IntroductionChronic kidney disease (CKD), diabetes, and hypertension play a disproportionate role in the growing public health challenge posed by noncommunicable diseases (NCDs) in East Africa. The impact of these NCDs may pose the greatest challenge in rural areas with limited screening and treatment facilities, although precise prevalence estimates of these conditions in rural Tanzania are lacking.MethodsThe prevalence of CKD, diabetes, and hypertension, were estimated from a probability sample of adults (n = 739) residing in 2 communities within Kisarawe, a rural district of Tanzania. Following consent, participants were studied in their homes. Random point-of-care (POC) measures of glycosylated hemoglobin and blood pressure, were obtained. Serum creatinine, drawn at the POC and measured at Muhimbili National University, was used to calculate estimated glomerular filtration rate with the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation.ResultsThe median age was 35 years (interquartile range 25−45 years). Overall the pooled prevalence for CKD stages III, IV, and V was 12.4% (95% confidence interval [CI] = 10.2−14.8). Surprisingly, the prevalence of CKD stage V (3.0%; 95% CI = 2.1−4.4) was high among the youngest age group (18−36 years). The prevalence estimates for prehypertension and hypertension were 38.0% (95% CI = 34.6−41.5) and 19.9% (95% CI = 17.1−22.9), respectively. The prevalence estimates for prediabetes and diabetes were 25.7% (95% CI = 22.6−29.1) and 14.8% (95% CI = 12.4−17.6), respectively.ConclusionAlthough this pilot study had a relatively small sample size, the prevalence estimates for CKD, diabetes, and hypertension were higher than we expected based on previous estimates from Tanzania. CKD was not significantly associated with diabetes or hypertension, suggesting the possibility of an alternative causality.

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Telemedicine is well established as a means of providing high-quality healthcare at a distance, particularly to patients in underserved populations. Technologies in teledermatology can be used to complement traditional methodologies of clinical trials, expanding accessibility of trials to people typically unable to participate in research. Tools of communication technology may enhance many aspects of clinical trials in dermatology, from recruitment and retention of participants to collection of real-time data. Clinical trials can be made completely virtual or incorporate aspects of virtual technologies at any stage of research. Virtual clinical trials are considered highly patient-centered, as the ability of participants to engage with research staff from their own home often supplants the need for many or all on-site clinic visits. As technological advances influence every aspect of modern life, clinical trials will also evolve to incorporate these tools, meeting participant expectations and overcoming traditional challenges of conducting research. Virtual clinical trials come with specific issues pertaining to analysis of data, technology, and oversight. As more virtual trials are conducted, advantages and limitations of using such technology in research will become clearer and regulatory guidelines will be more firmly established.

4. Scheinfeld N. Film photography's limitations in imaging skin of color underlies racial imaging disparities; new digital photography features facilitate the imaging of skin of color.

In utero smoke exposure appears to be associated with an increased likelihood of high waist circumference and body mass index percentiles, especially among female adolescents. Our study demonstrates the long-term cardiometabolic impact in offspring, highlighting the importance of prepregnancy smoking cessation.

Study limitations include the retrospective design, data obtained from a single centre possibly being biased for patients with more severe AGA, lack of blinding and proper control, and operator-dependent variation in hair counting. Although PRP is reported as a monotherapy for AGA, it is likely that patients are using multiple treatment modalities by the time they or their physician decide to pursue adjuvant PRP. Hair specialists disagree on the number of PRP treatments needed before assessing clinical efficacy; 1,3 however, these arguments are often based on anecdotes. Our data reveal that it is possible to use quantitative trichoscopy to stratify therapeutic response to adjuvant PRP after two treatment sessions (i.e. 2 months after initial PRP injections). Many factors affecting PRP efficacy and treatment response (e.g. platelet and growth factor concentration, leucocyte content, platelet activation, centrifugation protocols, total treatment sessions, duration between sessions, and maintenance therapy) are unknown, and it is possible that initial 'nonresponders' may respond to PRP therapy with continued sessions. Future directions include further characterization of patient response to adjuvant PRP based on response to prior AGA therapies, disease duration prior to PRP initiation, and the amount of PRP delivered per treatment. We hope our findings will help physicians counsel patients on the therapeutic benefit(s) of adjuvant PRP, and inform patient decisions regarding further treatment.

Background: While usually straightforward, diagnostic features of cutaneous herpes simplex virus and varicella zoster virus infection (HSV/VZV) are not always present in biopsy specimens. Although intuitively the presence of eosinophils may lead the pathologist away from the diagnosis of cutaneous HSV/VZV infection, in our practice we have noted that eosinophils are often encountered in diagnostic specimens. Methods: To deduce the frequency with which the inflammatory response accompanying cutaneous HSV/VZV infection includes significant numbers of eosinophils, we performed a retrospective review. We included 159 specimens from our database, diagnosed between 2009 and 2017. We determined the number of eosinophils in 10 high-power fields and noted additional histologic factors including presence of follicular involvement, ulceration, and pseudolymphomatous change.Results: Of all included cases, 63% had 0-1 eosinophils, 24% had 2-10 eosinophils, and 13% had more than 10 eosinophils. Statistical analysis did not reveal a significant association between any demographic or histologic features examined and the presence of increased eosinophils.Conclusions: In this study, more than one-third of biopsy specimens diagnostic of cutaneous HSV/VZV infection had a prominent number of eosinophils. The detection of eosinophils should not be unexpected and should not lessen diagnostic suspicion for cutaneous HSV/VZV infection. K E Y W O R D Scutaneous herpes infection, eosinophils, herpes, varicella