune responses and driven by self-perpetuating cytokine networks.
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Advances in understanding the pathogenic cytokine network of psoriasis have led to the development of new treatments
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that provide greater efficacy in terms of complete skin clearance.
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The motivation to completely clear psoriasis plaques from the skin of patients has grown in response to accumulating evidence that residual skin disease can affect a patient’s health-related quality of life
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similar to that associated with chronic conditions such as type 2 diabetes.
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Ixekizumab, a recombinant, high-affinity, humanized, IgG4-κ monoclonal . . .
The aim of this study is to determine the potency of newly emerging detergents, laundry bleach, and toilet soap on bacteria isolates from fairly used clothes and Female Underwear. The current study ...included sample collection from used clothing and female underwear and compared the efficacy of detergents, toilet soap and laundry bleach (Jik),to reduce the microbial load in the used cloth. Organisms were isolated from the used cloth and female underwear, identified, and microbiologically characterized using the conventional method of microbiology assay. i.e, biochemical test,a compilation of cultural colonial and characteristics. Test Samples were washed using four (4) types of detergents and five (5) types of toilet soap and laundry bleach. The results of the colony-forming unit (CFU) before and after washing with detergent and toilet soap and laundry bleach were recorded, washing with detergents and toilet soap. The results showed that detergents were more effective in reducing bacterial load than toilet soap in all test samples. the addition of laundry bleach (Jik) also shows the effectiveness in reducing bacterial load in fairly used clothes and Female Underwear The antibiotics susceptibility test were determined using disc diffusion and agar well diffusion methods respectively. Eight (8) bacteria were identified include Aerobacter aerogenes (3), Bacillus polymyxa (5), Staphylococcus aureus (2), Veillonella parvula (5), Escherichia freundii (1), Escherichia coli (3), Enterobacter aerogenes (2) and Aerobacter cloacae (1). Bacillus polymyxa, and Veillonella parvula were the most common organism isolated and followed by Escherichia coli from fairly used clothes and Female Underwear. In this study, some of the Gram-positive(+ve) bacteria isolates were sensitive to commonly used antibiotics like Streptomycin, Tarivid, Reflacine Ciprofloxacin, Augmentin, Gentamycin, Ceporex, Nalidixic acid, Septrin, and Amplicin. Gram-negative bacteria isolated were sensitive to Ciprofloxacin and all the isolated organisms were resistant to Ceporex. Gram-positive (-ve) bacteria were sensitive to Streptomycin and were resistant to Rifampicin. To determine the growth dynamics and killing kinetics of the isolated organisms, from fairly used clothes and Female Underwear, an Ultraviolet spectrophotometer were used to determine the wavelength and killing kinetics of isolated organisms from fairly used clothes and Female Underwear. The addition of antibiotics to the isolated organisms at the 48th-hour speed up the death rate of the isolates from fairly used clothe washed with different detergent Laundry Bleach and toilet soaps. It can be deduced that this study validates the efficacy of newly emerging detergents, Laundry bleach, and toilet soap against bacteria isolated from fairly used clothes. It is also recommended to wash fairly used clothes using different methods of soaking the fairly used clothes and female underwear in the Laundry Bleach for some days before finally washing in detergents and ironing before use. This method will drastically reduce and remove bacterial load in the fairly used clothes and female underwear.
Background
Psoriasis in many patients is a chronic and recalcitrant disease that requires long‐term treatment, reinforcing the importance of long‐term safety data. Ixekizumab, a high‐affinity ...monoclonal antibody that selectively targets interleukin (IL)‐17A, is approved for treating patients with moderate‐to‐severe plaque psoriasis.
Objective
To determine long‐term safety of ixekizumab in psoriasis.
Methods
Integrated safety data are presented from 12‐week induction period, 12–60‐week maintenance period, and from all ixekizumab‐treated patients from 11 clinical studies. Exposure‐adjusted incidence rates (IRs) per 100 patient‐years are reported.
Results
Overall, 5689 patients accounted for 12 061.5 patient‐years of ixekizumab exposure from 11 studies. Over 156 weeks, a total of 83.9% (n = 4775) of patients reported treatment‐emergent adverse events (AEs). Most opportunistic infections (IR 95% confidence interval; CI 1.8 1.6, 2.1) reported were mucocutaneous candidiasis. The IR (95% CI) for oral Candida infection was 0.9 (0.8, 1.1). There was no trend of increase in IR of AEs of special interest. Serious AEs were reported in 11.8% of patients; death occurred in 0.4% (n = 23) of patients.
Conclusion
The 3‐year, long‐term maintenance treatment with ixekizumab did not show any new safety signals in patients with moderate‐to‐severe plaque psoriasis.
The primary objective of this study was to test the hypothesis that 1 or more dose levels of LY2140023 monohydrate, an oral prodrug of the potent metabotropic glutamate (mGlu) 2/3 receptor agonist ...LY404039, given to patients with schizophrenia for 4 weeks would demonstrate significantly greater efficacy than placebo. The HBBI study was a multicenter, randomized, double-blind, parallel, placebo- and active-controlled trial. Male and female patients aged 18 to 65 years who met the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria for schizophrenia were randomized in a 2:2:2:2:2:1 ratio to receive 5-, 20-, 40-, or 80-mg LY2140023 monohydrate twice daily, placebo twice daily, or placebo (am) and 15 mg of olanzapine (pm) daily. Efficacy was defined as the change from baseline on the Positive and Negative Syndrome Scale (PANSS) total score assessed at 4 weeks. The primary analysis did not show that any of the 4 LY2140023 monohydrate doses were more efficacious than placebo as measured by the PANSS total score. Similarly, olanzapine did not significantly separate from placebo. A higher-than-anticipated treatment effect (14.6-point improvement) in the placebo group was observed on PANSS total score. LY2140023 monohydrate was generally well tolerated, although 4 patients reported the serious adverse event of convulsion. LY2140023 monohydrate-treated patients showed little change in dopamine-related adverse events and weight. The results of the HBBI study are considered to be inconclusive because LY2140023 monohydrate and the active control olanzapine did not separate from placebo in the treatment of patients with acutely exacerbated schizophrenia. Additional efficacy, safety, and tolerability testing are needed.
Summary
Background
Genital psoriasis (GenPs) is a common, debilitating and difficult‐to‐treat manifestation of plaque psoriasis. However, few controlled, interventional studies of GenPs exist.
...Objectives
To determine the efficacy of ixekizumab vs. placebo in patients with moderate‐to‐severe GenPs with ≥ 1% involved body surface area (BSA).
Methods
Patients with moderate‐to‐severe GenPs, defined as a baseline static Physician's Global Assessment of Genitalia (sPGA‐G) score of ≥ 3, with BSA ≥ 1% were randomized 1 : 1 to receive placebo (n = 74) or the recommended dosing of ixekizumab (n = 75). Major outcomes included the percentage of patients achieving 0 or 1 scores on the sPGA‐G (primary end point), overall sPGA, GenPs Sexual Frequency Questionnaire (GenPs‐SFQ) item 2, and ≥ 3‐point improvement from baseline on the GenPs itch numerical rating scale.
Results
At week 12, ixekizumab was superior to placebo for sPGA‐G 0/1 (73% vs. 8%, P < 0·001), overall sPGA 0/1 (73% vs. 3%, P < 0·001), GenPs‐SFQ item 2 score of 0 or 1 (78% vs. 21%, P < 0·001) and genital itch (60% vs. 8%, P < 0·001). No candidiasis was reported, no deaths occurred and one (1%) serious adverse event was reported in a patient receiving placebo.
Conclusions
Ixekizumab was superior to placebo for the treatment of moderate‐to‐severe GenPs with BSA ≥ 1%. The safety profile of ixekizumab was consistent with previous studies in moderate‐to‐severe plaque psoriasis.
What's already known about this topic?
Genital psoriasis is a common and burdensome form of plaque psoriasis, but there are few controlled studies of effective therapies.
What does this study add?
Ixekizumab significantly improved the severity of genital psoriasis and associated disease characteristics.
Ixekizumab may be appropriate for treatment of moderate‐to‐severe genital psoriasis, even in patients with limited body surface involvement.
Linked Editorial: Becher and Burden. Br J Dermatol 2018; 179:811–812.
Plain language summary available online
As part of a community-based study of Alzheimer's Disease (AD) in a Nigerian population aged 65 years and over, we have determined apolipoprotein E (APOE) genotypes on 56 subjects (39 controls and 17 ...subjects with dementia, including 12 with AD). The epsilon 4 allele of APOE was not associated with AD or dementia in this community-based sample. The epsilon 4 allele frequency was 17.6% in demented patients and 16.7% in AD patients compared with 20.5% in the control subjects. These findings are in marked contrast to the strong association between the epsilon 4 allele and AD in our previously reported study with African Americans.
A door-to-door survey to detect commonly occurring neurologic diseases was carried out in Igbo-Ora, a large Nigerian town with a population of approximately 20,000. Effective health care facilities ...have been operating in the community since 1963. Primary health care workers and nondoctor personnel administered a complete census, a screening questionnaire, and a simple screening neurologic examination. The pretested screening questionnaire had been shown in a pilot study to have a sensitivity of 95% for identifying those with epilepsy. Individuals positive on the screening phase of the survey were evaluated by neurologists and neurosurgeons, who used well-defined criteria to make the diagnosis. There were 101 (48 males and 53 females) who suffered from active epilepsy (5.3 cases/1,000) on prevalence day. The highest age-specific prevalence ratios occurred in those below age 20. The most common of the identifiable seizure types was complex partial seizures (52 cases). The prevalence ratio of epilepsy in this Nigerian town (with an effective health care system) is similar to that reported in some developed countries and several times lower than figures derived from studies in developing countries. These data suggest that an improved health care system would probably reduce the prevalence and burden of epilepsy in developing countries.
Background & Aims The inflammatory bowel diseases (IBD) ulcerative colitis (UC) and Crohn’s disease (CD) cause significant morbidity and are increasing in prevalence among all populations, including ...African Americans. More than 200 susceptibility loci have been identified in populations of predominantly European ancestry, but few loci have been associated with IBD in other ethnicities. Methods We performed 2 high-density, genome-wide scans comprising 2345 cases of African Americans with IBD (1646 with CD, 583 with UC, and 116 inflammatory bowel disease unclassified) and 5002 individuals without IBD (controls, identified from the Health Retirement Study and Kaiser Permanente database). Single-nucleotide polymorphisms (SNPs) associated at P < 5.0 × 10−8 in meta-analysis with a nominal evidence ( P < .05) in each scan were considered to have genome-wide significance. Results We detected SNPs at HLA-DRB1, and African-specific SNPs at ZNF649 and LSAMP, with associations of genome-wide significance for UC. We detected SNPs at USP25 with associations of genome-wide significance associations for IBD. No associations of genome-wide significance were detected for CD. In addition, 9 genes previously associated with IBD contained SNPs with significant evidence for replication ( P < 1.6 × 10−6 ): ADCY3, CXCR6, HLA-DRB1 to HLA-DQA1 (genome-wide significance on conditioning), IL12B, PTGER4, and TNC for IBD; IL23R, PTGER4, and SNX20 (in strong linkage disequilibrium with NOD2) for CD; and KCNQ2 (near TNFRSF6B) for UC. Several of these genes, such as TNC (near TNFSF15), CXCR6, and genes associated with IBD at the HLA locus, contained SNPs with unique association patterns with African-specific alleles. Conclusions We performed a genome-wide association study of African Americans with IBD and identified loci associated with CD and UC in only this population; we also replicated loci identified in European populations. The detection of variants associated with IBD risk in only people of African descent demonstrates the importance of studying the genetics of IBD and other complex diseases in populations beyond those of European ancestry.
As part of a community-based study of Alzheimer's disease (AD) in the African-American population age 65 and over, we have determined apolipoprotein E (Apo E) genotypes in 85 subjects (31 AD patients ...and 54 controls). The epsilon 4 allele of Apo E was strongly associated with AD in this population sample. The epsilon 4 allele frequency in AD patients was 40.3% compared with 13.9% in the control group, and 22.6% of the AD patients were homozygous for this allele compared with 3.7% of the control subjects (p = 0.01). This study extends the association of Apo E-epsilon 4 and AD to nonwhite populations and provides further evidence that the observed allelic association is biologically relevant.
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