BACKGROUND & AIMS: :Recent advances in personality theory indicate that there are distinct constructs that dispose individuals to rash action and risky behavior, as opposed to one broad trait of impulsivity. Two are emotion based, two represent deficits in conscientiousness, and one is sensation seeking. Previous studies of impulsivity and its relationship to bulimia nervosa have yielded mixed findings. The authors applied this advance in personality theory to the study of bulimia nervosa (BN) to test the hypothesis that the emotion-based disposition of negative urgency (the tendency to act rashly when distressed) relates most strongly to BN symptoms. A meta-analysis of 50 articles indicated the following. Negative urgency had by far the largest effect size (weighted r=.38), followed by sensation seeking (weighted r=.16); lack of planning (weighted r=.16) and lack of persistence (weighted r=.08). Methodological moderators of the effect of distinct traits on BN symptoms were the use of scales that precisely measured one construct as opposed to general impulsivity scales that measured several constructs, clinical vs. non-clinical samples, and whether or not the personality scale was translated from its original language or not. Negative urgency appears especially important for BN; more broadly, researchers should consider the role of emotion-based dispositions to rash acts in their risk theories.

背景与目标： : 人格理论的最新进展表明，与冲动性的一种广泛特征相反，有不同的结构使个人倾向于轻率的行为和冒险的行为。两个是基于情感的，两个代表着责任心的不足，一个是寻求感觉。先前对冲动及其与神经性贪食症的关系的研究得出了不同的发现。作者将人格理论的这一进步应用于对神经性贪食症 (BN) 的研究，以检验以下假设: 基于情绪的消极紧迫感倾向 (痛苦时轻率行事的倾向) 与BN症状最密切相关。对50篇文章的荟萃分析表明:到目前为止，负紧迫性具有最大的效应大小 (加权r =.38)，其次是寻求感觉 (加权r =.16); 缺乏计划 (加权r =.16) 和缺乏持久性 (加权r =.08)。不同性状对BN症状影响的方法学调节剂是使用精确测量一种结构的量表，而不是测量几种结构，临床和非临床样本的一般冲动性量表，以及人格量表是否从其原始语言翻译。消极的紧迫性对于BN尤为重要; 更广泛地说，研究人员应该考虑基于情绪的处置在其风险理论中对轻率行为的作用。

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背景与目标： -2

BACKGROUND & AIMS: :There are no apparent biologic obstacles to immunization against fetal/placental infection with cytomegalovirus (CMV), and vaccine candidates have been developed. The major obstacles for a human CMV vaccine are difficulties associated with the design and execution of efficacy trials. These trials will be prolonged with difficulties in recruiting subjects, and hampered by several factors: First is a lack of public awareness of CMV, making recruitment into vaccine trials difficult. Second is that trials using fetal infection as an endpoint will be prolonged since vaccine administration must occur preconception. Third, behavioral changes by subjects will affect infection rates, and controls for behavioral changes will have to be in place in any clinical trial. Fourth, not all women are at equal risk for CMV infections. High risk women may become infected by contact with young children or via sexual activity. Thus, the mode of acquisition may be a confounding variable in vaccine efficacy trials. In spite of these potential obstacles, successful evaluation of CMV vaccines is possible and likely when considered against similar obstacles encountered by several other recently licensed vaccines.

背景与目标： : 针对巨细胞病毒 (CMV) 的胎儿/胎盘感染的免疫没有明显的生物学障碍，并且已经开发了候选疫苗。人类CMV疫苗的主要障碍是与功效试验的设计和执行相关的困难。这些试验将在招募受试者方面遇到困难，并受到以下几个因素的阻碍: 首先是公众对CMV的认识不足，这使得疫苗试验的招募变得困难。其次，使用胎儿感染作为终点的试验将被延长，因为疫苗给药必须在孕前发生。第三，受试者的行为改变将影响感染率，并且在任何临床试验中都必须对行为改变进行控制。第四，并非所有女性感染CMV的风险都相同。高危妇女可能会因与幼儿接触或通过性活动而感染。因此，在疫苗功效试验中，采集模式可能是一个混杂变量。尽管存在这些潜在障碍，但考虑到其他几种最近获得许可的疫苗遇到的类似障碍，成功评估CMV疫苗是可能的。

BACKGROUND & AIMS: OBJECTIVES:Nilotinib and dasatinib are second-generation tyrosine kinase inhibitors approved for the treatment of chronic myeloid leukemia (CML). In clinical trials, they have both been reported to cause rash in a significant number of patients, but its incidence varies significantly and has not been characterized clinically or histologically. The aim of this study was to determine the incidence of rash with nilotinib and dasatinib, and to provide a clinical and histopathological description of the rash. METHODS:We conducted a meta-analysis of clinical trials evaluating nilotinib and dasatinib to determine and compare the incidence of rash with these medications. Additionally, we performed a retrospective chart review to analyze the clinical presentation and histology of patients presenting with rash. RESULTS:The incidence of all-grade (grade 1-4) rash with nilotinib was 34.3% (95% CI, 27.9-41.3), higher (P = 0.017) than with dasatinib (23.3%; 95% CI, 18.8-28.6). Similarly, the incidence of high-grade rash with nilotinib (2.6%; 95% CI, 2.1-3.4) was higher (P = 0.002) than with dasatinib (1.1%; 95% CI, 0.8-1.6). The clinical presentation often consisted of a pruritic, perifollicular hyperkeratotic, occasionally erythematous papular rash affecting most areas of the body, depending on the severity. CONCLUSIONS:Both nilotinib and dasatinib are associated with rash in a significant number of patients. Further studies to prevent and treat rash with nilotinib and dasatinib are required to improve patient quality of life, adherence with therapy and oncologic outcome.

背景与目标：

BACKGROUND & AIMS: -2

背景与目标： -2

BACKGROUND & AIMS: BACKGROUND:Skin rash remains one of the most prevalent and troublesome clinical problems experienced by patients on chemotherapy and targeted therapy. To ensure high-quality care, guidelines are seen as the best guidance. Considering the quality of guidelines varies greatly, a systematical appraisal of the methodological quality of guidelines for the management of skin rash in patients on chemotherapeutic drugs and targeted anticancer therapies was undertaken, in order to identify appropriate ones for healthcare professionals. METHODS:A systematic search of databases and Internet was conducted to obtain pertinent guidelines. Two reviewers independently assessed the eligibility of guidelines according to the inclusion criteria. Then the guidelines included were appraised by three researchers with the methodological quality of eligible guideline using Appraisal of Guidelines for Research and Evaluation II (AGREEII). RESULTS:Totally nineteen guidelines met the inclusion criteria. The quality ranged from good to acceptable in scope and purpose (mean: 78.80%, range: 66.67-94.44%) and clarity of presentation domains (mean: 85.38%, 75.00-91.67%), but not in stakeholder involvement (mean: 50.15%, range: 36.11-75.00%), rigor of development (mean: 23.65%, range: 6.25-70.83%), applicability (mean: 23.96%, range: 4.17-52.08%), and editorial independence domains (mean: 45.18%, range: 0.00-87.50%). Overall, two guidelines were classified as "recommended". CONCLUSIONS:Only two guidelines were recommended to manage skin rash in patients on chemotherapy and targeted therapies, most guidelines issued were of low to moderate quality. Thus, more attention should be paid to the methodological quality of guideline development in this field.

背景与目标：

BACKGROUND & AIMS: :Cefditoren pivoxil is an oral antimicrobial used increasingly in pediatric bacterial infections. We report a case of rash and arthralgia following administration of cefditoren pivoxil for lower respiratory tract infection in a four-year-old female child. On discontinuation of the antibiotic, the child recovered full function of the knee joint within seven days. The causality of the event assessed as per the WHO-UMC system for standardized case causality assessment criteria can be considered as 'probable'. Analyzed by the Naranjo's ADR probability scale, the score was 7, which also makes it a 'probable' event.

背景与目标： : 头孢托仑pivoxil是一种口服抗菌剂，越来越多地用于小儿细菌感染。我们报告了一名四岁女童使用头孢托仑pivoxil治疗下呼吸道感染后出现皮疹和关节痛的情况。停用抗生素后，孩子在7天内恢复了膝关节的全部功能。根据WHO-UMC标准化案例因果关系评估标准系统评估的事件因果关系可被视为 “可能”。通过Naranjo的ADR概率量表分析，得分为7，这也使其成为 “可能” 事件。

BACKGROUND & AIMS: :Leprosy, a rare chronic granulomatous communicable disease caused by Mycobacterium leprae, is classically known to have cutaneous and neurologic sequelae. As a result of immigration, the disease, endemic in Brazil, India, Nepal, Madagascar, Myanmar, and Indonesia, has been recognized to be present in North America and the Caribbean. We describe a case of a woman presenting with a long history of a recurrent rash and leg numbness, initially diagnosed with systemic lupus, who was later proven to have lepromatous leprosy. It is a reminder that this underappreciated disease should still be considered in the differential diagnosis of skin rash and neuropathy, even in nonendemic regions.

背景与目标： 麻风病是一种由麻风分枝杆菌引起的罕见的慢性肉芽肿性传染病，通常已知有皮肤和神经系统后遗症。由于移民，该疾病在巴西，印度，尼泊尔，马达加斯加，缅甸和印度尼西亚流行，已被认为存在于北美和加勒比海地区。我们描述了一名妇女，该妇女长期患有反复发作的皮疹和腿部麻木，最初被诊断为系统性红斑狼疮，后来被证明患有麻风病。提醒我们，即使在非流行地区，在皮疹和神经病的鉴别诊断疾病中，仍应考虑这种未被重视的疾病。

BACKGROUND & AIMS: :Solid organ transplant patients are well established to be at risk of herpes simplex virus and varicella zoster virus infection and reactivation. We present a case of a 41-year-old woman with a history of pancreas and renal transplant who presented with what appeared to be disseminated herpes simplex virus or varicella zoster virus induced rash, but who was ultimately diagnosed and treated as linear IgA bullous dermatosis. This case alerts physicians to other non-infectious dermatoses as a cause of vesiculobullous rash in solid organ transplant patients.

背景与目标： : 实体器官移植患者有单纯疱疹病毒和水痘带状疱疹病毒和再激活的风险。我们介绍了一例41岁的女性，该女性有胰腺和肾移植史，出现了似乎是播散性单纯疱疹病毒或水痘带状疱疹病毒引起的皮疹，但最终被诊断为线性IgA大疱性皮肤病。该病例提醒医生注意其他非感染性皮肤病是实体器官移植患者中水泡状皮疹的原因。

BACKGROUND & AIMS: :We report a singular clinical condition observed following a short duration treatment with sulphasalazine (SSZ) in a 64-year-old woman affected by psoriatic arthritis. Two weeks after starting treatment, a high degree, subcontinuous fever occurred, together with systemic discomfort, fatigue, headache, and ultimately a moderate wakefulness impairment. Upon admission to the hospital, a malar rash became evident. Modest notes of hepatotoxicity were also evident. All of the symptoms suddenly resolved after SSZ withdrawal. The markers of hepatitis become negative just 2 months later. It is interesting to note that after dismissal, in order to counteract the severe arthritic conditions and the presence of a type 2 diabetes, a combined therapy with methotrexate and cyclosporin had to be used, with no renal or hepatic side effects and remarkable therapeutic effects. No markers of autoimmunity were found in this patient. The chronology and the clinical events here described may confirm the hypothesis of a idiosyncratic reaction to SSZ, closely resembling a rare, sometimes irreversible, condition known as "the 3 week sulphasalazine syndrome".

背景与目标： : 我们报告了在一名受银屑病关节炎影响的64岁女性中，用磺胺嘧啶 (SSZ) 进行短期治疗后观察到的单一临床状况。开始治疗两周后，出现高度持续发热，伴有全身不适、乏力、头痛，最终出现中度清醒障碍。入院后，黄斑皮疹变得明显。适度的肝毒性也很明显。所有症状在SSZ停药后突然消失。仅2个月后，肝炎标志物就变为阴性。有趣的是，在解雇后，为了抵消严重的关节炎疾病和2型糖尿病的存在，必须使用甲氨蝶呤和环孢菌素的联合治疗，没有肾或肝副作用和显着的治疗效果。该患者未发现自身免疫标志物。此处描述的时间顺序和临床事件可能证实了对SSZ的特殊反应的假设，该假设非常类似于一种罕见的，有时是不可逆的，称为 “3周磺胺嘧啶综合征”。

BACKGROUND & AIMS: :Since the eradication of smallpox approximately 39 years ago, monkeypox virus remains the most pathogenic poxvirus, being mainly restricted to Central and West Africa. Before 1970, there were no reports of human monkeypox in Nigeria, while between 1971 and 1978 there were three cases, with none having been reported thereafter. However, in September 2017, a case of contagious skin rash disease, typical of monkeypox, was observed in an 11-year-old boy from the southern part of the country and confirmed to be associated with the monkeypox virus. This large outbreak consisted of 262 suspected, 115 confirmed cases, and 7 mortalities across 26 states and the Federal Capital Territory (FCT), Abuja. The aim of this manuscript is to provide an updated, comprehensive, and timely review of monkeypox, an important emerging infection in Nigeria. Monkeypox is now a major threat to global health security, requiring an urgent multidisciplinary approach involving veterinarians, physicians, virologists, and public health experts to fast-track the development of diagnostic assays, vaccines, antivirals, and other control strategies.

背景与目标： : 自从大约39年前消灭天花以来，猴痘病毒仍然是最具致病性的痘病毒，主要限于中部和西部非洲。1970年之前，尼日利亚没有人猴痘的报告，而1971年和1978则有3例，此后没有报告。然而，在2017年9月，在该国南部的一名11岁男孩中观察到传染性皮疹疾病，典型的猴痘，并证实与猴痘病毒有关。这次大规模爆发包括26个州和阿布贾联邦首都地区 (FCT) 的262个疑似病例，115个确诊病例和7个死亡病例。本手稿的目的是提供对猴痘 (尼日利亚一种重要的新兴感染) 的最新，全面和及时的回顾。猴痘现在是对全球健康安全的主要威胁，需要采取紧急的多学科方法，涉及兽医，医生，病毒学家和公共卫生专家，以快速跟踪诊断分析，疫苗，抗病毒药和其他控制策略的开发。

BACKGROUND & AIMS: :Negative urgency (NU: tendency to act rashly when distressed) is the facet of impulsive personality that has been most predictive of binge eating, but less is known about the relative role of positive urgency (PU: tendency to act rashly in response to positive emotions). In addition, most studies have exclusively focused on women and the examination of pathological eating outcomes, using a dimensional symptom approach, has been somewhat limited. This study aimed to replicate and extend upon prior work. We examined the extent to which NU and/or PU are uniquely associated with dysregulated eating, using a latent factor comprised of dimensional symptoms, and directly tested whether effects differ by sex. Two independent cross-sectional samples of women and men were used (Sample 1: Midwestern university, 437 females, 348 males; Sample 2: Southwestern university, 301 females, 236 males). NU and PU were assessed with the UPPS-P Impulsive Behavior Scale, and dysregulated eating symptoms (i.e., binge eating, loss of control eating, eating concerns) were assessed with well-validated self-report questionnaires. Although both NU and PU showed significant positive associations with dysregulated eating, NU showed the strongest unique relationship with dysregulated eating in both samples. The relative role of PU was weakened in Sample 1 and completely attenuated in Sample 2 once its shared variance with NU was accounted for. All results were similar in men and women. Overall, findings continue to suggest that NU is the form of impulsivity that is most relevant to dysregulated eating in both men and women.

背景与目标： : 消极紧迫感 (NU: 苦恼时轻率行事的倾向) 是冲动性人格的一个方面，它最能预测暴饮暴食，但对积极紧迫感的相对作用知之甚少 (PU: 对积极情绪做出反应时轻率行事的倾向)。此外，大多数研究都只针对女性，使用维度症状方法对病理性饮食结果的检查受到一定程度的限制。本研究旨在复制和扩展先前的工作。我们使用由维度症状组成的潜在因素检查了NU和/或PU与饮食失调的独特程度，并直接测试了效果是否因性别而异。使用了两个独立的女性和男性横截面样本 (样本1: 中西部大学，437名女性，348名男性; 样本2: 西南大学，301名女性，236名男性)。使用UPPS-P冲动行为量表评估NU和PU，并使用经过验证的自我报告问卷评估饮食失调的症状 (即暴饮暴食，饮食失控，饮食问题)。尽管NU和PU与饮食失调均显示出显着的正相关，但NU在两个样本中与饮食失调均显示出最强的独特关系。考虑到PU与NU的共同方差，PU的相对作用在样本1中减弱，而在样本2中完全减弱。所有结果在男性和女性中相似。总体而言，研究结果继续表明，NU是一种冲动形式，与男性和女性饮食失调最相关。

BACKGROUND & AIMS: :Cladribine is an approved drug for the treatment of highly active multiple sclerosis. We report a 28-years-old man with a poor response to previous treatments, elected to treatment with Cladribine. He developed a lichenoid rash two weeks after taking the first and second treatment cycles. This symptom regressed with specific therapy. A lichenoid drug eruption is a rare side effect which can occur following the administration of several different medications, but it has never been described after treatment with oral Cladribine.

背景与目标： : 克拉屈滨是一种被批准用于治疗高度活跃的多发性硬化症的药物。我们报告了一名28岁的男性，对先前的治疗反应不佳，选择接受克拉屈滨治疗。他在接受第一和第二个治疗周期后两周出现了苔藓样皮疹。这种症状在特定治疗后会消退。地衣样药疹是一种罕见的副作用，可以在服用几种不同的药物后发生，但在口服克拉屈滨治疗后从未描述过。

BACKGROUND & AIMS: :Rationale: Kawasaki disease (KD) is an acute vasculitis of small and medium vessels; whereas systemic lupus erythematosus (SLE) is a chronic systemic autoimmune disease. Their presentation is varied and not always straightforward, leading to misdiagnosis. There have been case reports of lupus onset mimicking KD and KD presenting as lupus-like. Coexistence of both diseases is also possible. Patient concerns: We present three adolescents, one with fever, rash, arthritis, nephritis, lymphopenia, and coronary aneurysms, a second patient with rash, fever, aseptic meningitis, and seizures, and a third patient with fever, rash, and pleural effusion. Diagnoses: The first patient was finally diagnosed with SLE and KD, the second patient initially diagnosed as KD but eventually SLE and the third patient was diagnosed at onset as lupus but finally diagnosed as KD. Interventions: The first patient was treated with IVIG, corticosteroids, aspirin, coumadin and mycophenolate mofetil. The second patient was treated with IVIG, corticosteroids and methotrexate and the third patient with IVIG, aspirin and corticosteroids. Lessons: Both diseases may mimic each other's clinical presentation. KD in adolescence presents with atypical signs, incomplete presentation, and develop coronary complications more commonly. An adolescent with fever and rash should include KD and SLE in the differential diagnosis.

背景与目标： : 原理: 川崎病 (KD) 是中小血管的急性血管炎; 而系统性红斑狼疮 (SLE) 是一种慢性全身性自身免疫性疾病。他们的介绍多种多样，并不总是直截了当，导致误诊。有病例报告称狼疮发作模仿KD和KD表现为狼疮样。两种疾病并存也是可能的。患者关注: 我们介绍了三名青少年，一名发热，皮疹，关节炎，肾炎，淋巴细胞减少和冠状动脉瘤，第二名患有皮疹，发热，无菌性脑膜炎和癫痫发作，第三名发热，皮疹和胸腔积液。诊断: 第一例患者最终被诊断为SLE和KD，第二例患者最初被诊断为KD，但最终被诊断为SLE，第三例患者在发病时被诊断为狼疮，但最终被诊断为KD。干预措施: 第一位患者接受IVIG，皮质类固醇，阿司匹林，香豆素和霉酚酸酯治疗。第二例患者接受IVIG，皮质类固醇和甲氨蝶呤治疗，第三例患者接受IVIG，阿司匹林和皮质类固醇治疗。经验教训: 两种疾病都可能模仿彼此的临床表现。青春期的KD表现为非典型体征，表现不完全，并更常见发生冠状动脉并发症。发热和皮疹的青少年应在鉴别诊断疾病中包括KD和SLE。

BACKGROUND & AIMS: -2

背景与目标： -2