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Curettage and cautery is a procedure used for treatment of low-risk skin malignancies and pre-cancerous lesions.Given good lesion selection andtechnique, high cure rates and goodcosmesis are routine for this quick,simple and cost-effective operation.

The purpose of this article is to review and summarise the steps in managing carefully selected cutaneous lesions with curettage and cautery.

This article will address lesion selection, technique, efficacy, complications and how to incorporate curettage into dailypractice.

This article will address lesion selection, technique, efficacy, complications and how to incorporate curettage into daily practice.

Infantile haemangiomas (IHs) are benign vascular tumours that affect up to 10% of infants and arise in the first few weeks-to-months of life. Some are associated with an increased risk of complications and poor cosmetic outcomes. General practitioners (GPs) are ideally placed to identify high-risk IHs and coordinate their management.

The aim of this article is to outline strategies to identify high-risk IHs and when to involve a multidisciplinary team.

IHs that involve the lower face or neckcan be associated with airway obstruction. Having five or more IHs is associated with hepatic haemangiomas, high-output cardiac failure and hypothyroidism. IHs that involve the eyesor mouth can cause functional impairments such as amblyopia and feeding difficulties, respectively. Large segmental IHs maybe associated with syndromic presentations including PHACE syndrome when on the lower face, PELVIS syndrome when on the perineum and LUMBAR syndrome whenon the lower back.

IHs that involve the lower face or neck can be associated with airway obstruction. Having five or more IHs is associated with hepatic haemangiomas, high-output cardiac failure and hypothyroidism. IHs that involve the eyes or mouth can cause functional impairments such as amblyopia and feeding difficulties, respectively. Large segmental IHs maybe associated with syndromic presentations including PHACE syndrome when on the lower face, PELVIS syndrome when on the perineum and LUMBAR syndrome when on the lower back.

Melasma is a common disorder ofhyperpigmentation of the skin, characterised by brown pigmentation primarily on the face. Given its frequent facial involvement, it has a significant impact on the quality of life of patients. Management can often be quite difficult, requiring extensive treatment periods andmultiple modalities for ongoing maintenance.

The aim of this article is to provide evidence-based clinical updates to clinicians, specifically general practitioners, to assist with their everyday practice and effective assessment and treatment of melasma.

Therapeutic modalities are chosen on thebasis of disease presentation, patient preference, treatment periods and side-effect profiles of treatment agents; often a combination of therapies is required.

Therapeutic modalities are chosen on the basis of disease presentation, patient preference, treatment periods and side-effect profiles of treatment agents; often a combination of therapies is required.Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has caused a global pandemic. Among several systemic abnormalities, little is known about the critical attack on the central nervous system (CNS). Several patient reports with multiple pathologies â€" ischemic strokes, mild infarcts, encephalitis, cerebro-vascular abnormalities, cerebral inflammation, and loss of consciousness, indicate CNS involvement. However, due to limited neuroimaging studies, conclusive group level effects are scarce in the literature and replication studies are necessary to verify if these effects persist in surviving acute-COVID patients. Furthermore, recent reports indicate fatigue is highly prevalent among slowly recovering patients. How early structural changes relate to fatigue need to be investigated. Our goal was to address this by scanning COVID subjects two weeks after hospital discharge. We hypothesized these surviving patients will demonstrate altered gray matter volume (GMV) when compared to healthy controls and further demonstrate correlation of GMV with fatigue. Voxel-based morphometry was applied to T1-weighted MRI images between 46 patients with COVID and 32 healthy controls. Significantly higher GMV in the Limbic System and Basal Ganglia regions were observed in surviving COVID-19 patients when compared to healthy controls. Moreover, within the patient group, there was a significant positive correlation between GMV and self-reported fatigue scores during work, within the ventral Basal Ganglia and Ventromedial Prefrontal Cortex regions. Therefore, our results align with both single case acute patient reports and current group level neuroimaging findings. Finally, we newly report a positive correlation of GMV with fatigue in COVID survivors.Large-scale population testing is a key tool to mitigate the spread of respiratory pathogens, as in the current COVID-19 pandemic, where swabs are used to collect samples in the upper airways (e.g. nasopharyngeal and mid-turbinate nasal cavities) for diagnostics. However, the high volume of supplies required to achieve large-scale population testing has posed unprecedented challenges for swab manufacturing and distribution, resulting in a global shortage that has heavily impacted testing capacity world-wide and prompted the development of new swabs suitable for large-scale production. Newly designed swabs require rigorous pre-clinical and clinical validation studies that are costly and time consuming ( i . e . months to years long); reducing the risks associated with swab validation is therefore paramount for their rapid deployment. To address these shortages, we developed a 3D-printed tissue model that mimics the nasopharyngeal and mid-turbinate nasal cavities, and we validated its use as a new tool to rapidfective validation tool for the rapid development of newly designed swabs.

The COVID-19 Delta pandemic wave in India surged and declined within 3 months; cases then remained low despite the continued spread of Delta elsewhere. Here we aim to estimate key epidemiological characteristics of the Delta variant based on data from India and examine the underpinnings of its dynamics.

We utilize multiple datasets and model-inference methods to reconstruct COVID-19 pandemic dynamics in India during March 2020 - June 2021. We further use model estimates to retrospectively predict cases and deaths during July - mid-Oct 2021, under various vaccination and vaccine effectiveness (VE) settings to estimate the impact of vaccination and VE for non-Delta-infection recoverees.

We estimate that Delta escaped immunity in 34.6% (95% CI 0 - 64.2%) of individuals with prior wildtype infection and was 57.0% (95% CI 37.9 - 75.6%) more infectious than wildtype SARS-CoV-2. Models assuming higher VE among those with prior non-Delta infection, particularly after the 1

dose, generated more accurate predily - Oct 2021.Implications of all the available evidence Our analysis reconstructs the interplay and effects of non-pharmaceutical interventions, infection seasonality, Delta variant emergence, and vaccination on COVID-19 pandemic dynamics in India. Modeling findings support prioritizing the first vaccine dose in populations with high prior infection rates, given vaccine shortages.England has experienced a heavy burden of COVID-19, with high infection levels observed throughout the summer months of 2021. Alongside the emergence of evidence suggesting that COVID-19 vaccine protection wanes over time, booster vaccinations began for individuals aged 50 and above in September 2021. Using a model fitted to 18 months of epidemiological data, we project potential dynamics of SARS-CoV-2 transmission in England to September 2022. We consider key uncertainties including behavioural change, waning vaccine protection, strategies for vaccination, and the reintroduction of public health and social measures. CX5461 We project the current wave of transmission will peak in Autumn 2021, with low levels of transmission in early 2022. The extent to which SARS-CoV-2 transmission resurges in 2022 depends largely on assumptions around waning vaccine protection and booster vaccinations. Widespread booster vaccinations or the reimposition of mild public health and social measures such as work-from-home policies could largely mitigate the wave of COVID-19 transmission projected to occur in England in Spring/Summer 2022.

An immune correlate of protection from SARS-CoV-2 infection is urgently needed.

We used an ongoing household cohort with an embedded transmission study that closely monitors participants regardless of symptom status. Real-time reverse-transcription polymerase chain reaction (RT-PCR) and Enzyme-linked immunosorbent assays (ELISAs) were used to measure infections and seropositivity. Sequencing was performed to determine circulating strains of SARS-CoV-2. We investigated the protection associated with seropositivity resulting from prior infection, the anti-spike antibody titers needed for protection, and we compared the severity of first and second infections.

In March 2021, 62.3% of the cohort was seropositive. After March 2021, gamma and delta variants predominated. Seropositivity was associated with 69.2% protection from any infection (95% CI 60.7%-75.9%), with higher protection against moderate or severe infection (79.4%, 95% CI 64.9%-87.9%). Anti-spike titers of 327 and 2,551 were associated with 50% lving vaccination will be needed to ease the burden of the SARS-CoV-2 pandemic.Coronavirus disease 2019 (COVID-19) is predominantly an acute respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and remains a significant threat to public health. COVID-19 is accompanied by neurological symptoms and cognitive decline, but the molecular mechanisms underlying this effect remain unclear. As aging induces distinct molecular signatures in the brain associated with cognitive decline in healthy populations, we hypothesized that COVID-19 may induce molecular signatures of aging. Here, we performed whole transcriptomic analysis of human frontal cortex, a critical area for cognitive function, in 12 COVID-19 cases and age- and sex-matched uninfected controls. COVID-19 induces profound changes in gene expression, despite the absence of detectable virus in brain tissue. Pathway analysis shows downregulation of genes involved in synaptic function and cognition and upregulation of genes involved in immune processes. Comparison with five independent transcriptomic datasets of aging human frontal cortex reveals striking similarities between aged individuals and severe COVID-19 patients. Critically, individuals below 65 years of age exhibit profound transcriptomic changes not observed among older individuals in our patient cohort. Our data indicate that severe COVID-19 induces molecular signatures of aging in the human brain and emphasize the value of neurological follow-up in recovered individuals.Development of optimal SARS-CoV-2 vaccines to induce potent, long-lasting immunity and provide cross-reactive protection against emerging variants remains a high priority. Here, we report that a modified porous silicon microparticle (mPSM)-adjuvanted SARS-CoV-2 receptor-binding domain (RBD) vaccine activated dendritic cells and generated more potent and durable SARS-CoV-2-specific systemic humoral and type 1 helper T (Th) cell-mediated immune responses than alum-formulated RBD following parenteral vaccination, and protected mice from SARS-CoV-2 and Beta variant infection. mPSM facilitated the uptake of SARS-CoV-2 RBD antigens by nasal and airway epithelial cells. Parenteral and intranasal prime and boost vaccinations with mPSM-RBD elicited potent systemic and lung resident memory T and B cells and SARS-CoV-2 specific IgA responses, and markedly diminished viral loads and inflammation in the lung following SARS-CoV-2 Delta variant infection. Our results suggest that mPSM can serve as potent adjuvant for SARS-CoV-2 subunit vaccine which is effective for systemic and mucosal vaccination.