Randomized Open-Label Trial Comparing Teledermatology vs. Face-to-Face Consultation in the Follow-Up of Patients with Mild-to-Moderate Acne

Background: Acne vulgaris is one of the most common dermatological diseases, especially in adolescents and young adults. Objective: The current study aimed to compare teledermatology versus face-to-face consultation in the follow-up of patients with mild-to-moderate acne. Methods: In this investigator-initiated, parallel arms, open-label, randomized clinical trial, after screening, participants were randomly assigned in a 1:1 ratio to be followed up through teledermatology or standard face-to-face consultations for a period of 6 months. The primary endpoint was the cumulative time spent by physician for consultations or online assessments. Results: 24 patients (21 females and 3 males; mean age 23.0 ± 3.3 years) underwent randomization in the two study groups. In intention-to-treat analysis, the cumulative time spent by physician was higher in the teledermatology group compared to face-to-face consultations with an average difference of 8:24 mm:ss (95% CI: 1:17-15:31). However, the cumulative time spent by the patient was significantly lower in the teledermatology group (mean difference 1:21:39 hh:mm:ss; 95% CI: 41:51-2:01:27). An optimal reduction of acne-severity was observed in both groups, without significant differences between them. The patient’s satisfaction did not change significantly over time and between groups, and was generally quite high. AEs were reported by one patient in the teledermatology group and four patients in the consultation group. Conclusion: Acne might be an optimal disease to be followed up using a teledermatology platform, to relieve the burden on patients and medical staff. However, it is necessary to implement more user-friendly platforms in order to achieve the best possible results in the treatment and follow-up of acne patients.

Putting global health high on the agenda of medical schools

In this opinion paper, we reflect on global health and global health education as well as challenges that the coming generation are likely to face. As the field is rapidly changing, it is vital to critically reflect categories of “global south” and “global north” as geographical boundaries, and rather think in terms of inequalities that are present in all countries. Global perspectives on health are useful to analyze structural challenges faced in all health care systems and help understand the diversity of cultures and patients’ concepts of disease. We first discuss burning questions and important challenges in the field and how those challenges are tackled. Rather than going into detail on topical issues, we reflect on approaches and attitudes that we think are important in global health education and present opportunities and challenges for young scholars who are interested in working in this field.

Calcium tartrate crystals in the midgut of the grape leafhopper

Calcium tartrate crystals were observed in the midgut of grape leafhoppers. This unique compound was found for the first time in insects. The size of the crystals varied strongly between and within individuals with a mean length of 153 +/- 87 microm and a mean width of 71 +/- 46 microm. In addition, the number of crystals per individual showed a broad variation and ranged from 1 to 150 crystals/individual. The occurrence of calcium tartrate crystals as well as the number of crystals per individual followed the same seasonal pattern as seasonal vine leaf concentrations of tartaric acid found in a previous study, indicating that calcium tartrate is formed to neutralize the tartaric acid in the gut system. It further implies that the grape leafhopper, rather than being a pure phloem sucker, employs a mixed feeding strategy to satisfy its demands for calcium uptake.

Size-dependent male reproductive success and size-assortative mating in the midwife toad Alytes obstetricans

Abstract

In a field population of the midwife toad, Alytes obstetricans, a temperate zone species with extensive paternal care, size-assortative mating was observed. During the more favourable mating season of 1987, larger males carried bigger single clutches, as expected from assortative matings. Furthermore, larger males experienced higher mating success over the whole season as well as during single egg carrying intervals. However, during the extraordinarily dry breeding period of 1988, no size-related male mating success was found. Males were in both years highly successful caretakers as far as hatching success of the tadpoles was concerned. Brood care was associated with conditional costs for egg-carrying males in 1988, but not in 1987. Neither hatching success nor hatching size of the tadpoles were correlated with male size. Possible causes, leading to the observed mating advantage of larger-sized males in some years, but not in others, are discussed.