Doxycycline as an anti-inflammatory agent: updates in dermatology

Doxycycline, a tetracycline antibiotic, is widely used in the field of dermatology for its antibiotic properties, anti-inflammatory properties and good safety profile. Over the past decades, numerous studies have clarified some of the anti-inflammatory mechanisms of doxycycline. In this review article, we aimed to provide an update on recent data on the anti-inflammatory properties of doxycycline and its potential role in cutaneous inflammatory diseases. Better understanding of these mechanisms might offer the practicing clinicians a better use of this therapeutic tool. In addition, research in this field could help clarify pathogenic aspects of inflammatory dermatologic diseases responsive to this medication. Further research is needed to fully elucidate the potential of doxycycline as an anti-inflammatory agent, and the development of new topical vehicles could open ways to new therapeutic possibilities for dermatologists.

Chromium isotopic composition of core-top planktonic foraminifera

The chromium isotope system (⁵³ Cr/⁵² Cr expressed as δ⁵³ Cr relative to NIST SRM 979) is potentially a powerful proxy for the redox state of the ocean-atmosphere system, but a lack of temporally continuous, well-calibrated archives has limited its application to date. Marine carbonates could potentially serve as a common and continuous Cr isotope archive. Here, we present the first evaluation of planktonic foraminiferal calcite as an archive of seawater δ⁵³ Cr. We show that single foraminiferal species from globally distributed core tops yielded variable δ⁵³ Cr, ranging from 0.1‰ to 2.5‰. These values do not match with the existing measurements of seawater δ⁵³ Cr. Further, within a single core-top, species with similar water column distributions (i.e., depth habitats) yielded variable δ⁵³ Cr values. In addition, mixed layer and thermocline species do not consistently exhibit decreasing trends in δ⁵³ Cr as expected based on current understanding of Cr cycling in the ocean. These observations suggest that either seawater δ⁵³ Cr is more heterogeneous than previously thought or that there is significant and species-dependent Cr isotope fractionation during foraminiferal calcification. Given that the δ⁵³ Cr variability is comparable to that observed in geological samples throughout Earth's history, interpreting planktonic foraminiferal δ⁵³ Cr without calibrating modern foraminifera further, and without additional seawater measurements, would lead to erroneous conclusions. Our core-top survey clearly indicates that planktonic foraminifera are not a straightforward δ⁵³ Cr archive and should not be used to study marine redox evolution without additional study. It likewise cautions against the use of δ⁵³ Cr in bulk carbonate or other biogenic archives pending further work on vital effects and the geographic heterogeneity of the Cr isotope composition of seawater.

Primary Care Sports Medicine in the Managed Care Environment: Coping in Today's Culture

Managed care is giving rise to changes in the practice of medicine. These changes can be problematic for physicians who care for athletes on sports teams if team physicians and athletes are not in the same insurance plan. Also, insurance carriers are sometimes unaware of the special needs of athletes. Physicians can function more efficiently in the managed care environment with coping strategies such as joining multiple insurance plans, cultivating referral options, negotiating directly with insurance companies, designating a staff referral specialist, developing sports medicine programs, and allying with other sports medicine physicians.