Background
Treatment of vitiligo is still a big challenge for dermatologists. The efficacy of statins in the treatment of vitiligo is controversial.
Aim and Objective
We studied possible therapeutic ...effect of topical 1% niosomal atorvastatin ointment combined with topical 0.1% tacrolimus in treatment of non‐segmental vitiligo.
Methods
This is a triple blind, pilot, randomized placebo‐controlled trial (RCT) that was performed in dermatology clinic. All the patients used topical 0.1% tacrolimus cream twice daily (BD). Moreover, the intervention group participants used topical 1% niosomal atorvastatin ointment, and control group participants were prescribed placebo ointment, BD. Patients were evaluated using vitiligo area surface index (VASI) score and patients' satisfaction at baseline and after 3 months treatment.
Results
The mean patient satisfaction in the intervention and control groups were 5 ± 1.4 and 3.5 ± 1.9; the difference between groups was not statistically significant (p = 0.9). We found statistically significant difference in VASI score before and after treatment in both intervention and control groups (p = 0.01 and p = 0.03, respectively). However, comparison of the VASI score between groups was not statistically significant (p = 0.62). We also found no significant correlation between VASI score and other variables.
Conclusion
The result of this study indicates that adding of niosomal atorvastatin 1% ointment to topical calcineurin inhibitor has no additional effect on non‐segmental type of vitiligo. Further large studies with different combinations are recommended before any conclusive result can be concluded on efficacy of statins in vitiligo.
Background: Vitiligo is a common chronic hypomelanotic skin disorder. An intricate pool of markers associated with a complex combination of biological and environmental factors is thought to be ...implicated in etiology. This study aims to investigate the most important markers associated with vitiligo pathogenesis, including redox status, inflammation, and immune profile, in patients with vitiligo. Materials and Methods: The study included a total of 96 subjects: 30 patients with active non-segmental vitiligo, 30 patients with stable non-segmental vitiligo, and 36 controls. The vitiligo area severity index (VASI) and vitiligo disease activity score (VIDA) were determined. The following serum parameters were assessed: antioxidant status (TAS), superoxide dismutase activity (SOD), catalase activity (CAT), glutathione peroxidase activity (GPx), glutathione-S-transferase activity (GST), malondialdehyde (MDA), advanced oxidation protein products (AOPP), C reactive protein (CRP), interleukin-15 (IL-15), and chemokines (CXCL9, CXCL10). Results: The VASI score was not significantly different between active and stable vitiligo patients, as it was approximately 0.1. TAS, CAT, GPx, and GST were significantly lower in vitiligo patients compared to controls (p < 0.05). They were also significantly lower in active vitiligo when compared to stable vitiligo (p < 0.05). However, SOD levels were significantly higher in vitiligo patients than in controls and in the active vitiligo group than in the stable vitiligo group (p < 0.05). MDA and AOPP levels were significantly higher in patients with active and stable vitiligo compared to controls (p < 0.05). However, they did not significantly differ between active and stable vitiligo patients (p < 0.05). In both active and stable vitiligo, CRP and IL-15 were significantly higher than controls (p < 0.05). Whereas CRP was significantly higher in active (range = 2.0–7.2, mean = 4.46 ± 1.09) than in stable vitiligo (range = 1.6–6.7, mean = 3.75 ± 1.08) (p < 0.05). There was no significant difference in IL-15 levels between active and stable vitiligo. In both active and stable vitiligo, CXCL9 and CXCL10 were significantly higher than controls (p < 0.05), and they were significantly higher in active than stable vitiligo (p < 0.05). Conclusions: In vitiligo, oxidative damage induces an increase in pro-inflammatory IL-15, which in turn promotes IFN-γ-inducible chemokines such as CXCL9 and CXCL10. Further, there seems to be a link between the VASI score and IL-15 levels. These data imply that inhibiting IL-15 could be a promising method for developing a potentially targeted treatment that suppresses the early interplay between oxidant stress and IL-15 keratinocyte production, as well as between resident and recirculating memory T cells.
To investigate the role of IFIH1 gene polymorphism C/T (rs1990760) in non-segmental vitiligo and to correlate the results with the available clinical data.
A case-control study was conducted on a ...total number of 100 subjects and categorized into: 50 patients with non-segmental vitiligo and 50 age and gender matched healthy volunteers. Patients were recruited from the Dermatology Outpatient Clinic, Menoufia University hospitals. Control subjects were selected from the blood bank attendants Menoufia University Hospital. Every patient was subjected to history taking, complete general examination, detailed dermatological examination with determination of site and number of lesions, assessment of severity of vitiligo and assessment of disease activity.
14 (28%) cases were with generalized vitiligo, 13 (26%) cases had acrofacial vitiligo, 12 (24%) cases were with focal vitiligo and 11 (22%) cases were with universal vitiligo. VASI score ranged from 3 to 50 with mean 16.78 ± 10.545 and VIDA score ranged from −1–4 with mean 2.08 ± 1.576. There was statistically highly significant difference between cases and controls regarding IFIH1 genotypes (P < 0.001), IFIH1 alleles (P < 0.001). TT genotype and T allele were significantly more frequent in non-segmental vitiligo patients when compared to healthy controls. There was statistically significant relationship between IFIH1 genotypes and onset of the disease, mucosal affection and type of non-segmental vitiligo (P = 0.005, 0.001, <0.001 respectively). There was statistically highly significant positive correlation between VASI score and duration of the disease in years (P < 0.001).
IFIH1 could be considered as a good candidate gene for vitiligo susceptibility.
In this article, a new method of virtual and actual signal injection (VASI) is proposed to realize the sensorless control and the maximum torque per ampere (MTPA) control simultaneously at the ...low-speed region. Sensorless control is realized by injecting a high-frequency signal in the third-harmonic space, and the MTPA control is achieved by virtual signal injection (VSI-MTPA) in the fundamental space. Due to inherent decoupling of these two spaces, the injected two signals are decoupled with each other. It means that the two control algorithms guarantee the requirements of control accuracy based on simultaneous realization. In general, the proposed method makes full use of the advantages that the MTPA control based on virtual signal injection will not cause additional loss to the system and the feature of five-phase interior permanent magnet synchronous motor dual-space decoupling. Besides, this method is used to save the cost of the encoder and achieve high-efficiency control of the motor and easy to be implemented. The feasibility of the proposed control scheme is verified through experimental results.
The present study was designed to evaluate the effect of combining fractional CO
2
laser with narrow-band ultraviolet B (NB-UVB) versus NB-UVB in the treatment of non-segmental vitiligo. The study ...included 20 patients with non-segmental stable vitiligo. They were divided into two groups. Group I received a single session of fractional CO
2
laser therapy on the right side of the body followed by NB-UVB phototherapy twice per week for 8 weeks. Group II received a second session of fractional CO
2
laser therapy after 4 weeks from starting treatment with NB-UVB. The vitiligo lesions were assessed before treatment and after 8 weeks of treatment by VASI. At the end of the study period, the vitiligo area score index (VASI) in group I decreased insignificantly on both the right (−2.6%) and left (−16.4%) sides. In group II, VASI increased insignificantly on the right (+14.4%) and left (+2.5%) sides. Using Adobe Photoshop CS6 extended program to measure the area of vitiligo lesions, group I showed a decrease of −1.02 and −6.12% in the mean area percentage change of vitiligo lesions on the right and left sides, respectively. In group II the change was +9.84 and +9.13% on the right and left sides, respectively. In conclusion, combining fractional CO
2
laser with NB-UVB for the treatment of non-segmental vitiligo did not show any significant advantage over treatment with NB-UVB alone. Further study of this combination for longer durations in the treatment of vitiligo is recommended.
Vitiligo is a disease characterized by depigmented macules and patches that occur as a result of the loss of functional melanocytes from the affected skin through a mechanism which has not been ...elucidated yet. Destruction of pigment cells in vitiligo may not remain limited to the skin; the eyelashes, iris, ciliary body, choroid, retinal pigment epithelium and meninges may also be affected. This study aims to compare the choroidal thickness of patients with and without vitiligo using optical coherence tomography (OCT).
Spectral-domain optical coherence tomography (SD-OCT) (Retina Scan Advanced RS-3000 NIDEK, Japan) instrument (with λ = 840 nm, 27,000 A-scans/second and 5 μm axial resolution) was used for the imaging. Statistical analysis was performed using SPSS 21.0 software package.
In all values except optic nevre area measurements, the choroidal thickness of all vitiligo patients was found out to be thinner compared to the control group.
In vitiligo, the choroidal thickness may be affected by the loss of melanocytes.
Si presentano in questo studio alcuni materiali ceramici di produzione apula, finora inediti, provenienti da un sequestro e conservati presso l’ex Soprintendenza Archeologia della Lombardia. I ...materiali sono inquadrati all’interno del panorama vascolare apulo e attribuiti a specifiche mani pittoriche. I vasi, di probabile provenienza funeraria, sono inoltre analizzati sotto l’aspetto iconografico e iconologico al fine di comprenderne il loro significato e il valore all’interno della società indigena alla quale si ipotizza fossero destinati. Questa, seppur piccola, collezione offre infatti un interessante spaccato di alcune delle tematiche più importanti e diffuse nella ceramica apula di IV secolo a.C. This paper presents a selection of vases of Apulian fabric, until now unpublished, coming from a seizure and stored in the former Soprintendenza Archeologia della Lombardia. These pieces are set within the Apulian workshops and they are attributed to specific pictorial hands. The paper undertakes an iconographic and iconological analysis of the vases, probably from funerary contexts, in order to understand their meaning and value within indigenous society, to which it is supposed they were addressed. This collection, even though small, offers an interesting image of some of the more important and common themes of Apulian pottery of the IV century B.C.
Although nature of science (NOS) and nature of scientific inquiry (NOSI) are related to each other, they are differentiated as NOS is being more related to the product of scientific inquiry (SI) ...which is scientific knowledge whereas NOSI is more related to the process of SI (Schwartz et al.
2008
). Lederman et al. (
Journal of Research in Science Teaching
,
51
, 65–8,
2014
) determined eight NOSI aspects for K-16 context. In this study, a science camp was conducted to teach scientific inquiry (SI) and NOSI to 24 6th and 7th graders (16 girls and 8 boys). The core of the program was guided inquiry in nature. The children working in small groups under guidance of science advisors conducted four guided-inquiries in the nature in morning sessions on nearby plants, animals, water, and soil. NOSI aspects were made explicit during and at the end of each inquiry session. Views about scientific inquiry (VASI) (Lederman et al.
Journal of Research in Science Teaching
,
51
, 65–8,
2014
) questionnaire was applied as pre- and post-test. The results of the study showed that children developed in all eight NOSI aspects, but higher developments were observed in “scientific investigations all begin with a question” and “there is no single scientific method,” and “explanations are developed from data and what is already known” aspects. It was concluded that the science camp program was effective in teaching NOSI.
The populations of rural areas across Europe, especially Slovenia, are ageing rapidly and the areas themselves are becoming depopulated. Therefore, this study aims to contribute to our understanding ...of the population dynamics and provide a method for forecasting housing and other long-term care needs.
The surveys questioned those responsible for long-term care, the caretakers in institutional care, and current and potential homecare users in rural areas of Slovenia. We wanted to discover what they considered as crucial in the process of long-term care deinstitutionalization. Our 2020-2050 projections are based on the surveys conducted across 38 municipalities in the Eastern Slovenian region and an in-depth empirical study in Posavje. The results are embedded in the demographic projections and the multistate transition model of the declining functional capacities to forecast the needed housing facilities and human resources.
The results are the time series of required capacities. Around 60% of respondents in Slovenian rural areas believe that even a better organization of homecare would not allow them to stay at home until death due to inadequately built housing and the absence of a continuous presence of caregivers. These findings were included in the projections. Therefore, community care in the network of Smart Silver Villages was proposed.
Investments are needed to renovate the housing stock of older adults and construct sheltered, assisted living housing and specialized households in the community. Moreover, proper education and training of human resources would increase the output. In addition, financial solutions are advised to develop Smart Silver Villages.
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