University of Texas Health Science Center at Houston

About: University of Texas Health Science Center at Houston is a education organization based out in Houston, Texas, United States. It is known for research contribution in the topics: Population & Poison control. The organization has 27309 authors who have published 42520 publications receiving 2151596 citations. The organization is also known as: UTHealth & The UT Health Science Center at Houston.

Skin injuries from fluoroscopically guided procedures: part 2, review of 73 cases and recommendations for minimizing dose delivered to patient.

Abstract: 13 he benefits of fluoroscopically guided interventional procedures are reflected in the increasing number of interventions that are performed each year. In 1996, more than 700,000 interventional procedures were performed in the United States [1, 2]. However, these procedures can deliver a high radiation dose to a patient’s skin. Unfortunately, some patients have been injured by the radiation [3–28]. In this report we review 73 cases of radiation-induced skin injury directly related to interventional work [3–28]. Most cases (67) were reported within the last 5 years (1996–2000). Seven cases originate from Wolff D (1999, personal communication), and nine cases originate from our own observations [21, 25] (Table 1). More are known; however, data are presently unavailable because of legal proceedings. Twenty of 26 cases reported to the United States Food and Drug Administration between 1992 and 1995 [6] were not included in our review because no details about procedures and skin damage were mentioned. In part 1 of this two-part series [29], we reviewed the biology and progression of skin injuries with examples from our database of 73 patients. In this report, we examine the same 73 patients for common features that may explain the causes of these injuries and identify ways to reduce the radiation dose to the skin. Case Reports The site of the skin injury depends on the type of procedure and corresponds in all cases to the beam entrance site. The site of injury is on the back when the tube is in a posteroanterior projection (e.g., transjugular intrahepatic portosystemic shunt (TIPS) placements or some coronary procedures), over the scapula when the beam is oriented in a left or right anterior oblique plane (e.g., coronary interventions), or in the axilla when the tube is positioned laterally (e.g., radiofrequency ablation and some coronary interventions).

Efficacy and safety of crisaborole ointment, a novel, nonsteroidal phosphodiesterase 4 (PDE4) inhibitor for the topical treatment of atopic dermatitis (AD) in children and adults

Abstract: Background Additional topical treatments for atopic dermatitis (AD) are needed that provide relief while minimizing risks. Objective We sought to assess the efficacy and safety of crisaborole ointment, a phosphodiesterase 4 inhibitor, in two phase III AD studies (AD-301: NCT02118766; AD-302: NCT02118792). Methods Two identically designed, vehicle-controlled, double-blind studies enrolled and randomly assigned (2:1, crisaborole:vehicle) patients aged 2 years or older with an Investigator's Static Global Assessment (ISGA) score of mild or moderate for twice-daily application for 28 days. The primary end point was ISGA score at day 29 of clear (0)/almost clear (1) with 2-grade or greater improvement from baseline. Additional analyses included time to success in ISGA score, percentage of patients achieving clear/almost clear, reduction in severity of AD signs, and time to improvement in pruritus. Results More crisaborole- than vehicle-treated patients achieved ISGA score success (clear/almost clear with ≥2-grade improvement; AD-301: 32.8% vs 25.4%, P = .038; AD-302: 31.4% vs 18.0%, P P = .005; 48.5% vs 29.7%, P P ≤ .001). Treatment-related adverse events were infrequent and mild to moderate in severity. Limitations Short study duration was a limitation. Conclusions Crisaborole demonstrated a favorable safety profile and improvement in all measures of efficacy, including overall disease severity, pruritus, and other signs of AD.

Outcomes in Hypertensive Black and Nonblack Patients Treated With Chlorthalidone, Amlodipine, and Lisinopril

Abstract: and nonblacks, respectively, the RRs for stroke were 1.40 (95% CI, 1.17-1.68) and 1.00 (95%CI,0.85-1.17)andforcombinedCVDwere1.19(95%CI,1.09-1.30)and1.06(95% CI, 1.00-1.13). For HF, the RRs were 1.30 (95% CI, 1.10-1.54) and 1.13 (95% CI, 1.001.28),withnosignificantinteractionbyrace.Time-dependentBPadjustmentdidnotsignificantly alter differences in outcome for lisinopril vs chlorthalidone in blacks. Conclusions In blacks and nonblack subgroups, rates were not lower in the amlodipine or lisinopril groups than in the chlorthalidone group for either the primary CHD or any other prespecified clinical outcome, and diuretic-based treatment resulted in the lowest risk of heart failure. While the improved outcomes with chlorthalidone were more pronounced for some outcomes in blacks than in nonblacks, thiazide-type diuretics remain the drugs of choice for initial therapy of hypertension in both black and nonblack hypertensive patients.

Nonrandomness of point mutation as reflected in nucleotide substitutions in pseudogenes and its evolutionary implications

Abstract: We have obtained a revised estimate of the pattern of point mutation by considering more pseudogene sequences. Compared with our previous estimate, it agrees better with expectations based on the double-strand structure of DNA. The revised pattern, like the previous one, indicates that mutation occurs nonrandomly among the four nucleotides. In particular, the proportion of transitional mutations (59%) is almost twice as high as the value (33%) expected under random mutation. The same high proportion of transitions is observed in synonymous substitutions in genes. The proportion of transitional changes observed among electrophoretic variants of human hemoglobin is about the same as that predicted by the revised pattern of mutation. We also show that nonrandom mutation increases, by about 15%, the proportion of synonymous mutations due to single-nucleotide changes in the codon table, and increases, from 10% to 50%, the rate of synonymous mutation in the seven genes studied. However, nonrandom mutation reduces (by about 10%) the proportion of polar changes among nonsynonymous mutations in a gene. As far as single-nucleotide changes (in the codon table) are concerned, nonrandom mutation only slightly favors relatively conservative amino acid interchanges, and has virtually no effect on the proportions of radical changes and nonsense mutations.