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Therapeutic solutions are not expected in the near term. Thus, identifying the genesis and magnitude of COVID-19's impact on African American communities is the requisite first step toward crafting an immediate well designed response. The mid and long term approach should incorporate population health based tactics and strategies.

Chronic pruritus dramatically disrupts quality of life, impairs sleep, and is difficult to treat. The pathogenesis and severity of chronic itch can vary significantly with race. Black skin has inherent structural and molecular characteristics that exacerbates pruritus, leading to unique presentations of pruritic conditions and added challenges in finding effective therapies. The aim of this review is to discuss structural variances in black skin, the subsequent epidemiological disparities in chronic pruritic conditions, and clinical management pearls for the management of itch in black patients.

Current literature including mechanistic, translational, and epidemiological data on racial differences in pruritus focusing on black skin were reviewed in Pubmed.

Black skin has several unique structural properties related to the pathogenesis of pruritus, including increased trans-epidermal water loss, decreased ceramide levels, lower pH in the stratum corneum, and increased size of mast cells. Black patients consequently are disproportionately affected by chronic pruritic disorders including atopic dermatitis, prurigo nodularis, HIV-related pruritic dermatoses, and cutaneous T-cell lymphoma.

Pruritus and chronic pruritus disorders disproportionately affects black patients. Management of pruritus of special importance in black patients includes low pH skin care products to protect the skin barrier along with emollients to diminish trans-epidermal water loss. Further mechanistic studies are needed to characterize racial differences in biomarkers and therapeutic targets of chronic itch.

Pruritus and chronic pruritus disorders disproportionately affects black patients. Management of pruritus of special importance in black patients includes low pH skin care products to protect the skin barrier along with emollients to diminish trans-epidermal water loss. Further mechanistic studies are needed to characterize racial differences in biomarkers and therapeutic targets of chronic itch.

A greater frequency of vasomotor symptoms (VMSs) has been associated with higher low-density lipoprotein cholesterol (LDL-C), but the association with high-density lipoprotein cholesterol (HDL-C) remains unclear. Endogenous estradiol (E2) levels are associated with both VMS and lipid levels and thus may confound such associations.

To assess the relationship of VMS frequency with HDL-C, LDL-C, and lipoprotein concentrations (HDL and LDL particles [HDL-P; LDL-P]) and lipoprotein sizes in midlife women and to evaluate whether these associations are explained by E2.

Participants were from the Study of Women's Health Across the Nation (SWAN) HDL ancillary study who had both nuclear magnetic resonance (NMR) spectroscopy lipoprotein subclass metrics and self-reported frequency of VMS measured 2-5 times over the menopause transition. VMS frequency was categorized into none, 1-5days (infrequent), or ≥6days (frequent) within the past 2weeks.

We evaluated 522 women [at baseline mean age 50.3 (SD 2.8) years; infrequent VMS 29.8%, frequent VMS 16.5%]. Adjusting for potential confounders except E2, frequent VMS was associated with smaller HDL size [β(SE) -0.06 (0.03); P=.04] and higher concentrations of LDL-C [β(SE) 3.58 (1.77); P=.04] and intermediate LDL-P [β(SE) 0.09 (0.05); P=.04] than no VMS. These associations were largely explained by E2, all P's>.05.

Frequent VMSs were associated with smaller HDL size and higher concentrations of LDL-C and intermediate LDL-P. These associations were explained by endogenous E2. Whether treating frequent VMS with exogenous E2 could simultaneously improve lipids/lipoproteins profile should be assessed in future studies.

Frequent VMSs were associated with smaller HDL size and higher concentrations of LDL-C and intermediate LDL-P. These associations were explained by endogenous E2. Whether treating frequent VMS with exogenous E2 could simultaneously improve lipids/lipoproteins profile should be assessed in future studies.

Anogenital distance (AGD), the distance from the anus to the genitals, is a marker of normal genital development. AGD and other biometric parameters of external female genitalia are important as ultrasonographic markers that can determine fetal gender in the first trimester. Neural tube defects are one of the commonest congenital malformations of the central nervous system, with anencephaly being the most severe defect. Female genitalia development and their association with anencephaly have not been previously described.

The aim of this study was to compare the biometric parameters of external female genitalia in fetuses with anencephaly and compare it to the parameters of normocephalic fetuses at different gestational ages.

We studied 34 female fetuses, 22 normocephalic and 12 anencephalic, aged between 12 and 22 weeks post-conception. The fetuses were placed in the classic lithotomy position and before the fetal dissection, the external female genitalia were photographed with a digital camera. Biometwithout significant differences (r

=0.01677; p<0.318).

This article is the first to report the female external genitalia parameters in fetuses with anencephaly. In our study we observed some alterations in biometry of the external genitalia in anencephalic fetuses, with a pattern of morphological reduction in this group. Troglitazone The vaginal opening length, clitoris to anus distance and vaginal opening to labia majora distance were significantly lower in anencephalic fetuses but we did not find statistical significance in clitoris measurements and AGD.

Anencephalic fetuses had some alterations in external genitalia development, but the anogenital distances did vary significantly between the groups.

Anencephalic fetuses had some alterations in external genitalia development, but the anogenital distances did vary significantly between the groups.

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