This study looked at the relationship of geographic tongue in psoriasis patients. Geographic tongue is an inflammatory condition of the mucous membrane of the tongue.

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Background:
Few studies have examined the clinical features of geographic tongue (GT), an inflammatory lesion, making diagnosis and the investigation of oral psoriasis difficult.

Purpose:
To investigate the clinical features of GT to facilitate its identification and understand its relationship with psoriasis.

Methods:
A total of 96 participants diagnosed with GT underwent stomatological and dermatological examinations. The parameters assessed were burning sensation; number, classification, and location of lesions; loss of papillae; severity of GT lesions; and association with fissured tongue (FT). Psoriatic patients (PS) and those without psoriasis (NPS) were compared.

Results:
Burning sensation was reported by 45 (47%) patients, 67 (70%) patients showed active GT, 68 (71%) presented with typical lesions, and 59 (61%) exhibited moderate lesions. GT was associated with FT in 75% of the cases and exhibited a diffused pattern associated with severe lesions. It was also more frequent in the PS group. The comparative analysis between the PS and NPS groups showed significant differences between the groups with regard to gender, presence of burning sensation, and GT severity.

Conclusion:
GT is a symptomatic lesion with a thick halo. In contrast, psoriatic patients are frequently asymptomatic and exhibit severe lesions with greater loss of papillae that are associated with severe FT. The present study is the first to demonstrate clinical differences in the GT of patients with and without psoriasis, suggesting that some GT cases may represent true oral psoriasis and some cases may represent only GT.

BIOREP is one of the first registries of patients with psoriasis treated with biologics in Central and Eastern Europe. This study analyzed the cohort of patients treated with biologics between May 2005 and May 2015.

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Background:
BIOREP is a Czech registry of psoriatic patients on biological treatment in a clinical setting. We describe the characteristics of patients with psoriasis at the time of enrollment and present comparisons with published data from other national registries.

Methods:
We analyzed the cohort of patients treated with biologics between May 2005 and May 2015. Demographic data, previous therapies, comorbidities, and severity of psoriasis were compared with data from other registries – DERMBIO, BIOBADADERM, BADBIR, and PSOBEST.

Results:
A total of 1412 psoriatic patients initiating biological treatment were included with a predominance of males (63.4%). The mean patient age was 50.2 years, and approximately 70.5% of patients were either overweight or obese. The mean baseline Psoriasis Area and Severity Index was 19.8, and the Dermatology Life Quality Index was 16.6. More than one-third of patients (41.0%) reported a history of psoriatic arthritis, and a high proportion of patients (49.5%) with cardiovascular risk factors (hypertension [35.2%], hyperlipidemia [27.7%], diabetes mellitus [11.4%], coronary heart disease [4.9%], and obesity [15.2%]) were observed. Most of the patients had been previously treated with phototherapy (85.4%), acitretin (74.0%), methotrexate (65.7%), or cyclosporine (53.1%).

Conclusion:
BIOREP is one of the first registries of patients with psoriasis treated with biologics in Central and Eastern Europe. Our results found a similar or higher prevalence of comorbidities, long disease duration, and high impact on the quality of life among patients included in Western European registries.

This study evaluated the efficacy and safety of Interleukin 17 treatments for psoriasis. *Cosentyx and Taltz are Interleukin 17 treatments.

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Background:
The interleukin-17 (IL-17) cytokine pathway plays a key role in the development of psoriasis. Antibodies targeting IL-17 or blocking its receptor may be a new therapeutic approach for psoriasis. To assist treatment selection in daily practice, it is essential to understand the benefit and risk profile of IL-17 antagonists.

Objective:
We performed a meta-analysis to evaluate the efficacy and safety of IL-17 antagonists in patients with psoriasis.

Methods:
We searched a number of databases for relevant randomized controlled trials (RCTs) published before May 2016. The following outcomes were evaluated: Psoriasis Area and Severity Index (PASI) 75, 90, 100 response, Investigator's Global Assessment (IGA) score of 0 or 1 response, adverse events (AEs) and withdrawals. The meta-analysis was performed using Review Manager 5.2 software.

Results:
Nine RCTs with 5951 patients were included. IL-17 antagonists achieved higher PASI 75, 90, 100 response rates and Dermatology Life Quality Index 0 or 1 response rates than placebo and a lower incidence of discontinuations due to lack of efficacy. In the safety analysis, no significant differences were found between the IL-17 antagonists and placebo in the proportion of patients with serious AEs, cardiovascular disease and discontinuations due to AEs. However, IL-17 antagonists were associated with a higher proportion of patients with any AEs and infections than placebo.

Conclusion:
IL-17 antagonists were effective, with an acceptable safety profile, for patients with plaque psoriasis. Vigilance because of the potential for infection will be necessary for IL-17 antagonists.

Recently I started using ketogenic diet (high fat, low carb and moderate protein) and am seeing amazing improvement with my psoriasis and psoriatic arthritis.

Hi
Im currently taking 3 x 120mg of fumaderm per day. I take one at 6am before setting off for work. The second about 2/3 pm. and the final one about 9pm before bed.
Its the first one in the morning that gets me. I only have a cup of tea before setting off for work. I go to the Lou before setting off and all seems pretty normal, but after an hours drive to work I am at the toilet for the next three hours probably up to ten visits. my stomach rarely settles until lunch time. I eat my lunch about 10am and after more visits my stomach settles. The other two tablets are relatively easy to tolerate. I am quite happy with the results as it is just starting to work. Can anyone shed any light on why this first tablet hits me so hard. I apologise for the subject t know who else to ask. but don't know who else to ask.

This study may interest those of you using methotrexate for psoriasis.

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Background:
Methotrexate is one of the most commonly used systemic drugs for the treatment of moderate to severe psoriasis; however, high-quality evidence for its use is sparse and limited to use of oral dosing. We aimed to assess the effect of an intensified dosing schedule of subcutaneous methotrexate in patients with moderate to severe plaque-type psoriasis.

Methods:
We did this prospective, multicentre, randomised, double-blind, placebo-controlled, phase 3 trial (METOP) at 16 sites in Germany, France, the Netherlands, and the UK. Eligible patients were aged 18 years or older, had a diagnosis of chronic plaque psoriasis for at least 6 months before baseline, had currently moderate to severe disease, and were methotrexate treatment-naive. Participants were randomly assigned (3:1), via a computer-generated random number sequence integrated into an electronic data capture system, to receive either methotrexate at a starting dose of 17·5 mg/week or placebo for the first 16 weeks, followed by methotrexate treatment of all patients up to 52 weeks (methotrexate–methotrexate vs placebo–methotrexate groups). Dose escalation to 22·5 mg/week was allowed after 8 weeks of methotrexate treatment if patients had not achieved at least a 50% reduction in baseline Psoriasis Area and Severity Index score (PASI), with corresponding volume increases in placebo injections. Treatment was combined with folic acid 5 mg/week. Group allocation was concealed from participants and investigators from the time of randomisation until an interim database lock at week 16, and was open label from week 16 onwards, with no masking of participants or investigators. The primary efficacy endpoint was a 75% reduction in PASI score (PASI 75) from baseline to week 16. We did analysis by modified intention to treat, with non-responder imputation. This study is registered with EudraCT, number 2012-002716-10.

Findings:
Between Feb 22, 2013, and May 13, 2015, we randomly assigned 120 patients to receive methotrexate (n=91) or placebo (n=29). At week 16, a PASI 75 response was achieved in 37 (41%) patients in the methotrexate group compared with three (10%) patients in the placebo group (relative risk 3·93, 95% CI 1·31–11·81; p=0·0026). Subcutaneous methotrexate was generally well tolerated; no patients died or had serious infections, malignancies, or major adverse cardiovascular events. Serious adverse events were recorded in three (3%) patients who received methotrexate for the full 52 week treatment period.

Interpretation:
Our findings show a favourable 52 week risk–benefit profile of subcutaneous methotrexate in patients with psoriasis. The route of administration and the intensified dosing schedule should be considered when methotrexate is used in this patient group.

Dear PsoriasisClub friends,

This post will tell about a treatment I have followed in the past year. This is the short version, you can read the long version in my new thread in the Members Journals, called [Group Specific], which will give you an insight over the last/past year.
You can only access the Members Journals, when you are a member, and have more than ten posts, that is obvious.  

Yet Long ago I came in contact with a doctor who prescribed me Psorinovo, which is the Dutch version of  Dimethylfumarate (enteric coated, slow release), and as you perhaps found out, I am a fan of DMF and I published quite some posts on that subject. (Dimethylfumarates and Psoriasis)
The product Psorinovo has been developed by a different doctor than the one who prescribed me, and after a number of years I came into contact with this doctor.
He pointed me to a site of his in which he described the contents of a treatment called auto-vaccination.
This treatment makes it possible to treat all kinds of diseases that have to do with the immune system. The basics of the treatment is already very old, in the time when antibiotics were not yet discovered, it was a normal treatment, for everything where bacteria were involved,  but as this treatment was a very slow one and after the discovery of antibiotics which appeared to be way faster, the Auto-vaccination treatment disappeared out of sight.

This doctor now has enhanced the treatment, made it according to modern standards of medics.

Auto-vaccination is aimed at enhancing the immune system to cope with all kinds of bacterial DNA that we all have floating in our body due to bacterial infections that we all have gone through. Imagine as a specific (but not limited to this) example of being bitten by a tick(nasty animals), which also can release bad bacteria in your body. Your immune system will deal with that but residues of DNA of these bacteria will stay floating around encapsulated by a fatty layer.
When for some reason this dna reaches certain places and looses its fatty layer, it can cause trouble in a great variation as we for instance know of Lyme’s disease.

Now there is in the mean time done quite some scientific research on bacteria related to immune diseases like psoriasis. I am quite sure that Fred somewhere on the site also has a report of such a research but there are more.

So…… It might be that….IF part of the cause of Psoriasis is located in bacteria, that this treatment might help.
I have been thinking about this treatment for three whole years. Reading about it, weighing it, while in the mean time I was using DMF for a very long time.
I hope that I still have to go for a very long time in my life. I did not know how long the DMF would stay working, though I know people who are using it way longer that I do, without problems. Also on several levels DMF seems to be some magic potion, more and more research is being done and industry gets involved, for instance leading to expensive products with DMF.

Let's not divert from the subject
I have been reading the testimonies of people who have followed the Auto-vaccination treatment and finally I also have spoken personally with them.
The Auto-vaccination treatment is harmless. Your blood is being taken in 12 small tubes, which undergo a process that clears the fatty layer from the DNA. This takes a number of weeks. Then the reworked blood can be injected back into your body. The injection is normally at a location close to your lymphatic system. This will see the DNA, conclude that it is not body owned and will start removing it by creating the correct T-cells for it. In other words, you are training your T-cells on recognising this DNA and get rid of it. If in the end of the treatment the T-cells see this DNA, it recognises it and will remove it.
(A really medically educated person probably will tell this differently, but well medics is totally not my profession, I can put a band-aid on someone but that is about it).
Every two weeks, you get an injection, or you self inject.

I decided to go for it.

By now I have had two treatments of 12 injections. And I am not using any medication anymore.

As this is certainly not a common type of treatment, I did not want it to be on the forum, without at least knowing and experiencing more.

On average my P and PsA is not gone, but it lays low, sometimes comes up a little, sometimes is hardly feelable, which is quite different from when I think back to before I used MTX ( ) and DMF, when a 15 minute walk was a painful hell.
Now I still can dance, walk, cycle, etcetera, for several hours.
As I said, it is not gone, I have tiny spots of P under my hair, and certainly the PsA is not fully gone. But…. I do not use medication anymore…

If you would like to read about my adventure, look into the Members Journals for [Group Specific].

This study looked at changing the dose of Bio treatments in psoriasis patients.

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Introduction:
Despite the large routine use of biologic drugs in psoriasis treatment, the majority of studies do not take into consideration dose-adjustment practice in “real life” dermatological setting.

In routine clinical practice the disease management may include a large number of conditions requiring non-standard dosage regimens, including dose-escalation, dose-reduction and/or off-label treatment interruption.

Objective:
The ONDA (Outcome of non-standard dosing regimen in Psoriasis and Psoriatic Arthritis) study aim was to retrospectively analyse dose-adjustment strategies among biologic therapies for psoriasis in dermatological practice during a 3-year period.

Results:
This retrospective, observational, multicentre study was carried out in 350 patients (68% male, 32% female) affected by plaque-type psoriasis (Pso) with a coexistence of psoriatic arthritis in 164 patients (46.9%). At baseline mean PASI score was 14.9 (SD 7.2). Dose-adjustment was demonstrated to be a common practice with 70/350 patients (20%) who needed a dose-variation during the treatment time, in particular a dose-increase in 20/70 patients (28.6%) and a dose-reduction in 50/70 patients (71.4%). Dose-increase was due to inefficacy on Pso parameters in 60% of cases and to inefficacy of PsA parameters in 40% of cases, while dose-reduction (or temporary off-label treatment interruption) was due to prolonged remission in 54% of cases, other reason in 18% of cases, patient choice or request in 14% of cases, occurrence of concomitant event in 12% of cases.

Conclusion:
Dose-adjustment is a common clinical practice, consisting of frequent dose-reduction when a disease prolonged remission is obtained or dose-increase to improve efficacy on Pso and PsA disease parameters.

Just to say Hello  and I have just joined the Forum.  My name is will20 and I suffer with Psoriasis for a very long time. Presently using Biological Drug Stelara, (used this 5 years ago) but have used 2 other Biological Drugs: Humira and Cosentyx. 

Hi all,
I've suffered with Psoriasis since my early teens . I'm 55 this year.
I've been using a 'heavy' but pleasant ointment since centre November 2016 called Sorion. The results have been impressive, to say the least. Plaque coverage has reduced from an itchy 10% of my skin coverage, down to a non - itchy 2%, with no side effects.
I'm the happiest I've ever been, and that annoying winter itchiness has gone, thankfully.
Sorion is readily available, and quite cheap if bought direct from its Indian manufacturer. Google it.
I'll be happy to answer any questions.

A while back my derm diagnosed psoriatic arthritis because I'd had plantar fasciitis and Achilles tendinitis problems, plus carpal tunnel.

I thought these things might be related to my psoriasis but when I read up on p a it doesn't describe my symptoms, they always talk about painful joints and swollen joints.

I'm wondering again about it because recently I've had a bad left shoulder and elbow, left hip and basically feel like I've overdone it in the gym (lol, not likely!) but it's not really my joints, it feels like stretched muscles or ligaments. Finding it hard to find a comfortable position to sleep..

What do you guys think?

Perhaps the Stelara will help..

I've had a patch of psoriasis on my lower leg for several years and it increased in size and got more itchy as time went on. I've googled various natural treatments but didn't actually try any of them until last week. Recently I started using Calamine lotion to ease the itching and it was quite helpful but I had to keep putting more of it on several times a day to keep the itching away. Then I read about coconut oil being effective and experimented a bit with that. Amazingly, I came up with something that really worked which is this: I mixed calamine lotion with coconut oil and rubbed it firmly on the patch and the surrounding skin several times a day and before going to bed. After only 24 hours of doing this the itching was gone and hasn't returned. NO itching! The patch is healing over like normal skin and without the silvery, scaly surface. I'll post here again with a progress report in a few days.

Hi again folks!    Sorry it's been a while since my last post, some of you asked me to update on my cosentyx treatment.

I had my first injection of the four weekly 'loading dose' back on December 5th.   I had the second and third week and my psoriasis was still rampaging away, I .   was bedridden with the whole of my back and sides covered, I am covered all over to some degree but can bear to lay on tummy at moment.   

On the Thursday that first week I was so red hot you could feel the heat a couple of feet away.   I was shaking, shivering, teeth chattering etc I think its called rigors??   Anyhow,  my husband took me to GP, this was just before Christmas and normally she said I would be admitted because she was worried about fluid loss, pain levels, and infection incase it was turning eyrothrodermic.  In the end it was decided I would be better off at home, and was given 2 weeks of a strong antibiotic but told I must go to hospital if things got worse.  I was using cool packs to keep the heat down and sooth things.  It has been truly horrendous with well over 60% body coverage.  

A few weeks on I have restarted my cosentyx, the consultant thinks it was another flare on top because I had to stop the methotrexate before starting the injections.   I have now had my first monthly jab.   We are taking weekly photographs to compare any changes.   I am still housebound but not bedridden, I can wear super soft clothes, but I still can't do much,  I tire so easily and drink an awful lot.   My skin today looks possibly slightly less angry, we are in a routine of using Epiderm or Hydromol ointment (yuk its like spreading on lard!)  which is better than the cream as I don't dry out as quick and my husband can now leave me for three hours while he works.  But when he gets home and I am greased all over again, I scream in pain and want to go to bed to shut the world out.  I find listening to talking books calms me down, and I usually fall asleep then come downstairs a couple hours later.  Its a never ending cycle right now but hopefully things will show improvement soon, 

I've moaned on a lot today so will say bye for now and hope everyone is having a good day.            

Marcia

While I wait for my fumaderm treatment to kick in I'm having issues with the psoriasis on my lower legs. They are red raw and look slightly swollen.

I can handle the redness, but the swelling hasfreaked me out a little. Has anyone else had any swelling with ther psoriasis? It is only mild but I can see it.

Could anyone advise me of what I can expect with my nails?  I'm in sad shape.  I have three toenails left and only one baby fingernail not affected.  

I've lost most completely and in their place are thick plaques.  In time (when this ever does go into remission) will those plaques simple fall off or will the nails grow out and push them off gradually?  The words ugly just don't seem to describe them enough.  

Any tips on getting them smoother.  I find the feel of even emery boards really awful.  I do keep them well treated with the Dovobet and moisturizers but I was wondering there were any other suggestions some of you may have.

May the God of Skin production bless us all with starvation.  Smile

I've never joined a forum before so please forgive my fumbling as I navigate this new experience.  To begin a little about me.  

I retired just about a year ago and by mid spring I finally acknowledged that was something odd about this spot on my lower back that just wouldn't heal.  Family became concerned so by the end of July I give in and went to the local clinic where a very young on-call doctor told me not to worry it wasn't cancer it was just an age spot.  I smiled and thanked him but I figured there was more to this then a cranky age spot so I made an appointment to see one of the regular doctors.  

Meanwhile I noticed a big toe nail had decided to start to lift and curl.  It had been ridiculously hot here in NS so I thought, Dear Lord, I must have some kind of nail fungus... I'm a bit horrified at the thought and I pretty much cleaned and disinfected every spot in my house. I certainly never connected the two problems.  I have a large selection of fungal creams if anyone needs some.  

I finally did get to see the regular doctor and she looks at my back and says "I have no idea what that is"... I blink because I didn't find that particularly helpful.  There is a long pause and I suggest perhaps a biopsy.  She doesn't think it is a good idea to do a biopsy because if it is cancer then a biopsy may make it grow faster, but she will make a request for a dermatologist to see it.  She gives me a script for a steroid cream.  Keep in mind, this is early August of 2016.  A week later I'm told that my appointment with the dermatologist is February of 2017.  I still shake my head at that.  Seriously, this is the God's truth.  If that puppy had of been cancer this would have been a eulogy.  I smile now but at the time I was completely baffled.  

Meanwhile that toenail is quite a site and I have to get what is left of it removed.  The spot on my back has spread like crazy and now there are more on my lower legs and arms.  So back I go and insist on a biopsy which they did do.   A few days later I am told it is psoriasis and that they can get me into a dermatologist by October.  Between August and  my first appointment in October I have them everywhere.  

And now since October and the start of Dovobet and light treatments (twice a week) it has moved to my scalp, ears, forehead but my legs are the worst.  I only have two toenails and two fingernails left.  Most of toes are purple from arthritis along with three of my fingers. The treatments are controlling the scaling and itching most of the time.  In between all of this they discover I have high liver counts and therefore no drugs until they can determine why.  Waiting for liver biopsy and catscans for the out come of that.  

So I guess that is my mess in a nutshell.  Sorry to lay it all out there but I guess I needed to just yell/scream/vent to someone.  That's it for a start.  ... got to rub more stuff on my body.  Good thing I'm retired, gives me lots of time to do that.

This study looked at 3,615 German psoriasis patients using systemic treatment over a 10 year period.

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Introduction:
Inequality between age groups has been demonstrated in the prescription of biologics, yet systematic real-world data about age-related differences in psoriasis care are missing.

Objective:
To investigate disparities in psoriasis characteristics by age groups and to identify potential impact on psoriasis health care.

Patients and Methods:

analysis included 3,615 patients from the German Psoriasis registry PsoBest, which observes adult patients with moderate to severe psoriasis or psoriatic arthritis (PsA) on systemic treatment over a time period of 10 years.

Results:
With 2,376 participants (65.7%), the majority of patients was assigned to the age group 35–64, followed by 776 (21.4%) and 463 (12.8%) for the age groups 18–34 and 65+, respectively. Psoriasis vulgaris was the most frequent form of psoriasis with nearly 90% patients affected. Appearance of psoriasis forms did not differentiate significantly between the age groups except for erythrodermic psoriasis, which was more frequent in the elderly than in patients aged 35–64 (1.9%, p ≤ 0.048). Nail psoriasis appeared significantly more often in patients aged 35–64 (55.5%, p ≤ 0.001) and also showed the highest number of nails involved (6.9 ± 3.3). PsA was less frequent in the age group 18–34 (9.5%, p ≤ 0.001). This group showed the highest affection of head psoriasis (85.8%) compared to the elder age groups (p ≤ 0.001). Biologicals were used significantly less in younger patients (16.2%) compared to the age groups 35-64 (23.9%, p ≤ 0.001) and 65+ (21.8%, p ≤ 0.042).

Conclusion:
Mid-aged patients show higher rates of PsA and nail psoriasis which may explain age dependent disparities in health care including the use of systemic treatment.

I have read this on another website and I thought I would quote it here and add my comments as it seems to make it look as if Fumaderm is a dangerous drug that should be avoided, which certainly is far from the reality.
As a Fumaderm user and very happy with the way it has worked for me for for the last 5 years,  I was rather annoyed to see it dismissed as something not safe to consider.

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An oral prescription drug called Fumaderm, which contains fumaric acid esters, has been used for decades in Europe to treat severe plaque psoriasis.

In the United States, however, the U.S. Food and Drug Administration (FDA) has not approved Fumaderm or any other fumaric acid ester drugs, but that hasn’t stopped some psoriasis patients from obtaining them with potentially serious consequences.

The drug works by inhibiting the immune system’s T cells. Taking it without a doctor’s supervision can lead to dangerously low T cell counts, as well as side effects including gastrointestinal problems, Ryan said.

Another bio in the pipeline for psoriasis patients.

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Aims:
To assess safety, pharmacokinetics (PK) and clinical efficacy of bimekizumab (formerly UCB4940), a novel humanized monoclonal antibody and dual inhibitor of interleukin (IL)-17A and IL-17F, in subjects with mild plaque psoriasis.

Methods:
Randomized, double-blind, first-in-human study of bimekizumab in 39 subjects who received single-dose intravenous bimekizumab (8–640 mg) or placebo (NCT02529956).

Results:
Bimekizumab demonstrated dose-proportional linear PK and was tolerated across the dose range assessed. No subject discontinued due to treatment-emergent adverse events and no severe adverse events were reported. Bimekizumab demonstrated fast onset of clinically-meaningful effects on skin of patients with mild psoriasis as early as Week 2. Maximal improvements (100% or near 100% reductions from baseline) in all measures of disease activity were observed between Weeks 8–12 in subjects receiving 160–640 mg bimekizumab. The duration of effect at doses ≥160 mg was evident up to Weeks 12–20 after a single intravenous dose, dependent on endpoint.

Conclusions:
This is the first study to demonstrate the safety, tolerability and clinical efficacy of a dual IL-17A and IL-17F inhibitor, in subjects with mild psoriasis. Bimekizumab showed fast onset of clinically-meaningful efficacy by Week 2, with a maximal or near-maximal magnitude of response that was maintained up to study Weeks 12–20. These findings support the continued clinical development of bimekizumab for diseases mediated by both IL-17A and IL-17F, including psoriasis.

Hello Everyone,

I've been taking Otezla off and on for about 6-7 months.  Recently I've been getting the nausea side effects and minor headaches.  The headaches I can deal with, but the nausea has been kicking my butt.  Normally I take Pepto or Alka Seltzer to subdue the upset stomach, which some times doesn't really help.  I've tried taking with food as well and same results.  I like the Otezla because it's a lot easier and "safer" than the biologicals.  I've used Enbrel, Humira, PUVA, PUVB, Desonide, Talconex, and other various rx steroid creams.  I've had good clearance with the Otezla, but want to know of any tips any other users have done to help with the nausea (IE: types of foods, when to take first pill, etc.)  I understand everyone has different reactions and the solutions might be different for each individual.  But anyone helpful advice, would be appreciated.

Thanks for your help and time.

Neil