Many patients with moderate-to-severe plaque psoriasis do not respond adequately to methotrexate monotherapy. This pilot study, with a small patient population, was performed to evaluate the effectiveness and safety of etanercept and methotrexate combination in patients with plaque psoriasis and inadequate response to methotrexate. Outpatients with plaque psoriasis (Psoriasis Area and Severity Index > or = 8 and/or body surface area > 10%), despite methotrexate treatment (> or = 3 months; > or = 7.5 mg/week) were randomized to either etanercept with metho nottrexate tapered and discontinued (n = 28) or etanercept with continuous methotrexate (n = 31). Significantly more patients had a Physicians' Global Assessment of "clear"/"almost clear" in the combination group compared with etanercept/methotrexate taper (66.7 vs. 37.0%, respectively; p = 0.025). Adverse events were similar for both groups, with no cases of tuberculosis, malignancies or opportunistic infections reported. Addition of etanercept to methotrexate achieved significant improvement in psoriasis after 24 weeks.

Breslow thickness and Clark level can be used to determine surgical procedures for cutaneous malignant melanoma and patient eligibility for experimental adjuvant therapy. Efforts to predict the thickness of melanomas using dermatoscopy have focused on differences between single dermatoscopic findings. The aim of this study was to develop a method for preoperative identification of melanomas of > or = 1 mm Breslow thickness using the entire range of dermatoscopic findings. Sixty-five melanomas were assessed for the presence of 22 dermatoscopic features. Ten dermatoscopic features showed differences in thick and thin melanomas and were selected for further analysis. A latent trait analysis construct implied that a progression in dermatoscopic features was associated with advancement of melanomas. Early melanomas are characterized by a light brown colour, a pigment network and irregularity or heterogeneity. Gray-blue areas, white scar-like areas and an atypical vascular pattern gradually displace these features. Likelihood ratios were determined for these 6 dermatoscopic findings and an algorithm for calculating the probability of thick malignant melanoma was established.

Wound infections frequently originate from the subcutaneous tissue. The effect of gentamicin in subcutaneous tissue has, however, normally been evaluated from concentrations in blood or wound fluid. The aim of the present study was to investigate the pharmacokinetic properties of gentamicin in human subcutaneous adipose tissue by a microdialysis technique. Seven healthy young volunteers each had four microdialysis probes placed in the fat (subcutaneous) layer of the abdominal skin. After the administration of a 240-mg gentamicin intravenous bolus, consecutive measurements of the drug concentrations in serum and subcutaneous interstitial fluid were obtained simultaneously for 6 h. The tissue gentamicin concentration peaked after 10 to 30 min. The peak concentration in the tissue was 6.7 +/- 2.0 mg.liter-1 (standard deviation), equivalent to 39.1% of the peak concentration in serum. The area under the concentration-versus-time curve for the first 6 h in the tissue was 1,281 +/- 390.0) mg.min liter-1, equivalent to 59.7% of the area under the concentration-versus-time curve in serum. It is concluded that the microdialysis technique can be used to make dynamic and quantitative measurements of the gentamicin concentration in human subcutaneous tissue. In this adipose tissue, the peak concentrations of gentamicin were approximately seven times the MIC for Pseudomonas aeruginosa and 33 times the MIC for Staphylococcus aureus after the administration of an intravenous bolus of 240 mg, indicating the presence of sufficient concentrations in the adipose tissue to be effective against common bacteria.

No abstract

The article presents the results of a survey on dictionary use in Europe, focusing on general monolingual dictionaries. The survey is the broadest survey of dictionary use to date, covering close to 10,000 dictionary users (and non-users) in nearly thirty countries. Our survey covers varied user groups, going beyond the students and translators who have tended to dominate such studies thus far. The survey was delivered via an online survey platform, in language versions specific to each target country. It was completed by 9,562 respondents, over 300 respondents per country on average. The survey consisted of the general section, which was translated and presented to all participants, as well as country-specific sections for a subset of 11 countries, which were drafted by collaborators at the national level. The present report covers the general section. IntroductionResearch into dictionary use has become increasingly important in recent years. In contrast to 15 years ago, new findings in this area are presented every year, e.g. at every Euralex or eLex conference. These studies range from questionnaire or log file studies to smaller-scale studies focussing on eye tracking, usability, or other aspects of dictionary use measurable in a lab. For an overview of different studies,