[신간의 별자리x] 우리/미술, 그리고 ‘슬픔의 박물관’

Summary Background Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described. Methods In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death. Findings 191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03–1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61–12·23; p Interpretation The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future. Funding Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.

Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(07)60750-8.pdf

Inflammatory bowel disease: cause and immunobiology

4 CLINICAL PARTICULARS 4.1 Therapeutic Indications Trimetazidine is indicated in adults as add-on therapy for the symptomatic treatment of patients with stable angina pectoris who are inadequately controlled by or intolerant to first-line antianginal therapies. 4.2 Posology and method of administration Oral administration. Posology The dose is one tablet of 35mg of trimetazidine twice daily during meals. Special populations Renal impairment In patients with moderate renal impairment (creatinine clearance [30-60] ml/min) (see sections 4.4 and 5.2), the recommended dose is 1 tablet of 35mg in the morning during breakfast. Elderly Elderly patients may have increased trimetazidine exposure due to age-related decrease in renal function (see section 5.2). In patients with moderate renal impairment (creatinine clearance [30-60] ml/min), the recommended dose is 1 tablet of 35mg in the morning during breakfast. Dose titration in elderly patients should be exercised with caution (see section 4.4). Health Products Regulatory Authority

Summary of product characteristics

The classical studies of nicotine by Langley at the turn of the 20th century introduced the concept of a “receptive substance,” from which the idea of a “receptor” came to light. Subsequent studies...

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Mammalian nicotinic acetylcholine receptors: from structure to function.

A . FU J IMOTO , 5 Y . SH IMOMURA Laboratory of Genetic Skin Diseases, and Division of Dermatology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata 951-8510, Japan Departments of Dermatology, and Biochemistry and Molecular Genetics, American University of Beirut Medical Center, Beirut, Lebanon Jordan University of Science and Technology, Irbid, Jordan Correspondence: Yutaka Shimomura. E-mail: yshimo@med.niigata-u.ac.jp

Combination treatment with a tumour necrosis factor antagonist and an oral retinoid: efficacy in severe acral psoriasis?

The first reference to mentorship can be found in Greek mythology, when Odysseus asked the goddess Athena to nurture his son Telemachus. She achieved this disguised in human form as an old family friend by the name of Mentor. The Oxford English Dictionary defines a mentor as ‘a person who acts as guide and adviser to another person, especially one who is younger and less experienced.’ In essence, mentorship involves a trusting relationship in which a more experienced person uses their knowledge to guide someone less experienced. Mentorship is an important element of an evolving academic career, not least to minimize unintended consequences of a trainee’s actions in novel situations. Making mistakes can be a valuable but potentially painful method of learning, and not all mistakes can be undone. A mentor who has been in a similar position can provide empathetic advice to avoid mistakes and can provide an overview based on their greater experience.

Academic mentorship in dermatology

026 Hidradenitis suppurativa prevalence and disease associations using the Clinical Practice Research Datalink

ized scleroderma: a retrospective analysis of 344 patients with paediatricor adult-onset disease. Br J Dermatol 2015; 172:722–8. 4 Martini G, Fadanelli G, Agazzi A et al. Disease course and long-term outcome of juvenile localized scleroderma: experience from a single pediatric rheumatology centre and literature review. Autoimmun Rev 2018; 17:727–34. 5 Weibel L, Sampaio MC, Visentin MT et al. Evaluation of methotrexate and corticosteroids for the treatment of localized scleroderma (morphoea) in children. Br J Dermatol 2006; 155:1013–20. 6 Li SC, Torok KS, Pope E et al. Development of consensus treatment plans for juvenile localized scleroderma: a roadmap toward comparative effectiveness studies in juvenile localized scleroderma. Arthritis Care Res (Hoboken) 2012; 64:1175–85.

Refining the hidradenitis suppurativa Hurley staging system for mild, moderate and severe disease.

Chronic spontaneous urticaria (CSU) is characterized by the recurrent appearance of weals, angio-oedema or both, occurring at least twice weekly for longer than 6 weeks. It is often managed with antihistamines, but occasionally requires other systemic agents in recalcitrant cases. A cross-sectional survey was conducted by means of an internet-based survey tool (Typeform; https://www. typeform.com). Participating consultants with a specialist interest in urticaria were identified through the specialist registers of the British Society of Allergy and Clinical Immunology (BSACI), the Improving Quality in Allergy Services (IQAS) Group and the British Association of Dermatologists (BAD), and invited to take part. The survey content was based on current CSU treatment guidelines from EAACI/GA2LEN/EDF/WAO and the British Society for Allergy and Clinical Immunology (BSACI). The EAACI/GA2LEN/EDF/WAO guidelines are a joint initiative of the Dermatology Section of the European Academy of Allergy and Clinical Immunology (EAACI), the Global Allergy and Asthma European Network (GA2LEN) (a European Union-funded network of excellence), the European Dermatology Forum (EDF), and the World Allergy Organization (WAO). To standardize responses, all participants were presented with a case of recalcitrant CSU (failed on maximum dose of nonsedating antihistamines and montelukast), requiring alternative systemic treatment. Questions covered usage of systemic treatments, routine disease severity assessments, adherence to treatment guidelines and perceived barriers to prescribing. Responses (Table 1) were received from 19 UK consultants (26 surveys sent; completion rate 73%), 15 of whom had > 10 years’ experience in the treatment of CSU. The majority were allergy (58%) and dermatology consultants (37%). Of the 19 consultants, 56% provide a dedicated urticaria service, 37% treat both adult and paediatric patients, and the majority (79%) use systemic medications other than antihistamines and montelukast. Omalizumab and ciclosporin were the most commonly used first-line agents (47% and 27% respectively) (Fig. 1). The majority (84%) of consultants use validated measures to assess disease severity, including the weekly Urticaria Table 1 Summary of survey results.

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John R. Ingram

Papers

Combination treatment with a tumour necrosis factor antagonist and an oral retinoid: efficacy in severe acral psoriasis?

Academic mentorship in dermatology

026 Hidradenitis suppurativa prevalence and disease associations using the Clinical Practice Research Datalink

Refining the hidradenitis suppurativa Hurley staging system for mild, moderate and severe disease.

A survey of the treatment and management of patients with severe chronic spontaneous urticaria