Systemic Agents in the Management of Acne

Topical therapy including incision of pustules and injection of corticosteroids into nodular and cystic lesions remains the mainstay of the management of acne.Systemic agents, including diuretics, corticosteroids, broad spectrum antibiotics and progestin-estrogen combinations are significant and valuable additions to the therapy of resistant pustulocystic acne. They are, however, not without side effects and they should be reserved for carefully selected patients for whom they may, when used with discretion, produce gratifying results with relatively low risk.     

Allometry, antilog transformations, and the perils of prediction on the original scale

Biologists often use allometric equations that take the form of power functions (e.g., Y = aM(b), where M stands for mass and a and b are empirically fitted constants). Typically, these allometric equations are fitted by taking the antilog of log-log regressions. Predictions from these allometric equations are biased, and the bias my be appreciable. Methods for making predictions that correct for the bias are available, but they have rarely, if ever, been used by ecological and evolutionary physiologists. Just as physiologists would not use an instrument that was not properly calibrated, they should not use allometric equations to make predictions unless they account for the bias of those predictions. We analyzed 20 interspecific and 10 intraspecific data sets. We compared predictions from standard allometric equations with those from several alternative methods. Our analyses suggest that the bias of predictions from interspecific data sets may be substantial. For the intraspecific data sets we analyzed, the bias was likely to be small. Biologists, including ecological and evolutionary physiologists, should exercise care when using allometric equations to make predictions, particularly given that methods to adjust for bias are easily implemented.     

Treatment of burns casualties after fire at Bradford City football ground.

On 11 May 1985 the main stand of Bradford City Football Club caught fire. Within four minutes the stand was alight from end to end. Fifty three people were burnt to death and about 250 injured; 83 required admission to hospital, and 55 of these were treated by primary excision of their burns and skin grafting. In such disasters the help of staff from other hospitals and areas is essential. Patients should be assessed to see whether they have burns that will ultimately be fatal; if they have they should not be sent to regional burns units, where they would take up beds that could be used for patients with treatable burns. All districts should ensure that their plans for accidents in which burns injuries predominate are adequate.     

Effect of Prolonged Thiazide Treatment on Renal Lithium Clearance

Renal lithium clearances were determined after the administration of a small test dose of lithium carbonate in 22 patients when they were on long-term treatment with thiazides and when they were not on such treatment. Thiazide administration led to a 24% reduction in the lithium clearance. Diuretic drugs should be used with caution in patients given lithium treatment, and lithium should be used with caution in patients receiving diuretic treatment.     

Pitfalls in the statistical analysis of microbiome amplicon sequencing data

Microbiome data are characterized by several aspects that make them challenging to analyse statistically: they are compositional, high dimensional and rich in zeros. A large array of statistical methods exist to analyse these data. Some are borrowed from other fields, such as ecology or RNA-sequencing, while others are custom-made for microbiome data. The large range of available methods, and which is continuously expanding, means that researchers have to invest considerable effort in choosing what method(s) to apply. In this paper we list 14 statistical methods or approaches that we think should be generally avoided. In several cases this is because we believe the assumptions behind the method are unlikely to be met for microbiome data. In other cases we see methods that are used in ways they are not intended to be used. We believe researchers would be helped by more critical evaluations of existing methods, as not all methods in use are suitable or have been sufficiently reviewed. We hope this paper contributes to a critical discussion on what methods are appropriate to use in the analysis of microbiome data.     

On the definition of element,chorotype and component in biogeography

Terms such as element, chorotype and component are widely used to indicate biogeographical units. As a result of variation in approaches and methodologies, these terms do not have a single definitive meaning, and similar concepts have been defined under different labels. As originally defined, element denotes a group of species that occur in previously defined biogeographical areas, while chorotype denotes a group of species with a similar distribution. The term component is widely used in ecology to denote the biotic or abiotic constituent of an ecosystem; within biogeography it has typically been used as a synonym for element. Applying the original meanings, current usage within the tradition of systematic biogeography should regard element as referring to groups of taxa defined according to the biogeographical areas they occupy. Within quantitative and evolutionary biogeography, chorotype should be used to define patterns of distribution that can be used to generate hypotheses about their causes and origins. In this paper I argue that component expresses a generic concept rather than a chorological category and should be avoided in biogeography.     

Measures of stratigraphic fit to phylogeny and their sensitivity to tree size, tree shape, and scale

Measures of stratigraphic fit to phylogeny are analyzed to test how they are affected by the shape and size of the phylogenetic trees and by the number of stratigraphic intervals encompassed. Monte Carlo randomizations are used to investigate the sensitivity of three commonly used measures (SCI, GER and MSM*) approximating their distribution of possible values under certain conditions. All are shown to vary in different ways as parameters are varied, although MSM* seems to be the most invariant in the analyzed parameter space. These results suggest that the raw metrics should not be used for comparing the fit of different taxonomic groups or competing phylogenetic trees of the same group that differ in tree size or balance. Tree balance also affects the distributions used in significance tests based on randomization and therefore their results should not be interpreted in terms of the amount of conflict implied by a phylogenetic tree.     

Trials to assess equivalence: the importance of rigorous methods.

The aim of an equivalence trial is to show the therapeutic equivalence of two treatments, usually a new drug under development and an existing drug for the same disease used as a standard active comparator. Unfortunately the principles that govern the design, conduct, and analysis of equivalence trials are not as well understood as they should be. Consequently such trials often include too few patients or have intrinsic design biases which tend towards the conclusion of no difference. In addition the application of hypothesis testing in analysing and interpreting data from such trials sometimes compounds the drawing of inappropriate conclusions, and the inclusion and exclusion of patients from analysis may be poorly managed. The design of equivalence trials should mirror that of earlier successful trials of the active comparator as closely as possible. Patient losses and other deviations from the protocol should be minimised; analysis strategies to deal with unavoidable problems should not centre on an "intention to treat" analysis but should seek to show the similarity of results from a range of approaches. Analysis should be based on confidence intervals, and this also carries implications for the estimation of the required numbers of patients at the design stage.     

Not the doctor’s business: Privacy,personal responsibility and data rights in medical settings

This paper argues that assessing personal responsibility in healthcare settings for the allocation of medical resources would be too privacy-invasive to be morally justifiable. In addition to being an inappropriate and moralizing intrusion into the private lives of patients, it would put patients’ sensitive data at risk, making data subjects vulnerable to a variety of privacy-related harms. Even though we allow privacy-invasive investigations to take place in legal trials, the justice and healthcare systems are not analogous. The duty of doctors and healthcare professionals is to help patients as best they can—not to judge them. Patients should not be forced into giving up any more personal information than what is strictly necessary to receive an adequate treatment, and their medical data should only be used for appropriate purposes. Medical ethics codes should reflect these data rights. When a doctor asks personal questions that are irrelevant to diagnose or treat a patient, the appropriate response from the patient is: ‘none of your business’.     

Mapping extrinsic traits such as extinction risks or modelled bioclimatic niches on phylogenies: does it make sense at all?

An increasing variety of extrinsic traits are used in comparative studies aimed at testing evolutionary hypotheses. After briefly reviewing the relevant literature, it appears that three different problems are implied by this trend. Some extrinsic traits are only surrogates for phenotypic traits, and should be redefined to better fit the requisites for phylogenetic analysis, such as selective regimes and extinction risks. Some others are already adequately defined and cannot be made less extrinsic, such as taxon age, geographical distribution, associates (parasites, symbionts, etc.), and bioclimatic modelled niches. Because they are not heritable, they should not be analysed by optimization onto a tree, but are better considered in sister‐group comparisons or within a reconciliation procedure, as already done for areas of biogeography. © The Willi Hennig Society 2010.     

Reliability and the value of information

When animals lack the ability to discriminate between correct and incorrect information, they must choose to either respond to or ignore an information source. I define the reliability of information as the probability that information is correct and introduce reliability into the value of information to explore the level of risk information consumers should incur when using information. I find that when information consumers do not control the reliability of information, they should be more discriminating as the benefit of correct information declines, as the cost of misinformation increases and when acquisition costs are greater. However, when consumers pay for reliability, I find that consumers should be more discriminating as the benefit of correct information increases, the cost of misinformation increases, and when acquisition is cheaper. Application of this theory suggests that: (1) selection for individual recognition should be stronger when the cost of misinformation (deception) is high; (2) mimics can outnumber models when models are very noxious or alternative prey are abundant; and (3) memory about predators should be longer than memory about prey.     

Disinfection and hygiene in the field of food of animal origin

The cleaning/disinfection procedure should minimize the usually high number of microorganisms (10⁷–10⁸ cm²) on surfaces to reasonably low levels of about one log per cm². Aseptic conditions are normally not achieved.Most commerical disinfectants are mixed preparations. The agents used in disinfectants should not provoke changes, neither in chemical pattern, nor in sensoric properties of the food. They should not be the cause for deposition of unhealthy residues or for corrosive influences on premises. The efficacy must be warranted. The disinfection should include bactericidal, fungicidal and possibly virucidal activities with only minimal static effects. The efficacy should be based on a short-term effect even at lower temperatures (about 10°C).Mostly in use are QACs, amphoteric surfactants and biguanides which are combined in many variations. Aldehydes in mixtures are used very seldomly and only in small amounts due to sensoric, corrosive or toxicological reactions. Alcohols are suitable for quick applications but they are flammable. Organic acids and peroxygens will deliver no residues but may be aggressive to tools and man. Alkylamines will have higher static effects and chlorine active compounds will suffer from protein load and pH deviations.In daily practice the efficacy has to be proved by microbiological monitoring, e.g. by cultural or, indirectly, by bioluminescence-techniques (with or without somatic ATP).Residue levels will remain low on premises if the disinfection is performed correctly, in adequate concentrations and with fresh water rinsing in sufficient amounts (about 8 liters per m²).     

Legal Implications of Sterilization

Sexual sterilization is legal when it is an integral part of a procedure for the preservation of the life or health of a patient. Done for other reasons it may not be illegal, but this has not been tested in Canadian courts. It is, broadly speaking, a surgical procedure; it is commonly, but not always, successful; complications, while rare, do occur; the results tend to be irreversible. The same end, the prevention of pregnancy, may be attained by other methods which are safer, less liable to complications, less permanent and so should be used unless contraindicated. Patients'' statements that they do not like contraceptives should not be accepted as a reason for sterilization. Sexual sterilization should be reserved for those occasions when it is necessary for the preservation of the health or life of the individual who is to be sterilized.     

Ontologies for molecular biology and bioinformatics

About five years ago, ontology was almost unknown in bioinformatics, even more so in molecular biology. Nowadays, many bioinformatics articles mention it in connection with text mining, data integration or as a metaphysical cure for problems in standardisation of nomenclature and other applications. This article attempts to give an account of what concept ontologies in the domain of biology and bioinformatics are; what they are not; how they can be constructed; how they can be used; and some fallacies and pitfalls creators and users should be aware of.     

Topography and identification of the parathyroid glands in the calf

There is considerable controversy in the literature concerning the topography of the parathyroid glands in the calf. In the present study, the position of the parathyroids III (external parathyroids) and of the parathyroids IV (internal parathyroids) was examined in 25 young calves, 10 veal calves and 5 adult oxen. Detailed data for the recognition and the collection of these glands are provided. The parathyroids III are well suited for removal in a fresh state, since they can readily be located. They are situated medial to the carotid bifurcation and ventrolateral to the vagus nerve, where the latter gives off the cranial laryngeal nerve. In all young calves and in most veal calves, they lie embedded in the sub-basilar portion of the thymus, from which they can usually be differentiated easily by their color. However, they should not be confused with lymph nodes and hemal nodes, which are located in the neighborhood. Light-microscopical substantiation is therefore advisable. The parathyroids IV are not suited for collection, since they cannot be distinguished macroscopically from the adjacent thyroid gland.     

Salmonella control in poultry: the need for the satisfactory evaluation of probiotics for this purpose

The Editors of Letters in Applied Microbiology will, at their discretion, publish invited and submitted 'Opinions' on subjects in the general area of Applied Microbiology. They will not be subjected to the normal refereeing procedures and reprints will not be provided. The 'Opinions' will not necessarily represent the views of the Society for Applied Bacteriology or of the Editors. The Editors may invite or readers may submit 'Responses' to published 'Opinions' , provided that they are not merely polemics, and these will also be published at the discretion of the Editors. 'Responses' will be treated precisely like 'Opinions' . They should clearly indicate, in their first sentence, the 'Opinion' to which they are a response.     

Experience of the use of probiotics for Salmonellae control in poultry

The Editors of Letters in Applied Microbiology will, at their discretion, publish invited and submitted 'Opinions' on subjects in the general area of Applied Microbiology. They will not be subjected to the normal refereeing procedures and reprints will not be provided. The 'Opinions' will not necessarily represent the views of the Society of Applied Bacteriology or of the Editors. The Editors may invite or readers may submit 'Responses' to published 'Opinions' , provided that they are not merely polemics, and these will also be published at the discretion of the Editors. 'Responses' will be treated precisely like 'Opinions' . They should clearly indicate, in their first sentence, the 'Opinion' to which they are a response.     

Implications for genetic toxicology of the chromosomal breakage syndromes

The activation of oncogenes and our knowledge of the chromosome breakage syndromes show that both intragenic mutations and chromosomal aberrations are important in carcinogenesis. Each suggests that an agent could produce genetic changes in a tissue without producing cancer there, if the types of genetic change do not match: chromosomal aberrations may be irrelevant in the mammary epithelium but be very significant in the bone marrow, and vice versa. This has vital implications for genetic toxicology: (1) both gene mutations and chromosomal aberrations should be measured, and (2) carcinogens may be mutagenic in tissues in which they are not carcinogenic. One might therefore expect in vivo assays for mutagenicity to correlate rather well with cancer bioassays; unfortunately, the bioassays themselves seem faulty. If cancer bioassays are valid, they would be reproducible. If bioassays are reproducible, they would be internally consistent. The information supplied by Tennant et al. (1987) for their validation of in vitro assays gives data from both sexes in rats and mice for 70 chemicals. When the data are analyzed site-by-site, positive results were not replicated in the other sex or in the other species much of the time: in half the cases the other sex does not give the same result; in two-thirds of the cases the other species does not give the same result. There are 3 potential explanations for these differing results: (1) genuine sex-specific carcinogens are common, (2) genuine species-specific carcinogens are common, or (3) the bioassay does not replicate well, i.e., is erratic. The third possibility best explains the data. The apparent inability of short-term in vitro tests to discriminate well between carcinogens and non-carcinogens may be more a reflection of the cancer bioassays that were used to determine which chemicals were carcinogenic than any defect in the assays. In this situation in vivo assays can scarcely be expected to do better even if they are better.