Paronychia revoluta, a new species of caryophyllaceae from Brazil

A new species of Paronychia, P revollita, from the state of Rio Grande do Sul, Brazil, is described and illustrated. This species is closely related to P camphorosmoides, distinguished from it by linear-subulate leaves with a revolute margin and prominent midribs. It is also allied to P. fascicidata, from which it differs in the lanceolate, acuminate, fimbriate, and whitish stipules, and linear-subulate leaves.

Afatinib versus cisplatin-based chemotherapy for EGFR mutation-positive lung adenocarcinoma (LUX-Lung 3 and LUX-Lung 6): analysis of overall survival data from two randomised, phase 3 trials

Background We aimed to assess the effect of afatinib on overall survival of patients with EGFR mutation-positive lung adenocarcinoma through an analysis of data from two open-label, randomised, phase 3 trials. Methods Previously untreated patients with EGFR mutation-positive stage IIIB or IV lung adenocarcinoma were enrolled in LUX-Lung 3 (n=345) and LUX-Lung 6 (n=364). These patients were randomly assigned in a 2:1 ratio to receive afatinib or chemotherapy (pemetrexed-cisplatin [LUX-Lung 3] or gemcitabine-cisplatin [LUX-Lung 6]), stratified by EGFR mutation (exon 19 deletion [del19], Leu858Arg, or other) and ethnic origin (LUX-Lung 3 only). We planned analyses of mature overall survival data in the intention-to-treat population after 209 (LUX-Lung 3) and 237 (LUX-Lung 6) deaths. These ongoing studies are registered with ClinicalTrials.gov, numbers NCT00949650 and NCT01121393. Findings Median follow-up in LUX-Lung 3 was 41 months (IQR 35–44); 213 (62%) of 345 patients had died. Median follow-up in LUX-Lung 6 was 33 months (IQR 31–37); 246 (68%) of 364 patients had died. In LUX-Lung 3, median overall survival was 28·2 months (95% CI 24·6–33·6) in the afatinib group and 28·2 months (20·7–33·2) in the pemetrexed-cisplatin group (HR 0·88, 95% CI 0·66–1·17, p=0·39). In LUX-Lung 6, median overall survival was 23·1 months (95% CI 20·4–27·3) in the afatinib group and 23·5 months (18·0–25·6) in the gemcitabine-cisplatin group (HR 0·93, 95% CI 0·72–1·22, p=0·61). However, in preplanned analyses, overall survival was significantly longer for patients with del19-positive tumours in the afatinib group than in the chemotherapy group in both trials: in LUX-Lung 3, median overall survival was 33·3 months (95% CI 26·8–41·5) in the afatinib group versus 21·1 months (16·3–30·7) in the chemotherapy group (HR 0·54, 95% CI 0·36–0·79, p=0·0015); in LUX-Lung 6, it was 31·4 months (95% CI 24·2–35·3) versus 18·4 months (14·6–25·6), respectively (HR 0·64, 95% CI 0·44–0·94, p=0·023). By contrast, there were no significant differences by treatment group for patients with EGFR Leu858Arg-positive tumours in either trial: in LUX-Lung 3, median overall survival was 27·6 months (19·8–41·7) in the afatinib group versus 40·3 months (24·3–not estimable) in the chemotherapy group (HR 1·30, 95% CI 0·80–2·11, p=0·29); in LUX-Lung 6, it was 19·6 months (95% CI 17·0–22·1) versus 24·3 months (19·0–27·0), respectively (HR 1·22, 95% CI 0·81–1·83, p=0·34). In both trials, the most common afatinib-related grade 3–4 adverse events were rash or acne (37 [16%] of 229 patients in LUX-Lung 3 and 35 [15%] of 239 patients in LUX-Lung 6), diarrhoea (33 [14%] and 13 [5%]), paronychia (26 [11%] in LUX-Lung 3 only), and stomatitis or mucositis (13 [5%] in LUX-Lung 6 only). In LUX-Lung 3, neutropenia (20 [18%] of 111 patients), fatigue (14 [13%]) and leucopenia (nine [8%]) were the most common chemotherapy-related grade 3–4 adverse events, while in LUX-Lung 6, the most common chemotherapy-related grade 3–4 adverse events were neutropenia (30 [27%] of 113 patients), vomiting (22 [19%]), and leucopenia (17 [15%]). Interpretation Although afatinib did not improve overall survival in the whole population of either trial, overall survival was improved with the drug for patients with del19 EGFR mutations. The absence of an effect in patients with Leu858Arg EGFR mutations suggests that EGFR del19-positive disease might be distinct from Leu858Arg-positive disease and that these subgroups should be analysed separately in future trials.

Fragmentos capilares provocando paroniquia e onicolise em barbeiros/cabeleireiros: Uma dermatose ocupacional

By means of observation of hair fragments provoking paronychia and onycholysis in a barber, the authors performed a epidemiological investigation in others barbers/hair-dressers of Botucatu (SP), that showed a high frequency of die dermatosis.

Onicodistrofia lupoide simétrica canina: relato de caso

Symmetric lupoid onychodystrophy, or lupoid onychitis, is a multifactor immune-mediated onychopathy. The aim of the present study is to report the occurrence of lupoid onychitis in a two year-old mongrel dog helped at the Small Animal Dermatology Service of Sao Paulo State University Veterinary Hospital, in Botucatu, São Paulo. The animal presented lameness, onycholysis in five digits, paronychia, onychomadesis, nail softening and leuchonychia, as well as melicerous crusts in interdigital spaces and nailbeds. No non-dermatological systemic symptoms were observed. Complementary exams were negative for parasites or fungi. After 15 days of treatment there was partial recovery followed by recurrence. Onychectomy was performed in two digits for histopathological examination and fungal culture, which was negative. Histopathology was consistent with lupoid onychitis, reinforcing the importance of this complementary exam.

Nail surgery

Nail surgery is a special branch of hand and dermatologic surgery. It is not widely performed, and many physicians do not feel at ease to perform it. The objective of this contribution is to give a short overview of the most important surgical procedures in clinical practice. References from the literature and the author's own experiences are condensed to describe what a dermatologic practitioner with knowledge of the nail and some surgical skills can perform. Nail surgery is a precise technique that requires careful administration and attention to details. Proper patient preparation starts with a patient history to identify potential contraindications and to prevent unnecessary complications. The author recommends isopropyl alcohol scrub and chlorhexidine for disinfection and ropivacaine 1% for anesthesia. The technique used for anesthesia depends on the type of surgery. Surgical procedures are described for diagnostic biopsies, nail avulsion in general, onychogryposis, paronychia treatment, hematomas and bone fracture due to trauma, removal of subungual foreign bodies, ingrowing nails, pincer nails, warts, ungual fibrokeratomas, digital myxoid pseudocyst, subungual exostoses, and various tumors. If performed correctly with adequate skills, nail surgery will lead to functionally and aesthetically satisfying results in the majority of instances.

Palynology of ODP Site 108-658

Ocean Drilling Program Site 658 at 21°N off northwest Africa has a high sedimentation rate and a high concentration of pollen grains and is thus very suitable for detailed pollen analysis. The time scale for the upper 100 m (the last 670 k.y.) of Site 658 is based on biostratigraphic data and isotope stratigraphy. The pollen record has been divided into 34 zones. These are classified into 7 zone types covering a range from very arid to rather humid conditions. The sequence shows a long-term climatic decline: strong glacial stages were found only after 480 k.y. and strong interglacial stages only before 280 k.y. The Site 658 record correlates well with a terrestrial sequence from northern Greece, although both records differ in their response to global climatic change. Spectral analysis shows a 100- and a 42-k.y. period in the curves of pollen brought in by the northwest trade winds and only a 42-k.y. period in the curves of pollen mostly transported by the African Easterly Jet. A 31-k.y. period is found in the curves for Ephedra and Chenopodiaceae-Amaranthaceae. In addition, Ephedra shows a 54-k.y. period.

Pollen analysis of sediment cores from the mouth of the river Congo to Walvis Bay and Lüderitz

The distribution of pollen in marine sediments is used to record vegetation changes over the past 30,000 years on the adjacent continent. A transect of marine pollen sequences from the mouth of the river Congo (~5°S) to Walvis Bay and Lüderitz (~25°S) shows vegetation changes in Congo, Angola and Namibia from the last glacial period into the Holocene. The comparison of pollen records from different latitudes provides information about the latitudinal shift of open forest and savannahs (Poaceae pollen), the extension of lowland forest (rain forest pollen) and Afromontane forest (Podocarpus pollen), and the position of the desert fringe (pollen of Caryophyllaceae, Chenopodiaceae and Amaranthaceae). High Cyperaceae pollen percentages in sediments from the last glacial period off the mouth of the river Congo suggest the presence of open swamps rather than savannah vegetation in the Congo Basin. Pollen from Restionaceae in combination with Stoebe-type pollen (probably from Elytropappus) indicates a possible northwards extension of winter rain vegetation during the last glacial period. The record of Rhizophora (mangrove) pollen is linked to erosion of the continental shelf and sea-level rise. Pollen influx is highest off river mouths (10-2000 grains year**-1 cm**-2), close to the coast (300-6000 grains year**-1 cm**-2), but is an order of magnitude lower at sites situated far from the continent (<10 grains year**-1 cm**-2).

Pollen analysis of surface sediment off northwest Africa

Over 100 samples of recent surface sediments from the bottomn of the Atlantic Ocean offshore NW Africa between 34° and 6° N have been analysed palynologically. The objective of this study was to reveal the relation between source areas, transport systems, and resulting distribution patterns of pollen and spores in marine sediments off NW Africa, in order to lay a sound foundation for the interpretation of pollen records of marine cores from this area. The clear zonation of the NW-African vegetation (due to the distinct climatic gradient) is helpful in determining main source areas, and the presence of some major wind belts facilitates the registration of the average course of wind trajectories. The present circulation pattern is driven by the intertropical front (ITCZ) which shifts over the continent between c. 22° N (summer position) and c. 4° N (winter position) in the course of the year. Determination of the period of main pollen release and the average atmospheric circulation pattern effective at that time of the years is of prime importance. The distribution patterns in recent marine sediments of pollen of a series of genera and families appear to record climatological/ecological variables, such as the trajectory of the NE trade, January trades, African Easterly Jet (Saharan Air Layer), the northernmost and southernmost position of the intertropical convergence zone, and the extent and latitudinal situation of the NW-African vegetation belt. Pollen analysis of a series of dated deep-sea cores taken between c. 35° and the equator off NW African enable the construction of paleo-distribution maps for time slices of the past, forming a register of paleoclimatological/paleoecological information.