Background: Topical 5-fluorouracil (5-FU) cream is widely used in the treatment of actinic keratoses (AKs) but the optimumtreatment regimen that provides efficacywhileminimizing side-effects remains unclear. Objective...
详细信息
Background: Topical 5-fluorouracil (5-FU) cream is widely used in the treatment of actinic keratoses (AKs) but the optimumtreatment regimen that provides efficacywhileminimizing side-effects remains unclear. Objectives A randomized trial to compare the efficacy and side-effects of daily vs. weekly application of 5%5-FU in the treatment of AKs of the scalp and face. Patients/methods Twenty patients were recruited and randomized to two groups. Group 1 (13 patients) appl ied 5%5-FU twice daily for 3 weeks, group 2 (seven patients) applied 5%5-FU twice daily for 1 day per week for 12 weeks. Patients were reviewed at weeks 3, 12, 24 and 52. At each review a lesion count and lesion map were completed and p atients were asked to score efficacy and inflammation. Results At week 0 the med ian lesion count was the same in both groups, 17.5 lesions. At 12 weeks the medi an lesion count in group 1 had fallen to 0 where it remained for the duration of follow-up. In group 2 the median lesion count fell to 6 at 12 weeks, 5.5 at 24 weeks and was 3 at 52 weeks. The difference in the lesion count was significant at all time points after week 0: P mean inflammation score was higher in patients clear of AKs at 12 we eks compared with those who had not cleared, 3.8 compared with 1.9. This differe nce was statistically significant (P mmation is nec essary for efficacy. Conclusions We conclude that daily application of 5%5-FU cream is more effective than weekly application at clearing AKs from the scalp a nd face. Our results also suggest that inflammation is likely to be required to achieve a therapeutic effect.
Suicide is the second leading cause of death in youth globally; however, there is uncertainty about how best to intervene. Suicide rates are typically higher in males than females, while the converse is true for suici...
详细信息
Suicide is the second leading cause of death in youth globally; however, there is uncertainty about how best to intervene. Suicide rates are typically higher in males than females, while the converse is true for suicide attempts. We review this "gender paradox" in youth, and in particular, the age-dependency of these sex/gender differences and the developmental mechanisms that may explain them. Epidemiologic, genetic,neurodevelopmental and psychopathological research have identified suicidal behaviour risks arising from genetic vulnerabilities and sex/gender differences in early adverse environments, neurodevelopment, mental disorder and their complex interconnections. Further, evolving sex-/gender-defined social expectations and norms have been thought to influence suicide risk. In particular, how youth perceive and cope with threats and losses(including conforming to others' or one's own expectations of sex/gender identity) and adapt to pain(through substance use and helpseeking behaviours). Taken together, considering brain plasticity over the lifespan, these proposed antecedents to youth suicide highlight the importance of interventions that alter early environment(s)(e.g., childhood maltreatment) and/or one's ability to adapt to them. Further, such interventions may have more enduring protective effects, for the individual and for future generations, if implemented in youth.
暂无评论