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Sample records for consecutive eczema patients

  1. Testing with fine fragrances in eczema patients

    DEFF Research Database (Denmark)

    Johansen, J D; Frosch, Peter J; Rastogi, Suresh Chandra

    2001-01-01

    The frequencies of contact allergic reactions to 2 fine fragrances were studied by patch testing. Further, a comparison was made of test results before and after evaporation of the solvent. A total of 480 consecutive eczema patients were included, 100 in the Dortmund clinic and 380 in the Gentoft...

  2. Eczema

    Science.gov (United States)

    Eczema is a term for several different types of skin swelling. Eczema is also called dermatitis. Most types cause dry, ... red, and to swell and itch even more. Eczema is not contagious. The cause is not known. ...

  3. Estimating emollient usage in patients with eczema.

    Science.gov (United States)

    Hon, K L E; Ching, G K; Leung, T F; Choi, C Y; Lee, K K C; Ng, P C

    2010-01-01

    Atopic eczema (AE) is characterized by reduced skin hydration (SH) and impaired integrity of the skin. Proper emollient usage is an important facet of AE management and patients are encouraged to use emollients liberally. To evaluate whether the amount of emollient and skin cleanser used correlates with eczema severity, SH or transepidermal water loss (TEWL), and whether liberal usage alters disease severity, SH and TEWL. We studied SH and TEWL at three common measurement sites on the forearm (antecubital flexure, 20 mm below the antecubital flexure, mid-forearm) and determined the SCORing Atopic Dermatitis (SCORAD) score, Nottingham Eczema Severity Score (NESS), Children's Dermatology Life Quality Index (CDLQI) and the amount of emollient and cleanser usage over a 2-week period in consecutive new patients seen at the paediatric skin clinic of a teaching hospital. In total, 48 subjects and 19 controls were recruited. Patients with AE had significantly higher TEWL and lower SH in the studied sites. Emollient and cleanser usage was significantly higher (P = 0.001 and P = 0.041, respectively) in patients with AE than in controls. The amount of emollient usage was correlated with NESS, SCORAD, CDLQI, TEWL and mid-forearm SH. No such correlation was found with cleanser usage. Regardless of SCORAD, prescribing 130 g/m(2)/week of emollient met the requirement of 95.8% of patients, and 73 g/m(2)/week met that of 85.4%; for the cleanser, prescribing 136 g/m(2)/week met the requirement of 91.7% of patients. Although skin dryness and SH were improved, there was no significant improvement in SCORAD or TEWL after 2 weeks. In terms of global acceptability of treatment, three-quarters of patients with AE and controls rated the combination of cream and cleanser as 'good' or 'very good'. Adequate amounts of emollient and bathing cleanser should be prescribed to patients with AE. These amounts can be conveniently estimated based on body surface area instead of the less readily

  4. User evaluation of patient counselling, combining nurse consultation and eHealth in hand eczema

    DEFF Research Database (Denmark)

    Mollerup, Annette; Harboe, Gitte; Johansen, Jeanne D

    2016-01-01

    BACKGROUND AND OBJECTIVE: This study reports the findings from a user evaluation of a counselling programme for hand eczema patients in which face-to-face encounters were supplemented with user access to a new website. PATIENTS AND METHODS: Patients treated for hand eczema in two different settings...... in clinical severity of hand eczema were found. The interviewees were generally satisfied with the counselling and the website. The strict log-on procedures were considered to be an obstacle to using the site. The consecutive inclusion of participants was considered to be a barrier to engagement...

  5. Eczema

    Science.gov (United States)

    ... could be a cause of the eczema . Sometimes allergies, such as ones to food , pets , pollens , or dust mites (in bedding), can trigger the rash or make it worse. If your child's eczema is caused by an allergy, avoid the trigger, if possible. Ask your child's ...

  6. Eczema

    Science.gov (United States)

    ... eczema and can't wear certain types of makeup, your dermatologist may be able to recommend some brands that are less likely to irritate your skin. Your self-esteem doesn't have to suffer just because you ...

  7. Factors associated with combined hand and foot eczema Associations between foot and hand eczema

    DEFF Research Database (Denmark)

    Agner, T; Aalto-Korte, K; Andersen, K E;

    2017-01-01

    BACKGROUND: As for hand eczema, the etiology of foot eczema is multifactorial, and not very well understood. The aim of the present study was to identify factors associated with foot eczema in a cohort of hand eczema patients being classified into different subgroups. METHODS: Associations between...... foot and hand eczema was studied in a cross sectional design in a cohort of hand eczema patients. Consecutive patients were recruited from 9 different European Centres during the period October 2011 - September 2012. Data on demographic factors, presence of foot eczema, hand eczema duration...... and severity, and whether the hand eczema was work-related or not were available, as well as patch-test results. RESULTS: Of a total of 427 hand eczema patients identified, information on foot eczema was available in 419 patients who were included in the present study. 125 patients (29.8 %) had concomitant...

  8. Topical therapy in patients with microbial eczema

    Directory of Open Access Journals (Sweden)

    Bakulev A.L.

    2012-06-01

    Full Text Available

    The study aimed to display that clinical and microbiologic research of patients with microbial eczema. The study revealed that the usage of co — formulated medication Supirocin — B was rather effcient, it promotes statistically authentic reduction of eczematous foci with pathogenic St.aureus and Str.spp. Besides, it has strong anti — infammatory effect and reduces eczematous process.

  9. Eczema

    Science.gov (United States)

    2011-01-01

    Introduction Eczema, as defined by the World Allergy Organization (WAO) revised nomenclature in 2003, affects 15% to 20% of school children and 2% to 5% of adults worldwide. About 50% of people with eczema demonstrate atopy, with specific immunoglobulin E responses to allergens. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of topical medical treatments, and dietary interventions in adults and children with established eczema? What are the effects of breastfeeding, reducing allergens, or dietary interventions for primary prevention of eczema in predisposed infants? We searched: Medline, Embase, The Cochrane Library, and other important databases up to May 2009 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 54 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: breastfeeding, controlling house dust mites, corticosteroids, dietary exclusion of eggs or cow's milk, elementary diets, emollients, essential fatty oils, few-foods diet, multivitamins, pimecrolimus, probiotics, pyridoxine, reducing maternal dietary allergens, tacrolimus, vitamin E, and zinc supplements. PMID:21609512

  10. Hand eczema: Correlation of morphologic patterns, atopy, contact sensitization and disease severity

    OpenAIRE

    2012-01-01

    Background: Hand eczema is a common distressing condition aggravated by a number of endogenous and exogenous factors. Various morphological forms of hand eczema have been described, but categorization into one of them is not always possible. Aims: To study the morphological patterns of hand eczema, relationship of atopy with hand eczema, and the implications of contact sensitization with respect to severity and diagnosis of hand eczema. Methods: Hundred consecutive patients of hand eczema att...

  11. Quality of life among patients with hand eczema in Iran

    Directory of Open Access Journals (Sweden)

    Hossein Safizadeh

    2013-09-01

    Full Text Available Background — Hand eczema is among the most common dermatological diseases with a chronic course. It has undesirable psychological, social and occupational outcomes affecting patient’s quality of life. Objective — The aim of the present study was to study the quality of life of patients with hand eczema in an Iranian population. Methods and Results — This cross-sectional study was performed on 196 patients with hand eczema through clinical exam and filling specific questionnaires. Hand Eczema Severity Index (HECSI and Dermatology Life Quality Index (DLQI were used for studying the disease severity and quality of life, respectively. Mean±SD of HECSI and DLQI scores were 57.05±48.85 and 14.80±5.79 respectively. In 94% of cases, hand eczema had significant effect on patients’ quality of life. Based on DLQI, symptoms, feelings and personal relationships were the most affected aspects. There was a significant positive relationship between DLQI and HECSI scores (p<0.05. No significant difference was found in the quality of life based on age, sex and the disease duration. Conclusions — Since hand eczema significantly affects the quality of life, beside medical treatments, attention to psycho-social and occupational outcomes of the disease is highly recommended.

  12. Immunomodulating effect of laser therapy in patients with microbial eczema

    Science.gov (United States)

    Dudchenko, Mycola O.; Denisenko, Olga I.

    1999-11-01

    While examining 90 patients suffering the microbial eczema (ME), we revealed disorders of the immune system in the majority of them (3/4). It was established that the inclusion of percutaneous laser irradiation of the blood in a course of multimodality treatment of patients with ME caused an immunomodulating action which resulted in an improved ME course in these patients.

  13. Fragrance allergy in patients with hand eczema - a clinical study

    DEFF Research Database (Denmark)

    Heydorn, Siri; Johansen, Jeanne Duus; Andersen, Klaus E

    2003-01-01

    Fragrance allergy and hand eczema are both common among dermatological patients. Fragrance mix (FM) and its constituents have a recognized relevance to exposure to fine fragrances and cosmetic products. Based on extensive chemical analysis and database search, a new selection of fragrances was es...

  14. Contact allergens in shoe leather among patients with foot eczema

    NARCIS (Netherlands)

    van Coevorden, AM; Coenraads, PJ; Pas, HH; van der Valk, PGM

    2002-01-01

    Some patients with relapsing foot eczema and a shoe leather allergy, who fail to show positive results with standard series and shoe wear screening tray patch testing, do not respond to the use of hypoallergenic shoe leather. We assume that relevant allergens are present in hypoallergenic shoe leath

  15. Fragrance allergy in patients with hand eczema - a clinical study

    DEFF Research Database (Denmark)

    Heydorn, Siri; Johansen, Jeanne Duus; Andersen, Klaus E;

    2003-01-01

    Fragrance allergy and hand eczema are both common among dermatological patients. Fragrance mix (FM) and its constituents have a recognized relevance to exposure to fine fragrances and cosmetic products. Based on extensive chemical analysis and database search, a new selection of fragrances was es...

  16. Patch test results of hand eczema patients : relation to clinical types

    NARCIS (Netherlands)

    Boonstra, M B; Christoffers, W A; Coenraads, P J; Schuttelaar, M L A

    2015-01-01

    BACKGROUND: Allergic contact dermatitis is a well-known cause of hand eczema, although the influence of contact allergens on different clinical types of hand eczema remains still unclear. OBJECTIVE: To identify most common positive tested allergens among hand eczema patients and to define the relati

  17. Patch test results of hand eczema patients : relation to clinical types

    NARCIS (Netherlands)

    Boonstra, M B; Christoffers, W A; Coenraads, P J; Schuttelaar, M L A

    BACKGROUND: Allergic contact dermatitis is a well-known cause of hand eczema, although the influence of contact allergens on different clinical types of hand eczema remains still unclear. OBJECTIVE: To identify most common positive tested allergens among hand eczema patients and to define the

  18. Long-term results of radiotherapy in patients with chronic palmo-plantar eczema or psoriasis

    Energy Technology Data Exchange (ETDEWEB)

    Sumila, M.; Notter, M.; Bodis, S.; Gruber, G. [State Hospital, Aarau (Switzerland). Inst. of Radiation Oncology; Itin, P. [State Hospital, Aarau (Switzerland). Dept. of Dermatology

    2008-04-15

    Background and Purpose: Radiotherapy (RT) is well accepted for therapy-refractory palmo-plantar eczema or psoriasis, despite of lacking evidence regarding beneficial long term effects. Furthermore, the optimal irradiation dose is unknown. We evaluated the outcome of RT with two different RT single/total dose (SD/TD) treatment policies. Patients and Methods: 28 consecutive patients with therapy-refractory eczema (n = 22) or psoriasis (n = 6) of palms and/or soles were irradiated twice a week either with a D{sub max} SD of 1 Gy (6/98-5/03; median TD: 12 Gy) or 0.5 Gy (6/03-7/04; median TD: 5 Gy). Median age was 52 years (27-71), median follow-up 20 months (4-76). Totally 88 regions were treated, 49 with 1 Gy, 39 with 0.5 Gy SD. Eight different symptoms were scored from 0 (absent) -3 (severe), giving a possible sum score of 0-24. Patients' rating of RT result was also documented (worse/stable/better/complete remission). Results: The sum score was 15 (6-23) before RT, 2 (0-16) at the end of RT, and 1 (0-21) at last follow-up, respectively. The improvement was highly significant in both treatment regimens. Better or complete remission by the patients were reported in 44 and 39 (= 83 out of 88) localisations, that was often stable during the follow-up. 5 (6%) regions in 3 (11%) patients didn't benefit from RT. Conclusion: RT reveals excellent results in palmo-plantar eczema or psoriasis. We recommend a SD of 0.5 Gy twice a week up to a TD of 4-5 Gy. (orig.)

  19. What do patients with occupational hand eczema know about skin care?

    DEFF Research Database (Denmark)

    Fisker, Maja H; Ebbehøj, Niels E; Jungersted, Jakob M

    2013-01-01

    The aim of the present study was to examine the knowledge of skin care and treatment of hand eczema (HE) in a sample of patients with newly reported occupational HE.......The aim of the present study was to examine the knowledge of skin care and treatment of hand eczema (HE) in a sample of patients with newly reported occupational HE....

  20. Content and reactivity to product perfumes in fragrance mix positive and negative eczema patients. A study of perfumes used in toiletries and skin-care products

    DEFF Research Database (Denmark)

    Johansen, J D; Rastogi, S C; Andersen, Klaus Ejner;

    1997-01-01

    The aim of the study was to investigate the elicitation potential of perfumes from 17 commonly sold lower-price cosmetic products. 8 of the perfumes were from stay-on cosmetics and 9 were from wash-off cosmetics. Each perfume was tested in 500 consecutive eczema patients, who also were tested wit...

  1. Content and reactivity to product perfumes in fragrance mix positive and negative eczema patients. A study of perfumes used in toiletries and skin-care products

    DEFF Research Database (Denmark)

    Johansen, J D; Rastogi, S C; Andersen, Klaus Ejner

    1997-01-01

    The aim of the study was to investigate the elicitation potential of perfumes from 17 commonly sold lower-price cosmetic products. 8 of the perfumes were from stay-on cosmetics and 9 were from wash-off cosmetics. Each perfume was tested in 500 consecutive eczema patients, who also were tested wit...

  2. Contact sensitisation in hand eczema patients-relation to subdiagnosis, severity and quality of life: a multi-centre study

    DEFF Research Database (Denmark)

    Agner, Tove; Andersen, Klaus Ejner; Brandao, Francisco M;

    2009-01-01

    BACKGROUND: Contact sensitisation has been identified as a factor associated with poor prognosis for patients with hand eczema. OBJECTIVES: To study implications of contact sensitisation with respect to severity, quality of life (QoL) and subdiagnosis of hand eczema. METHODS: The study...... was performed as a multi-centre, cross-sectional study from 10 European clinics. All patients were patch tested, and severity of hand eczema assessed by Hand Eczema Severity Index. A multi-variate analysis was performed to explore which factors influenced severity, QoL and sick leave. RESULTS: A total 416...... eczema and presence of contact sensitisation were independent risk factors for increased severity as measured by Hand Eczema Severity Index. Furthermore, the severity of hand eczema increased by the number of contact sensitisations detected (P = 0.023). High age and personal history of atopic eczema were...

  3. The first clinical experience of nanostructured propolis usage in treatment of patients with microbial eczema

    Directory of Open Access Journals (Sweden)

    Schnaider D.A.

    2016-09-01

    Full Text Available One of the most common forms of eczema is microbial eczema constituting 12-27% of all the cases of eczema. Application of nanotechnology in the field of medicine, including dermatology and cosmetology continues to increase. An example of innovation, demonstrating the results of research within the chemical technology and practical dermatology and cosmetology is a cosmetic product based on nanostructured systems "core — shell", which is an aqueous dispersion of nanoscale flavonoid "cores", derived from natural propolis which are stabilized by polyelectrolyte "shell". The purpose of this work is to conduct primary research on cosmetic product "Mellisol" on the basis of composite structures "core — shell" stabilized by polyelectrolyte membrane, for its application in the complex therapy in the treatment of microbial eczema. Description of these cases under clinical observation shows high efficacy and safety of cosmetic product "Mellisol" in the treatment of patients with microbial eczema in its acute phase.

  4. Hand eczema.

    Science.gov (United States)

    Agarwal, Uma Shankar; Besarwal, Raj Kumar; Gupta, Rahul; Agarwal, Puneet; Napalia, Sheetal

    2014-05-01

    Hand eczema is often a chronic, multifactorial disease. It is usually related to occupational or routine household activities. Exact etiology of the disease is difficult to determine. It may become severe enough and disabling to many of patients in course of time. An estimated 2-10% of population is likely to develop hand eczema at some point of time during life. It appears to be the most common occupational skin disease, comprising 9-35% of all occupational diseases and up to 80% or more of all occupational contact dermatitis. So, it becomes important to find the exact etiology and classification of the disease and to use the appropriate preventive and treatment measures. Despite its importance in the dermatological practice, very few Indian studies have been done till date to investigate the epidemiological trends, etiology, and treatment options for hand eczema. In this review, we tried to find the etiology, epidemiology, and available treatment modalities for chronic hand eczema patients.

  5. Contact sensitisation in hand eczema patients-relation to subdiagnosis, severity and quality of life: a multi-centre study

    DEFF Research Database (Denmark)

    Agner, T.; Andersen, K.E.; Brandao, F.M.

    2009-01-01

    Background Contact sensitisation has been identified as a factor associated with poor prognosis for patients with hand eczema. Objectives To study implications of contact sensitisation with respect to severity, quality of life (QoL) and subdiagnosis of hand eczema. Methods The study was performed...... as a multi-centre, cross-sectional study from 10 European clinics. All patients were patch tested, and severity of hand eczema assessed by Hand Eczema Severity Index. A multi-variate analysis was performed to explore which factors influenced severity, QoL and sick leave. Results A total 416 patients were...... and presence of contact sensitisation were independent risk factors for increased severity as measured by Hand Eczema Severity Index. Furthermore, the severity of hand eczema increased by the number of contact sensitisations detected (P = 0.023). High age and personal history of atopic eczema were independent...

  6. Stratum corneum lipids, skin barrier function and filaggrin mutations in patients with atopic eczema

    National Research Council Canada - National Science Library

    Jungersted, J. M; Scheer, H; Mempel, M; Baurecht, H; Cifuentes, L; Hogh, J. K; Hellgren, L. I; Jemec, G. B. E; Agner, T; Weidinger, S

    2010-01-01

    ..., Høgh JK, Hellgren LI, Jemec GBE, Agner T, Weidinger S. Stratum corneum lipids, skin barrier function and filaggrin mutations in patients with atopic eczema. Allergy 2010; 65: 911-918. Background...

  7. [The role of various Candida species in oral candidiasis etiology in psoriasis and eczema patients].

    Science.gov (United States)

    Sakharuk, N A

    2013-01-01

    Among the factors, contributing to the development of candidiasis in the oral cavity, eczema and psoriasis have great value. The most common type of agent which causes oral candidiasis is fungi C. albicans, but the role of non-albicans species is also sufficient. In order to identify candidiasis, candidiasis carriage and species identification of the causative agent, using clinical and laboratory methods have been examined 222 persons with psoriasis, 110 - with eczema and 93 persons became the control group. Among patients with skin diseases (psoriasis, eczema) incidence of oral candidiasis was significantly higher compared with the control group (pcandidiasis in all investigated groups after C. albicans were C. krusei and C. parapsilosis.

  8. Quality of life in patients with hand eczema as health promotion: a case control study.

    Science.gov (United States)

    Ghaderi, Reza; Saadatjoo, Alireza

    2014-01-01

    Health promotion has been defined by the World Health Organization's (WHO) 2005 Bangkok Charter for Health Promotion as "the process of enabling people to increase control over their health and its determinants, and thereby improve their health". One of the most important determinants of health is quality of life. Hand eczema is a common skin disease that can adversely affect the quality of life of patients. The aim of this study was to determine the quality of life in patients with hand eczema. This case-control study was performed on 70 patients with hand eczema and 70 healthy controls. All the patients filled out two questionnaires: Short Form 36 (SF-36) and Dermatology Life Quality index (DLQI). The data were analyzed using the statistical software package for social sciences (SPSS). The mean score score of quality of life in dimensions of physical functioning, vitality, and general health in the SF-36 was lower compared to the control group. The mean score in DLQI in patients with hand eczema was 8.68. There was a significant negative correlation between the scores of different dimensions of QOL obtained in the two questionnaires (SF36 and DLQI). The study demonstrated that the quality of life in patients with hand eczema was lower than that of controls. It seems advisable that psychiatric consultations or psychotherapy be included in the treatment of chronic hand eczema.

  9. [Quantified determination of dermographism in patients with atopic eczema].

    Science.gov (United States)

    Schönberger, A; Langenstein, B; Heyer, G; Hornstein, O P

    1988-02-01

    The usual method of checking dermatographism (D), which is typically white in atopic eczema (AE), allows only a qualitative rating. To allow reproducible quantification of D we have developed an easily used instrument, called a Dermographometer. This can be fitted with one to three blunt tapered metal bars of different weights applying a constant stretching pressure over the whole skin areas to be examined or different pressures at isolated points. We used this device to study D in 27 patients with AE and in 20 healthy controls. Of the 27 patients, 21 had white D, 2, red D, and 4, none at each pressure applied. In 18 of the controls D was red. In addition, the two groups differed significantly in the time to onset and the duration of the D elicited, which was much longer in patients with AE. Simultaneous and constant application of distinct grades of pressure for quantitative dermatographometry is a method that can reliably be used for the study of inter- and intraindividual variation in vascular reactivity in the course of various dermatoses, especially.

  10. Sorbitan sesquioleate; a rare cause of contact allergy in consecutively patch tested dermatitis patients

    DEFF Research Database (Denmark)

    Bennike, Niels Højsager; Johansen, Jeanne Duus

    2016-01-01

    BACKGROUND: Sorbitan sesquioleate (SSO) has been added to fragrance mix I (FM I) as an emulsifier since the 1990s. Being a contact allergen itself, SSO has the potential to cause false-positive reactions to FM I. Recent results obtained with selected FM I-positive patients have shown that 5% have...... concomitant positive reactions to SSO. OBJECTIVES: To investigate the 5-year prevalence of contact allergy to SSO and evaluate the importance of SSO allergy when patch test results for FM I are interpreted. METHODS: This was a retrospective database study of consecutively patch tested eczema patients (n = 4 6...... 3 7) from 2010 to 2014. All patients were tested with our baseline series including FM I and SSO 20% in pet. RESULTS: Sensitization to SSO was identified in 9 (0.2%) patients. The proportion of FM I-positive patients with concomitant positive reactions to SSO was 1.4%. CONCLUSIONS: SSO is a rare...

  11. Exposure to selected fragrance materials. A case study of fragrance-mix-positive eczema patients

    DEFF Research Database (Denmark)

    Johansen, J D; Rastogi, Suresh Chandra; Menné, T

    1996-01-01

    The aim of the present study was to assess exposure to constituents of the fragrance mix from cosmetic products used by fragrance-mix-positive eczema patients. 23 products, which had either given a positive patch and/or use test in a total of 11 fragrance-mix-positive patients, were analyzed....... In all cases, the use of these cosmetics completely or partly explained present or past episodes of eczema. Between 1 to 6 constituents of the fragrance mix were found in 22 out of 23 products. The cosmetics of all the patients sensitive to hydroxycitronellal, eugenol, cinnamic alcohol and alpha....... It is concluded that exposure to constituents of the fragrance mix is common in fragrance-allergic patients with cosmetic eczema, and that the fragrance mix is a good reflection of actual exposure....

  12. Serum levels of Th1/Th2 cytokines in aged patients and their correlation with eczema development and clinical manifestation

    Institute of Scientific and Technical Information of China (English)

    Wei-Gang Wang; Feng-Lin Hou; Xiu-Ming Zhang; Shi-Wu Ma; Jin-Jun Chen

    2016-01-01

    Objective:To investigate variations of Th1/Th2 cytokine levels, as well as their correlation with eczema development and clinical manifestation in aged patients.Methods: A total of 92 patients (above 60 years old) with eczema diagnosed by the outpatient department of dermatology and venerology of our hospital were included as the eczema group, while 60 aged patients without eczema as the healthy group. Patients' serum levels of Th1/Th2 cytokines were examined for inter-group comparison and stratified analysis as per clinical manifestation. Results:Serum levels of interleukin (IL)-2, IL-4, IL-10, IL-12, tumor necrosis factor (TNF)-α and interferon (IFN)-γ were all significantly higher in patients of the eczema group than the healthy group. Acute stage levels of IL-2, IL-4, IL-10 and IFN-γ were significantly higher in patients of the eczema group than the healthy group. There was no significant difference in the levels of IL-12 and TNF-α between patients of the acute stage and those of the chronic stage. And no significant difference existed in the levels of IL-2, IL-4, IL-10, IL-12, TNF-α and IFN-γ between generalized and localized eczema patients.Conclusion:Compared with the healthy population, Th1/Th2 cytokine levels are significantly different in eczema patients, especially those in the acute stage.

  13. Hand eczema and related factors in patients referred to Razi Hospital, Spring, 1376

    Directory of Open Access Journals (Sweden)

    Ghaninezhad Ahary H

    1998-08-01

    Full Text Available Introduction: Hand eczema is one of the most common causes of disabiliting dermatoses. Objective: Our purpose was to determine the frequency of hand eczema in out patients seen in Razi hospital (university medical center. Design: Of 3754 patients with skin problems, 206 were investigated for hand eczema and the study was carried out with regard to age, sex, occupation, exposure to chemical and physical irritants and predispositional factors. Results: The prevalence of hand eczema was 5.48%. The mean age was 30.8 years. The female: male ratio was 1.6. The highest number of patients were in the occupational group with exposure to reegents and water (we couldn't do patch test because it was not available. The most common complaint was itching (85.5% and the fingers were the predominant affected sites. Conclusion: The major cause of hand eczema in contact dermatitis (Irritant and Allergic and patch testing in necessary to determine the allergic agent, that can be helpful in allergic contact dermatitis (ACD but are sometimes discouraged because of high false-positive rate and also in many instances, simultaneous exposure to irritant factors plays an essential role in the development of ACD.

  14. Hand eczema

    Directory of Open Access Journals (Sweden)

    Uma Shankar Agarwal

    2014-01-01

    Full Text Available Hand eczema is often a chronic, multifactorial disease. It is usually related to occupational or routine household activities. Exact etiology of the disease is difficult to determine. It may become severe enough and disabling to many of patients in course of time. An estimated 2-10% of population is likely to develop hand eczema at some point of time during life. It appears to be the most common occupational skin disease, comprising 9-35% of all occupational diseases and up to 80% or more of all occupational contact dermatitis. So, it becomes important to find the exact etiology and classification of the disease and to use the appropriate preventive and treatment measures. Despite its importance in the dermatological practice, very few Indian studies have been done till date to investigate the epidemiological trends, etiology, and treatment options for hand eczema. In this review, we tried to find the etiology, epidemiology, and available treatment modalities for chronic hand eczema patients.

  15. The effectiveness of integrated care for patients with hand eczema: Results of a randomized, controlled trial

    NARCIS (Netherlands)

    Gils, R.F. van; Boot, C.R.L.; Knol, D.L.; Rustemeyer, T.; Mechelen, W. van; Valk, P.G.M. van der; Anema, J.R.

    2012-01-01

    Objectives. To evaluate the effectiveness of integrated, multidisciplinary care as compared with usual care for patients with moderate to severe, chronic hand eczema after 26 weeks of follow-up. Background. This study was designed as a randomized, controlled trial. Methods. Patients who visited one

  16. Assessment of severity of hand eczema : discrepancies between patient- and physician-rated scores

    NARCIS (Netherlands)

    van Coevorden, A. M.; van Sonderen, E.; Bouma, J.; Coenraads, P. J.

    2006-01-01

    Background In clinical practice or trials on hand eczema the severity of this disease can be 'measured' in different ways: by means of a physician-rated clinical severity score, a patient-rated clinical severity score or by an indicator of the burden of disease. We assume that the patient-rated seve

  17. The effectiveness of integrated care for patients with hand eczema: Results of a randomized, controlled trial

    NARCIS (Netherlands)

    Gils, R.F. van; Boot, C.R.L.; Knol, D.L.; Rustemeyer, T.; Mechelen, W. van; Valk, P.G.M. van der; Anema, J.R.

    2012-01-01

    Objectives. To evaluate the effectiveness of integrated, multidisciplinary care as compared with usual care for patients with moderate to severe, chronic hand eczema after 26 weeks of follow-up. Background. This study was designed as a randomized, controlled trial. Methods. Patients who visited one

  18. Sex and the skin: a qualitative study of patients with acne, psoriasis and atopic eczema.

    Science.gov (United States)

    Magin, Parker; Heading, Gaynor; Adams, Jon; Pond, Dimity

    2010-08-01

    Quantitative questionnaire-based research has suggested a considerable effect of skin disease on the sexual life of sufferers. In this study, we explored the effects of acne, psoriasis and atopic eczema upon sexual functioning and sexual relationships in the context of a wider exploration of the psychological sequelae of these diseases. We employed a qualitative methodology employing in-depth semi-structured interviews and involving thematic analysis and constant comparison. Participants were patients with currently active acne, psoriasis or atopic eczema. Purposive sampling aimed to obtain a sample reflecting a wide range of participant characteristics including skin disease severity, age, sex, and care by general practitioner or dermatologist. Sixty-two semi-structured interviews were conducted. Acne had adverse effects on participants' self-perceived sexual attractiveness and self-confidence, as did psoriasis and eczema. But psoriasis and eczema also had marked effects on sexual well-being and on capacity for intimacy. These were related to issues of self-esteem and sexual self-image and were often pervasive, resulting in marked behavioural avoidance of intimate situations and continuing effects on sexual well-being even in long-established sexual relationships. Effects of psoriasis and eczema on sexual well-being and sexual relationships were mediated more by appearance and texture of non-genital skin than by involvement of genital skin. We conclude that, while recognising the distressing effects of acne on self-perceived sexual attractiveness, clinicians should be especially aware of the capacity of psoriasis and eczema to profoundly affect patients' psychological and sexual well-being.

  19. Allergens associated with severe symptoms of hand eczema and a poor prognosis

    DEFF Research Database (Denmark)

    Hald, Marianne; Agner, Tove; Blands, Jette

    2009-01-01

    BACKGROUND: Contact allergy is frequent among persons with hand eczema and may be associated with a poor prognosis. OBJECTIVES: To identify allergens associated with the most severe initial clinical symptoms and the worst prognosis in a cohort of hand eczema patients followed for 6 months. METHODS......: The study population comprised 799 consecutive hand eczema patients enrolled during January 2006-February 2007. All patients were patch tested with the European baseline series. Severity assessment of the hand eczema was performed initially and at the 6-month follow-up using a validated scoring system...... (HECSI). With logistic regression analyses, associations of severe hand eczema or a poor prognosis with 15 individual allergens were analysed and adjusted for by sex, age, atopic dermatitis and other allergens. RESULTS: At baseline, greater severity of hand eczema was associated with a positive patch...

  20. Eczema, Atopic Dermatitis, or Atopic Eczema

    DEFF Research Database (Denmark)

    Xu, Shuai; Thyssen, Jacob P; Paller, Amy S

    2017-01-01

    BACKGROUND: The lack of standardized nomenclature for atopic dermatitis (AD) creates challenges for scientific communication, patient education, and advocacy. OBJECTIVE: We sought to determine the relative popularity of the terms eczema, AD, and atopic eczema (AE) using global search engine volumes....... METHODS: A retrospective analysis of average monthly search volumes from 2014 to 2016 of Google, Bing/Yahoo, and Baidu was performed for eczema, AD, and AE in English and 37 other languages. Google Trends was used to determine the relative search popularity of each term from 2006 to 2016 in English......% for AE. Search popularity for eczema increased from 2006 to 2016 but remained stable for AD and AE. CONCLUSIONS: Given the ambiguity of the term eczema, we recommend the universal use of the next most popular term, AD....

  1. HAND ECZEMA AND ITS IMPACT ON WELLBEING AND QUALITY OF LIFE OF PATIENTS

    Directory of Open Access Journals (Sweden)

    Filka Georgieva

    2017-03-01

    Full Text Available Hand eczema (HE is a common skin condition with a chronic course. Both genetics and contact allergens triggers this form of eczema. It often affects people who work in cleaning, catering, hairdressing, healthcare and mechanical jobs where they may come into contact with chemicals or other irritants. The aim of the study is to assess the impact of hand eczema on quality of life (QoL. Material and methods: The presented study includes 78 out-patients diagnosed with HE. Demographic data and disease-related characteristics were collected. For the evaluation of QoL Dermatological Life Quality Index (DLQI questionnaire was applied. Disease severity was assessed by hand eczema severity index (HECSI score. Result and discussion: HE is more common in female 67, 94% than in male 32, 06%. The mean age of the patients was 34.14±12.16 years with range from 16 years to 52 years. The total DLQI score reported by the patients with hand eczema is 10.3±4.19 (median 11.00; IQR 4.00-26.00. Patients’ scores were high for all questions (p<0,001 with the exception of Q4 (cloths and Q10 (treatment. High scores was for Q1 (feelings, Q2 (embarrassment, Q3 (daily work, Q8 (relationship and Q9 (sexual. The highest scores was for Q7 (job. Conclusion: All the reported and analyzed results indicate that HE has a negative impact on all the QoL-domains for majority of patients (p<0.001.

  2. Hand eczema classification

    DEFF Research Database (Denmark)

    Diepgen, T L; Andersen, Klaus Ejner; Brandao, F M;

    2008-01-01

    Summary Background Hand eczema is a long-lasting disease with a high prevalence in the background population. The disease has severe, negative effects on quality of life and sometimes on social status. Epidemiological studies have identified risk factors for onset and prognosis, but treatment...... of the disease is rarely evidence based, and a classification system for different subdiagnoses of hand eczema is not agreed upon. Randomized controlled trials investigating the treatment of hand eczema are called for. For this, as well as for clinical purposes, a generally accepted classification system...... for hand eczema is needed. Objectives The present study attempts to characterize subdiagnoses of hand eczema with respect to basic demographics, medical history and morphology. Methods Clinical data from 416 patients with hand eczema from 10 European patch test clinics were assessed. Results...

  3. Hand eczema: Correlation of morphologic patterns, atopy, contact sensitization and disease severity

    Directory of Open Access Journals (Sweden)

    Sanjeev Handa

    2012-01-01

    Full Text Available Background: Hand eczema is a common distressing condition aggravated by a number of endogenous and exogenous factors. Various morphological forms of hand eczema have been described, but categorization into one of them is not always possible. Aims: To study the morphological patterns of hand eczema, relationship of atopy with hand eczema, and the implications of contact sensitization with respect to severity and diagnosis of hand eczema. Methods: Hundred consecutive patients of hand eczema attending the contact dermatitis clinic of the institute were recruited over a two year period from 2004-05. Objective assessment was done using hand eczema severity index (HECSI and all the patients were patch tested using Indian standard series. Results: Unspecified type of hand eczema with no definite morphologic picture was seen in 62% followed by pompholyx in 14%. Hand eczema severity was not found to be statistically associated with age, sex, and atopic status of the patient. Positive patch test to one or more allergen was present in 65% of patients. The most common allergens were potassium dichromate (25%, fragrance mix (16%, nickel sulphate (14%, and PPD (13%. There was no significant correlation between patch test positivity and hand eczema severity or atopic status of the patient. Among the morphological patterns pompholyx was strongly associated with an atopic status (P=0.004. Conclusions: Hand eczema was seen twice more commonly in men. Atopic and non-atopic patients of hand eczema had no difference in the severity of disease. Contact sensitivity to different allergens did not correlate with increased eczema severity.

  4. Food Allergies and Eczema.

    Science.gov (United States)

    Santiago, Sabrina

    2015-07-01

    Eczema is one of the most common skin conditions of childhood. Patients with eczema suffer in a chronic cycle of itch, scratch, and inflammation. For children with severe eczema, constant itching and scratching can have many consequences including skin infections, behavioral issues, and sleep problems. Parents often find themselves searching for a trigger for their child's eczema flare, and after they have switched detergents, applied a thick moisturizer and topical steroids, and removed all wool clothing from their child's wardrobe, they wonder, "Could food allergies be playing a role?"

  5. Features of the autonomic nervous system in elderly patients with paratraumatic eczema with concomitant varicosis and arterial hypertension

    Directory of Open Access Journals (Sweden)

    Ahmad Mohammadamin Ahmad Baninaser

    2016-01-01

    Full Text Available Relevance. In elderly and senile age there are changes in the neuroendocrine regulation in the body. Aim. In order to determine the status of cardiac activity autonomic regulation in elderly and old age patients with paratraumatic eczema 25 patients with paratraumatic eczema on the background of varicose symptom complex and hypertension aged 60-74 years, 25 patients with paratraumatic eczema on the background of varicose symptom. complex and hypertension aged 75-89 years, 15 patients with paratraumatic eczema on the background of varicose veins, but no concomitant hypertension and 15 patients aged 20-35 years were studied. Methods and results. Significant decrease in HRV fluctuations has been established, especially in the high frequency HF, describing parasympathetic influence on the heart. Statistically significant difference (p<0.05 among patients with varicose eczema on the background of hypertension was established as compared with older patients (60-74 years and patients without hypertension: 311.61±95 ms² (р<0.001, 544.7±131 ms² (р<0.01 and 662.9±127 ms² (р<0.01, respectively. Conclusion. These data indicate that the state of cardiac autonomic regulation of patients with paratraumatic eczema directly correlates with the age and the presence of comorbidity (chronic venous failure and hypertension.

  6. Reconstruction of alveolar defects in patients with cleft lip and palate - 111 consecutive patients

    DEFF Research Database (Denmark)

    Andersen, Kristian

    2012-01-01

    Reconstruction of alveolar defects in patients with cleft lip and palate - 111 consecutive patients......Reconstruction of alveolar defects in patients with cleft lip and palate - 111 consecutive patients...

  7. Classification of hand eczema

    DEFF Research Database (Denmark)

    Agner, T; Aalto-Korte, K; Andersen, K E;

    2015-01-01

    BACKGROUND: Classification of hand eczema (HE) is mandatory in epidemiological and clinical studies, and also important in clinical work. OBJECTIVES: The aim was to test a recently proposed classification system of HE in clinical practice in a prospective multicentre study. METHODS: Patients were...... HE, protein contact dermatitis/contact urticaria, hyperkeratotic endogenous eczema and vesicular endogenous eczema, respectively. An additional diagnosis was given if symptoms indicated that factors additional to the main diagnosis were of importance for the disease. RESULTS: Four hundred and twenty......%) could not be classified. 38% had one additional diagnosis and 26% had two or more additional diagnoses. Eczema on feet was found in 30% of the patients, statistically significantly more frequently associated with hyperkeratotic and vesicular endogenous eczema. CONCLUSION: We find that the classification...

  8. Dyshidrotic eczema

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/000832.htm Dyshidrotic eczema To use the sharing features on this page, please enable JavaScript. Dyshidrotic eczema is a condition in which small blisters develop ...

  9. Cost-of-illness analysis of patients with chronic hand eczema in routine care in Germany: focus on the impact of occupational disease.

    Science.gov (United States)

    Diepgen, Thomas L; Purwins, Sandra; Posthumus, Jan; Kuessner, Daniel; John, Swen M; Augustin, Matthias

    2013-09-04

    Chronic hand eczema places a heavy burden on patients, often affecting their ability to work. This paper compares the cost-of-illness and treatment approaches for patients with refractory chronic hand eczema, in relation to whether the disease was occupational or unrelated to work factors. Data from 2 surveys, comprising 310 patients with chronic hand eczema insured by German statutory health insurance (SHI) (including work-impaired patients, work-unaffected patients and non-working patients) and known work-related chronic hand eczema insured by occupational health insurance (OHI). Annual healthcare costs of managing work-impaired patients (SHI) and patients with work-related chronic hand eczema (OHI) were €3,164 and €3,309, respectively, approximately double the costs of managing non-working and work-unaffected (SHI) patients. This analysis shows that the costs associated with chronic hand eczema are affected by the correlation of chronic hand eczema with work, with costs being higher for occupational patients with chronic hand eczema.

  10. Effectiveness of the Healthy Skin Clinic - a randomized clinical trial of nurse-led patient counselling in hand eczema

    DEFF Research Database (Denmark)

    Mollerup, Annette; Veien, Niels K; Johansen, Jeanne D

    2014-01-01

    -led counselling programme, the Healthy Skin Clinic, emphasizing the patient's self-management, resources, and risks. PATIENTS AND METHODS: Patients (n = 306) referred for diagnostic work-up and treatment of hand eczema were randomized and allocated either to the programme or to usual care. The primary outcome...

  11. Contact allergy in Indonesian patients with foot eczema

    NARCIS (Netherlands)

    Febriana, Sri Awalia; Subono, Hardyanto; Coenraads, Pieter Jan; Schuttelaar, Marie-Louise

    2014-01-01

    Background: Shoe dermatitis is a form of contact dermatitis resulting from exposure to shoes (1). Diagnostic is based on patient history, the presence of skin lesions, positive patch test reactions to allergens in the 'screening' tray, and the absence of dermatitis in a patient wearing proper substi

  12. Eczema Herpeticum in Pregnancy

    Directory of Open Access Journals (Sweden)

    Grigoriy E. Gurvits

    2011-09-01

    Full Text Available Eczema Herpeticum (EH, or Kaposi’s varicelliform eruption, is a skin infection with herpes simplex type I virus (HSV-1 that occurs in patients with compromised skin integrity, such as atopic dermatitis (AD. Unrecognized, it may be fatal and viremia in pregnancy may lead to fetal demise and miscarriage. We describe a rare case of EH in pregnancy, eczema herpeticum gravidarum (EHG, which is the third published report in the literature to date.

  13. Tartrazine in atopic eczema.

    OpenAIRE

    Devlin, J.; David, T. J.

    1992-01-01

    Multiple double blind placebo controlled challenges with tartrazine 50 mg (three challenges) and glucose placebo (three challenges) were performed in 12 children with atopic eczema aged 1 to 6 years. The children were selected on the basis of severity (regular clinic attenders) and a parental history that tartrazine provoked worsening of the eczema. In only one patient did the three tartrazine challenge periods correspond with the highest symptom scores or the highest physician observer score...

  14. Repeated exposures to cobalt or chromate on the hands of patients with hand eczema and contact allergy to that metal

    DEFF Research Database (Denmark)

    Nielsen, N H; Kristiansen, J; Borg, L

    2000-01-01

    The present study aimed at evaluating the effects of daily repeated exposures to low cobalt or chromate concentrations on the hands of patients with hand eczema and cobalt or chromate allergy. For 2 weeks, the patients immersed a finger for 10 min daily into the appropriate metal salt solution in...

  15. Post-stroke seizures in consecutive elderly stroke patients

    Institute of Scientific and Technical Information of China (English)

    Yue Chen; Lufang Chen; Yiqing Tao; Maomao Han; Chunlan Cui; Shichao Liu

    2011-01-01

    This prospective study sought to investigate the clinical, radiological and electroencephalographic (EEG) characteristics of seizures in elderly stroke patients, and their outcomes. Over a 2-year study period, 158 consecutive eldedy patients with stroke were examined and followed up. Of these patients, 32 (20%) developed seizures, primarily related to stroke, within a follow up period between 5 months and 2 years. Of these 32 cases, 20 experienced infarctions, and 12 experienced hemorrhages. Involvement of cortical regions was detected in most of the patients exhibiting seizures. In these patients, 44% of the lesions involved cortical areas exclusively or in addition to subcortical areas observed on computed tomography (CT) images. Twenty-five patients (78%)developed early seizures (within 2 weeks after stroke), and half exhibited immediate post-stroke seizures. None of the patients exhibiting early onset seizures developed recurrent seizures or epilepsy, while 57% of late onset seizures (four cases) developed epilepsy. No specific EEG patterns were apparent in those who later developed epilepsy. Overall, early onset seizures after stroke were found to be relatively common, and did not affect outcome. Late onset seizures were less common, but were associated with chronic epilepsy.

  16. 20 Years of standard patch testing in an eczema population with focus on patients with multiple contact allergies

    DEFF Research Database (Denmark)

    Carlsen, Berit Christina; Menné, Torkil; Johansen, Jeanne Duus

    2007-01-01

    (Me)isothiazolinone, and primin and poor for paraben mix. 5.1% were multiple allergic, primarily women, and 90% got diagnosed by the first test. Frequency of multiple allergies increased with age. More multiple- than mono/double-allergic patients were tested multiple times. Persistency and sensitivity rates in a Danish eczema...

  17. Atopic eczema and food allergy.

    Science.gov (United States)

    Wassmann, Anja; Werfel, Thomas

    2015-01-01

    Approximately one-third of children with severe atopic eczema suffer from a food allergy, whereas in adult patients, food allergies are rare. In child patients, three different clinical reaction patterns can be differentiated as follows: (1) immediate-type reactions, (2) isolated late eczematous reactions, and (3) combined immediate-type and late eczematous reactions. In childhood food allergies, food allergens, such as cow's milk or hen's egg, are primarily responsible for allergic reactions, while in adolescents and adults, food allergies often develop consecutively after primary sensitization to pollen allergens. Dysfunctions in the epidermal barrier seem to be vitally important in the development of food allergies in patients with atopic eczema by facilitating sensitization after epicutaneous allergen exposure. Further investigation is required to determine the role of intestinal epithelial barrier defects in the pathogenesis of these allergies as well as the genetic characteristics associated with an increased risk of food allergy. The diagnosis of eczematous reactions to food requires a careful diagnostic procedure, taking into account a patient's history and sensitization patterns. The clinical relevance of sensitization often has to be proven by an oral food challenge, with the rating of the skin condition by validated scores after 24 h and the later evaluation of the eczematous reaction.

  18. Diffuse aspiration bronchiolitis: analysis of 20 consecutive patients

    Directory of Open Access Journals (Sweden)

    Xiaowen Hu

    2015-04-01

    Full Text Available OBJECTIVE: Aspiration can cause a variety of pulmonary syndromes, some of which are not well recognized. The objective of this study was to assess the demographic, clinical, radiological, and histopathological correlates of diffuse aspiration bronchiolitis (DAB, a bronchiolocentric disorder caused by recurrent aspiration. METHODS: This was a retrospective study of 20 consecutive patients with DAB seen at the Mayo Clinic in Rochester, Minnesota, between January 1, 1998 and June 30, 2014. RESULTS: The median age of the patients was 56.5 years (range, 22-76 years, and the male/female ratio was 2.3:1.0. In 18 patients, the diagnosis of DAB was based on the results of a lung biopsy; in the 2 remaining patients, it was based on clinical and radiological features, together with documented aspiration observed in a videofluoroscopic swallow study. In 19 patients (95%, we identified predisposing factors for aspiration, including gastroesophageal reflux disease (GERD, drug abuse, and dysphagia. Common presenting features included cough, sputum production, dyspnea, and fever. Twelve patients (60% had a history of recurrent pneumonia. In all of the patients, chest CT revealed bilateral pulmonary infiltrates consisting of micronodules and tree-in-bud opacities. In the majority of patients, interventions aimed at preventing recurrent aspiration (e.g., anti-GERD therapies led to improvement in the symptoms of DAB. CONCLUSIONS: Young to middle-aged subjects with recognizable predisposing factors for aspiration and who report a history of recurrent pneumonia are at increased risk for DAB. Although DAB is not well recognized, certain chest CT features are characteristic of the disorder.

  19. Allergens associated with severe symptoms of hand eczema and a poor prognosis.

    Science.gov (United States)

    Hald, Marianne; Agner, Tove; Blands, Jette; Ravn, Henrik; Johansen, Jean Duus

    2009-08-01

    Contact allergy is frequent among persons with hand eczema and may be associated with a poor prognosis. To identify allergens associated with the most severe initial clinical symptoms and the worst prognosis in a cohort of hand eczema patients followed for 6 months. The study population comprised 799 consecutive hand eczema patients enrolled during January 2006-February 2007. All patients were patch tested with the European baseline series. Severity assessment of the hand eczema was performed initially and at the 6-month follow-up using a validated scoring system (HECSI). With logistic regression analyses, associations of severe hand eczema or a poor prognosis with 15 individual allergens were analysed and adjusted for by sex, age, atopic dermatitis and other allergens. At baseline, greater severity of hand eczema was associated with a positive patch test to formaldehyde, methyldibromo glutaronitrile, sesquiterpene lactone mix, nickel sulfate and potassium dichromate. A poor prognosis was associated with chromate allergy, odds ratio: 4.18 (95% CI: 1.42-12.28). Nickel, chromate, formaldehyde, methyldibromo glutaronitrile and sesquiterpene lactone mix were allergens associated with the greatest severity of hand eczema. Patients with chromate allergy had the worst prognosis.

  20. Atopic eczema.

    Science.gov (United States)

    Brown, Sara J

    2016-02-01

    Atopic eczema is an itchy inflammatory skin disease with a chronic relapsing-remitting course; it has increased in prevalence in recent decades and now affects up to 25% of school-aged children in the developed world and up to 10% of adults. Recent advances in understanding the aetiology of eczema have focused interest on skin barrier dysfunction as a common precursor and pathological feature. In addition, genetically determined skin barrier dysfunction (associated with mutations in the gene encoding filaggrin) is known to predispose to multiple systemic atopic diseases. First-line treatments for atopic eczema focus on maintaining and repairing the skin barrier (emollients) and reducing inflammation (topical steroids); allergen and irritant avoidance are also important to achieve disease control. Second and third-line treatments include topical calcineurin inhibitors, ultraviolet light and systemic immunosuppressant therapies of which only ciclosporin is licenced for the treatment of atopic eczema in adults. Novel biological therapies are in phase II-III clinical trials.

  1. Auricular Oedema and Dyshidrotic Eczema in a Patient with Acute Myeloid Leukaemia Treated with Cytarabine

    Directory of Open Access Journals (Sweden)

    K. Brandt

    2010-10-01

    Full Text Available Cytarabine is an effective drug in the treatment of haematological malignancies. The therapy is associated with various complications. Frequencies of dermatological side-effects range from 2–72% and occur most commonly after high-dose regimens. Although most cutaneous reactions are mild and resolve spontaneously within several days, they may result in an increased risk of infection and alterations in comfort. In some cases, severe life-threatening reactions have been reported. Here we describe the case of a patient with acute myeloid leukaemia, who developed severe exceptional skin toxicity in terms of auricular oedema and palmar dyshidrotic eczema after the application of low-dose cytarabine. Re-administration of the drug resulted in reduced skin toxicity during further cycles of chemotherapy. Negative epicutaneous patch-testing supported the existence of cytarabine-provoked toxicity.

  2. Hand eczema - prognosis and consequences

    DEFF Research Database (Denmark)

    Petersen, A. H.; Johansen, J D; Hald, M

    2014-01-01

    BACKGROUND: Hand eczema is recognized as a long-lasting disease with personal and societal repercussions. Long-term studies are required to generate information on factors contributing to a poor outcome. OBJECTIVES: The aims of this 7-year follow-up study were to evaluate the clinical course...... of patients with hand eczema, the occupational consequences and to identify risk factors associated with a poor prognosis. MATERIALS AND METHODS: In all, 536 patients with hand eczema participated and were examined by a dermatologist. The clinical severity was assessed at baseline and 7 years later using...... a self-administrated photographic guide. Additional information was obtained from a questionnaire. RESULTS: Based on the photographic guide, 73% experienced a clinical improvement. Notably, 20% had moderate to very severe hand eczema at follow-up. Severe hand eczema or frequent eruptions at baseline...

  3. Evaluating Written Patient Information for Eczema in German: Comparing the Reliability of Two Instruments, DISCERN and EQIP.

    Directory of Open Access Journals (Sweden)

    Megan E McCool

    Full Text Available Patients actively seek information about how to cope with their health problems, but the quality of the information available varies. A number of instruments have been developed to assess the quality of patient information, primarily though in English. Little is known about the reliability of these instruments when applied to patient information in German. The objective of our study was to investigate and compare the reliability of two validated instruments, DISCERN and EQIP, in order to determine which of these instruments is better suited for a further study pertaining to the quality of information available to German patients with eczema. Two independent raters evaluated a random sample of 20 informational brochures in German. All the brochures addressed eczema as a disorder and/or therapy options and care. Intra-rater and inter-rater reliability were assessed by calculating intra-class correlation coefficients, agreement was tested with weighted kappas, and the correlation of the raters' scores for each instrument was measured with Pearson's correlation coefficient. DISCERN demonstrated substantial intra- and inter-rater reliability. It also showed slightly better agreement than EQIP. There was a strong correlation of the raters' scores for both instruments. The findings of this study support the reliability of both DISCERN and EQIP. However, based on the results of the inter-rater reliability, agreement and correlation analyses, we consider DISCERN to be the more precise tool for our project on patient information concerning the treatment and care of eczema.

  4. Postoperative morbidity after reconstruction of alveolar bone defects with chin bone transplants in cleft patients - 111 consecutive patients

    DEFF Research Database (Denmark)

    Andersen, Kristian; Nørholt, Sven Erik; Knudsen, Johan;

    Postoperative morbidity after reconstruction of alveolar bone defects with chin bone transplants in cleft patients - 111 consecutive patients......Postoperative morbidity after reconstruction of alveolar bone defects with chin bone transplants in cleft patients - 111 consecutive patients...

  5. 皮炎湿疹599例致病因素分析%Pathogenesis Analysis of 599 Eczema Patients

    Institute of Scientific and Technical Information of China (English)

    刘广仁; 韩永智; 黄庚史; 李邻峰

    2012-01-01

    目的 探讨环境接触性因素在皮炎湿疹类疾病发病中的作用及影响因素.方法 对诊断皮炎湿疹的患者做斑贴试验并进行问卷调查.结果 599例皮炎湿疹患者中变应性接触性皮炎167例(27.88%),在整个患者中所占比例最高.斑贴试验结果变应原呈阳性反应者有441例(73.62%).阳性率由高到低排列的前6位变应原为:硫酸镍、硫柳汞、辛酸盐、芳香混合物、卡巴混合物和重铬酸钾.结论 斑贴试验是寻找皮炎湿疹病因的有效手段.%Objective To investigate the role of the environmental contact factors in the pathogenesis of eczema and the outcome. Methods Eczema patients were investigated by patch test and questionnaire interview. Results Five hundreds and ninety-nine eczema patients were recruited, and 167 cases(27. 88% ) were diagnosed as allergic contact dermatitis (ACD) , which was the most common. Of all patients, 441 patients showed positive patch test results, which accounted for 73.62%. The most common allergens were nickel sulfate,thimerosal, octyl gallate, fragrance mix, carba mix and potassium dichromate, in descending order. Conclusion Patch test is a good method for screening pathogenesis of eczema.

  6. Hand eczema

    DEFF Research Database (Denmark)

    Ibler, K.S.; Jemec, G.B.E.; Flyvholm, M.-A.

    2012-01-01

    /materials/methods. A survey of 3181 healthcare workers was performed. Data were analysed with logistic regression. Data on sick leave and notification to the authorities were obtained. Results. The response rate was 71% (2274 of 3181). The 1-year prevalence of hand eczema was 21%, and was positively associated with atopic...

  7. The capsaicin cough reflex in eczema patients with respiratory symptoms elicited by perfume.

    Science.gov (United States)

    Elberling, Jesper; Dirksen, Asger; Johansen, Jeanne Duus; Mosbech, Holger

    2006-03-01

    Respiratory symptoms elicited by perfume are common in the population but have unclear pathophysiology. Increased capsaicin cough responsiveness has been associated with the symptoms, but it is unknown whether the site of the symptoms in the airways influences this association. The aim of this study was to investigate the association between the site of airway symptoms elicited by perfume and cough responsiveness to bronchial challenge with capsaicin. 21 eczema patients with respiratory symptoms elicited by perfume were compared with 21 healthy volunteers in a sex- and age-matched case control study. The participants completed a symptom questionnaire and underwent a bronchial challenge with capsaicin. Lower, but not upper, respiratory symptoms elicited by perfume were associated with increased capsaicin cough responsiveness. Having severe symptoms to perfume (n=11) did not relate to the site of the symptoms in the airways and was not associated with increased capsaicin cough responsiveness. In conclusion, respiratory symptoms elicited by perfume may reflect local hyperreactivity related to defensive reflexes in the airways, and measurements of the capsaicin cough reflex are relevant when patients with lower respiratory symptoms related to environmental perfume exposures are investigated.

  8. Flexural eczema versus atopic dermatitis

    DEFF Research Database (Denmark)

    Jacob, Sharon E; Goldenberg, Alina; Nedorost, Susan

    2015-01-01

    Flexural eczema and atopic dermatitis are frequently synonymized. As respiratory atopy is rarely tested for and found in these patients, systematically equating a flexural distribution of dermatitis with atopic dermatitis may too frequently result in misclassified diagnoses and potentially missed...

  9. The capsaicin cough reflex in eczema patients with respiratory symptoms elicited by perfume

    DEFF Research Database (Denmark)

    Elberling, Jesper; Dirksen, Asger; Johansen, Jeanne Duus

    2006-01-01

    Respiratory symptoms elicited by perfume are common in the population but have unclear pathophysiology. Increased capsaicin cough responsiveness has been associated with the symptoms, but it is unknown whether the site of the symptoms in the airways influences this association. The aim of this st......Respiratory symptoms elicited by perfume are common in the population but have unclear pathophysiology. Increased capsaicin cough responsiveness has been associated with the symptoms, but it is unknown whether the site of the symptoms in the airways influences this association. The aim...... of this study was to investigate the association between the site of airway symptoms elicited by perfume and cough responsiveness to bronchial challenge with capsaicin. 21 eczema patients with respiratory symptoms elicited by perfume were compared with 21 healthy volunteers in a sex- and age-matched case...... control study. The participants completed a symptom questionnaire and underwent a bronchial challenge with capsaicin. Lower, but not upper, respiratory symptoms elicited by perfume were associated with increased capsaicin cough responsiveness. Having severe symptoms to perfume (n=11) did not relate...

  10. Evaluation of the Frequency of Food and Aeroallergens in Patients with Eczema and Urticaria in Province of Bushehr: Based on Skin Prick Test Reactivity

    Directory of Open Access Journals (Sweden)

    Shokrollah Farrokhi

    2014-10-01

    Full Text Available Background: In recent years frequency of skin allergic diseases such as atopic dermatitis (eczema and urticaria is reported to be high in the region. Identification of reactive allergens in different areas are very important in the diagnosis and treatment of these diseases. The aim of this study was to determine frequency of common allergens in patients with skin allergies in province of Bushehr with regards to eczema and urticaria. Materials and methods: In this cross-sectional study, 234 patients with urticarial and eczema were enrolled. The participants reacted to at least one allergen with SPT. Skin prick test with standard inhaled and food was performed on patients according to the herbal geography of the area. Results: Among 837 patients referred to allergy clinic, 91 patients had eczema and 143 had urticaria. The frequency of both eczema and urticaria was significantly higher in females than in males. The most common food allergens in patients with eczema were almond (56.6%, walnut (47.7% and soybean (46.1%. And in patients with urticaria were almond (58%, walnut (53.1% and tomato (48.2%. Also, aeroallergens in the subjects were house dust mite (HDM (63.7%, Russian thistle (57.7% and Alternaria alternara (51.6%. Meanwhile, the common aeroallergens in the patients were HDM (66.4%, Russian thistle (52.4% and date palm (51%. Conclusion: Our findings indicated that almond and walnut are important food allergens in participants with eczema and urticaria. Moreover, SPT reactivity was positive with aeroallergens such as HDM and weeds.

  11. Hand eczema: An update

    Directory of Open Access Journals (Sweden)

    Chembolli Lakshmi

    2012-01-01

    Full Text Available Eczema, the commonest disorders afflicting the hands, is also the commonest occupational skin disease (OSD. In the dermatology outpatient departments, only the severe cases are diagnosed since patients rarely report with early hand dermatitis. Mild forms are picked up only during occupational screening. Hand eczema (HE can evolve into a chronic condition with persistent disease even after avoiding contact with the incriminated allergen / irritant. The important risk factors for hand eczema are atopy (especially the presence of dermatitis, wet work, and contact allergy. The higher prevalence in women as compared to men in most studies is related to environmental factors and is mainly applicable to younger women in their twenties. Preventive measures play a very important role in therapy as they enable the affected individuals to retain their employment and livelihood. This article reviews established preventive and therapeutic options and newer drugs like alitretinoin in hand eczema with a mention on the etiology and morphology. Identifying the etiological factors is of paramount importance as avoiding or minimizing these factors play an important role in treatment.

  12. Promoting effective education for children with eczema.

    Science.gov (United States)

    Thompson, Deryn

    2016-01-27

    Patient and parent education for children with eczema should follow a consistent approach, guided by an established framework that combines aspects of nursing, education and cognitive psychology. Using the framework enables nurses to understand how to use and develop their skills when providing education about the management of eczema in children, and enables patients and parents to understand and develop the skills required to manage a chronic condition such as eczema. This framework is transferable to the adult context.

  13. Relation between patients' and physicians' severity assessment of occupational hand eczema

    DEFF Research Database (Denmark)

    Cvetkovski, Rikke Skoet; Jensen, H; Olsen, J

    2005-01-01

    BACKGROUND: Severity assessment of occupational hand eczema (OHE) is important not only in clinical settings but also in research. Questionnaires with self-rated assessment of severity may be an attractive tool for assessing severity because of their cost efficiency in comparison with expensive...

  14. Electron diffraction study of lipids in non-lesional stratum corneum of atopic eczema patients

    NARCIS (Netherlands)

    Janssens, M.; Mulder, A.A.W.; Smeden, J. van; Pilgram, G.S.; Wolterbeek, R..; Lavrijsen, A.P.M.; Koning, R.I.; Koster, A.J.; Bouwstra, J.A.

    2013-01-01

    Skin barrier impairment is thought to be an important factor in the pathogenesis of atopic eczema (AE). The skin barrier is located in the stratum corneum (SC), consisting of corneocytes embedded in lipids. Ceramides, cholesterol and free fatty acids are the major lipid classes and are crucial for

  15. No Increased Risk of Cancer after Coal Tar Treatment in Patients with Psoriasis or Eczema

    NARCIS (Netherlands)

    Roelofzen, Judith H. J.; Aben, Katja K. H.; Oldenhof, Ursula T. H.; Coenraads, Pieter-Jan; Alkemade, Hans A.; van de Kerkhof, Peter C. M.; van der Valk, Pieter G. M.; Kiemeney, Lambertus A. L. M.

    Coal tar is an effective treatment for psoriasis and eczema, but it contains several carcinogenic compounds. Occupational and animal studies have shown an increased risk of cancer after exposure to coal tar. Many dermatologists have abandoned this treatment for safety reasons, although the risk of

  16. Chinese herbal medicine research in eczema treatment

    Directory of Open Access Journals (Sweden)

    Leung Ping

    2011-04-01

    Full Text Available Abstract Eczema is a chronic relapsing atopic dermatitis (AD associated with pruritus, sleep disturbance and poor quality of life of the patient. Treatment of eczema includes use of emollient, topical and systemic antimicrobial agents, corticosteroid or immunomodulating agents. Many patients also seek alternative treatments such as dietary avoidance, supplementation or both. This article reviews the basic pathophysiology of eczema and clinical trials involving Chinese medicine in the treatment of eczema. Research reports on Chinese herbal medicine for eczema were retrieved from PubMed and the Cochrane Database for Systematic Reviews for this review. Only a few RCTs demonstrated the efficacy (or lack of efficacy of Chinese medicinal herbs in treating atopic eczema. Further larger scale trials are warranted.

  17. Laparoscopy in 100 consecutive patients with 128 impalpable testes

    DEFF Research Database (Denmark)

    Cortes, D; Thorup, J M; Lenz, K

    1995-01-01

    ; in the remainder, cord structures could be seen passing through the ring, indicating an intracanalicular testis. The impalpable testis was absent in 77% of patients with a contralateral scrotal testis. A seminoma was found in one 18.6-year-old patient with bilateral cryptorchidism. No intratubular germ cell...

  18. Triage and mortality in 2875 consecutive trauma patients

    DEFF Research Database (Denmark)

    Meisler, Rikke; Thomsen, A B; Abildstrøm, H

    2010-01-01

    Most studies on trauma and trauma systems have been conducted in the United States. We aimed to describe the factors predicting mortality in European trauma patients, with focus on triage.......Most studies on trauma and trauma systems have been conducted in the United States. We aimed to describe the factors predicting mortality in European trauma patients, with focus on triage....

  19. Atopic dermatitis, atopic eczema, or eczema?

    DEFF Research Database (Denmark)

    Kantor, R; Thyssen, J P; Paller, A S;

    2016-01-01

    terms for AD. METHODS: A systematic review of the MEDLINE, EMBASE, and LILACS (1945-2016) for the terms AD, atopic eczema (AE), and multiple other eczematous disorders. RESULTS: In MEDLINE, 33 060 were identified, of which 21 299 (64.4%) publications used the term 'AD', 15 510 (46.9%) 'eczema', and only...... 2471 (7.5%) AE. Most of these publications used the term AD (82.0%) or eczema (70.8%) without additional nomenclature; only 1.2% used AE alone. Few publications used the terminology 'childhood eczema', 'flexural eczema', 'infantile eczema', 'atopic neurodermatitis', or 'Besnier's prurigo'. AD...... was rarely used until the late 1970s, after which it became the most commonly used of the three terms and continuously increased until 2015. Atopic eczema decreased between 2008 and 2015. Atopic dermatitis was the most commonly used term in studies across almost all publication types, languages, and journals...

  20. The liver in consecutive patients with morbid obesity

    DEFF Research Database (Denmark)

    Andersen, T; Christoffersen, Pernille Yde; Gluud, C

    1984-01-01

    and an elevated serum alkaline phosphatase activity (P less than 0.0001) compared with non-obese controls. Serum lactate dehydrogenase and aspartate aminotransferase were significantly raised only in patients with fatty change. With respect to serum bilirubin and plasma cholesterol concentrations no significant...

  1. Content and reactivity to product perfumes in fragrance mix positive and negative eczema patients. A study of perfumes used in toiletries and skin-care products

    DEFF Research Database (Denmark)

    Johansen, J D; Rastogi, Suresh Chandra; Andersen, K E

    1997-01-01

    The aim of the study was to investigate the elicitation potential of perfumes from 17 commonly sold lower-price cosmetic products. 8 of the perfumes were from stay-on cosmetics and 9 were from wash-off cosmetics. Each perfume was tested in 500 consecutive eczema patients, who also were tested...... with the European standard patch test series. 4.2% reacted to 1 or more of the wash-off product perfumes and 3.2% to 1 or more of the stay-on product perfumes. Concordant positive reactions between the fragrance mix and the product perfumes were found in 81.3% of positive reactions to the stay-on product perfumes...... and in 52.4% of the reactions to the wash-off product perfumes. Compared to the fragrance mix alone, only 1 additional case of contact allergy to the product perfumes was detected by balsam of Peru. Chemical analysis revealed that between 1 and 5 of the chemically-defined constituents of the fragrance mix...

  2. Assessing health-related quality of life in hand eczema patients: how to overcome psychometric faults when using the dermatology life quality index.

    Science.gov (United States)

    Ofenloch, Robert F; Diepgen, Thomas L; Weisshaar, Elke; Elsner, Peter; Apfelbacher, Christian J

    2014-11-01

    Health-related quality of life (HRQOL) has become an important patient reported outcome in health service research. The dermatology life quality index (DLQI) is the most commonly used instrument in dermatology. In recent years, the psychometric properties of the DLQI have been a subject of debate as requirements of modern test theory seem not to be fulfilled. The aim of this study was to test whether those violations also occur in patients with hand eczema. We collected data of 602 hand eczema patients who participated in an inpatient dermatology rehabilitation program in Germany. In order to report meaningful scores of the DLQI, data were analysed according to the principles of modern test theory. We calibrated the DLQI using the Rasch model, resulting in a 6 item version with a range between 0-15 points. This version showed no significant misfit to the Rasch model (p>0.14). By using a Rasch analysis the results were evaluated in a second sample of hand eczema patients (n=511). Even if all demographic characteristic of this sample were different, we were able to replicate the results found in this study (p>0.21). In conclusion, we recommend to use an alternative scoring procedure as presented in this article if the DLQI is used in hand eczema patients.

  3. 160例慢性湿疹患者脉图分析%Pulse Picture Analysis of 160 Patients with Chronic Eczema

    Institute of Scientific and Technical Information of China (English)

    于志峰; 陆小左; 张玉环; 王学民

    2013-01-01

    Objective: To explore the changes and significance of pulse on chronic eczema patients. Methods: The 160 patients with chronic eczema were selected, and 80 healthy volunteers were taken in the control group. The pulse signal processing systems and the clinical observation were applied to analyze the pulse manifestations. Results: The h1, h3, h4 , h5 of the patients with chronic eczema were significantly different from that in the control group(P <0. 05). The t1,t4 ,t5 of the patients with chronic eczema were significantly different from that in the control group(P <0. 05). The h3/h1 ,h4/ h1, h5/h1 of the patients with chronic eczema were significantly different from that in the control group( P < 0. 05 ). Conclusion: A number of indicators in the patients with chronic eczema are significantly different from that in the control group which can provide an objective evidence for the diagnosis for patients with chronic eczema.%目的:探讨慢性湿疹患者脉象的变化及其临床意义.方法:选择符合诊断标准的湿疹病人160例,并选择健康志愿者80例作为对照组.采用脉象采集系统和临床结合的方法进行脉象的识别分析.结果:湿疹组h1、h3 、h4、h5与对照组比较均有统计学差异(P<0.05);湿疹组t1、t4、t5与对照组比较均有统计学差异(P<0.05);湿疹组h3/h1、h4/h1、h5/h1与对照组比较均有统计学差异(P<0.05).结论:湿疹组脉图多项指标与正常人比较有显著性差异,此研究结果为慢性湿疹的中医诊断提供了客观依据.

  4. Study of Objectification of Pulse values of Patients with Chronic Eczema%慢性湿疹患者脉象客观化研究

    Institute of Scientific and Technical Information of China (English)

    于志峰; 陆小左; 张玉环; 王学民

    2013-01-01

    Objective: To explore the changes of pulse in different TCM syndromes of patients with chronic eczema and its sig-nificance. Methods: 160 patients with chronic eczema were divided into 2 subgroups according to TCM syndromes, 80 in the group of spleen deficiency with dampness, 80 in the group of blood deficiency and wind - dry. 160 healthy volunteers were taken in the control group. The pulse signal processing systems and the clinical observation were applied to analyze the pulse manifestations. Results:The values of h1 , h3 ,h4 and h5 of the patients with chronic eczema were significantly different from that in the control group ( P < 0. 05 ). The values of t1 , t4 and t5 of the patients with chronic eczema were significantly different from that in the control group( P < 0. 05 ) . The values of h3/h1 , h4/h1 and h5/h1 of the patients with chronic eczema were significantly different from that in the control group( P <0. 05). In the patients with chronic eczema, the values of h3/h1 , h5/h1 and w/t of blood deficiency and wind - dry were significantly different from that in the spleen deficiency with dampness. Conclusion: A number of indicators in the patients with chronic eczema are significantly different from that in the control group. The changes of pulses in different TCM syndromes of patients with chronic eczema show a syndrome specificity. They can provide the objective evidence for the diagnosis and syndrome differentiation for patients with chronic eczema.%目的:探讨慢性湿疹中医不同证型脉象的变化及其临床意义.方法:选择符合诊断标准的湿疹病人160例,根据中医辨证分为脾虚湿蕴型80例,血虚风燥型80例.另选择健康志愿者80例作为对照组.采用脉象采集系统和临床结合的方法进行脉象的识别分析.结果:湿疹组h1、h3、h4、h5与对照组比较均有统计学差异(P<0.05);湿疹组t1、t4t5与对照组比较均有统计学差异(P<0.05);湿疹组h3/h1、h4/h1、h5/h1与对照

  5. Eczema in North West of Libya

    Science.gov (United States)

    Arshah, TM; Shambesh, MK; Grera, AM; AlBaccush, M

    2008-01-01

    The life style and demographic structure of Libyan society is changing, and this could affect the epidemiology of certain diseases, including eczema. The aim of this study was to assess the burden of eczema among a selected patient population in the Zliten area in the northwest of Libya. We conducted a retrospective study by reviewing case notes and records in public and private dermatology practices in the Zliten area. The frequency of eczema among patients attending dermatology clinics in the Zliten area was 12.8%, and the male to female ratio was almost 1:1. The most affected age group among patients was 20-29 years. Eczema represented a larger proportion of dermatologic conditions during spring and summer. Of all cases of eczema, 72.6% were endogenous and 24.9% were exogenous (p<0.001). The most common type of eczema was contact dermatitis (22.7% of all cases), followed by atopic dermatitis (19.7%) and pityriasis alba (10.5%). In conclusion, eczema is a public health problem in Zliten-Libya, and this necessitates prospective studies to determine its incidence and prevalence. PMID:21499454

  6. An unusual case of eruptive syringomas presenting as itchy symmetrical lesions on both forearms in a patient of hyperkeratotic eczema.

    Science.gov (United States)

    Verma, Shyam B

    2011-07-01

    This report describes an unusual case of bilaterally symmetrically occurring hyperpigmented itchy popular lesions on both forearms of a 50-year-old woman. The woman had antecedent hyperkeratotic eczema of the feet and she had a similar eruption in the past which had cleared with topical steroid application. Biopsy of the lesion showed syringomas. We present this case to highlight an unusual case of bilaterally symmetrical papular pruritic eruption against a background of hyperkeratotic eczema. Some syringomas are supposed to be a response to an inflammatory trigger and we wonder if in this case the eczema acted as an inflammatory trigger.

  7. An unusual case of eruptive syringomas presenting as itchy symmetrical lesions on both forearms in a patient of hyperkeratotic eczema

    Directory of Open Access Journals (Sweden)

    Shyam B Verma

    2011-01-01

    Full Text Available This report describes an unusual case of bilaterally symmetrically occurring hyperpigmented itchy popular lesions on both forearms of a 50-year-old woman. The woman had antecedent hyperkeratotic eczema of the feet and she had a similar eruption in the past which had cleared with topical steroid application. Biopsy of the lesion showed syringomas. We present this case to highlight an unusual case of bilaterally symmetrical papular pruritic eruption against a background of hyperkeratotic eczema. Some syringomas are supposed to be a response to an inflammatory trigger and we wonder if in this case the eczema acted as an inflammatory trigger.

  8. [Health services research: the example of hand eczema].

    Science.gov (United States)

    Apfelbacher, C J; Diepgen, T L

    2011-03-01

    Hand eczema is one of the most frequent skin diseases with a lifetime prevalence of up to 15% and a median incidence rate of 6 cases per 1000 person-years. Female gender, contact allergy, atopic eczema and wet work have been identified as the most important associated risk factors. Hand eczema has a high public health and socio-economic significance, since the vast majority of occupational skin disease is hand eczema. Hand eczema is often chronic, chronically relapsing or persisting. It entails substantial impairment of health-related quality of life for the affected individual. The cost-of-illness of hand eczema is estimated to be in the range of moderate to severe psoriasis and even higher than that of atopic eczema. Although various therapeutic options to treat hand eczema exist, an assessment of these options in randomized, controlled clinical trials to build up an evidence base is mostly lacking. The investigation of the treatment of chronic hand eczema under everyday conditions in dermatological clinics and private practices has only just begun. The first register of patients with chronic hand eczema (acronym: carpe) is expected to yield substantial insights in the effectiveness and safety of different therapeutic measures. A related task is the assessment of the quality of care in the light of the guidelines for the management of chronic hand eczema.

  9. Results of partial fasciectomy for Dupuytren disease in 261 consecutive patients

    NARCIS (Netherlands)

    Coert, JH; Nerin, JPB; Meek, MF

    Many different surgical techniques are still being used for Dupuytren disease. The outcome of 558 consecutive operations with 1 technique was reviewed. Distinct subgroups were made to detect risk factors for a poor outcome and complications. The mean follow-up time was 7.3 years. Younger patients

  10. Transanal endoscopic microsurgery in 143 consecutive patients with rectal adenocarcinoma. Results from a Danish multicenter study

    DEFF Research Database (Denmark)

    Baatrup, G; Breum, B; Qvist, N;

    2009-01-01

    Aim: The long term results are presented on total survival, cancer specific survival and recurrence in 143 consecutive patients treated with transanal endoscopic microsurgery (TEM) for adenocarcinoma of the rectum. Methods: Four Danish centres established in 1995 a database for registration of all...

  11. Results of partial fasciectomy for Dupuytren disease in 261 consecutive patients

    NARCIS (Netherlands)

    Coert, JH; Nerin, JPB; Meek, MF

    2006-01-01

    Many different surgical techniques are still being used for Dupuytren disease. The outcome of 558 consecutive operations with 1 technique was reviewed. Distinct subgroups were made to detect risk factors for a poor outcome and complications. The mean follow-up time was 7.3 years. Younger patients (f

  12. Spectral-domain optical coherence tomography findings of the macula in 500 consecutive patients with uveitis.

    Science.gov (United States)

    Grajewski, R S; Boelke, A C; Adler, W; Meyer, S; Caramoy, A; Kirchhof, B; Cursiefen, C; Heindl, L M

    2016-11-01

    PurposeTo analyze the macular structure in a large series of consecutive patients with different types of uveitis using spectral-domain optical coherence tomography (SD-OCT).Patients and methodsFive hundred eyes of 500 consecutive patients with anterior, intermediate, posterior, and panuveitis underwent standardized macular examination using SD-OCT. Central retinal thickness (CRT), macular volume (MV), and presence of cystoid macular edema (CME), diffuse macular edema (DME), serous retinal detachment (SRD), epiretinal membrane with (ERM+) and without (ERM-) retinal surface wrinkling were determined.ResultsThe anatomic location of inflammation affected significantly CRT and MV (Puveitis (17%); SRD was most frequent in panuveitis (15%) and posterior uveitis (10%); ERM+ was most frequent in panuveitis (45%) and intermediate uveitis (30%); and ERM- was most frequent in intermediate (14%) and posterior uveitis (15%).ConclusionSD-OCT of the macula is recommended for all uveitis patients. CRT, MV, and the incidence of CME were highest in intermediate and panuveitis.

  13. Increase in short-chain ceramides correlates with an altered lipid organization and decreased barrier function in atopic eczema patients.

    Science.gov (United States)

    Janssens, Michelle; van Smeden, Jeroen; Gooris, Gert S; Bras, Wim; Portale, Guiseppe; Caspers, Peter J; Vreeken, Rob J; Hankemeier, Thomas; Kezic, Sanja; Wolterbeek, Ron; Lavrijsen, Adriana P; Bouwstra, Joke A

    2012-12-01

    A hallmark of atopic eczema (AE) is skin barrier dysfunction. Lipids in the stratum corneum (SC), primarily ceramides, fatty acids, and cholesterol, are crucial for the barrier function, but their role in relation to AE is indistinct. Filaggrin is an epithelial barrier protein with a central role in the pathogenesis of AE. Nevertheless, the precise causes of AE-associated barrier dysfunction are largely unknown. In this study, a comprehensive analysis of ceramide composition and lipid organization in nonlesional SC of AE patients and control subjects was performed by means of mass spectrometry, infrared spectroscopy, and X-ray diffraction. In addition, the skin barrier and clinical state of the disease were examined. The level of ceramides with an extreme short chain length is drastically increased in SC of AE patients, which leads to an aberrant lipid organization and a decreased skin barrier function. Changes in SC lipid properties correlate with disease severity but are independent of filaggrin mutations. We demonstrate for the first time that changes in ceramide chain length and lipid organization are directly correlated with the skin barrier defects in nonlesional skin of AE patients. We envisage that these insights will provide a new therapeutic entry in therapy and prevention of AE.

  14. Analysis of hemochromatosis gene mutations in 52 consecutive patients with polycythemia vera.

    Science.gov (United States)

    Franchini, Massimo; de Matteis, Giovanna; Federici, Francesca; Solero, Pietro; Veneri, Dino

    2004-01-01

    A literature review reports increased erythrocyte indices [hemoglobin concentration, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin (MCH), MCH concentration] in subjects with hereditary hemochromatosis (HH). We, therefore, screened 52 consecutive patients with polycythemia vera for 12 HH gene mutations, comparing iron status and red cell parameters between patients positive or negative for HH gene mutations. Our results support the evidence that there is no association between these two conditions.

  15. Which aeroallergens are associated with eczema severity?

    Science.gov (United States)

    Hon, K L E; Leung, T F; Lam, M C A; Wong, K Y; Chow, C M; Fok, T F; Ng, P C

    2007-07-01

    We investigated if a correlation exists between aeroallergen sensitization and the severity of eczema. Data on aeroallergen response to skin-prick testing (SPT) and disease severity of children with eczema (n = 119) were evaluated. Atopy, as defined by at least one positive response to aeroallergen skin prick testing, was found in > 90% of eczema patients. House dust mite was the most commonly sensitized aeroallergen, followed by cat fur. Dermatophagoides pteronyssinus and Dermatophagoides farinae sensitization were associated with eczema severity (present in 67% of the mild and 97% of the severe group; P = 0.001). However, there was no association between eczema severity and higher strengths of SPT response (defined as SPT > 1+ to dust mites or dust). Atopy to moulds, Bermuda grass, cockroach, cat and dog was less prevalent and was not associated with eczema severity. It is sensible to advise parents on specific avoidance strategies only in severely affected children who have a definitive history of eczema exacerbation by specific aeroallergens and who are not responsive to conventional treatment.

  16. 1840例婴儿湿疹临床特征分析%Clinical analysis of 1840 patients with infant eczema

    Institute of Scientific and Technical Information of China (English)

    曹婷婷; 葛宏松; 周洁

    2012-01-01

    目的 了解婴儿湿疹的临床特点.方法 对1 840例生后20~12个月的婴儿湿疹病因、临床表现、湿疹对婴儿的影响及实验室检查进行总结和分析.结果 婴儿湿疹急性期占57.50%,74.57%的患儿皮损分布以头面部为主,42.50%的患儿表现为渗出型湿疹,患儿伴有不同程度的瘙痒,湿疹复发率占66.21%.其病因复杂,患儿血清食物特异性IgE升高占41.72%;血清吸入特异性IgE升高占19.02%.结论 婴儿湿疹以头面部为主,具有急性、渗出性、伴有瘙痒及反复发作的特点,过敏是婴儿湿疹的主要原因之一,对食物过敏较对吸人物过敏更为重要.%Objective To analyze the clinical features of infant eczema. Methods The etiology, clinical manifestation and laboratory examination were analyzed in 1840 infants with eczema who were aged from 20 days to 12 months. Results Acute eczema was presented in 57. 50% of these infants. 74. 57% of the infants had skin lesions on the head and face, and the exudative type of lesions was found in 42. 50% of them. All of the infants had different degrees of itching. The relapse rate in this group of patients was 66. 21% . The etiology of infant eczema was complicated. 41.72% of patients had higher serum level of IgE for special food, and 19. 02% for special inhaling materials. Conclusion Infant eczema is an acute and relapsing disease with exudative and pruritic skin lesions, which mainly occur on the head and face, Hypersensitivity is one of the main causes for infant eczema, Hypersensitivity to food is more important than that to inhaling materials.

  17. DIAGNOSTIC VALUE OF PATCH TEST IN HAND AND FOOT ECZEMAS

    Directory of Open Access Journals (Sweden)

    Sravani Sandhya Bellam

    2016-11-01

    Full Text Available BACKGROUND The present study is undertaken to evaluate the results of patch test in 50 patients having hand and foot eczema attending skin OPD from October 2010 to September 2012 at KIMS, Narketpally. RESULTS Maximum number of cases in this study belong to 16-30 yrs. (46%.  In majority of cases, eczema was seen in both hands and feet (40%. Hand and foot eczema was commonly seen in construction workers (42.3%.  Mean duration of illness is 19.48 months.  42% of patients presented with acute eczema followed by subacute eczema (38% and then chronic eczema (20%.  Personal and family history of atopy was seen in only 4% and 6%, respectively.  Hand and foot eczema (42.3% was the commonest eczema followed by hand (30.74% and then foot eczema (11.53% and others (15.37%.  57.69% of patients are positive to more than one allergen and 42.3% were positive to single allergen.  Multiple allergens positivity is seen in construction workers (30.76%.  Potassium di chromate (28.5% is the common allergen found in patch test followed by Parthenium (16.6% followed by Paraphenylenediamine (14% and then Cobalt sulphate and Thiuram mix (9.5% and lastly Parabens mix, Nickel sulphate, Black rubber mix and Neomycin (4.7%.  Positive patch test is more commonly observed in patients having hands and or foot eczemas (42.30%. CONCLUSION Hand and foot eczema (42% was the commonest eczema followed by hand (30% and then foot eczema (11.5% and others (15.3%. Potassium dichromate is the commonest sensitiser (28.8%. We encountered a high degree of patch test positivity in our study group and the Indian standard series proved to be very useful.

  18. Atopic eczema in a multiracial country (Malaysia).

    Science.gov (United States)

    Jaafar, R B; Pettit, J H

    1993-11-01

    A total of 14,342 patients with skin diseases who had attended either the National University of Malaysia skin clinic or a private dermatological office were analysed. Five hundred and thirty-four cases (3.7%) had atopic eczema, the prevalence being highest among the Malays (4.3%). The prevalence of atopic eczema among clinic attenders is lower in all three major Malaysian races when compared with studies from England.

  19. Flexural eczema versus atopic dermatitis.

    Science.gov (United States)

    Jacob, Sharon E; Goldenberg, Alina; Nedorost, Susan; Thyssen, Jacob P; Fonacier, Luz; Spiewak, Radoslaw

    2015-01-01

    Flexural eczema and atopic dermatitis are frequently synonymized. As respiratory atopy is rarely tested for and found in these patients, systematically equating a flexural distribution of dermatitis with atopic dermatitis may too frequently result in misclassified diagnoses and potentially missed opportunity for intervention toward improving patients' symptoms and quality of life. We present a critical review of the available evidence for the atopic dermatitis diagnosis and discuss the similarities between atopic dermatitis and allergic contact dermatitis. Because neither flexural predilection nor atopy is specific for atopic dermatitis, we conclude that the term atopic dermatitis is a misnomer and propose an etymologic reclassification of atopic dermatitis to "atopy-related" dermatitis. Allergic contact dermatitis can induce an atopic dermatitis-like phenotype, and thus, flexural dermatitis cannot be assumed as atopic without further testing. Patch testing should at least be considered in cases of chronic or recurrent eczema regardless of the working diagnosis.

  20. Clinical Analysis of 175 Cases of Acute Eczema Patients%175例急性期湿疹患者临床分析

    Institute of Scientific and Technical Information of China (English)

    黄博; 邓佳; 王琪; 许爱娥

    2012-01-01

    目的 观察急性期湿疹住院患者临床特征及治疗周期.方法 对175例急性湿疹住院患者的病历资料进行统计分析.结果 175例患者中男81例,女94例,平均发病年龄(45.98±21.79)岁.其中首次发病者57例占32.55%,属慢性湿疹急性发作者118例占67.45%.其中19例(10.86%)认为有明显的诱发因素.有25例患者(14.28%)曾患有其他过敏性疾病.渗出物细菌培养以金黄色葡萄球菌为主.复方甘草酸苷的总体治疗周期与糖皮质激素相比差异没有统计学意义,但起效时间相对较慢.结论 急性湿疹患者常有慢性湿疹病史,多无明显诱因,常伴随皮肤细菌感染.复方甘草酸苷治疗急性湿疹疗效确切,患者住院时间与糖皮质激素相比无统计学意义,不良反应小,可以作为急性湿疹的治疗方法之一.%Objective To observe the clinical characteristics and treatment cycle of acute phase of eczema inpatients. Methods 175 cases of acute eczema hospitalized patients medical records data were collected for statistical analysis. Results Among 175 patients , 81 cases were male and 94 cases were female, and the average age of onset was (45.98 ± 21.79) years old. 57 cases were the first onset accounting for 32.55% and 118 cases were recurrence of chronic eczema accounting for 67.45%. 19 cases (10.86%) had obvious predisposing factor and 25 patients (14.28%) had other allergic diseases. Exudate of bacterial culture was main staphylococcus aureus. The treatment cycles between compound glycyrrhizin and corticosteroid had no significant difference, but onset time of compound glycyrrhizin was relatively slow. Conclusion Acute eczema patients often have chronic eczema history, many with no obvious predisposing factors, and often be accompanied by bacterial infection of skin. The curative effect of compound glycyrrhizin in treating acute eczema is accurate, Compared with glucocorticosteroid, the hospitalization time has no statistical

  1. Size and location of ruptured intracranial aneurysms: consecutive series of 1993 hospital-admitted patients.

    Science.gov (United States)

    Korja, Miikka; Kivisaari, Riku; Rezai Jahromi, Behnam; Lehto, Hanna

    2016-12-02

    OBJECTIVE Large consecutive series on the size and location of ruptured intracranial aneurysms (RIAs) are limited, and therefore it has been difficult to estimate population-wide effects of size-based treatment strategies of unruptured intracranial aneurysms. The authors' aim was to define the size and location of RIAs in patients diagnosed with subarachnoid hemorrhage due to aneurysm rupture in a high-volume academic center. METHODS Consecutive patients admitted to a large nonprofit academic hospital with saccular RIAs between 1995 and 2009 were identified, and the size, location, and multiplicity of RIAs were defined and reported by patient sex. RESULTS In the study cohort of 1993 patients (61% women) with saccular RIAs, the 4 most common locations of RIAs were the middle cerebral (32%), anterior communicating (32%), posterior communicating (14%), and pericallosal arteries (5%). However, proportional distribution of RIAs varied considerably by sex; for example, RIAs of the anterior communicating artery were more frequently found in men than in women. Anterior circulation RIAs accounted for 90% of all RIAs, and 30% of the patients had multiple intracranial aneurysms. The median size (measured as maximum diameter) of all RIAs was 7 mm (range 1-43 mm), but the size varied considerably by location. For example, RIAs of the ophthalmic artery had a median size of 11 mm, whereas the median size of RIAs of the pericallosal artery was 6 mm. Of all RIAs, 68% were smaller than 10 mm in maximum diameter. CONCLUSIONS In this large consecutive series of RIAs, 83% of all RIAs were found in 4 anterior circulation locations. The majority of RIAs were small, but the size and location varied considerably by sex. The presented data may be of help in defining effective prevention strategies.

  2. Combination antihypertensive therapy in clinical practice. The analysis of 1254 consecutive patients with uncontrolled hypertension.

    Science.gov (United States)

    Petrák, O; Zelinka, T; Štrauch, B; Rosa, J; Šomlóová, Z; Indra, T; Turková, H; Holaj, R; Widimský, J

    2016-01-01

    The aim of the study was to analyze the clinical use of different types of combination therapy in a large sample of consecutive patients with uncontrolled hypertension referred to Hypertension Centre. We performed a retrospective analysis of combination antihypertensive therapy in 1254 consecutive patients with uncontrolled hypertension receiving at least triple-combination antihypertensive therapy. Among the most prescribed antihypertensive classes were renin-angiotensin blockers (96.8%), calcium channel blockers (82.5%), diuretics (82.0%), beta-blockers (73.0%), centrally acting drugs (56.0%) and urapidil (24.1%). Least prescribed were spironolactone (22.2%) and alpha-1-blockers (17.1%). Thiazide/thiazide-like diuretics were underdosed in more than two-thirds of patients. Furosemide was prescribed in 14.3% of patients treated with diuretics, while only indicated in 3.9%. Inappropriate combination therapy was found in 40.4% of patients. Controversial dual and higher blockade of renin-angiotensin system occurred in 25.2%. Incorrect use of a combination of two antihypertensive drugs with the similar mechanism of action was found in 28.1%, most commonly a combination of two drugs with central mechanism (13.5%). In conclusion, use of controversial or incorrect combinations of drugs in uncontrolled hypertension is common. Diuretics are frequently underdosed and spironolactone remains neglected in general practice. The improper combination of antihypertensive drugs may contribute to uncontrolled hypertension.

  3. Two consecutive partial liver transplants in a patient with Classic Maple Syrup Urine Disease

    Directory of Open Access Journals (Sweden)

    H.L. Chin

    2015-09-01

    Full Text Available Maple syrup urine disease is caused by a deficiency in the branched chain ketoacid dehydrogenase (BCKAD complex. This results in the accumulation of branched chain amino acids (BCAA and branched chain ketoacids in the body. Even when aggressively treated with dietary restriction of BCAA, patients experience long term cognitive, neurological and psychosocial problems. Liver transplantation from deceased donors has been shown to be an effective modality in introducing adequate BCKAD activity, attaining a metabolic cure for patients. Here, we report the clinical course of the first known patient with classic MSUD who received two consecutive partial liver grafts from two different living non-carrier donors and his five year outcome posttransplant. We also show that despite the failure of the first liver graft, and initial acute cellular rejection of the second liver graft in our patient, his metabolic control remained good without metabolic decompensation.

  4. Increase in short-chain ceramides correlates with an altered lipid organization and decreased barrier function in atopic eczema patients

    NARCIS (Netherlands)

    M. Janssens (Michelle); J. van Smeden (Jeroen); G.S. Gooris (Gert); W. Bras (Wim); G. Portale (Guiseppe); P.J. Caspers (Peter); R. Vreeken (Rob); T. Hankemeier (Thomas); S. Kezic (Sanja); R. Wolterbeek (Ron); A.P.M. Lavrijsen (Adriana); J.A. Bouwstra (Joke)

    2012-01-01

    textabstractA hallmark of atopic eczema (AE) is skin barrier dysfunction. Lipids in the stratum corneum (SC), primarily ceramides, fatty acids, and cholesterol, are crucial for the barrier function, but their role in relation to AE is indistinct. Filaggrin is an epithelial barrier protein with a

  5. Predictors for 1-year mortality following hip fracture: a retrospective review of 465 consecutive patients.

    Science.gov (United States)

    Heyes, G J; Tucker, A; Marley, D; Foster, A

    2017-02-01

    In Europe, trauma admissions and in particular hip fractures are on the rise. In recent years, health care systems have placed particular emphasis, including financial incentives, on delivering patients quickly and safely to surgery. At our unit, we have observed that hip fracture patients appear to be at significant risk of mortality even up to a year following injury. This study reviews a consecutive population of hip fracture patients to identify predictors of excess risk. Four hundred and sixty-five consecutive patients were treated over a 2-year period at our district general hospital with no ward-based orthogeriatricians. Follow-up was for 1 year following hip fracture admission. Statistical analysis of variables and their influence on 1-year mortality were performed by calculating odd's ratio (OR) using a logistic regression model and a p value year was 50 %. Following hip fracture, we found an overall 1-year mortality rate of 15.1 %. Patients with a time to surgery ≥36 h were at significantly increased risk of mortality even up to 1 year. We did not identify a further reduction in mortality in those operated on within 24 h. Raised ORs (p > 0.05) were found with increasing comorbidity, surgery type, independence on discharge, alcohol ingestion, history of smoking, readmission and several biochemical markers. Minimising mortality risk, even over the longer term, should begin on admission with prompt optimisation of any acute medical or biochemical abnormalities, followed by early surgery and intensive rehabilitation to maintain patients' functional independence.

  6. Provisional stenting in the real world: results in 1058 consecutive patients undergoing percutaneous coronary angioplasty.

    Science.gov (United States)

    Ten Berg, Jurriën M; Kelder, Johannes C; Suttorp, Maarten Jan; Plokker, Thijs HW

    2001-09-01

    OBJECTIVE: To study a strategy of aggressive coronary balloon angioplasty with provisional stenting in allcomers. In randomized trials, stenting has improved the outcome of patients undergoing coronary intervention. However, whether these results hold up in clinical practice is largely unknown. Furthermore, the results of balloon angioplasty have also improved dramatically. It is therefore essential to evaluate the current results of balloon angioplasty and to assess whether stents are required in all patients. METHODS: The authors prospectively studied the occurrence of death, myocardial infarction (MI) and target lesion revascularization (TLR) of a large consecutive group of patients undergoing aggressive balloon angioplasty with provisional stenting. None of the patients received a platelet glycoprotein IIb/IIIa receptor blocker. The results were compared with the outcome of routine stenting in recent randomized trials. RESULTS: Angioplasty was performed in 1058 patients of whom 369 (34.9%) received a stent. The angiographic success rate was 98.9%. During hospital stay, 4.8% of the patients suffered any cardiac event. At one-year follow-up, death occurred in 1.1%, MI in 3.3%, TLR in 12.4% and any event in 16.7% of the patients. Event-free survival at one-year was 82.3%. These results compare favorably with routine stenting in recent trials. CONCLUSIONS: Aggressive balloon angioplasty with provisional stenting yields excellent results in a general patient population.

  7. Eczema (For Parents)

    Science.gov (United States)

    ... Word! Skin Test Asthma Center Rashes: The Itchy Truth Taking Care of Your Skin Eczema Skin Problem: ... The Nemours Foundation, iStock, Getty Images, Corbis, Veer, Science Photo Library, Science Source Images, Shutterstock, and Clipart. ...

  8. Remarkable improvement of relapsing dyshidrotic eczema after treatment of coexistant hyperhidrosis with oxybutynin.

    Science.gov (United States)

    Markantoni, Vasiliki; Kouris, Anargyros; Armyra, Kalliopi; Vavouli, Charitomeni; Kontochristopoulos, George

    2014-01-01

    Dyshidrotic hand eczema is a common condition, which can be resistant to various treatments. Although a number of etiologic factors are involved in the pathogenesis of dyshidrotic eczema, hyperhidrosis is assumed to play a significant role. Oxybutynin is an alternative treatment for hyperhidrosis. We present the cases of two patients suffering from hyperhidrosis and dyshidrotic eczema, who were treated with oxybutynin with impressive results.

  9. Occupational hand eczema among nursing staffs in Korea: Self-reported hand eczema and contact sensitization of hospital nursing staffs.

    Science.gov (United States)

    Lee, Sang W; Cheong, Seung H; Byun, Ji Y; Choi, You W; Choi, Hae Y

    2013-03-01

    Occupational hand eczema is frequent in hospital workers, especially in nurses. A comprehensive understanding regarding hand eczema is essential for establishing proper prevention and treatment strategies. The purpose of this study was to identify the risk factors for hand eczema in hospital nursing staffs. A self-administered questionnaire study was performed on hospital nursing staffs at a single general hospital in Korea. In addition, 70 patients with hand eczema underwent patch testing. Five hundred and twenty-five of 700 invited nurses completed the study (response rate, 75.0%). The overall frequency of symptom-based hand eczema was 75.6%, and self-reported hand eczema was 31.0%. Risk factors for hand eczema were young age, history of atopic dermatitis, frequent hand washing (>20 times/day) and long duration of glove wearing (>5 min). Hand eczema was less frequent among frequent hand moisturizer users (>3-4 times/day). Positive patch test reactions were observed in 61.4%. Frequent allergens were nickel sulfate (35.7%), cobalt chloride (28.6%) and thiomersal (21.4%). Among various antibiotics, ciprofloxacin (11.4%), trimethoprim/sulfamethoxazole (11.4%) and gentamicin (7.1%) were revealed as common allergens, in order of frequency. Hand eczema is quite common among hospital nursing staffs. Proper preventive programs and educations are demanded.

  10. Creams used by hand eczema patients are often contaminated with staphylococcus aureus

    DEFF Research Database (Denmark)

    Lundov, Michael D; Johansen, Jeanne D; Zachariae, Claus

    2012-01-01

    Patienter med håndeksem er ofte bærere af bakterien Staphylococcus aureus, og dette kan være medvirkende til at forværre sværhedsgraden af eksemet. Vi undersøgte, om de håndcremer, som patienter med håndeksem bruger, er kontamineret med mikroorganismer og især S. aureus. Håndcremerne fra 20 patie...

  11. Staphylococcus aureus colonization related to severity of hand eczema.

    Science.gov (United States)

    Mernelius, S; Carlsson, E; Henricson, J; Löfgren, S; Lindgren, P-E; Ehricht, R; Monecke, S; Matussek, A; Anderson, C D

    2016-08-01

    Knowledge on Staphylococcus aureus colonization rates and epidemiology in hand eczema is limited. The aim of this study was to clarify some of these issues. Samples were collected by the "glove juice" method from the hands of 59 patients with chronic hand eczema and 24 healthy individuals. Swab samples were taken from anterior nares and throat from 43 of the 59 patients and all healthy individuals. S. aureus were spa typed and analysed by DNA-microarray-based genotyping. The extent of the eczema was evaluated by the hand eczema extent score (HEES). The colonization rate was higher on the hands of hand eczema patients (69 %) compared to healthy individuals (21 %, p eczema (HEES ≥ 13) had a significantly higher S. aureus density on their hands compared to those with milder eczema (HEES = 1 to 12, p = 0.004). There was no difference between patients and healthy individuals regarding colonization rates in anterior nares or throat. spa typing and DNA-microarray-based genotyping indicated certain types more prone to colonize eczematous skin. Simultaneous colonization, in one individual, with S. aureus of different types, was identified in 60-85 % of the study subjects. The colonization rate and density indicate a need for effective treatment of eczema and may have an impact on infection control in healthcare.

  12. Neuro-ophthalmology of invasive fungal sinusitis: 14 consecutive patients and a review of the literature.

    Science.gov (United States)

    Thurtell, Matthew J; Chiu, Alison L S; Goold, Lucy A; Akdal, Gulden; Crompton, John L; Ahmed, Rebekah; Madge, Simon N; Selva, Dinesh; Francis, Ian; Ghabrial, Raf; Ananda, Arj; Gibson, John; Chan, Raymond; Thompson, Elizabeth O; Rodriguez, Michael; McCluskey, Peter J; Halmagyi, G Michael

    2013-08-01

    Invasive fungal sinusitis is a rare condition that usually occurs in immunocompromised patients and often presents as an orbital apex syndrome. It is frequently misdiagnosed on presentation and is almost always lethal without early treatment. Retrospective case series of 14 consecutive patients with biopsy-proven invasive fungal sinusitis from four tertiary hospitals. Fourteen patients (10 men and 4 women; age range 46-82 years). Retrospective chart review of all patients presenting with invasive fungal sinusitis between 1994 and 2010 at each hospital, with a close analysis of the tempo of the disease to identify any potential window of opportunity for treatment. Demographic data, background medical history (including predisposing factors), symptoms, signs, radiological findings, histopathological findings, treatment approach and subsequent clinical course were recorded and analysed. Only one patient was correctly diagnosed at presentation. Only two patients were not diabetic or immunocompromised. The tempo was acute in two patients, subacute in nine patients and chronic in three patients. In the subacute and chronic cases, there was about 1 week of opportunity for treatment, from the time there was a complete orbital apex syndrome, and still a chance for saving the patient, to the time there was central nervous system invasion, which was invariably fatal. Only two patients survived - both had orbital exenteration, as well as antifungal drug treatment. Invasive fungal sinusitis can, rarely, occur in healthy individuals and should be suspected as a possible cause of a progressive orbital apex syndrome. © 2012 The Authors. Clinical and Experimental Ophthalmology © 2012 Royal Australian and New Zealand College of Ophthalmologists.

  13. Classification of atopic hand eczema and the filaggrin mutations

    DEFF Research Database (Denmark)

    Giwercman, C.; Lerbaek, A.; Bisgaard, H.

    2008-01-01

    Hand eczema is a common disease with various risk factors of which atopic dermatitis is known to be one of the most important. Recently, two mutations in the gene coding for filaggrin, a protein important for the skin barrier, have repeatedly been shown to be associated with atopic dermatitis....... Moreover, one study point towards an association between the filaggrin null alleles and the subgroup of patients having both hand eczema and atopic dermatitis. For the remainder of hand eczema patients, still unknown genetic risk factors exist. We propose that in future, classification of atopic hand...... eczema should distinguish between patients with and without the filaggrin null alleles and to further differentiate between associations with type I allergy, type IV allergy and exposure to irritants, respectively. Furthermore, we suggest future studies of atopic hand eczema to analyse for the filaggrin...

  14. Retrospective analysis of 100 consecutive patients undergoing related living donor renal transplantation.

    Science.gov (United States)

    Diethelm, A G; Sterling, W A; Aldrete, J S; Shaw, J F; Morgan, J M

    1976-01-01

    One hundred consecutive patients receiving related donor kidneys were analyzed in regards to graft and patient survival, morbidity, mortality, histocompatibility and rehabilitation. The average followup was 3 years and 2 months with a minimum post transplant evaluation of one year. Donor morbidity was minimal and the mortality nil. Recipient mortality was 17%, all of which occurred after the first two post transplant months. The most serious life threatening complications after transplantation were due to infection. The greatest morbidity was secondary to aseptic necrosis. The overall graft survival at one year was 94%, 2 years--87%, 3 years--81% and 4 and 5 years--72%. Separation of patients according to tissue typing revealed 95% of recipients with A and B matched kidneys to be alive 5 years later compared to 55% of patients receiving C and D matched kidneys. Rehabilitation was good to excellent in 76% of the living patients and poor in only 4%. These results suggest related donor renal transplantation to be the treatment of choice for patients with chronic renal failure excluding only those individuals who are exceptionally high risks in terms of morbidity and mortality. PMID:776105

  15. Anterior Petrosectomy: Consecutive Series of 46 Patients with Attention to Approach-Related Complications.

    Science.gov (United States)

    Van Gompel, Jamie J; Alikhani, Puya; Youssef, A Samy; Loveren, Harry R van; Boyev, K Paul; Agazzi, Sivero

    2015-09-01

    Objective Anterior petrosectomy(AP) was popularized in the 1980s and 1990s as micro-neurosurgery proliferated. Original reports concentrated on the anatomy of the approach and small case series. Recently, with the advent of additional endonasal approaches to the petrous apex, the morbidity of AP remains unclear. This report details approach-related morbidity around and under the temporal lobe. Methods A total of 46 consecutive patients identified from our surgical database were reviewed retrospectively. Results Of the 46 patients, 61% were women. Median age of the patients was 50 years (mean: 48 ± 2 years). Median follow-up of this cohort was 66 months. Most procedures dealt with intradural pathology (n = 40 [87%]). Approach-related morbidity consisted of only two patients (4%) with new postoperative seizures. There were only two significant postoperative hemorrhages (4%). Cerebrospinal fluid leakage occurred in two patients (4%) requiring reoperation. Conclusion Approach-related complications such as seizures and hematoma were infrequent in this series, < 4%. This report describes a contemporary group of patients treated with open AP and should serve as a comparison for approach-related morbidity of endoscopic approaches. Given the pathologies treated with this approach, the morbidity appears acceptable.

  16. Stratum corneum lipids, skin barrier function and filaggrin mutations in patients with atopic eczema

    DEFF Research Database (Denmark)

    Høgh, Julie Kaae; Hellgren, Lars; Jungersted, JM

    2010-01-01

    Background: Prior to the discovery of filaggrin (FLG) mutations, evidence for an impaired skin barrier in atopic dermatitis (AD) has been documented, and changes in ceramide profile, altered skin pH and increased trans-epidermal water loss (TEWL) in patients with AD have been reported. Until now......, no studies have analysed stratum corneum (SC) lipids combined with skin barrier parameters in subjects of known FLG genotype. Methods: A cohort of 49 German individuals genotyped for the most common FLG mutations (R501X, 2282del4) had SC samples taken for lipid analysis by high-performance thin layer...... differences were observed for ceramide 2, 3, 5 and 6. FLGmut individuals had significantly higher skin pH values than individuals not carrying FLG mutations. Patients with AD with FLG mutations had significantly higher erythema compared to patients with AD without FLG mutations. Conclusion: Our results...

  17. Quality of life and depression in a population of occupational hand eczema patients

    DEFF Research Database (Denmark)

    Cvetkovski, Rikke Skoet; Zachariae, Robert; Jensen, Hans Henrik

    2006-01-01

    has considerable impact on quality of life (QoL) and may lead to depression. The aims of the study were to determine risk factors for low QoL, the frequency and severity of depression among OHE patients and changes in QoL and depression after 12 months of follow up. The study population, 758 patients......, comprised all new recognized cases from the Danish National Board of Industrial Injuries Registry between October 2001 and November 2002. All patients received a questionnaire to determine impairment of QoL and depressive symptoms. A similar follow-up questionnaire was posted after 1 year. The response rate...... was 82% at baseline and 91% at follow up. The mean Dermatology Life Quality Index total score was 5.5 for all patients and 7.8 for severe OHE cases. Severe OHE cases and lower socioeconomic status were independently associated with low QoL. The prevalence of moderate-to-severe depression was 9%. Only...

  18. Robot-assisted low anterior resection in fifty-three consecutive patients: an Indian experience.

    Science.gov (United States)

    Kenawadekar, R D; Dhange, R Z; Pandit, A; Bandawar, M S; Joshi, S; Agarwal, G; Jagtap, A P; Puntambekar, S

    2013-12-01

    From December 2005 to December 2009, we performed 150 laparoscopic colorectal procedures. Based on this experience, we started offering robot-assisted colorectal surgery from December 2009. This study is a prospective evaluation of consecutive patients in order to study the technical feasibility and oncological outcome of robot-assisted low anterior resection. This investigation was conducted at a single minimal access surgery institute. Between December 2009 and December 2011, 53 consecutive patients with rectal adenocarcinoma underwent a robot-assisted low anterior resection (LAR) or ultralow anterior resection (ULAR) with total mesorectal excision (TME), using the standard da Vinci 'S' model. Patient demographics, mean operative time, mean postoperative hospital stay, blood loss, days to first flatus, resumption of oral feeds, urinary incontinence, and sexual dysfunction were studied. Surgical and pathological outcomes such as quality of TME, free circumferential margins, and number of lymph nodes dissected were also evaluated. Robot docking and undocking times were noted. Of the 53 patients, 41 were men and 12 were women. Their mean age was 66.7 years (range 37-90 years). The ASA grades were distributed as follows: ASA I 15 (28.3 %), ASA II 25 (47.16 %), ASA III 12 (22.64 %), ASA IV 1 (1.88 %). The mean operative time was 180 min (150-230 min) and the mean blood loss was 101.6 ml (50-300 ml). The robot docking time was 10 min (15-25 min) and the undocking time was 5 min (3-10 min). The mean hospital stay was 8 days (7-15 days). None of the patients was converted to either laparoscopic or open procedure. The longitudinal and circumferential margins were negative in all patients. Histopathological reports of 45 patients showed complete TME while 8 patients showed nearly complete TME. No repositioning of the robot was needed for splenic flexure mobilization, thus decreasing the operative time. Along with TME, even the splenic flexure mobilization

  19. Comparison of four methods for assessment of severity of hand eczema

    NARCIS (Netherlands)

    Agner, Tove; Jungersted, Jacob Mutanu; Coenraads, Pieter-Jan; Diepgen, Thomas

    2013-01-01

    Background Several instruments for the assessment of the severity of hand eczema and health-related quality of life (HR-QoL) related to hand eczema have been developed. Objectives The aim of the present study was to evaluate the correlation between frequently used methods. Methods Consecutive patien

  20. Stratum corneum lipids, skin barrier function and filaggrin mutations in patients with atopic eczema

    DEFF Research Database (Denmark)

    Jungersted, J M; Scheer, H; Mempel, M

    2010-01-01

    Prior to the discovery of filaggrin (FLG) mutations, evidence for an impaired skin barrier in atopic dermatitis (AD) has been documented, and changes in ceramide profile, altered skin pH and increased trans-epidermal water loss (TEWL) in patients with AD have been reported. Until now, no studies...... have analysed stratum corneum (SC) lipids combined with skin barrier parameters in subjects of known FLG genotype....

  1. Stratum corneum lipids, skin barrier function and filaggrin mutations in patients with atopic eczema.

    Science.gov (United States)

    Jungersted, J M; Scheer, H; Mempel, M; Baurecht, H; Cifuentes, L; Høgh, J K; Hellgren, L I; Jemec, G B E; Agner, T; Weidinger, S

    2010-07-01

    Prior to the discovery of filaggrin (FLG) mutations, evidence for an impaired skin barrier in atopic dermatitis (AD) has been documented, and changes in ceramide profile, altered skin pH and increased trans-epidermal water loss (TEWL) in patients with AD have been reported. Until now, no studies have analysed stratum corneum (SC) lipids combined with skin barrier parameters in subjects of known FLG genotype. A cohort of 49 German individuals genotyped for the most common FLG mutations (R501X, 2282del4) had SC samples taken for lipid analysis by high-performance thin layer chromatography. In addition, TEWL, erythema, skin hydration and pH were measured. In 27 of the 49 individuals, a 24-h irritation patch test with sodium lauryl sulphate was performed. For the analysis, both the AD group and the control group were stratified by FLG mutation status (FLGmut/FLGwt). In the FLGmut AD group, significantly lower levels of ceramide 4 and significantly higher levels of ceramide 7 were observed when compared to both healthy control groups. However, ceramide 7 levels also significantly differed between FLGwt AD and FLGwt controls, as did ceramide 1 levels. No significant differences were observed for ceramide 2, 3, 5 and 6. FLGmut individuals had significantly higher skin pH values than individuals not carrying FLG mutations. Patients with AD with FLG mutations had significantly higher erythema compared to patients with AD without FLG mutations. Our results confirm previous observations of altered ceramide levels in AD, which however appear to show no clear relationship with FLG mutations.

  2. Surgery for lumbar disc herniation: Analysis of 500 consecutive patients treated in an interdisciplinary spine centre.

    Science.gov (United States)

    Schmid, S L; Wechsler, C; Farshad, M; Antoniadis, A; Ulrich, N H; Min, K; Woernle, C M

    2016-05-01

    Surgical removal of a symptomatic herniated lumbar disc is performed either with or without the support of a microscope. Up to the time of writing, the literature has reported similar clinical outcomes for the two procedures. Five hundred consecutive patients, operated upon for primary single-level lumbar disc herniation in our University Spine Center between 2003-2011, with (n=275), or without (n=225), the aid of a microscope were included. Data were retrospectively analyzed, comparing the primary endpoint of clinical outcome and the secondary endpoints of complications, surgical time and length of hospitalization. Clinical outcomes and reoperation rates were comparable in both groups. Surgical time was significantly shorter with a mean time of 47minutes without use of the microscope compared to the mean time of 87minutes (plumbar disc herniation is associated with similar clinical outcomes and reoperation rates. Open sequestrectomy is associated with shorter operation times. Microdiscectomy is associated with shorter hospitalization stays.

  3. Pre-operative sestamibi-technetium subtraction scintigraphy in primary hyperparathyroidism: Experience with 156 consecutive patients

    Energy Technology Data Exchange (ETDEWEB)

    Jones, J. Mark; Russell, Colin F.J.; Ferguson, W. Rodney; Laird, James D

    2001-07-01

    AIM: The aim of this study was to assess the usefulness of pre-operative sestamibi-technetium subtraction scintigraphy in a large cohort of patients with primary hyperparathyroidism (HPT). MATERIALS AND METHODS: A group of 156 consecutive patients with biochemically proven HPT underwent sestamibi-technetium subtraction scintigraphy before cervical exploration. Images were interpreted and reported prospectively and influenced the extent of surgical exploration. The intraoperative findings were compared retrospectively with the pre-operative scintigram reports in 154 individuals with technically satisfactory scintigrams. RESULTS: Of the 154 patients with satisfactory scintigrams, 122 (78.2%) demonstrated a single focus of activity following subtraction, 31 (19.9%) had negative findings and the remaining scintigram showed four foci of activity. At operation 138 (89.6%) solitary adenomas were removed, 13 patients (8.4%) had multi-gland disease and in three individuals (2.0%) no abnormal parathyroid tissue was found. The pre-operative scintigram accurately localized 91 of 98 (92.9%) solitary tumours weighing > 500 mg but only 18 of 35 (51.4%) adenomas weighing < 500 mg, (P < 0.0001). Overall sensitivity of sestamibi-technetium scintigraphy for localizing single parathyroid adenomas was 83.7%. CONCLUSION: Sestamibi-technetium subtraction scintigraphy will accurately localize a high proportion of solitary parathyroid adenomas but its usefulness is diminished by its inability to consistently identify smaller tumours. Jones, J.M. et al. (2001)

  4. Squamous cell carcinoma of the oropharynx--an analysis of treatment results in 289 consecutive patients

    Energy Technology Data Exchange (ETDEWEB)

    Johansen, L.V.; Grau, C.; Overgaard, J. [Aarhus Univ. Hospital (Denmark). Dept. of Experimental Clinical Oncology

    2001-01-01

    In this retrospective study the results of primary and salvage treatment of oropharyngeal carcinoma were evaluated. A total of 289 consecutive patients (103 females and 186 males) were included in the study. Most tumours originated in the tonsil area (58%) and comprised stages I 8%, II 19%, III 46% and IV 28%. The primary treatment was delivered with curative intent in 276 cases (96%). Of these, 266 received primary radiotherapy. The median radiation dose was 62 Gy, given as laterally opposed fields to the primary tumour and bilateral neck. Eight patients were treated with primary surgery and two with chemotherapy as part of a curatively intended treatment programme including radiotherapy. Six patients received palliative treatment, and seven were not treated at all. Out of 276 tumours treated with curative intent, 173 reappeared; 72% recurred in T position, 38% in N position, and 12% at distant metastatic sites, some in combination. Salvage surgery was possible in 52 patients, and 24 treatments were successful. Salvage radiotherapy or cryotherapy was used in 22 patients and 4 were controlled. For the entire group, the 5-year locoregional tumour control, disease-specific survival and overall survival rates were 38%, 44% and 31%, respectively. For patients treated with curative intent, clinical T- and N-stage, stage, tumour size, gender, age, and pretreatment haemoglobin were significant prognostic parameters in a univariate analysis. The Cox multivariate analysis showed that T-stage, N-stage and gender were independent prognostic factors. It is concluded that T-stage, N-stage and gender are significant independent prognostic factors. The primary control of the carcinoma in the T-position is crucial for overall success, but salvage surgery is found to have a favourable success rate in patients suitable for relapse treatment.

  5. 泛发性湿疹患者外周血淋巴细胞亚群的研究%Research of lymphocyte subpopulation in peripheral blood of generalized eczema patients

    Institute of Scientific and Technical Information of China (English)

    韩莹; 程欣

    2015-01-01

    Objective To investigate changes of immunologic function in generalized eczema patients. Methods Lymphocyte subpopulation in peripheral blood of 200 generalized eczema patients (generalized eczema group) were detected by flow cytometry method, and they were compared with those in 200 normal people (normal group).Results Compared with the normal group, the generalized eczema group had decreased CD3+ T cells, CD3+CD4+ T cells, CD3-CD16+56+ NK cells, CD4+/CD8+ T cells, and increased CD3+CD8+ T cells. The difference had statistical significance (P<0.05).Conclusion Immune function disorder is one of the main mechanism of generalized eczema patients, and it acts with important effect in occurrence and progress of generalized eczema.%目的:探讨泛发性湿疹患者的免疫功能变化。方法应用流式细胞仪分析检测200例泛发性湿疹患者(泛发性湿疹组)外周血中的淋巴细胞亚群,并与200例正常人(正常组)进行比较。结果与正常组相比泛发性湿疹组的CD3+ T细胞降低, CD3+CD4+ T细胞降低, CD3+CD8+ T细胞升高, CD3-CD16+56+ NK细胞降低, CD4+/CD8+降低,差异有统计学意义(P<0.05)。结论免疫功能的紊乱是泛发性湿疹患者发病的一个重要机制,在泛发性湿疹的发生、发展过程中可能起到重要的作用。

  6. The European baseline series in Lithuania: results of patch testing in consecutive adult patients.

    Science.gov (United States)

    Beliauskiene, A; Valiukeviciene, S; Uter, W; Schnuch, A

    2011-01-01

    In Lithuania, data on patch testing are lacking and the applicability of the European baseline series needs to be evaluated. The aim of the study was to examine the prevalence of contact allergy to the European baseline series in the population of patients with suspected allergic contact dermatitis in Lithuania. Between April 2006 and October 2008, 816 consecutive adult patients referred to the Department of Skin and Venereal Diseases, Kaunas University of Medicine, with suspected allergic contact dermatitis were patch tested with the European baseline series. Demographic data were collected in accordance with the European Surveillance System on Contact Allergies 'minimal data set'. The positive patch test was observed in 384 (47.4%) patients. The most prevalent contact allergens were nickel sulphate (17.1%), Myroxylon pereirae resin (8.0%), p-phenylenediamine (6.0%), methyldibromo glutaronitrile (5.5%) and colophonium (5.0%). The sex and age factors strongly influenced the prevalence of nickel sensitization. The lowest sensitization prevalences were found to N-isopropyl-N'-phenyl-p-phenylene diamine (0.1%) and 2-mercaptobenzothiazole (0.1%). Differences in the sensitization prevalences to some allergens of the European baseline series compared with other European countries were recognized. The current European baseline series is a suitable diagnostic tool for contact allergy in Lithuania. © 2010 The Authors. Journal of the European Academy of Dermatology and Venereology © 2010 European Academy of Dermatology and Venereology.

  7. Clinical and contact allergological observations on hand eczema: a descriptive study.

    Science.gov (United States)

    Bhattarai, S; Agrawal, S; Rijal, A

    2014-09-01

    Hand eczema (HE) is a common and distressing condition that is perplexing to the patient and the physician alike. To study the frequency and clinical features of hand eczema and to correlate the frequency of atopy and contact sensitization with different clinical features a total of 61 clinically diagnosed patient of Hand eczema were included within a period of one year. Patch test was done in 47 patients and graded accordingly. The frequency of hand eczema was 0.57%. Morphologically pompholyx was the most common type while aetiologically endogenous hand eczema was the commonest. Contact allergy was observed in 55.3% of the cases of which nickel sulphate (18.5%) was found to be the commonest sensitiser followed by Gentamicin and Fragrance mix though contact allergens with positive patch test in different morphological types of hand eczema have no apparent relevance but it still could contribute to the persistence or exacerbation of hand eczema.

  8. Intraspinal anomalies in scoliosis: An MRI analysis of 177 consecutive scoliosis patients

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    Rajasekaran S

    2010-01-01

    Full Text Available Background : The association of intraspinal neural anomalies with scoliosis is known for more than six decades. However, there are no studies documenting the incidence of association of intraspinal anomalies in scoliotic patients in the Indian population. The guide lines to obtain an magnetic resonance imaging (MRI scan to rule out neuro-axial abnormalities in presumed adolescent idiopathic scoliosis are also not clear. We conducted a prospective study (a to document and analyze the incidence and types of intraspinal anomalies in different types of scoliosis in Indian patients. (b to identify clinico-radiological ′indicators′ that best predict the findings of neuro-axial abnormalities in patients with presumed adolescent idiopathic scoliosis, which will alert the physician to the possible presence of intraspinal anomalies and optimize the use of MRI in this sub group of patients. Materials and Methods : The data from 177 consecutive scoliotic patients aged less than 21 years were analyzed. Patients were categorized into three groups; Group A - congenital scoliosis (n=60, group B -presumed idiopathic scoliosis (n=94 and group C - scoliosis secondary to neurofibromatosis, neuromuscular and connective tissue disorders (n=23. The presence and type of anomaly in the MRI was correlated to patient symptoms, clinical signs and curve characteristics. Results : The incidence of intraspinal anomalies in congenital scoliosis was 35% (21/60, with tethered cord due to filum terminale being the commonest anomaly (10/21. Patients with multiple vertebral anomalies had the highest incidence (48% of neural anomalies and isolated hemi vertebrae had none. In presumed ′idiopathic′ scoliosis patients the incidence was higher (16% than previously reported. Arnold Chiari-I malformation (AC-I with syringomyelia was the most common neural anomaly (9/15 and the incidence was higher in the presence of neurological findings (100%, apical kyphosis (66.6% and early

  9. Femoral access in 100 consecutive subarachnoid hemorrhage patients: the "craniotomy" of endovascular neurosurgery

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    Huang Judy

    2010-11-01

    Full Text Available Abstract Background Femoral access is a fundamental element of catheter-based cerebral angiography. Knowledge of location of the common femoral artery (CFA bifurcation is important as the risk of retroperitoneal bleeding is increased if the puncture is superior to the inguinal ligament and there is an increased risk of thrombosis and arteriovenous fistula formation if the puncture is distal into branch vessels. We sought to characterize the location of the CFA bifurcation along with the presence of significant atherosclerosis or iliac tortuosity in a contemporary series of subarachnoid hemorrhage (SAH patients. Findings The records of a prospective single-center aneurysm database were reviewed to identify 100 consecutive SAH patients. Using an oblique femoral arteriogram, the presence of significant atherosclerosis, iliac tortuosity, and the CFA bifurcation were assessed. The CFA bifurcation was graded according to its position with respect to the femoral head: below (grade 1, lower half (grade 2, and above the upper half (grade 3. We found a CFA bifurcation grade 1 in 50 patients (50%, mean age 51.2 years, grade 2 in 40 patients (40%, mean age 55.5 years, and grade 3 in 10 patients (10%, mean age 58.2 years. Whereas 30 of 90 patients with CFA grades I or II were male (33%, only 10% with grade 3 were male (1 of 10, p = 0.12. Mean age for significant atherosclerosis was 65.5 +/- 2.6 years versus 50.9 +/- 1.6 years (p Conclusions Although a requisite element of endovascular treatment in SAH patients, femoral access can be complicated by a high common femoral artery bifurcation and the presence of atherosclerotic disease and/or iliac artery tortuosity. In this study, we found a grade 3 (above the femoral head CFA bifurcation in 10% patients, with 90% of these patients being female. We also found the presence of atherosclerotic disease and iliac tortuosity to be significantly more likely in patients older than 65 years of age.

  10. Clinicopathological Features of Cervical Esophageal Cancer: Retrospective Analysis of 63 Consecutive Patients Who Underwent Surgical Resection.

    Science.gov (United States)

    Saeki, Hiroshi; Tsutsumi, Satoshi; Yukaya, Takafumi; Tajiri, Hirotada; Tsutsumi, Ryosuke; Nishimura, Sho; Nakaji, Yu; Kudou, Kensuke; Akiyama, Shingo; Kasagi, Yuta; Nakashima, Yuichiro; Sugiyama, Masahiko; Sonoda, Hideto; Ohgaki, Kippei; Oki, Eiji; Yasumatsu, Ryuji; Nakashima, Torahiko; Morita, Masaru; Maehara, Yoshihiko

    2017-01-01

    The objectives of this retrospective study were to elucidate the clinicopathological features and recent surgical results of cervical esophageal cancer. Cervical esophageal cancer has been reported to have a dismal prognosis. Accurate knowledge of the clinical characteristics of cervical esophageal cancer is warranted to establish appropriate therapeutic strategies. The clinicopathological features and treatment results of 63 consecutive patients with cervical esophageal cancer (Ce group) who underwent surgical resection from 1980 to 2013 were analyzed and compared with 977 patients with thoracic or abdominal esophageal cancer (T/A group) who underwent surgical resection during that time. Among the patients who received curative resection, the 5-year overall and disease-specific survival rates of the Ce patients were significantly better than those of the T/A patients (overall: 77.3% vs 46.5%, respectively, P = 0.0067; disease-specific: 81.9% vs 55.8%, respectively, P = 0.0135). Although total pharyngo-laryngo-esophagectomy procedures were less frequently performed in the recent period, the rate of curative surgical procedures was markedly higher in the recent period (2000-1013) than that in the early period (1980-1999) (44.4% vs 88.9%, P = 0.0001). The 5-year overall survival rate in the recent period (71.5%) was significantly better than that in the early period (40.7%, P = 0.0342). Curative resection for cervical esophageal cancer contributes to favorable outcomes compared with other esophageal cancers. Recent surgical results for cervical esophageal cancer have improved, and include an increased rate of curative resection and decreased rate of extensive surgery.

  11. Spinal stab injury with retained knife blades: 51 Consecutive patients managed at a regional referral unit.

    Science.gov (United States)

    Enicker, Basil; Gonya, Sonwabile; Hardcastle, Timothy C

    2015-09-01

    Spinal stab wounds presenting with retained knife blades (RKB) are uncommon, often resulting in spinal cord injury (SCI) with catastrophic neurological consequences. The purpose of this study is to report a single unit's experience in management of this pattern of injury at this regional referral centre. Retrospective review of medical records identified 51 consecutive patients with spinal stabs presenting with a RKB at the Neurosurgery Department at Inkosi Albert Luthuli Central Hospital between January 2003 and February 2015. The data was analyzed for patient characteristics, level of the RKB, neurological status using the ASIA impairment scale, associated injuries, radiological investigations, management, hospital length of stay, complications and mortality. The mean age was 28±10.9 years (range 14-69), with 45 (88%) males (M: F=7.5:1). The median Injury Severity Score was 16 (range 4-26). RKB were located in the cervical [9,18%], thoracic [38,74%], lumbar [2,4%] and sacral [2,4%] spine. Twelve patients (24%) sustained complete SCI (ASIA A), while 21 (41%) had incomplete (ASIA B, C, D), of which 17 had features of Brown-Sequard syndrome. Eighteen (35%) patients were neurologically intact (ASIA E). There were 8 (16%) associated pneumothoraces and one vertebral artery injury. Length of hospital stay was 10±7.1 days (range 1-27). One patient (2%) died during this period. Stab injuries to the spine presenting with RKB are still prevalent in South Africa. Resources should be allocated to prevention strategies that decrease the incidence of inter-personal violence. All RKBs should be removed in the operating theatre by experienced surgeons to minimise complications. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. DiscoGel® in patients with discal lumbosciatica. Retrospective results in 25 consecutive patients.

    Science.gov (United States)

    Léglise, A; Lombard, J; Moufid, A

    2015-09-01

    Discogenic lumbosciatica is a common disorder in patients between 30 and 40 years old. Because of the frequency and socio-professional impact of this entity, it represents a real public health problem. DiscoGel® is a class III medical device used for nucleolysis to avoid discectomy. The goal of this study was to evaluate the effectiveness of this treatment in patients with discogenic lumbosciatica following unsuccessful conservative medical treatment. This is a retrospective, single-center study including 25 patients who were treated with DiscoGel® between 2010 and 2011 at Niort Hospital, France. The severity of lumbar and radicular pain was assessed by a verbal numeric scale (VNS) and patient satisfaction. Patients were classified as successes or failures. Treatment was found to reduce the severity of lumbar pain in 73% and of radicular pain in 80% of patients in the success group. Treatment was a failure in 64% of patients. A comparison of the two groups showed that a preoperative MODIC 2 MRI signal of the adjacent vertebral end plate was significantly associated with treatment failure (Chi(2)=8572, P lumbosciatica in 16 patients. These results do not support others in the literature. A lack of statistical power could partly explain these results. The most important result of this study is found in the subgroup analysis which suggests that indications for DiscoGel® treatment could be modified in the future in relation to preoperative imaging data. 4. Copyright © 2015. Published by Elsevier Masson SAS.

  13. The functional intraoral Glasgow scale in floor of mouth carcinoma: longitudinal assessment of 62 consecutive patients.

    Science.gov (United States)

    Ellabban, Mohamed A; Shoaib, Taimur; Devine, John; McMahon, Jeremy; Morley, Stephen; Adly, Osama A; Farrag, Sherif H; Moati, Taha A; Soutar, David

    2013-03-01

    The functional integrity of the floor of the mouth (FOM) is essential in maintaining tongue mobility, deglutition, and control and disposal of saliva. The present study focused on reporting oral function using functional intraoral Glasgow scale (FIGS) in patients who had surgical ablation and reconstruction of FOM carcinoma with or without chemo-radiotherapy. The study included patients who had surgical treatment of floor of mouth cancer in two regional head and neck units in Glasgow, UK between January 2006 and August 2007. Patients were assessed using FIGS before surgery, 2 months, 6 months and 1 year after surgery. It is a five-point scale self-questionnaire to allow patients to self-assess speech, chewing and swallowing. The maximum total score is 15 points. The influence of socio-demographic parameters, tumour characteristics and surgical parameters was addressed in the study. A total of 62 consecutive patients were included in the study; 41 (66.1 %) were males and 21 (33.9 %) were females. The patients' mean age at the time of diagnosis was 60.6 years. Fifty (80.6 %) patients had unilateral origin of FOM tumours and 10 (19.4 %) had bilateral origin. Peroral approach was the most common approach used in 35 (56.4 %) patients. The mean preoperative FIGS score was 14. Two months after surgery, it droped to 9.4 then started to increase gradually thereafter and recorded 10.1 at 6 months and 11 at 1 year. Unilateral FOM resection recorded better score than bilateral and lateral FOM tumours than anterior at 1 year postoperatively. Furthermore, direct closure showed better functional outcome than loco-regional and free flaps. The FIGS is a simple and comprehensive way of assessing a patient's functional impairment following surgery in the FOM. Tumour site and size, surgical access, surgical resection and method of reconstruction showed significant influence on oral function following surgical resection. A well-designed rehabilitation programme is required to improve

  14. Retropubic radical prostatectomy: Clinicopathological observations and outcome analysis of 428 consecutive patients

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    Jagdeesh N Kulkarni

    2011-01-01

    Full Text Available Aim : We report the outcome analysis of retropubic radical prostatectomy (RRP performed in 428 patients in terms of pathological findings, complications, and survival. Materials and Methods : Systematically recorded case reports forms of consecutive 428 RRPs done over a 14-year period were analyzed using the SPSS 14 software. Secondary analysis was done to evaluate era specific (pre and post 2002 changes in clinical features and survivals. Results : Seven-year overall survival (OAS, cancer-specific survival (CSS, and event-free survival (EFS was 83.2%, 82.8%, and 69.8% respectively in our series. Era-specific survival showed higher CSS post 2002, and there was an increase in presentation with organ-confined disease. Univariate and multivariate analysis showed statistically significant impact on era specific outcome. With the improvement in techniques decrease in complications rate and increase in quality of life was noted. Conclusions : Our series spanning over decade demonstrates that RRP is viable option to offer cure to organ-confined carcinoma prostate. Further, there is evidence of stage migration and improvements in outcome in post 2002 patients. Although our series is modest in number, the success rates and outcome data matches those reported in the literature.

  15. The prevalence of xerosis in the outpatients with eczema%门诊湿疹皮炎患者干皮症调查

    Institute of Scientific and Technical Information of China (English)

    郭金竹; 李邻峰

    2012-01-01

    目的:探讨干皮症在湿疹皮炎患者中的发病情况及其与洗浴习惯的关系.方法:对319例湿疹皮炎与242例非湿疹患者进行问卷调查及体格检查,对两组的干皮症及洗浴习惯等进行比较分析.结果:湿疹皮炎组患者的干皮症构成比为81.2%,显著高于非湿疹组的65.3%;除特应性皮炎和乏脂性湿疹均为干皮症外,未分类湿疹的干皮症构成比为82.3%,也显著高于非湿疹组的65.3%,湿疹皮炎患者的洗浴习惯与非湿疹组无统计学差异.结论:未分类湿疹患者干皮症多见,与洗浴习惯无明显关联,可能与其机体内部的易感因素有关.%Objective: To investigate the prevalence of xerosis in the outpatients with eczema and explore its potential relation to bathing habit. Methods: Consecutive patients with eczema and non-eczema attended dermatitis clinic between January and March in 2008 were investigated by using a questionnaire and examination for xerosis. Results: The prevalence of xerosis in eczema patients was 81.2%, which was much higher than that in non-eczema control 65.3%). The prevalence of xerosis showed no significant difference between classified eczema patients and control. The prevalence of xerosis in unclassified eczema patients was 82.3%, which was much higher than that in control (65.3%). The bathing habit showed no significant difference between eczema and control. Conclusion: Xerosis is prevalent in unclassified eczema patients, which is no relation to bathing habit. It maybe is related to susceptible factors within the body.

  16. Smoking and Histological Factors Influencing Long-term Survival of Gastric Carcinoma in Consecutive Patient Series

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    Ali Delpisheh

    2014-06-01

    Full Text Available Background: There is little information about the possible influence of lifestyle and etiologic risk factors on survival amongst patients with gastric cancer. Methods: We recruited a consecutive series of 249 patients with definite diagnosis of gastric cancer who had been hospitalized in Towhid Hospital, Sanandaj, Kurdistan Province in Western Iran during a five-year period from 2006 until 2011. Survival rate was calculated according to the Kaplan-Meier and log rank statistical methods. Cox hazard regression was used to investigate the effect of the variables and adjust for the effect of age. Results: According to univariate analysis, related variables that included age, gender, Residence, histology grade, histology type, familial history of gastrointestinal cancer and mental illness during the disease had no significant effects on survival rate variation. Significant independent factors on survival included past medical history of gastrointestinal diseases (P-value = 0.010, tobacco smoking (P-value = 0.012, and early diagnosis (P-value = 0.008. Cox-regression analysis of demographic, lifestyle and histological factors with >45 years of age as the reference revealed that patients 46-65 years of age at diagnosis (HR=0.602; 95% CI=0.250-1.44; P=0.256 and those >66 years of age (HR=1.07, 95% CI=0.46-2.50, P≤0.001 had an increased risk for disease progression and death. Conclusions: Past medical history of gastrointestinal diseases, tobacco smoking and early stage diagnosis might influence the long-term survival of patients with gastric cancer.

  17. Two consecutive twin and a singleton pregnancy in a patient with chronic myeloid leukemia.

    Science.gov (United States)

    Halim, T A; Nabeel, N

    2014-01-01

    Consecutive multiple pregnancies with Chronic myeloid leukemia is a rare event and little is known about its prevalence and management with or without chemotherapy. We present a case of three consecutive pregnancies in a woman with CML, two of which were multiple pregnancies.

  18. Comparison of oral psoralen-UV-A with a portable tanning unit at home vs hospital-administered bath psoralen-UV-A in patients with chronic hand eczema - An open-label randomized controlled trial of efficacy

    NARCIS (Netherlands)

    van Coevorden, AM; Kamphof, WG; van Sonderen, E; Bruynzeel, DP; Coenraads, PJ

    2004-01-01

    Objective: To study whether oral psoralen-UV-A (PUVA) with a portable tanning unit at home is as effective as hospital-administered bath PUVA in patients with chronic hand eczema. Design: Open-label randomized controlled trial, with a 10-week treatment period and an 8-week follow-up period. Setting:

  19. Anal fistula: results of surgical treatment in a consecutive series of patients

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    Paulo Gonçalves de Oliveira

    2012-03-01

    Full Text Available OBJECTIVES: To evaluate the results of surgical treatment of patients with anal fistulas in a consecutive series of patients. METHODS: A retrospective analytical study of a consecutive series of cases prospectively collected. The sample comprised 210 patients who underwent surgery; demographic data, signs and symptoms, intraoperative classification of the fistulas and healing time were analyzed. RESULTS: The median age was 38 years and 69.0% of the patients were male. The most frequent symptom was perianal orifice with purulent drainage. The fistulas were classified as transsphincteric in 60.9% and the most used operative treatment was the marsupialization of fistulotomy, in 84.2% of cases. Complete healing occurred in all patients between 2 and 16 weeks. One hundred and seventy-eight patients, 84.8% of the patients who underwent surgery, were evaluated at least one year after surgery and recurrence occurred in 6.4% of cases. CONCLUSIONS: There was male prevalence (2.2/1, and most fistulas were transsphincteric. The marsupialization of fistulotomy was the most used operative treatment, and it presented acceptable low rates of morbidity and recurrence of 6.4%.OBJETIVOS: Avaliar os resultados do tratamento cirúrgico de pacientes portadores de fístulas anais em uma série consecutiva de pacientes. MÉTODOS: Estudo analítico, retrospectivo, de uma série consecutiva de casos que foram coletados de forma prospectiva. A casuística englobou 210 pacientes operados, tendo sido analisados os dados demográficos, os sinais e sintomas, a classificação transoperatória das fístulas e o tempo até a cicatrização completa. RESULTADOS: A mediana de idade foi de 38 anos e 69,0% dos pacientes eram homens. O sintoma mais frequente foi a drenagem de secreção purulenta por orifício perianal. As fístulas foram classificadas como transesfincterianas em 60,9%, e o tratamento operatório mais empregado foi a fistulotomia com marsupialização do trajeto

  20. Comparaing the causes of abortion in patients with two or more than two consecutive miscarriages

    Directory of Open Access Journals (Sweden)

    Azam Azargoon MD. A

    2011-07-01

    Full Text Available "n 800x600 Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman","serif";} Background: Recurrent miscarriage is defined as the loss of three or more pregnancies. Recurrent Pregnancy Loss (RPL is traditionally investigated after three or more consecutive losses. Although some believe that the investigation must be launched after two miscarriages, there is not enough compelling evidence to draw conclusion. "n"nMethods : In this cross-sectional study, we studied 58 women with two or more consecutive abortions (37 women with two and 21 women with three or more miscarriages from 2005 to 2009. The following risk factors were analyzed and compared between the two groups: endocrine dysfunctions, genetic abnormalities, uterine anomalies, infections, thrombophilia, polycystic ovary syndrome, autoimmune disorders, sperm characteristics, and advanced maternal age."n"nResults : We did not find any known factor for pregnancy losses in 18 (31.03% patients but in the rest, the most common cause of Recurrent pregnancy loss was endocrine disorders (41.4%. The other causes were uterine abnormalities (12.1%, infections (12.1%, maternal age more than 35 years (12.1%, thrombophilia (8.6%, abnormal semen analysis (8.6%, genetic defects (6.9% and autoimmune disorders (1.7%. There were no significant differences between the two groups in regards with the causes of abortion except uterine abnormality (P=0.039 which was more frequent in women with three or more three miscarriages (23.8% relative to women with two abortions (5.4%."n"nConclusion: There were no significant differences between women

  1. Molecular mechanisms in atopic eczema: insights gained from genetic studies.

    Science.gov (United States)

    Brown, Sara J

    2017-01-01

    Atopic eczema (synonymous with atopic dermatitis) is a common heterogeneous phenotype with a wide spectrum of severity, from mild transient disease to a severe chronic disorder with atopic and non-atopic comorbidities. Eczema is a complex trait, resulting from the interaction of multiple genetic and environmental factors. The skin, as an organ that can be biopsied easily, provides opportunities for detailed molecular genetic analysis. Strategies applied to the investigation of atopic eczema include candidate gene and genome-wide studies, extreme phenotypes, and comparative analysis of inflammatory skin diseases. Genetic studies have identified a central role for skin barrier impairment in eczema predisposition and perpetuation; this has brought about a paradigm shift in understanding atopic disease, but specific molecular targets to improve skin barrier function remain elusive. The role of Th2-mediated immune dysfunction is also central to atopic inflammation, and has proved to be a powerful target for biological therapy in atopic eczema. Advances in understanding eczema pathogenesis have provided opportunities for patient stratification, primary prevention, and therapy development, but there remain considerable challenges in the application of this knowledge to optimize benefit for patients with atopic eczema in the era of personalized medicine. Copyright © 2016 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd. Copyright © 2016 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.

  2. Gastro-duodenal perforations: conventional plain film, US and CT findings in 166 consecutive patients

    Energy Technology Data Exchange (ETDEWEB)

    Grassi, Roberto; Romano, Stefania E-mail: stefromano@libero.it; Pinto, Antonio; Romano, Luigia

    2004-04-01

    Introduction: Gastro-duodenal perforations may be suspected in patients with history of ulceration, who present with acute pain and abdominal wall rigidity, but radiological findings in these cases may be unable to confirm a clinical diagnosis. The aim of our study was to report our experience in the diagnosis of gastro-duodenal perforation by conventional radiography, US and CT examinations. Material and methods: We retrospectively reviewed medical records of 166 consecutive patients who presented in the last 2 years to our institutions with symptoms of acute abdomen and submitted to surgery at the Emergency Unit of the ''A.Cardarelli'' Hospital of Naples with a surgical finding of perforated gastro-duodenal ulcer. The evidence of free intraperitoneal air on abdominal plain film was considered as a direct or suggestive finding of perforation. Evidence of intraperitoneal free fluid and/or reduced intestinal peristalsis at sonographic examination were considered indirect signs of gastro-duodenal perforation. Evidence of free peritoneal gas at CT was considered as a direct evidence of gastro-duodenal perforation. Results: Twenty patients underwent immediate surgery with no preoperative imaging evaluation, in 10 of them the site of perforation was found in a juxta-pyloric region and in the others at level of duodenum. In 146 patients submitted to serial radiological investigations before surgery, the site of perforation was in 56 (38.3%) duodenal, in 52 (35.6%) juxta-pyloric, in 28 (19.1%) gastric and in 10 (6.8%) pyloric. The cause of perforation was in all cases gastric or duodenal ulceration, in seven cases involving pancreatic parenchyma. In 110 (75.4%) patients with direct findings of perforation, in 94 cases (85.5%) the correct diagnosis was established on abdominal plain film, in two (1.8%) with radiographic and sonographic examinations and in 14 (12.7%) on CT findings. In 36 (24,6%) patients with no direct findings of perforation, only 24

  3. KumaFix fixation for thoracolumbar burst fractures: a prospective study on selective consecutive patients

    Institute of Scientific and Technical Information of China (English)

    Yan Liang; Guo Hua; Xu Zhengwei; Liu Tuanjiang; Wang Xiaodong; He Baorong; Hao Dingjun

    2014-01-01

    Background Short-segment U-shaped pedicle screw fixation has been widely used to treat thoracolumbar burst fracture.Some studies have reported the disadvantages of traditional U-shaped pedicle screw,which included a relatively high rate of adjacent segment degeneration and screw failure,including screw pullout and breakage.The purpose of this study was to assess the efficacy of open reduction and fixation using KumaFix fixation system in treatment of thoracolumbar burst fractures.Methods From June 2011 to June 2012,45 consecutive patients with thoracolumbar burst fractures were enrolled.They were randomly assigned to treatment with KumaFix (the treatment group,n=23) or traditional U-shaped pedicle screw (the control group,n=22).The patients were followed up postoperatively and were assessed with regard to radiologic and clinical outcomes.Radiologic outcomes were assessed mainly on the basis of Cobb angle and vertebral wedge angle.Clinical outcomes were evaluated mainly with use of Visual Analog Scale (VAS) for pain and the Oswestry Disability Index (ODI) Questionnaire.Results All patients were followed up from 9 to 22 months.There were no significant differences between the two groups with regard to preoperative indices.The operation time in the treatment group was significantly lower than that in the control group.Preoperative Cobb angles and vertebral wedge angles in two groups were significantly decreased after surgery,and these have been well maintained at the last follow-up with mild correction losses.The results of clinical outcome showed lower VAS and ODI scores in two groups compared with those preoperative,and the treatment group had greater improvement on the ODI compared with the control group at the last follow-up.Conclusions Compared with traditional U-shaped pedicle screw,KumaFix fixation system can achieve gradual,controlled reduction,provide enough space for bone implantation,and avoid acceleration of adjacent segment degeneration.It is an effective

  4. Testicular parenchymal abnormalities in Klinefelter syndrome: a question of cancer? Examination of 40 consecutive patients

    Directory of Open Access Journals (Sweden)

    Giacomo Accardo

    2015-02-01

    Full Text Available Klinefelter syndrome (KS is a hypergonadotropic hypogonadism characterized by a 47, XXY karyotype. The risk of testicular cancer in KS is of interest in relation to theories about testicular cancer etiology generally; nevertheless it seems to be low. We evaluated the need for imaging and serum tumor markers for testicular cancer screening in KS. Participants were 40 consecutive KS patients, enrolled from December 2009 to January 2013. Lactate dehydrogenase (LDH, alpha-fetoprotein (AFP, and beta-human chorionic gonadotrophin subunit (β-HCG serum levels assays and testicular ultrasound (US with color Doppler, were carried out at study entry, after 6 months and every year for 3 years. Abdominal magnetic resonance (MR was performed in KS when testicular US showed micro-calcifications, testicular nodules and cysts. Nearly 62% of the KS had regular testicular echotexture, 37.5% showed an irregular echotexture and 17.5% had micro-calcifications and cysts. Eighty seven percent of KS had a regular vascular pattern, 12.5% varicocele, 12.5% nodules 1 cm. MR ruled out the diagnosis of cancer in all KS with testicular micro calcifications, nodules and cysts. No significant variations in LDH, AFP, and β-HCG levels and in US pattern have been detected during follow-up. We compared serum tumor markers and US pattern between KS with and without cryptorchidism and no statistical differences were found. We did not find testicular cancer in KS, and testicular US, tumor markers and MR were, in selected cases, useful tools for correctly discriminating benign from malignant lesions.

  5. Testicular parenchymal abnormalities in Klinefelter syndrome: a question of cancer? Examination of 40 consecutive patients.

    Science.gov (United States)

    Accardo, Giacomo; Vallone, Gianfranco; Esposito, Daniela; Barbato, Filomena; Renzullo, Andrea; Conzo, Giovanni; Docimo, Giovanni; Esposito, Katherine; Pasquali, Daniela

    2015-01-01

    Klinefelter syndrome (KS) is a hypergonadotropic hypogonadism characterized by a 47, XXY karyotype. The risk of testicular cancer in KS is of interest in relation to theories about testicular cancer etiology generally; nevertheless it seems to be low. We evaluated the need for imaging and serum tumor markers for testicular cancer screening in KS. Participants were 40 consecutive KS patients, enrolled from December 2009 to January 2013. Lactate dehydrogenase (LDH), alpha-fetoprotein (AFP), and beta-human chorionic gonadotrophin subunit (β-HCG) serum levels assays and testicular ultrasound (US) with color Doppler, were carried out at study entry, after 6 months and every year for 3 years. Abdominal magnetic resonance (MR) was performed in KS when testicular US showed micro-calcifications, testicular nodules and cysts. Nearly 62% of the KS had regular testicular echotexture, 37.5% showed an irregular echotexture and 17.5% had micro-calcifications and cysts. Eighty seven percent of KS had a regular vascular pattern, 12.5% varicocele, 12.5% nodules 1 cm. MR ruled out the diagnosis of cancer in all KS with testicular micro calcifications, nodules and cysts. No significant variations in LDH, AFP, and β-HCG levels and in US pattern have been detected during follow-up. We compared serum tumor markers and US pattern between KS with and without cryptorchidism and no statistical differences were found. We did not find testicular cancer in KS, and testicular US, tumor markers and MR were, in selected cases, useful tools for correctly discriminating benign from malignant lesions.

  6. Testicular parenchymal abnormalities in Klinefelter syndrome:a question of cancer? Examination of 40 consecutive patients

    Institute of Scientific and Technical Information of China (English)

    Giacomo Accardo; Gianfranco Vallone; Daniela Esposito; Filomena Barbato; Andrea Renzullo; Giovanni Conzo; Giovanni Docimo; Katherine Esposito; Daniela Pasquali

    2015-01-01

    Klinefelter syndrome (KS) is a hypergonadotropic hypogonadism characterized by a 47, XXY karyotype. The risk of testicular cancer in KS is of interest in relation to theories about testicular cancer etiology generally; nevertheless it seems to be low. We evaluated the need for imaging and serum tumor markers for testicular cancer screening in KS. Participants were 40 consecutive KS patients, enrolled from December 2009 to January 2013. Lactate dehydrogenase (LDH), alpha‑fetoprotein (AFP), and beta‑human chorionic gonadotrophin subunit (β‑HCG) serum levels assays and testicular ultrasound (US) with color Doppler, were carried out at study entry, after 6 months and every year for 3 years. Abdominal magnetic resonance (MR) was performed in KS when testicular US showed micro‑calcifications, testicular nodules and cysts. Nearly 62% of the KS had regular testicular echotexture, 37.5% showed an irregular echotexture and 17.5% had micro‑calcifications and cysts. Eighty seven percent of KS had a regular vascular pattern, 12.5% varicocele, 12.5% nodules 1 cm. MR ruled out the diagnosis of cancer in all KS with testicular micro calcifications, nodules and cysts. No significant variations in LDH, AFP, and β‑HCG levels and in US pattern have been detected during follow‑up. We compared serum tumor markers and US pattern between KS with and without cryptorchidism and no statistical differences were found. We did not find testicular cancer in KS, and testicular US, tumor markers and MR were, in selected cases, useful tools for correctly discriminating benign from malignant lesions.

  7. Classification of atopic hand eczema and the filaggrin mutations

    DEFF Research Database (Denmark)

    G. Carson, Charlotte; Jørkov, Anne Lerbæk; Bisgaard, Hans

    2008-01-01

    Hand eczema is a common disease with various risk factors of which atopic dermatitis is known to be one of the most important. Recently, two mutations in the gene coding for filaggrin, a protein important for the skin barrier, have repeatedly been shown to be associated with atopic dermatitis....... Moreover, one study point towards an association between the filaggrin null alleles and the subgroup of patients having both hand eczema and atopic dermatitis. For the remainder of hand eczema patients, still unknown genetic risk factors exist. We propose that in future, classification of atopic hand...... mutations. We believe this will increase the possibility of subgrouping this otherwise heterogenic disease and thereby enable a better phenotype-genotype characterization of hand eczema. This could improve the preventive initiatives, secure better information of patients about the prognosis...

  8. Prospective study on the expression of cancer testis genes and antibody responses in 100 consecutive patients with primary breast cancer.

    NARCIS (Netherlands)

    Mischo, A.; Kubuschok, B.; Ertan, K.; Preuss, K.D.; Romeike, B.; Regitz, E.; Schormann, C.; Bruijn, D.R.H. de; Wadle, A.; Neumann, F.; Schmidt, W.; Renner, C.; Pfreundschuh, M.

    2006-01-01

    To determine the expression of cancer testis (CT) genes and antibody responses in a nonselected population of patients with primary breast cancer, we investigated the composite expression of 11 CT genes by RT-PCR in fresh biopsies of 100 consecutive cases of primary breast carcinoma and by immunohis

  9. Course of contact allergy in consecutive eczema patients patch tested with TRUE Test panels 1 and 2 at least twice over a 12-year period

    DEFF Research Database (Denmark)

    Jensen, Charlotte D; Andersen, Klaus E

    2005-01-01

    -year period using the TRUE Test standardized patch test system. Out of 297 positive reactions, 66% remained positive in a 2nd test, 10% were scored as doubtful and 24% as negative. Among the previously recorded doubtful reactions, 13% were positive in the 2nd test, 13% were again doubtful and 74...... on the back and the presence of more or less active dermatitis....

  10. Drug Survival and reasons for discontinuation of intramuscular methotrexate: a study of 212 consecutive patients switching from oral methotrexate

    DEFF Research Database (Denmark)

    Linde, Louise; Hetland, Merete Lund; Østergaard, Mikkel

    2006-01-01

    Drug survival and reasons for discontinuation of intramuscular methotrexate: a study of 212 consecutive patients switching from oral methotrexate.Linde L, Hetland ML, Ostergaard M. Department of Rheumatology, Copenhagen University Hospital, Hvidovre Hospital, Hvidovre, Denmark. louiselinde......@dadlnet.dk OBJECTIVES: To assess the drug survival and reasons for discontinuation of intramuscular methotrexate (imMTX) in rheumatological patients who had switched to imMTX from oral methotrexate (oMTX). METHODS: Data from 212 consecutive patients who switched from oMTX to imMTX therapy at our outpatient clinic...... had stopped oMTX because of adverse events, 22% also withdrew from imMTX because of adverse events. CONCLUSION: Half of the patients benefited from switching from oral to intramuscular methotrexate for at least 6 months, but only a minority adhered to the treatment for years. Lack of efficacy...

  11. A novel molecular disease classifier for psoriasis and eczema.

    Science.gov (United States)

    Garzorz-Stark, Natalie; Krause, Linda; Lauffer, Felix; Atenhan, Anne; Thomas, Jenny; Stark, Sebastian P; Franz, Regina; Weidinger, Stephan; Balato, Anna; Mueller, Nikola S; Theis, Fabian J; Ring, Johannes; Schmidt-Weber, Carsten B; Biedermann, Tilo; Eyerich, Stefanie; Eyerich, Kilian

    2016-10-01

    Novel specific therapies for psoriasis and eczema have been developed, and they mark a new era in the treatment of these complex inflammatory skin diseases. However, within their broad clinical spectrum, psoriasis and eczema phenotypes overlap making an accurate diagnosis impossible in special cases, not to speak about predicting the clinical outcome of an individual patient. Here, we present a novel robust molecular classifier (MC) consisting of NOS2 and CCL27 gene that diagnosed psoriasis and eczema with a sensitivity and specificity of >95% in a cohort of 129 patients suffering from (i) classical forms; (ii) subtypes; and (iii) clinically and histologically indistinct variants of psoriasis and eczema. NOS2 and CCL27 correlated with clinical and histological hallmarks of psoriasis and eczema in a mutually antagonistic way, thus highlighting their biological relevance. In line with this, the MC could be transferred to the level of immunofluorescence stainings for iNOS and CCL27 protein on paraffin-embedded sections, where patients were diagnosed with sensitivity and specificity >88%. Our MC proved superiority over current gold standard methods to distinguish psoriasis and eczema and may therefore build the basis for molecular diagnosis of chronic inflammatory skin diseases required to establish personalized medicine in the field. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. Clinical severity and prognosis of hand eczema

    DEFF Research Database (Denmark)

    Hald, M; Agner, T; Blands, J

    2009-01-01

    BACKGROUND: Hand eczema (HE) is a frequent, long-lasting disease with both personal and societal repercussions. Consequently, more information is needed on factors that maintain symptoms. OBJECTIVES: In this study, patients with HE were followed for 6 months from the first visit to a dermatologist...... to identify factors associated with severe disease and a poor prognosis. METHODS: Study participants were 799 patients with HE from nine dermatological clinics in Denmark. Severity assessment of the HE was done at baseline and at the 6-month follow-up using the Hand Eczema Severity Index (HECSI......) and by patients using a self-administered photographic guide. Additional information was obtained from a baseline questionnaire. RESULTS: At baseline, 60.3% assessed their HE as moderate to very severe using the self-administered photographic guide compared with 36.1% at follow-up. The mean HECSI value decreased...

  13. Staphylococcus aureus and hand eczema severity

    DEFF Research Database (Denmark)

    Haslund, P; Bangsgaard, N; Jarløv, J O

    2009-01-01

    BACKGROUND: The role of bacterial infections in hand eczema (HE) remains to be assessed. OBJECTIVES: To determine the prevalence of Staphylococcus aureus in patients with HE compared with controls, and to relate presence of S. aureus, subtypes and toxin production to severity of HE. METHODS......: Bacterial swabs were taken at three different visits from the hand and nose in 50 patients with HE and 50 controls. Staphylococcus aureus was subtyped by spa typing and assigned to clonal complexes (CCs), and isolates were tested for exotoxin-producing S. aureus strains. The Hand Eczema Severity Index...... was used for severity assessment. RESULTS: Staphylococcus aureus was found on the hands in 24 patients with HE and four controls (P hands...

  14. Hand eczema, atopic dermatitis and filaggrin mutations in adult Danes

    DEFF Research Database (Denmark)

    Heede, Nina G; Thuesen, Betina H; Thyssen, Jacob P

    2017-01-01

    BACKGROUND: Atopic dermatitis and hand eczema often impair the ability of people to work. Only a few studies have investigated whether individuals with loss-of-function filaggrin gene (FLG) mutations, who often have severe and early onset of dermatitis, experience occupational consequences....... OBJECTIVE: To investigate the personal consequences of having atopic dermatitis and/or hand eczema and FLG mutations. METHOD: Adult Danes from the general population (n = 3247) and patients with atopic dermatitis and/or hand eczema (n = 496) were genotyped for common FLG mutations, and completed...... in the general population, especially among individuals with a history of atopic dermatitis. Moreover, self-reported hand eczema and atopic dermatitis were associated with particularly high risk of disability pension among FLG mutation carriers [odds ratio (OR) 4.02 and 95% confidence interval (CI): 1...

  15. Increase in short-chain ceramides correlates with an altered lipid organization and decreased barrier function in atopic eczema patients[S

    Science.gov (United States)

    Janssens, Michelle; van Smeden, Jeroen; Gooris, Gert S.; Bras, Wim; Portale, Guiseppe; Caspers, Peter J.; Vreeken, Rob J.; Hankemeier, Thomas; Kezic, Sanja; Wolterbeek, Ron; Lavrijsen, Adriana P.; Bouwstra, Joke A.

    2012-01-01

    A hallmark of atopic eczema (AE) is skin barrier dysfunction. Lipids in the stratum corneum (SC), primarily ceramides, fatty acids, and cholesterol, are crucial for the barrier function, but their role in relation to AE is indistinct. Filaggrin is an epithelial barrier protein with a central role in the pathogenesis of AE. Nevertheless, the precise causes of AE-associated barrier dysfunction are largely unknown. In this study, a comprehensive analysis of ceramide composition and lipid organization in nonlesional SC of AE patients and control subjects was performed by means of mass spectrometry, infrared spectroscopy, and X-ray diffraction. In addition, the skin barrier and clinical state of the disease were examined. The level of ceramides with an extreme short chain length is drastically increased in SC of AE patients, which leads to an aberrant lipid organization and a decreased skin barrier function. Changes in SC lipid properties correlate with disease severity but are independent of filaggrin mutations. We demonstrate for the first time that changes in ceramide chain length and lipid organization are directly correlated with the skin barrier defects in nonlesional skin of AE patients. We envisage that these insights will provide a new therapeutic entry in therapy and prevention of AE. PMID:23024286

  16. Magnetic resonance venography in consecutive patients with suspected deep vein thrombosis of the upper extremity: initial experience

    Energy Technology Data Exchange (ETDEWEB)

    Baarslag, H.J.; Reekers, J.A. [Academic Medical Centre, Amsterdam (Netherlands). Dept. of Radiology; Beek, E.J. van [Royal Hallamshire Hospital, Sheffield (United Kingdom). Unit of Academic Radiology

    2004-02-01

    To assess the feasibility and accuracy of two magnetic resonance (MR) venography methods in a consecutive series of patients with suspected deep vein thrombosis of the upper extremity (DVTUE). Consecutive in- and outpatients who were referred for imaging of suspected DVTUE in a large teaching hospital during the period April 2001 to October 2002 were eligible for inclusion. All patients were scheduled to undergo contrast venography with the intention to perform additional MR venography. Both time-of-flight and gadolinium-enhanced 3D MR venography were scheduled. All MR imaging were interpreted independently by consensus of two experienced radiologists, who were blinded for contrast venography outcome. Patients were managed based on contrast venography only. A total of 44 patients were eligible for inclusion. Thirteen patients were excluded (5 refused consent, 2 inability to gain venous access, 2 renal failure, 4 logistic reasons). Contrast venography was performed in 31 patients, and demonstrated DVTUE in 11 patients. MR imaging was not feasible in 10 patients (4 unable to lie flat, 3 claustrophobia, 1 too large for MR scanner, 1 osteosynthesis of shoulder, 1 pacemaker). The sensitivity and specificity of TOF MRV versus Gadolinium 3D MRV was 71% and 89% versus 50% and 80%, respectively. A high number of patients were unable to undergo MR venography in this setting. Contrast-enhanced MRV did not improve diagnostic accuracy. The clinical utility of MR venography in the setting of suspected DVTUE seems disappointing.

  17. Analysis of the Results of Patch Test for 430 Patients with Dermatitis and Eczema%430例皮炎湿疹患者斑贴试验结果分析

    Institute of Scientific and Technical Information of China (English)

    陈海燕; 唐燕笑; 廖小玉

    2014-01-01

    [Objective]To explore the distribution of common allergens in pitch test for 430 patients with dermatitis and eczema.[Methods]A total of 430 patients wit dermatitis and eczema were chosen.Ruimin patch test reagent was used for allergen test.The result of allergens was analyzed.[Results]The most common aller-gens of patients with dermatitis and eczema were cobalt chloride,nickel sulfate,potassium dichromate,Kappa mixtures and aromatic mixture.[Conclusion]At present,heavy metal compound such as cobalt chloride and aromatic organic compound are the main allergens of dermatitis and eczema.%【目的】探讨430例皮炎湿疹患者斑贴试验中常见过敏原的分布情况。【方法】选取皮炎湿疹患者430例,采用“瑞敏牌”斑贴试剂进行过敏原测试,分析其过敏原结果。【结果】皮炎湿疹患者过敏原以氯化钴、硫酸镍、重铬酸钾、卡巴混合物、芳香混合物最为常见。【结论】氯化钴等重金属化合物及芳香族有机化合物是目前主要的皮炎湿疹过敏原。

  18. Contact allergens causing hand eczema in ethnic Kashmiri population: A study of 7-years

    Directory of Open Access Journals (Sweden)

    Imran Majid

    2016-01-01

    Full Text Available Background: Hand eczema is one of the commonest eczemas encountered in dermatology practice. Contact allergens responsible for causing hand eczema vary from one geographical area of the world to another. Aim: The study tries to identify the commonest allergens causing hand eczema in ethnic Kashmiri population. Material and Methods: A total of 800 patients were patch tested at a sole patch testing facility for the local population over a 7-year period out of which 278 were diagnosed with hand eczema. The morphological type of hand eczema was noted and the patch testing results were analyzed. Past or present relevance of the patch-test result to the clinical diagnosis was also analyzed. Results: Hand eczema was the most common type of eczema patch tested over the 7-year period, constituting 34.75% of the patch-tested population. A positive patch-test result was obtained in 135 patients (48.5% out of which it was found to be clinically relevant in about 65% cases. Nickel and potassium dichromate were found to be the two commonest allergens causing hand eczema in our population with positive patch test reactions in 45 and 27 patients respectively. Females showed a much higher incidence of hand eczema as well as higher patch test positivity than males (54.1% vs. 38.1%. Conclusions: Hand eczema with a positive patch-test report was found to be much more common in females than males and nickel and potassium dichromate were seen to be the commonest allergens causing hand eczema in ethnic Kashmiri population.

  19. Evaluation of the impact of severity of itching symptoms on the level of depression in patients with allergic contact eczema (preliminary study

    Directory of Open Access Journals (Sweden)

    Małgorzata Czarny-Działak

    2014-06-01

    Full Text Available Introduction : Allergic contact dermatitis is one of the most frequent skin disorders in the general population as well as among people who work professionally. Allergic contact allergens are simple chemical compounds. The most common are nickel and fragrance substances. Aim of the research : To estimate if and how the degree of itching in allergic contact dermatitis influences the development of depression. Material and methods: The treatment was conducted on a group of 17 people with allergic contact dermatitis. Each person was treated in order to estimate the level of depression using Becks scale and the level of itching. Next, it was estimated if the level of itching had any influence on the development of depression. Results: All skin diseases, including allergic contact eczema affect the biological and psychosocial functioning, and the quality of human. Five patients out of 17 showed features of depression: 3 mild (2 men and 1 woman, which is the most common state of transition, and 2 (women moderately-severe depressive symptoms. Both patients with moderately-severe depressive symptoms had a significant degree of severity of pruritus. Conclusions: It was stated that the level of itching has no influence on the development of depression.

  20. A Double-Blind, Randomised Study Comparing the Skin Hydration and Acceptability of Two Emollient Products in Atopic Eczema Patients with Dry Skin.

    Science.gov (United States)

    Djokic-Gallagher, Jasmina; Rosher, Phil; Oliveira, Gabriela; Walker, Jennine

    2017-07-04

    Healthcare professionals tend to recommend emollients based primarily on patient/consumer preference and cost, with cheaper options assumed to be therapeutically equivalent. The aim of this study was therefore to compare the effects on skin hydration of two emollients prescribed in the UK, Doublebase Dayleve™ gel (DELP) and a cheaper alternative, Zerobase Emollient™ cream (ZBC). This was a single-centre, randomised, double-blind, concurrent bi-lateral (within-patient) comparison in 18 females with atopic eczema and dry skin on their lower legs. DELP gel and ZBC cream were each applied to one lower leg twice daily for 4 days and on the morning only on day 5. The efficacy of both products was assessed by hydration measurements using a Corneometer CM825 probe (Courage-Khazaka Electronic). The measurements were made three times daily on days 1 to 5. The primary efficacy variable was the area under the curve (AUC) of the change from baseline corneometer readings over the 5 days. Skin hydration using DELP gel was significantly higher than using ZBC cream (p emollients can perform differently. Dermal Laboratories Ltd. EudraCT number:2014-001026-16.

  1. Cost-effectiveness of oral alitretinoin in patients with severe chronic hand eczema - a long-term analysis from a Swiss perspective

    Directory of Open Access Journals (Sweden)

    Blank Patricia R

    2010-06-01

    Full Text Available Abstract Background The impact on patients suffering from chronic hand eczema (CHE is enormous, as no licensed systemic treatment option with proven efficacy for CHE is available. Alitretinoin is a novel agent which showed high clinical efficacy in patients with severe, refractory CHE. We assessed the cost-effectiveness of alitretinoin for CHE patient treatment from a Swiss third party payer perspective. A further objective of this study was to determine the burden of disease in Switzerland. Methods A long-term Markov cohort simulation model was used to estimate direct medical costs (€ and clinical effectiveness (quality adjusted life years, QALYs of treating severe CHE patients with alitretinoin. Comparison was against the standard treatment of supportive care (optimised emollient therapy. Information on response rates were derived from a randomized controlled clinical trial. Costs were considered from the perspective of the Swiss health system. Swiss epidemiological data was derived from official Swiss Statistic institutions. Results Annual costs of alitretinoin treatment accounted for €2'212. After a time horizon of 22.4 years, average remaining long-term costs accounted for €42'208 or €38'795 in the alitretinoin and the standard treatment arm, respectively. Compared with the standard therapy, the addition of alitretinoin yielded an average gain of 0.230 QALYs at the end of the simulation. Accordingly, the incremental cost-effectiveness ratio resulted in €14'816/QALY gained. These results were robust to changes in key model assumptions. Conclusion The therapy for CHE patients is currently insufficient. In our long-term model we identified the treatment with alitretinoin as a cost-effective alternative for the therapy of CHE patients in Switzerland.

  2. Correlation of consecutive serum thyroglobulin levels during hormone withdrawal and failure of initial radioiodine ablation in thyroid cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Hyuk Jin; Kim, Sung Hoon; O, Joo Hyun; Lee, Yeong Joo; Kim, Hyoung Woo [Dept. of Radiology, Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of); Seo, Ye Young [Dept. of Nuclear Medicine, College of Medicine, The Inje University Sanggye Paik Hospital, Seoul (Korea, Republic of); Ryu, Ji Young [Dept. of Radiology, Incheon St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2015-12-15

    The aim of this study was to evaluate the value of thyroglobulin (Tg) kinetics during preparation of radioiodine ablation for prediction of initial radioiodine ablation failure in thyroid cancer patients. Thyroid cancer patients after total thyroidectomy who underwent radioiodine ablation with 3–4 weeks of hormone withdrawal between May 2011 and January 2012 were included. Consecutive serum Tg levels 5–10 days before ablation (Tg1) and on the day of ablation (Tg2) were obtained. The difference between Tg1 and Tg2 (ΔTg), daily change rate of Tg (ΔTg/day) and Tg doubling time (Tg-DT) were calculated. Success of initial ablation was determined by the results of the follow-up ultrasonography, diagnostic radioiodine scan and stimulated Tg level after 6 to 20 months. A total of 143 patients were included. Failed ablation was reported in 52 patients. Tg2 higher than 5.6 ng/ml and Tg-DT shorter than 4.2 days were significantly related to a high risk of ablation failure. ΔTg and ΔTg/day did not show significant correlation with ablation failure. Thyroglobulin kinetics on consecutive blood sampling during hormone withdrawal may be helpful in predicting patients with higher risk of treatment failure of initial radioiodine ablation therapy in thyroid cancer patients.

  3. Early detection of tumor relapse/regrowth by consecutive minimal residual disease monitoring in high-risk neuroblastoma patients

    Science.gov (United States)

    Hirase, Satoshi; Saitoh, Atsuro; Hartomo, Tri Budi; Kozaki, Aiko; Yanai, Tomoko; Hasegawa, Daiichiro; Kawasaki, Keiichiro; Kosaka, Yoshiyuki; Matsuo, Masafumi; Yamamoto, Nobuyuki; Mori, Takeshi; Hayakawa, Akira; Iijima, Kazumoto; Nishio, Hisahide; Nishimura, Noriyuki

    2016-01-01

    Neuroblastoma is an aggressive pediatric tumor accounting for ~15% of cancer-associated mortalities in children. Despite the current intensive therapy, >50% of high-risk patients experience tumor relapse or regrowth caused by the activation of minimal residual disease (MRD). Although several MRD detection protocols using various reverse transcription-quantitative polymerase chain reaction (RT-qPCR) markers have been reported to evaluate the therapeutic response and disease status of neuroblastoma patients, their clinical significance remains elusive. The present study reports two high-risk neuroblastoma patients, whose MRD was consecutively monitored using 11 RT-qPCR markers (CHRNA3, CRMP1, DBH, DCX, DDC, GABRB3, GAP43, ISL1, KIF1A, PHOX2B and TH) during their course of treatment. The two patients initially responded to the induction therapy and reached MRD-negative status. The patients' MRD subsequently became positive with no elevation of their urinary homovanillic acid, urinary vanillylmandelic acid and serum neuron-specific enolase levels at 13 or 19 weeks prior to the clinical diagnosis of tumor relapse or regrowth. The present cases highlight the possibility of consecutive MRD monitoring using 11 markers to enable an early detection of tumor relapse or regrowth in high-risk neuroblastoma patients. PMID:27446404

  4. Food allergy and atopic eczema.

    Science.gov (United States)

    Worth, Allison; Sheikh, Aziz

    2010-06-01

    To review recent developments on the inter-relationship between food allergy and atopic eczema, with a particular focus on understanding the role of filaggrin gene defects. Filaggrin gene defects have recently been identified as a major risk factor for the development of atopic eczema. These skin barrier defects increase the risk of early onset, severe and persistent forms of atopic eczema. They also increase the risk of allergic sensitization, and asthma and allergic rhinitis in those with co-existent eczema. These skin barrier defects are also likely to increase the risk of food allergy. Atopic dermatitis and food allergy are frequently herald conditions for other manifestations of 'the allergic march'. They commonly co-exist, particularly in those with early onset, severe and persistent atopic eczema. Filaggrin gene defects substantially increase the risk of atopic eczema. The increased skin permeability may increase the risk of sensitization to food and other allergens, this pointing to the possible role of cutaneous allergen avoidance in early life to prevent the onset of atopic eczema and food allergy. Emerging evidence also indicates that oral exposure to potentially allergenic foods may be important for inducing immunological tolerance.

  5. N-palmitoylethanolamine and N-acetylethanolamine are effective in asteatotic eczema: results of a randomized, double-blind, controlled study in 60 patients.

    Science.gov (United States)

    Yuan, Chao; Wang, Xue-Min; Guichard, Alexandre; Tan, Yi-Mei; Qian, Chun-Yan; Yang, Li-Jie; Humbert, Philippe

    2014-01-01

    Asteatotic eczema (AE) is characterized by itchy, dry, rough, and scaling skin. The treatments for AE are mainly emollients, usually containing urea, lactic acid, or a lactate salt. N-palmitoylethanolamine (PEA) and N-acetylethanolamine (AEA) are both endogenous lipids used as novel therapeutic tools in the treatment of many skin diseases. The purpose of this study was to compare a PEA/AEA emollient with a traditional emollient in the treatment of AE. A monocentric, randomized, double-blind, comparative trial was conducted in 60 AE patients to evaluate and compare the efficacy of the two emollients. The level of skin dryness among the subjects ranged from mild to moderate. The subjects' skin barrier function and the current perception threshold were tested for 28 days by clinical scoring and bioengineering technology. The results showed that, although some aspects were improved in both groups, the group using the emollient containing PEA/AEA presented a better skin surface change in capacitance. However, the most impressive finding was the ability of the PEA/AEA emollient to increase the 5 Hz current perception threshold to a normal level after 7 days, with a significant difference between values at baseline and after 14 days. A current perception threshold of 5 Hz was positively and significantly correlated with skin surface hydration and negatively correlated with transepidermal water loss in the PEA/AEA emollient group. Compared with traditional emollients, regular application of a topical PEA/AEA emollient could improve both passive and active skin functions simultaneously.

  6. Variations in spa types found in consecutive MRSA isolates from the same patients

    DEFF Research Database (Denmark)

    Boye, Kit; Westh, Henrik

    2010-01-01

    Very little is known about how the spa gene mutates over time in methicillin-resistant Staphylococcus aureus (MRSA) from the same patient. Copenhagen is an area with low prevalence of MRSA but with high variability in spa types. We collected 1536 MRSA isolates from 319 patients during a 5-year...... period and found spa type alterations in 30 MRSA isolates (2%) from 13 patients (4%). The alteration most often seen was the deletion of repeats followed by repeat duplication and point mutation....

  7. Variations in spa types found in consecutive MRSA isolates from the same patients

    DEFF Research Database (Denmark)

    Boye, Kit; Westh, Henrik

    2010-01-01

    Very little is known about how the spa gene mutates over time in methicillin-resistant Staphylococcus aureus (MRSA) from the same patient. Copenhagen is an area with low prevalence of MRSA but with high variability in spa types. We collected 1536 MRSA isolates from 319 patients during a 5-year...... period and found spa type alterations in 30 MRSA isolates (2%) from 13 patients (4%). The alteration most often seen was the deletion of repeats followed by repeat duplication and point mutation....

  8. Slow pathway modification in patients presenting with only two consecutive AV nodal echo beats.

    Science.gov (United States)

    Wegner, Felix K; Silvano, Maria; Bögeholz, Nils; Leitz, Patrick R; Frommeyer, Gerrit; Dechering, Dirk G; Zellerhoff, Stephan; Kochhäuser, Simon; Lange, Philipp S; Köbe, Julia; Wasmer, Kristina; Mönnig, Gerold; Eckardt, Lars; Pott, Christian

    2017-02-01

    Slow pathway modification (SPM) is the therapy of choice for AV-nodal reentry tachycardia (AVNRT). When AVNRT is not inducible, empirical ablation can be considered, however, the outcome in patients with two AV nodal echo beats (AVNEBs) is unknown. Out of a population of 3003 patients who underwent slow pathway modification at our institution between 1993 and 2013, we retrospectively included 32 patients with a history of symptomatic tachycardia, lack of paroxysmal supraventricular tachycardia (pSVT) inducibility but occurrence of two AVNEBs. pSVT documentation by electrocardiography (ECG) was present in 20 patients. The procedural endpoint was inducibility of less than two AVNEBs. This was reached in 31 (97%) patients. Long-term success was assessed by a telephone questionnaire (follow-up time 63±9 months). A total 94% of the patients benefited from the procedure (59% freedom from symptoms; 34% improvement in symptoms). Among those patients in whom ECG documentation was not present, 100% benefited (58% freedom from symptoms, 42% improvement). This is the first collective analysis of a group of patients presenting with symptoms of pSVT and inducibility of only two AVNEBs. Procedural success and clinical long-term follow-up were in the range of the reported success rates of slow pathway modification of inducible AVNRT, independent of whether ECG documentation was present. Thus, SPM is a safe and effective therapy in patients with two AVNEBs. Copyright © 2016. Published by Elsevier Ltd.

  9. Systematic review of cost-of-illness studies in hand eczema.

    Science.gov (United States)

    Politiek, Klaziena; Oosterhaven, Jart A F; Vermeulen, Karin M; Schuttelaar, Marie-Louise A

    2016-08-01

    The individual burden of disease in hand eczema patients is considerable. However, little is known about the socio-economic impact of this disease. The aims of this review were to evaluate the literature on cost-of-illness in hand eczema, and to compose a checklist for future use. The literature was retrieved from the MEDLINE and EMBASE databases up to October 2015. Quality evaluation was based on seven relevant items in cost-of-illness studies. Cost data (direct and indirect) were extracted and converted into euros (2014 price level) by use of the Dutch Consumer Price Index. Six articles were included. The mean annual total cost per patient ranged from €1712 to €9792 (direct cost per patient, €521 to €3829; and indirect cost per patient, €100 to €6846). Occupational hand eczema patients showed indirect costs up to 70% of total costs, mainly because of absenteeism. A large diversity in hand eczema severity was found between studies. The socio-economic burden of hand eczema is considerable, especially for more severe and/or occupational hand eczema. Absenteeism from paid work leads to a high total cost-of-illness, although disregard of presenteeism often leads to underestimation of indirect costs. Differences in included cost components, the occupational status of patients and hand eczema severity make international comparison difficult. A checklist was added to standardize the approach to cost-of-illness studies in hand eczema.

  10. Bath additives for the treatment of childhood eczema (BATHE): protocol for multicentre parallel group randomised trial

    Science.gov (United States)

    Santer, Miriam; Rumsby, Kate; Ridd, Matthew J; Francis, Nick A; Stuart, Beth; Chorozoglou, Maria; Wood, Wendy; Roberts, Amanda; Thomas, Kim S; Williams, Hywel C; Little, Paul

    2015-01-01

    Introduction Bath emollients are widely prescribed for childhood eczema, yet evidence of their benefits over direct application of emollients is lacking. Objectives To determine the clinical and cost-effectiveness of adding bath emollient to the standard management of eczema in children Methods and analysis Design: Pragmatic open 2-armed parallel group randomised controlled trial. Setting: General practitioner (GP) practices in England and Wales. Participants: Children aged over 12 months and less than 12 years with eczema, excluding inactive or very mild eczema (5 or less on Nottingham Eczema Severity Scale). Interventions: Children will be randomised to either bath emollients plus standard eczema care or standard eczema care only. Outcome measures: Primary outcome is long-term eczema severity, measured by the Patient-Oriented Eczema Measure (POEM) repeated weekly for 16 weeks. Secondary outcomes include: number of eczema exacerbations resulting in healthcare consultations over 1 year; eczema severity over 1 year; disease-specific and generic quality of life; medication use and healthcare resource use; cost-effectiveness. Aiming to detect a mean difference between groups of 2.0 (SD 7.0) in weekly POEM scores over 16 weeks (significance 0.05, power 0.9), allowing for 20% loss to follow-up, gives a total sample size of 423 children. We will use repeated measures analysis of covariance, or a mixed model, to analyse weekly POEM scores. We will control for possible confounders, including baseline eczema severity and child's age. Cost-effectiveness analysis will be carried out from a National Health Service (NHS) perspective. Ethics and dissemination This protocol was approved by Newcastle and North Tyneside 1 NRES committee 14/NE/0098. Follow-up will be completed in 2017. Findings will be disseminated to participants and carers, the public, dermatology and primary care journals, guideline developers and decision-makers. Trial registration number ISRCTN

  11. "Paraduodenal" pancreatitis: results of surgery on 58 consecutives patients from a single institution.

    Science.gov (United States)

    Casetti, L; Bassi, C; Salvia, R; Butturini, G; Graziani, R; Falconi, M; Frulloni, L; Crippa, S; Zamboni, G; Pederzoli, P

    2009-12-01

    Cystic dystrophy of heterotopic pancreas, groove pancreatitis, pancreatic hamartoma of the duodenum, paraduodenal wall cyst, and myoadenomatosis are all terms grouped together, from a pathological viewpoint, as definitions of paraduodenal pancreatitis (PP). The objective of the present study was to investigate the clinical characteristics, therapeutic strategies, and results in 58 patients undergoing pancreatic resection for PP. From January 1990 to December 2006 data were prospectively collected on 58 patients who were diagnosed with PP who then underwent pancreaticoduodenectomy. In this patient cohort the median age was 44.7 years; only 4 patients were women, and only 3 had non-drinker and/or non smoker habits. The overall morbidity was 18.9%, and the median hospitalization was 11 days. There were no postoperative deaths. In a median follow-up of 96.3 months, all patients noted a decrease in the pain associated with PP; 35 patients (76%) had complete disappearance of pain, whereas occasional relapsing pain occurred in the remaining 11 (24%). Patients with PP have clinical characteristics similar to those of chronic pancreatitis. The diagnostic imaging modalities of choice are ultrasonographic endoscopy and magnetic resonance cholangiopancreaticography. Based on our surgical experience, pancreaticoduodenectomy seems to be a reasonable choice of treatment in patients with PP.

  12. Impact of hand eczema severity on quality of life

    Directory of Open Access Journals (Sweden)

    Ujwala Priya Charan

    2013-01-01

    Full Text Available Background: Hand eczema is a common disease seen in dermatological practice comprising of a spectrum ranging from mild disease to a severe distressing and chronic course with a negative impact on the quality of life. Aim: To assess the impact of hand eczema severity on quality of life. Materials and Methods: Patients with hand eczema were enrolled in a prospective study. Disease severity was assessed by hand eczema severity index (HECSI score and quality of life by dermatology life quality index (DLQI questionnaire. Results: Forty-six patients participated of which 22 (47.8% were males and 24 (52.2% females. The commonest age group affected among men and women was 50-59 years (31.8% and 40-49 years (41.7% respectively. History of atopy was found in 23.9% and 63% had persistent disease. In 28 (60.9%, the trigger was washing soaps and detergents of which 21 (87.5% were housewives. Of those employed, 27.7% reported loss of work days. The mean HECSI score was 14.46 (S.D = 20.98 and mean DLQI score was 9.54 (S.D = 5.62. Gender, age, occupation and duration of disease did not significantly affect the quality of life or disease severity. Increased episodes of eczema (>4 episodes/year showed a statistically significant correlation with DLQI (P value = 0.021. There was no significant correlation between HECSI score and DLQI in this study. Conclusion: Majority of the patients with hand eczema had a significant impairment of their quality of life. The impairment of quality of life in this study was mainly dependent on increased frequency of the eruptions and not on hand eczema severity.

  13. Cardiac sarcoidosis and heart transplantation: a report of four consecutive patients

    DEFF Research Database (Denmark)

    Milman, N.; Andersen, Claus Bøgelund; Mortensen, Sven Aage;

    2008-01-01

    Heart transplantation (HTx) is a well-established treatment for severe cardiac failure. However, HTx for cardiac sarcoidosis is rare; less than 80 patients have been reported worldwide. In many patients, the diagnosis was not made prior to HTx. The aim of this study was to describe the use of HTx...... to HTx. In three patients, all with dilated cardiomyopathy due to myocardial sarcoidosis, the final diagnosis was obtained by examination of the explanted heart. Arrythmias (supraventricular and ventricular), heart block, mitral valve insufficiency and dilated cardiomyopathy were prominent clinical...... features. None of the patients had recurrence of sarcoid disease in the allograft. Two patients are long-term survivors and two are deceased, one of primary graft failure, the other from Cytomegalovirus myocarditis. In conclusion, HTx is a viable treatment for cardiac sarcoidosis with end stage cardiac...

  14. Moderate precision of prognostic scoring systems in a consecutive, prospective cohort of 544 patients with metastatic spinal cord compression

    DEFF Research Database (Denmark)

    Morgen, Søren Schmidt; Nielsen, Dennis Hallager; Larsen, Claus Falck

    2014-01-01

    PURPOSE: Improved survival among cancer patients and diverse conclusions from recent studies make it relevant to reassess the performance of the Tokuhashi Revised score and the Tomita score. The aim of this study was to validate and compare these two scoring systems in a recent and unselected...... and compared to the observed survival. We assessed how precise the scoring systems predicted survival with McNemar's test. The prognostic value was illustrated with Kaplan-Meier curves, and the individual prognostic components were analyzed with Cox regression analysis. RESULTS: The mean age was 65 years...... cohort of patients with metastatic spinal cord compression (MSCC). METHODS: In 2011, we conducted a prospective cohort study of 544 patients who were consecutively admitted with MSCC to one treatment facility. Patients estimated survival were assessed with the Tokuhashi Revised score and the Tomita score...

  15. Human granulocytic anaplasmosis in Austria: epidemiological, clinical, and laboratory findings in five consecutive patients from Tyrol, Austria.

    Science.gov (United States)

    Walder, Gernot; Fuchs, Dietmar; Sarcletti, Mario; Berek, Klaus; Falkensammer, Barbara; Huber, Klaus; Petrovec, Miro; Dierich, Manfred P; Würzner, Reinhard

    2006-05-01

    We report five consecutive cases of Anaplasma (A.) phagocytophilum infection (the causative agent of human granulocytic anaplasmosis (HGA)) from western Austria. All infections were acquired between June and August in 2003 and 2004 in the Inn valley (Tyrol, Austria). Four patients required hospitalisation, one patient was treated as an outpatient. During the acute stage of illness, laboratory findings included thrombocytopenia (5/5), elevated C-reactive protein (5/5), elevated neopterin (5/5), elevated lactate dehydrogenase (4/5), and elevation of liver enzymes (4/5). Leukopenia (3/5) and elevated procalcitonin (2/5) were less frequently observed. All patients were treated with tetracyclines, which led to prompt improvement of the clinical conditions. Anti-platelet antibodies were observed in one of four patients, but remained unchanged after complete covalescence.

  16. Consecutive thrombelastography clot strength profiles in patients with severe sepsis and their association with 28-day mortality

    DEFF Research Database (Denmark)

    Ostrowski, Sisse R; Windeløv, Nis A; Ibsen, Michael

    2013-01-01

    sepsis admitted to the intensive care unit (ICU). Clinical scores/variables, infection, TEG, biochemistry, therapy, and overall mortality were recorded. RESULTS: Fifty patients (60% men, median age 62 years, 28-day mortality 24%) were included. At admission, 22%, 48%, and 30% had a hypocoagulable......PURPOSE: The aim of this study was to assess associations between consecutive thrombelastography (TEG) profiles and standard coagulation tests and disease severity and mortality in patients with severe sepsis. MATERIALS AND METHODS: This was a prospective observational study of adults with severe......, normocoagulable, and hypercoagulable TEG clot strength (maximum amplitude [MA]), respectively. Hypocoagulable patients had higher Sequential Organ Failure Assessment and disseminated intravascular coagulation scores compared with hypercoagulable patients and higher 28-day mortality compared with normocoagulable...

  17. Chronic hand eczema - self-management and prognosis: a study protocol for a randomised clinical trial

    Directory of Open Access Journals (Sweden)

    Mollerup Annette

    2012-06-01

    Full Text Available Abstract Background Hand eczema has a one-year prevalence of approximately 10 % in the general Danish population. Often the disease becomes chronic with numerous implications for the individual’s daily life, occupation and quality of life. However, no guidelines of self-management recommendations beyond the acute stage are given. Self-management of the disease is pivotal and involves self-monitoring of the condition, medication adherence, and preventive behaviour. Interventions best to support the individual in this ongoing process need to be developed. Methods/design This paper describes the design of a randomised clinical trial to test a newly developed intervention of individual counselling versus conventional information. 300 patients consecutively referred to dermatologic treatment at two different settings are individually randomised to either the intervention programme, named ‘The Healthy Skin Clinic’ or to the control group. Block-wise randomisation according to setting and gender is carried out. The intervention offers a tool for self-monitoring; basic and specific individual counselling; the possibility of asynchronous communication with the intervention team; and an electronic patient dialogue forum. Primary outcome variable is objective assessment of the hand eczema severity performed at baseline prior to randomisation, and repeated at six months follow-up. Secondary outcome variables are dermatology related life quality and perceived global burden of disease. Discussion The trial aims at evaluating a newly developed guidance programme which is expected to support self-management of patients referred to dermatology treatment due to chronic hand eczema. The design of the protocol is pragmatic with blinding of neither participants nor the investigator. Thus, in the interpretation of the results, the investigator takes into account effects that may be attributed to actors of the interventions rather than the intervention per se as

  18. Outcomes in cardiac surgery in 500 consecutive Jehovah's Witness patients: 21 year Experience

    Directory of Open Access Journals (Sweden)

    Vaislic Claude D

    2012-09-01

    Full Text Available Abstract Background Refusal of heterogenic blood products can be for religious reasons as in Jehovah's Witnesses or otherwise or as requested by an increasing number of patients. Furthermore blood reserves are under continuous demand with increasing costs. Therefore, transfusion avoidance strategies are desirable. We describe a historic comparison and current results of blood saving protocols in Jehovah's Witnesses patients. Methods Data on 250 Jehovah's Witness patients operated upon between 1991 and 2003 (group A were reviewed and compared with a second population of 250 patients treated from 2003 to 2012 (group B. Results In group A, mean age was 51 years of age compared to 68 years in group B. An iterative procedure was performed in 13% of patients in group B. Thirty days mortality was 3% in group A and 1% in group B despite greater operative risk factors, with more redo, and lower ejection fraction in group B. Several factors contributed to the low morbidity-mortality in group B, namely: preoperative erythropoietin to attain a minimal hemoglobin value of 14 g/dl, warm blood cardioplegia, the implementation of the Cornell University protocol and fast track extubation. Conclusions Cardiac surgery without transfusion in high-risk patients such as Jehovah Witnesses can be carried out with results equivalent to those of low risk patients. Recent advances in surgical techniques and blood conservation protocols are main contributing factors.

  19. Diagnostics of septic arthritis in the sternoclavicular region - 10 consecutive patients and literature review

    Energy Technology Data Exchange (ETDEWEB)

    Bodker, Tina; Jurik, Anne Grethe [Dept. of Radiology, Aarhus Univ. Hospital, Aarhus (Denmark)], e-mail: tina.b.madsen@gmail.com; Toettrup, Mikkel; Kjaer Petersen, Klaus [Dept. of Orthopedic Surgery, The Infection Team, Aarhus Univ. Hospital, Aarhus (Denmark)

    2013-02-15

    Background: Septic arthritis in the sternoclavicular (SC) region is rare and may be difficult to diagnose clinically and radiologically. It mainly affects immunocompromised persons, and can clinically be misinterpreted as tumor and rheumatic disorders. Lacking radiological reference standard, a multimodality approach may contribute to a prolonged diagnostic process. Purpose: To describe the diagnostics of septic arthritis in the SC region. Material and Methods: Between 2001 and 2011, 10 patients with Staphylococcus infection in the SC region were investigated in our institution. Clinical, biochemical, radiological, and microbiological findings were studied retrospectively; all CT and MR examinations were re-evaluated. Results: Initial radiography in nine patients and ultrasonography in six patients were inconclusive resulting in supplementary MRI and/or CT. Five patients examined by MRI were immediately diagnosed with septic arthritis whereas CT in five patients led to the diagnosis in only one. Three were subsequently diagnosed by MRI, but delayed more than 2.5 weeks, and one was diagnosed by surgery. The median time to diagnosis was 1.5 weeks. The delay caused by imaging was 0 days to 11.5 weeks (median 0 days). By re-evaluation overlooked complications included mediastinitis in seven patients (three diffuse, four localized), and abscesses and pleuritis each in four patients. Conclusion: Awareness of infection in the SC region is important to avoid diagnostic delay. MRI is proposed as the initial imaging procedure.

  20. Delay in medical attention to hand eczema: a follow-up study

    DEFF Research Database (Denmark)

    Hald, M; Agner, T; Blands, J

    2009-01-01

    BACKGROUND: Hand eczema often runs a chronic course but early medical intervention may be assumed to improve the prognosis. OBJECTIVES: To follow patients with hand eczema for 6 months after seeing a dermatologist to investigate if delay in medical attention would impair the prognosis. METHODS......: Study participants were 333 patients with hand eczema from nine dermatological clinics in Denmark. Severity of hand eczema was assessed by the patients at baseline and at the 6-month follow up using a self-administered photographic guide. Additional information was obtained by self...... months (IQR 1-8). In a logistic regression model, the odds ratio of a poor prognosis increased by a factor of 1.11 [95% confidence interval (CI) 1.02-1.21] per month of patient delay and by 1.05 (95% CI 1.00-1.10) per month of healthcare delay. CONCLUSIONS: A poorer prognosis of hand eczema...

  1. Intraindividual genome expression analysis reveals a specific molecular signature of psoriasis and eczema.

    Science.gov (United States)

    Quaranta, Maria; Knapp, Bettina; Garzorz, Natalie; Mattii, Martina; Pullabhatla, Venu; Pennino, Davide; Andres, Christian; Traidl-Hoffmann, Claudia; Cavani, Andrea; Theis, Fabian J; Ring, Johannes; Schmidt-Weber, Carsten B; Eyerich, Stefanie; Eyerich, Kilian

    2014-07-09

    Previous attempts to gain insight into the pathogenesis of psoriasis and eczema by comparing their molecular signatures were hampered by the high interindividual variability of those complex diseases. In patients affected by both psoriasis and nonatopic or atopic eczema simultaneously (n = 24), an intraindividual comparison of the molecular signatures of psoriasis and eczema identified genes and signaling pathways regulated in common and exclusive for each disease across all patients. Psoriasis-specific genes were important regulators of glucose and lipid metabolism, epidermal differentiation, as well as immune mediators of T helper 17 (TH17) responses, interleukin-10 (IL-10) family cytokines, and IL-36. Genes in eczema related to epidermal barrier, reduced innate immunity, increased IL-6, and a TH2 signature. Within eczema subtypes, a mutually exclusive regulation of epidermal differentiation genes was observed. Furthermore, only contact eczema was driven by inflammasome activation, apoptosis, and cellular adhesion. On the basis of this comprehensive picture of the pathogenesis of psoriasis and eczema, a disease classifier consisting of NOS2 and CCL27 was created. In an independent cohort of eczema (n = 28) and psoriasis patients (n = 25), respectively, this classifier diagnosed all patients correctly and also identified initially misdiagnosed or clinically undifferentiated patients.

  2. Mucosal proctectomy and ileoanal pull-through technique and functional results in 23 consecutive patients.

    Science.gov (United States)

    Bodzin, J H; Kestenberg, W; Kaufmann, R; Dean, K

    1987-07-01

    Mucosal proctectomy with ileoanal pull-through in the treatment of ulcerative colitis and familial polyposis provides a technique for the preservation of the anal sphincters and relatively normal mechanisms of continence. Five patients had straight ileoanal anastomosis while 18 had the construction of a J-pouch. A two-team approach was used for simultaneous abdominal and perineal procedures to facilitate a shortened operating time. A loop ileostomy was routinely used in the postoperative period and was closed an average of 4.5 months (range: 2-16 months) later without complication. Prolonged preoperative hospitalization was rarely necessary and outpatient steroid enema preparation was routinely used. There were no deaths. Nineteen patients with functioning pull-through procedures have been followed an average of 23 months (range: 3-42 months). Two other patients have not had ileostomy closure because of complications. The two remaining patients had intractable diarrhea and have since undergone conversion to a permanent ileostomy. The 19 patients are continent, having three to nine bowel movements each day. Nearly all wear a perineal sanitary pad because of rare, unpredictable leakage of small amounts of fluid, especially at night. Complications were significant in this group of patients. Intestinal obstruction was a frequent problem, occurring in 52 per cent of the entire series and necessitating reoperation in 22 per cent. Anal stricture was a problem in another five patients. A variety of other minor problems occurred and most were treated nonoperatively. In spite of moderate diarrhea and occasional leakage of stool, all patients with functioning pull-through procedures prefer their current status to life with an ileostomy.(ABSTRACT TRUNCATED AT 250 WORDS)

  3. Probiotics and infantile atopic eczema

    Directory of Open Access Journals (Sweden)

    Akelma AZ

    2015-09-01

    Full Text Available Ahmet Zülfikar Akelma,1 Aziz Alper Biten2 1Pediatric Allergy and Immunology Unit, Ankara Kecioren Teaching and Research Hospital, Ankara, Turkey; 2General Directorate of Management Services, Republic of Turkey Ministry of Health, Ankara, Turkey Abstract: Pediatric eczema is a common disease which causes economic and social burden. Its incidence differs among the societies, with an incidence reported to reach up to 20% in developed countries. Eczema is the first allergic disease seen in the childhood, and it is recognized as a precursor for the development of atopic diseases such as asthma, allergic rhinitis, and food allergy in the forthcoming years of children. Increased incidence of eczema in recent years has led to new research in epidemiology, prevention, and intervention of this disease. It is no doubt important to treat itching, rash, and excoriation of the skin; however, treatment of pediatric eczema should not be considered only as a treatment of skin lesions. Considering skin treatment as the tip of the iceberg, proper management of the allergic processes can be accepted as the rest of the iceberg. The role of probiotics in the prevention of atopic eczema is yet to be clarified. Evidence presented by existing studies suggesting that probiotics may prevent pediatric eczema is not strong enough. A positive effect, if any, may be related with onset time, dose, duration, and use of specific probiotics. To date, there is no strong evidence for use of probiotics in the treatment of eczema; however, administration of probiotics in breast-feeding mothers in the prenatal period and in infants in the postnatal period can be accepted as a safe and helpful option in the prevention of eczema. Nevertheless, there are still questions to be answered in the future about probiotic administration for eczema. Clinical use of probiotics will gradually become more widespread when these questions are answered. Based on current information, the administration

  4. Cognitive and adaptive evaluation of 21 consecutive patients with Dravet syndrome.

    Science.gov (United States)

    Villeneuve, Nathalie; Laguitton, Virginie; Viellard, Marine; Lépine, Anne; Chabrol, Brigitte; Dravet, Charlotte; Milh, Mathieu

    2014-02-01

    In order to assess the cognitive and adaptive profiles of school-aged patients with Dravet syndrome (DS), we proposed to evaluate the intelligence and adaptive scores in twenty-one 6- to 10-year-old patients with DS followed in our institution between 1997 and 2013. Fourteen patients were tested using the Wechsler Intelligence Scale for Children (WISC) and the Vineland Adaptive Behavioral Scales (VABS); 6 patients could not be tested with the WISC and were tested with the VABS only, and one was tested with the WISC only. Data regarding the epilepsy were retrospectively collected. Statistical analysis (Spearman rank order and Pearson correlation coefficient) was used to correlate early epilepsy characteristics with the cognitive and adaptive scores. Sodium channel, neuronal alpha-subunit type 1 (SCN1A) was mutated in 19 out of 21 patients. After the age of 6years, none of the DS patients had a normal intelligence quotient (IQ) using WISC (age at the testing period: mean=100±5; median=105months; mean total IQ=47±3; n=15). Only five patients had a verbal and/or a non verbal IQ of more than 60 (points). Their cognitive profile was characterized by an attention deficit, an inability to inhibit impulsive responses, perseverative responses and deficit in planning function. Administering the Vineland Adaptive Behavioral Scales in the same period, we showed that socialization skills were significantly higher than communication and autonomy skills (age at the testing period: mean=100±4; median=100months; n=20). We did not find any significant correlation between the IQ or developmental quotient assessed between 6 and 10years of age and the quantitative and qualitative parameters of epilepsy during the first two years of life in this small group of patients. Despite an overall moderate cognitive deficit in this group of patients, the Vineland Adaptive Behavioral Scales described an adaptive/behavioral profile with low communication and autonomy capacities, whereas the

  5. Malignant pleural mesothelioma: Clinicopathologic and survival characteristic in a consecutive series of 40 patients

    Directory of Open Access Journals (Sweden)

    Bagheri R

    2009-05-01

    Full Text Available "n Normal 0 false false false EN-GB X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Pleural malignant mesothelioma is an uncommon but extremely invasive tumor which originates from mesothelial cells and usually occures after prolonged exposure to asbestos. The aim of this study was to clinicopathologically evaluation of 40 patients with pleural malignant mesothelioma and the main factors influencing their prognosis. "n"n Methods: In this study patients with definitive diagnosis, who had been followed up for at least three years were studied based on gender, age presenting symptoms, and clinicopathological patterns."n"n Results: Male to female ratio of the study patients was three to one any the average age of them was 55 years. Chest pain was the most common symptoms in 34(85% patients. Most of the study patients were in Buchard stage I (37/5% and the epithelial form was the most common pathological pattern 25(62.5%. 19(47.5% of cases received only radiotherapy and chemotherapy. Extrapleural pneumonectomy was performed on eight (20% patients, seven (17.5% patients underwent decortication and pleurectomy beside adjuvant therapy and 15% of the cases rejected any type of treatment. Surgical mortality occurred in one patient and the most common surgical complication was wound infection. The

  6. The Günther-Tulip retrievable IVC filter: clinical experience in 118 consecutive patients.

    Science.gov (United States)

    Ota, Satoshi; Yamada, Norikazu; Tsuji, Akihiro; Ishikura, Ken; Nakamura, Mashio; Isaka, Naoki; Ito, Masaaki

    2008-02-01

    The purpose of this study was to assess the use of the Günther Tulip Filter (GTF) for the management of venous thromboembolism (VTE). Between December 2000 and April 2005, 118 patients (42 males, 76 females; mean age 60.5 years) diagnosed with VTE, underwent treatment with a GTF. The filter was left permanently in 52 patients. In the other 66 patients, attempts were made to retrieve it, with success in 60 cases (90.9%). No major complication was found throughout the filter's use. Of the 58 patients with the permanent filters, 41 underwent enhanced computed tomography at follow-up in the chronic phase. Thirty-eight filters (92.7%) remained patent, and under low-intensity anticoagulation therapy (international normalized ratio 1.8+/-0.4), the patency rate was 97.1%. Penetration of the inferior vena cava (IVC) wall by the filter's struts beyond a distance of 3 mm occurred in 23 patients (56.1%), but there was no observable leakage from the IVC or injury to adjacent organs. The GTF is feasible and safe for treating VTE. When used permanently, GTFs have a high patency rate, and there is neither leakage from the IVC nor injury to adjacent organs in the event of penetration by the struts.

  7. Chiari-related hydrocephalus: assessment of clinical risk factors in a cohort of 297 consecutive patients.

    Science.gov (United States)

    Guan, Jian; Riva-Cambrin, Jay; Brockmeyer, Douglas L

    2016-11-01

    OBJECTIVE Patients treated for Chiari I malformation (CM-I) with posterior fossa decompression (PFD) may occasionally and unpredictably develop postoperative hydrocephalus. The clinical risk factors predictive of this type of Chiari-related hydrocephalus (CRH) are unknown. The authors' objective was to evaluate their experience to identify risk factors that may predict which of these patients undergoing PFD will develop CRH after surgery. METHODS The authors performed a retrospective clinical chart review of all patients who underwent PFD surgery and duraplasty for CM-I at the Primary Children's Hospital in Utah from June 1, 2005, through May 31, 2015. Patients were dichotomized based on the need for long-term CSF diversion after PFD. Analysis included both univariate and multivariable logistic regression analyses. RESULTS The authors identified 297 decompressive surgeries over the period of the study, 22 of which required long-term postoperative CSF diversion. On multivariable analysis, age < 6 years old (OR 3.342, 95% CI 1.282-8.713), higher intraoperative blood loss (OR 1.003, 95% CI 1.001-1.006), and the presence of a fourth ventricular web (OR 3.752, 95% CI 1.306-10.783) were significantly associated with the need for long-term CSF diversion after decompressive surgery. CONCLUSIONS Younger patients, those with extensive intraoperative blood loss, and those found during surgery to have a fourth ventricular web were at higher risk for the development of CRH. Clinicians should be alert to evidence of CRH in this patient population after PFD surgery.

  8. The vital threat of an upper gastrointestinal bleeding: Risk factor analysis of 121 consecutive patients

    Institute of Scientific and Technical Information of China (English)

    Peter Schemmer; Frank Decker; Genevieve Dei-Anane; Volkmar Henschel; Klaus Buhl; Christian Herfarth; Stefan Riedl

    2006-01-01

    AIM: To analyze the importance in predicting patients risk of mortality due to upper gastrointestinal (UGI)bleeding under today's therapeutic regimen.METHODS: From 1998 to 2001, 121 patients with the diagnosis of UGI bleeding were treated in our hospital.Based on the patients' data, a retrospective multivariate data analysis with initially more than 270 single factors was performed. Subsequently, the following potential risk factors underwent a logistic regression analysis:age, gender, initial hemoglobin, coumarines, liver cirrhosis, prothrombin time (PT), gastric ulcer (small curvature), duodenal ulcer (bulbus back wall), Forrest classification, vascular stump, variceal bleeding, MalloryWeiss syndrome, RBC substitution, recurrent bleeding,conservative and surgical therapy.RESULTS: Seventy male (58%) and 51 female (42%)patients with a median age of 70 (range: 21-96) years were treated. Their in-hospital mortality was 14%. While 12% (11/91) of the patients died after conservative therapy, 20% (6/30) died after undergoing surgical therapy. UGI bleeding occurred due to duodenal ulcer (n = 36; 30%), gastric ulcer (n = 35; 29%), esophageal varicosis (n = 12; 10%), Mallory-Weiss syndrome (n = 8; 7%), erosive lesions of the mucosa (n = 20;17%), cancer (n = 5; 4%), coagulopathy (n = 4; 3%),lymphoma (n = 2; 2%), benign tumor (n = 2; 2%)and unknown reason (n = 1; 1%). A logistic regression analysis of all aforementioned factors revealed that liver cirrhosis and duodenal ulcer (bulbus back wall)were associated risk factors for a fatal course after UGI bleeding. Prior to endoscopy, only liver cirrhosis was an assessable risk factor. Thereafter, liver cirrhosis,the location of a bleeding ulcer (bulbus back wall) and patients' gender (male) were of prognostic importance for the clinical outcome (mortality) of patients with a bleeding ulcer.CONCLUSION: Most prognostic parameters used in clinical routine today are not reliable enough in predicting a patient's vital threat posed by

  9. Alitretinoin and acitretin in severe chronic hand eczema; results from a retrospective daily practice study

    NARCIS (Netherlands)

    Politiek, Klaziena; Christoffers, Wietske Andrea; Coenraads, Pieter-Jan; Schuttelaar, Marie-Louise Anna

    2016-01-01

    Acitretin has been used off-label for years to treat chronic hand eczema, but acitretin is less often prescribed as alitretinoine was approved. This study evaluates both retinoids in a daily practice cohort of patients with severe chronic hand eczema in terms of drug survival and reasons for discont

  10. Systematic review of cost-of-illness studies in hand eczema

    NARCIS (Netherlands)

    Politiek, Klaziena; Oosterhaven, Jart A. F.; Vermeulen, Karin M.; Schuttelaar, Marie-Louise A.

    2016-01-01

    The individual burden of disease in hand eczema patients is considerable. However, little is known about the socio-economic impact of this disease. The aims of this review were to evaluate the literature on cost-of-illness in hand eczema, and to compose a checklist for future use. The literature was

  11. Randomized controlled observer-blinded treatment of chronic foot eczema with iontophoresis and bath-PUVA

    NARCIS (Netherlands)

    Tupker, Ron A; Coenraads, Pieter Jan; Zanen, Pieter; Schuttelaar, Marielouise

    2013-01-01

    The aim of this study was to investigate the effect of iontophoresis combined with local psoralen plus ultraviolet A (PUVA) therapy in chronic foot eczema. A randomized, observer-blinded, multi-centre study was conducted in 48 patients with chronic moderate-to-severe foot eczema randomized to one of

  12. Rorschach Inkblot Method data at baseline and after 2 years treatment of consecutively admitted patients with first-episode schizophrenia

    DEFF Research Database (Denmark)

    Rosenbaum, Bent; Andersen, Palle Bent; Knudsen, Per Bjerregaard;

    2012-01-01

    Background: The Rorschach Inkblot Method is regarded as an important clinical instrument for detailed diagnostic description of the integrative capacities of individuals in psychotic states and as an instrument for measuring progression in the course of treatment. Aims: To describe relevant...... Rorschach variables at baseline in a group of consecutively admitted patients with first-episode schizophrenia. Furthermore, to describe the changes in these variables from baseline to year 2 for the group of patients given psychiatric standard treatment, and to compare these changes with changes in other......'s Rorschach Comprehensive System at inclusion and after 2 years. Results: Core variables of the Rorschach, assumed to show changes (e.g. reality testing, perceptual and thought disorders) in patients with a first episode of schizophrenia, all improved but revealed no significant changes after 2 years...

  13. Laparoscopic splenectomy in patients with hereditary spherocytosis: report on 12 consecutive cases.

    Science.gov (United States)

    Vecchio, R; Intagliata, Eva; Ferla, F; Marchese, S; Cacciola, R R; Cacciola, E

    2013-12-01

    Hereditary spherocytosis is an inherited hemolytic anemia caused by a deficiency in erythrocyte membrane proteins. Removal of the spleen may reduce the intra-splenic hemolytic process of the disease and, therefore, may correct the anemia. Furthermore, it seems to decrease the levels of serum bilirubin, thus reducing the formation of gallbladder stones. Indications and timing of splenectomy, however, are still debated. Twelve patients with severe hereditary spherocytosis operated on with laparoscopic splenectomy were retrospectively reviewed. Median age at diagnosis was 13.8 years (range 8-25 years). Male to female ratio was 5/7. Indications for laparoscopic removal of the spleen included anemia unresponsive to iron supplementation in eight patients (66.6 %) with increase need for red cells transfusions, and jaundice with symptoms related to cholelitiasis in four patients (33.3 %). Laparoscopic splenectomy was associated in four cases to laparoscopic cholecystectomy. Mean operative time was 50 min (range 40-75 min) with no conversion to open surgery. Mean hospital stay ranged from 3 to 7 days. In a 16-month follow-up, no complications were recorded and a persistent correction of anemia was observed. With the advent of laparoscopic surgery, splenectomy has been performed by this mini-invasive approach in referral centers. Laparoscopic splenectomy is an effective technique, when performed in patients with hereditary spherocytosis. Low complication rate and persistent correction of the hematologic disorders can be expected after the laparoscopic splenectomy, provided that a proper technique is performed and an experienced surgical team is available.

  14. Patch Test as a Diagnostic Tool in Hand Eczema

    Science.gov (United States)

    Vigneshkarthik, Natarajan; Kuruvila, Sheela

    2016-01-01

    Introduction Allergic contact dermatitis is an important cause of hand eczema. Patch testing is the only investigation available to prove the diagnosis of allergic contact dermatitis. Exposures to allergens differ according to geographical, occupational, economic and social factors. Accordingly, patterns of allergic contact dermatitis differ in different parts of the world and different regions of the same country. Aim To study the causes of allergic contact dermatitis in adult patients with hand eczema with the help of patch testing. Materials and Methods This was a cross-sectional study involving 54 hand eczema patients conducted between October 2013 and June 2015, at a tertiary care centre in Southern India. After a detailed history including history of occupational exposure and detailed examination, patch test was done on these patients with Indian standard series. The patches were removed after 48 hours. Another reading was taken after 72 hours. The readings were interpreted according to International Contact Dermatitis Research Group criteria and noted down. The data were summarized using mean and standard deviation for continuous variables and percentages for categorical and dichotomous variables. The test of association was done with Fisher’s-exact test. Results Hyperkeratotic hand eczema was the commonest morphological type (29%), followed by discoid eczema. Pompholyx was significantly more common among patients with history of atopy. A total of 20 patients (37%) showed patch test positivity to a total of 25 allergens. Nickel was the most common allergen (11.11%) followed by para-phenylenediamine (PPD) (7.4%). Nickel (6 patients) and cobalt (3 patients) were the common allergens among women, while potassium dichromate (3 patients) and parthenium (2 patients) were the common allergens among men. Potassium dichromate allergy was significantly more common among masons and PPD allergy was significantly more common among hair dye users. Discoid pattern of

  15. Effects of 15 consecutive cryotherapy sessions on the clinical output of fibromyalgic patients.

    Science.gov (United States)

    Bettoni, Lorenzo; Bonomi, Felice Giulio; Zani, Viviana; Manisco, Luigia; Indelicato, Annamaria; Lanteri, Patrizia; Banfi, Giuseppe; Lombardi, Giovanni

    2013-09-01

    Fibromyalgia is a chronic widespread pain disorder in which, the neurogenic origin of the pain, featured by allodynia and hyperalgesia, results from an imbalance in the levels of neurotransmitters and consequently of the peripheral pro- and anti-inflammatory mediators. Whole body cryotherapy is a peculiar physical therapy known to relieve pain and inflammatory symptoms characteristics of rheumatic diseases, through the regulation of the cytokine expression. The aim of this study was to qualitatively evaluate the effects of cryotherapy on the clinical output of fibromyalgic patients. A total of 100 fibromyalgic patients (age range 17-70 years) were observed; 50 subjects were addressed to cryotherapy, while the second group (n = 50) did not underwent to the cryotherapic treatment. All subjects kept the prescribed pharmacological therapy during the study (analgesic and antioxidants). The referred health status pre- and post-observation was evaluated with the following scales: Visual Analogue Scale, Short Form-36, Global Health Status and Fatigue Severity Scale. Fibromyalgic patients treated with cryotherapy reported a more pronounced improvement of the quality of life, in comparison with the non-cryo treated fibromyalgic subjects, as indicated by the scores of the qualitative indexes and sub-indexes, that are widely recognized tools to assess the overall health status and the effect of the treatments. We speculate that this improvement is due to the known direct effect of cryotherapy on the balance between pro- and anti-inflammatory mediators having a recognized role in the modulation of pain.

  16. Hypopharyngeal squamous cell carcinoma--treatment results in 138 consecutively admitted patients

    Energy Technology Data Exchange (ETDEWEB)

    Johansen, L.V.; Grau, C.; Overgaard, J. [Danish Cancer Society, Aarhus (Denmark). Dept. of Experimental Clinical Oncology

    2000-07-01

    The aim of this study was to evaluate the results of the initial and salvage treatment for hypopharyngeal carcinoma. The study was conducted in 1963 to 1991 and included 138 patients (38 females and 100 males). Most of the tumours originated in the piriform sinus (86%). Tumour stage distribution was T1: 20%, T2: 27%, T3: 37% and T4: 17% and nodal stage distribution was N0: 45%, N1: 25%, N2: 10%, and N3: 20%. Primary treatment was delivered with curative intent in 124 out of 138 cases. Treatment failure was noted in 98 patients, with 55% recurrence in T-position, 39% in N-position, and 14% at distant metastases sites. Salvage surgery was successful in 9 out of 32 patients. The overall 5-year locoregional tumour control, cause-specific and overall survival rates were 20%, 25% and 19%, respectively. Univariate actuarial analysis showed that T- and N-stage, clinical stage, tumour size and well-differentiated tumours were significant prognostic parameters. A Cox multivariate analysis showed that only the T- and N-stages were independent prognostic factors. In conclusion, the prognosis for advanced hypopharyngeal carcinoma is extremely poor and the meagre results with conventional radiotherapy alone indicate that other treatment modalities should be introduced in the management of this disease.

  17. Patient Characteristics by Type of Hypersexuality Referral: A Quantitative Chart Review of 115 Consecutive Male Cases.

    Science.gov (United States)

    Sutton, Katherine S; Stratton, Natalie; Pytyck, Jennifer; Kolla, Nathan J; Cantor, James M

    2015-01-01

    Hypersexuality remains an increasingly common but poorly understood patient complaint. Despite diversity in clinical presentations of patients referred for hypersexuality, the literature has maintained treatment approaches that are assumed to apply to the entire phenomenon. This approach has proven ineffective, despite its application over several decades. The present study used quantitative methods to examine demographic, mental health, and sexological correlates of common clinical subtypes of hypersexuality referrals. Findings support the existence of subtypes, each with distinct clusters of features. Paraphilic hypersexuals reported greater numbers of sexual partners, more substance abuse, initiation to sexual activity at an earlier age, and novelty as a driving force behind their sexual behavior. Avoidant masturbators reported greater levels of anxiety, delayed ejaculation, and use of sex as an avoidance strategy. Chronic adulterers reported premature ejaculation and later onset of puberty. Designated patients were less likely to report substance abuse, employment, or finance problems. Although quantitative, this article nonetheless presents a descriptive study in which the underlying typology emerged from features most salient in routine sexological assessment. Future studies might apply purely empirical statistical techniques, such as cluster analyses, to ascertain to what extent similar typologies emerge when examined prospectively.

  18. Epilepsy Surgery Series: A Study of 502 Consecutive Patients from a Developing Country

    Directory of Open Access Journals (Sweden)

    Abdulaziz Alsemari

    2014-01-01

    Full Text Available Purpose. To review the postoperative seizure outcomes of patients that underwent surgery for epilepsy at King Faisal Specialist Hospital & Research Centre (KFSHRC. Methods. A descriptive retrospective study for 502 patients operated on for medically intractable epilepsy between 1998 and 2012. The surgical outcome was measured using the ILAE criteria. Results. The epilepsy surgery outcome for temporal lobe epilepsy surgery (ILAE classes 1, 2, and 3 at 12, 36, and 60 months is 79.6%, 74.2%, and 67%, respectively. The favorable 12- and 36-month outcomes for frontal lobe epilepsy surgery are 62% and 52%, respectively. For both parietal and occipital epilepsy lobe surgeries the 12- and 36-month outcomes are 67%. For multilobar epilepsy surgery, the 12- and 36-month outcomes are 65% and 50%, respectively. The 12- and 36-month outcomes for functional hemispherectomy epilepsy surgery are 64.2% and 63%, respectively. According to histopathology diagnosis, mesiotemporal sclerosis (MTS and benign CNS tumors had the best favorable outcome after surgery at 1 year (77.27% and 84.3%, resp., and 3 years (76% and 75%, resp.,. The least favorable seizure-free outcome after 3 years occurred in cases with dual pathology (66.6%. Thirty-four epilepsy patients with normal magnetic resonance imaging (MRI brain scans were surgically treated. The first- and third-year epilepsy surgery outcome of 17 temporal lobe surgeries were (53% and (47% seizure-free, respectively. The first- and third-year epilepsy surgery outcomes of 15 extratemporal epilepsy surgeries were (47% and (33% seizure-free. Conclusion. The best outcomes are achieved with temporal epilepsy surgery, mesial temporal sclerosis, and benign CNS tumor. The worst outcomes are from multilobar surgery, dual pathology, and normal MRI.

  19. Eight-point Compass Rose Underlay Technique in 72 Consecutive Elderly Patients with Large Incisional Hernia

    Directory of Open Access Journals (Sweden)

    Attilio Ignazio Lo Monte

    2011-09-01

    Conclusion: This surgical procedure, like laparoscopic treatment, allows the surgeon to avoid dissection of the abdominal layer and improves prosthesis adhesion with reinforcement of the incisional area near the abdominal defect. The reduction in operation time is remarkable. Despite good results in terms of safety and minimal recurrence for laparoscopy in the management of IH, the use of minimally invasive techniques for large incisional wall defects, especially in elderly patients, is still controversial and practiced by few surgeons. This open technique avoids cardiopulmonary complications arising from pneumoperitoneum in the elderly.

  20. Pallidal stimulation for segmental dystonia: long term follow up of 11 consecutive patients.

    Science.gov (United States)

    Sensi, Mariachiara; Cavallo, Michele A; Quatrale, Rocco; Sarubbo, Silvio; Biguzzi, Sara; Lettieri, Cristian; Capone, Jay G; Tugnoli, Valeria; Tola, Maria Rosaria; Eleopra, Roberto

    2009-09-15

    Pallidal stimulation is a convincing and valid alternative for primary generalized dystonia refractory to medical therapy or botulinum toxin. However, the clinical outcome reported in literature is variable most likely because of heterogeneity DBS techniques employed and /or to clinical dystonic pattern of the patients who undergo surgery. In this study, we report the long term follow up of a homogeneous group of eleven subjects affected by segmental dystonia who were treated with bilateral stimulation of the Globus Pallidus pars interna (GPi) from the years 2000 to 2008. All the patients were evaluated, before surgery and at 6-12-24-36 months after the treatment, in accordance with the Burke Fahn Marsden Dystonia Rating Scale (BFMDRS). Our study indicates that DBS promotes an early and significant improvement at 6 months with an even and a better outcome later on. The analysis of specific sub items of the BFMDRS revealed an earlier and striking benefit not only as far as segmental motor function of the limbs but also for the complex cranial functions like face, (eyes and mouth), speech and swallowing, differently from results reported in primary generalized dystonia. Deep Brain Stimulation of GPi should be considered a valid indication for both generalized and segmental dystonia when other therapies appear ineffective.

  1. ETFAD/EADV Eczema task force 2015 position paper on diagnosis and treatment of atopic dermatitis in adult and paediatric patients.

    Science.gov (United States)

    Wollenberg, A; Oranje, A; Deleuran, M; Simon, D; Szalai, Z; Kunz, B; Svensson, A; Barbarot, S; von Kobyletzki, L; Taieb, A; de Bruin-Weller, M; Werfel, T; Trzeciak, M; Vestergard, C; Ring, J; Darsow, U

    2016-05-01

    Atopic dermatitis (AD) is a clinically defined, highly pruritic, chronic inflammatory skin disease of children and adults. The diagnosis is made using evaluated clinical criteria. Disease activity is best measured with a composite score assessing both objective signs and subjective symptoms, such as SCORAD. The management of AD must consider the clinical and pathogenic variabilities of the disease and also target flare prevention. Basic therapy includes hydrating topical treatment, as well as avoidance of specific and unspecific provocation factors. Anti-inflammatory treatment of visible skin lesions is based on topical glucocorticosteroids and the topical calcineurin inhibitors tacrolimus and pimecrolimus. Topical calcineurin inhibitors are preferred in sensitive locations. Tacrolimus and mid-potent steroids are proven for proactive therapy, which is long-term intermittent anti-inflammatory therapy of the frequently relapsing skin areas. Systemic anti-inflammatory or immunosuppressive treatment is indicated for severe refractory cases. Biologicals targeting key mechanisms of the atopic immune response are promising emerging treatment options. Microbial colonization and superinfection may induce disease exacerbation and can justify additional antimicrobial treatment. Systemic antihistamines (H1R-blockers) may diminish pruritus, but do not have sufficient effect on lesions. Adjuvant therapy includes UV irradiation, preferably UVA1 or narrow-band UVB 311 nm. Dietary recommendations should be patient specific and elimination diets should only be advised in case of proven food allergy. Allergen-specific immunotherapy to aeroallergens may be useful in selected cases. Psychosomatic counselling is recommended to address stress-induced exacerbations. 'Eczema school' educational programmes have been proven to be helpful for children and adults.

  2. Safety of dental extraction among consecutive patients on oral anticoagulant treatment managed using a specific dental management protocol.

    Science.gov (United States)

    Zanon, Ezio; Martinelli, Franco; Bacci, Christian; Cordioli, GianPiero; Girolami, Antonio

    2003-01-01

    We found no prospective studies on dental extraction in anticoagulated patients in the literature, even though most authors suggest that there is no need to change anticoagulant treatment and to utilize a local haemostatic measure after extraction. In the present study, we have verified the incidence of bleeding complications after dental extraction in a group of 250 consecutive anticoagulated patients. Two hundred and fifty non-anticoagulated subjects requiring dental extraction represented the control group. In all patients, anticoagulant treatment was not changed (International Normalized Ratio, 1.8-4) and local haemostatic measures (fibrin sponge, silk suture and a gauze saturated with tranexamic acid) were used. All procedures were performed in an outpatient clinic setting. We registered four bleeding complications in the group of anticoagulated patients and three in the control group. The difference of bleeding complications in the two groups was not statistically different (relative risk, 1.14; 95% confidence interval, 0.29-6.04; P = 0.7). None of the post-operative late bleeding required hospitalization and/or blood transfusions, and further local measures were sufficient to stop the bleeding. The protocol proposed in the present study makes dental extractions in anticoagulated patients possible on an outpatient basis with a cost reduction for the community and minor discomfort for the patients.

  3. Treatment of Visceral Aneurysm Using Multilayer Stent: Two-Year Follow-Up Results in Five Consecutive Patients

    Energy Technology Data Exchange (ETDEWEB)

    Balderi, Alberto, E-mail: balders@libero.it; Antonietti, Alberto, E-mail: antonietti.a@ospedale.cuneo.it; Pedrazzini, Fulvio, E-mail: pedrazzini.f@ospedale.cuneo.it; Sortino, Davide, E-mail: davide.sortino@hotmail.it; Vinay, Claudia, E-mail: claudia.vinay@gmail.com; Grosso, Maurizio, E-mail: grosso.m@ospedale.cuneo.it [AO Santa Croce e Carle Hospital, Department of Radiology (Italy)

    2013-10-15

    Purpose: The present study was performed to analyze the midterm results (five consecutive patients, 2-year follow-up) of the endovascular management of visceral artery aneurysms using the Cardiatis Multilayer Flow Modulator (CMFM) (Cardiatis, Isnes, Belgium), a self-expandable stent. Materials and Methods: From August 2009 to January 2011, we implanted five CMFMs in five patients (all men; mean age 73 years) to treat two common hepatic artery aneurysms, one celiac trunk aneurysm, one splenic artery aneurysm, and one superior mesenteric artery aneurysm (diameter 25-81 mm). The primary end point was technical success. The secondary end point was stent patency, absence of aneurysm rupture or reperfusion, and shrinking of the sac at 6-, 12-, and 24-month follow-up using computed tomography angiography. Follow-up ranged from 24 to 48 months (mean 31.2). Results: Technical success was achieved in all patients. Complete exclusion of the aneurysm with sac shrinking was achieved in two patients. Two stents became occluded at 6- and 24-month follow-up, respectively; both patients were asymptomatic and were not retreated. One patient developed sac reperfusion due to incomplete aneurysm exclusion. Conclusion: Long-term results in a wider population are needed to validate the effectiveness of the CMFM.

  4. New Eczema Drug Promising in Early Trial

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_163883.html New Eczema Drug Promising in Early Trial Nemolizumab significantly ... the appearance of moderate to severe eczema, a new, preliminary trial finds. Nemolizumab is a man-made, ...

  5. Genotype-phenotype relationships in the low-phospholipid-associated cholelithiasis syndrome: a study of 156 consecutive patients.

    Science.gov (United States)

    Poupon, Raoul; Rosmorduc, Olivier; Boëlle, Pierre Yves; Chrétien, Yves; Corpechot, Christophe; Chazouillères, Olivier; Housset, Chantal; Barbu, Véronique

    2013-09-01

    The low-phospholipid-associated cholelithiasis syndrome (LPAC; OMIM 171060) is a peculiar form of intrahepatic cholelithiasis occurring in young adults, associated with ABCB4/MDR3 gene sequence variations. Our aim was to determine the genotype-phenotype relationships in 156 consecutive patients with the criteria of LPAC syndrome. A variant was detected in 79 (61 missense and 18 truncating sequence variants), 63 being monoallelic. The clinical features (age at onset, high prevalence in women, frequency and severity of acute and chronic complications, intrahepatic cholestasis of pregnancy [ICP]) were similar in the patients with or without ABCB4 gene sequence variation. Truncating variations were associated with an earlier onset of symptoms both in women and men. Acute and chronic biliary complications were variant-independent. Half of the women who had pregnancy developed ICP. The frequency of ICP and fetal complications were similar in patients with missense and truncating variants. The LPAC syndrome is more frequent in women and highly associated with ICP. Half of the patients harbored missense or truncating variants of the ABCB4 gene. The characteristics of the patients without detectable variant are similar to those with variant, indicating that yet unexplored regions of the ABCB4 and other genes may be involved. © 2013 by the American Association for the Study of Liver Diseases.

  6. Complications and safety aspects of kyphoplasty for osteoporotic vertebral fractures: a prospective follow-up study in 102 consecutive patients

    Directory of Open Access Journals (Sweden)

    Kayser Ralph

    2008-01-01

    Full Text Available Abstract Background Kyphoplasty represents an established minimal-invasive method for correction and augmentation of osteoporotic vertebral fractures. Reliable data on perioperative and postoperative complications are lacking in the literature. The present study was designed to evaluate the incidence and patterns of perioperative complications in order to determine the safety of this procedure for patients undergoing kyphoplasty. Patients and Methods We prospectively enrolled 102 consecutive patients (82 women and 20 men; mean age 69 with 135 operatively treated fractured vertebrae who underwent a kyphoplasty between January 2004 to June 2006. Clinical and radiological follow-up was performed for up 6 months after surgery. Results Preoperative pain levels, as determined by the visual analogous scale (VAS were 7.5 +/- 1.3. Postoperative pain levels were significantly reduced at day 1 after surgery (VAS 2.3 +/- 2.2 and at 6-month follow-up (VAS 1.4 +/- 0.9. Fresh vertebral fractures at adjacent levels were detected radiographically in 8 patients within 6 months. Two patients had a loss of reduction with subsequent sintering of the operated vertebrae and secondary spinal stenosis. Accidental cement extravasation was detected in 7 patients in the intraoperative radiographs. One patient developed a postoperative infected spondylitis at the operated level, which was treated by anterior corporectomy and 360 degrees fusion. Another patient developed a superficial wound infection which required surgical revision. Postoperative bleeding resulting in a subcutaneous haematoma evacuation was seen in one patient. Conclusion The data from the present study imply that percutaneous kyphoplasty can be associated with severe intra- and postoperative complications. This minimal-invasive surgical procedure should therefore be performed exclusively by spine surgeons who have the capability of managing perioperative complications.

  7. The Incidence of Patent Foramen Ovale in 1,000 Consecutive Patients: A Contrast Transesophageal Echocardiography Study

    Science.gov (United States)

    Fisher, Daniel C.; Fisher, Edward A.; Budd, Jacqueline H.; Rosen, Stacey E.; Goldman, Martin E.

    1995-01-01

    Study objective: Patent foramen ovale (PFO) is present in 10 to 35% of people and has been reported to be an important risk factor for cardioembolic cerebrovascular accidents (CVAs) and transient ischemic attacks (TIAS), especially in younger patients. While contrast transthoracic echocardiography has been used to detect PFO, contrast transesophageal echocardiography (TEE) has a greater sensitivity. Prior studies reported the incidence of PFO in patients presenting with a CVA or TIA. Design: To determine the incidence of PFO in a more general population, we reviewed 1,000 consecutive TEES performed with contrast and color Doppler for the presence of PFO and other cardioembolic risk factors, including atrial septal aneurysm (ASA), aortic plaque, atrial fibrillation (AFib), and atrial thrombi. While imaging with monoplane or biplane TEE, multiple injections of agitated saline solution were injected during cough or Valsalva maneuver to detect flow through a PFO. Patients: There were 482 male and 518 female patients with mean age of 60 + 17 years (range 11 to 93 years). Results: Patent foramen ovale was found in 9.2% of all patients and, though seen in all age groups divided by decade, the incidence in patients aged 40 to 49 years was greater than those aged 70 to 79 years (12.96% vs 6.15%',, p=0.03). Contrast TEE had a much higher detection rate than color Doppler alone. Importantly, there was no greater incidence of PFO in patients with CVA vs thos without CVA, or in male vs female patients. Also, there was a very strong correlation between the presence of ASA and PFO (p<.001). Conclusion: Thus, PFO detected by TEE, frequently seen with ASA, is seen in all age groups and does not in itself present a risk factor for CVA. The association of PFO with peripheral thrombosis and CVA needs further study.

  8. Anatomic variations of the pancreatic duct and their relevance with the Cambridge classification system: MRCP findings of 1158 consecutive patients.

    Science.gov (United States)

    Adibelli, Zehra Hilal; Adatepe, Mustafa; Imamoglu, Cetin; Esen, Ozgur Sipahi; Erkan, Nazif; Yildirim, Mehmet

    2016-12-01

    The study was conducted to evaluate the frequencies of the anatomic variations and the gender distributions of these variations of the pancreatic duct and their relevance with the Cambridge classification system as morphological sign of chronic pancreatitis using magnetic resonance cholangiopancreatography (MRCP). We retrospectively reviewed 1312 consecutive patients who referred to our department for MRCP between January 2013 and August 2015. We excluded 154 patients from the study because of less than optimal results due to imaging limitations or a history of surgery on pancreas. Finally a total of 1158 patients were included in the study. Among the 1158 patients included in the study, 54 (4.6%) patients showed pancreas divisum, 13 patients (1.2%) were defined as ansa pancreatica. When we evaluated the course of the pancreatic duct, we found the prevalence 62.5% for descending, 30% for sigmoid, 5.5% for vertical and 2% for loop. The most commonly observed pancreatic duct configuration was Type 3 in 528 patients (45.6%) where 521 patients (45%) had Type 1 configuration. Vertical course (p = 0.004) and Type 2 (p = 0.03) configuration of pancreatic duct were more frequent in females than males. There were no statistically significant differences between the gender for the other pancreatic duct variations such as pancreas divisium, ansa pancreatica and course types other than vertical course (p > 0.05 for all). Variants of pancreas divisum and normal pancreatic duct variants were not associated with morphologic findings of chronic pancreatitis by using the Cambridge classification system. The ansa pancreatica is a rare type of anatomical variation of the pancreatic duct, which might be considered as a predisposing factor to the onset of idiopathic pancreatitis.

  9. The Incidence of Patent Foramen Ovale in 1,000 Consecutive Patients: A Contrast Transesophageal Echocardiography Study

    Science.gov (United States)

    Fisher, Daniel C.; Fisher, Edward A.; Budd, Jacqueline H.; Rosen, Stacey E.; Goldman, Martin E.

    1995-01-01

    Study objective: Patent foramen ovale (PFO) is present in 10 to 35% of people and has been reported to be an important risk factor for cardioembolic cerebrovascular accidents (CVAs) and transient ischemic attacks (TIAS), especially in younger patients. While contrast transthoracic echocardiography has been used to detect PFO, contrast transesophageal echocardiography (TEE) has a greater sensitivity. Prior studies reported the incidence of PFO in patients presenting with a CVA or TIA. Design: To determine the incidence of PFO in a more general population, we reviewed 1,000 consecutive TEES performed with contrast and color Doppler for the presence of PFO and other cardioembolic risk factors, including atrial septal aneurysm (ASA), aortic plaque, atrial fibrillation (AFib), and atrial thrombi. While imaging with monoplane or biplane TEE, multiple injections of agitated saline solution were injected during cough or Valsalva maneuver to detect flow through a PFO. Patients: There were 482 male and 518 female patients with mean age of 60 + 17 years (range 11 to 93 years). Results: Patent foramen ovale was found in 9.2% of all patients and, though seen in all age groups divided by decade, the incidence in patients aged 40 to 49 years was greater than those aged 70 to 79 years (12.96% vs 6.15%',, p=0.03). Contrast TEE had a much higher detection rate than color Doppler alone. Importantly, there was no greater incidence of PFO in patients with CVA vs thos without CVA, or in male vs female patients. Also, there was a very strong correlation between the presence of ASA and PFO (pCVA. The association of PFO with peripheral thrombosis and CVA needs further study.

  10. Aquaporin-4 Immuneglobulin G testing in 36 consecutive Jamaican patients with inflammatory central nervous system demyelinating disease

    Directory of Open Access Journals (Sweden)

    Sherri Sandy

    2014-08-01

    Full Text Available Epidemiological studies of neuromyelitis optica (NMO in Jamaica are lacking. Here we reviewed the clinical records of 700 patients undergoing neurological evaluation at the Kingston Public Hospital, the largest tertiary institution in Jamaica over a 4 month period. We investigated the diagnostic utility of Aquaporin-4 ImmuneglobulinG (AQP4-IgG testing in 36 consecutive patients with a diagnosis of an inflammatory demyelinating disorder (IDD of the central nervous system (CNS. Patients were classified into 3 categories: i NMO, n=10; ii multiple sclerosis (MS, n=14 and iii unclassified IDD (n=12. All sera were tested for AQP-IgG status by cell binding assay (Euroimmun. No MS cases were positive. Ninety per cent of NMO cases were positive. Four of 12 patients with unclassified IDD tested positive for AQP4-IgG. AQP4-IgG seropositivity was associated with a lower socioeconomic status, higher EDSS (P=0.04 and lower pulmonary function than the seronegative cases (P=0.007. Aquaporin-4 autoimmunity may account for a significant proportion of Jamaican CNS IDDs.

  11. Evidence for obtaining a second successive semen sample for intrauterine insemination in selected patients: results from 32 consecutive cases.

    Science.gov (United States)

    Ortiz, Alejandra; Ortiz, Rita; Soto, Evelyn; Hartmann, Jonathan; Manzur, Alejandro; Marconi, Marcelo

    2016-06-01

    The goal of this study was to compare the semen parameters of two successive samples obtained within an interval of less than 60 minutes from patients planning to undergo intrauterine insemination (IUI) whose first samples exhibited low semen quality. Thirty-two consecutive patients were enrolled in the study. On the day of IUI, the semen analysis of the samples initially presented by all patients met at least two of the following criteria: sperm concentration <5×10(6)/mL, total sperm count <10×10(6), progressive sperm motility (a+b) in the native sample <30%, and total motile sperm count (TMSC) <4×10(6). A successive semen sample was obtained no more than 60 minutes after the first sample. Compared to the first sample, the second exhibited significantly (p<0.05) improved sperm concentration, TMSC, progressive motility, and vitality. Regarding TMSC, the most critical parameter on the day of IUI, 23 patients (71.8%) improved it, while nine (28.2%) displayed poorer outcomes. In defined cases, requesting a second successive ejaculate on the day of insemination may result in a high percentage of cases in an improvement of the quality of the sample.

  12. Levels of Th1 and Th2 cytokines in elderly patients with eczema%老年湿疹患者T辅助细胞相关细胞因子水平分析

    Institute of Scientific and Technical Information of China (English)

    杨敏; 郝洪军; 张春媚; 常建民; 李邻峰

    2012-01-01

    目的 研究老年湿疹患者Th1/Th2细胞因子的血清水平与湿疹的发展及其临床表现的相关性. 方法 应用酶联免疫吸附法(ELISA)测定50例老年湿疹患者(≥60岁)白介素(IL)-2、4、10、12和肿瘤坏死因子(TNF-α)的血清水平并与34例健康老年人(对照组)进行比较;比较急性和慢性,或泛发性和局限性湿疹上述细胞因子的水平差异. 结果 老年湿疹组IL-2 [(16.03±0.47)比(15.72±0.33) μg/L]、IL-4 [(14.04±0.56)比(13.56±0.16)μg/L]、IL-10[(33.01±5.40)比(29.49±1.07) μg/L]、IL-12 [(39.32±3.54)比(37.93±1.17) μg/L]和TNF-α [(27.33±0.72)比(26.38±0.48) μg/L]水平均高于对照组(t/t'=3.55,5.74,4.4 9,2.58,6.69,均P<0.05).急性湿疹组血清细胞因子水平均高于对照组(t/t'=3.59,6.44,4.68,3.35,2.00,均P<0.05);慢性湿疹组中IL-2、IL-4、IL-10和TNF-α的血清水平高于对照组(t'=2.46,5.50,3.83,3.10,均P<0.05),而IL-12水平与对照组的差异无统计学意义(t'=1.77,P>0.05);急性与慢性湿疹患者血清细胞因子的水平差异无统计学意义(P>0.05).泛发性与局限性湿疹患者血清IL-2、II4、IL-10和IL-12、TNF-α的水平差异无统计学意义(t=0.18,5.74,4.49,0.91,0.25,1.11,均P>0.05). 结论细胞因子IL-2、IL-4、IL-10、Th1/Th2和TNF-α可能与老年人湿疹发生相关,不同临床类型的老年湿疹患者可能并无特定的Th1/Th2细胞因子变化模式.%Objective To investigate the serum levels of Th1 and Th2 cytokines and explore its roles in development and clinical features in the elderly patients with eczema. Methods The serum levels of interleukin-2(IL-2),interleukin 4(IL-4),interleukin-10(IL-10),interleukin-12(IL-12) and tumor necrosis factor alpha (TNF-α) were derected in 50 elderly patients with eczema and 34 healthy elderly as control by enzyme-linked immunosorbent assay (ELISA). The above cytokines were compared between acute and chronic,generalized and localized eczema. Results The serum

  13. EXPRESSION AND CLINICAL SIGNIFICANCES OF IL-17 AND IL-23 IN PATIENTS WITH ECZEMA%IL-17和 IL-23在湿疹患者中的表达及临床意义

    Institute of Scientific and Technical Information of China (English)

    吴浩浪; 杨广智; 谢振生; 麦丽霞

    2015-01-01

    Objective To explore the expression and clinical significances of interleukin -17( IL-17) and IL-23 in the blood of eczema patients .Methods 78 cases of eczema treated in our hospital from September 2012 to December 2013 were selected as the observation group .30 healthy volunteers in the same period were selected as the control group .IL-17 and IL-23 levels among the two groups and patients with different severity of eczema were compared.The lymphocyte count , platelet count and serum creatinine in two groups were also compared .Results IL-17 and IL-23 levels in the observation group were significantly higher than those in the control group , and the more serious eczema cases were , the higher levels of IL -17 and IL-23 were (p<0.05).The lymphocyte count and serum creatinine in the observation group were higher than those in the control group , while its platelet count was less than that in the control group .Conclusion Expression levels of IL -17 and IL-23 in eczema patients are sig-nificantly increasedwith the deterioration of the disease .Expression levels of IL -17 and IL-23 may be involved in the pathogenesis of eczema , andit has a correlation to the severity of disease .%目的:研究湿疹(Eczama)患者血液中白细胞介素-17(IL-17)及IL-23的表达水平及临床意义。方法选择2012年9月~2013年12月在我院接受治疗的湿疹患者78例,记为观察组。再选取同期进行健康体检的志愿者30例,记为对照组。对比两组及不同分级湿疹患者的IL-17、IL-23水平,对两组间的淋巴细胞计数、血小板计数以及血肌酐也进行比较。结果观察组的IL-17、IL-23水平均显著高于对照组,并且湿疹越严重IL-17、IL-23水平越高。差异均有统计学意义(均p<0.05)。而观察组的淋巴细胞计数及血肌酐高于对照组,血小板计数少于对照组。结论湿疹患者体内的IL-17和IL-23水平表达明显升高,并且随着患

  14. Development and evaluation of quality of life scale for patients with eczema%湿疹患者生活质量量表的编制和考评

    Institute of Scientific and Technical Information of China (English)

    朱武; 李湘辉; 蔡太生; 谢红付

    2009-01-01

    Objective To develop a specific quality of life scale for eczema patients(EQOLS).Method The theory and methodology had been adopted before the item pool formed.Five methods had been used in the item analyzing with the data of 351 eczema patients had been recruited.And the reliability and validity of the scale were also tested.Result The eczema quality of life scale with 28 items was developed,including 4 domains (morbid,physical,social psychological) and one item on general QOL.The test-retest correlation coefficient,Cronbach' s Alpha coefficient and split-half reliability coefficient of EQOLS were 0.912,0.9346 and 0.9046,respectively.The EQOLS scores were significantly decreased after one week' s treatment(P<0.01).There was a significantly positive correlation between EQOLS and EASI scores (r=0.805,P < 0.01).Confirmatory factor analysis showed that X~2/df=2.211 ,CFI=0.902,NNFI=0.892,RMSEA=0.059,respectively.Conclusion EQOLS is reliable,valid and sensitive,and can be used to evaluate the quality of life for eczema patients.%目的 编制湿疹患者生活质量量表.方法 编制湿疹患者生活质量初始量表,采用初始量表对湿疹患者进行实测,收集有效问卷351份.采用5种方法进行条目分析,由保留条目组成量表测试版.并对量表进行信度和效度考评.结果 (1)编制出28个条目的 湿疹生活质量量表(eczema quality of life scale,EQOLS),分别属于由疾病、心理、生理、社会4个维度和1个反应总体生活质量的条目.(2)EQOLS总量表重测信度0.912,Cronbach's α系数0.935,分半信度系数0.905.(3)EQOLS总分与皮肤病生活质量指数(Dernmatology Life Quality Index,DLQI)总分、病情(eczema area and severity index,EASI)评分值、反映总体生活质世条目A43值,相关系数分别为0.795,0.805,0.812,(P<0.01).患者治疗1周前后EQOLS值有显著差异(P<0.01).(4)验证性因子分析:拟合优度的卡方检验X~2/df=2.211,比较拟合指数CFI=0.902,

  15. Expression of Klf4 in the lesions of the patients with psoriasis or eczema%Klf4在银屑病和湿疹患者皮损中的表达

    Institute of Scientific and Technical Information of China (English)

    郭坤; 肖生祥; 耿松梅

    2016-01-01

    目的::检测Klf4在银屑病及湿疹皮损中的表达。方法:采用免疫组化技术检测Klf4在16例银屑病患者皮损、16例湿疹皮损及16例正常皮肤中的表达。结果:银屑病皮损Klf4阳性细胞数为(346.56±24.91)高于正常皮肤的(235.12±20.32),(P<0.05),湿疹皮损为(75.94±15.61),低于正常皮肤( P<0.05)。结论:湿疹患者的Klf4表达下调而在银屑病患者中上调,KIf4在不同疾病中可能发挥不同的生物学作用。%Objective:To detect the expression levels of Klf4 in the lesions of the patients with psoriasis or eczema. Methods:The expression levels of Klf4 in the lesions of psoriasis or eczema was detected by immuno-histochemistry methods. Results: The average number of KIf4 positive cells in the psoriatic lesions was (346.56±24.91), which was higher than that in the normal skin (235.12±20.32), with a significant differ-ence (P<0.05). The average number of KIf4 positive cells in the eczema lesions was (75.94±15.61), which was lower than that in normal skin ( P<0.05) . Conclusion:Klf4 was down-regulated in patients with eczema and was up-regulated in the patients with psoriasis. Klf4 may play a different role in the pathogenesis of differ-ent diseases.

  16. Exposures related to hand eczema

    DEFF Research Database (Denmark)

    Ibler, K.S.; Jemec, G.B.E.; Agner, T.

    2012-01-01

    between exposures (domestic and at work) and prevalence and severity of hand eczema. Methods. Self-administered questionnaires were sent to 3181 healthcare workers in Denmark. Results. Two thousand two hundred and sixty-nine (71%) workers responded to the questionnaire. Frequent hand washing....... Conclusions. Although healthcare workers are recommended to use disinfectants when the hands are not visibly dirty, hand washing is still significantly related to hand eczema. Frequent hand washing may be a question of behavioural habits, and a focus for future guidance should be on changing hand washing......Background. Hand eczema is common in healthcare workers, owing to intensive exposure to wet work and skin irritants. Targeted interventions and vocational guidance based on documented exposures and risk factors are needed. Objectives. The aims of the study were to investigate the relationship...

  17. The prevalence of vitamin D deficiency in consecutive new patients seen over a 6-month period in general rheumatology clinics.

    LENUS (Irish Health Repository)

    Haroon, Muhammad

    2012-02-01

    The objectives of this study are to assess: (a) the prevalence of vitamin D deficiency among new patients attending rheumatology outpatient departments, (b) the age profile of these low vitamin D patients and (c) whether any diagnostic category had a particularly high number of vitamin D-deficient patients. All new patients seen consecutively in general rheumatology clinics between January to June 2007 inclusive were eligible to partake in this study, and 231 out of 264 consented to do so. Parathyroid hormone, 25-hydroxyvitamin D, creatinine, calcium, phosphate, albumin and alkaline phosphatase levels were measured. We defined vitamin D deficiency as <\\/=53 nmol\\/l and severe deficiency as <\\/=25 nmol\\/l. Overall, 70% of 231 patients had vitamin D deficiency, and 26% had severe deficiency. Sixty-five percent of patients aged >\\/=65 and 78% of patients aged <\\/=30 years had low vitamin D levels. Vitamin D deficiency in each diagnostic category was as follows: (a) inflammatory joint diseases\\/connective tissue diseases (IJD\\/CTD), 69%; (b) soft tissue rheumatism, 77%; (c) osteoarthritis, 62%; (d) non-specific musculoskeletal back pain, 75% and (e) osteoporosis, 71%. Seasonal variation of vitamin D levels was noted in all diagnostic groups apart from IJD\\/CTD group, where the degree of vitamin D deficiency persisted from late winter to peak summer. Very high prevalence of vitamin D deficiency was noted in all diagnostic categories (p = 0.006), and it was independent of age (p = 0.297). The results suggest vitamin D deficiency as a possible modifiable risk factor in different rheumatologic conditions, and its role in IJD\\/CTD warrants further attention.

  18. The prevalence of vitamin D deficiency in consecutive new patients seen over a 6-month period in general rheumatology clinics.

    Science.gov (United States)

    Haroon, Muhammad; Bond, Ursula; Quillinan, Niamh; Phelan, Mark J; Regan, Michael J

    2011-06-01

    The objectives of this study are to assess: (a) the prevalence of vitamin D deficiency among new patients attending rheumatology outpatient departments, (b) the age profile of these low vitamin D patients and (c) whether any diagnostic category had a particularly high number of vitamin D-deficient patients. All new patients seen consecutively in general rheumatology clinics between January to June 2007 inclusive were eligible to partake in this study, and 231 out of 264 consented to do so. Parathyroid hormone, 25-hydroxyvitamin D, creatinine, calcium, phosphate, albumin and alkaline phosphatase levels were measured. We defined vitamin D deficiency as ≤53 nmol/l and severe deficiency as ≤25 nmol/l. Overall, 70% of 231 patients had vitamin D deficiency, and 26% had severe deficiency. Sixty-five percent of patients aged ≥65 and 78% of patients aged ≤30 years had low vitamin D levels. Vitamin D deficiency in each diagnostic category was as follows: (a) inflammatory joint diseases/connective tissue diseases (IJD/CTD), 69%; (b) soft tissue rheumatism, 77%; (c) osteoarthritis, 62%; (d) non-specific musculoskeletal back pain, 75% and (e) osteoporosis, 71%. Seasonal variation of vitamin D levels was noted in all diagnostic groups apart from IJD/CTD group, where the degree of vitamin D deficiency persisted from late winter to peak summer. Very high prevalence of vitamin D deficiency was noted in all diagnostic categories (p = 0.006), and it was independent of age (p = 0.297). The results suggest vitamin D deficiency as a possible modifiable risk factor in different rheumatologic conditions, and its role in IJD/CTD warrants further attention.

  19. Fifty-six Cases of Stubborn Eczema Treated by Oral Administration and Topical Application of Herbal Medicine

    Institute of Scientific and Technical Information of China (English)

    罗维丹; 邬成霖

    2001-01-01

    @@ Eczema is a kind of very common dermatopathy. The cases with a long course of illness and hard to be cured are termed as stubborn eczema. We have obtained good results in its treatment since 1995 with the Chu Shi Tang (除湿汤Dampness-Clearing Decoction) for oral intake and the Fu Fang Ku Shen Xi Ye (复方苦参洗液) for topical application. The following is a clinical report for treating 56 patients with stubborn eczema.

  20. Hexa-herbal Chinese formula for eczema

    DEFF Research Database (Denmark)

    Chang, J.; Jäger, Anna; Heinrich, M.

    2014-01-01

    Diverse pharmacological activities and reliable clinical performances of Chinese herbal medicines have attracted worldwide attention in terms of its modernization. Here, a hexa-herbal Chinese formula (HHCF) for treating eczema topically has been studied from both chemical and biological perspective...... colonizes the skin of most patients with AD and produces superantigens that could further increase severity of AD via subverting T-regulatory cell activity and inducing corticosteroid resistance. [3] Therefore, activity of the decoctions prepared from mixture and individual medicinal plants of the formula...

  1. Single-Centre Experience with Percutaneous Cryoablation of Breast Cancer in 23 Consecutive Non-surgical Patients

    Energy Technology Data Exchange (ETDEWEB)

    Cazzato, Roberto Luigi, E-mail: r.cazzato@unicampus.it [Institut Bergonié, Comprehensive Cancer Centre, Department of Medical Imaging (France); Lara, Christine Tunon de, E-mail: c.tunondelara@bordeaux.unicancer.fr [Institut Bergonié, Comprehensive Cancer Centre, Department of Surgery (France); Buy, Xavier, E-mail: x.buy@bordeaux.unicancer.fr; Ferron, Stéphane, E-mail: s.ferron@bordeaux.unicancer.fr; Hurtevent, Gabrielle, E-mail: g.hurtevent@bordeaux.unicancer.fr [Institut Bergonié, Comprehensive Cancer Centre, Department of Medical Imaging (France); Fournier, Marion, E-mail: m.fournier@bordeaux.unicancer.fr [Institut Bergonié, Comprehensive Cancer Centre, Department of Surgery (France); Debled, Marc, E-mail: m.debled@bordeaux.unicancer.fr [Institut Bergonié, Comprehensive Cancer Centre, Department of Medical Oncology (France); Palussière, Jean, E-mail: j.palussiere@bordeaux.unicancer.fr [Institut Bergonié, Comprehensive Cancer Centre, Department of Medical Imaging (France)

    2015-10-15

    AimTo present our single-centre prospective experience on the use of cryoablation (CA) applied to treat primary breast cancer (BC) in a cohort of patients unsuitable for surgical treatment.Materials and MethodsTwenty-three consecutive post-menopausal female patients (median age 85 years; range 56–96) underwent percutaneous CA of unifocal, biopsy-proven BC, under ultrasound/computed tomography (US/CT) guidance. Clinical and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) follow-ups were systematically scheduled at 3, 12, 18 and 24 months. Local tumour control was assessed by comparing baseline and follow-up DCE-MRI.ResultsTwenty-three BC (median size 14 mm) were treated under local anaesthesia (78.3 %) or local anaesthesia and conscious sedation (21.7 %). Median number of cryo-probes applied per session was 2.0. A “dual-freezing” protocol was applied for the first ten patients and a more aggressive “triple-freezing” protocol for the remaining 13. Median follow-up was 14.6 months. Five patients recurred during follow-up and two were successfully re-treated with CA. Five patients presented immediate CA-related complications: four hematomas evolved uneventfully at 3-month follow-up and one skin burn resulted in skin inflammation and skin retraction at 3 and 12 months, respectively.ConclusionsPercutaneous CA is safe and well tolerated for non-resected elderly BC patients. Procedures can be proposed under local anaesthesia only. Given the insulation properties of the breast gland, aggressive CA protocols are required. Prospective studies are needed to better understand the potential role of CA in the local treatment of early BC.

  2. The pattern of lower gastrointestinal disease in the eastern region of Saudi Arabia: A retrospective analysis of 1590 consecutive patients

    Directory of Open Access Journals (Sweden)

    Al Quorain Abdulaziz

    2000-01-01

    Full Text Available To determine the pattern of lower gastrointestinal disease in the Eastern region of Saudi Arabia we analysed 1907 colorectal biopsies obtained from 1590 consecutive patients (1256 males &334 females, evaluated during a 13 year period (1983-1996 in a tertiary care teaching hospital. The age range was 6-81 years with a mean of 37 + 15. During the same period 6874 new patients were seen in the Gastroenterology Clinics. Saudi Arabs constituted 970 (61 % of all patients. The remaining 620 (39% were non-Saudi, mostly of Arab origin from neighbouring countries. The most common presenting symptom for referral was abdominal pain (1193 patients, 75% followed by diarrhea (636 patients, 40%. The most frequent histologic diagnosis was a normal mucosa followed by non specific proctocolitis accounting respectively for 37.9% and 37.4% of all cases. These were followed by schistosomiasis, 113 (7.1%, adenocarcinoma, 91 (5.7% and ulcerative colitis, 91 cases with a relative frequency of 5.7% and a calculated prevalence of 1.3%. Of significance was the encounter of 14 cases of Crohn′s disease amounting to 0.9% of all cases with a calculated prevalence of 0.2%. A minority of 83 patients (5.2% were cases of either a benign polyp, diverticular disease, tuberculosis, ischaemia, lymphoma, pseudomembranous colitis (PMC, eosinophilic gastroenteritis or malacoplakia. These data show that although a "normal mucosa" and "nonspecific proctocolitis" were the dominant diagnoses, significantly, ulcerative colitis and Crohn′s disease exist and should be considered in the differential diagnosis of lower GI disease.

  3. Hand eczema in the TOACS cohort

    DEFF Research Database (Denmark)

    Mortz, C G; Bindslev-Jensen, C; Andersen, Klaus Ejner

    2014-01-01

    in women. At the clinical examination 6.4% (30/469) had hand eczema. Factors in childhood of importance for adult hand eczema were atopic dermatitis together with hand eczema. Wet work in adulthood was a risk factor together with taking care of small children at home. Interestingly, hand eczema among...... unselected young adults, was associated with sick leave/pension/rehabilitation indicating possible severe social consequences. LIMITATIONS: Only 39% participated in the clinical examination while 75% answered the questionnaire. CONCLUSIONS: A high incidence and prevalence of hand eczema was found in 28...

  4. Superiority of resection over enucleation for schwannomas of the cervical vagus nerve: A retrospective cohort study of 22 consecutive patients.

    Science.gov (United States)

    Illuminati, Giulio; Pizzardi, Giulia; Minni, Antonio; Masci, Federica; Ciamberlano, Bernardo; Pasqua, Rocco; Calio, Francesco G; Vietri, Francesco

    2016-05-01

    Schwannoma of the cervical vagus nerve is rare. Treatment options include intracapsular enucleation and en bloc resection. The purpose of this study was to compare the outcomes of enucleation and resection in terms of postoperative mortality and morbidity, freedom from vocal cord palsy, freedom from local recurrence, quality-adjusted life-year (QALY) and vocal handicap index (VHI). Twentytwo consecutive patients were divided into two groups. Patients in group A (n = 9) underwent intracapsular enucleation, whereas patients in Group B (n = 13) underwent en bloc resection. Main endpoints of the study were postoperative mortality and morbidity, freedom from vocal cord palsy, freedom from local recurrence and quality of life. The quality of life after surgery was assessed according to the quality-adjusted life-year (QALY) EQ-5D-5L methodology, and calculation of the voice handicap index (VHI). Postoperative mortality was nil. Morbidity included 1 wound dehiscence in group A and 2 transitory dysphagias in group B. Freedom from vocal cord palsy was 22% in group A and zero in group B (p = 0.15). Operation-specific local recurrence rate was 33% (3/9 patients) in group A and nil in group B (0/23 patients) (p = 0.05). QALYs was 0.55 in group A and 0.54 in group B (p = 1.0). VHI was 23.77 in group A and 26.15 in group B (p = 1.00). Resection is superior to enucleation in terms of freedom from local recurrence. Functional results are comparable for both techniques. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  5. Trends of contact allergy to fragrance mix I and Myroxylon pereirae among Danish eczema patients tested between 1985 and 2007

    DEFF Research Database (Denmark)

    Thyssen, Jacob P; Carlsen, Berit Christina; Menné, Torkil

    2008-01-01

    BACKGROUND: Fragrance contact allergy has for long been recognized as an important health issue. In Denmark, the frequency of fragrance mix (FM) I contact allergy increased between 1985-1986 and 1997-1998 among male and female dermatitis patients. OBJECTIVES: To investigate the development of FM I...... and Myroxylon pereirae (MP) contact allergy between 1985 and 2007 with an emphasis on recent years. METHODS: A retrospective analysis of all patch test data from our database was performed. Comparison of sensitivity rates was made using a chi-squared test for trend. Logistic regression analyses were used...

  6. Dentofacial effects of bone-anchored maxillary protraction: A controlled study of consecutively treated Class III patients

    Science.gov (United States)

    De Clerck, Hugo; Cevidanes, Lucia; Baccetti, Tiziano

    2011-01-01

    Introduction In this cephalometric investigation, we analyzed the treatment effects of bone-anchored maxillary protraction (BAMP) with miniplates in the maxilla and mandible connected by Class III elastics in patients with Class III malocclusion. Methods The treated sample consisted of 21 Class III patients consecutively treated with the BAMP protocol before the pubertal growth spurt (mean age, 11.10 ± 1.8 years) and reevaluated after BAMP therapy, about 1 year later. The treated group was compared with a matched control group of 18 untreated Class III subjects. Significant differences between the treated and control groups were assessed with independent-sample t tests (P<0.05). Results Sagittal measurements of the maxilla showed highly significant improvements during active treatment (about 4 mm more than the untreated controls), with significant protraction effects at orbitale and pterygomaxillare. Significant improvements of overjet and molar relationship were recorded, as well as in the mandibular skeletal measures at Point B and pogonion. Vertical skeletal changes and modifications in incisor inclination were negligible, except for a significant proclination of the mandibular incisors in the treated group. Significant soft-tissue changes reflected the underlying skeletal modifications. Conclusions Compared with growth of the untreated Class III subjects, the BAMP protocol induced an average increment on skeletal and soft-tissue advancement of maxillary structures of about 4 mm, and favorable mandibular changes exceeded 2 mm. PMID:21055597

  7. Coronary artery imaging during preoperative CT staging: preliminary experience with 64-slice multidetector CT in 99 consecutive patients

    Energy Technology Data Exchange (ETDEWEB)

    Delhaye, Damien; Remy-Jardin, Martine; Rozel, Celine; Remy, Jacques [University Center of Lille, Boulevard Jules Leclerc, Department of Thoracic Imaging, Hospital Calmette, Lille cedex (France); Dusson, Catherine; Wurtz, Alain [University Center of Lille, Department of Thoracic Surgery, Hospital Calmette, Lille cedex (France); Delannoy-Deken, Valerie; Duhamel, Alain [University of Lille, Department of Medical Statistics, Lille cedex (France)

    2007-03-15

    The purpose of this study was to evaluate the clinical feasibility of coronary artery imaging during routine preoperative 64-slice MDCT scans of the chest. Ninety-nine consecutive patients in sinus rhythm underwent a biphasic multidetector-row spiral CT examination of the chest without the administration of beta-blockers, including an ECG-gated acquisition over the cardiac cavities, followed by a non-gated examination of the upper third of the thorax. Data were reconstructed to evaluate coronary arteries and to obtain presurgical staging of the underlying disease. The percentage of assessable segments ranged from 65.4% (972/1,485) when considering all coronary artery segments to 88% (613/693) for the proximal and mid segments, reaching 98% (387/396) for proximal coronary artery segments. The 387 interpretable proximal segments included 97 (97%) LM, 99 (100%) LAD, 96 (97%) LCX and 95 (96%) RCA with a mean attenuation of 280.70{+-}52.93 HU. The mean percentage of assessable segments was significantly higher in patients with a heart rate {<=}80 bpm (n=48) than in patients with a heart rate greater than 80 bpm (n=35) (80{+-}11% vs. 72{+-}13%; P=0.0008). Diagnostic image quality was achieved in all patients for preoperative staging of the underlying disorder. The mean estimated effective dose was 12.06{+-}3.25 mSv for ECG-gated scans and 13.88{+-}3.49 mSv for complete chest examinations. Proximal and mid-coronary artery segments can be adequately evaluated during presurgical CT examinations of the chest obtained with 64-slice MDCT without the administration of {beta}-blockers. (orig.)

  8. Diagnostic accuracy of 64-slice multidetector CT for detection of in-stent restenosis in an unselected, consecutive patient population

    Energy Technology Data Exchange (ETDEWEB)

    Haraldsdottir, Sigurdis, E-mail: sigurdisha@gmail.com [Boston Medical Center, 72 East Concord Street (Evans 124), Boston, MA, 02118 (United States); Gudnason, Thorarinn, E-mail: thorgudn@landspitali.is [Landspitali University Hospital, Hringbraut, 101 Reykjavik (Iceland); Sigurdsson, Axel F., E-mail: axelfsig@landspitali.is [Landspitali University Hospital, Hringbraut, 101 Reykjavik (Iceland); Gudjonsdottir, Jonina, E-mail: jonina@rd.is [Rontgen Domus Medica, Egilsgata 3, 101 Reykjavik (Iceland); Lehman, Sam J., E-mail: slehman@partners.org [Massachusetts General Hospital, 165 Cambridge Street, Suite 400, Boston, MA 02114 (United States); Eyjolfsson, Kristjan, E-mail: kristey@landspitali.is [Landspitali University Hospital, Hringbraut, 101 Reykjavik (Iceland); Scheving, Sigurpall S., E-mail: sigurpal@landspitali.is [Landspitali University Hospital, Hringbraut, 101 Reykjavik (Iceland); Gibson, C. Michael, E-mail: mgibson@perfuse.org [Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02115 (United States); Hoffmann, Udo, E-mail: uhoffmann@partners.org [Massachusetts General Hospital, 165 Cambridge Street, Suite 400, Boston, MA 02114 (United States); Jonsdottir, Birna, E-mail: birna@rd.is [Rontgen Domus Medica, Egilsgata 3, 101 Reykjavik (Iceland); Andersen, Karl, E-mail: andersen@landspitali.is [Landspitali University Hospital, Hringbraut, 101 Reykjavik (Iceland)

    2010-11-15

    Objectives: To investigate the diagnostic accuracy of 64-slice multidetector computed tomography (64-CT) for detection of in-stent restenosis (ISR) in an unselected, consecutive patient population. Background: Detection of in-stent restenosis by cardiac CT would be a major advance for the evaluation of patients suspected of having ISR. However, the diagnostic accuracy of current generation 64-CT in this context is not fully established. Methods: We conducted a prospective study on patients with stable angina or acute coronary syndrome with no prior history of coronary artery disease. Six months after percutaneous coronary intervention (PCI) with stent placement they underwent a 64-CT scan (Toshiba Multi-Slice Aquilion 64) and consequently a repeat coronary angiography for comparison. Cardiac CT data sets were analyzed for the presence of in-stent restenosis by two independent expert readers blinded to the coronary angiographic data. Results: Ninety-three patients with a total of 140 stents were evaluated. Males comprised 82% of the study group and the mean age was 63 {+-} 10 years. The mean time from PCI to the repeat coronary angiography was 208 {+-} 37 days and the mean time from 64-CT to repeat coronary angiography was 3.7 {+-} 4.9 days. The restenosis rate according to coronary angiography was 26%. Stent diameter, strut thickness, heart rate and body mass index (BMI) significantly affected image quality. The sensitivity, specificity, positive and negative predictive values of 64-CT for detection of in-stent restenosis were 27%, 95%, 67% and 78%, respectively. Conclusions: Current generation, 64-slice CT, remains limited in its ability to accurately detect in-stent restenosis.

  9. Management of chronic hand eczema

    NARCIS (Netherlands)

    Diepgen, Thomas L.; Agner, Tove; Aberer, Werner; Berth-Jones, John; Cambazard, Frederic; Elsner, Peter; McFadden, John; Coenraads, Pieter Jan

    2007-01-01

    Hand eczema (HE) is one of the most frequent skin diseases and has often a chronically relapsing course with a poor prognosis resulting in a high social and economic impact for the individual and the society. In this article, we highlight the results of an expert workshop on the 'management of sever

  10. Thoracolumbar instrumentation with CT-guided navigation (O-arm) in 270 consecutive patients: accuracy rates and lessons learned.

    Science.gov (United States)

    Rivkin, Mark A; Yocom, Steven S

    2014-03-01

    Thoracolumbar instrumentation has experienced a dramatic increase in utilization over the last 2 decades. However, pedicle screw fixation remains a challenging undertaking, with suboptimal placement contributing to postoperative pain, neurological deficit, vascular complications, and return to the operating suite. Image-guided spinal surgery has substantially improved the accuracy rates for these procedures. However, it is not without technical challenges and a learning curve for novice operators. The authors present their experience with the O-arm intraoperative imaging system and share the lessons they learned over nearly 5 years. The authors performed a retrospective chart review of 270 consecutive patients who underwent thoracolumbar pedicle screw fixation utilizing the O-arm imaging system in conjunction with StealthStation navigation between April 2009 and September 2013 at a single tertiary care center; 266 of the patients underwent CT scanning on postoperative Day 1 to evaluate hardware placement. The CT scans were interpreted prospectively by 3 neuroradiologists as part of standard work flow and retrospectively by 2 neurosurgeons and a senior resident. Pedicle screws were evaluated for breaches according to the 3-tier classification proposed by Mirza et al. Of 270 patients, 266 (98.5%) were included in the final analysis based on the presence of a postoperative CT scan. Overall, 1651 pedicle screws were placed in 266 patients and yielded a 5.3% breach rate; 213 thoracic and 1438 lumbosacral pedicle screws were inserted with 6.6% and 5.1% breach rates, respectively. Of the 87 suboptimally placed screws, there were 13 Grade 1, 16 Grade 2, and 12 Grade 3 misses as well as 46 anterolateral or "tip-out" perforations at L-5. Four patients (1.5%) required a return to the operating room for pedicle screw revision, 2 of whom experienced transient radicular symptoms and 2 remained asymptomatic. Interestingly, the pedicle breach rate was higher than anticipated at 13

  11. Congenital coronary artery fistulas: dual-source CT findings from consecutive 6624 patients with suspected or confirmed coronary artery disease

    Institute of Scientific and Technical Information of China (English)

    YUN Hong; ZENG Meng-su; YANG Shan; JIN Hang; YANG Xue

    2011-01-01

    Background Coronary artery fistulas (CAFs) are rare congenital abnormality often unintentionally found in patients with coronary artery disease.Clinical diagnosis of CAFs is difficult due to symptomless or lack of specific symptoms.Dual-source computed tomography (DSCT) might be a useful diagnostic tool for CAFs.The study aimed to retrospectively summarize the imaging features of CAFs delineated at DSCT in 48 CAF patients detected from consecutive 6624 patients with suspected or confirmed coronary artery disease in our institution.Methods Forty-eight patients underwent DSCT angiography by using retrospective electrocardiographic (ECG) gating after infusion of 70 ml of intravenous contrast material during breath hold.Maximum intensity projection (MIP),curved planar reconstruction (CPR),and volume rendering technique (VR) were obtained.Anomalous termination of coronary artery in each subject was evaluated by two radiologists (with more than 10 years experience with cardiovascular imaging),and disagreement between diagnosis readers was settled by a consensus reading.Ten of 48 patients also underwent traditional coronary angiography (CAG) simultaneously.Results In each CAF case,DSCT angiography clearly demonstrated the origin,the termination,the size of abnormal vessel and its course in relation to surrounding great vessels.CAF arising from right coronary artery was the most common type,left circumflex was the least one involved among three coronaries,and pulmonary artery was the most common drainage site.Aneurismal fistulous tract,coronary atherosclerosis,myocardial bridging and anomalous origin of coronary artery were also detected in this group.The demonstration of drainage sites in CAG was consistent with DSCT angiography in 9 patients,and judgment on one anomalous connection in CAG was inconsistent with that in DSCT angiography.Conclusions DSCT angiography could provide accurate delineation of anomalous communications,size and numbers of fistulas in patients with

  12. Alitretinoin: A Review in Severe Chronic Hand Eczema.

    Science.gov (United States)

    Blair, Hannah A; Scott, Lesley J

    2016-09-01

    Chronic hand eczema is a common but frequently disabling skin condition which poses a significant social and economic burden. Although skin protection measures and topical therapies are fundamental in its management, some patients are refractory to first-line therapy with topical corticosteroids and require systemic treatment. Alitretinoin (9-cis-retinoic acid; Toctino(®)) is an endogenous vitamin A derivative with high binding affinity for both retinoic acid receptors and retinoid X receptors. Alitretinoin is the first systemic treatment to be approved in the EU for use in patients with severe chronic hand eczema unresponsive to potent topical corticosteroids. This article updates an earlier review of alitretinoin in this indication, focusing on recently published data. In clinical trials, treatment with alitretinoin 10 or 30 mg once daily for up to 24 weeks improved the severity and extent of severe chronic hand eczema in adults, with significantly more alitretinoin than placebo recipients achieving ratings of 'clear' or 'almost clear' hands on the Physician Global Impression of Change scale. For the most part, data obtained in real-world studies were consistent with those observed in clinical trials. Alitretinoin was generally well tolerated, with most adverse events being reversible, dose-dependent and of mild or moderate severity. Thus, oral alitretinoin is a useful treatment option for patients with severe chronic hand eczema unresponsive to potent topical corticosteroids.

  13. The hands in health and disease of individuals with filaggrin loss-of-function mutations: clinical reflections on the hand eczema phenotype.

    Science.gov (United States)

    Kaae, Jeanette; Menné, Torkil; Carlsen, Berit C; Zachariae, Claus; Thyssen, Jacob P

    2012-09-01

    During the last 2 years, we have performed filaggrin genotyping in patients with eczema seen in our hand eczema clinic. We present pictures of healthy and diseased hands from individuals with filaggrin gene (FLG) mutations to describe a clinical entity of hand eczema. We show that xerosis and hyperkeratosis on the dorsal aspects of the hands and fingers, as well as palmar hyperlinearity, should alert the clinician about a possible inherited barrier abnormality of the skin resulting from FLG mutations. The series of photographs range from the hands of an individual with FLG mutations but no history of eczema, to the hands of individuals with typical and atypical filaggrin hand eczema, and finally to the hands of an individual with FLG mutations and hand eczema caused by exposure to irritants and allergens. We briefly discuss this possible subtype of hand eczema, present pathomechanisms, and indicate the signs that should alert the clinicians about a possible inherited skin barrier defect.

  14. A prospective study of direct medical costs in a large cohort of consecutively enrolled patients with refractory epilepsy in Italy.

    Science.gov (United States)

    Luoni, Chiara; Canevini, Maria Paola; Capovilla, Giuseppe; De Sarro, Giovambattista; Galimberti, Carlo Andrea; Gatti, Giuliana; Guerrini, Renzo; La Neve, Angela; Mazzucchelli, Iolanda; Rosati, Eleonora; Specchio, Luigi Maria; Striano, Salvatore; Tinuper, Paolo; Perucca, Emilio

    2015-07-01

    To evaluate direct medical costs and their predictors in patients with refractory epilepsy enrolled into the SOPHIE study (Study of Outcomes of PHarmacoresistance In Epilepsy) in Italy. Adults and children with refractory epilepsy were enrolled consecutively at 11 tertiary referral centers and followed for 18 months. At entry, all subjects underwent a structured interview and a medical examination, and were asked to keep records of diagnostic examinations, laboratory tests, specialist consultations, treatments, hospital admissions, and day-hospital days during follow-up. Study visits included assessments every 6 months of seizure frequency, health-related quality of life (Quality of Life in Epilepsy Inventory 31), medication-related adverse events (Adverse Event Profile) and mood state (Beck Depression Inventory-II). Cost items were priced by applying Italian tariffs. Cost estimates were adjusted to 2013 values. Of 1,124 enrolled individuals, 1,040 completed follow-up. Average annual cost per patient was € 4,677. The highest cost was for antiepileptic drug (AED) treatment (50%), followed by hospital admissions (29% of overall costs). AED polytherapy, seizure frequency during follow-up, grade III pharmacoresistance, medical and psychiatric comorbidities, and occurrence of status epilepticus during follow-up were identified as significant predictors of higher costs. Age between 6 and 11 years, and genetic (idiopathic) generalized epilepsies were associated with the lowest costs. Costs showed prominent variation across centers, largely due to differences in the clinical characteristics of cohorts enrolled at each center and the prescribing of second-generation AEDs. Individual outliers associated with high costs related to hospital admissions had a major influence on costs in many centers. Refractory epilepsy is associated with high costs that affect individuals and society. Costs differ across centers in relation to the characteristics of patients and the extent of

  15. Personal experience on 71 consecutive patients with acute cholecystitis; Esperienza personale in settantuno pazienti consecutivi con colecistite acuta

    Energy Technology Data Exchange (ETDEWEB)

    Pinto, A.; Romano, L.; Scaglione, M.; Pinto, F. [Azienda Ospedaliera di Rilievo Nazionale A. Cardarelli, Neaples (Italy). Dipt. di Diagnostica per Immagini; Romano, S.; Grassi, R.; Cappabianca, S. [Neaples Seconda Univ., Neaples (Italy). Ist. di Scienze Radiologiche; Del Vecchio, W. [Neaples Univ. Federico 2, Neaples (Italy). Ist. di Radiologia

    2000-02-01

    Acute cholecystitis is one of the most frequent abdominal inflammatory processes. If untreated or misdiagnosed it can result in severe complications such as gallbladder rupture, abscesses, or peritonitis. It was retrospectively reviewed a series of 71 consecutive patients with surgical confirmation of acute cholecystitis and then compared the results of the diagnostic techniques that have been used preoperatively. Over 16 months, 71 consecutive patients (42 women and 29 men; age range: 34-84 years, mean: 58) with acute abdominal pain were operated on for acute cholecystitis at Cardarelli Hospital, Naples. On abdominal plain films, it was retrospectively searched the following signs: densities projected over the gallbladder, linear calcifications in gallbladder walls, gallbladder enlargement, focal gas collections within the gallbladder, and air-fluid levels in the gallbladder wall lumen. On US images it has been looked for: gallbladder wall thickening (>3 mm), intraluminal content in the gallbladder, pericholecystic fluid, US Murphy's sign, and gallbladder distension. On CT images, it has been investigated: gallbladder distensions, wall thickening, intraluminal content, pericholecystic fluid, and inflammatory changes in pericholecystic fat. On plain abdominal films it was found densities projected over the gallbladder (16.9%) and linear calcifications in the gallbladder wall (4.6%). US appears to be the most useful imaging technique in patients with suspected acute cholecystitis, for both screening and final diagnosis. CT plays a limited role in the early assessment of these patients, but can a useful tool in diagnosing acute cholecystitis in patients with questionable physical findings or in investigating related complications. [Italian] La colecistite acuta e' una delle flogosi addominali con riscontro piu' frequente. Presenta complicanze (perforazione, ascesso, peritonite) quando non curata o non diagnosticata. Gli autori conducono l

  16. Chronic hand eczema: perception and knowledge in non-affected individuals from general and dermatological practice.

    Science.gov (United States)

    Letulé, Valerie; Herzinger, Thomas; Schirner, Astrid; Hertrich, Frank; Lange, Dirk; Ruzicka, Thomas; Molin, Sonja

    2014-11-01

    Misunderstanding and stigmatisation are common problems encountered by patients with hand eczema. Various misconceptions about the disease circulate in the general population. Although hand eczema has gained more attention in dermatology during the past years, information on public perception of the disease is still lacking. The aim of our study was to investigate perception of and level of knowledge on the subject hand eczema. There were 624 patients included from 2 general medicine practices and 2 dermatological practices. A self-administered questionnaire was filled out by the participants, covering issues on history of hand eczema, level of knowledge and attitude towards a clinical photograph of hand eczema. We found that a larger proportion of individuals from dermatological practice were more familiar with hand eczema as a disease than those from general medical practice. Women knew significantly more about and had a more positive perception of the disease than men. Our results imply that the level of knowledge on hand eczema in the general public is rather low and influenced by prejudice.

  17. Prevalence and Location of Neuropathic Pain in Lumbar Spinal Disorders: Analysis of 1804 Consecutive Patients With Primary Lower Back Pain.

    Science.gov (United States)

    Orita, Sumihisa; Yamashita, Toshihiko; Ohtori, Seiji; Yonenobu, Kazuo; Kawakami, Mamoru; Taguchi, Toshihiko; Kikuchi, Shin-Ichi; Ushida, Takahiro; Konno, Shin-Ichi; Nakamura, Masaya; Fujino, Keiji; Matsuda, Shuichi; Yone, Kazunori; Takahashi, Kazuhisa

    2016-08-01

    A cross-sectional study of 1804 consecutive patients. The aim of this study was to investigate the prevalence of pathological pain and its distribution features in patients with chronic lumbar spinal disorders. Clinical spinal disorders can involve pathological neuropathic pain (NeP) as well as physiological nociceptive pain (NocP), as they have varied pathology, including spinal cord injury, stenosis, and compression. A study conducted by the Japanese Society for Spine Surgery and Related Research (JSSR) has determined a prevalence of 29.4% for NeP in patients with lumbar spinal disorder. However, the data did not include information on pain location. Patients aged 20 to 79 years with chronic lower back pain (≥3 months, visual analog scale score ≥30) were recruited from 137 JSSR-related institutions. Patient data included an NeP screening questionnaire score and pain location (lower back, buttock, and legs). The association between the pain pathology and its location was analyzed statistically using the unpaired t test and Chi-square test followed by Fisher test. P < 0.05 was considered significant. Low back pain subjects showed 31.9% of NeP prevalence, and the pain distribution showed [NocP(%)/NeP(%)] low back pain only cases: 44/22, while low back pain with leg pain cases showed a prevalence of 56/78. This indicates that low back pain alone can significantly induce NocP rather than NeP (P < 0.01). Buttock pain was revealed to significantly induce both lower back pain and leg pain with NeP properties (P < 0.01). Leg pain was revealed to be predominantly neuropathic, especially when it included peripheral pain (P < 0.01). Low back pain with no buttock pain induces NocP rather than NeP. Buttock pain is significantly associated with NeP prevalence whether or not leg pain exists. Leg pain can increase the prevalence of NeP, especially when it contains a peripheral element. 3.

  18. Low-energy electromagnetic irradiation for eczema treatment

    Directory of Open Access Journals (Sweden)

    Karakaeva A.V.

    2014-09-01

    Full Text Available Purpose: to study the efficacy of treatment and diagnostic complex "Elec-troMAG" as a new method of physical therapy in complex treatment of truths-term eczema. Matherial and Methods. The article presents the results of application in complex treatment of 42 patients with a diagnosis of true eczema low-intensity electromagnetic radiation. The course of treatment consisted of 12 sessions. Acomparison group (30 patients received conventional therapy with standard doses and regimens of drugs without the use of physiotherapy therapies. The clinical efficiency was estimated on the basis of the definition of the functional state of the aquatic components of the internal environment of an organism at eczematous process and on the basis of defined-dividing the index of prevalence and severity of eczema EASI. Results. Identified a high effectiveness of low-intensity electromagnetic effect on the disease process, as evidenced by the earlier reduction of the clinical symptoms than in the comparison group, confirming the reduction of the absolute values of the index EASI. Conclusion. The obtained results suggest the safety and effectiveness of high-efficiency of this method of physical therapy treatment of eczema

  19. Patch testing with markers of fragrance contact allergy. Do clinical tests correspond to patients' self-reported problems?

    DEFF Research Database (Denmark)

    Johansen, J D; Andersen, T F; Veien, N

    1997-01-01

    The aim of the present study was to investigate the relationship between patients' own recognition of skin problems using consumer products and the results of patch testing with markers of fragrance sensitization. Eight hundred and eighty-four consecutive eczema patients, 18-69 years of age, fill...

  20. Integrated, multidisciplinary care for hand eczema : design of a randomized controlled trial and cost-effectiveness study

    NARCIS (Netherlands)

    van Gils, Robin F.; van der Valk, Pieter G. M.; Bruynzeel, Derk; Coenraads, Pieter J.; Boot, Cecile R. L.; van Mechelen, Willem; Anema, Johannes R.

    2009-01-01

    Background: The individual and societal burden of hand eczema is high. Literature indicates that moderate to severe hand eczema is a disease with a poor prognosis. Many patients are hampered in their daily activities, including work. High costs are related to high medical consumption, productivity

  1. Integrated, multidisciplinary care for hand eczema : design of a randomized controlled trial and cost-effectiveness study

    NARCIS (Netherlands)

    Gils, R.F. van; Valk, P.G.M. van der; Bruynzeel, D.; Coenraads, P.J.; Boot, C.R.L.; Mechelen, W. van; Anema, J.R.

    2009-01-01

    BACKGROUND: The individual and societal burden of hand eczema is high. Literature indicates that moderate to severe hand eczema is a disease with a poor prognosis. Many patients are hampered in their daily activities, including work. High costs are related to high medical consumption, productivity

  2. Lack of association between neuropeptide S receptor 1 gene (NPSR1) and eczema in five European populations.

    NARCIS (Netherlands)

    Ekelund, E.; Bradley, M.; Weidinger, S.; Jovanovic, D.L.; Johansson, C.; Lindgren, C.M.; Todorova, A.; Jakob, T.; Illig, T.; von Mutius, E.; Braun-Fahrlander, C.; Doekes, G.; Riedler, T.; Scheynius, A.; Pershagen, G.; Kockum, I.; Kere, J.

    2009-01-01

    Eczema is often associated with development of allergic asthma. The Neuropeptide S Receptor 1 (NPSR1) gene has previously been associated with asthma and elevated serum IgE levels. The aim of this study was to investigate a potential association between the NPSR1 gene and eczema in patients and heal

  3. Integrated, multidisciplinary care for hand eczema : design of a randomized controlled trial and cost-effectiveness study

    NARCIS (Netherlands)

    van Gils, Robin F.; van der Valk, Pieter G. M.; Bruynzeel, Derk; Coenraads, Pieter J.; Boot, Cecile R. L.; van Mechelen, Willem; Anema, Johannes R.

    2009-01-01

    Background: The individual and societal burden of hand eczema is high. Literature indicates that moderate to severe hand eczema is a disease with a poor prognosis. Many patients are hampered in their daily activities, including work. High costs are related to high medical consumption, productivity l

  4. Integrated, multidisciplinary care for hand eczema : design of a randomized controlled trial and cost-effectiveness study

    NARCIS (Netherlands)

    Gils, R.F. van; Valk, P.G.M. van der; Bruynzeel, D.; Coenraads, P.J.; Boot, C.R.L.; Mechelen, W. van; Anema, J.R.

    2009-01-01

    BACKGROUND: The individual and societal burden of hand eczema is high. Literature indicates that moderate to severe hand eczema is a disease with a poor prognosis. Many patients are hampered in their daily activities, including work. High costs are related to high medical consumption, productivity l

  5. Endovascular management of central thoracic veno-occlusive diseases in hemodialysis patients: a single institutional experience in 69 consecutive patients.

    Science.gov (United States)

    Nael, Kambiz; Kee, Stephen T; Solomon, Houman; Katz, Steven G

    2009-01-01

    To assess the functional status and long-term outcomes of endovascular management for the treatment of central veno-occlusive disease in patients undergoing hemodialysis. Retrospective chart evaluation of 600 patients with threatened upper extremity dialysis access showed central veno-occlusive disease in 69 patients (11%; 30 women and 39 men; mean age, 63.9 years; age range, 26-92 years). A total of 92 venous segments were involved with disease. Initial endovascular procedures consisted of transvenous angioplasty (n = 88) and stent placement (n = 6); there were 134 repeat interventions (14 stents). The mean follow-up was 14.5 months (range, 1-44 months). Angiographic data were reviewed prospectively by two independent observers for the extent of veno-occlusive disease. Technical failures were defined as residual stenosis of at least 30% or lesions that were unable to be dilated or crossed. Statistical analysis, including interobserver agreement and Kaplan-Meier analysis, was performed. Technical success rates for initial and follow-up interventional procedures were 90% (81 of 92 segments) and 96% (129 of 134 interventions), respectively. Two complications required treatment with interventional procedures. There was excellent interobserver agreement (kappa = 0.84; 95% confidence interval: 0.67, 0.93) for grading the degree of venous stenoses. Primary patency rates of hemodialysis access at 1, 6, and 12 months were 81%, 46%, and 22%, respectively, which significantly (P = .001) improved to assisted patency rates of 91%, 77%, and 63% at 1, 6, and 12 months, respectively. Endovascular management including a combination of angioplasty and selective stent placement can be effectively used to treat central veno-occlusive disease and preserve functional access in patients with threatened upper extremity dialysis access.

  6. Iron therapy in hand eczema: A new approach for management

    Directory of Open Access Journals (Sweden)

    Ashimav Deb Sharma

    2011-01-01

    Full Text Available It is observed that adequate iron intake and status can limit nickel absorption from the diet in the human body. Chronic vesicular hand eczema (CVHE due to nickel sensitivity is a common dermatological condition where the dietary nickel acts as a provocating factor. Such patients are usually treated with low nickel diet (LND. The present study was conducted to observe the result of addition of oral iron with LND in the treatment of CVHE in patients due to nickel sensitivity. 23 patients with CVHE due to nickel sensitivity were taken for this study. Study group (12 patients were advised LND with oral iron for a period of 12 weeks. Control group (11 patients were advised LND alone for a period of 12 weeks. Fast improvement noted in the skin lesions of the study group patients; 10 (83.33% patients had complete clearance of their hand eczemas at the end of 12 weeks. There were significant reductions in the blood level of nickel in those patients. Moderate improvement noted in the skin lesions of the control group patients; 5 (45.45% patients showed complete clearance of hand eczema at the end of 12 weeks. This study showed that oral iron helped to reduce nickel absorption from the diet. The study also showed that combination of LND and oral iron can bring a faster reduction in the severity of clinical symptoms of CVHE in a nickel sensitive individual.

  7. Reflux esophagitis and hiatal hernia as concomitant abnormality in patients presenting with active duodenal or gastric ulcer: cross-sectional endoscopic study in consecutive patients.

    Science.gov (United States)

    Loffeld, R J.L.F.; van der Putten, A B.M.M.

    2002-05-01

    BACKGROUND: Follow-up studies have shown that patients with ulcer disease are at risk of developing reflux esophagitis (RE) after successful eradication of Heliobacter pylori. It is still not clear whether this is induced by eradication of H. pylori or whether RE is already present at the time the ulcer is diagnosed. A cross-sectional study was done in consecutive patients suffering from active ulcer disease in order to assess coincidental RE. METHODS: Patients with an active duodenal or gastric ulcer were included in the study. Concomitant RE and the presence of hiatal hernia (HH) were scored. Biopsy specimens were taken for detection of H. pylori. RESULTS: In 375 patients (77%), an active duodenal ulcer was the only abnormality. In 43 patients (8.8%), duodenal ulcer and concomitant RE were present and 69 patients (14.2%) had a duodenal ulcer with concomitant HH. Patients with a duodenal ulcer were significantly younger than patients with concomitant RE or HH. From 374 patients (76.8%) with a duodenal ulcer, biopsy specimens were available for the detection of H. pylori. The majority of duodenal ulcer patients were H. pylori-positive. H. pylori was significantly more often present in patients with an active duodenal ulcer than it was in duodenal ulcer patients suffering from concomitant RE (P=0.04). In 218 patients (76%), a gastric ulcer was the only abnormality. Fifteen patients (5.2%) also had RE and 54 patients (18.8%) had a concomitant HH. There was no difference in H. pylori status in these three groups of patients. CONCLUSIONS: Given the low prevalence of concomitant RE, it is concluded that this condition is likely to occur in a large percentage of patients suffering from H. pylori-positive ulcer disease after successful eradication therapy.

  8. Hand eczema severity and quality of life

    DEFF Research Database (Denmark)

    Agner, Tove; Andersen, Klaus E; Brandao, Francisco M

    2008-01-01

    was found for hand eczema severity and age (P sick leave was getting higher (P ... test clinics participated in the study. Data on QoL were obtained from a self-administered questionnaire using the Dermatology Life Quality Index (DLQI). Severity was assessed by a scoring system (Hand Eczema Severity Index, HECSI) as well as frequency of eruptions and sick leave due to hand eczema...

  9. A comparison between criteria for diagnosing atopic eczema in infants

    DEFF Research Database (Denmark)

    Jøhnke, H; Vach, W; Norberg, L A

    2005-01-01

    ; and to describe the association between atopic heredity and postnatal sensitization, respectively, and the development of AE according to the different diagnostic criteria. METHODS: During a 1-year period a consecutive series of 1095 newborns and their parents were approached at the maternity ward at the Odense...... Research Centre (DARC) criteria developed for this study and doctor-diagnosed visible eczema with typical morphology and atopic distribution. Additionally, the U.K. diagnostic criteria based on a questionnaire were used at 1 year of age. Agreement between the four criteria was analysed at each time point...

  10. Cranialization in a cohort of 154 consecutive patients with frontal sinus fractures (1987-2007): review and update of a compelling procedure in the selected patient.

    Science.gov (United States)

    Pollock, Richard A; Hill, Joseph L; Davenport, Daniel L; Snow, David C; Vasconez, Henry C

    2013-07-01

    Retrospective review of charts of 180 consecutive patients with frontal sinus fractures managed by plastic surgeons at the University of Kentucky between 1987 and 2007 was performed with institutional review board approval. Twenty-six charts did not meet the criteria. The remaining 154 records provided 1-to-20-year follow-up. The study included 34 patients who underwent cranialization and 120 patients who did not. A low-complication rate of 6% after cranialization is ascribed by the authors to meticulous sinus mucosal debridement; thorough obliteration of the frontal sinus outflow tract (with sterile gelatin sponge pledgets and bone chips from the outer cortex of the temporoparietal skull); and avoidance of avascular barriers, such as abdominal fat. As high-resolution computerized tomography with parasaggital views was introduced, an increasing ability to preoperatively define the extent of injury of the medial and lateral sinus floor was observed. The authors conclude selective use of cranialization is indicated.

  11. Dermoscopy in differential diagnosis of palmar psoriasis and chronic hand eczema.

    Science.gov (United States)

    Errichetti, Enzo; Stinco, Giuseppe

    2016-04-01

    Clinical differentiation between palmar psoriasis and chronic hand eczema may sometimes be a diagnostic challenge; in such cases histopathological analysis helps to differentiate the two conditions. In the present study, palmar psoriasis and chronic hand eczema were investigated using dermoscopy and the significance of specific dermoscopic features was assessed in order to improve their non-invasive differentiation. Ten patients with biopsy-proven palmar psoriasis and 11 patients with biopsy-proven chronic hand eczema were included in the study. We found that the presence of diffuse white scales was significant in palmar psoriasis whereas the presence of yellowish scales, brownish-orange dots/globules and yellowish-orange crusts was significant in chronic hand eczema.

  12. NOS2 and CCL27: clinical implications for psoriasis and eczema diagnosis and management.

    Science.gov (United States)

    Garzorz, Natalie; Eyerich, Kilian

    2015-02-01

    Chronic inflammatory skin diseases such as psoriasis and eczema are a major medical challenge. Development of highly specific therapies for both conditions is opposed by the lack of translation of basic knowledge into biomarkers for clinical use. Furthermore, to distinguish psoriasis from eczema might be difficult occasionally, but specific and costly therapies would not be efficient in misdiagnosed patients. In the era of high-throughput 'omics'-technologies, comparing the molecular signature of psoriasis and eczema is a promising approach to gain insight into their complex pathogeneses and develop new diagnostic and therapeutic strategies. Investigating patients affected by both psoriasis and eczema simultaneously, we recently constructed a disease classifier consisting of only two genes (NOS2 and CCL27) that reliably predicts the correct diagnosis even in clinically unclear cases. When such easy-to-handle approaches are combined with individual therapeutic response, we might reach the ultimate goal of personalized medicine in inflammatory skin diseases in near future.

  13. Laparoscopic left and right adrenalectomy from an anterior approach – is there any difference? Outcomes in 176 consecutive patients

    Directory of Open Access Journals (Sweden)

    Lukas Kokorak

    2016-12-01

    Full Text Available Introduction : Traditionally, in open surgery, right adrenalectomy is considered technically more demanding than its left-sided counterpart. This belief is supposed to be attributable mainly to different anatomic characteristics of the adrenal veins. Whether this opinion is also correct for laparoscopic adrenalectomy remains elusive. Aim : To compare the outcomes of left versus right laparoscopic adrenalectomy from an anterior approach. Material and methods: Retrospective statistical analysis of a prospectively compiled database of consecutive patients undergoing laparoscopic adrenalectomy in a single center with focus on potential differences in the left- versus right-sided procedure in terms of demographic parameters, tumor size, operating time, occurrence of serious intraoperative complications, conversion, length of hospital stay and re-operation rate. Results: One hundred seventy-six patients underwent elective laparoscopic adrenalectomy – 80 left-sided (45.45% and 96 right-sided (54.55%. No significant difference was found between the groups in terms of age (54.09 ±11.2 vs. 56.27 ±11.6; p = 0.2, tumor size (3.39 ±1.86 vs. 3.26 ±1.66; p = 0.64, operating time (71.84 ±22.33 vs. 72.06 ±30.99; p = 0.95, occurrence of serious intraoperative complications (7.5% vs. 10.4%; p = 0.5, conversion (1.25% vs. 1.04%; p = 0.9, length of hospital stay (4.52 ±1.30 vs. 4.37 ±1.91; p = 0.55 or reoperation rate (5% vs. 1%; p = 0.11. There was no mortality. Conclusions : No significant difference was found between the left and right laparoscopic adrenalectomy in terms of operating time, occurrence of serious intraoperative complications, conversion rate or postoperative outcome. Therefore, the opinion that the right-sided procedure is more difficult does not seem to be justified for laparoscopic adrenalectomy from the anterior approach.

  14. Mapping randomized controlled trials of treatments for eczema - The GREAT database (The Global Resource of Eczema Trials: a collection of key data on randomized controlled trials of treatments for eczema from 2000 to 2010

    Directory of Open Access Journals (Sweden)

    Williams Hywel C

    2011-05-01

    Full Text Available Abstract Background Massive duplication of effort occurs when researchers all over the world undertake extensive searches for randomized controlled trials when preparing systematic reviews, when developing evidence-based guidelines and when applying for research funding for eczema treatments. Such duplication wastes valuable resources. Searching for randomized controlled trials of eczema is a laborious task involving scrutiny of thousands of individual references from diverse electronic databases in order to obtain a few papers of interest. Clinicians and patients who wish to find out more about a particular treatment are at risk of missing the relevant evidence if they are not trained in electronic bibliographic searching. Systematic reviews cannot be relied upon to comprehensively inform current optimal eczema treatments due to incomplete coverage and because many may be out of date. An international, publically available and comprehensive resource which brings together all randomized controlled trials on eczema treatment using a highly sensitive search has the potential to release more filtered knowledge about patient care to those who need it most and to significantly shorten the duration and costs of many clinical eczema research and guideline projects. Description The Global Resource of EczemA Trials brings together information on all randomized controlled trials of eczema treatments published from the beginning of 2000 up to the end of 2010 and will be updated every month. We searched the Cochrane Central Register of Controlled Trials in The Cochrane Library and the Cochrane Skin Group Specialised Register, MEDLINE, EMBASE, LILACS, AMED and CINHAL databases. We included 268 RCTs (24th March 2011 covering over 70 different treatment interventions. The structure of the Global Resource of Eczema Trials allows the user as much, or as little, specificity when retrieving information on trials as they wish, in an easy to use format. For each

  15. Alitretinoin – its use in intractable hand eczema and other potential indications

    Directory of Open Access Journals (Sweden)

    Bibi Petersen

    2009-02-01

    Full Text Available Bibi Petersen, Gregor BE JemecDept of dermatology, Health Sciences faculty, University of Copenhagen, Roskilde Hospital, DenmarkAbstract: Chronic hand eczema is a significant cause of morbidity. A number of treatments are traditionally used, and often useful, but in spite of this a sizeable group of patients develop chronic recalcitrant hand eczema. Retinoids are known to influence keratinization and inflammation, and acitretin has shown some effect in the treatment of chronic hand eczema. Alitretinoin (9-cis-retinoic acid is a panagonist retinoid binding to all six known retinoid receptors (RAR-α, -β, -γ and RXR-α, -β, -γ. Several studies have been carried out with this new drug, and it has been shown to be effective in 28% to 89% of patients with previously intractable hand eczema. In addition, alitretinoin appears to have some potential in the treatment of AIDS-related Kaposi sarcoma. Attempts to use the drug in secondary prophylaxis has shown some promise in former tobacco smokers, whereas no effect was seen in patients with cervical intraepithelial neoplasia. Currently, the primary therapeutic potential of alitretinoin appears to be the treatment of chronic recalcitrant hand eczema, which also forms a large and hitherto neglected group of patients.Keywords: alitretinoin, hand, eczema, dermatitis

  16. Analysis of the results of patch test in 192 patients with hand eczema%192例手部湿疹患者斑贴试验结果分析

    Institute of Scientific and Technical Information of China (English)

    杨素莲; 朱国兴; 尹颂超; 陈海燕; 张云青; 赖维

    2016-01-01

    目的 探讨手部湿疹患者的常见变应原及其分布特点.方法 于2014年11月至2016年3月,选取手部湿疹患者192例,采用日常生活系列斑贴试剂盒检测患者的接触变应原.结果 192例手部湿疹患者中178例检出1种或1种以上变应原,总阳性率为92.71%;前5位最常见的变应原依次为氯化镍(23.96%)、氯化钴(18.75%)、芳香族混合物(17.19%)、硫酸镍(16.67%)及硫柳汞(13.54%);男性手部湿疹患者中卡巴混合物、萘基混合物、对叔丁基酚醛树脂的阳性率分别为16.88%、14.29%、11.69%,明显高于女性(5.22%、4.35%、3.48%),差异均有统计学意义(x2=7.039、5.963、4.925,均P<0.05).结论 手部湿疹患者常见的变应原为氯化镍、氯化钴、芳香族混合物、硫酸镍和硫柳汞.%Objective To investigate the common allergens in the patients with hand eczema.Methods From November 2014 to March 2016,the patients with hand eczema were tested by the patch test kit of daily life series.Results The results of the patch test of 192 patients with hand eczema were collected.Allergens were detected in 178 (92.71%) cases.The top 5 allergens were nickel chloride (23.96%),cobalt chloride (18.75%),aromatic compounds (17.19%),nickel sulfate (16.67%) and thimerosal (13.54%).The positive rates of kappa mixture,aromatic compounds,tertiary butyl phenolic resin in males were 16.88%,14.29%,11.69%,respectively,which were higher than those (5.22%,4.35%,3.48%) in females.Conclusion Nickel chloride,cobalt chloride,aromatic compounds,nickel sulfate and thimerosal are common allergens in patients with hand eczema.

  17. One-sample determination of glomerular filtration rate (GFR) in children. An evaluation based on 75 consecutive patients

    DEFF Research Database (Denmark)

    Henriksen, Ulrik Lütken; Kanstrup, Inge-Lis; Henriksen, Jens Henrik Sahl

    2013-01-01

    Abstract Background and aim. From a clinical point of view determination of glomerular filtration rate (clearance) is important. The aim of the present study was to compare the one-sample clearance to reference multiple-sample (51)Cr-EDTA clearance in consecutively referred children suspected of ...

  18. Rectal adenocarcinoma and transanal endoscopic microsurgery. Diagnostic challenges, indications and short term results in 142 consecutive patients

    DEFF Research Database (Denmark)

    Baatrup, G; Elbrønd, H; Hesselfeldt, Peter;

    2007-01-01

    PURPOSE: The objective of this study was to present short-term results of transanal endoscopic microsurgery (TEM) of rectal adenocarcinomas registered in a national database. METHODS: A Danish TEM group was established in 1995. The group organized a database for prospective and consecutive regist...

  19. Bath additives for the treatment of childhood eczema (BATHE): protocol for multicentre parallel group randomised trial.

    Science.gov (United States)

    Santer, Miriam; Rumsby, Kate; Ridd, Matthew J; Francis, Nick A; Stuart, Beth; Chorozoglou, Maria; Wood, Wendy; Roberts, Amanda; Thomas, Kim S; Williams, Hywel C; Little, Paul

    2015-11-01

    Bath emollients are widely prescribed for childhood eczema, yet evidence of their benefits over direct application of emollients is lacking. Objectives To determine the clinical and cost-effectiveness of adding bath emollient to the standard management of eczema in children Pragmatic open 2-armed parallel group randomised controlled trial. General practitioner (GP) practices in England and Wales. Children aged over 12 months and less than 12 years with eczema, excluding inactive or very mild eczema (5 or less on Nottingham Eczema Severity Scale). Children will be randomised to either bath emollients plus standard eczema care or standard eczema care only. Primary outcome is long-term eczema severity, measured by the Patient-Oriented Eczema Measure (POEM) repeated weekly for 16 weeks. Secondary outcomes include: number of eczema exacerbations resulting in healthcare consultations over 1 year; eczema severity over 1 year; disease-specific and generic quality of life; medication use and healthcare resource use; cost-effectiveness. Aiming to detect a mean difference between groups of 2.0 (SD 7.0) in weekly POEM scores over 16 weeks (significance 0.05, power 0.9), allowing for 20% loss to follow-up, gives a total sample size of 423 children. We will use repeated measures analysis of covariance, or a mixed model, to analyse weekly POEM scores. We will control for possible confounders, including baseline eczema severity and child's age. Cost-effectiveness analysis will be carried out from a National Health Service (NHS) perspective. This protocol was approved by Newcastle and North Tyneside 1 NRES committee 14/NE/0098. Follow-up will be completed in 2017. Findings will be disseminated to participants and carers, the public, dermatology and primary care journals, guideline developers and decision-makers. ISRCTN84102309. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  20. 氯地松乳膏治疗皮炎湿疹的疗效观察%Clinical Observation of the Therapeutic Effect of Dexamethason and Chloromycetin Cream on Patients with Dermatitis and Eczema

    Institute of Scientific and Technical Information of China (English)

    徐音

    2015-01-01

    Objective To observe the effect and safety to Dexamethason and Chloromycetin cream on patients with dermatitis and eczema. Methods Sixty cases from the clinic and inpatient were treated with Dexamethason and Chloromycetin cream twice a day followed-up once a week and ended in the three weeks.Results 33 cases(55%) were cured, all effective rate was up to 81.7%. No one had side-effect.Conclusion Dexamethason and Chloromycetin cream is effective, safe remedy to patients with dermatitis and eczema, especially for basic clinic and hospital.%目的:观察氯地松乳膏治疗皮炎湿疹的疗效,耐受性及不良反应。方法:60例患者,男55例,女5例。年龄19~77岁,平均53.2±16.3岁;病程2天~20年,平均9.5±25.1月,每日2次外用氯地松乳膏涂于患处,每周随访1次,共3周。结果:治愈33例(55.0%),显效16例(26.7%),好转4例(6.6%),无效7例(11.7%)。总有效率81.7%。结论:氯地松乳膏是治疗皮炎湿疹类皮肤病的安全有效药物。

  1. Randomized controlled observer-blinded treatment of chronic foot eczema with iontophoresis and bath-PUVA.

    Science.gov (United States)

    Tupker, Ron A; Coenraads, Pieter J; Zanen, Pieter; Schuttelaar, Marie Louise A

    2013-07-06

    The aim of this study was to investigate the effect of iontophoresis combined with local psoralen plus ultraviolet A (PUVA) therapy in chronic foot eczema. A randomized, observer-blinded, multi-centre study was conducted in 48 patients with chronic moderate-to-severe foot eczema randomized to one of 3 groups: In the iontophoresis group local bath-PUVA was preceded by iontophoresis. In the PUVA group only local PUVA was given. The corticosteroid group was treated with fluticasone. All treatments were given for 8 weeks, with an 8-week follow-up period. The primary efficacy parameter was eczema score described by Rosén et al. Secondary efficacy parameters were a global impression by the patient, and the Dermatology Life Quality Index (DLQI). The eczema score and the DLQI decreased significantly over time. There were no significant differences in the decrease in eczema score (p=0.053) and DLQI values (p=0.563) between the 3 treatments. The DLQI values in our chronic foot eczema patients were high. There was no obvious advantage of local bath-PUVA with or with-out iontophoresis over local steroid therapy.

  2. Update on the use of alitretinoin in treating chronic hand eczema

    Directory of Open Access Journals (Sweden)

    Pedram Ghasri

    2010-04-01

    Full Text Available Pedram Ghasri1, Noah Scheinfeld21University of California, Irvine School of Medicine, Irvine, CA, USA; 2Department of Dermatology, Columbia University, School of Medicine, New York, USAAbstract: Chronic hand eczema is a debilitating dermatological condition with significant economic, social, and functional impacts. To date, conventional treatments such as topical corticosteroids, phototherapy, and systemic immunosuppressants have yielded disappointing results, owing to either a lack of efficacy or significant adverse events. Oral alitretinoin (9-cis-retinoic acid is a unique panagonist retinoid with immunomodulatory and anti-inflammatory activity that has emerged as a novel treatment for chronic hand eczema. Several large-scale clinical studies have demonstrated oral alitretinoin’s high efficacy rate of 28% to 89%, its safe tolerability profile, and its positive impact on quality of life, validating it as a therapeutic option for patients with severe chronic hand eczema refractory to standard treatment.Keywords: hand eczema, alitretinoin, 9-cisretinoic acid

  3. The hand eczema severity index (HECSI)

    DEFF Research Database (Denmark)

    Held, E; Skoet, R; Johansen, J D

    2005-01-01

    BACKGROUND: There is a need for a standardized clinical grading system for a more objective and accurate assessment of the severity of hand eczema (HE). OBJECTIVES: To develop and validate a scoring system called the hand eczema severity index (HECSI) designed for clinical assessment of HE. METHODS...

  4. Analysis of contact allergens in 1065 patients with dermatitis or eczema in Wuxi city%无锡市1065例皮炎湿疹类皮肤病的接触性变应原分析

    Institute of Scientific and Technical Information of China (English)

    胡燕; 戴迅毅; 曹蕾; 陆雪芬; 张娟; 范莹; 周爱奋; 杨莉佳

    2012-01-01

    目的 探讨无锡市皮炎湿疹类皮肤病患者的接触性变应原及其临床意义.方法 斑贴试剂盒对门诊确诊的1065例皮炎湿疹类皮肤病患者进行斑贴试验,并对结果作统计学处理.结果 斑贴试验总阳性率83.19%,性别、年龄差异无统计学意义.阳性率居前6位的变应原依次为重铬酸钾、氯化钴、硫酸镍、甲醛、卡巴混合物和芳香混合物.其中重铬酸钾和卡巴混合物的阳性检出率男性显著高于女性,硫酸镍和甲醛的阳性检出率女性显著高于男性,差异有统计学意义(P<0.01).氯化钴的阳性检出率中青年组和老年组显著高于儿童组,硫酸镍的阳性检出率中青年组显著高于儿童组,差异有统计学意义(P<0.05).结论 重铬酸钾、氯化钴、硫酸镍、甲醛、卡巴混合物和芳香混合物是无锡市引起皮炎湿疹类皮肤病的主要变应原.%Objective To determine contact allergens and their clinical significance in patients with dermatitis or eczema in Wuxi city.Methods Patch test was conducted in 1065 patients with a clinical diagnosis of dermatitis or eczema.A statistical analysis was carried out.Results Positive patch test reactions were observed in 83.19% of the patients,with no statistical differences in the frequency of positive patch test reactions between female and male patients or between patients of different age groups.The most frequent 6 allergens were potassium dichromate,cobalt chloride,nickle sulfate,formaldehyde,carba mix and fragrance mix in these patients.Female patients showed a higher frequency of positive patch test reaction to nickle sulfate and formaldehyde,but a lower frequency to potassium dichromate and carba mix compared with male patients (all P< 0.01 ); young,middle-aged,and old patients exhibited an increased frequency of positive reaction to cobaly chloride compared with child patients,while young and middle-aged patients showed a decreased frequency to nickel sulfate

  5. Alitretinoin for the treatment of severe chronic hand eczema

    Directory of Open Access Journals (Sweden)

    King T

    2014-11-01

    Full Text Available Thomas King, John McKenna, Anton B Alexandroff Department of Dermatology, University Hospitals of Leicester, Leicester Royal Infirmary, Leicester, UK Abstract: Chronic hand eczema is a common and often debilitating condition. Alitretinoin, a 9-cis-retinoic acid and pan-retinoic acid agonist, is a new and effective systemic treatment for chronic hand eczema, which provides another treatment option. A “clear” or “almost clear” response can be achieved in up to half of patients within a 24-week course of treatment. Even higher rates of remission can be obtained with a longer duration of treatment. Alitretinoin has a favorable overall profile of adverse effects; however, female patients who are at risk of becoming pregnant should follow a strict pregnancy-prevention program due to the teratogenic effects of this drug. Keywords: dermatitis, toctino, CTCL

  6. Patient acceptability, efficacy, and skin biophysiology of a cream and cleanser containing lipid complex with shea butter extract versus a ceramide product for eczema.

    Science.gov (United States)

    Hon, K L; Tsang, Y C; Pong, N H; Lee, Vivian W Y; Luk, N M; Chow, C M; Leung, T F

    2015-10-01

    To investigate patient acceptability, efficacy, and skin biophysiological effects of a cream/cleanser combination for childhood atopic dermatitis. Paediatric dermatology clinic at a university teaching hospital in Hong Kong. Consecutive paediatric patients with atopic dermatitis who were interested in trying a new moisturiser were recruited between 1 April 2013 and 31 March 2014. Swabs and cultures from the right antecubital fossa and the worst eczematous area, disease severity (SCORing Atopic Dermatitis index), skin hydration, and transepidermal water loss were obtained prior to and following 4-week usage of a cream/cleanser containing lipid complex with shea butter extract (Ezerra cream; Hoe Pharma, Petaling Jaya, Malaysia). Global or general acceptability of treatment was documented as 'very good', 'good', 'fair', or 'poor'. A total of 34 patients with atopic dermatitis were recruited; 74% reported 'very good' or 'good', whereas 26% reported 'fair' or 'poor' general acceptability of treatment of the Ezerra cream; and 76% reported 'very good' or 'good', whereas 24% reported 'fair' or 'poor' general acceptability of treatment of the Ezerra cleanser. There were no intergroup differences in pre-usage clinical parameters of age, objective SCORing Atopic Dermatitis index, pruritus, sleep loss, skin hydration, transepidermal water loss, topical corticosteroid usage, oral antihistamine usage, or general acceptability of treatment of the prior emollient. Following use of the Ezerra cream, mean pruritus score decreased from 6.7 to 6.0 (P=0.036) and mean Children's Dermatology Life Quality Index improved from 10.0 to 8.0 (P=0.021) in the 'very good'/'good' group. There were no statistically significant differences in the acceptability of wash (P=0.526) and emollients (P=0.537) with pre-trial products. When compared with the data of another ceramide-precursor moisturiser in a previous study, there was no statistical difference in efficacy and acceptability between the two

  7. Tuina Treatment of Infantile Eczema

    Institute of Scientific and Technical Information of China (English)

    ZHAO Xiao-mei; LI Dong

    2004-01-01

    以推拿疗法联合西药治疗20例小儿湿疹患者,并以西药治疗18例作对照.两组有效率分别为100%和90.0%,疗效有差异(P<0.01).%Twenty cases of infantile eczema were treated by combination of Tuina therapy and Western medications, and 18 cases were treated by Western medications. The therapeutic effective rate was respectively 100% and 90.0% in the two groups, with a difference between them (P< 0.01).

  8. Probiotics in the prevention of eczema: a randomised controlled trial

    OpenAIRE

    Allen, Stephen J; Jordan, Sue; Storey, Melanie; Catherine A Thornton; Gravenor, Michael B.; Garaiova, Iveta; Plummer, Susan F; Wang, Duolao; Morgan, Gareth

    2014-01-01

    Objective To evaluate a multistrain, high-dose probiotic in the prevention of eczema. Design A randomised, double-blind, placebo-controlled, parallel group trial. Settings Antenatal clinics, research clinic, children at home. Patients Pregnant women and their infants. Interventions Women from 36 weeks gestation and their infants to age 6 months received daily either the probiotic (Lactobacillus salivarius CUL61, Lactobacillus paracasei CUL08, Bifidobacterium animalis subspecies lactis CUL34 a...

  9. The Hand Eczema Trial (HET: design of a randomised clinical trial of the effect of classification and individual counselling versus no intervention among health-care workers with hand eczema

    Directory of Open Access Journals (Sweden)

    Ibler Kristina

    2010-08-01

    Full Text Available Abstract Background Hand eczema is the most frequently recognized occupational disease in Denmark with an incidence of approximately 0.32 per 1000 person-years. Consequences of hand eczema include chronic severe eczema, prolonged sick leave, unemployment, and impaired quality of life. New preventive strategies are needed to reduce occupational hand eczema. Methods/Design We describe the design of a randomised clinical trial to investigate the effects of classification of hand eczema plus individual counselling versus no intervention. The trial includes health-care workers with hand eczema identified from a self-administered questionnaire delivered to 3181 health-care workers in three Danish hospitals. The questionnaire identifies the prevalence of hand eczema, knowledge of skin-protection, and exposures that can lead to hand eczema. At entry, all participants are assessed regarding: disease severity (Hand Eczema Severity Index; self-evaluated disease severity; number of eruptions; quality of life; skin protective behaviour, and knowledge of skin protection. The patients are centrally randomised to intervention versus no intervention 1:1 stratified for hospital, profession, and severity score. The experimental group undergoes patch and prick testing; classification of the hand eczema; demonstration of hand washing and appliance of emollients; individual counselling, and a skin-care programme. The control group receives no intervention. All participants are reassessed after six months. The primary outcome is observer-blinded assessment of disease severity and the secondary outcomes are unblinded assessments of disease severity; number of eruptions; knowledge of skin protection; skin-protective behaviour, and quality of life. Trial registration The trial is registered in ClinicalTrials.Gov, NCT01012453.

  10. Nipple eczema, an indicative manifestation of atopic dermatitis? A clinical, histological, and immunohistochemical study.

    Science.gov (United States)

    Song, Hyo Sang; Jung, Soo-Eun; Kim, You Chan; Lee, Eun-So

    2015-04-01

    Nipple eczema exhibits as a minor manifestation of atopic dermatitis (AD) or occurs as a single skin symptom on the nipple. To characterize the relationship between nipple eczema and AD, a clinical evaluation and an immunohistochemical study were performed. All cases of nipple eczema were confirmed histopathologically. We divided the patients with nipple eczema into 2 groups, namely, those with AD and those without AD, and compared several clinical features. Upon histological examination, the degree of inflammation was subjectively graded as mild, moderate, or severe by 2 separate investigators. Immunohistochemical stainings were performed by using antiinterleukin (IL)-4, anti-IL-13, anti-CD4, and anti-CD8 antibodies, and the results were scored semiquantitatively. In 43 cases evaluated, 12 were nipple eczema with AD. The clinical analysis and histological examination showed no significant differences between the groups. There were consistent findings of IL-4 expressions throughout the epidermis and IL-13 expression mainly in the perivascular area of the dermis. Although CD4 and CD8 were expressed in the cells in the dermis, CD8 expression was detected in the serocrusts of the epidermis. Expression levels of IL-4, IL-13, CD4, and CD8 exhibited no significant differences between the nipple eczema group with AD and the nipple eczema group without AD. Although nipple eczema may accompany AD, we found no definite differences in the degree or pattern of inflammation and cytokine expression level regardless of whether AD was present or not. Serocrust formation seemed to be mainly a collection of CD8-positive cells.

  11. Therapy of atopic eczema

    Science.gov (United States)

    Werfel, Thomas; Claes, Christa; Kulp, Werner; Greiner, Wolfgang; von der Schulenburg, Johann-Matthias

    2006-01-01

    Objectives Major objective is the evaluation of the medical effectiveness of different therapeutical approaches and the cost effectiveness with relevance for Germany. Methods This health technology assessment (HTA) evaluates systemically randomized controlled studies (RCT) on the therapy of atopic dermatitis which were published between 1999 and 2004. Further it includes some important clinical studies which have been published after 2004 and other updates the English HTA report by Hoare et al. [1]. Results Topical corticosteroids and topical calcineurin-inhibitors are the principal substances which are currently used for anti-inflammatory therapy in atopic dermatitis. These substances have shown a significant therapeutic efficacy in controlled studies. In newer controlled studies no difference was observable when corticosteroids were applied once or more than once daily onto the skin. Moreover, there is now one controlled study available which points to the fact that an interval therapy with a stronger topical corticosteroid over a limited time (some weeks) may lower the risk of recurrent flares of atopic dermatitis. Both topical calcineurin-inhibitors pimecrolimus and tacrolimus have shown a significant therapeutical efficacy in a number of placebo-controlled prospective studies. The wealth of data is high for these substances. Both substances have been shown to be efficient in infants, children and adult patients with atopic dermatitis. The importance of a so-called basic therapy with emollients which have to be adapted to the current status of skin is generally accepted in clinical practice. Controlled studies show the efficacy of ”basic therapy” - although the level of evidence is quite low for this approach. The skin of patients with atopic dermatitis is colonized in the majority with Staphylococcus aureus, a gram-positive bacterium. Therefore, a therapeutical approach for the treatment of atopic dermatitis is the anti-bacterial or anti-septic treatment

  12. Therapy of atopic eczema

    Directory of Open Access Journals (Sweden)

    von der Schulenburg, Johann-Matthias

    2006-10-01

    Full Text Available Objectives: Major objective is the evaluation of the medical effectiveness of different therapeutical approaches and the cost effectiveness with relevance for Germany. Methods: This health technology assessment (HTA evaluates systemically randomized controlled studies (RCT on the therapy of atopic dermatitis which were published between 1999 and 2004. Further it includes some important clinical studies which have been published after 2004 and other updates the English HTA report by Hoare et al. [1]. Results: Topical corticosteroids and topical calcineurin-inhibitors are the principal substances which are currently used for anti-inflammatory therapy in atopic dermatitis. These substances have shown a significant therapeutic efficacy in controlled studies. In newer controlled studies no difference was observable when corticosteroids were applied once or more than once daily onto the skin. Moreover, there is now one controlled study available which points to the fact that an interval therapy with a stronger topical corticosteroid over a limited time (some weeks may lower the risk of recurrent flares of atopic dermatitis. Both topical calcineurin-inhibitors pimecrolimus and tacrolimus have shown a significant therapeutical efficacy in a number of placebo-controlled prospective studies. The wealth of data is high for these substances. Both substances have been shown to be efficient in infants, children and adult patients with atopic dermatitis. The importance of a so-called basic therapy with emollients which have to be adapted to the current status of skin is generally accepted in clinical practice. Controlled studies show the efficacy of ”basic therapy” - although the level of evidence is quite low for this approach. The skin of patients with atopic dermatitis is colonized in the majority with Staphylococcus aureus, a gram-positive bacterium. Therefore, a therapeutical approach for the treatment of atopic dermatitis is the anti-bacterial or

  13. Probiotics in the prevention of eczema: a randomised controlled trial

    Science.gov (United States)

    Allen, Stephen J; Jordan, Sue; Storey, Melanie; Thornton, Catherine A; Gravenor, Michael B; Garaiova, Iveta; Plummer, Susan F; Wang, Duolao; Morgan, Gareth

    2014-01-01

    Objective To evaluate a multistrain, high-dose probiotic in the prevention of eczema. Design A randomised, double-blind, placebo-controlled, parallel group trial. Settings Antenatal clinics, research clinic, children at home. Patients Pregnant women and their infants. Interventions Women from 36 weeks gestation and their infants to age 6 months received daily either the probiotic (Lactobacillus salivarius CUL61, Lactobacillus paracasei CUL08, Bifidobacterium animalis subspecies lactis CUL34 and Bifidobacterium bifidum CUL20; total of 1010 organisms/day) or matching placebo. Main outcome measure Diagnosed eczema at age 2 years. Infants were followed up by questionnaire. Clinical examination and skin prick tests to common allergens were done at 6 months and 2 years. Results The cumulative frequency of diagnosed eczema at 2 years was similar in the probiotic (73/214, 34.1%) and placebo arms (72/222, 32.4%; OR 1.07, 95% CI 0.72 to 1.6). Among the secondary outcomes, the cumulative frequency of skin prick sensitivity at 2 years was reduced in the probiotic (18/171; 10.5%) compared with the placebo arm (32/173; 18.5%; OR 0.52, 95% CI 0.28 to 0.98). The statistically significant differences between the arms were mainly in sensitisation to cow's milk and hen's egg proteins at 6 months. Atopic eczema occurred in 9/171 (5.3%) children in the probiotic arm and 21/173 (12.1%) in the placebo arm (OR 0.40, 95% CI 0.18 to 0.91). Conclusions The study did not provide evidence that the probiotic either prevented eczema during the study or reduced its severity. However, the probiotic seemed to prevent atopic sensitisation to common food allergens and so reduce the incidence of atopic eczema in early childhood. Trial registration Number ISRCTN26287422. PMID:24947281

  14. The formation and design of the TRIAGE study--baseline data on 6005 consecutive patients admitted to hospital from the emergency department

    DEFF Research Database (Denmark)

    Plesner, Louis Lind; Iversen, Anne Kristine Servais; Langkjær, Sandra

    2015-01-01

    (3.6 %) died within 30 days. A higher triage acuity level was associated with numerous events, including acute surgery, endovascular intervention, i.v. treatment, cardiac arrest, stroke, admission to intensive care, hospital transfer, and mortality within 30 days (p ... the formation of the TRIAGE database and characteristize the included patients. METHODS: We included consecutive patients ≥ 17 years admitted to hospital after triage staging in the ED. Blood samples for a biobank were collected and plasma stored in a freezer (-80 °C). Triage was done by a trained nurse using...

  15. Eczema Can Take a Toll on Adults

    Science.gov (United States)

    ... poorer job performance, disrupts sleep, and contributes to mental health problems such as anxiety and depression, he explained. Also, someone with visible eczema may feel social stigma if others incorrectly believe the disease is contagious ...

  16. The Feasibility and Safety of Laparoscopic Cholecystectomy Approach without the Intraopertative Cholangiography Use: A Retrospective Study on 750 Consecutive Patients.

    Science.gov (United States)

    Atahan, Kemal; Gur, Serhat; Durak, Evren; Cokmez, Atilla; Tarcan, Ercument

    2012-08-01

    We have retrospectively reviewed the results of all common bile duct (CBD)-stone preoperative asymptomatic patients operated on our unit to point out the feasibility and safety of the laparoscopic cholecystectomy approach without the IOC use. From January 2004 and June 2008 we analyzed all the data from hospital records and follow up results of all the patients who underwent LC. The indications for performing preoperative endoscopic retrograde cholangiopancreatography (ERCP) or selective IOC were abnormal liver function tests, history of jaundice, cholangitis or pancreatitis, and ultrasonographic evidence of CBD stone or dilation (≥ 10 mm). These patients were excluded from study. The follow up of the all patients were done by liver function tests and abdominal ultrasonography when needed at the time of the visit. Between January 2006 and June 2010, 750 patients were operated in our clinic. In 34 patients, operations were converted to open cholecystectomy (OC). Of these 750 patients, 98 of them had one or more exclusion criteria and were excluded from the further analyzes. We did not perform any IOC during LC. Regular follow up of at least two years was obtained in 618 (618/657, 94.0%) patients. No operative mortality was encountered among the patients. Postoperative morbidity was detected in 15 of the patients (2.5%). In one patient, CBD injury was detected (0.017%). The mean follow up was 35 (24 - 74) months. Retained stone was detected in three patients (3/577, 0.5%) during the follow up. This approach allows to omit routine IOC and to perform LC safely in selected patients group given the low percentage of both CBD injuries and symptomatic retained stones observed in the late follow up period in our 618 operated patients, we consider our approach a feasible and safe approach to manage patients with gallbladder stones re-confirming the results of other studies.

  17. Eczema

    Science.gov (United States)

    ... 2 • 3 • 4 For Teens For Kids For Parents MORE ON THIS TOPIC Vitiligo Ringworm Molluscum Contagiosum Hygiene Basics Tips for Taking Care of Your Skin Stress Hives (Urticaria) Body Image and Self-Esteem Food Allergies Contact Us Print Resources Send to ...

  18. Incidence of difficult airway situations during prehospital airway management by emergency physicians--a retrospective analysis of 692 consecutive patients.

    Science.gov (United States)

    Thoeni, Nils; Piegeler, Tobias; Brueesch, Martin; Sulser, Simon; Haas, Thorsten; Mueller, Stefan M; Seifert, Burkhardt; Spahn, Donat R; Ruetzler, Kurt

    2015-05-01

    In the prehospital setting, advanced airway management is challenging as it is frequently affected by facial trauma, pharyngeal obstruction or limited access to the patient and/or the patient's airway. Therefore, incidence of prehospital difficult airway management is likely to be higher compared to the in-hospital setting and success rates of advanced airway management range between 80 and 99%. 3961 patients treated by an emergency physician in Zurich, Switzerland were included in this retrospective analysis in order to determine the incidence of a difficult airway along with potential circumstantial risk factors like gender, necessity of CPR, NACA score, GCS, use and type of muscle relaxant and use of hypnotic drugs. 692 patients underwent advanced prehospital airway management. Seven patients were excluded due to incomplete or incongruent documentation, resulting in 685 patients included in the statistical analysis. Difficult intubation was recorded in 22 patients, representing an incidence of a difficult airway of 3.2%. Of these 22 patients, 15 patients were intubated successfully, whereas seven patients (1%) had to be ventilated with a bag valve mask during the whole procedure. In this physician-led service one out of five prehospital patients requires airway management. Incidence of advanced prehospital difficult airway management is 3.2% and eventual success rate is 99%, if performed by trained emergency physicians. A total of 1% of all prehospital intubation attempts failed and alternative airway device was necessary. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  19. Study on the effect of external application of Chinese medicine in the treatment of patients with damp heat immersed type of hand eczema%中药外敷在湿热浸淫型手部湿疹中的应用及疗效研究

    Institute of Scientific and Technical Information of China (English)

    沈安强

    2016-01-01

    目的:评价中药外敷在湿热浸淫型手部湿疹中应用的疗效。方法:收治湿热浸淫型手部湿疹的患者82例,随机分为两组,治疗组进行中药外敷治疗,对照组仅用糠酸莫米松乳膏。观察手部湿疹评分(JHS)、瘙痒程度评分(VAS)和生活质量量表评分(DLQI)情况。结果:治疗组总有效率85.37%,高于对照组的43.90%(P<0.05)。结论:中药外敷治疗湿热浸淫型手部湿疹疗效显著,可全面改善生活质量。%Objective:To investigate the effect of external application of Chinese medicine in the treatment of patients with damp heat immersed type of hand eczema.Methods:82 patients with damp heat immersed type of hand eczema were selected.They were randomly divided into the two groups.The treatment group was treated with external application of Chinese medicine,and the control group only treated with mometasone furoate cream.The Jena hand eczema score(JHS),visual analogue scale(VAS)and dermatology life quality index(DLQI)were observed.Results:The total effective rate of the treatment group was 85.37%,which was higher than that in the control group of 43.90%(P<0.05).Conclusion:The effect of external application of Chinese medicine in the treatment of patients with damp heat immersed type of hand eczema is significant,which can improve the quality of life.

  20. Quality of life, use of topical medications and socio-economic data in hand eczema: a Swedish nationwide survey.

    Science.gov (United States)

    Bingefors, Kerstin; Lindberg, Magnus; Isacson, Dag

    2011-06-01

    Hand eczema is common and has an adverse impact on the lives of patients. There is a need for population-based surveys on the pharmacoepidemiological aspects, quality of life and impact of socioeconomic factors in hand eczema. The aim of this cross-sectional study was to investigate these factors. A questionnaire-based nationwide survey of health was performed, including questions on hand eczema, use of pharmaceuticals and socioeconomic factors. Quality of life was estimated with the generic instrument Short Form 36 (SF-36). The questionnaire was sent to 7,985 persons (age range 18-84 years), response rate 61.1% (n = 4,875). The 1-year prevalence of hand eczema in the study population was 7.5%. In this group, quality of life was lower. All dimensions of SF-36 were affected, most markedly general health and those dimensions reporting on mental health. In the group with self-reported hand eczema, 51% reported using topical pharmaceuticals. Hand eczema was more common among women (9.1%, n = 2,630) than among men (5.6%, n = 2,245) and in the age group below 65 years (8.5%, n = 3,274) compared with those aged 65 years and over (4.3%, n = 1,151). This survey clearly demonstrates the impact of hand eczema on several dimensions of life and also highlights age, gender and socioeconomic differences.

  1. Multidisciplinary approach and long-term follow-up in a series of 640 consecutive patients with sarcoidosis

    Science.gov (United States)

    Mañá, Juan; Rubio-Rivas, Manuel; Villalba, Nadia; Marcoval, Joaquim; Iriarte, Adriana; Molina-Molina, María; Llatjos, Roger; García, Olga; Martínez-Yélamos, Sergio; Vicens-Zygmunt, Vanessa; Gámez, Cristina; Pujol, Ramón; Corbella, Xavier

    2017-01-01

    Abstract Cohort studies of large series of patients with sarcoidosis over a long period of time are scarce. The aim of this study is to report a 40-year clinical experience of a large series of patients at Bellvitge University Hospital, a tertiary university hospital in Barcelona, Spain. Diagnosis of sarcoidosis required histological confirmation except in certain specific situations. All patients underwent a prospective study protocol. Clinical assessment and follow-up of patients were performed by a multidisciplinary team. From 1976 to 2015, 640 patients were diagnosed with sarcoidosis, 438 of them (68.4%) were female (sex ratio F/M 2:1). The mean age at diagnosis was 43.3 ± 13.8 years (range, 14–86 years), and 613 patients (95.8%) were Caucasian. At diagnosis, 584 patients (91.2%) showed intrathoracic involvement at chest radiograph, and most of the patients had normal pulmonary function. Erythema nodosum (39.8%) and specific cutaneous lesions (20.8%) were the most frequent extrapulmonary manifestations, but there was a wide range of organ involvement. A total of 492 patients (76.8%) had positive histology. Follow-up was carried out in 587 patients (91.7%), over a mean of 112.4 ± 98.3 months (range, 6.4–475 months). Corticosteroid treatment was administered in 255 patients (43.4%), and steroid-sparing agents in 49 patients (7.7%). Outcomes were as follows: 111 patients (18.9%) showed active disease at the time of closing this study, 250 (42.6%) presented spontaneous remission, 61 (10.4%) had remission under treatment, and 165 (28.1%) evolved to chronic sarcoidosis; among them, 115 (19.6%) with mild disease and 50 (8.5%) with moderate to severe organ damage. A multivariate analysis showed that at diagnosis, age more than 40 years, the presence of pulmonary involvement on chest radiograph, splenic involvement, and the need of treatment, was associated with chronic sarcoidosis, whereas Löfgren syndrome and mediastinal lymphadenopathy on chest

  2. Endoscopic Surgical Treatment of Lumbar Synovial Cyst: Detailed Account of Surgical Technique and Report of 11 Consecutive Patients.

    Science.gov (United States)

    Oertel, Joachim M; Burkhardt, Benedikt W

    2017-07-01

    Lumbar synovial cysts (LSCs) are an uncommon cause of radiculopathy and back pain. Open surgical treatment is associated with extensive bone resection and muscle trauma. The endoscopic tubular-assisted LSC resection has not been described in detail. Here the authors assessed the effectiveness of this technique for LSC resection. Eleven patients (4 female and 7 male patients) were operated on via an ipsilateral approach for resection of LSC using an endoscopic tubular retractor system. Preoperative magnetic resonance imaging was evaluated for signs of degeneration and instability. At follow-up a standardized questionnaire including the Oswestry Disability Index and functional outcome according to MacNab criteria was conducted. Additionally, a personal examination with particular reference to back and leg pain was performed. The mean follow-up was 10.5 months. Preoperatively, spondylolisthesis grade 1 was noted in 4 patients (36.4%). Ten patients had bilateral facet joint effusion (90.9%). At follow-up 10 patients reported being free of leg pain (90.9%), eight patients reported no back pain (72.7%), ten patients had full motor strength (90.9%), and 9 patients had no sensory deficit (81.8%). Nine patients reported an excellent or a good clinical outcome (81.8%). The mean Oswestry Disability Index was 4.7%. None of the patients developed new mechanical low back pain or required subsequent fusion procedure. The endoscopic tubular-assisted procedure is a safe way to treat LSC. It offers complete resection of LSC and achieves good clinical outcome by preserving muscle and ligamentous and bony structures, which prevents delayed instability. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Hyperfractionated Radiotherapy with Concurrent Cisplatin/5-Fluorouracil for Locoregional Advanced Head and Neck Cancer: Analysis of 105 Consecutive Patients

    Directory of Open Access Journals (Sweden)

    David Zaboli

    2012-01-01

    Full Text Available Objective. We reviewed a cohort of patients with previously untreated locoregional advanced head and neck squamous cell carcinoma (HNSCC who received a uniform chemoradiotherapy regimen. Methods. Retrospective review was performed of 105 patients with stage III or IV HNSCC treated at Greater Baltimore Medical Center from 2000 to 2007. Radiation included 125 cGy twice daily for a total 70 Gy to the primary site. Chemotherapy consisted of cisplatin (12 mg/m2/h daily for five days and 5-fluorouracil (600 mg/m2/20 h daily for five days, given with weeks one and six of radiation. All but seven patients with N2 or greater disease received planned neck dissection after chemoradiotherapy. Primary outcomes were overall survival (OS, locoregional control (LRC, and disease-free survival (DFS. Results. Median followup of surviving patients was 57.6 months. Five-year OS was 60%, LRC was 68%, and DFS was 56%. Predictors of increased mortality included age ≥55, female gender, hypopharyngeal primary, and T3/T4 stage. Twelve patients developed locoregional recurrences, and 16 patients developed distant metastases. Eighteen second primary malignancies were diagnosed in 17 patients. Conclusions. The CRT regimen resulted in favorable outcomes. However, locoregional and distant recurrences cause significant mortality and highlight the need for more effective therapies to prevent and manage these events.

  4. Hyperfractionated Radiotherapy with Concurrent Cisplatin/5-Fluorouracil for Locoregional Advanced Head and Neck Cancer: Analysis of 105 Consecutive Patients

    Science.gov (United States)

    Zaboli, David; Tan, Marietta; Gogineni, Hrishikesh; Lake, Spencer; Fan, Katherine; Zahurak, Marianna L.; Messing, Barbara; Ulmer, Karen; Zinreich, Eva S.; Levine, Marshall A.; Tang, Mei; Pai, Sara I.; Blanco, Ray G.; Saunders, John R.; Best, Simon R.; Califano, Joseph A.; Ha, Patrick K.

    2012-01-01

    Objective. We reviewed a cohort of patients with previously untreated locoregional advanced head and neck squamous cell carcinoma (HNSCC) who received a uniform chemoradiotherapy regimen. Methods. Retrospective review was performed of 105 patients with stage III or IV HNSCC treated at Greater Baltimore Medical Center from 2000 to 2007. Radiation included 125 cGy twice daily for a total 70 Gy to the primary site. Chemotherapy consisted of cisplatin (12 mg/m2/h) daily for five days and 5-fluorouracil (600 mg/m2/20 h) daily for five days, given with weeks one and six of radiation. All but seven patients with N2 or greater disease received planned neck dissection after chemoradiotherapy. Primary outcomes were overall survival (OS), locoregional control (LRC), and disease-free survival (DFS). Results. Median followup of surviving patients was 57.6 months. Five-year OS was 60%, LRC was 68%, and DFS was 56%. Predictors of increased mortality included age ≥55, female gender, hypopharyngeal primary, and T3/T4 stage. Twelve patients developed locoregional recurrences, and 16 patients developed distant metastases. Eighteen second primary malignancies were diagnosed in 17 patients. Conclusions. The CRT regimen resulted in favorable outcomes. However, locoregional and distant recurrences cause significant mortality and highlight the need for more effective therapies to prevent and manage these events. PMID:22778748

  5. Heart murmur and N-terminal pro-brain natriuretic peptide as predictors of death in 2977 consecutive hospitalized patients

    DEFF Research Database (Denmark)

    Iversen, Kasper; Nielsen, O.W.; Kirk, V.

    2008-01-01

    Background: Little is known about the prognostic importance of murmur in unselected patients. It is difficult to distinguish between innocent and significant murmurs. N-terminal pro-brain natriuretic peptide (NT-pro-BNP) and BNP have recently been shown to be useful in small series of patients......-pro-BNP, discovery of valvular heart disease by echocardiography yielded no additional prognostic information. Conclusions: Detection of a cardiac murmur during routine medical examination of hospitalized patients is associated with increased risk of death within a year. A blood test for NT-pro-BNP gives significant...

  6. Treatment by medical compression stockings among 144 consecutive patients with non-complicated primary varicose veins: results on compliance.

    Science.gov (United States)

    Rastel, D

    2014-12-01

    Compression stockings are the major long-term treatment of non-complicated primary varicose veins recommended by international consensus. Nevertheless there are few data concerning the patient compliance to treatment. Hundred and forty-four patients with varicose veins of primary origin were prospectively recruited and questioned about their compression therapy: 29.2% patients are wearing compression stockings, and for 10.4% on a daily basis; 32.6% do not wear their compression mainly because it is not well tolerated; 38.2% do not have compression treatment because it is not recommended or not prescribed by the physician.

  7. Treatment of complex intracranial aneurysms using flow-diverting silk® stents. An analysis of 32 consecutive patients.

    Science.gov (United States)

    Buyukkaya, Ramazan; Kocaeli, Hasan; Yildirim, Nalan; Cebeci, Hakan; Erdogan, Cüneyt; Hakyemez, Bahattin

    2014-12-01

    This study describes the peri-procedural and late complications and angiographic follow-up results of 32 patients with 34 complex aneurysms treated with flow diverter Silk stents in a single centre. In this retrospective study, 40 Silk stents (SS) were implanted in 34 complex intracranial aneurysms in 32 patients. In our series, 20 (58.8%) carotid-ophthalmic internal carotid artery (ICA), six (17.6%) cavernous ICA, two (5.9%) supraclinoid ICA, two (5.9%) petrosal ICA (the same patient- bilateral) and four (11.8%) posterior circulation aneurysms were treated. One of the posterior circulation lesions was a fenestrated-type aneurysm. Twenty wide-necked, saccular; eight neck remnant; four fusiform and two blister-like aneurysms were included in our series. SS were successfully implanted in all patients (100%). Misdeployment occurred in 17.6% of patients. In two of these patients adequate stent openness was achieved via Hyperglide balloon dilatation. Coil embolization in addition to SS placement was utilized in four aneurysms. One patient (3%) experienced transient morbidity due to a thromboembolic event and there was one mortality (3%) due to remote intraparenchymal haemorrhage. Complete occlusion of 27/33 (81.8 %) and 29/33 (87.9 %) aneurysms was achieved six and 12 months after the procedure, respectively. In-stent intimal hyperplasia was detected in 6.1 % patients. Flow-diverter Silk stent implantation is an effective method of treating complex aneurysms with acceptable mortality and morbidity rates. Complete occlusion is achieved in most of the complex aneurysms.

  8. 婴儿湿疹对134例患儿及其家庭生活质量影响的调查分析%Investigation of 134 infantile eczema patients and their family on life quality

    Institute of Scientific and Technical Information of China (English)

    张杏平; 刘跃; 刘江波

    2014-01-01

    目的:探讨婴儿湿疹对患儿及其家庭生活质量的影响。方法分别采用婴儿皮炎生活质量指数(IDQOL)和皮炎家庭影响调查表(DFI)评估婴儿湿疹患儿及其家庭的生活质量,并分析相关影响因素。两份问卷均由患儿家长填写,并对婴儿湿疹严重程度的评分(根据IDQOL内单独项)进行分析。结果134例婴儿湿疹患儿平均年龄为(5.11±3.03)个月。IDQOL平均评分(8.35±4.33)分(0~18分);DFI平均评分(7.84±4.71)分(0~21分);IDQOL评分高的前3项分别是症状(1.45±0.78)分,睡眠影响(1.19±0.98)分,情绪(1.01±0.76)分;DFI评分高的前3项分别是情绪苦恼(1.13±0.67)分,感到疲惫(1.05±0.78)分,睡眠影响(1.02±0.81)分;疾病严重程度评分与IDQOL评分、DFI评分相比差异有统计学意义(r=0.212, P=0.014;r=0.300,P<0.01);IDQOL评分与DFI评分二者间差异有统计学意义(r=0.679, P<0.01);分别对患儿性别、填表家长性别、患儿喂养方式及家族中有无过敏史进行比较, IDQOL评分与DFI评分相比差异均无统计学意义。结论婴儿湿疹对患儿及其家庭的生活质量有明显的负面影响,湿疹越严重,负面影响越大。婴儿生活质量影响较显著的是症状(瘙痒)、睡眠和情绪,其家庭生活质量影响较显著的是情绪、疲惫和睡眠。%Objective To explore the impact of infantile eczema on the patient's life quality and their family. Methods The infant's dermatitis quality of life index(IDQOL english version) and dermatitis family impact questionnaire(DFI Chinese version)were used respective to evaluate the quality of life of patients with infantile eczema and their family (n=134);Severity of infantile eczema was determined by parents by an additional question on the IDQOL. Results The mean age of the 134 patients was 5.11±3.03 months old. The mean score for IDQOL was 8.35±4.33 (range 0

  9. The endoscopic trans-fourth ventricle aqueductoplasty and stent placement for the treatment of trapped fourth ventricle: Long-term results in a series of 18 consecutive patients

    Directory of Open Access Journals (Sweden)

    Pasquale Gallo

    2012-01-01

    Full Text Available Background: Different surgical approaches have been described in the past to treat a trapped fourth ventricle (TFV but, unfortunately, these techniques showed a high rate of dysfunction and complications. During the last 10 years the development of neuroendoscopy has dramatically changed the outcome of these patients. Materials and Methods: We conducted a retrospective evaluation of the safety, effectiveness, and long-term outcome of endoscopic aqueductoplasty and stent placement, performed in 18 consecutive patients with symptomatic TFV through a trans-fourth ventricle approach between 1994 and 2010. Thirteen patients underwent endoscopic aqueductoplasty and stent placement and 5 patients underwent aqueductoplasty alone using a tailored suboccipital approach through the foramen of Magendie in prone or sitting position. Results: The mean age of the patients at the time of surgery was 15.2 years. All patients but 3 had a supratentorial ventriculoperitoneal shunt. Fifteen patients presented with slit supratentorial ventricles. At a mean followup of 90.8 months all patients experienced a stable clinical improvement. Only two complications were observed: A transient diplopia due to dysconjugate eye movements in one patient and a transient trochlear palsy in another one. Conclusions: Our experience and the literature review suggest that endoscopic trans-fourth ventricle aqueductoplasty and stent placement is a minimally invasive, safe, and effective technique for the treatment of TFV and should be strongly recommended, especially in patients with supratentorial slit ventricles.

  10. Hand eczema guidelines based on the Danish guidelines for the diagnosis and treatment of hand eczema

    DEFF Research Database (Denmark)

    Menné, Torkil; Johansen, Jeanne D; Sommerlund, Mette

    2011-01-01

    Background. Classification of hand eczema has traditionally been based both on aetiology and clinical appearance. For 20% of cases, the aetiology is unknown. Objectives. To suggest a classification based on well-defined aetiology as well as on predefined clinical patterns and on the dynamics...... of hand eczema. Methods. Literature studies and discussions among members of the Danish Contact Dermatitis Group. Results. Criteria are given for the aetiological diagnoses of allergic contact dermatitis of the hands, irritant contact dermatitis of the hands, protein contact dermatitis of the hands......, atopic hand eczema and aetiologically unclassifiable hand eczema. Six different clinical patterns are described and illustrated. Suggestions for general treatment principles are given. Conclusion. Operational guidelines for the diagnosis and treatment of hand eczema are described....

  11. Sums of Consecutive Integers

    Science.gov (United States)

    Pong, Wai Yan

    2007-01-01

    We begin by answering the question, "Which natural numbers are sums of consecutive integers?" We then go on to explore the set of lengths (numbers of summands) in the decompositions of an integer as such sums.

  12. Revision of failed primary adjustable gastric banding to mini-gastric bypass: results in 48 consecutive patients.

    Science.gov (United States)

    Piazza, Luigi; Di Stefano, Carla; Ferrara, Francesco; Bellia, Angelo; Vacante, Marco; Biondi, Antonio

    2015-12-01

    Although laparoscopic adjustable gastric banding (LAGB) has been found to be a generally successful weight loss operation, many patients require revision for weight regain, mechanical complications or intolerance to restriction. We report our experience with laparoscopic mini-gastric bypass (LMGB) as a revisional procedure for failed primary LAGB. From June 2007 to November 2012, 48 patients, who had undergone LAGB, underwent revisional surgery to LMGB. Patient demographics, reasons for band removal, interval between removal and LMGB, operative times, complications, change in comorbidities, and weight loss were collected. The revisions to a mini-gastric bypass (MGB) were completed laparoscopically in all cases except in four, when the MGB was deferred because of gastric tube damage. Mean age was 38 years (range 20-59) and BMI was 43.4 ± 4.2 kg/m(2); 82 % of patients were females. Revision was performed after a mean of 28.6 months. The mean hospital stay was 3.25 days. Within 60 days of the MGB, mortality and morbidity were nil. We observed a significant difference in mean BMI after 6 months' follow-up (P < 0.001). Diabetes remission was observed in 88 % of patients, apnea remission in 66 %, and hypertension remission in 66 % after LMGB (p < 0.001). Moreover, four patients with GERD were cured. All LAGB patients had positive outcomes after the conversion to MGB, with a mean gain of 1.7 points in the bariatric analysis and reporting outcome system questionnaire. Our results suggested that LMGB is a safe, feasible, effective and easy-to-perform revisional procedure for failed LAGB.

  13. Reconstruction of cranial defects with individually formed cranial prostheses made of polypropylene polyester knitwear: an analysis of 48 consecutive patients.

    Science.gov (United States)

    Kasprzak, Piotr; Tomaszewski, Grzegorz; Kotwica, Zbigniew; Kwinta, Borys; Zwoliński, Jerzy

    2012-04-10

    This article presents a new method of cranioplasty in which polypropylene polyester knitwear was used as the filling material. The basis for prosthesis shaping was a three-dimensional model of the defect made according to the patient's CT scans. Previously, such material has never been a subject of computer-aided design and computer-aided manufacturing (CAD/CAM) individual forming. The process of the prosthesis design included CT bone scans and mold preparation for each patient. Such prostheses were implanted in 48 patients with cranial defects. The total number of prostheses applied was 51. The follow-up time was at least 6 months up to 36 months. The group of treated patients is described here, and sample pictures are shown to illustrate the results. The smallest defect had a size of 15 cm(2); the biggest, 178 cm(2). The coverage and the aesthetic results were very good in all cases. Two patients had postoperative complications. The cranioplastic solution described here is a valuable addition to the existing reconstructive methods, because of the low cost of the implant, the ease of its adjustment to the shape of the defect, and the short time of preparation.

  14. Thoracic and lumbar spinal surgery under local anesthesia for patients with multiple comorbidities: A consecutive case series

    Directory of Open Access Journals (Sweden)

    Muhammad Babar Khan

    2014-01-01

    Full Text Available Background: Although some patients with symptomatic spinal disease may benefit greatly from surgery, their multiple attendant comorbidities may make general anesthesia risky or contraindicated. However, there is scarce literature describing the efficacy and safety of local anesthesia to perform these operations. Here we report seven patients who successfully underwent spinal surgery utilizing local anesthesia to limit the risks and complications of general anesthesia. Methods: Seven patients for whom general anesthesia was contraindicated were prospectively followed for a minimum of 3 months following spinal surgery performed under local anesthesia. Pain and functional improvement were assessed utilizing the Visual Analog Scores (VAS and Oswestry Disability Index (ODI scores. Results: Five patients had interlaminar decompressions for stenosis alone, while two patients had laminectomies for debulking of tumors. The mean duration of surgery was 79.8 ± 16.6 min, the mean estimated blood loss was 157.1 ± 53.4 ml, the mean dose of local anesthetic was 1.9 ± 0.7 mg/kg, and the mean length of hospital stay after surgery was 3.2 ± 1.2 days. There were no intraoperative complications. The surgery resulted in improved VAS and ODI scores consistent with significant improvement in pain (P = 0.017 and functionality (P = 0.011. Conclusions: Performing spinal surgery under local anesthesia is a safe and effective alternative when patient′s major comorbidities preclude a general anesthetic. For all the seven patients studied, spinal surgery, performed under a local anesthetic, resulted in a statistically significant reduction in pain and improvement in function.

  15. A novel impermeable adhesive membrane to reinforce dural closure: a preliminary retrospective study on 119 consecutive high-risk patients.

    Science.gov (United States)

    Ferroli, Paolo; Acerbi, Francesco; Broggi, Morgan; Schiariti, Marco; Albanese, Erminia; Tringali, Giovanni; Franzini, Angelo; Broggi, Giovanni

    2013-01-01

    Postoperative cerebrospinal fluid (CSF) leak in neurosurgery remains a significant source of morbidity. TissuePatchDural (TPD), a novel impermeable adhesive membrane, can be used to reinforce dural closure in cases considered at high risk to develop postoperative CSF leak. A retrospective, single-center, clinical investigation was conducted on 119 patients who underwent elective neurosurgical procedures between January and June 2010. Inclusion criteria included adult patients undergoing clean elective surgeries where a primary watertight closure was not possible. Three groups of patients were considered: 1) infratentorial, 67 cases; 2) supratentorial, 34 cases; and 3) spinal, 18 cases. All these patients received TPD to reinforce dural closure. Preoperative (long-term corticosteroid therapy, previous surgery and radiotherapy), intraoperative (site of procedures and size of dural gap), and postoperative (early and late hydrocephalus) conditions were analyzed as possible risk factors associated with CSF leakage. The mean follow-up was 7.14 months (range 6-12 months). CSF leak was detected in 11 of 119 cases (9.2%). The presence of pre- and postoperative risk factors was associated with a higher percentage of CSF leakage: 8 of 22 cases (36.3%) vs. 3 of 97 cases (3.1%) (P < 0.0001). All leaks could be conservatively treated and no patient required readmission or second surgery. No TPD-related adverse or allergic effects were observed. TPD seems to be a safe tool to be used to reinforce dural closure in patients with a high risk of developing CSF leaks. Copyright © 2013 Elsevier Inc. All rights reserved.

  16. [Predictors of positive surgical margins after nephron-sparing surgery for renal cell carcinoma: retrospective analysis on 298 consecutive patients].

    Science.gov (United States)

    Schiavina, Riccardo; Borghesi, Marco; Chessa, Francesco; Rizzi, Simona; Martorana, Giuseppe

    2014-01-01

    Aim of our study was to evaluate the predictive factors of positive surgical margins (PSM) in a cohort of patients who underwent partial nephrectomy (PN) for renal cell carcinoma. We retrospectively evaluated our Institutional database of patients treated with open or laparoscopic PN between 200 and 2013. Categorical variables were compared using Pearson's chi-square test and linear-by-linear association. Multivariable Cox analysis was used in order to evaluate independent predictors of PSM. Surgical margins were found to be negative in 274 out of 298 patients (91.9%), and the remaining 24 (8.1%) patients had PSM at the final pathological exam. The median clinical size was significantly lower in patients with PSM than those with negative margins (2.6 vs. 3 cm, p=0.03). At univariable analysis, a shorter operative time (p=0.04), a malignant histotype (p=0.04) and higher Fuhrman grade (p=0.02) were observed in patients with positive surgical margins compared to those without PSM. At multivariable analysis, median tumor dimension (p=0.02), the malignant histotype (p=0.01) and the high Fuhrman grade (3-4) (p=0.01) were found to be independent predictive factors of PSM. The most important goal of any PN is to reach negative surgical margins. In our study, clinical tumor dimensions, malignant tumor histotype and the high Fuhrman grade demonstrated to be independent predictive factors of PSM after nephron sparing surgery for renal cell carcinoma. Other prospective, multi-institutional studies are needed in order to confirm these results.

  17. Stereotactic Body Radiotherapy for Medically Inoperable Lung Cancer: Prospective, Single-Center Study of 108 Consecutive Patients

    Energy Technology Data Exchange (ETDEWEB)

    Taremi, Mojgan, E-mail: mojgan.taremi@rmp.uhn.on.ca [Radiation Medicine Program, Princess Margaret Hospital, Toronto, ON (Canada); Department of Radiation Oncology, University Health Network, Toronto, ON (Canada); Department of Radiation Oncology, VU University Medical Center, Amsterdam (Netherlands); Hope, Andrew [Radiation Medicine Program, Princess Margaret Hospital, Toronto, ON (Canada); Department of Radiation Oncology, University Health Network, Toronto, ON (Canada); Dahele, Max [Department of Radiation Oncology, Stronach Regional Cancer Center, Newmarket, ON (Canada); Pearson, Shannon [Radiation Medicine Program, Princess Margaret Hospital, Toronto, ON (Canada); Fung, Sharon [Department of Biostatistics, Princess Margaret Hospital, Toronto, ON (Canada); Purdie, Thomas [Radiation Medicine Program, Princess Margaret Hospital, Toronto, ON (Canada); Brade, Anthony [Radiation Medicine Program, Princess Margaret Hospital, Toronto, ON (Canada); Department of Radiation Oncology, University Health Network, Toronto, ON (Canada); Department of Radiation Oncology, VU University Medical Center, Amsterdam (Netherlands); Cho, John; Sun, Alexander; Bissonnette, Jean-Pierre; Bezjak, Andrea [Radiation Medicine Program, Princess Margaret Hospital, Toronto, ON (Canada); Department of Radiation Oncology, University Health Network, Toronto, ON (Canada)

    2012-02-01

    Purpose: To present the results of stereotactic body radiotherapy (SBRT) for medically inoperable patients with Stage I non-small-cell lung cancer (NSCLC) and contrast outcomes in patients with and without a pathologic diagnosis. Methods and Materials: Between December 2004 and October 2008, 108 patients (114 tumors) underwent treatment according to the prospective research ethics board-approved SBRT protocols at our cancer center. Of the 108 patients, 88 (81.5%) had undergone pretreatment whole-body [18F]-fluorodeoxyglucose positron emission tomography/computed tomography. A pathologic diagnosis was unavailable for 33 (28.9%) of the 114 lesions. The SBRT schedules included 48 Gy in 4 fractions or 54-60 Gy in 3 fractions for peripheral lesions and 50-60 Gy in 8-10 fractions for central lesions. Toxicity and radiologic response were assessed at the 3-6-month follow-up visits using conventional criteria. Results: The mean tumor diameter was 2.4-cm (range, 0.9-5.7). The median follow-up was 19.1 months (range, 1-55.7). The estimated local control rate at 1 and 4 years was 92% (95% confidence interval [CI], 86-97%) and 89% (95% CI, 81-96%). The cause-specific survival rate at 1 and 4 years was 92% (95% CI, 87-98%) and 77% (95% CI, 64-89%), respectively. No statistically significant difference was found in the local, regional, and distant control between patients with and without pathologically confirmed NSCLC. The most common acute toxicity was Grade 1 or 2 fatigue (53 of 108 patients). No toxicities of Grade 4 or greater were identified. Conclusions: Lung SBRT for early-stage NSCLC resulted in excellent local control and cause-specific survival with minimal toxicity. The disease-specific outcomes were comparable for patients with and without a pathologic diagnosis. SBRT can be considered an option for selected patients with proven or presumed early-stage NSCLC.

  18. Effect of patient Age on surgical outcomes for Graves’ disease: a case–control study of 100 consecutive patients at a high volume thyroid surgical center

    Directory of Open Access Journals (Sweden)

    Breuer Christopher K

    2013-01-01

    Full Text Available Abstract Objective To compare outcomes between children ( Summary of background data Reported complication rates for children undergoing surgery for Graves’ disease are worse than for adults. Methods 100 consecutive patients (32 children; 68 adults who underwent total thyroidectomy for Graves’ disease (GD by a high-volume endocrine surgery team from were compared. Results The mean patient age was 9.7 yrs (range 3.4-17.9 yrs in children versus 44.9 yrs (range 18.4-84.2 yrs in adults. Operative times were longer in children (2.18 ± 0.08 hrs than in adults (1.66 ± 0.03 hrs (p = 0.003. Pediatric thyroid specimens averaged 38.6.0 ± 8.9 gm (range: 9–293 gm and adult thyroid specimens averaged 48.0 ± 6.4 gm (range: 6.6-203 gm (p = 0.34. Thyroid to body weight ratios were greater in children (0.94 ± 0.11 gm/kg than adults (0.67 ± 0.8 gm/kg (p = 0.05. In all patients, the hyperthyroid state resolved after surgery. There was no operative mortality, recurrence, or permanent hypoparathyroidism. Transient post-operative hypocalcemia requiring calcium infusion was greater in children than adults (6/32 vs. 1/68; p = 0.004. Transient recurrent laryngeal nerve dysfunction occurred in two children and in no adults (p = 0.32. Postoperative hematoma occurred in two adults and in no children (p = 0.46. The length of stay was longer for children (1.41 ± 0.12 days than for adults (1.03 ±0.03 days (p = 0.004. Conclusion Surgical management of GD is technically more challenging in children as evidenced by longer operative times. Whereas temporary hypocalcemia occurs more commonly in children than adults, the risks of major complications including disease recurrence, permanent hypoparathyroidism, recurrent laryngeal nerve injury, or neck hematoma were indistinguishable. These data suggest that excellent and equivalent outcomes can be achieved for GD surgery in children and adults when care is rendered

  19. The combined diagnosis of allergic and irritant contact dermatitis in a retrospective cohort of 1000 consecutive patients with occupational contact dermatitis

    DEFF Research Database (Denmark)

    Ferløv Schwensen, Jakob; Menné, Torkil; Johansen, Jeanne D

    2014-01-01

    BACKGROUND: The diagnosis of combined allergic and irritant contact dermatitis is an accepted subdiagnosis for hand dermatitis, and it is often considered in a patient with contact dermatitis, a positive and relevant patch test result, and wet work exposure. We therefore hypothesize....... OBJECTIVES: To find the statistically expected number of combined allergic and irritant contact dermatitis cases in 1000 patients, and to evaluate the diagnostic criteria for the diagnosis. METHODS: One thousand consecutive patients with occupational contact dermatitis from a hospital unit in Denmark were...... assessed. RESULTS: The expected number of cases with the diagnosis of combined allergic and irritant contact dermatitis was 0.33%, as compared with the observed number of 6.4%. Females occupied in wet occupations were often diagnosed with combined allergic and irritant contact dermatitis (p 

  20. Portal vein thrombosis: Prevalence, patient characteristics and lifetime risk: A population study based on 23796 consecutive autopsies

    Institute of Scientific and Technical Information of China (English)

    Mats (O)gren; David Bergqvist; Martin Bj(o)rck; Stefan Acosta; Henry Eriksson; Nils H Sternby

    2006-01-01

    AIM: To assess the lifetime cumulative incidence of porGl venous thrombosis (PVT) in the general population.METHODS: Between 1970 and 1982, 23 796 autopsies,representing 84% of all in-hospital deaths in the Malmo city population, were performed, using a standardised protocol including examination of the portal vein. PVT patients were characterised and the PVT prevalence at autopsy, an expression of life-time cumulative incidence,assessed in high-risk disease categories and expressed in terms of odds ratios and 95% CI.RESULTS: The population prevalence of PVT was 1.0%.Of the 254 patients with PVT 28% had cirrhosis, 23%primary and 44% secondary hepatobiliary malignancy,10% major abdominal infectious or inflammatory disease and 3% had a myeloproliferative disorder. Patients with both cirrhosis and hepatic carcinoma had the highest PVT risk, OR 17.1 (95% CI 11.1-26.4). In 14% no cause was found; only a minority of them had developed portal-hypertension-related complications.CONCLUSION: In this population-based study, PVT was found to be more common than indicated by previous clinical series. The markedly excess risk in cirrhosis and hepatic carcinoma should warrant an increased awareness in these patients for whom prospective studies of directed intervention might be considered.

  1. Prediction of Deep Neck Abscesses by Contrast-Enhanced Computerized Tomography in 76 Clinically Suspect Consecutive Patients

    NARCIS (Netherlands)

    Freling, Nicole; Roele, Elise; Schaefer-Prokop, Cornelia; Fokkens, Wytske

    2009-01-01

    Objectives/Hypothesis: Contrast-enhanced computerized tomography (CECT) has become the imaging method of choice in patients with clinical suspicion of a deep neck abscess. The purpose of this retrospective study was to assess the predictive value of the diagnosis of deep neck abscess using CECT. Stu

  2. Bilateral Breast Reconstruction with Abdominal Free Flaps: A Single Centre, Single Surgeon Retrospective Review of 55 Consecutive Patients

    Directory of Open Access Journals (Sweden)

    Peter McAllister

    2016-01-01

    Full Text Available Breast reconstruction using free tissue transfer is an increasingly utilised oncoplastic procedure. The aim was to review all bilateral breast reconstructions using abdominal free flaps by a single surgeon over an 11-year period (2003–2014. A retrospective review was performed on all patients who underwent bilateral breast reconstruction using abdominal free flaps between 2003 and 2014 by the senior author (DAM. Data analysed included patient demographics, indication for reconstruction, surgical details, and complications. Fifty-five female patients (mean 48.6 years [24–71 years] had bilateral breast reconstruction. The majority (41, 74.5% underwent immediate reconstruction and DIEP flaps were utilised on 41 (74.5% occasions. Major surgical complications occurred in 6 (10.9% patients, all of which were postoperative vascular compromise of the flap. Failure to salvage the reconstruction occurred on 3 (5.5% occasions resulting in a total flap failure rate of 2.7%. Obesity (>30 kg/m2 and age > 60 years were shown to have a statistically increased risk of developing postoperative complications (P60 years were associated with higher complication rates.

  3. 老年湿疹患者 Th 1/Th2细胞因子的血清水平与湿疹的发展及其临床表现的相关性%Serum levels of Th1/Th2 cytokines in aged patients and their correlation with eczema devel-opment and cl inical manifestation

    Institute of Scientific and Technical Information of China (English)

    汪为刚; 侯枫林; 张秀明; 马世武; 陈金军

    2016-01-01

    Objective:To investigate variations of Th1/Th2 cytokine levels,as well as their correlation with eczema de-velopment and clinical manifestation in aged patients.Methods:A total of 92 patients (above 60 years old)with eczema diag-nosed by the outpatient department of dermatology and venerology of our hospital were included as the eczema group,while 60 aged patients without eczema as the healthy group.Patients'serum levels of Th1/Th2 cytokines were examined for inter-group comparison and stratified analysis as per clinical manifestation.Results:Serum levels of interleukin (IL)-2,IL-4,IL-10,IL-12,tumor necrosis factor (TNF)-ɑand interferon (IFN)-γwere all significantly higher in patients of the eczema group than the healthy group (P 0.05).And no significant difference existed in the levels of IL-2,IL-4, IL-10,IL-12,TNF-ɑand IFN-γbetween generalized and localized eczema patients (P >0.05).Conclusion:Compared with the healthy population,Th1/Th2 cytokine levels are significantly different in eczema patients,especially those in the acute stage.%目的::研究分析老年湿疹患者 Th1/Th2细胞因子的水平变化与患者疾病发展及临床表现的关系.方法:选取本院皮肤性病门诊确诊的60岁以上的老年人92例(湿疹组)和60例健康老年人(健康组)作为研究对象,检测两组血清 Th1/Th2细胞因子水平并进行比较,并根据患者临床表现进行分层分析.结果:湿疹组患者的 IL-2、IL-4、IL-10、IL-12、TNF-ɑ、IFN-γ水平均显著的高于健康组人群且差异均具有统计学意义(P <0.05);湿疹组急性期患者的 IL-2、IL-4、IL-10、IFN-γ水平均显著的高于健康组人群且差异均具有统计学意义(P <0.05);急性期与慢性期湿疹患者的 IL-12、TNF-ɑ水平差异无统计学意义(P >0.05).湿疹组患者泛发性和局限性的 IL-2、IL-4、IL-10、IL-12、TNF-ɑ、IFN-γ水平均差异均不具有统计学意义(P >0.05).结论:湿疹患者的 Th

  4. Influence of weather and climate on subjective symptom intensity in atopic eczema

    Science.gov (United States)

    Vocks, E.; Busch, R.; Fröhlich, C.; Borelli, S.; Mayer, H.; Ring, J.

    The frequent clinical observation that the course of atopic eczema, a skin disease involving a disturbed cutaneous barrier function, is influenced by climate and weather motivated us to analyse these relationships biometrically. In the Swiss high-mountain area of Davos the intensity of itching experienced by patients with atopic eczema was evaluated and compared to 15 single meteorological variables recorded daily during an entire 7-year observation period. By means of univariate analyses and multiple regressions, itch intensity was found to be correlated with some meteorological variables. A clear-cut inverse correlation exists with air temperature (coefficient of correlation: -0.235, Peczema is significantly dependent on meteorological conditions. The data suggest that, in patients with atopic eczema, a certain range of thermo-hygric atmospheric conditions with a balance of heat and water loss on the skin surface is essential for the skin to feel comfortable.

  5. Eczema May Leave Some Flu Shots Less Effective, Study Finds

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_163564.html Eczema May Leave Some Flu Shots Less Effective, Study ... But a new study suggests that people with eczema should request the vaccine be given into the ...

  6. Study Challenges Touted Link Between Eczema and Heart Disease

    Science.gov (United States)

    ... html Study Challenges Touted Link Between Eczema and Heart Disease Researcher now probing whether more severe cases of ... a link between eczema and increased risk of heart disease, researchers report. The findings challenge recent studies suggesting ...

  7. Procedural results and 30-day clinical events analysis following Edwards transcatheter aortic valve implantation in 48 consecutive patients: initial experience

    Institute of Scientific and Technical Information of China (English)

    ZHAO Quan-ming; Therese Lognone; Calin Ivascau; Remi Sabatier; Vincent Roule; Ziad Dahdouh; Massimo Massetti; Gilles Grollier

    2012-01-01

    Background Transcatheter aortic valve implantation (TAVI) is a rapidly evolving strategy for therapy of aortic stenosis.We presented the procedural results and analyzed the death causes of 30-day mortality and clinical events in patients who underwent TAVI with Edwards prosthetic valves in University Hospital of Caen,France.Methods The patients with severe aortic stenosis but at high surgical risk or inoperable were considered as candidates for TAVI.Forty-eight patients undergoing TAVI from July 2010 to September 2011 were enrolled in this registry.The Edwards prosthetic valves were solely used in this clinical trial.Results Overall 48 patients underwent TAVI,28 of which accepted TAVI by trans-femoral (TF) approaches,20 by trans-apical approaches (TA).The aortic valve area (AVA) was (0.70±0.23) cm2,left ventricular ejection fraction (LVEF)was (57.4±17.6)%,Log EuroSCORE was (19.2±15.8)%,mean gradient was (47.0±16.6) mmHg.There were no significant differences between TF and TA groups in all these baseline parameters.Device success rate was 95.8%,and procedural success rate was 93.7% in total.Procedural mortality was 6.7% (3/48):two deaths in TA group (10%),and one death in TF group (3.6%).Forty-six Edwards valves were implanted:10 Edwards Sapien and 36 Edwards XT.Procedure-related complications included cardiac tamponade in 2 cases (4.2%),acute myocardial infarction (AMI) in 1 case (2.1%),permanent pacemaker implantation in 1 case (2.1%),life-threatening and major bleeding in 3 cases; access site related major complication in 1 case,AKI stage 3 in 3 cases (6.3%),minor stroke in 1 case (2.1%).Thirty-day survival rate was 89.6%.There were 5 deaths in total (10.4%):4 in TA group (20%) and 1 in TF group (3.6%).Conclusion The procedural success rate and 30-day mortality were acceptable in these high risk patients with Edwards prosthetic valves in the first 48 TAVI.

  8. Prevalence of depression in consecutive patients with type 2 diabetes mellitus of 5-year duration and its impact on glycemic control

    Directory of Open Access Journals (Sweden)

    Cynthia Susan Mathew

    2012-01-01

    Full Text Available Context: Type 2 diabetes mellitus doubles the odds of suffering from depressive illness. Co-morbid depression is associated with poorer outcomes in diabetes mellitus in terms of glycemic control, medication adherence, quality of life, physical activity, and blood pressure control. Aim: The present study aims to estimate the prevalence of depression among a consecutive group of patients with type 2 diabetes and assess its impact on glycemic and blood pressure control. Setting: Outpatient department of the endocrinology department of a university affiliated teaching hospital in north India. Subjects: Consecutive adult patients (18-65 years with type 2 diabetes mellitus of over 5-year duration with no prior history of psychiatric illnesses or intake of anti-depressants. Materials and Methods: A semi-structured questionnaire was used for demographic data, HbA1c was obtained to assess glycemic control, and blood pressure was recorded twice during patient interview to assess blood pressure control. Depression was assessed with the Major Depression Inventory and scores obtained were classified as consistent with mild, moderate and severe depression. Data was analyzed with SPSS v16, and multiple logistical regression test was done to compare the effect of depression on glycemic control after adjusting for age and sex. Results: Of the 80 patients interviewed, 31 (38.8% had depressive symptoms. Among them 20 (25% had mild depression, 10 (12.5% had moderate depression, and 1 (1.3% had severe depression. Conclusions: Over one third of patients with type 2 diabetes mellitus of over 5-year duration had depressive symptoms. The presence of depressive symptoms was associated with a significant worsening of glycemic control.

  9. Occurrence of self reported hand eczema in Swedish bakers

    OpenAIRE

    1998-01-01

    OBJECTIVES: To estimate the risk of bakers developing hand eczema. The importance of atopy was studied as well as change of job due to hand eczema. METHODS: A retrospective cohort study was performed among bakers trained in Swedish trade schools in 1961-89 (n = 2923). School referents followed other programmes (n = 1258); population controls were randomly selected from the general population (n = 1258). A questionnaire on self reported hand eczema, year of onset of hand eczema, change o...

  10. Impact of hand eczema severity on quality of life: a hospital based cross-sectional study

    Directory of Open Access Journals (Sweden)

    Bharat Bhushan Mahajan

    2016-01-01

    Full Text Available Introduction: Hands are important organs of expression, communication, and are necessary for household and work-related activity. Thus, hand eczema can deteriorate quality of life. This study aims to find impact of hand eczema severity on quality of life. Methods: A cross-sectional study was done in a tertiary care hospital in Punjab from January to July, 2014. A total of 69 hand eczema patients of either gender aged ≥16 years were enrolled after taking an informed consent. Disease severity was assessed by hand eczema severity index (HECSI score; and quality of life by dermatology life quality index (DLQI questionnaire. The data was evaluated using statistical tests like frequency, chi-square, oneway ANOVA, t-test etc. Results: Out of 69 patients, 63.8% were males and 36.2% females. The commonest age group affected was 21-40 years (55.1% cases. Aggravating factors were reported by 76.8% patients, the commonest trigger being summer season (47.8% followed by soaps and detergents (21.7%. The mean±S.D. for DLQI was 6.22±5.42 and for HECSI was 18.54±17.05. There was no statistically significant impact of age, occupation and duration of disease on DLQI or disease severity except gender (p-value being 0.028 for DLQI; 0.035 for HECSI. There was no significant correlation between HECSI score and DLQI. Conclusion: Majority of the patients with hand eczema had a significant impairment of their quality of life. There was a statistically significant impact of gender on hand eczema severity; although no correlation was found between DLQI and HECSI score in this study.

  11. Magnetoencephalographic study of hand and foot sensorimotor organization in 325 consecutive patients evaluated for tumor or epilepsy surgery

    Directory of Open Access Journals (Sweden)

    Ronald B. Willemse

    2016-01-01

    Conclusions: MEG localization of sensorimotor cortex activation was more successful for the hand compared to the foot. In patients with neural lesions, there were signs of brain reorganization as measured by more frequent ipsilateral motor cortical activation of the foot in addition to the traditional sensory and motor activation patterns in the contralateral hemisphere. The presence of ipsilateral neural reorganization, especially around the foot motor area, suggests that careful mapping of the hand and foot in both contralateral and ipsilateral hemispheres prior to surgery might minimize postoperative deficits.

  12. Correlations between neurological signs and brain MR images of patients in consecutive stages of subacute sclerosing panencephalitis

    Energy Technology Data Exchange (ETDEWEB)

    Kulczycki, J.; Kryst-Widzgowska, T.; Sobczyk, W.; Bochynska, A.; Pilkowska, E.; Milewska, D. [Pracownia Rezonansu Magnetycznego, Inst. Psychiatrii i Neurologii, Warsaw (Poland)

    1994-12-31

    Correlations between neurological symptoms and brain MRI changes during the course of SSPE in 10 patients were studied. Visual agnosia and mental regression - very frequent symptoms at the early stages of the disease were caused by nearly symmetrical, focal involvement of the occipital and frontal white matter in all cases. Pyramidal and extrapyramidal disturbances reflected rather diffuse lesions of both cerebral hemispheres in late second stage of the illness. In cases with clinical improvement the brain changes disclosed an entire stability, but not diminishing intensity. (author) 9 refs, 8 figs, 3 tabs

  13. Evaluation of skin barrier function in patients with facial acne, eczema, melasma and solar dermatitis and its clinical significance%面部痤疮、湿疹、黄褐斑及日光皮炎皮肤屏障功能评价及其临床意义

    Institute of Scientific and Technical Information of China (English)

    邹菥; 何黎; 杨成; 庞勤

    2013-01-01

    Objective To compare skin barrier function among patients with facial acne,subacute eczema,melasma and solar dermatitis.Methods Three hundred patients,including 80 patients with facial acne,60 subacute facial eczema,80 facial melasma and 60 facial solar dermatitis,as well as 60 healthy controls were recruited in this study.Skin sebum content and transepidermal water loss (TEWL) were measured by a sebmeter and Tewameter TM 210 (Courage and Khazaka,Germany),respectively.Stratum comeum hydration was measured with a Scalar Moisture Checker (Scalar Corporation,Japan).Statistical analysis was carried out using analysis of variance and t test.Results Compared with the healthy controls,patients with facial acne showed increased skin sebum content and TEWL value but decreased stratum corneum hydration (all P < 0.01),and patients with subacute eczema,solar dermatitis and melasma displayed lower sebum content and stratum corneum hydration but higher TEWL value (all P < 0.01).Skin sebum content was significantly higher in patients with facial acne than in patients with subacute eczema,solar dermatitis and melasma ((184.65 ± 83.07) vs.(21.86 ± 18.94),(25.10 ±14.22) and (36.05 ± 32.84) μg/cm2,all P < 0.01),but was similar between the patients with subacute eczema,solar dermatitis and melasma (P > 0.05).In terms of stratum corneum hydration,patients with subacute eczema and solar dermatitis were statistically lower than those with acne and melasma (18.66% ± 7.85% and 20.91% ± 8.05% vs.24.32% ± 8.16% and 28.02% ± 4.67%,all P < 0.01),patients with facial subacute eczema were similar to those with solar dermatitis (P > 0.05),and patients with facial acne were statistically lower than those with melasma (P <0.01).TEWL value was significantly higher in patients with melasma than in patients with acne,solar dermatitis and subacute eczema ((13.80 ± 4.t 3) vs.(20.86 ± 8.78),(22.85 ± 9.84) and (22.48 ± 10.37) μg/m2 h,all P < 0.01),but similar

  14. Preoperative Direct Puncture Embolization of Advanced Juvenile Nasopharyngeal Angiofibroma in Combination with Transarterial Embolization: An Analysis of 22 Consecutive Patients

    Energy Technology Data Exchange (ETDEWEB)

    Lv Mingming, E-mail: lvmingming001@163.com; Fan, Xin-dong, E-mail: fanxindong@yahoo.com.cn [Shanghai Jiao Tong University School of Medicine, Department of Radiology, Ninth People' s Hospital (China); Su Lixin, E-mail: sulixin1975@126.com [Shanghai Jiao Tong University School of Medicine, Department of Oral and Maxillofacial Surgery, Ninth People' s Hospital (China); Chen Dong, E-mail: chenjsun@public8.sta.net.cn [Shanghai Jiao Tong University School of Medicine, Department of Otolaryngology, Ninth People' s Hospital (China)

    2013-02-15

    ObjectiveThis study was designed to evaluate the clinical application of preoperative auxiliary embolization for juvenile nasopharyngeal angiofibroma (JNA) by direct puncture embolization (DPE) of the tumor in combination with transarterial embolization (TAE). The study included 22 patients. An 18-gauge needle was used to puncture directly into the tumor, and 20-25 % N-butyl cyanoacrylate was injected under the guidance of fluoroscopy after confirming the placement of the needle into the JNA and no leaking into the surrounding tissue. Tumors were obstructed later via TAE. The supplying arteries of JNA were from branches of the internal carotid and external carotid arteries. Control angiography showed the obliteration of contrast stain in the entire tumor mass and the distal supplying arteries disappeared after DPE in combination with TAE. Surgical resection was performed within 4 days after embolization and none of the patients required blood transfusion. The use of DPE in combination with TAE was a safe, feasible, and efficacious method. It can devascularize effectively the JNAs and reduce intraoperative bleeding when JNAs are extirpated.

  15. Ultrasound-guided treatment of meralgia paresthetica (lateral femoral cutaneous neuropathy): technical description and results of treatment in 20 consecutive patients.

    Science.gov (United States)

    Tagliafico, Alberto; Serafini, Giovanni; Lacelli, Francesca; Perrone, Nadia; Valsania, Valtero; Martinoli, Carlo

    2011-10-01

    The purposes of this study were to describe a technique for treatment of meralgia paresthetica (lateral femoral cutaneous neuropathy) using ultrasound guidance and to report the results of treatment. Twenty consecutive patients (7 male and 13 female; age range, 23-66 years; mean, 39 years) with meralgia paresthetica confirmed by electromyography were treated with perineural injection of 1 mL of methylprednisolone acetate (40 mg/mL) and 8 mL of mepivacaine, 2%, under direct ultrasound guidance. Main outcome measures included the technical success of the procedure, visual analog scale score for the lateral femoral cutaneous nerve (pain, burning sensation, and paresthesia), and visual analog scale global quality of life score. Technical success (successful nerve block at the distribution of the lateral femoral cutaneous nerve) was achieved in all patients. Five patients felt slight sharp pain during needle insertion. The symptoms in 16 patients (80%) diminished progressively after the first week. The 4 remaining patients (20%) required a further perineural injection. The symptoms disappeared in all patients 2 months after injection (mean visual analog scale score ± SD for lateral femoral cutaneous neuropathy at baseline, 8.1 ± 2.1; at 2 months, 2.1 ± 0.5; t = 6.2; P meralgia paresthetica with ultrasound-guided perineural injections resulted in substantial symptom relief in most patients 2 months after injection. Randomized placebo-controlled trials of this treatment should be considered in the future.

  16. [Prevention of atopic eczema. Evidence based guidelines].

    Science.gov (United States)

    Schäfer, T

    2005-03-01

    With an estimated prevalence of 12% for preschool children and 3% for adults, atopic eczema is a serious public health problem. This disease severely jeopardizes quality of life and is associated with considerable costs. Since there is still no causal therapy, primary and secondary prevention are especially important. Here the evidence basis for recommendations on prevention of atopic eczema is discussed on the basis of the first evidence-based consensus guideline (S3) on allergy prevention. This recommends that babies should be breastfed exclusively for at least 4 months and exposure to passive smoking be avoided even during pregnancy; restriction of the maternal diet during pregnancy has no influence, though during breastfeeding it can lower the incidence of eczema among babies at risk. Thereby this measure should be balanced with potential consequences of malnutrition. There seems to be a positive correlation between keeping small rodents (rabbits, guinea pigs), and possibly cats, and the occurrence of atopic eczema, while keeping dogs has no effect or even a protective effect. Avoidance of an unfavorable indoor climate is probably also helpful in preventing eczema. There is no evidence to support deviating from the current recommendations of the standing committee for vaccination.

  17. Risk analysis of early childhood eczema

    DEFF Research Database (Denmark)

    Bisgaard, Hans; Halkjaer, Liselotte B; Hinge, Rikke

    2009-01-01

    BACKGROUND: The increasing prevalence of eczema suggests the role of environmental factors triggering a genetic predisposition. OBJECTIVE: To analyze the effect of environmental exposures in early life and genetic predisposition on the development of eczema before age 3 years. METHODS: The Copenh......BACKGROUND: The increasing prevalence of eczema suggests the role of environmental factors triggering a genetic predisposition. OBJECTIVE: To analyze the effect of environmental exposures in early life and genetic predisposition on the development of eczema before age 3 years. METHODS......: The Copenhagen Study on Asthma in Childhood is a prospective clinical study of a birth cohort of 411 children born of mothers with asthma. Eczema was diagnosed, treated, and monitored at the clinical research unit, and complete follow-up for the first 3 years of life was available for 356 children. Risk...... assessments included filaggrin loss-of-function mutation; parent's atopic disease; sex; social status; previous deliveries; third trimester complications and exposures; anthropometrics at birth; month of birth; duration solely breast-fed; introduction of egg, cow's milk, and fish; time spent in day care; cat...

  18. Emollients and moisturisers for eczema.

    Science.gov (United States)

    van Zuuren, Esther J; Fedorowicz, Zbys; Christensen, Robin; Lavrijsen, Adriana; Arents, Bernd WM

    2017-02-06

    Eczema is a chronic skin disease characterised by dry skin, intense itching, inflammatory skin lesions, and a considerable impact on quality of life. Moisturisation is an integral part of treatment, but it is unclear if moisturisers are effective. To assess the effects of moisturisers for eczema. We searched the following databases to December 2015: Cochrane Skin Specialised Register, CENTRAL, MEDLINE, Embase, LILACS, the GREAT database. We searched five trials registers and checked references of included and excluded studies for further relevant trials. Randomised controlled trials in people with eczema. We used standard Cochrane methodological procedures. We included 77 studies (6603 participants, mean age: 18.6 years, mean duration: 6.7 weeks). We assessed 36 studies as at a high risk of bias, 34 at unclear risk, and seven at low risk. Twenty-four studies assessed our primary outcome 'participant-assessed disease severity', 13 assessed 'satisfaction', and 41 assessed 'adverse events'. Secondary outcomes included investigator-assessed disease severity (addressed in 65 studies), skin barrier function (29), flare prevention (16), quality of life (10), and corticosteroid use (eight). Adverse events reporting was limited (smarting, stinging, pruritus, erythema, folliculitis).Six studies evaluated moisturiser versus no moisturiser. 'Participant-assessed disease severity' and 'satisfaction' were not assessed. Moisturiser use yielded lower SCORAD than no moisturiser (three studies, 276 participants, mean difference (MD) -2.42, 95% confidence interval (CI) -4.55 to -0.28), but the minimal important difference (MID) (8.7) was unmet. There were fewer flares with moisturisers (two studies, 87 participants, RR 0.40, 95% CI 0.23 to 0.70), time to flare was prolonged (median: 180 versus 30 days), and less topical corticosteroids were needed (two studies, 222 participants, MD -9.30 g, 95% CI -15.3 to -3.27). There was no statistically significant difference in adverse events

  19. Hand eczema in hairdressers: a Danish register-based study of the prevalence of hand eczema and its career consequences

    DEFF Research Database (Denmark)

    Lysdal, Susan Hovmand; Søsted, Heidi; Andersen, Klaus Ejner

    2011-01-01

    Occupational hand eczema is common in hairdressers, owing to wet work and hairdressing chemicals.......Occupational hand eczema is common in hairdressers, owing to wet work and hairdressing chemicals....

  20. Clinical Characteristics and Treatment of Extremity Chronic Osteomyelitis in Southern China: A Retrospective Analysis of 394 Consecutive Patients.

    Science.gov (United States)

    Jiang, Nan; Ma, Yun-Fei; Jiang, Yi; Zhao, Xing-Qi; Xie, Guo-Ping; Hu, Yan-Jun; Qin, Cheng-He; Yu, Bin

    2015-10-01

    Although extremity chronic osteomyelitis is common in China, updated data were still limited regarding its characterizations. The present study aimed to review clinical features of extremity chronic osteomyelitis in Southern China.A retrospective analysis was conducted in the patients who had sought medical attention from January 2010 to April 2015 for extremity chronic osteomyelitis in Nanfang Hospital in Southern China. Clinical data were collected and analyzed.A total of 394 patients (307 males and 87 females) were included, giving a gender ratio of 3.53. The median age at first diagnosis was 42 years for all. The most frequent type was traumatic osteomyelitis (262 cases, 66.50%), which was mainly caused by open injury (166 cases, 63.36%) and during a road accident (91 cases, 34.73%). Single-site infection accounted for 81.98% (323 cases), with tibia (126 cases), femur (79 cases), calcaneus (37 cases), and toes (37 cases) as the top sites. The positive rate of intraoperative culture was 70.63% (214/303), 78.97% (169/214) of which was monomicrobial infection. Staphylococcus aureus (59 cases) was the most frequent bacteria for monomicrobial infection, followed by Pseudomonas aeruginosa (29 cases) and Escherichia coli (11 cases). The positive ratios of preoperative serum white blood cell (WBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), procalcitonin (PCT), interleukin-6 (IL-6), and tumor necrosis factor alpha (TNF-α) were 21.63%, 64.92%, 53.27%, 42.25%, 72.82%, and 66.67%, respectively. The most frequently used intravenous antibiotic was cephalosporins. The overall cure rate was 77.74%, with a total amputation rate of 16.75%.In this representative Chinese cohort, extremity chronic osteomyelitis was mostly caused by open injury and during a road accident, predominated in males and favored the tibia. S. aureus was the most frequent pathogenic organism. Preoperative elevated levels of serum IL-6, TNF-α, and ESR may be helpful diagnostic

  1. The significance of allergen detection for eczema, allergic rhinitis and asthma patients%过敏原检测对湿疹、过敏性鼻炎和哮喘患者的意义

    Institute of Scientific and Technical Information of China (English)

    尧荣凤; 姜培红; 许国祥; 徐龙; 李智; 薛龙; 赵迪

    2015-01-01

    Objective To understand allergen IgE antibody distribution for different allergic diseases, in order to provide the reference for clinical prevention and treatment.Methods A total of 236 patients with allergic rhinitis, 250 patients with asthma and 275 patients with eczema were enrolled.Western blot was performed to detect the serological specific allergen IgE antibody.The allergens for allergic rhinitis, asthma and eczema were analyzed comparatively. Results The inhaled allergen detection rate was 41.66% in the 761 patients, and the ingested allergen detection rate was 8.28%.Dust mite(43.10%) was the most common allergen, and dog hair (12.22%),milk(11.43%) and house dust(10.78%) were the other 3 common allergens.The prevalence rates of dust mite(62.35%), dog hair(21.11%), house dust(18.89%) and milk (26.47%) in 11-30 years old group were higher than those in the other age groups (P 0.05).Conclusions Serum allergen detection might be conducive to identify the allergic status of patients, and provides a reliable reference to assist in the diagnosis of allergic diseases, prevent from environmental factors and make treatment plan.%目的:了解过敏原 IgE 抗体在不同过敏性疾病中的分布情况,为临床防治提供依据。方法采用免疫印迹法检测过敏性鼻炎(236例)、哮喘(250例)和湿疹(275例)患者血清过敏原特异性 IgE 抗体,同时对过敏性鼻炎、哮喘和湿疹患者的过敏原进行比较分析。结果761例患者吸入性过敏原检出率为41.66%,食入性过敏原检出率为8.28%;最常见的过敏原为户尘螨(43.10%)、狗毛皮屑(12.22%)、牛奶(11.43%)和屋尘(10.78%)。11~30岁组的户尘螨(62.35%)、狗毛皮屑(21.11%)、屋尘(18.89%)和牛奶(26.47%)阳性率明显高于其他年龄组(P <0.05)。湿疹患者蟑螂、牛奶和点青霉/分枝孢霉/烟曲霉/黑曲霉/交链孢霉的阳

  2. Surgery for ovarian masses in infants, children, and adolescents: 102 consecutive patients treated in a 15-year period.

    Science.gov (United States)

    Cass, D L; Hawkins, E; Brandt, M L; Chintagumpala, M; Bloss, R S; Milewicz, A L; Minifee, P K; Wesson, D E; Nuchtern, J G

    2001-05-01

    Ovarian pathology, although rare in children, must be included in the differential diagnosis of all girls who present with abdominal pain, an abdominal mass, or precocious puberty. To improve clinical appreciation of these lesions, the authors reviewed the presentation, evaluation, and outcome of all patients with ovarian pathology surgically treated at their institution since 1985. One hundred two girls (aged 9.8 +/- 5.5 years; range, 2 days to 20 years) underwent 106 separate ovarian operations (43 salpingo-oophorectomies, 21 oophorectomies, 33 ovarian cystectomies, and 9 ovarian biopsies). Of those presenting with acute abdominal pain (n = 59), 25 (42%) had ovarian torsion (14 associated with a mature teratoma), and only 1 (2%) had a malignant tumor. In contrast, of those presenting with an abdominal mass (n = 23), 6 (26%) had malignancies. There was no age difference between those with benign disease (9.9 +/- 5.6 years; n = 96) and those with malignant tumors (8.6 +/- 3.9 years, n = 10). Nine children had 10 operations for presumed malignant tumors (3 dysgerminomas, 2 immature teratomas with foci of yolk sac tumor, 2 juvenile granulosa cell tumors, 1 yolk sac tumor, and 1 Sertoli-Leydig cell tumor). These patients all had unilateral salpingo-oophorectomy, 4 had chemotherapy, and all are now disease free at 8.4 +/- 4.1 years follow-up. Ovarian pathology remains a rare indication for surgery in girls less than 20 years of age. Because most of these lesions are benign, ovarian-preserving operations should be performed whenever feasible. Copyright 2001 by W.B. Saunders Company.

  3. Registro Absorb Italiano (BVS-RAI): an investigators-owned and -directed, open, prospective registry of consecutive patients treated with the Absorb™ BVS: study design.

    Science.gov (United States)

    Cortese, Bernardo; Ielasi, Alfonso; Varricchio, Attilio; Tarantini, Giuseppe; LaVecchia, Luigi; Pisano, Francesco; Facchin, Michela; Gistri, Roberto; D'Urbano, Maurizio; Lucci, Valerio; Loi, Bruno; Tumminello, Gabriele; Colombo, Alessandro; Limbruno, Ugo; Nicolino, Annamaria; Calzolari, Diego; Tognoni, Gianni; Defilippi, Gianfranco; Buccheri, Dario; Tespili, Maurizio; Corrado, Donatella; Steffenino, Giuseppe

    2015-09-01

    The Absorb™ BVS is a bioresorbable, everolimus-eluting scaffold approved and marketed for coronary use. Published data on long-term results after treatment are limited to a small number of patients, most of them with elective PCI of simple lesions. The importance of scaffold resorption is variably appreciated among cardiologists, and indications for use from health technology assessment bodies or guidelines are missing. Instruments are needed to collect, share and assess the experience being accumulated with this new device in several centres. The BVS-RAI Registry is a spontaneous initiative of a group of Italian interventional cardiologists in cooperation with Centro di Ricerche Farmacologiche e Biomediche "Mario Negri" Institute, and is not recipient of funding or benefits originating from the BVS manufacturer. It is a prospective registry with 5-year follow-up of all consecutive patients who have undergone successful implantation of 1 or more coronary BVS following the indications, techniques and protocols used in each of the participating institutions. Outcome measures are BVS target lesion failure within one year and device-oriented major adverse cardiac events within 5years. The registry started in October 2012 and will extend enrolment throughout 2015, with the aim to include about 1000 patients. ClinicalTrials.gov identifier is CT02298413. The BVS-RAI Registry will contribute observational knowledge on the long-term safety and efficacy of the Absorb™ BVS as used in a number of Italian interventional centres in a broad spectrum of settings. Unrewarded and undirected consecutive patient enrolments are key-features of this observation, which is therefore likely to reflect common clinical practice in those centres. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Registro Absorb Italiano (BVS-RAI): an investigators-owned and -directed, open, prospective registry of consecutive patients treated with the Absorb™ BVS: study design

    Energy Technology Data Exchange (ETDEWEB)

    Cortese, Bernardo, E-mail: bcortese@gmail.com [Azienda Ospedaliera Fatebenefratelli e Oftalmico, Milano (Italy); Ielasi, Alfonso [Azienda Ospedaliera Bolognini, Seriate (Italy); Varricchio, Attilio [Ospedale Monaldi, Napoli (Italy); Tarantini, Giuseppe [Azienda Ospedaliera Universitaria, Padova (Italy); LaVecchia, Luigi [Azienda Ospedaliera San Bortolo, Vicenza (Italy); Pisano, Francesco [Ospedale Regionale, Aosta (Italy); Facchin, Michela [Ospedale di Este (Italy); Gistri, Roberto [Ospedale S. Andrea, La Spezia (Italy); D’Urbano, Maurizio [Ospedale di Magenta (Italy); Lucci, Valerio [Ospedale di Avezzano (Italy); Loi, Bruno [Azienda Ospedaliera Brotzu, Cagliari (Italy); Tumminello, Gabriele [Ospedale Cardinal Massaia, Asti (Italy); Colombo, Alessandro [Ospedale Sacco, Milano (Italy); Limbruno, Ugo [Ospedale della Misericordia, Grosseto (Italy); Nicolino, Annamaria [Ospedale Santa Corona, Pietra Ligure (Italy); Calzolari, Diego [Azienda Ospedaliera Ca Foncello, Treviso (Italy); Tognoni, Gianni [Centro di Ricerche Farmacologiche e Biomediche ' Mario Negri' , Milano (Italy); Defilippi, Gianfranco [Ospedale Cardinal Massaia, Asti (Italy); Buccheri, Dario [Azienda Ospedaliera Fatebenefratelli e Oftalmico, Milano (Italy); Tespili, Maurizio [Azienda Ospedaliera Bolognini, Seriate (Italy); and others

    2015-09-15

    Background: The Absorb™ BVS is a bioresorbable, everolimus-eluting scaffold approved and marketed for coronary use. Published data on long-term results after treatment are limited to a small number of patients, most of them with elective PCI of simple lesions. The importance of scaffold resorption is variably appreciated among cardiologists, and indications for use from health technology assessment bodies or guidelines are missing. Instruments are needed to collect, share and assess the experience being accumulated with this new device in several centres. Methods/Design: The BVS-RAI Registry is a spontaneous initiative of a group of Italian interventional cardiologists in cooperation with Centro di Ricerche Farmacologiche e Biomediche 'Mario Negri' Institute, and is not recipient of funding or benefits originating from the BVS manufacturer. It is a prospective registry with 5-year follow-up of all consecutive patients who have undergone successful implantation of 1 or more coronary BVS following the indications, techniques and protocols used in each of the participating institutions. Outcome measures are BVS target lesion failure within one year and device-oriented major adverse cardiac events within 5 years. The registry started in October 2012 and will extend enrolment throughout 2015, with the aim to include about 1000 patients. ClinicalTrials.gov identifier is CT02298413. Conclusions: The BVS-RAI Registry will contribute observational knowledge on the long-term safety and efficacy of the Absorb™ BVS as used in a number of Italian interventional centres in a broad spectrum of settings. Unrewarded and undirected consecutive patient enrolments are key-features of this observation, which is therefore likely to reflect common clinical practice in those centres. - Highlights: • prospective data collection of successful Absorb implantation; • expert Italian centers; • no restrictions for enrollment/no exclusion criteria; • clinical follow up;

  5. Surgical treatment of "chin-on-pubis" deformity in a patient with ankylosing spondylitis: a case report of consecutive cervical, thoracic, and lumbar corrective osteotomies.

    Science.gov (United States)

    Kim, Ki-Tack; Lee, Sang-Hun; Son, Eun-Seok; Kwack, Yoon-Ho; Chun, Young-Soo; Lee, Jae-Hoon

    2012-07-15

    A case report. To report the successful consecutive spinal osteotomies of multiple segments performed on a patient with extremely severe kyphotic deformity. There have been no reports on the experience and surgical strategy of spinal osteotomy on multiple segments for severe global spine deformity. A 48-year-old man, a patient with ankylosing spondylitis with "chin-on-pubis" deformity, underwent consecutive spinal osteotomies to correct the severe, fixed global kyphosis. The axial skeletons from the skull, all vertebrae, and both sacroiliac joints and hip joint were fused into a single bone. After both hip resectional arthroplasties for the first step, staged, sequential spinal osteotomies, including pedicle subtraction osteotomy (PSO) on C6, posterior vertebral column resection on T11-T12, and PSO on L3, were performed. Finally, both total hip arthoroplasties were performed. The chin-brow vertical angle improved from 140° to 15°. Correction angles of 45°, 70°, and 30° in the cervical, thoracic, and lumbar spines, respectively, were achieved without complication. At the last follow-up, excellent improvement in activities of daily living and horizontal gaze were achieved. This is the first report on C6 PSO and spinal osteotomies in whole spine segments. For patients with a severe global kyphotic deformity, it is important to place the patient in a stable prone position so that corrective surgery can be performed on the thoracolumbar spine. To accomplish this, initially correcting the deformities in the hip joints and the cervical spine can yield excellent clinical results.

  6. Effect of 3 M painless protective film for the skin on crissum eczema in patients with fecal incontinence%3M无痛皮肤保护膜预防大便失禁患者肛周湿疹的效果

    Institute of Scientific and Technical Information of China (English)

    曾龙英

    2011-01-01

    Objective To discuss the effective precaution against crissum eczema caused by fecal incontinence in patients of neurology department.Methods 78 patients with fecal incontinence in the neurology department were randomly divided into two groups (39 in each).The control group was given borage oil to protect crissum skin,while the experimental group was given 3 M painless protective film for the skin.The status of crissum eczema in both groups was documented.Results The incidence of crissum eczema of the experimental group was lower than the control group (7.69% vs 41.00% ),the difference was statistically significant ( x2 =11.76,P < 0.01 ).The degree of crissum eczema of the experimental group was also significantly lower than the control group (Z =3.42,P < 0.01 ).Conclusions 3 M painless protective film for the skin can effectively prevent crissum eczema.%目的 探讨神经内科大便失禁患者肛周湿疹有效的预防措施.方法 将78例神经内科大便失禁患者随机分为实验组和对照组各39例,对照组行常规使用紫草油保护肛周皮肤,实验组预防性使用3M无痛皮肤保护膜喷洒局部皮肤,观察两组肛周湿疹的发生情况.结果 实验组肛周湿疹发生数较对照组减少(7.69%比41.00%),差异有统计学意(x2=11.76,P<0.0l);实验组肛周湿疹发生程度明显轻于对照组,差异有统计学意义(Z=3.42,P<0.01).结论 3M无痛皮肤保护膜能有效预防肛周湿疹发生.

  7. An observation of the characteristics of allergens and curative effect for patients with chronic intractable eczema in Zhaoqing%肇庆地区慢性顽固性湿疹患者的过敏原特征及疗效观察

    Institute of Scientific and Technical Information of China (English)

    帅春海; 陈洁华

    2014-01-01

    Objective To explore the relations between various allergens in nature and the morbidity of chronic eczema so as to provide guidance for prevention and treatment for the patients, and carry out a statistical assessment towards the curative effect after the treatment. Methods Allergens of 274 patients with chronic eczema were tested via BIotray866 Auto Blot Processor produced in Shenzhen Rayto Life and Analytical Sciences Co.,Ltd. The curative effect was observed after desensitization treatment. 125 patients with chronic eczema were selected as a control group, and received regular treatment for eczema instead of the desensitization treatment. Results Positive rate of allergens in 274 patients with chronic eczema reached up to 79.56%(218 patients); among the allergens for patients with positive results, the positive rate of dermatophagoides farina ranked the first with 46 patients, and other allergens were seafood, cow's milk and sheep's milk. Some patients were allergic to multiple allergens. The patients received desensitization treatment and kept away from the allergens, and only 28 patients(12.84%) relapsed in a 1-year follow-up, showing a significantly curative effect compared with 72 relapsed patients(57.6%) in the control group. Conclusion For patients with chronic intractable eczema, causes of disease should be actively traced during diagnosis and treatment, and related allergens should be avoided during their daily life. In such way, diseases can be effectively treated and prevented, and relapse rate can be significantly reduced.%目的:探讨自然界各种过敏原与慢性湿疹患者发病的关系,为患者的预防和治疗提供指导依据,并对治疗后的效果进行统计学评价。方法采用深圳雷杜BIotray866全自动过敏原分析仪器对274例慢性湿疹患者进行过敏原的检测,在脱敏治疗后观察疗效,同时设立125例对照湿疹患者,不进行脱敏治疗只进行常规湿疹治疗。结果274例慢性

  8. 900例湿疹及荨麻疹患者血清食物过敏原特异性IgG检测的临床意义%Clinical significance of detecting food allergic specific IgG in serum of patients with eczema and chronic urticaria

    Institute of Scientific and Technical Information of China (English)

    谭丽娜; 张桂英; 颜兰香; 王盛; 陆前进

    2010-01-01

    Objective To investigate the levels of 14 kinds of food allergic specific IgG antibody in eczema and chronic urticaria patients'serum and the role of food allergens in allergic skin diseases and provide scientific basis for clinical treatment and prophylaxis. Methods We used ELISA method to detect the concentration of 14 kinds of food allergic specific IgG antibody in the serum of 900 eczema and chronic urticaria patients and 18 healthy people. Results The food allergen of positive rate in studied group and control group was 90.2% and 11.1%. The positive rate of 14 kinds of food allergic specific IgG antibody in 900 eczema and chronic urticaria patients' serum from high to low was eggs, wheat, shrimp, milk, soja,crab, rice, corn, tomato, chicken, mushroom, beef, pork and ling. The food allergen positive rate in eczema and chronic urticaria patients'serum was 91.9% and 88. 9% ( P >0. 05). The positive rate of shrimp,mushroom and ling in eczema patients'serum was higher than that in chronic urticaria patients'serum ( P 0. 05 ). The main allergens were egg, wheat and milk in children's group. The sensitization of crab and shrimp increased as people grew up. In 812 positive patients, who were intolerant of three and more than three foods accounted for 53.7%. In 175 follow-up patients, the effective rate was 50.9% in 20 days and 61.1% in 60 days after they avoided the intolerant food. The patients'diet was adjusted according to the test results.In 325 follow-up patients, the effective rate in eczema group was 59.9% in 20 days and 70. 4% in 60 days ( P 0.05).湿疹患者中虾、蘑菇和鳕鱼的阳性率明显高于慢性荨麻疹患者(P0.05).少儿组以鸡蛋、小麦和牛奶为主要过敏原,随着年龄的增长,虾、蟹的致敏性逐渐增高;(3)食物过敏原检测阳性的812例患者中,3种以上食物过敏原阳性的患者占53.7%,随访了其中175例患者,避免接触不耐受食物20 d和60 d后,有效率分别为50.9%和61.1%;(4)根据检测结

  9. A survey of occupational hand eczema in Denmark

    DEFF Research Database (Denmark)

    Skoet, Rikke; Olsen, Jorn; Mathiesen, Bent

    2004-01-01

    dermatitis (ICD), mainly caused by wet occupations. The proportion of occupational ICD was equal for males and females, 59.7% and 63.1%, respectively. The estimated rates of OHE were high for bakers, hairdressers and dental surgery assistants, and a high proportion of apprentices were found among...... hairdressers. The prevalence of atopic dermatitis was low (16.4%) compared to previous studies among hand eczema patients. The prevalence of occupational allergic contact dermatitis in the study population was substantially higher among males than females, and the most frequent causes among males were allergy...

  10. The importance of emollients in treating the increasing incidence of atopic eczema.

    Science.gov (United States)

    Kownacki, Stephen

    Atopic eczema affects 15-20% of schoolchildren and 2-10% of adults. Its incidence has increased significantly in recent years for reasons not fully understood. Environmental factors--such as exposure to soaps, hard water and allergens such as house dust mites--are thought to be important. Genetic factors are also thought to play a part. The key to managing eczema is an effective skin-care routine using emollients to increase hydration of the stratum corneum. Emollients come in a variety of formulations, and continual therapy using these in combination maximises their beneficial effects. Patient education is important, as it enhances concordance with treatment.

  11. Portal vein embolization with n-butyl-cyanoacrylate through an ipsilateral approach before major hepatectomy: single center analysis of 50 consecutive patients.

    Science.gov (United States)

    Luz, José Hugo Mendes; Luz, Paula Mendes; Bilhim, Tiago; Martin, Henrique Salas; Gouveia, Hugo Rodrigues; Coimbra, Élia; Gomes, Filipe Veloso; Souza, Roberto Romulo; Faria, Igor Murad; de Miranda, Tiago Nepomuceno

    2017-09-20

    To evaluate the efficacy of portal vein embolization (PVE) with n-Butyl-cyanoacrylate (NBCA) through an ipsilateral approach before major hepatectomy. Secondary end-points were PVE safety, liver resection and patient outcome. Over a 5-year period 50 non-cirrhotic consecutive patients were included with primary or secondary liver cancer treatable by hepatectomy with a liver remnant (FLR) volume less than 25% or less than 40% in diseased livers. There were 37 men and 13 women with a mean age of 57 years. Colorectal liver metastases were the most frequent tumor and patients were previously exposed to chemotherapy. FLR increased from 422 ml to 629 ml (P < 0.001) after PVE, corresponding to anincrease of 52%. The FLR ratio increased from 29.6% to 42.3% (P < 0.001). Kinetic growth rate was 2.98%/week. A negative association was observed between increase in the FLR and FLR ratio and FLR volume before PVE (P = 0.002). In 31 patients hepatectomy was accomplished and only one patient presented with liver insufficiency within 30 days after surgery. PVE with NBCA through an ipsilateral puncture is effective before major hepatectomy. Meticulous attention is needed especially near the end of the embolization procedure to avoid complications. Clinical Study ISRCTN registration number: ISRCTN39855523 . Registered March 13th 2017.

  12. Maternal factor V Leiden and prothrombin mutations do not seem to contribute to the occurrence of two or more than two consecutive miscarriages in Caucasian patients.

    Science.gov (United States)

    Baumann, Kristin; Beuter-Winkler, Petra; Hackethal, Andreas; Strowitzki, Thomas; Toth, Bettina; Bohlmann, Michael K

    2013-12-01

    We analysed the prevalence of the most common hereditary thrombophilia (hTP) - factor V Leiden (FVL) mutation, prothrombin 20210 G>A substitution (PT) - and the 677 C>T replacement in the 5,10-methylenetetrahydrofolate reductase (MTHFR) gene in Caucasian patients with a history of two and more consecutive recurrent miscarriages (RMs) as compared to healthy controls with an identical ethnic background and at least one live birth. A multicenter analysis of three hTP was performed in 641 RM patients identically screened at specialized university centres. The study groups consisted of 240 patients with 2 (1) and 401 patients with >2 miscarriages (2) and were compared with 157 controls. There was no significant difference in the prevalence of the hTP between RM patients and controls nor within the two study groups. Subgroup analysis showed that the homozygous MTHFR polymorphism was significantly more prevalent in the study group 2 as compared to study group 1 (13.9 versus 7.9%, P = 0.02). In Caucasians, maternal FVL or PT mutations do not seem to contribute to the pathophysiology of RM, irrespective of the number of miscarriages. However, the role of the homozygous MTHFR polymorphism merits further investigation. © 2013 John Wiley & Sons Ltd.

  13. The prevalence of skeletal Class II patients found in a consecutive population presenting for TMD treatment compared to the national average.

    Science.gov (United States)

    Simmons, H Clifton; Oxford, D Eric; Hill, Matthew D

    2008-01-01

    Fifty-six consecutive patients in a referral-based practice seeking treatment for a complex chronic painful temporomandibular disorder (TMD) were enrolled in a retrospective study to evaluate the skeletal relationship of patients with TMD compared to the distribution of skeletal patterns found in the average population. During the standard clinical workup, lateral cephalometric radiographs were performed. Using Wits appraisal all of the fifty-six (56) cephalometric radiographs were analyzed. Based on the results of the Wits analysis, 34.6 percent of the patients were skeletal Class I, 63.6 percent were skeletal Class II, and 1.8 percent were skeletal Class III. These results were compared with the data published by the National Health and Nutrition Examination Survey (NHANES) in Proffit's text Contemporary Orthodontics. This study states that in the general population occlusal diversity is eighty to eighty-five percent (80-85%) skeletal Class I, fifteen percent (15%) are skeletal Class II, and one percent (1%) are skeletal Class III. The conclusion can be drawn that the patient sampling analyzed shows that TMD patients have a higher prevalence for skeletal Class II than the general population.

  14. Patch testing with markers of fragrance contact allergy. Do clinical tests correspond to patients' self-reported problems?

    DEFF Research Database (Denmark)

    Johansen, J D; Andersen, T F; Veien, Niels

    1997-01-01

    The aim of the present study was to investigate the relationship between patients' own recognition of skin problems using consumer products and the results of patch testing with markers of fragrance sensitization. Eight hundred and eighty-four consecutive eczema patients, 18-69 years of age, fill...... of Peru balsam in detecting relevant fragrance contact allergy is limited, while most fragrance mix-positive patients are aware that the use of scented products may cause skin problems....

  15. CT-guided percutaneous lung biopsy: Comparison of conventional CT fluoroscopy to CT fluoroscopy with electromagnetic navigation system in 60 consecutive patients

    Energy Technology Data Exchange (ETDEWEB)

    Grand, David Justin, E-mail: dgrand@lifespan.org [Department of Diagnostic Imaging, Warren Alpert School of Medicine, Brown University, Providence, RI 02903 (United States); Atalay, Michael A., E-mail: matalay@lifespan.org [Department of Diagnostic Imaging, Warren Alpert School of Medicine, Brown University, Providence, RI 02903 (United States); Cronan, John J., E-mail: cronan@lifespan.org [Department of Diagnostic Imaging, Warren Alpert School of Medicine, Brown University, Providence, RI 02903 (United States); Mayo-Smith, William W., E-mail: wmayo-smith@lifespan.org [Department of Diagnostic Imaging, Warren Alpert School of Medicine, Brown University, Providence, RI 02903 (United States); Dupuy, Damian E., E-mail: ddupuy@lifespan.org [Department of Diagnostic Imaging, Warren Alpert School of Medicine, Brown University, Providence, RI 02903 (United States)

    2011-08-15

    Purpose: To determine if use of an electromagnetic navigation system (EMN) decreases radiation dose and procedure time of CT fluoroscopy guided lung biopsy in lesions smaller than 2.5 cm. Materials/methods: 86 consecutive patients with small lung masses (<2.5 cm) were approached. 60 consented and were randomized to undergo biopsy with CT fluoroscopy (CTF) (34 patients) or EMN (26 patients). Technical failure required conversion to CTF in 8/26 EMN patients; 18 patients completed biopsy with EMN. Numerous biopsy parameters were compared as described below. Results: Average fluoroscopy time using CTF was 28.2 s compared to 35.0 s for EMN (p = 0.1). Average radiation dose was 117 mGy using CTF and 123 mGy for EMN (p = 0.7). Average number of needle repositions was 3.7 for CTF and 4.4 for EMN (p = 0.4). Average procedure time was 15 min for CTF and 20 min for EMN (p = 0.01). There were 7 pneumothoracesin the CTF group and 6 pneumothoraces in the EMN group (p = 0.7). One pneumothorax in the CTF group and 3 pneumothoraces in the EMN group required chest tube placement (p = 0.1). One pneumothorax patient in each group required hospital admission. Diagnostic specimens were obtained in 31/34 patients in the CTF group and 22/26 patients in the EMN group (p = 0.4). Conclusions: EMN was not statistically different than CTF for fluoroscopy time, radiation dose, number of needle repositions, incidence of pneumothorax, need for chest tube, or diagnostic yield. Procedure time was increased with EMN.

  16. Risk profile of patients developing nonunion of the clavicle and outcome of treatment-analysis of fifty five nonunions in seven hundred and twenty nine consecutive fractures

    DEFF Research Database (Denmark)

    Ban, Ilija; Troelsen, Anders

    2016-01-01

    PURPOSE: The most common complication following treatment of a clavicle fracture is nonunion. Most nonunions are symptomatic and treatment is mostly operative. The aim of this study was to describe risk profiles of patients developing nonunion and what outcome is observed following operative...... treatment of clavicle nonunions. METHODS: In a consecutive series of 729 clavicle fractures we retrospectively identified 55 that developed nonunion (49 diaphysial and six lateral). All were treated operatively by reconstruction with (n = 28) or without (n = 27) autologous bone graft. Assessment...... was anatomic site, fracture complexity, female gender, smoking habits and initial treatment. A total of eight post-operative complications were found. Remission of symptoms was reported by 29 of the 33. Outright satisfaction with current shoulder condition was reported by 24. The overall median DASH was 8...

  17. Systematic Analysis of Th Cell Related Cytokine Levels and Pathological Characteristics of Elderly Patients with Eczema%Th细胞相关细胞因子水平与老年湿疹患者病理特征的系统分析

    Institute of Scientific and Technical Information of China (English)

    石志坚

    2016-01-01

    Objective To observe the expression of helper T cell 1 ( Th1) ,helper T cell 2 ( Th2) and helper T cell 17 ( Th17) in serum of elderly patients with eczema,and to explore the correlation between serum cytokine levels and patho-logical characteristics of eczema. Methods The clinical data of 60 elderly patients diagnosed with eczema in our depart-ment between June 2013 and September 2015 were collected and 40 cases of healthy persons were selected as control group. The expression levels of serum Th cell related cytokines[ interferon-γ( INF-γ) ,interleukin-4 ( IL-4) ,interleukin-17A ( IL-17A)] were detected by enzyme linked immunosorbent assay (ELISA).The differences of Th cell related cytokines in acute and chronic,or generalized and localized eczema were compared. Results The levels of serum IFN-γ,IL-4 and IL-17A in elderly patients with eczema were significantly higher than those in the healthy control group ( t=10.570,10. 874,14.611;all P<0.001).The levels of serum IFN-γ,IL-4 and IL-17A in elderly patients with acute eczema were significantly higher than those in patients with chronic eczema ( t=3.787,3.815,5.338,all P<0.001);The levels of serum IFN-γ,IL-4 and IL-17A in patients with generalized eczema were significantly higher than those in patients with localized eczema ( t=2.458,2. 139,3.019;all P<0.05). Conclusion Serum IFN-γ,IL-4 and IL-17A are involved in the progression and prognosis of eczema,and the different expression of Th cytokines can be used as indicators for reflecting clinical types.%目的:观察辅助性T细胞1( Th1)、辅助性T细胞2( Th2)、辅助性T细胞17( Th17)在老年湿疹患者血清中的表达,探讨血清细胞因子水平与湿疹的病理特征的相关性。方法收集在本科确诊为老年湿疹患者60例的临床资料,并选取健康对照组40例。采用酶联免疫吸附法( ELISA)检测血清中Th的特征细胞因子γ-干扰素( INF-γ)、白介素-4( IL-4)及白介素-17A( IL-17A)的表达水平,分别

  18. Disulfiram and low nickel diet in the management of hand eczema: A clinical study

    Directory of Open Access Journals (Sweden)

    Sharma Ashimav

    2006-01-01

    Full Text Available Background: Hand eczema due to nickel sensitivity is a challenging task for the dermatologist. The average human diet provides sufficient amount of nickel, which acts as a provocating factor in nickel-sensitive individuals. When such patients are treated with steroid or other immunosuppressives, only short-term remission is obtained. This is because unless the dietary intake of nickel is minimized and the existing amount of nickel in the body of the sensitized individual is depleted, long-term remission is unlikely. Aim: To evaluate the efficacy of oral disulfiram, a nickel-chelating agent and low nickel diet (LND in reducing the clinical symptoms and preventing frequent relapse of hand eczema in nickel-sensitive individuals. Methods: A total of 21 patients with chronic vesicular hand eczema with nickel sensitivity were taken for this study. Patients were randomly divided into two groups: (a Study group consisting of 11 patients (8 females and 3 males. They were prescribed disulfiram orally for a period of 4 weeks; they started LND 2 weeks prior to initiation of disulfiram therapy and continued till the end of follow-up period. (b Control (placebo group consisting of 10 patients (7 females and 3 males. They were allowed to continue with normal diet. Each of them received lactose tablet daily as placebo for 4 weeks. It was a comparative study and participants were not aware if they belonged to study group or control group (single blind trial. Results: Hand eczema healed completely in 10 (90.9% out of 11 patients treated with disulfiram and LND during the treatment period in the study group, compared with 1 out 10 patients in control (placebo group (non significant. Mild relapse was noted in 5 patients in between 2-12 weeks of follow-up period. Conclusion: Low nickel diet and short course of oral disulfiram therapy can be considered a good option for the control of chronic hand eczema in nickel-sensitive individuals.

  19. The Effect of Modified Weiling Decoction (加减胃苓汤) in Treating 120 Chronic Hand Eczema

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@  From February 1995 to March 1999, compared by 108 patients treated by western medicine, 120 patients suffering from chronic eczema on their hands have been treated by the authors with modified Weiling Decoction (WLD) and the therapeutical effects observed. The results are reported as follows. METHODS Clinical Data   All the patients who suffered from eczema on hands were outpatients and were tested by local squamous fungus culture before treatment, with the results negative, and conformed to the diagnostic standards of eczema in “Clinical Dermatology”(2nd edition, Nanjing, Jiangsu Science and Technology Press. 1999∶512-515). The patients were divided into the treated group and the control group. There were 120 patients in the treated group, 56 males and 64 females, their age ranging from 24 to 64 years, mean age 44 years; the illness course were 1-12 years, mean course 6.5 years, 35 of the patients were accompanied with eczema on other parts of the body or nail change. At the same time there were 108 patients in the control group, 46 males and 62 females; their age ranging from 18 to 56 years, mean age 37 years; the illness course ranging from 3 to 10 years , mean course 6.5 years, 38 of the cases were accompanied with eczema on other parts of the body or with nail change. Statistical analysis indicated that the two groups were comparable.

  20. Incidence and risk factors of synchronous colorectal cancer in patients with esophageal cancer: an analysis of 480 consecutive colonoscopies before surgery.

    Science.gov (United States)

    Yoshida, Naoya; Tamaoki, Yuka; Baba, Yoshifumi; Sakamoto, Yasuo; Miyamoto, Yuji; Iwatsuki, Masaaki; Shono, Takashi; Miyamoto, Hideaki; Imuta, Masanori; Kurashige, Junji; Sawayama, Hiroshi; Tokunaga, Ryuma; Watanabe, Masayuki; Sasaki, Yutaka; Yamashita, Yasuyuki; Baba, Hideo

    2016-12-01

    The precise incidence rates of multiple primary colorectal cancers in esophageal cancer patients are unknown. In total, 480 consecutive patients with esophageal cancers surgically resected in the Kumamoto University Hospital received preoperative total colonoscopy for the assessment of colorectal disease between April 2005 and February 2016. We retrospectively investigated the occurrence of synchronous colorectal cancer with esophageal cancer. In addition, we examined the risk factors for the incidence of multiple primary colorectal cancers. Of the 480 patients, 14 (2.9 %) had synchronous colorectal cancers, 13 had well-differentiated tubular adenocarcinomas, and 1 had papillary adenocarcinoma. Other 14 patients had metachronous colorectal cancer. The current incidence rates of synchronous and total (both synchronous and metachronous) colorectal cancers outnumbered those in normal healthy population and those in esophageal cancer patients which previously reported by The Japan Esophageal Society. The age ≥70 years (hazard ratio 4.82, 95 % confidence interval 1.473-15.78; p = 0.009) and Brinkman index ≥800 (hazard ratio 3.47, 95 % confidence interval 1.056-11.37; p = 0.040) were the independent risk factors for the incidence of synchronous colorectal cancer. They were also the independent risk factors for the incidence of total colorectal cancer. The results of the present study suggested that pretreatment screening with total colonoscopy is meaningful for patients with esophageal cancer, because the frequency of synchronous colorectal cancer was not negligible. Particularly, in patients >70 years and with history of heavy smoking, pretreatment colonoscopy might be necessary.

  1. Process evaluation of an integrated, multidisciplinary intervention programme for hand eczema.

    NARCIS (Netherlands)

    Gils, R.F. van; Groenewoud, K.; Boot, C.R.L.; Rustemeyer, T.; Mechelen, W. van; Valk, P.G.M. van der; Anema, J.R.

    2012-01-01

    BACKGROUND. Over the last decade, few randomized controlled trials of high methodological quality have been carried out to evaluate the effectiveness of interventions for patients with hand eczema. Little to no attention has been paid to the feasibility of these interventions. This process evaluatio

  2. Response shift in severity assessment of hand eczema with visual analogue scales

    DEFF Research Database (Denmark)

    Mollerup, Annette; Johansen, Jeanne D

    2015-01-01

    BACKGROUND: Hand eczema is a common and fluctuating disease. Visual analogue scales (VASs) are used to assess disease severity, both currently and when at its worst. However, such patient-reported outcomes may be at risk of being flawed owing to recall bias or response shifts. OBJECTIVE: To explore...

  3. A cosmeceutical formulation based on boswellic acids for the treatment of erythematous eczema and psoriasis

    Science.gov (United States)

    Togni, Stefano; Maramaldi, Giada; Di Pierro, Francesco; Biondi, Massimo

    2014-01-01

    Background Boswellic acids (BAs) show anti-inflammatory properties in a variety of inflammatory diseases, including rheumatoid arthritis, osteoarthritis, and asthma. A topical administration route is currently used to deliver active compounds in psoriatic and eczematous patients. In this double-blind study we compare a novel BA formulation (containing Bosexil®, INCI [International Nomenclature of Cosmetic Ingredients]: lecithin, Boswellia serrata resin extract) with a placebo formulation. A third arm of the trial received a formulation of Vaccinium myrtillus seed oil, previously demonstrated as an effective local treatment for psoriatic lesions. Methods Patients with psoriasis or erythematous eczema were randomly assigned, in a 1:1:1 ratio, to Bosexil®, V. myrtillus seed oil, or placebo. In order to evaluate the effects of treatment, the changes of scales and erythema from diagnosis to the end of treatment were scored in psoriatic patients, while changes in itch and erythema were analyzed for erythematous eczema patients. Psoriasis Area Severity Index and Eczema Area and Severity Index scores were also calculated. Results In patients with psoriasis, scales and erythema improved both with Bosexil® and the V. myrtillus seed oil treatment in comparison with placebo. In particular, the treatment with Bosexil® formulation improved scales (70% of cases) and erythema (50% of cases) without any case of worsening. In patients with eczema, the administration of placebo did not result in any improvement in 90% of cases, and in the remaining 10% worsened both itch and erythema. Bosexil® formulation improved both itch (60% of cases) and erythema (60% of cases) without any case of worsening. V. myrtillus seed oil improved itch and erythema in 66.7% and 77.8% of patients, respectively. Conclusion A topical formulation of Bosexil® may be promising for the treatment of psoriasis and erythematous eczema. Long-term studies are recommended to evaluate the adherence to this

  4. Eczema Coxsackium Caused by Coxsackievirus A6

    DEFF Research Database (Denmark)

    Horsten, Hans-Henrik; Fisker, Niels; Bygum, Anette

    2016-01-01

    We present the first case of atypical hand, food, and mouth disease in our department with the distinct cutaneous morphology of eczema coxsackium. Clinicians should be aware of the possibility for more extensive cutaneous eruption related to coxsackievirus A6 infection and the diagnostic methods...

  5. Hand eczema and stratum corneum ceramides

    DEFF Research Database (Denmark)

    Jungersted, J. M.; Høgh, Julie Kaae; Hellgren, Lars

    2015-01-01

    Background: Hand eczema (HE) is a multifactorial disease, comprising different aetiological conditions and different morphologies. There are two aetiologically distinct groups of HE recognised: exogenous, such as contact dermatitis (allergic and/or irritant HE) and endogenous, such as the classic...

  6. Health care cost consequences of using robot technology for hysterectomy: a register-based study of consecutive patients during 2006-2013.

    Science.gov (United States)

    Laursen, Karin Rosenkilde; Hyldgård, Vibe Bolvig; Jensen, Pernille Tine; Søgaard, Rikke

    2017-07-10

    The objective of this study is to examine the costs attributable to robotic-assisted laparoscopic hysterectomy from a broad healthcare sector perspective in a register-based longitudinal study. The population in this study were 7670 consecutive women undergoing hysterectomy between January 2006 and August 2013 in public hospitals in Denmark. The interventions in the study were total and radical hysterectomy performed robotic-assisted laparoscopic hysterectomy (RALH), total laparoscopic hysterectomy (TLH), or open abdominal hysterectomy (OAH). Service use in the healthcare sector was evaluated 1 year before to 1 year after the surgery. Tariffs of the activity-based remuneration system and the diagnosis-related grouping case-mix system were used for valuation of primary and secondary care, respectively. Costs attributable to RALH were estimated using a difference-in-difference analytical approach and adjusted using multivariate linear regression. The main outcome measure was costs attributable to OAH, TLH, and RALH. For benign conditions RALH generated cost savings of € 2460 (95% CI 845; 4075) per patient compared to OAH and non-significant cost savings of € 1045 (95% CI -200; 2291) when compared with TLH. In cancer patients RALH generated cost savings of 3445 (95% CI 415; 6474) per patient when compared to OAH and increased costs of € 3345 (95% CI 2348; 4342) when compared to TLH. In cancer patients undergoing radical hysterectomy, RALH generated non-significant extra costs compared to OAH. Cost consequences were primarily due to differences in the use of inpatient service. There is a cost argument for using robot technology in patients with benign disease. In patients with malignant disease, the cost argument is dependent on comparator.

  7. Safety and efficacy of coronary stent implantation. Acute and six month outcomes of 1,126 consecutive patients treated in 1996 and 1997

    Directory of Open Access Journals (Sweden)

    Luiz Alberto Mattos

    1999-07-01

    Full Text Available PURPOSE: The authors analyzed the 30-day and 6-month outcomes of 1,126 consecutive patients who underwent coronary stent implantation in 1996 and 1997. METHODS: The 30-day results and 6-month angiographic follow-up were analyzed in patients treated with coronary stents in 1996 and 1997. All patients underwent coronary stenting with high-pressure implantation (>12 atm and antiplatelet drug regimen (aspirin plus ticlopidine. RESULTS: During the study period, 1,390 coronary stents were implanted in 1,200 vessels of 1,126 patients; 477 patients were treated in the year 1996 and 649 in 1997. The number of percutaneous procedures performed using stents increased significantly in 1997 compared to 1996 (64 % vs 48%, p=0.0001. The 30-day results were similar in both years; the success and stent thrombosis rates were equal (97% and 0.8%, respectively. The occurrence of new Q wave MI (1.3% vs 1.1%, 1996 vs 1997, p=NS, emergency coronary bypass surgery (1% vs 0.6%, 1996 vs 1997, p=NS and 30-day death rates (0.2% vs 0.5%, 1996 vs 1997, p=NS were similar. The 6-month restenosis rate was 25% in 1996 and 27% in 1997 (p= NS; the target vessel revascularization rate was 15% in 1996 and 16% in 1997 (p = NS. CONCLUSIONS: Intracoronary stenting showed a high success rate and a low incidence of 30-day occurrence of new major coronary events in both periods, despite the greater angiographic complexity of the patients treated with in 1997. These adverse variables did not have a negative influence at the 6-month clinical and angiographic follow-up, with similar rates of restenosis and ischemia-driven target lesion revascularization rates.

  8. An "all 5 mm ports" technique for laparoscopic day-case anti-reflux surgery: A consecutive case series of 205 patients.

    Science.gov (United States)

    Almond, L M; Charalampakis, V; Mistry, P; Hodson, J; Lafaurie, G; Matthews, J; Singhal, R; Super, P

    2016-11-01

    Laparoscopic anti-reflux surgery is conventionally performed using two 10/12 mm ports. While laparoscopic procedures reduce post-operative pain, the use of larger ports invariably increases discomfort and affects cosmesis. We describe a new all 5 mm ports technique for laparoscopic anti-reflux surgery and present a review of our initial experience with this approach. All patients undergoing laparoscopic fundoplication over a 35 month period from February 2013 under the care of a single surgeon were included. A Lind laparoscopic fundoplication was performed using an all 5 mm port technique. Data was recorded prospectively on patient demographics, operating surgeon, surgical time, date of discharge, readmissions, complications, need for re-intervention, and reasons for admission. Two hundred and five consecutive patients underwent laparoscopic fundoplication over the study period. The all 5 mm port technique was used in all cases, with conversion to a 12 mm port only once (0.49%). Median operating time was 52 min 185 (90.2%) patients were discharged as day cases. Increasing ASA grade and the presence of a hiatus hernia were associated with the need for overnight stay with admission required in 33% of patients with ASA 3, compared to 4% with ASA 1 (p = 0.001), and 29% of those with a hiatus hernia vs. 5% without (p effective technique which facilitates same day discharge and minimises port related complications. National commissioning guidelines in the UK should target quality improvements in anti-reflux surgery based around day-case management. This would improve the service for these patients and culminate in cost savings for the NHS. Copyright © 2016. Published by Elsevier Ltd.

  9. Detection of the value of consecutive serum total light chain (sTLC) in patients diagnosed with diffuse large B cell lymphoma.

    Science.gov (United States)

    Zhai, Linzhu; Zhao, Yuanyuan; Peng, Songguo; Zhu, Ke; Yu, Rongjian; Chen, Hailong; Lin, Tongyu; Lin, Lizhu

    2016-12-01

    There are limited data on serum total light chain (sTLC) in lymphoma and its relative role on the outcome of diffuse large B cell lymphoma (DLBCL) patients. Blood samples from 46 cases newly diagnosed with DLBCL were collected consecutively during chemotherapy to detect sTLC, IgG, IgA, and IgM levels. Clinical data and survival outcomes were analyzed according to the results of sTLC measurements. In summary, 22 patients (47.8 %) had abnormal k or λ light chain, respectively, and 6 patients (13.0 %) had both abnormal k and λ light chains before chemotherapy. Patients with elevated k light chain more frequently displayed multiple extra-nodal organ involvement (P = 0.01) and had an inferior overall survival (OS) (P = 0.041) and progression-free survival (PFS) (P = 0.044) compared to patients with normal level of k light chain. Furthermore, patients with elevated level of both k and λ also exhibited significant association with shorter OS (P = 0.002) and PFS (P = 0.009). Both elevated k alone and concurrent elevated k and λ had independent adverse effects on PFS (P = 0.031 and P = 0.019, respectively). sTLC level was reduced gradually by treatment in this study and reached the lowest point after the fourth cycle of chemotherapy, which was consistent with the disease behavior during chemotherapy. Considering the small sample size of this study, these results should be confirmed in a larger prospective study.

  10. Tolerance of Iloprost and results of treatment of chronic severe lower limb ischaemia in diabetic patients. A retrospective study of 64 consecutive cases.

    Science.gov (United States)

    Duthois, S; Cailleux, N; Benosman, B; Lévesque, H

    2003-02-01

    The aim of this study was to assess the tolerance and report obtained results with a stable prostacyclin analogue (iloprost) in diabetic patients with severe forms of permanent lower limb ischaemia. Sixty-four consecutive unselected patients, in stage III and IV of Leriche and Fontaine, turned down for vascular surgery after angiography and treated with iloprost during 28 days, were enrolled in this study. Patients were followed-up clinically (ischemic pain, trophic change, walking distance) and with transcutaneous oxymetry (D28). Long-term assessment (6 and 12 months) was expressed as rate of death, major amputation and of live patients with viable limbs and walking. There was no manifestation of intolerance to iloprost. Were considered as responders patients offering a lack or significant decrease in pain, a reduction of trophic lesions and improvement or recovery of walking. Response at two months is lasting: 29 responders (45.3%) and 35 non-responders (54.7%). At 6 months and one year, we observed that 8 (12.5%) and 15 (24.1%) patients respectively had died; 19 (29.6%) and 22 (34.3%) patients underwent major amputation, but 41 (64%) and 34 (53.1%) patients were still alive with their limb and conservative walking. In responder group, at 6 months, 28 (96.5%) patients were alive without amputation for only 13 (37.1%) among non-responders. At one year, 79.3% of the responders and 31.4% of the non-responders were alive without amputation. A total loss of walking, a segmental amputation and a previous amputation of opposite limb were more often noted in no responder group. But no predictive factor was referred to TcPO(2) in particular. Results ware similar in the group of 136 non diabetic patients treated during the same period (67.9% alive with limb at 6 months). This retrospective study, despite its limitations, underlines the clinical particularities of critical ischaemia in diabetics and the good tolerance to iloprost. This point allowed patients, in non

  11. Endovascular treatment for dural arteriovenous fistula at the foramen magnum: report of five consecutive patients and experience with balloon-augmented transarterial Onyx injection.

    Science.gov (United States)

    Liang, Guobiao; Gao, Xu; Li, Zhiqing; Wang, Xiaogang; Zhang, Haifeng; Wu, Zhongxue

    2013-05-01

    Foramen magnum dural arteriovenous fistulas (DAVF) with perimedullary venous drainage represent a small minority of intracranial DAVF, and only a number of small series with limited cases have been reported. The purpose of this retrospective study is to summarize experience of transarterial Onyx embolisation in the treatment of these lesions, with emphasis on the balloon-augmented technique. Five consecutive patients with DAVF at the foramen magnum were treated by transarterial embolisation using the Onyx system. Their symptoms included myelopathy (n=4) and SAH (n=1). Suppliers were from the vertebral artery (VA) (n=4), occipital artery (OA) (n=4), and ascending pharyngeal artery (APA) (n=2), with drainage to the perimedullary veins. After catheterization of the dilated supplier, the fistulous connections, proximal draining veins and appropriate distal segment of the feeders of these DAVF were transarterial embolized using Onyx-18. In three patients, balloon-augmented technique was used to assist embolisation. The technical feasibility of the procedure, angiographic results, and clinical outcome were evaluated. In every case, complete obliteration was achieved. Neither intraprocedural vessel rupture nor other procedure-related complications occurred. The results remained stable in all patients on follow-up angiograms (mean, 7.2 months). At the last clinical follow-up (mean, 17.6 months), two patients showed complete resolution of the initial symptoms, and three patients showed significant improvement. We found that Onyx embolisation is a feasible and safe alternative to open surgery in the treatment of selective DAVF at the foramen magnum. The balloon-augmented technique widens indications for transarterial Onyx packing of these lesions, and improved safety of the procedure. Copyright © 2013. Published by Elsevier Masson SAS.

  12. The Latarjet procedure for the treatment of recurrence of anterior instability of the shoulder after operative repair: a retrospective case series of forty-nine consecutive patients.

    Science.gov (United States)

    Schmid, Samuel L; Farshad, Mazda; Catanzaro, Sabrina; Gerber, Christian

    2012-06-06

    Recurrence of anterior shoulder instability after operative repair is an uncommon but disabling condition for which treatment options have been insufficiently studied. Coracoid transfer as described by Latarjet is a highly successful primary operation for recurrent anterior shoulder instability. The purpose of this study was to verify the hypothesis that this procedure is also effective for treating recurrent glenohumeral instability after previous operative repair. Forty-nine consecutive patients with either one (n = 32), two (n = 12), or at least three (n = 5) previous stabilizations other than a Latarjet procedure and recurrence of anterior glenohumeral instability associated with a lesion of the anterior aspect of the glenoid rim had revision with a coracoid transfer as described by Latarjet. Clinical outcomes at a mean of thirty-eight months postoperatively included the subjective shoulder value, the Constant-Murley score, and glenohumeral stability. Standardized anteroposterior and axial radiographs before and after the Latarjet revision were used to grade the degree of glenohumeral osteoarthritis. The results in all forty-nine patients were reviewed. No shoulder redislocated, subluxations recurred in two patients, and five patients reported slight, unspecified shoulder symptoms. No revision surgery was needed. Forty-three shoulders (88%) were subjectively graded as excellent or good; three, fair; and three, poor. Dissatisfaction was associated with persistent pain, and patients with preoperative pain had a twentyfold higher probability of having postoperative pain. The mean subjective shoulder value increased from 53% preoperatively to 79% at the time of follow-up (p Latarjet can effectively restore anterior glenohumeral shoulder stability if previous operation(s) have failed to do so. If recurrence is associated with chronic pain, the pain is likely to persist and compromise the subjective outcome.

  13. Management of facial burns with a collagen/glycosaminoglycan skin substitute-prospective experience with 12 consecutive patients with large, deep facial burns.

    Science.gov (United States)

    Klein, Matthew B; Engrav, Loren H; Holmes, James H; Friedrich, Jeffrey B; Costa, Beth A; Honari, Shari; Gibran, Nicole S

    2005-05-01

    Management of deep facial burns remains one of the greatest challenges in burn care. We have developed a protocol over the past 20 years for management of facial burns that includes excision and coverage with thick autograft. However, the results were not perfect. Deformities of the eyelids, nose and mouth as well as the prominence of skin graft junctures demonstrated the need to explore novel approaches. Integra has been used with success in the management of burns of the trunk and extremities. The purpose of this study was to prospectively evaluate the aesthetic outcome of the use of Integra for deep facial burns. Twelve consecutive patients underwent excision of large, deep facial burns and placement of Integra. Integra provides excellent color and minimally visible skin graft junctures. The texture is good but not as supple as thick autograft. Integra is not well suited for use in the coverage of eyelid burns due to the need to wait 2 weeks for adequate vascularization. In summary, thick autograft remains the gold standard for deep facial burns. However, for patients with extensive burns and limited donor sites, Integra provides an acceptable alternative.

  14. Does Fibrin Glue Sealant Used During Pancreaticoduodenectomy Reduce Post-Operative Complication? Audit of 100 Consecutive Patients Undergoing Whipple's Procedure by a Single Surgeon

    Directory of Open Access Journals (Sweden)

    Shafiq Rehman

    2016-03-01

    Full Text Available Introduction This study evaluated the effect of fibrin glue applied as a sandwich film between a two layer pancreatico-jejunostomy anastomosis following pancreaticoduodenectomy. Primary end-points were post-operative pancreatic fistulae, overall complication rates and post-operative length of stay. Methods Pancreaticoduodenectomy was performed by fashioning a two layer pancreatico-jejunostomy with or without a glue sealant which when applied, formed a thin film external to the ductal anastomosis but internal to the seromuscularpancreatic parenchymal layer. Results Following audit of 100 consecutive patients undergoing pancreaticoduodenectomy, patients were separated into two groups; those with glue augmented anastomosis [Glue (G N=50] or those without [No Glue (NG, N=50]. Each group was matched with regard to age [median, G=68 years vs. NG=66 years, (P=0.19] and sex (P=0.84. There were no statistically significant differences between the two groups with respect to overall POPF [G N=7(14% vs. NG N=11(22%, (P=0.42], significant complications (Clavien Grade 3 or more, [G N=4(8% vs. NG N=2(4% (P=0.40], or post-operative length of stay [G 13 days vs. NG 14 days, (P=0.90]. In those patients with the highest fistulae risk score, there were significantly more post-operative pancreatic fistulae in the no glue cohort. There was no mortality in either group. Conclusion This study shows that application of sealant glue significantly reduces post-operative pancreatic fistulae in high-risk patients, but does not reduce overall complications or hospital stay following pancreaticoduodenectomy.

  15. Harlequin ichthyosis in an infant born to a father with eczema.

    Science.gov (United States)

    Fatima, Saba; Rafiq, Ali; Majid, Zain

    2015-04-01

    Harlequin ichthyosis is characterized by thickening of the layer of the skin which contains keratin. Eczema is a chronic relapsing skin disorder which is also associated with disrupted epidermal barrier. We report the case of a 6-hour-old male patient who was brought to the neonatal intensive care unit of our hospital with crusting skin lesions all over the body, presence of a severe ectropion and deranged electrolytes. A diagnosis of harlequin ichthyosis was made, and the neonate was managed accordingly. However, the infant eventually expired on the seventh day of life. The infant's father was a patient of eczema with a chronic relapsing course and was on oral steroid therapy. As per our knowledge, this is the first reported case of an infant with harlequin ichthyosis born to a father suffering from eczema. The similarities in the pathogenesis of the two diseases and the genetic mutation of filaggrin might suggest an association between the two conditions. Harlequin ichthyosis can hence be looked out for in infants born of parents with eczema.

  16. Can contact allergy to p-phenylenediamine explain the high rates of terpene hydroperoxide allergy? - An epidemiological study based on consecutive patch test results

    DEFF Research Database (Denmark)

    Bennike, Niels Højsager; Lepoittevin, Jean-Pierre; Johansen, Jeanne D

    2017-01-01

    on proteins in mechanistic studies. OBJECTIVES: To test the hypothesis that patients sensitized to PPD are at increased risk of concomitant reactivity to either of the terpene hydroperoxides, owing to a 'common pathway' of skin protein oxidation. METHODS: A database study of consecutively patch tested eczema...... patients (n = 3843) from 2012 to 2015, tested concomitantly with PPD, Lim-OOHs and Lin-OOHs, was performed. Associations were examined by level of concordance and odds ratios (ORs) adjusted for age, sex, and contact allergy to fragrance mix I and fragrance mix II. RESULTS: Concomitant reactions to PPD were...... increased risk (OR 2.11, 95%CI:0.92-4.80) of a positive patch test reaction to Lin-OOHs. CONCLUSIONS: PPD sensitization cannot explain the high rates of sensitization to Lin-OOHs and/or Lim-OOHs. Contact allergy to oxidized linalool is more strongly associated with fragrance allergy than with PPD allergy....

  17. What Should General Practice Trainees Learn about Atopic Eczema?

    Directory of Open Access Journals (Sweden)

    Deepani Munidasa

    2015-02-01

    Full Text Available Effective atopic eczema (AE control not only improves quality of life but may also prevent the atopic march. The Royal College of General Practitioners’ (RCGP curriculum does not currently provide specific learning outcomes on AE management. We aimed to gain consensus on learning outcomes to inform curriculum development. A modified Delphi method was used with questionnaires distributed to gather the views of a range of health care professionals (HCPs including general practitioners (GPs, dermatologists, dermatology nurses and parents of children with AE attending a dedicated paediatric dermatology clinic. Ninety-one questionnaires were distributed to 61 HCPs and 30 parents; 81 were returned. All agreed that learning should focus on the common clinical features, complications and management of AE and the need to appreciate its psychosocial impact. Areas of divergence included knowledge of alternative therapies. Parents felt GPs should better understand how to identify, manage and refer severe AD and recognized the value of the specialist eczema nurse. Dermatologists and parents highlighted inconsistencies in advice regarding topical steroids. This study identifies important areas for inclusion as learning outcomes on AE management in the RCGP curriculum and highlights the importance of patients and parents as a valuable resource in the development of medical education.

  18. The learning curve effect on embolization of cerebral dural arteriovenous fistula single-center experience in 48 consecutive patients.

    Science.gov (United States)

    Le Foll, D; Raoult, H; Ferré, J C; Naudet, F; Trystram, D; Gauvrit, J Y

    2017-02-01

    Cerebral dural arteriovenous fistulas (DAVFs) are rare intracranial vascular lesions but can cause significant morbidity and mortality. To analyze the effect of the center's experience on DAVF embolization efficacy and safety. From May 2008 to October 2014, 57 embolization procedures were attempted on 48 patients (37 men and 11 women; median age: 63.9 years) for DAVF in a single center. DAVF presented with cortical venous reflux in 44/48 cases (91.7%) and hemorrhagic manifestation in 21/48 cases (43.75%). Angiographic occlusion quality, whether complete or incomplete (efficacy), and neurological complications (safety) were recorded. The patient population was divided into four consecutive quartiles during the inclusion period to assess the progress profile. Efficacy and safety outcomes were compared with Fisher's test. A logistic regression was performed to explore a learning curve phenomenon, showing a significant association between the chronological rank in the cohort and embolization efficacy (P=0.007). Significant differences were found between first and last quarter (P=0.036). The endovascular technique involved an arterial injection of Onyx(®) in 36/48 cases (75%), administered via the middle meningeal artery in 25/36 cases (69.5%). The complete occlusion rate improved significantly from 33.3% for the first quartile of the population, to 75.0% for the 2nd and 3rd quartiles and 83.3% for the last quartile. Neurological complications were found in 7/48 patients (14.6%), the rate decreased by 41.7% to 16.7%, without statistically difference. The efficacy and safety of DAVF embolization improved with the experience gained at the center, suggesting the existence of a learning curve. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  19. What Have We Learned from CONFIRM? Prognostic Implications from a Prospective Multicenter International Observational Cohort Study of Consecutive Patients Undergoing Coronary Computed Tomographic Angiography

    Science.gov (United States)

    Otaki, Yuka; Arsanjani, Reza; Gransar, Heidi; Cheng, Victor Y.; Dey, Damini; Labounty, Troy; Lin, Fay Y.; Achenbach, Stephan; Al-Mallah, Mouaz; Budoff, Matthew J.; Cademartiri, Filippo; Callister, Tracy Q.; Chang, Hyuk-Jae; Chinnaiyan, Kavitha; Chow, Benjamin J. W.; Delago, Augustin; Hadamitzky, Martin; Hausleiter, Joerg; Kaufmann, Philipp; Maffei, Erica; Raff, Gilbert; Shaw, Leslee J.; Villines, Todd C.; Dunning, Allison; Cury, Ricardo C.; Feuchtner, Gudrun; Kim, Yong-Jin; Leipsic, Jonathon; Berman, Daniel S.; Min, James K.

    2014-01-01

    Coronary computed tomographic angiography (CCTA) employing CT scanners of 64-detector rows or greater represents a novel noninvasive method for detection of coronary artery disease (CAD), providing excellent diagnostic information when compared to invasive angiography. In addition to its high diagnostic performance, prior studies have shown that CCTA can provide important prognostic information, although these prior studies have been generally limited to small cohorts at single centers. The Coronary CT Angiography EvaluatioN For clinical Outcomes: An InterRnational Multicenter Registry, or CONFIRM, is a large, prospective, multinational, dynamic observational cohort study of patients undergoing CCTA. This registry currently represents more than 32,000 consecutive adults suspected of having CAD who underwent ≥ 64–detector row CCTA at 12 centers in 6 countries between 2005 and 2009. Based on its large sample size and adequate statistical power, the data derived from CONFIRM registry has and will continue to provide key answers to many important topics regarding CCTA. Based on its multisite international national design, the results derived from CONFIRM should be considered as more generalizable than prior smaller single-center studies. This article summarizes the current status of several studies from CONFIRM registry. PMID:22689072

  20. Spiral Perfusion Imaging With Consecutive Echoes (SPICE™) for the Simultaneous Mapping of DSC- and DCE-MRI Parameters in Brain Tumor Patients: Theory and Initial Feasibility

    Science.gov (United States)

    Paulson, Eric S.; Prah, Douglas E.; Schmainda, Kathleen M.

    2017-01-01

    Dynamic contrast-enhanced (DCE) and dynamic susceptibility contrast (DSC) magnetic resonance imaging (MRI) are the perfusion imaging techniques most frequently used to probe the angiogenic character of brain neoplasms. With these methods, T1- and T2/T2*-weighted imaging sequences are used to image the distribution of gadolinium (Gd)-based contrast agents. However, it is well known that Gd exhibits combined T1, T2, and T2* shortening effects in tissue, and therefore, the results of both DCE- and DSC-MRI can be confounded by these opposing effects. In particular, residual susceptibility effects compete with T1 shortening, which can confound DCE-MRI parameters, whereas dipolar T1 and T2 leakage and residual susceptibility effects can confound DSC-MRI parameters. We introduce here a novel perfusion imaging acquisition and postprocessing method termed Spiral Perfusion Imaging with Consecutive Echoes (SPICE) that can be used to simultaneously acquire DCE- and DSC-MRI data, which requires only a single dose of the Gd contrast agent, does not require the collection of a precontrast T1 map for DCE-MRI processing, and eliminates the confounding contrast agent effects due to contrast extravasation. A detailed mathematical description of SPICE is provided here along with a demonstration of its utility in patients with high-grade glioma. PMID:28090589

  1. Complication rates associated with 3-column osteotomy in 82 adult spinal deformity patients: retrospective review of a prospectively collected multicenter consecutive series with 2-year follow-up.

    Science.gov (United States)

    Smith, Justin S; Shaffrey, Christopher I; Klineberg, Eric; Lafage, Virginie; Schwab, Frank; Lafage, Renaud; Kim, Han Jo; Hostin, Richard; Mundis, Gregory M; Gupta, Munish; Liabaud, Barthelemy; Scheer, Justin K; Diebo, Bassel G; Protopsaltis, Themistocles S; Kelly, Michael P; Deviren, Vedat; Hart, Robert; Burton, Doug; Bess, Shay; Ames, Christopher P

    2017-02-17

    OBJECTIVE Although 3-column osteotomy (3CO) can provide powerful alignment correction in adult spinal deformity (ASD), these procedures are complex and associated with high complication rates. The authors' objective was to assess complications associated with ASD surgery that included 3CO based on a prospectively collected multicenter database. METHODS This study is a retrospective review of a prospectively collected multicenter consecutive case registry. ASD patients treated with 3CO and eligible for 2-year follow-up were identified from a prospectively collected multicenter ASD database. Early (≤ 6 weeks after surgery) and delayed (> 6 weeks after surgery) complications were collected using standardized forms and on-site coordinators. RESULTS Of 106 ASD patients treated with 3CO, 82 (77%; 68 treated with pedicle subtraction osteotomy [PSO] and 14 treated with vertebral column resection [VCR]) had 2-year follow-up (76% women, mean age 60.7 years, previous spine fusion in 80%). The mean number of posterior fusion levels was 12.9, and 17% also had an anterior fusion. A total of 76 early (44 minor, 32 major) and 66 delayed (13 minor, 53 major) complications were reported, with 41 patients (50.0%) and 45 patients (54.9%) affected, respectively. Overall, 64 patients (78.0%) had at least 1 complication, and 50 (61.0%) had at least 1 major complication. The most common complications were rod breakage (31.7%), dural tear (20.7%), radiculopathy (9.8%), motor deficit (9.8%), proximal junctional kyphosis (PJK, 9.8%), pleural effusion (8.5%), and deep wound infection (7.3%). Compared with patients who did not experience early or delayed complications, those who had these complications did not differ significantly with regard to age, sex, body mass index, Charlson Comorbidity Index, American Society of Anesthesiologists score, smoking status, history of previous spine surgery or spine fusion, or whether the 3CO performed was a PSO or VCR (p ≥ 0.06). Twenty-seven (33

  2. Infant feeding and the development of food allergies and atopic eczema: An update.

    Science.gov (United States)

    Gamboni, Sarah E; Allen, Katrina J; Nixon, Rosemary L

    2013-05-01

    There is an increasing awareness of food allergies in the community. Dermatologists frequently see patients with atopic eczema, where parents are extremely concerned about the role of food allergy. Advice given to parents regarding the timing of introduction of solid foods has changed markedly over the past decade. Whereas previous advice advocated delaying the introduction of solid foods until the infant's gastrointestinal system had matured, recent studies suggest that the introduction of solids from around 4 to 6 months may actually prevent the development of allergies. Studies on maternal dietary restrictions during pregnancy and lactation have led researchers to believe that antigen avoidance does not play a significant role in the prevention of atopic disease. Breastfeeding exclusively for 4 to 6 months has multiple benefits for mother and child, however, it does not convincingly prevent food allergies or decrease atopic eczema. New evidence suggests that the use of hydrolysed formulas does not delay or prevent atopic eczema or food allergy. This article aims to highlight current evidence and provide an update for dermatologists on the role of food exposure in the development of atopic disease, namely atopic eczema.

  3. Cupping Therapy May be Harmful for Eczema: A PubMed Search.

    Science.gov (United States)

    Hon, Kam Lun E; Luk, David Chi Kong; Leong, Kin Fon; Leung, Alexander K C

    2013-01-01

    Eczema is a common childhood atopic condition and treatment is with emollients, topical corticosteroids, and avoidance of possible triggers. S. aureus colonization is a common complication. As there is no immediate cure, many parents seek alternative therapies that claim unproven therapeutic efficacy. We report a girl with long history of treatment noncompliance. After practicing a long period of dietary avoidance and supplementation, the grandparents took her to an alternative medicine practitioner. Following cupping therapy and acupuncture, the child developed blistering and oozing over her back the next day, which rapidly evolved to two large irregular-edge deep ulcers. She was treated with intravenous antibiotics and received multidisciplinary supportive intervention. Using search words of  "cupping," "eczema," and "atopic dermatitis," only two reports were found on PubMed. Therapeutic efficacy was claimed but not scientifically documented in these reports. Childhood eczema is an eminently treatable atopic disease. Extreme alternative therapy seems not to be efficacious and may even be associated with serious undesirable sequelae. Physicians should be aware of various alternative treatment modalities and be prepared to offer evidence-based advice to the patients with eczema and their families.

  4. Cupping Therapy May be Harmful for Eczema: A PubMed Search

    Directory of Open Access Journals (Sweden)

    Kam Lun E. Hon

    2013-01-01

    Full Text Available Eczema is a common childhood atopic condition and treatment is with emollients, topical corticosteroids, and avoidance of possible triggers. S. aureus colonization is a common complication. As there is no immediate cure, many parents seek alternative therapies that claim unproven therapeutic efficacy. We report a girl with long history of treatment noncompliance. After practicing a long period of dietary avoidance and supplementation, the grandparents took her to an alternative medicine practitioner. Following cupping therapy and acupuncture, the child developed blistering and oozing over her back the next day, which rapidly evolved to two large irregular-edge deep ulcers. She was treated with intravenous antibiotics and received multidisciplinary supportive intervention. Using search words of  “cupping,” “eczema,” and “atopic dermatitis,” only two reports were found on PubMed. Therapeutic efficacy was claimed but not scientifically documented in these reports. Childhood eczema is an eminently treatable atopic disease. Extreme alternative therapy seems not to be efficacious and may even be associated with serious undesirable sequelae. Physicians should be aware of various alternative treatment modalities and be prepared to offer evidence-based advice to the patients with eczema and their families.

  5. Outcome of Resection and Chemotherapy versus Chemotherapy Alone for Retroperitoneal Recurrence of Testicular Cancer Involving the Inferior Vena Cava: A Retrospective Cohort Study of 22 Consecutive Patients.

    Science.gov (United States)

    Illuminati, Giulio; Calio, Francesco G; Angelici, Alberto M; Pizzardi, Giulia; Pasqua, Rocco; Masci, Federica; Vietri, Francesco

    2016-07-01

    Optimal treatment strategy for retroperitoneal recurrence of testicular cancer involving the inferior vena cava (IVC) is uncertain. The purpose of this study was to validate the hypothesis that surgical resection, en-bloc with the involved segment of IVC and its subsequent reconstruction followed by chemotherapy, would yield better oncologic results than chemotherapy alone. Two consecutive series of patients with retroperitoneal recurrence of testicular cancer involving the IVC, treated with surgical resection plus chemotherapy (group A, n=14) or chemotherapy alone (group B, n=8) were retrospectively reviewed. The mean duration of follow-up was was 65 months (range=8-184). Operative mortality and morbidity in group A, response to chemotherapy in group B, disease-specific survival and quality adjusted life-years (QALY) for both groups, were primary end-points of the study. Postoperative mortality and morbidity (group A) were, respectively, nil and 14%. In group B, two patients (25%) fully responded to chemotherapy and remained free from disease progression. Disease-specific survival at 3 and 5 years was 81% and 54% in group A and 36% in group B both at 3 and 5 years, respectively (p=0.02). QALY was 3.92 in group A and 0.77 for both 3 and 5 years in group B, respectively, (p=0.031). En bloc resection of retroperitoneal recurrence of testicular tumors invading the IVC, followed by chemotherapy, allows a better survival rate compared to chemotherapy alone. Copyright© 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  6. Validation of self-reporting of hand eczema among Danish hairdressing apprentices

    DEFF Research Database (Denmark)

    Bregnhøj, Anne; Søsted, Heidi; Menné, Torkil

    2011-01-01

    Hairdressing apprentices have a high incidence of hand eczema. Most studies use self-reported hand eczema as a cost-effective method to estimate the prevalence of hand eczema. No validation studies on self-reported hand eczema among hairdressing apprentices exist.......Hairdressing apprentices have a high incidence of hand eczema. Most studies use self-reported hand eczema as a cost-effective method to estimate the prevalence of hand eczema. No validation studies on self-reported hand eczema among hairdressing apprentices exist....

  7. Comparison of fumaric acid 5% cream versus triamcinolone 0.1% cream in the treatment of hand eczema.

    Directory of Open Access Journals (Sweden)

    Farideh Jowkar

    2014-07-01

    Full Text Available Hand eczema is a common distressing skin problem. It is an immune reaction to haptens. Thus, substances that inhibit Immune system can be effective in the treatment of hand eczema. In this study, topical fumaric acid 5% cream is compared with topical steroid in the treatment of hand eczema. Patients with hand eczema were randomly divided into two groups. One group received fumaric acid 5% in a cream base, and the other received triamcinolone 0.1% in the same cream base. Both groups used creams twice daily for one month. Patients were checked for erythema, excoriation, population and lichenification, EASI score, and pruritus before and after treatment. In both groups, the mean of all signs of the disease and EASI score decreased after one month of treatment. There was no significant difference between the two treatments in decreasing erythema, but excoriation, population, lichenification, EASI score and itching were all decreased more in triamcinolone 0.1 % group. Although fumaric acid can inhibit the immune system; it was less effective for the treatment of all signs of hand eczema except erythema in comparison to triamcinolone. These results may be justified for two reasons: low penetration of topical fumaric acid through the skin or a low concentration used in this study.

  8. Comparison of fumaric acid 5% cream versus triamcinolone 0.1% cream in the treatment of hand eczema.

    Science.gov (United States)

    Jowkar, Farideh; Saki, Nasrin; Mokhtarpour, Akbar; Saki, Mohammad Reza

    2014-01-01

    Hand eczema is a common distressing skin problem. It is an immune reaction to haptens. Thus, substances that inhibit Immune system can be effective in the treatment of hand eczema. In this study, topical fumaric acid 5% cream is compared with topical steroid in the treatment of hand eczema. Patients with hand eczema were randomly divided into two groups. One group received fumaric acid 5% in a cream base, and the other received triamcinolone 0.1% in the same cream base. Both groups used creams twice daily for one month. Patients were checked for erythema, excoriation, population and lichenification, EASI score, and pruritus before and after treatment. In both groups, the mean of all signs of the disease and EASI score decreased after one month of treatment. There was no significant difference between the two treatments in decreasing erythema, but excoriation, population, lichenification, EASI score and itching were all decreased more in triamcinolone 0.1 % group. Although fumaric acid can inhibit the immune system; it was less effective for the treatment of all signs of hand eczema except erythema in comparison to triamcinolone. These results may be justified for two reasons: low penetration of topical fumaric acid through the skin or a low concentration used in this study.

  9. Pathological changes in platelet histamine oxidases in atopic eczema

    Directory of Open Access Journals (Sweden)

    Reinhold Kiehl

    1993-01-01

    Full Text Available Increased plasma histamine levels were associated with significantly lowered diamine and type B monoamine oxidase activities in platelet-rich plasma of atopic eczema (AE patients. The diamine oxidase has almost normal cofactor levels (pyridoxal phosphate and Cu2+ but the cofactor levels for type B monoamine oxidase (flavin adenine dinucleotide and Fe2+ are lowered. The biogenic amines putrescine, cadaverine, spermidine, spermine, tyramine and serotonin in the sera, as well as dopamine and epinephrine in EDTA-plasma were found to be normal. It is unlikely, therefore, that these amines are responsible for the decreased activities of monoamine and diamine oxidase in these patients. The most likely causative factors for the inhibition of the diamine oxidase are nicotine, alcohol, food additives and other environmental chemicals, or perhaps a genetic defect of the diamine oxidase.

  10. Does hyperthermic intraoperative chemotherapy lead to improved outcomes in patients with ovarian cancer? A single center cohort study in 111 consecutive patients

    Directory of Open Access Journals (Sweden)

    Warschkow Rene

    2012-06-01

    Full Text Available Abstract Background For recurrent disease or primary therapy of advanced ovarian cancer, cytoreductive surgery (CRS followed by adjuvant chemotherapy is a therapeutic option. The aim of this study was to evaluate the outcome for patients with epithelial ovarian cancer treated with hyperthermic intraoperative chemotherapy (HIPEC and completeness of cytoreduction (CC. Methods Data were retrospectively collected from 111 patients with recurrent or primary ovarian cancer operated with the contribution of visceral surgical oncologists between 1991 and 2006 in a tertiary referral hospital. Results Ninety patients received CRS and 21 patients CRS plus HIPEC with cisplatin. Patients with complete cytoreduction (CC0 were more likely to receive HIPEC. Overall, 19 of 21 patients (90.5 % with HIPEC and 33 of 90 patients (36.7 % with CRS had a complete cytoreduction (P  Conclusions Completeness of cytoreduction was proved to be crucial for long-term outcome. HIPEC procedures in ovarian cancer should be performed in clinical trials to compare CRS, HIPEC and systemic chemotherapy against CRS with systemic chemotherapy. Concerning the safety of HIPEC with cisplatin, the risk of persistent renal failure must be considered when dosage is based on body surface.

  11. 综合护理干预对精神病合并泛发性湿疹患者的临床疗效评价%Therapeutic evaluation of comprehensive nursing intervention on patients with psycho-sis and universal eczema

    Institute of Scientific and Technical Information of China (English)

    黄华珊; 冼美娘; 吕春子

    2016-01-01

    AIM: To investigate the effect of comprehensive nursing intervention on patients with psychosis and universal ecze-ma. METHODS: A total of 50 cases of patients with psychosis and universal eczema admitted into The Third People’s Hospital of Zhongshan from January 2014 to December 2014 were chosen as the research objects and randomly divided into the control group and the experimental group, with 25 patients in each group. The control group received routine nursing, while the experimental group received comprehensive nursing on the basis of routine nurs-ing according to patients’ individualized condition. The eczema area and itch degree of two groups one month after treatment were compared. RESULTS:After one month, the improvement rate of eczema area in the experimental group was higher than the control group, and its itch degree was lighter than the control group, with statistically significant difference ( P<0.05);The cure rate of ex-perimental group was 84%( 21/25 ) , while that of the control group was 64%( 16/25 ) , with statistically significant difference (P<0.05). CONCLUSION: The comprehensive nursing inter-vention shows better effects than routine nursing for patients with psychosis and universal eczema, which is worthy of clinical application.%目的:探讨综合护理干预应用于精神病合并泛发性湿疹患者的护理效果.方法:选取广东省中山市第三人民医院2014-01/2014-12收治的50例合并泛发性湿疹的精神病患者,将其随机分为对照组( n=25)和实验组( n=25).对照组行常规护理,实验组在常规护理基础上,针对患者的个人情况进行综合护理,1个月后对比两组患者湿疹面积和瘙痒程度.结果:1个月后,实验组的湿疹面积好转率高于对照组,瘙痒程度轻于对照组,两组护理效果比较,差异具有统计学意义(P<0.05);实验组治愈率为84%(21/25),对照组治愈率为64%(16/25),

  12. Application evaluation of the levels of serum total IgE and food allergen-specific IgG antibody in patients with chronic urticaria and eczema%血清总IgE与食物特异性IgG检测在慢性荨麻疹和慢性湿疹中的应用评价

    Institute of Scientific and Technical Information of China (English)

    靳情

    2015-01-01

    目的:探讨慢性荨麻疹和慢性湿疹患者食物特异性IgG变应原和血清总IgE的水平,为临床诊治提供参考。方法:应用ELISA法,检测153例慢性荨麻疹患者与135例慢性湿疹患者血清总IgE与14种食物特异性IgG,并与48名健康体检者对照。结果:慢性荨麻疹食物特异性IgG阳性率94.1%,慢性湿疹阳性率95.6%,而健康体检人群阳性率54.2%。以鸡蛋(蛋白/蛋黄)、牛奶、鳕鱼、螃蟹、大豆阳性率最高,鸡肉、玉米、大米、虾、西红柿、小麦次之,猪肉、牛肉、蘑菇较低。慢性荨麻疹和慢性湿疹患者血清总IgE均为100.0%阳性,而健康体检人群仅有29.8%。结论:慢性荨麻疹、慢性湿疹不仅与IgE介导的Ⅰ型变态反应有关,还与食物特异性IgG引起的不耐受有一定相关性;其检测可及时调整患者食谱,缓解临床症状,为患者诊治提供有益帮助。%Objective:To explore the levels of serum total IgE and food allergen-specific IgG antibody in patients with chronic urticaria and eczema,and provide the reference for their clinical diagnosis and therapy. Methods:The levels of the serum total IgE in 153 patients with chronic urticaria and 135 patients with chronic eczema, and allergen-specific IgG antibodies in 14 kinds of food were measured by enzyme linked immunosorbent assay( ELISA) . Forty-eight healthy people were set as the control. Results:The total positive rates of specific IgG antibodies in chronic urticaria,chronic eczema and healthy people were 94. 1%,95. 6% and 54. 2%,respectively. The most common food allergen were egg,milk,cod,crab and bean,followed by chicken,maize,rice,shrimp,tomato and wheat,and then pork,beef and mushrooms. The total positive rates of total serum IgE in chronic urticaria and eczema patients were 100. 0%,but it was 29. 8% in healthy people. Conclusions:The chronic urticaria and eczema are not only associated with typeⅠallergy,but also with food intolerance induced by the

  13. Specific IgG and IgA of common foods in Chinese children with eczema: friend or foe.

    Science.gov (United States)

    Hon, Kam Lun E; Poon, Terence Chuen W; Pong, Nga Hin H; Wong, Yuen Hung K; Leung, Sophie S; Chow, Chung Mo; Leung, Ting Fan

    2014-12-01

    Specific immunoglobulins G and A (IgG and IgA) for common food items have been extensively measured as surrogate markers of food allergy, and dietary avoidance based on the test results advocated. We reviewed the prevalence of specific food IgG and IgA in children with eczema and evaluated outcome of dietary avoidance in these children. Specific immunoglobulins of 96 food items were measured for 30 consecutive atopic dermatitis (AD) patients and disease severity [SCORing atopic dermatitis (SCORAD) and Nottingham eczema severity score (NESS)], Children Dermatology Life Quality Index (CDLQI), skin hydration (SH), transepidermal water loss (TEWL), topical corticosteroid and oral antihistamine usage were evaluated. Twenty seven of these patients received dietary avoidance advice based on IgG and IgA data. General acceptability of treatment (GAT) was documented at the end of 3 months. There were generally no correlations among levels of IgG or IgA of the 96 food items and disease severity, quality of life, SH or TEWL. Two-third patients reported very good or good and one-third reported fair or poor GAT following dietary avoidance advice. There was no difference in any clinical parameters between the two groups following dietary avoidance. Patient with lower sunflower seed IgA (p = 0.043), casein IgG (p = 0.041), milk IgG (p = 0.037) or whey IgG (p = 0.014) had improved SCORAD and objective SCORAD following dietary advice. Children with AD are sensitized to many food allergens via IgG and IgA mechanisms. Levels of food IgG or IgA do not seem to correlate with any clinical parameters in AD. Subjectively, two third of patients accepted dietary manipulations as very good or good for their AD. Objectively, dietary avoidance had few clinical effects on the clinical parameters. Sensitization should not be generalized to mean allergy to common food.

  14. Associations between proinflammatory cytokines in the synovial fluid and radiographic grading and pain-related scores in 47 consecutive patients with osteoarthritis of the knee

    Directory of Open Access Journals (Sweden)

    Yamashita Masaomi

    2011-06-01

    Full Text Available Abstract Background One of the sources of knee pain in osteoarthritis (OA is believed to be related to local chronic inflammation of the knee joints, which involves the production of inflammatory cytokines such as tumor necrosis factor alpha (TNFα, interleukin (IL-6, and nerve growth factor (NGF in the synovial membrane, and these cytokines are believed to promote pathological OA. In the present study, correlations between proinflammatory cytokines in knee synovial fluid and radiographic changes and functional scores and pain scores among OA patients were examined. Methods Synovial fluid was harvested from the knees of 47 consecutive OA patients, and the levels of TNFα, IL-6, and NGF were measured using enzyme-linked immunosorbent assays. Osteoarthritic knees were classified using Kellgren-Lawrence (KL grading (1-4. The Western Ontario and McMaster University Osteoarthritis Index (WOMAC was used to assess self-reported physical function, pain, and stiffness. Results TNFα and IL-6 were detectable in knee synovial, whereas NGF was not. TNFα was not correlated with the KL grade, whereas IL-6 had a significantly negative correlation. We observed differences in the correlations between TNFα and IL-6 with WOMAC scores and their subscales (pain, stiffness, and physical function. TNFα exhibited a significant correlation with the total score and its 3 subscales, whereas IL-6 exhibited a moderately significant negative correlation only with the subscale of stiffness. Conclusions The present study demonstrated that the concentrations of proinflammatory cytokines are correlated with KL grades and WOMAC scores in patients with knee OA. Although TNFα did not have a significant correlation with the radiographic grading, it was significantly associated with the WOMAC score. IL-6 had a significant negative correlation with the KL grading, whereas it had only a weakly significant correlation with the subscore of stiffness. The results suggest that these

  15. Adjuvant treatment of atopic eczema: assessment of an emollient containing N-palmitoylethanolamine (ATOPA study).

    Science.gov (United States)

    Eberlein, B; Eicke, C; Reinhardt, H-W; Ring, J

    2008-01-01

    For long-term management of atopic eczema, the use of skin care creams is recommended, but effectiveness of this treatment is not well established. The objective of this study was to yield data on the skin care properties of a cream with a unique lamellar matrix containing N-palmitoylethanolamine (PEA) and to assess quality-of-life variables in patients with mild to moderate atopic eczema. In this multinational, multicentre, observational, non-controlled, prospective cohort study, patients between 2 and 70 years of age were enrolled. All patients were supplied with the study product sufficient for treatment over the entire study period. Outcome was followed in periods between 3 and 7 days and 4 and 6 weeks after study start. Data were gathered from doctor reports and patient self-assessments via patient questionnaires. Data from 2456 patients entered the database. The mean examination intervals were 6 days for the 3- to 7-day period and 38 days for the 4- to 6-week period. At study end, intensities of erythema, pruritus, excoriation, scaling, lichenification and dryness were significantly reduced with a combined score reduction of 58.6% in the entire population (57.7% in adults > 12 years and 60.5% in children effectiveness (decline of pruritus and loss of sleep) indicated a gain in quality of life in these patients. The reduced use of topical corticosteroids is important in view of safety and pharmacoeconomic implications in the treatment of atopic eczema.

  16. Is abdominal CT useful for the management of patients with severe acute colitis complicating inflammatory bowel disease? A study in 54 consecutive patients.

    Science.gov (United States)

    Mege, D; Monsinjon, M; Zappa, M; Stefanescu, C; Treton, X; Maggiori, L; Bouhnik, Y; Panis, Y

    2017-04-01

    To evaluate the contribution of CT for the management of patients with severe acute exacerbation of colitis (SAC) complicating inflammatory bowel disease (IBD); in particular, its contribution to surgical decision making. All patients who were admitted to our institution for SAC complicating IBD were divided into two groups: group A (those who received surgical treatment); and group B (those who received medical treatment). Admission CT results were compared between groups. From 2006 to 2015, 54 patients [26 male; median age 39 (17-71) years] presenting with SAC were placed in either group A (n = 41; 76%) or group B (n = 13; 24%). Surgical patients in group A more frequently had altered general status (50 vs 17%; P = 0.01). Physical examination, Lichtiger score, endoscopic findings and laboratory results were similar between the groups. There was no significant difference in CT data between the groups with respect to extent of the colitis (pan-colitis in 54 and 69%, respectively, P = 0.35), median colonic thickness [10 (4-16) vs 8 (6-11) mm, P = 0.15], target enhancement (88 vs 77%, P = 0.38) and occurrence of toxic megacolon (2 vs 0%). Admission CT is not helpful in surgical decision making in SAC. Colorectal Disease © 2017 The Association of Coloproctology of Great Britain and Ireland.

  17. The role of dynamic susceptibility contrast-enhanced perfusion MR imaging in differentiating between infectious and neoplastic focal brain lesions: results from a cohort of 100 consecutive patients.

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    Valdeci Hélio Floriano

    Full Text Available BACKGROUND AND PURPOSE: Differentiating between infectious and neoplastic focal brain lesions that are detected by conventional structural magnetic resonance imaging (MRI may be a challenge in routine practice. Brain perfusion-weighted MRI (PWI may be employed as a complementary non-invasive tool, providing relevant data on hemodynamic parameters, such as the degree of angiogenesis of lesions. We aimed to employ dynamic susceptibility contrast-enhanced perfusion MR imaging (DSC-MRI to differentiate between infectious and neoplastic brain lesions by investigating brain microcirculation changes. MATERIALS AND METHODS: DSC-MRI perfusion studies of one hundred consecutive patients with non-cortical neoplastic (n = 54 and infectious (n = 46 lesions were retrospectively assessed. MRI examinations were performed using a 1.5-T scanner. A preload of paramagnetic contrast agent (gadolinium was administered 30 seconds before acquisition of dynamic images, followed by a standard dose 10 seconds after starting imaging acquisitions. The relative cerebral blood volume (rCBV values were determined by calculating the regional cerebral blood volume in the solid areas of lesions, normalized to that of the contralateral normal-appearing white matter. Discriminant analyses were performed to determine the cutoff point of rCBV values that would allow the differentiation of neoplastic from infectious lesions and to assess the corresponding diagnostic performance of rCBV when using this cutoff value. RESULTS: Neoplastic lesions had higher rCBV values (4.28±2.11 than infectious lesions (0.63±0.49 (p<0.001. When using an rCBV value <1.3 as the parameter to define infectious lesions, the sensitivity of the method was 97.8% and the specificity was 92.6%, with a positive predictive value of 91.8%, a negative predictive value of 98.0%, and an accuracy of 95.0%. CONCLUSION: PWI is a useful complementary tool in distinguishing between infectious and neoplastic brain

  18. Double-hit BCL2/MYC translocations in a consecutive cohort of patients with large B-cell lymphoma - a single centre's experience

    DEFF Research Database (Denmark)

    Pedersen, Mette Ø; Gang, Anne O; Poulsen, Tim S;

    2012-01-01

    Concurrent BCL2 and MYC translocations, so called double hit (DH), are a rare finding in large B-cell lymphoma (LBCL). Based on data from retrospective series, DH has been correlated with aggressive clinical behaviour and poor outcome. We conducted a consecutive study of DH incidence and correlat......Concurrent BCL2 and MYC translocations, so called double hit (DH), are a rare finding in large B-cell lymphoma (LBCL). Based on data from retrospective series, DH has been correlated with aggressive clinical behaviour and poor outcome. We conducted a consecutive study of DH incidence...

  19. Prognosis of occupational hand eczema

    DEFF Research Database (Denmark)

    Cvetkovski, Rikke Skoet; Zachariae, Robert; Jensen, Hans Henrik

    2006-01-01

    November 10, 2002. INTERVENTIONS: Participants received a questionnaire covering self-rated severity, sick leave, loss of job, depression, and health-related quality of life. One year after the questionnaire was returned, all responders (N = 621) received a follow-up questionnaire, and 564 (91%) returned...... to moderate disease. Patients with atopic dermatitis fared poorly compared with other patients. Patients younger than 25 years fared clearly better than older groups. Furthermore, severe OHE, age 40 years or greater, and severe impairment of quality of life at baseline appeared to be important predictors...

  20. Occupational fingertip eczema from acrylates in a manicurist

    Directory of Open Access Journals (Sweden)

    Denitza Zheleva

    2015-04-01

    Full Text Available Occupational hand eczema due to acrylates present in the workplace is a disease frequently reported among dentists, printers, and fiberglass workers. Acrylate monomers are used in the production of a great variety of polymers, including nail cosmetics. Our case report demonstrates a rare clinical presentations of allergic contact dermatitis from acrylic nails. Our patient was working as a manicurist and the diagnostic analyses revealed sensitation to some of the (meth acrylate compounds of her new nail cosmetics. Sculptured artificial acrylic and UV-hardened nails s are widely used in developed countries and they are gaining more and more popularity. We expect an increase in the number of cases of contact allergic dermatitis among manicurists and customers.

  1. Associations between lifestyle factors and hand eczema severity

    DEFF Research Database (Denmark)

    Sørensen, Jennifer A; Fisker, Maja H; Agner, Tove

    2017-01-01

    for assessment of severity of hand eczema and questions on quality of life. RESULTS: A total of 773 individuals (546 women and 227 men) responded to the questionnaire and were included in the study. A strong association was found between tobacco smoking and hand eczema severity (p = 0.003), whereas...

  2. Contact sensitization in venous eczema: Preliminary results of patch testing with Indian standard series and topical medicaments

    Directory of Open Access Journals (Sweden)

    Jindal Rashmi

    2009-01-01

    Full Text Available Background and Aims: Elimination of allergens/topical medications causing contact dermatitis in venous eczema, which poses a significant problem in its chronicity and treatment, provides the basis for better therapeutic outcome. Our objective was to determine the pattern of contact sensitization in venous eczema patients in Himachal Pradesh (India. Methods: Thirty-four patients (M:F, 31:3 and 10 controls (M:F, 6:4 were patch tested with Indian standard series and 10 commonly used topical medicaments. Results: Positive patch test results were seen in 50% (M:F, 16:1 of the patients. Common allergens were Fragrance mix (15%, p-phenylendiamine (15%, nickel (9%, wool alcohol (9%, chinoform (9%, balsum of Peru (5%, cobalt chloride (5%, potassium dichromate (3%, epoxy resin (3%, thiuram mix (3% and formaldehyde (3%. Only sisomycin and miconazole among the topical medications elicited a positive patch test reaction in 3 and 5% patients, respectively. Neomycin contact sensitivity was not seen in any of the patients. One patient who had exacerbation of venous eczema following accidental application of topical diclofenac showed a positive patch test reaction to it. Conclusions: Patch test should be used to identify the topical agents that may be responsible for perpetuation or aggravation of eczema, especially in patients who do not improve despite adequate treatment of other underlying cause(s.

  3. [The clinical effectiveness of the application of interferential currents for the combined treatment of onychopathies associated with psoriasis and eczema].

    Science.gov (United States)

    Nemchaninova, O B; Lykova, S G; Pozdnyakova, O N; Reshetnikova, T B; Makhnovets, E N; Simonova, E P; Spitsyna, A V

    2016-01-01

    The frequency of the development of clinically significant changes in the nail plates was estimated in the present study that included 454 patients presenting with psoriasis and 140 patients with eczema characterized by the localization of the pathological process on the skin of the wrists and/or feet. The changes in the nail plates were shown to occur in 56,2% of the patients with psoriasis and in 90,7% of those suffering from eczema. The capillaroscopy of the microvessels feeding the affected nails was carried out to determine the type of the capillaroscopic picture. The patients with onychopathies were largely characterized by the spastic-atonic type of the changes in the microcirculatory bed. The changes of this type were documented in 86,5% of the patients with psoriatic onychopathy and in 83,9% of those presenting with onychodystrophy associated with eczema. The effectiveness of the combined treatment including the application of interferential currents was estimated in comparison with that of standard therapy. It was shown that the use of interferential currents for the treatment of the patients with psoriasis results in a decrease of the severity index of nail damage by 47,8% in comparison with 18,1% in the case of standard medicamentous therapy. Similarly, a 77,2 and 51,3% decrease of the index of severity was documented in the patients with eczema after their treatment with the use of interferential currents and standard medicamentous therapy, respectively.

  4. Rapid needle-out patient-rollover approach after cone beam CT-guided lung biopsy: effect on pneumothorax rate in 1,191 consecutive patients

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jung Im [Seoul National University College of Medicine, Department of Radiology, Jongno-gu, Seoul (Korea, Republic of); Seoul National University Medical Research Center, Institute of Radiation Medicine, Seoul (Korea, Republic of); Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Park, Chang Min; Goo, Jin Mo [Seoul National University College of Medicine, Department of Radiology, Jongno-gu, Seoul (Korea, Republic of); Seoul National University, Cancer Research Institute, Seoul (Korea, Republic of); Lee, Sang Min [Seoul National University College of Medicine, Department of Radiology, Jongno-gu, Seoul (Korea, Republic of)

    2015-07-15

    To investigate the effect of rapid needle-out patient-rollover approach on the incidence of pneumothorax and drainage catheter placement due to pneumothorax in C-arm Cone-beam CT (CBCT)-guided percutaneous transthoracic needle biopsy (PTNB) of lung lesions. From May 2011 to December 2012, 1227 PTNBs were performed in 1191 patients with a 17-gauge coaxial needle. 617 biopsies were performed without (conventional-group) and 610 with rapid-rollover approach (rapid-rollover-group). Overall pneumothorax rates and incidences of pneumothorax requiring drainage catheter placement were compared between two groups. There were no significant differences in overall pneumothorax rates between conventional and rapid-rollover groups (19.8 % vs. 23.1 %, p = 0.164). However, pneumothorax rate requiring drainage catheter placement was significantly lower in rapid-rollover-group (1.6 %) than conventional-group (4.2 %) (p = 0.010). Multivariate analysis revealed male, age > 60, bulla crossed, fissure crossed, pleura to target distance > 1.3 cm, emphysema along needle tract, and pleural punctures ≥ 2 were significant risk factors of pneumothorax (p < 0.05). Regarding pneumothorax requiring drainage catheter placement, fissure crossed, bulla crossed, and emphysema along needle tract were significant risk factors (p < 0.05), whereas rapid-rollover approach was an independent protective factor (p = 0.002). The rapid needle-out patient-rollover approach significantly reduced the rate of pneumothorax requiring drainage catheter placement after CBCT-guided PTNB. (orig.)

  5. Overview of studies of treatments for hand eczema - the EDEN hand eczema survey

    NARCIS (Netherlands)

    Van Coevorden, AM; Coenraads, PJ; Svensson, A; Bavinck, JNB; Diepgen, TL; Naldi, L; Elsner, P; Williams, HC

    2004-01-01

    Background Hand eczema is a major cause of morbidity and lost earnings. Many interventions ranging from topical steroids to oral ciclosporin are used, but their evidence base and the best methods to assess their efficacy are uncertain. Objectives As part of a long-term project to improve standards o

  6. Patch testing with dermatophagoides and its correlation with chronic eczema and atopic dermatitis

    Directory of Open Access Journals (Sweden)

    Kapur Chetna

    2009-01-01

    Full Text Available Background: Chronic eczema is commonly encountered in the Indian set up. So also is atopic dermatitis. House dust mites (Dermatophagoides are implicated in various diseases like atopic dermatitis, asthma, and perennial rhinitis. It has also been proven that patch testing with Dermatophagoides pteronyssinus (DP is important for detection of contact sensitization in chronic dermatitis. Aims: To study clinical characteristics of DP mix positive patients with regards to chronic dermatitis and atopic dermatitis. Methods: Dermatology outpatients presenting to the department of Skin and STD of Kasturba Medical College (KMC, with clinically diagnosed atopic dermatitis and chronic eczema were chosen for the study. Inclusion and exclusion criteria were well demarked. Eighty six randomly selected patients of dermatitis were subjected to patch testing with standard series and DP mix. Results: Of the 86, 50 (58% showed positive reaction to DP mix. Among these positive patients, chronic dermatitis was seen in 42 (84% with involvement of exposed parts in 37 (74%. Atopic dermatitis was seen in 19 patients (38% from DP positive group whereas it was observed in 4 patients (17% from the other group. Conclusion: Dermatophagoides mix positivity was statistically significant in chronic eczema as well as atopic dermatitis. Patch testing is an important tool to detect delayed type allergy to house dust mite.

  7. Factors promoting psychological adjustment to childhood atopic eczema.

    Science.gov (United States)

    Dennis, Hannah; Rostill, Helen; Reed, Julie; Gill, Steve

    2006-06-01

    Research has found that children with atopic eczema are more likely to experience psychosocial difficulties than would be expected within the general population. This article aims to explore the relationship between child, parent and family factors in promoting positive adjustment to atopic eczema. Children aged five to 11 years with atopic eczema and their parents were identified from a specialist children's dermatology clinic. Seventy-four respondents completed questionnaires assessing child behaviour, parental well-being and family functioning. Parental psychological health, a supportive family environment and low impact of atopic eczema on family functioning were found to predict lower levels of internalizing behaviour (anxiety, depression and social withdrawal). These findings emphasize the importance of family and parental psychological processes rather than biomedical variables in promoting positive adjustment to atopic eczema.

  8. Therapeutic benefits of enhancing permeability barrier for atopic eczema

    Directory of Open Access Journals (Sweden)

    George Man

    2015-06-01

    Full Text Available The regulatory role of epidermal permeability barrier function in cutaneous inflammation has been well appreciated. While barrier disruption induces cutaneous inflammation, improvement of permeability barrier function alleviates inflammation. Studies have demonstrated that improvement of epidermal permeability barrier function not only prevents the development of atopic eczema, but also delays the relapse of these diseases. Moreover, enhancing the epidermal permeability barrier also alleviates atopic eczema. Furthermore, co-applications of barrier enhancing products with glucocorticoids can increase the therapeutic efficacy and reduce the adverse effects of glucocorticoids in the treatment of atopic eczema. Therefore, utilization of permeability barrier enhancing products alone or in combination with glucocorticoids could be a valuable approach in the treatment of atopic eczema. In this review, we discuss the benefits of improving the epidermal permeability barrier in the management of atopic eczema.

  9. Tobacco smoking and hand eczema - is there an association?

    DEFF Research Database (Denmark)

    Sørensen, Jennifer A; Clemmensen, Kim K; Nixon, Rosemary L

    2015-01-01

    BACKGROUND: Numerous risk factors have been suggested for hand eczema. This systematic review evaluates the association between tobacco smoking and hand eczema. OBJECTIVE: To review the literature systematically on the association between smoking and hand eczema. METHODS: The PubMed and EMBASE...... databases were searched up to 27 January 2015 for articles on the association between tobacco smoking and hand eczema, including human studies in English and German only. Experimental studies, studies on tobacco allergy, case reports, reviews and studies on second-hand smoking were excluded. RESULTS: Twenty...... articles were included. Among studies in occupational settings, three of seven found a statistically significant positive association between tobacco smoking and hand eczema prevalence rate, as did four of eight population-based studies. The association was stronger for studies in occupational settings...

  10. Evidence-based training as primary prevention of hand eczema in a population of hospital cleaning workers

    DEFF Research Database (Denmark)

    Clemmensen, Kim K B; Randbøll, Ingelise; Ryborg, Malene F.

    2015-01-01

    , of these 86 (82%) were included. At follow-up after 3 months there was a shift towards fewer daily hand washings and hand disinfections (p ...BACKGROUND: Skin disorders accounted for one third of all recognised occupational diseases in Denmark in 2010. Wet work is a risk factor for the development of occupational hand eczema. The consequences of occupational hand eczema include sick leave, loss of job and impaired quality of life....... OBJECTIVES: The aim of the present study was to investigate exposures related to cleaning and the effect of an evidence-based educational intervention on the prevention of hand eczema among hospital cleaners. PATIENTS/MATERIALS/METHODS: The intervention consisted of a 1 hr course in hand protective behaviour...

  11. Treating eczema in TCM therapy%内科湿疹的中医临床治疗

    Institute of Scientific and Technical Information of China (English)

    赵静

    2015-01-01

    湿疹是炎症的表现,其病因非常复杂,病情易于反复,给患者造成了很大的困扰。本文分析了湿疹的中医临床治疗效果及优点,对提高湿疹的诊治水平具有重要作用。%Eczema is a manifestation of inflammation,the etiology was very complex, and the condition was easy to repeat. It caused great distress to patients. In this article, the effects and advantage of the TCM therapy on eczema were analyzed, that had an important role to improve the diagnosis and treatment of eczema.

  12. 益生菌辅助糖皮质激素对湿疹治疗的疗效及机制分析%Study on the efficacy and mechanism of probiotic assisted glucocorticoid on the treatment of the patients with eczema

    Institute of Scientific and Technical Information of China (English)

    袁珍珍; 张铎

    2017-01-01

    目的 研究益生菌辅助糖皮质激素对湿疹治疗的疗效及机制.方法 将于2015年2月~2017年3月就诊的湿疹患者92例根据治疗方式分为常规治疗组和联合治疗组,每组46例.常规治疗组采用糖皮质激素制剂治疗;联合治疗组采用益生菌辅助糖皮质激素制剂治疗.就2组患者治疗前后血清炎症因子水平和湿疹治疗效果、不良反应发生率进行比较.结果 联合治疗组湿疹治疗效果明显高于常规治疗组(P<0.05).2组患者无严重不良反应发生.治疗前2组的血清炎症因子水平差异无统计学意义.治疗后联合治疗组患者血清炎症因子水平均明显优于常规治疗组(P<0.05).结论 益生菌辅助糖皮质激素制剂对湿疹治疗的疗效确切,可更好降低机体炎症水平,改善病情,无明显不良反应,安全有效.%Objective To study the efficacy and mechanism of probiotic assisted glucocorticoid on the treatment of the patients with eczema. Methods 92 cases with eczema from February 2015 to March 2017 were divided into two groups according to the treatment methods, the conventional group and the combined group, 46 cases in each group. The conventional group were given glucocorticoid, and the combined treatment group were received probiotics combined with glucocorticoid. The levels of serum inflammatory factors, the treatment effects of eczema and the incidence of adverse reactions were compared between the two groups before and after treatment. Results The treatment effect of eczema in combined group was higher than that in routine group (P<0.05). No severe adverse reactions occurred in the two groups. There was no significant difference in serum inflammatory factors between the two groups before treatment. The level of serum inflammatory factors in combined group was significantly better than that in tconventional group (P<0.05). Conclusion Probiotic assisted glucocorticoid is effective in the treatment of eczema. It can lower the

  13. Clinical efficacy of combined therapy for perianal eczema caused by anal diseases in 160 cases

    Directory of Open Access Journals (Sweden)

    Zhi-Chao LIU

    2007-01-01

    Full Text Available Perianal eczema is a kind of inflammatory dermatosis on the perianal skin and mucosa. The aim of the study was to evaluate the clinical efficacy of the combined therapy of medicine and operation for the perianal eczema caused by the anal diseases such as hemorrhoids, fissures and fistulas. One hundred and sixty patients with perianal eczema were involved in this study. They were randomly divided into four groups and treated by different therapies for four weeks respectively. Group A (40 patients was only treated with medicine, Group B (40 patients only with operation, Group C (40 patients firstly with medicine and then with operation and Group D (40 patients firstly with operation and then with medicine. The efficacy was determined as reduction of lesion size relative to initial size. The cure rate was 22.50%, 32.50%, 57.50% and 45.00% in Group A, B, C and D, respectively. The effective rate was 40.00%, 52.50%, 85.00% and 75.00%, respectively. The efficacy was significantly different (H=20.8689, g = 3, P value =0.0001. The results of group comparison showed that there were significant difference between Group C and Group A, Group C and Group B, Group D and Group A (all P values, < 0.05. It was concluded that the combined therapy of medicine and operation is optimal choice for the perianal eczema caused by the anal diseases such as hemorrhoids, fissures, and fistula. It highly improves the cure rate and efficacy rate.

  14. Validation of self-reporting of hand eczema among Danish hairdressing apprentices

    DEFF Research Database (Denmark)

    Bregnhøj, Anne; Søsted, Heidi; Menné, Torkil

    2011-01-01

    Hairdressing apprentices have a high incidence of hand eczema. Most studies use self-reported hand eczema as a cost-effective method to estimate the prevalence of hand eczema. No validation studies on self-reported hand eczema among hairdressing apprentices exist....

  15. Comparison of four methods for assessment of severity of hand eczema

    DEFF Research Database (Denmark)

    Agner, Tove; Jungersted, Jacob Mutanu; Coenraads, Pieter-Jan

    2013-01-01

    Several instruments for the assessment of the severity of hand eczema and health-related quality of life (HR-QoL) related to hand eczema have been developed.......Several instruments for the assessment of the severity of hand eczema and health-related quality of life (HR-QoL) related to hand eczema have been developed....

  16. Occupational eczema: Practice differences between dermatologists, workplace doctors and family practitioners

    OpenAIRE

    2016-01-01

    Background and Design: Occupational hand eczema is a commonly encountered problem. The time interval between onset and diagnosis is often long and this leads to increased morbidity. Besides dermatologists, family practitioners and workplace doctors play a role in the diagnosis and treatment of the disease. We aimed in our study to evaluate the discrepancies in how the disease is diagnosed and how the patients are handled between these specialty groups. We also aimed to determine the ...

  17. 湿疹喷雾剂联合湿疹纳米乳膏治疗慢性局限性湿疹的临床观察%Clinical Observation of Eczema Spray Combined with Eczema Nano Cream for the Treatment of Chronic Regional Eczema

    Institute of Scientific and Technical Information of China (English)

    杨志波; 唐雪勇; 朱明芳; 尹敏; 米兰; 李小莎

    2011-01-01

    Objective To observe the efficacy of eczema spray combined with eczema nano cream for the treatment of chronic regional eczema. Methods 82 patients were randomly divided into two groups. 41 patients in treatment group were treated with eczema spray combined with eczema nano cream, and 41 patients in control group were treated with Halometasone cream. After 1st, 2nd, 3rd treatment process, the clinical efficacy of these two groups were observed and compared. Results After one and two weeks' treatment, there was no significant difference between these two groups (P> 0.05). After three weeks' treatment, the total effective rate of the treatment group was 85.37%, and that of the control group was 70.73%. There was significant difference between two groups (P <0.05). Conclusion The efficacy of eczema spray combined with eczema nano cream for the treatment of chronic regional eczema is obvious, therefore this method is worthwhile to be applied more extensively.%目的 探讨湿疹喷雾剂联合湿疹纳米乳膏治疗慢性局限性湿疹的临床疗效.方法将82例患者随机分为两组,治疗组41例给予湿疹喷雾剂联合湿疹纳米乳膏治疗,对照组41例予卤米松软膏治疗,观察比较两组治疗第1、2、3周后的疗效.结果两组在治疗第1、2周后疗效比较,差异无显著性(P>o.05);治疗第3周后治疗组有效率为85.37%,对照组有效率为70.73%,差异有统计学意义(P<0.05).结论湿疹喷雾剂联合湿疹纳米乳膏治疗慢性局限性湿疹疗效确切,值得临床应用.

  18. Zhang Zhili's Experience in Treatment of Eczema

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@Prof. Zhang Zhili has practised traditional medicine for more than 40 years, hence an accumulation of rich clinical experience. As we have been fortunately guided by him in medical practice we would like to share with readers his experience in treatment of eczema as follows: Analyses of Pathogenesis Prof. Zhang holds that eczema is often caused by both endogenic and exogenic pathogens conflicting in skin and muscles: endogenic factors refer to improper diet or over-intake of irritative foods which may hurt the spleen and stomach, resulting in dysfunction of the spleen in transport and, as a result, leading to the accumulation of dampness-heat in the body; and exogenic factors refer to the invasion of exogenic pathogenic wind, dampness and heat. Moreover, a prolonged course of the illness may exhaust yin and blood and, consequently, turn pathogenic dryness factor into wind-evil. In the case of children, it is mostly caused by pathogenic heat stagnating in the gastrointestinal region due to weak congenital resistance and improper diet.

  19. Occupational eczema: Practice differences between dermatologists, workplace doctors and family practitioners

    Directory of Open Access Journals (Sweden)

    Emek Kocatürk Göncü

    2016-03-01

    Full Text Available Background and Design: Occupational hand eczema is a commonly encountered problem. The time interval between onset and diagnosis is often long and this leads to increased morbidity. Besides dermatologists, family practitioners and workplace doctors play a role in the diagnosis and treatment of the disease. We aimed in our study to evaluate the discrepancies in how the disease is diagnosed and how the patients are handled between these specialty groups. We also aimed to determine the level of knowledge about occupational eczema and how the knowledge could be increased. Materials and Methods: This was a descriptive study performed between January 2012 and December 2013. A questionnaire was sent via email to dermatologists, family practitioners and workplace doctors. Results: A total of 393 doctors, including 313 dermatologists, 53 family practitioners and 27 workplace doctors were enrolled in the study. Sixty-three percent of the doctors were examining 10-100 patients with hand eczema in a mouth. Eighty-five percent was “always” asking the occupation of the patient. 71.7% was asking “everytime” what materials are handled in the work place. The answers to the question “What is your approach to the patient after you diagnose occupational hand eczema” was “I refer the patient” and “I tell the patient to quit the job” was higher in family practitioners and family doctors. The center for referral was “dermatologists” for the workplace doctors and family practitioners while dermatologists referred the patients to “a clinic performing patch tests” or “occupational diseases centers”. 91.2% of the responders stated that they wanted to have more knowledge about occupational eczema and the issue of wonder mostly found was “the allergens/irritants encountered in the workplace”. Conclusion: A high number of the respondents stated that they wanted to gain more knowledge about occupational eczema. More courses, meetings

  20. Natural advances in eczema care.

    Science.gov (United States)

    Eichenfield, Lawrence F; Fowler, Joseph F; Rigel, Darrell S; Taylor, Susan C

    2007-12-01

    Atopic dermatitis (AD) is a chronic relapsing dermatitis characterized by increased transepidermal water loss (TEWL) and subjective symptoms of pruritus, inflammation, skin sensitivity, and dryness. AD is a frequent issue for individuals of color, though it may be underrecognized. Therapy for AD is based on reducing pruritus and inflammation, and normalizing skin surface lipids, particularly ceramides. Topical corticosteroids are the gold-standard treatment for controlling disease flares, but a variety of active natural ingredients can be used adjunctively to help control itch, inflammation, and dryness. Oatmeal, particularly avenanthramides, a newly discovered oat fraction, may be of particular value in restoring the cutaneous barrier and reducing symptoms of AD. Feverfew, licorice, and dexpanthenol also have been shown to be effective in the management of inflammation. Licorice, which has some skin-lightening activity, may be helpful in patients with postinflammatory hyperpigmentation (PIH). The compromised skin barrier in AD is especially vulnerable to UV radiation exposure. Several new long-lasting photostable sunscreen ingredients provide longer durations of protection with improved cosmetic attributes.

  1. Evidence from a large-scale meta-analysis indicates eczema reduces the incidence of glioma

    Science.gov (United States)

    Cao, Chao; Dong, Jing; Chu, Yudong; He, Guijuan; Xu, Zhiwei

    2016-01-01

    We investigated the relationship between eczema and the risk of primary glioma. Relevant studies were selected through electronic searches of PubMed and EMBASE. A meta-analysis of 12 case-control studies and one cohort study was performed. A fixed effect model was applied to analyze 13 studies consisting of 10,897 glioma cases and 56,081 controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to assess the strength of the associations. The data demonstrate that eczema significantly reduces the risk of glioma (OR = 0.69, 95% CI = 0.61–0.78, P < 0.001). Additional studies with larger patient cohorts are required to validate our findings. PMID:27566584

  2. Proof of efficacy of Kamillosan(R) cream in atopic eczema.

    Science.gov (United States)

    Patzelt-Wenczler, R; Ponce-Pöschl, E

    2000-04-19

    Kamillosan(R) cream contains chamomile extract as active principle manufactured from the chamomile sort Manzana which is rich in active principles and has been proved not to exhibit a chamomile-related allergen potential. For this reason Kamillosan(R) cream is suited for local therapy of atopic eczema. In a partially double-blind, randomized study carried out as a half-side comparison, Kamillosan(R) cream was tested vs. 0.5% hydrocortisone cream and the vehicle cream as placebo in patients suffering from medium-degree atopic eczema. After a 2-week treatment Kamillosan(R) cream showed a mild superiority towards 0.5% hydrocortisone and a marginal difference as compared to placebo.

  3. Challenges of identifying eczema in darkly pigmented skin.

    Science.gov (United States)

    Myers, Joan

    2015-07-01

    There is a paucity of information about the difference in the presentation of eczema in darkly pigmented skin compared to children with fair or white skin. This article describes the possible challenges of diagnosing eczema in children with darkly pigmented skin. The physiological difference in darkly pigmented skin compared with fair or white skin is explored, and how eczema may be manifested and identified in darkly pigmented skin. The author uses the term darkly pigmented skin to describe children of black Caribbean, African or Asian descent.

  4. 慢性湿疹患者生活质量及其影响因素的临床研究%Quality of Life of Patients with Chronic Eczema and Its Influencing Factors:A clinical study

    Institute of Scientific and Technical Information of China (English)

    章承中; 徐小英; 颜美秋

    2011-01-01

    目的 探讨慢性湿疹患者的生活质量状况及其影响因素,为提高患者的生活质量和临床疗效提供帮助.方法 以2009年8月-2010年8月在温岭市第一人民医院皮肤科门诊就诊、临床确诊的慢性湿疹患者为研究对象,以同期健康体检者为对照.应用世界卫生组织生活质量测定量表简表(WHOQOL-BREF)以及皮肤病生活质量指数量表(DLQI)对200例慢性湿疹患者及100例体检者进行生活质量评价,并应用多元回归分析方法寻找影响慢性湿疹患者生活质量的因素.结果 (1)湿疹组的DLQI总分为(14.56±5.43)分,高于对照组的(0.13±0.05)分,差异有统计学意义(P<0.01).对其六个方面分别进行比较,发现湿疹组患者症状与情感、社会交际、治疗等六个方面的得分均比对照组高,差异均有统计学意义(P<0.01).(2)比较湿疹组和对照组的WHOQOL-BREF得分,对总体感受及生理、心理、社会、环境四个领域的比较发现差异均有统计学意义(P<0.01).(3)多元逐步回归表明,影响DLQI总分的因素为病情、受教育程度和经济状况;影响WHOQOL-BREF得分的因素为病情和受教育程度.结论 慢性湿疹患者生活质量较差,病情、受教育程度、经济状态是影响慢性湿疹患者生活质量的重要因素.%Objective To explore the quality of life of Patients with chronic eczema ( CE ) and its influencing factors.Methods Totally 200 patients presenting in our hospital from August 2009 to August 2010 and being diagnosed clinically with CE were recruited as the trial group, and 100 healthy people who concurrently took physical examination were enrolled as the controls.Dermatology Life Quality Index ( DLQI ) and World Health Organization Quality of Life Assessment Instrument - Brief ( WHOQOL- BREF ) were used to evaluate the quality of life.Multiple regression analysis was used to search the risk factors influencing the quality of life.Results ( 1 ) The total mean DLQI

  5. A randomised placebo-controlled trial of oral and topical antibiotics for children with clinically infected eczema in the community: the ChildRen with Eczema, Antibiotic Management (CREAM) study.

    Science.gov (United States)

    Francis, Nick A; Ridd, Matthew J; Thomas-Jones, Emma; Shepherd, Victoria; Butler, Christopher C; Hood, Kerenza; Huang, Chao; Addison, Katy; Longo, Mirella; Marwick, Charis; Wootton, Mandy; Howe, Robin; Roberts, Amanda; Haq, Mohammed Inaam-Ul; Madhok, Vishnu; Sullivan, Frank

    2016-01-01

    BACKGROUND Secondary skin infection is common during eczema exacerbations and many children are treated with antibiotics when this is suspected, although there is little high-quality evidence to justify this practice. OBJECTIVE To determine the clinical effectiveness of oral and topical antibiotics, in addition to standard treatment with emollients and topical corticosteroids, in children with clinically infected eczema. DESIGN Multicentre randomised, double-blind, placebo-controlled trial. SETTING General practices and dermatology clinics in England, Wales and Scotland. PARTICIPANTS Children (aged 3 months to < 8 years) with a diagnosis of eczema (according to U.K. Working Party definition) and clinical suspicion of infection. INTERVENTIONS (1) Oral flucloxacillin and topical placebo; (2) topical fusidic acid (Fucidin(®), Leo Laboratories Limited) and oral placebo; and (3) oral and topical placebos, all for 1 week. MAIN OUTCOME MEASURES Patient-Orientated Eczema Measure (POEM) at 2 weeks (assessing subjective severity in the week following treatment). RESULTS We randomised 113 children (36 to oral antibiotic, 37 to topical antibiotic and 40 to placebo), which was fewer than our revised target sample size of 282. A total of 103 (92.0%) children had one or more clinical features suggestive of infection and 78 (69.6%) children had Staphylococcus aureus cultured from a skin swab. Oral and topical antibiotics resulted in a 1.52 [95% confidence interval (CI) -1.35 to 4.40] and 1.49 (95% CI -1.55 to 4.53) increase (worse subjective severity) in POEM score at 2 weeks, relative to placebo and controlling for baseline POEM score. Eczema Area and Severity Index (objective severity) scores were also higher (worse) in the intervention groups, at 0.20 (95% CI -0.12 to 0.52) and 0.42 (95% CI 0.09 to 0.75) for oral and topical antibiotics, respectively, at 2 weeks. Analyses of impact on the family, quality of life, daily symptom scores, and longer-term outcomes were all

  6. On the relationships between DSM-5 dysfunctional personality traits and social cognition deficits: A study in a sample of consecutively admitted Italian psychotherapy patients.

    Science.gov (United States)

    Fossati, Andrea; Somma, Antonella; Krueger, Robert F; Markon, Kristian E; Borroni, Serena

    2017-05-11

    This study aims at testing the hypothesis that the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5) alternative model of personality disorder (AMPD) traits may be significantly associated with deficits on 2 different social cognition tasks, namely, the Reading the Mind in the Eyes Test and the Movie for the Assessment of Social Cognition, in a sample of consecutively admitted inpatients and outpatients. The sample was composed of 181 consecutively admitted participants (57.5% women; mean age = 38.58 years). Correlation coefficients and partial correlation coefficients were computed in order to assess the associations among social cognition tasks, DSM-5 AMPD traits, and dimensionally assessed DSM-5 Section II personality disorders. Specific maladaptive traits listed in the DSM-5 AMPD were significantly associated with Reading the Mind in the Eyes Test scores and Movie for the Assessment of Social Cognition scores, even when the effect of selected DSM-5 Section II personality disorders was controlled for. Our results support the relevance of studying social cognitive functioning in subjects suffering from personality disorders. Copyright © 2017 John Wiley & Sons, Ltd.

  7. Acid-coated Textiles (pH 5.5-6.5)--a New Therapeutic Strategy for Atopic Eczema?

    Science.gov (United States)

    Jaeger, Teresa; Rothmaier, Markus; Zander, Holger; Ring, Johannes; Gutermuth, Jan; Anliker, Mark D

    2015-07-01

    Increased transepidermal water loss (TEWL) and decreased skin capacitance are characteristic features of the disturbed epidermal barrier in atopic eczema (AE). The "acid mantle", which is a slightly acidic film on the surface of the skin has led to the development of acidic emollients for skin care. In this context, the effect of citric acid-coated textiles on atopic skin has not been examined to date. A textile carrier composed of cellulose fibres was coated with a citric acid surface layer by esterification, ensuring a constant pH of 5.5-6.5. Twenty patients with AE or atopic diathesis were enrolled in the study. In a double-blind, half-side experiment, patients had to wear these textiles for 12 h a day for 14 days. On day 0 (baseline), 7 and 14, tolerability (erythema, pruritus, eczema, wearing comfort) and efficacy on skin barrier were assessed by TEWL skin hydration (corneometry/capacitance), pH and clinical scoring of eczema (SCORAD). Citric acid-coated textiles were well tolerated and improved eczema and objective parameters of skin physiology, including barrier function and a reduced skin surface pH, with potential lower pathogenic microbial colonisation.

  8. Skip the Antibiotics for Mild Eczema in Kids

    Science.gov (United States)

    ... medlineplus.gov/news/fullstory_164083.html Skip the Antibiotics for Mild Eczema in Kids Skin condition cleared ... March 14, 2017 (HealthDay News) -- Despite widespread use, antibiotics are not an effective treatment for milder cases ...

  9. TCM Treatment for Two Cases of Chronic and Intractable Eczema

    Institute of Scientific and Technical Information of China (English)

    He Kuanqi; Zhu Hanting

    2008-01-01

    @@ The author treated 2 cases of chronic and intractable eczema,who were once treated by western drugs without good results,with Chinese medicine and obtained satisfactory therapeutic effects.Now it is reported as follows.

  10. Intolerance to oral and intravenous calcium supplements in atopic eczema.

    OpenAIRE

    Devlin, J; David, T J

    1990-01-01

    Children treated with dietary restriction for food intolerance may require calcium supplementation, particularly if cows' milk and milk substitutes are not tolerated. We report two children with atopic eczema who reacted adversely to a number of calcium supplement formulations.

  11. [Allergic contact eczema from epoxy resin].

    Science.gov (United States)

    Calzado, Leticia; Ortiz-de Frutos, Francisco J; del Prado Sánchez-Caminero, María; Galera, Carmen María; Valverde, Ricardo; Vanaclocha, Francisco

    2005-11-01

    Epoxy resins are plastics that are widely used as electrical insulation, in coatings, and as adhesives and paints. They have strong sensitizing power and are one of the main causes of allergic contact eczema, both in the workplace and elsewhere. We present the case of a worker at a plastics/chemical plant, who handled aeronautical components in the process of manufacturing fuselage parts. He consulted his physician because of eczematous lesions on his fingers, hands and forearms which had developed over a two-year period and were clearly related to his work. The standard battery of skin tests was performed, along with the plastics and adhesives series and tests using the products from his workplace. Positivity was shown to epoxy resins (standard battery) and to the products from his workplace, which included different fiberglass and carbon fiber sheets impregnated with epoxy resins and epoxy adhesives.

  12. Inability to produce white dermographism in the early stage of infantile eczema.

    Science.gov (United States)

    Aizawa, H; Tagami, H

    1989-03-01

    White dermographism constitutes an abnormal vascular reaction characteristically demonstrable in atopic dermatitis; however, there is no information about it in the infantile phase of atopic dermatitis. Therefore we examined 73 infants younger than 3 years of age with eczematous dermatitis for the demonstrability of white dermographism after mechanical stroking of the lesional skin. None of the 40 healthy control infants showed white dermographism on their normal skin. In contrast, an age-dependent increase was demonstrated in patients with infantile eczema, from 11% in those 1 to 2 months of age to 85% in those older than 7 months. There was no correlation between the demonstrability of white dermographism in early infancy and the prognosis of infantile eczema. Based on our study of various types of dermatitis experimentally induced in adult volunteers, we think that, in addition to the immaturity of infantile skin, the presence of acute dermatitic changes may be related to inability to demonstrate white dermographism in the early phase of infantile eczema.

  13. CLINICAL PROFILE OF HAND ECZEMA AND ITS EVALUATION BY PATCH TESTING

    Directory of Open Access Journals (Sweden)

    Shreeya

    2016-05-01

    Full Text Available BACKGROUND Allergic contact dermatitis (ACD is the classical presentation of delayed type hypersensitivity response to exogenous agents. The disease can have a chronic and relapsing course if the causal allergen is not identified. The best solution for ACD is avoidance of further exposure to the allergen. OBJECTIVES To identify the various presentations of hand eczema and to correlate the patch test results with the clinically suspected antigen. An attempt to identify the most common population affected and the frequently encountered allergen was made. METHODS The study was conducted at MVJ Medical College and Research Hospital, Bangalore. Patch test was done with Indian Standard Series and indigenous antigens. The patches were removed after approximately 48 hours, and reading was taken after 30 minutes. The results were recorded, tabulated and analysed according to statistical proportion. RESULTS: A total of 100 patients of hand eczema were studied. The incidence was 69% in males and 31% females. The male to female ratio was 2.3:1. The commonest occupation among males was construction work (36%, and most of the females were housewives (27%. Patch testing was positive in 51%, of which potassium dichromate (28, parthenium (11, paraphenylenediamine (7 were the common sensitisers. CONCLUSION Patch testing is a very useful investigative procedure for hand eczema, but association between clinical patterns and the allergens cannot be predicted with patch test alone. The Indian Standard series is useful to a certain extent, but insufficient.

  14. Diversity of the gut microbiota and eczema in early life

    Directory of Open Access Journals (Sweden)

    Litonjua Augusto A

    2008-09-01

    Full Text Available Abstract Background A modest number of prospective studies of the composition of the intestinal microbiota and eczema in early life have yielded conflicting results. Objective To examine the relationship between the bacterial diversity of the gut and the development of eczema in early life by methods other than stool culture. Methods Fecal samples were collected from 21 infants at 1 and 4 months of life. Nine infants were diagnosed with eczema by the age of 6 months (cases and 12 infants were not (controls. After conducting denaturating gradient gel electrophoresis (DGGE of stool samples, we compared the microbial diversity of cases and controls using the number of electrophoretic bands and the Shannon index of diversity (H' as indicators. Results Control subjects had significantly greater fecal microbial diversity than children with eczema at ages 1 (mean H' for controls = 0.75 vs. 0.53 for cases, P = 0.01 and 4 months (mean H' for controls = 0.92 vs. 0.59 for cases, P = 0.02. The increase in diversity from 1 to 4 months of age was significant in controls (P = 0.04 but not in children who developed eczema by 6 months of age (P = 0.32. Conclusion Our findings suggest that reduced microbial diversity is associated with the development of eczema in early life.

  15. Topical treatment with fresh human milk versus emollient on atopic eczema spots in young children: a small, randomized, split body, controlled, blinded pilot study.

    Science.gov (United States)

    Berents, Teresa Løvold; Rønnevig, Jørgen; Søyland, Elisabeth; Gaustad, Peter; Nylander, Gro; Løland, Beate Fossum

    2015-05-04

    Public health nurses report on effects of fresh human milk as treatment for conjunctivitis, rhinitis and atopic eczema (AE), the latter being highly prevalent in early childhood. Emollients and topical corticosteroids are first line treatment of AE. As many caregivers have steroid phobia, alternative treatment options for mild AE are of interest. The aim of this small pilot study was to assess the potential effects and risks of applying fresh human milk locally on eczema spots in children with AE. This was a split body, controlled, randomized and physician blinded pilot study, of children with AE with two similar contralateral eczema spots having a mother breastfeeding the child or a sibling. Fresh expressed milk and emollient was applied on the intervention spot and emollient alone on the control area, three times a day for four weeks. The severity and area of the eczema spots was evaluated weekly, and samples from milk and the spots were analysed weekly with respect to bacterial colonisation. Of nine patients included, six completed the study. Mean age at inclusion was 18.5 months. The spots examined were localized on the arms, legs or cheeks. The spots were similar in severity, but differed in area. In one patient the eczema ceased after inclusion. In four patients both control and intervention areas increased during the intervention. The relative change in eczema area compared to baseline showed less increase in the intervention spots in two patients, whereas the opposite was observed in three. In four children Staphylococcus aureus was found in their eczema once or more. In three of the 28 human milk samples, Staphylococcus aureus, alfa haemolytic streptococci or coagulase negative staphylococci were detected. Staphylococcus aureus was found once both in human milk and in the eczema spots, no clinical signs of infection were however observed. No secondary infection due to milk application was detected. In this small pilot study, no effect was found on eczema

  16. 整合式心理治疗对慢性湿疹病人心理健康状况及神经肽的影响1)%Influence of integrated psychological treatment on psychological health status and neuropeptide of patients with chronic eczema

    Institute of Scientific and Technical Information of China (English)

    谷利斌; 徐浩翔; 谭娟; 王挺; 徐德国

    2014-01-01

    Obj ective:To probe into the effect of integrated psychological treatment on psychological health status and neuropeptide of the patients with chronic eczema.Methods:A total of 5 2 patients with chronic eczema were randomly divided into intervention group and control group,25 ca-ses in intervention group,while 27 cases in control group.The patients in intervention group received integrated psychological treatment,and the patients in control group only received telephone follow up,once in 2 weeks,then to urge the patients regular medication and regular follow up.Before and after the intervention,the SCL 90 score and the levels of serum neuropeptides were compared between two groups.Results:Before the integrated psychological treatment,there was statistically significant difference in factors scores including total SCL 90 score,somatization, interpersonal sensitivity,depression,anxiety,paranoia,psychoticism scores in the eczema patients compared with the norm(P<0.01);total SCL 90 score,somatization,interpersonal sensitivity,depression,anxie-ty,paranoia,mental disease scores in patients with eczema were correla-ted with serum SP and VIP levels(P<0.05);while after the integrated psychological treatment,the total score of SCL 90,the scores of somati-zation,depression,anxiety,psychoticism and additional factors of inter-vention group were significantly lower than that in control group(P<0.05),and the levels of serum SP and VIP were significantly higher than that in control group (P<0.05 ).Conclusion:Integrated psychological treatment based on the pharmacotherapy could effectively improve the chronic eczema patients’mental health status,and to promote their men-tal health,reduce the symptoms of the disease and promote the disease rehabilitation.%[目的]探讨整合式心理治疗对慢性湿疹病人心理健康状况及神经肽的影响。[方法]将慢性湿疹病人52例随机分为干预组25例和对照组27例。干预组进行整合式心理

  17. Formulation and clinical evaluation of topical dosage forms of Indian Penny Wort, walnut and turmeric in eczema.

    Science.gov (United States)

    Khiljee, Sonia; Rehman, Nisarur; Khiljee, Tanzila; Loebenberg, Raimar; Ahmad, Rao Saeed

    2015-11-01

    Eczema is characterized by itching, lichenification, scaling, oedema and erythema. Current management strategies include corticosteroids, which are limited due to side effects. Many herbal remedies are used traditionally but unfortunately have not been validated in controlled clinical trials. Three popular traditional treatments of eczema include Indian pennywort, Walnut and Turmeric. In this study three topical formulations (micro emulsion, gel and ointment) were prepared from extracts of Indian pennywort, Walnut and Turmeric. These formulations were monitored for stability for a period of three months. Controlled clinical trials were conducted on 360 eczema patients. Clinical parameters observed were degree of erythema, oedema, scaling, itching and lichenification. Effects of each formulation on these clinical parameters were compared with placebo formulations. Micro emulsion formulations in all cases proved to be more effective in reducing semi quantitative scores of erythema and oedema. Itching was relieved more by gel formulation. The ointment showed more efficacy towards scaling and lichenification. Comparison of the effects of placebo and the specific formulations was performed by chi-square statistics and found to be highly significant. In summary it is concluded that all the formulations could be used as promising source for treatment of eczema.

  18. Comparison of P2Y12 inhibitors for mortality and stent thrombosis in patients with acute coronary syndromes: Single center study of 10 793 consecutive 'real-world' patients.

    Science.gov (United States)

    Gosling, Rebecca; Yazdani, Momina; Parviz, Yasir; Hall, Ian R; Grech, Ever D; Gunn, Julian P; Storey, Robert F; Iqbal, Javaid

    2017-03-07

    Three oral platelet P2Y12 inhibitors, clopidogrel, prasugrel, and ticagrelor, are available for reducing the risk of cardiovascular death and stent thrombosis in patients with acute coronary syndromes (ACS). We sought to compare the efficacy of these antiplatelet drugs in contemporary practice. Data were collected for 10 793 consecutive ACS patients undergoing coronary angiography at Sheffield, UK (2009-2015). Since prasugrel use was mostly restricted to the STEMI subgroup, clopidogrel and ticagrelor were compared for all ACS patients, and all three agents were compared in the STEMI subgroup. Differences in outcomes were evaluated at 12 months by KM curves and log-rank test after adjustment for independent risk factors. Of 10 793 patients with ACS (36% STEMI), 43% (4653) received clopidogrel, 11% (1223) prasugrel and 46% (4917) ticagrelor, with aspirin for all. In the overall group, ticagrelor was associated with lower all-cause mortality compared with clopidogrel (adjusted hazard ratio (adjHR) 0.82, 95% confidence intervals (CI) 0.71-0.96, p = 0.01). In the STEMI subgroup, both prasugrel and ticagrelor were associated with a lower mortality compared with clopidogrel (prasugrel vs. clopidogrel: adjHR 0.65, CI 0.48-0.89, p = 0.007; ticagrelor vs. clopidogrel: adjHR 0.70, CI 0.61-0.99, p = 0.05). Of the 7595 patients who underwent PCI, 78 (1.0%) had definite stent thrombosis by 12 months. Patients treated with ticagrelor had a lower incidence of definite stent thrombosis compared with clopidogrel (0.6% vs. 1.1%; adjHR 0.51, CI 0.29-0.89, p = 0.03). In the STEMI subgroup, there was no significant difference between the three groups (ticagrelor 1.0%, clopidogrel = 1.5%, prasugrel = 1.6%; p = 0.29). In conclusion, ticagrelor was superior to clopidogrel for reduction in both mortality and stent thrombosis in unselected invasively managed ACS patients. In STEMI patients, both ticagrelor and prasugrel were associated with lower mortality compared with clopidogrel, but

  19. Coronary angioplasty for unstable angina: immediate and late results in 200 consecutive patients with identification of risk factors for unfavorable early and late outcome

    NARCIS (Netherlands)

    P.J. de Feyter (Pim); H. Suryapranata (Harry); P.W.J.C. Serruys (Patrick); K.J. Beatt (Kevin); M.J.B.M. van den Brand (Marcel); J.J. Tijssen; A.J. Azar (Aida); P.G. Hugenholtz (Paul); R.T. van Domburg (Ron)

    1988-01-01

    textabstractTwo hundred patients (mean age 56 years, range 36 to 74) with unstable angina (chest pain at rest, associated with ST-T changes) underwent coronary angioplasty. In 65 patients with multivessel disease, only the "culprit" lesion was dilated. The initial success rate was 89.5% (179 of 200

  20. Ultrasound-guided central venous catheterization in cancer patients improves the success rate of cannulation and reduces mechanical complications: A prospective observational study of 1,978 consecutive catheterizations

    Directory of Open Access Journals (Sweden)

    Gorgni Silvia

    2010-10-01

    Full Text Available Abstract Background A central venous catheter (CVC currently represents the most frequently adopted intravenous line for patients undergoing infusional chemotherapy and/or high-dose chemotherapy with hematopoietic stem-cell transplantation and parenteral nutrition. CVC insertion represents a risk for pneumothorax, nerve or arterial punctures. The aim of this prospective observational study was to explore the safety and efficacy of CVC insertion under ultrasound (US guidance and to confirm its utility in clinical practice in cancer patients. Methods Consecutive adult patients attending the oncology-hematology department were eligible if they had solid or hematologic malignancies and required CVC insertion. Four types of possible complication were defined a priore: mechanical, thrombotic, infection and malfunctioning. The patient was placed in Trendelenburg's position, a 7.5 MHZ puncturing US probe was placed in the supraclavicular site and a 16-gauge needle was advanced under real-time US guidance into the last portion of internal jugular vein. The Seldinger technique was used to place the catheter, which was advanced into the superior vena cava until insertion into right atrium. Within two hours after each procedure, an upright chest X-ray and ultrasound scanning were carried out to confirm the CVC position and to rule out a pneumotorax. CVC-related infections, symptomatic vein thrombosis and malfunctioning were recorded. Results From December 2000 to January 2009, 1,978 CVC insertional procedures were applied to 1,660 consecutive patients. The procedure was performed 580 times in patients with hematologic malignancies and 1,398 times those with solid tumors. A single-needle puncture of the vein was performed on 1,948 of 1,978 procedures (98.48%; only eighteen attempts among 1,978 failed (0.9%. No pneumotorax, no major bleeding, and no nerve puncture were reported; four cases (0.2% showed self-limiting hematomas. The mean lifespan of CVC was 189

  1. The Scandinavian total ankle replacement: long-term, eleven to fifteen-year, survivorship analysis of the prosthesis in seventy-two consecutive patients.

    Science.gov (United States)

    Brunner, Samuel; Barg, Alexej; Knupp, Markus; Zwicky, Lukas; Kapron, Ashley L; Valderrabano, Victor; Hintermann, Beat

    2013-04-17

    The objective of this study was to determine the long-term survivorship and clinical and radiographic results of the Scandinavian Total Ankle Replacement (STAR). From February 1996 to March 2000, seventy-seven ankles in seventy-two patients (thirty-seven female and thirty-five male patients, with an average age of fifty-six years) underwent total ankle replacement using the STAR prosthesis with a single coating of hydroxyapatite. Two patients were lost to follow-up, and twelve patients with thirteen ankle replacements died. The average duration of follow-up for the patients without revision was 12.4 years (range, 10.8 to 14.9 years). Sixty-two of the seventy-seven ankles were available for final follow-up. Twenty-nine (38%) of the seventy-seven ankles had a revision of at least one of the metallic components. The probability of implant survival was 70.7% at ten years and 45.6% at fourteen years. The main reasons for revision were aseptic loosening, subsidence of the talar component, and progressive cyst formation. Polyethylene insert fractures were observed in eleven ankles. While the midterm to short-term results for patients managed with the STAR prosthesis have been encouraging at 3.7 years, the long-term survivorship of the same cohort was considerably inferior. The subjective and clinical results of the patients with retained prostheses are generally good and comparable with results reported in the current literature.

  2. Retrospective analysis of a VACM (vacuum-assisted closure and mesh-mediated fascial traction treatment manual for temporary abdominal wall closure – results of 58 consecutive patients

    Directory of Open Access Journals (Sweden)

    Beltzer, Christian

    2016-07-01

    Full Text Available Introduction: The optimal treatment concept for temporary abdominal closure (TAC in critically ill visceral surgery patients with open abdomen (OA continues to be unclear. The VACM (vacuum-assisted closure and mesh-mediated fascial traction therapy seems to permit higher delayed primary fascial closure rates (FCR than other TAC procedures. Material and methods: Patients of our clinic (n=58 who were treated by application of a VAC/VACM treatment manual in the period from 2005 to 2008 were retrospectively analysed. Results: The overall FCR of all patients was 48.3% (95% confidence interval: 34.95–61.78. An FCR of 61.3% was achieved in patients who had a vicryl mesh implanted at the fascial level (VACM therapy in the course of treatment. Mortality among patients treated with VACM therapy was 45.2% (95% CI: 27.32–63.97.Conclusions: The results of our own study confirm the results of previous studies which showed an acceptable FCR among non-trauma patients who were treated with VACM therapy. VACM therapy currently appears to be the treatment regime of choice for patients with OA requiring TAC.

  3. Disease-free ovarian cancer patients report severe pain and fatigue over time: prospective quality of life assessment in a consecutive series.

    Science.gov (United States)

    Shinde, S; Wanger, T; Novotny, P; Grudem, M; Jatoi, A

    2015-01-01

    objective: Among ovarian cancer patients, cancer treatment is aggressive and yet survival is often so limited; hence, this study sought to measure quality of life with the ultimate goal of identifying ways of improving it over the duration of these patients' lives. The medical records of all ovarian cancer patients who received some/all of their initial chemotherapy at the Mayo Clinic in Rochester, Minnesota from late 2010 through 2012 were reviewed. Patient-reported quality of life was derived from the following ten-point linear analogue scale questions which had been administered to all patients: 1) How would you describe your degree of pain, on average? 2) How would you describe your level of fatigue, on average? 3) How would you describe your overall quality of life? Quality of life data were censored upon cancer recurrence. Among 59 eligible patients, the median cumulative interval during which quality of life was serially assessed was 1.15 years (range: three months, 3.2 years). Area under the curve for pain, fatigue, and global quality of life showed no statistically significant differences between patients treated with dose-dense chemotherapy with carboplatin/paclitaxel (n = 10) versus three-week chemotherapy with carboplatin/paclitaxel (n = 36) versus other (n = 13). Although pain, fatigue, and global quality of life improved over time, 35 of 59 (59%) patients reported grade 4 or worse pain during follow up, and 47 of 59 (80%) reported grade 4 or worse fatigue (higher scores denote worse pain or fatigue). After completion of cancer treatment, 30 (51%) described grade 4 or worse pain or fatigue. The most common pain site was the abdomen/pelvis, followed by the back, followed by the hands, feet, fingers, and toes. In ovarian cancer patients who remain cancer-free, severe pain and fatigue occur years after cancer treatment. Further research should focus on how best to address these symptoms.

  4. Retrospective, nonrandomized controlled study on autoadjusting, dual-pressure positive airway pressure therapy for a consecutive series of complex insomnia disorder patients

    Science.gov (United States)

    Krakow, Barry; McIver, Natalia D; Ulibarri, Victor A; Nadorff, Michael R

    2017-01-01

    Purpose Emerging evidence shows that positive airway pressure (PAP) treatment of obstructive sleep apnea (OSA) and upper airway resistance syndrome (UARS) in chronic insomnia patients (proposed “complex insomnia” disorder) leads to substantial decreases in insomnia severity. Although continuous PAP (CPAP) is the pressure mode most widely researched, intolerance to fixed pressurized air is rarely investigated or described in comorbidity patients. This retrospective study examined dual pressure, autoadjusting PAP modes in chronic, complex insomnia disorder patients. Patients and methods Chronic insomnia disorder patients (mean [SD] insomnia severity index [ISI] =19.11 [3.34]) objectively diagnosed with OSA or UARS and using either autobilevel PAP device or adaptive servoventilation (ASV) device after failing CPAP therapy (frequently due to intolerance to pressurized air, poor outcomes, or emergence of CSA) were divided into PAP users (≥20 h/wk) and partial users (insomnia patients, PAP users (n=246) averaged 6.10 (1.78) nightly hours and 42.71 (12.48) weekly hours and partial users (n=56) averaged 1.67 (0.76) nightly hours and 11.70 (5.31) weekly hours. For mean (SD) decreases in total ISI scores, a significant (group × time) interaction was observed (F[1,300]=13.566; Pinsomnia symptoms (r=−0.256, PInsomnia severity significantly decreased in patients using autoadjusting PAP devices, but the study design restricts interpretation to an association. Future research must elucidate the interaction between insomnia and OSA/UARS as well as the adverse influence of pressure intolerance on PAP adaptation in complex insomnia patients. Randomized controlled studies must determine whether advanced PAP modes provide benefits over standard CPAP modes in these comorbidity patients. PMID:28331381

  5. 100例新生儿湿疹护理体会%Nursing Experience in 100 Cases of Newborn Eczema

    Institute of Scientific and Technical Information of China (English)

    李萌

    2015-01-01

    ObjectiveTo discuss the nursing methods of newborn eczema. Methods To select 100 cases of children with eczema from January 2013 to January 2015 in our hospital, nursing intervention on them, the treatment results were analyzed and summarized. ResultsThrough nursing intervention on children with eczema, satisfactory results are obtained, excelent in 54 cases (54%), effective in 42 cases (42%), invalid in 4 cases (4%), the total efficiency is 96%. Conclusion Nursing intervention on children with eczema can effectively prevent newborn eczema, improve the life quality of children and relatives of patients for nursing satisfaction. Nursing personnel should timely summarize, generalize and popularize effective nursing method.%目的:探讨新生儿湿疹的护理方法。方法选取2013年1月~2015年1月在本院就诊的100例湿疹患儿,对其进行护理干预,对治疗结果进行分析和总结。结果通过对湿疹患儿进行护理干预,获得了较为满意的结果,显效54例(54%)、有效42例(42%)、无效4例(4%),总有效率96%。结论对湿疹患儿进行护理干预,可以有效防治新生儿湿疹,提高患儿的生活质量及患者家属对护理的满意度,对于行之有效的护理方法,护理人员应及时总结并加以推广和普及。

  6. Insights into the problem of alarm fatigue with physiologic monitor devices: a comprehensive observational study of consecutive intensive care unit patients

    National Research Council Canada - National Science Library

    Drew, Barbara J; Harris, Patricia; Zègre-Hemsey, Jessica K; Mammone, Tina; Schindler, Daniel; Salas-Boni, Rebeca; Bai, Yong; Tinoco, Adelita; Ding, Quan; Hu, Xiao

    2014-01-01

    Physiologic monitors are plagued with alarms that create a cacophony of sounds and visual alerts causing "alarm fatigue" which creates an unsafe patient environment because a life-threatening event...

  7. EGFR Mutations in Surgically Resected Fresh Specimens from 697 Consecutive Chinese Patients with Non-Small Cell Lung Cancer and Their Relationships with Clinical Features

    Directory of Open Access Journals (Sweden)

    Yuanyang Lai

    2013-12-01

    Full Text Available We aimed to reveal the true status of epidermal growth factor receptor (EGFR mutations in Chinese patients with non-small cell lung cancer (NSCLC after lung resections. EGFR mutations of surgically resected fresh tumor samples from 697 Chinese NSCLC patients were analyzed by Amplification Refractory Mutation System (ARMS. Correlations between EGFR mutation hotspots and clinical features were also explored. Of the 697 NSCLC patients, 235 (33.7% patients had tyrosine kinase inhibitor (TKIs sensitive EGFR mutations in 41 (14.5% of the 282 squamous carcinomas, 155 (52.9% of the 293 adenocarcinomas, 34 (39.5% of the 86 adenosquamous carcinomas, one (9.1% of the 11 large-cell carcinomas, 2 (11.1% of the 18 sarcomatoid carcinomas, and 2 (28.6% of the 7 mucoepidermoid carcinomas. TKIs sensitive EGFR mutations were more frequently found in female patients (p < 0.001, non-smokers (p = 0.047 and adenocarcinomas (p < 0.001. The rates of exon 19 deletion mutation (19-del, exon 21 L858R point mutation (L858R, exon 21 L861Q point mutation (L861Q, exon 18 G719X point mutations (G719X, including G719C, G719S, G719A were 43.4%, 48.1%, 1.7% and 6.8%, respectively. Exon 20 T790M point mutation (T790M was detected in 3 squamous carcinomas and 3 adenocarcinomas and exon 20 insertion mutation (20-ins was detected in 2 patients with adenocarcinoma. Our results show the rates of EGFR mutations are higher in all types of NSCLC in Chinese patients. 19-del and L858R are two of the more frequent mutations. EGFR mutation detection should be performed as a routine postoperative examination in Chinese NSCLC patients.

  8. Time trends, ethnicity and risk factors for eczema in New Zealand children: ISAAC Phase Three

    OpenAIRE

    Clayton, Tadd; Asher, M Innes; Crane, Julian; Ellwood, Philippa; Mackay, Richard; Mitchell, Edwin A; Moyes, Chris D; Pattemore, Philip; Pearce, Neil; Stewart, Alistair W.

    2013-01-01

    Background Eczema is a common chronic disease which has significant morbidity and costs for children and their families. Phase One (1993) of the International Study of Asthma and Allergies in Childhood (ISAAC) found a high prevalence of symptoms of eczema in New Zealand. Objective In Phase Three (2001-3) we aimed to answer these three questions: Is the prevalence of eczema changing over time?; Are there ethnic differences in prevalence?; and What are the risk factors for eczema? Methods Five ...

  9. Mycosis Fungoides mimic chronic eczema? Observation

    Directory of Open Access Journals (Sweden)

    Jacek Andruszkiewicz

    2013-07-01

    Full Text Available Mycosis fungoides (MF is the most common type of cutaneous T-cell lymphoma [1]. Because of its great variety of clinical features and nonspecific histological findings (especially in early stages has been named the "great imitator "and can induce many wrong diagnosis [2,3]. Mycosis fungoides (MF, is an epidermotropic lymphoma included as an indolent form in the recent WHO/EORTC classification. From a clinical point of view, the classic disease progression usually is slow and takes over years or even decades, and characterized by the evolution from patches to more infiltrated plaques and eventually to tumours or erythroderma. However, the analysis of the MF disease course has been greatly impaired by the rarity of the disease, thus data about the time course of disease progression and pattern of relapse during time are not well known [4,5]. Therefore very often Mycosis fungoides is misdiagnosed as chronic eczema [6]. MF can also mimic: vitiligo [6], alopecia-Areata [7], ecchymosis [8].

  10. Sigmoid resection with primary anastomosis and ileostomy versus laparoscopic lavage in purulent peritonitis from perforated diverticulitis: outcome analysis in a prospective cohort of 40 consecutive patients.

    Science.gov (United States)

    Catry, Jonathan; Brouquet, Antoine; Peschaud, Frédérique; Vychnevskaia, Karina; Abdalla, Solafah; Malafosse, Robert; Lambert, Benoit; Costaglioli, Bruno; Benoist, Stéphane; Penna, Christophe

    2016-10-01

    This prospective study aimed to compare outcomes after laparoscopic peritoneal lavage (LPL) and sigmoid resection with primary colorectal anastomosis (RPA). From June 2010 to June 2015, 40 patients presenting with Hinchey III peritonitis from perforated diverticulitis underwent LPL or RPA. Patients with Hinchey II or IV peritonitis and patients who underwent an upfront Hartmann procedure were excluded. Primary endpoint was overall 30-day or in-hospital postoperative morbidity after surgical treatment of peritonitis. Twenty-five patients underwent RPA and 15 LPL. Overall postoperative morbidity and mortality rates were not significantly different after RPA and LPL (40 vs 67 %, p = 0.19; 4 vs 6.7 %, p = 1, respectively). Intra-abdominal morbidity and reoperation rates were significantly higher after LPL compared to RPA (53 vs 12 %, p < 0.01; 40 vs 4 %, p = 0.02, respectively). Multivariate analysis showed that LPL (p = 0.028, HR = 18.936, CI 95 % = 1.369-261.886) was associated with an increased risk of postoperative intra-abdominal septic morbidity. Among 6 patients who underwent reoperation after LPL, 4 had a Hartmann procedure. All surviving patients who had a procedure requiring stoma creation underwent stoma reversal after a median delay of 92 days after LPL and 72 days after RPA (p = 0.07). LPL for perforated diverticulitis is associated with a high risk of inadequate intra-abdominal sepsis control requiring a Hartmann procedure in up to 25 % of patients. RPA appears to be safer and more effective. It may represent the best option in this context.

  11. Patterns of Recurrence After Low-Dose-Rate Prostate Brachytherapy: A Population-Based Study of 2223 Consecutive Low- and Intermediate-Risk Patients

    Energy Technology Data Exchange (ETDEWEB)

    Lo, Andrea C.; Morris, W. James, E-mail: JMorris@bccancer.bc.ca; Pickles, Tom; Keyes, Mira; McKenzie, Michael; Tyldesley, Scott

    2015-03-15

    Objectives: This study examined patterns of recurrence after low–dose-rate prostate brachytherapy (LDR-PB), estimated local recurrence rate and compared that rate to the estimated local recurrence rate after radical prostatectomy (RP). Methods and Materials: A prospective database was maintained with clinical, dosimetric, and outcome data for all LDR-PB implantation procedures performed at our institution. From 1998 to 2008, 2223 patients with prostate cancer received LDR-PB without supplemental external beam radiation therapy. Patients who developed Phoenix-defined biochemical failure were reviewed for sites of relapse and investigations completed. Results: At a median follow-up of 5 years, 108 of 2223 patients (4.8%) developed biochemical relapse. In 1 additional patient, local relapse was found on transurethral prostate resection, but his prostate-specific antigen concentration was well short of triggering Phoenix-defined failure. Of the 109 patients with disease relapse, 18 of 2223 (0.8%) had a proven local recurrence, and 30 of 2223 (1.3%) had a proven distant recurrence. The remaining 61 of 2223 patients (2.7%) had unidentified sites of recurrence; of these, 57 patients (93%) had digital rectal examinations (DREs), 18 (30%) had post-treatment biopsies, 45 (74%) had bone scans, and 34 (56%) had computed tomography imaging of the abdomen and pelvis. If every biochemical failure were local, the local recurrence rate would be as high as 4.9%; however, by excluding those with proven distant failure and those with both a negative DRE and biopsy, we estimate that the local recurrence rate is 2.7% or less. Conclusions: In the context of limitations of the study design, our population-based analysis indicates that the local recurrence rate after LDR-PB is as low or lower than that after RP in our jurisdiction.

  12. Incidence, risk factors and clinical outcomes of acute kidney injury associated with scrub typhus: a retrospective study of 510 consecutive patients in South Korea (2001–2013)

    Science.gov (United States)

    Hwang, Kyungo; Jang, Ha Nee; Lee, Tae Won; Cho, Hyun Seop; Bae, Eunjin; Chang, Se-Ho; Park, Dong Jun

    2017-01-01

    Objectives Renal involvement in scrub typhus ranges from simple urinary abnormalities to acute kidney injury (AKI) leading to death. This study evaluated the incidence, predictors and prognosis of AKI associated with scrub typhus according to the RIFLE (risk, injury, failure, loss, end-stage kidney disease) criteria. Methods We retrospectively evaluated the medical records of patients diagnosed with scrub typhus from January 2001 to November 2013 in Gyeongsang National University Hospital. Results During the study period, 510 patients were diagnosed with scrub typhus and the incidence of AKI was 35.9%. There were 132 (25.9%) patients at risk, 37 (7.3%) with injury and 14 (2.7%) with failure. In comparison with the non-AKI group, the AKI group was older (73.9 vs 63.4 years, pIntensive care unit admission and death were more frequent in the AKI group. The renal function of most patients with AKI recovered without sequelae, except for 1 patient who had underlying CKD. Multivariate analysis showed that age, presence of CKD, serum albumin level and time to hospital presentation after symptom onset were independent predictors of AKI in patients with scrub typhus. Conclusions Our current results suggest that the presence of underlying CKD, older age, lower serum albumin level and time to hospital presentation after symptom onset were important risk factors to determine occurrence of AKI. Whether earlier diagnosis and treatment in patients with the above risk factors reduce the incidence and severity of AKI deserves to be investigated. PMID:28298367

  13. Functional outcomes, morbidity, mortality, and fracture healing in 58 consecutive patients with geriatric odontoid fracture treated with cervical collar or posterior fusion.

    Science.gov (United States)

    Molinari, William J; Molinari, Robert W; Khera, Oner A; Gruhn, William L

    2013-03-01

    Controversy exists as to the most effective management option for elderly patients with type II odontoid fractures. The purpose of this study is to evaluate outcomes associated with rigid cervical collar and posterior fusion surgery. Patients with ≥ 50% odontoid displacement were treated with posterior fusion surgery including C1-2 (PSF group, n = 25, average age = 80 years). Patients with cervical collar for 12 weeks (collar group, n = 33, average age = 83 years). These inhomogeneous groups were followed for an average of 14 months. Fracture healing rates were higher in the operative group (28% versus 6%). Neck Disability Index scores were slightly lower in the nonoperative group (13 versus 18.3, p = 0.23). Analogue pain scores were also slightly lower in the nonoperative group (1.3 versus 1.9, p = 0.26). The mortality rate was 12.5% in the collar group and 20% in the operative group. Complications were higher in the operative group (24% versus 6%). Rates of type II odontoid facture healing and stability appear to be higher in geriatric patients treated with posterior fusion surgery. Fracture healing and stability did not correlate with improved outcomes with respect to levels of pain, function, and satisfaction. Mortality and complication rates are lower in those patients with lesser-displaced fractures who are treated with a cervical collar and early mobilization.

  14. The prevalence, characteristics of and risk factors for eczema in Belgian schoolchildren.

    Science.gov (United States)

    Govaere, Elke; Van Gysel, Dirk; Verhamme, Katia M C; Doli, Erenik; Oranje, Arnold P; De Baets, Frans

    2009-01-01

    Childhood eczema is common in infants, but its nature and extent during later childhood remains unclear. In this cross-sectional study we examined the prevalence and characteristics of eczema in an unbiased community population of 2,021 Belgian schoolchildren, aged 3.4 to 14.8 years with skin prick testing and parental questionnaires. Our study identified an eczema prevalence of 23.3% and a considerable allergic comorbidity, mainly in sensitized children. The reported prevalence of eczema in infancy was 18.5% and for current eczema 11.6%. The overall sensitization rate (33.2%) as well as sensitization rates for the individual allergens were significantly higher in children with "eczema ever." Sensitization to Dermatophagoides pteronyssinus (19.6%), mixed grass pollen (15.1%), and cat (9.1%) were most common. Until the age of 6 years, boys with eczema were significantly more sensitized than girls (p = 0.007). Children with both eczema in infancy and current eczema show a tendency to be more sensitized than children with eczema in infancy only or current eczema only, but significance was only noted for a few individual allergens. Analysis of factors associated with eczema revealed a predominantly atopic profile characterized by family or personal history of allergy. Breastfeeding and environmental factors seemed to assume little relevance except for a protective effect of prematurity and having a dog at birth.

  15. Hand eczema among healthcare professionals in the Netherlands: prevalence, absenteeism, and presenteeism

    NARCIS (Netherlands)

    Meer, E.W. van der; Boot, C.R.L.; Gulden, J.W.J. van der; Jungbauer, F.H.; Coenraads, P.J.; Anema, J.R.

    2013-01-01

    BACKGROUND: Healthcare professionals have a high risk of developing hand eczema. Hand eczema can interfere with their work. OBJECTIVES: To investigate the prevalence of self-reported hand eczema among healthcare professionals in the Netherlands, and to investigate absenteeism and presenteeism result

  16. Hand eczema among healthcare professionals in the Netherlands : prevalence, absenteeism, and presenteeism

    NARCIS (Netherlands)

    van der Meer, Esther W. C.; Boot, Cecile R. L.; van der Gulden, Joost W. J.; Jungbauer, Frank H. W.; Coenraads, Pieter Jan; Anema, Johannes R.

    2013-01-01

    Background. Healthcare professionals have a high risk of developing hand eczema. Hand eczema can interfere with their work. Objectives. To investigate the prevalence of self-reported hand eczema among healthcare professionals in the Netherlands, and to investigate absenteeism and presenteeism result

  17. INSULIN-LIKE GROWTH FACTOR-1 (IGF-1: DEMOGRAPHIC, CLINICAL AND LABORATORY DATA IN 120 CONSECUTIVE ADULT PATIENTS WITH THALASSAEMIA MAJOR

    Directory of Open Access Journals (Sweden)

    V. De Sanctis

    2014-11-01

    Full Text Available Introduction:  Insulin-like growth factor 1 (IGF-1 is a key peptide involved in cell growth and protein turnover, acting as the primary mediator of many of the responses regulated by growth hormone (GH in tissues. Signs and symptoms of adult GH deficiency (AGHD in patients with β-thalassaemia major (TM  may be subtle and overlap with those of the disease itself; therefore, the diagnosis may be missed or delayed, with potentially serious consequences. The diagnosis of AGHD requires an appropriate clinical setting and is confirmed through biochemical testing. The  aim of this study  was  to measure IGF-1 values and other clinical data in a large number of adult  patients with TM and to  evaluate whether an  IGF-1 concentration 2 SDs below normative values  could be used as an effective index supporting  the probable presence of  AGHD. Patients and Methods: A cohort of 120 adult patients with TM was studied for plasma levels of IGF-1. Plasma total IGF-1 was determined by chemiluminescent immunometric assay (CLIA method. In eleven patients (4 males the GH response during glucagon stimulation test (GST was also evaluated.  Results:  Fifty percent of patients (33 males and 27 females had IGF-1 levels   -2SDs. In multivariate regression analyses,  height, weight, BMI, serum ferritin, ALT, HCV serology and left ventricular ejection fraction (LVEF were not significantly related to IGF-1,  but a significant correlation was found in females between HCV-RNA positivity and IGF-1, ALT and serum ferritin (p= 0.043. AGHD was diagnosed in 6 (4 males out of 11 patients (54.5% who had glucagon stimulation tests and in 5 out of 8 (62.5% with IGF-1 <-2SD. The mean age of patients with GHD was 39.3 years (range: 25-49 years versus 35.8 years (range: 27-45 years in non-GHD patients. A positive correlation between GH peak after GST and IGF-1 level was found (r: 0.6409; p: < 0.05. Conclusions: On the basis of the present results and data from the

  18. Alitretinoin for the treatment of severe chronic hand eczema.

    Science.gov (United States)

    Paulden, M; Rodgers, M; Griffin, S; Slack, R; Duffy, S; Ingram, J R; Woolacott, N; Sculpher, M

    2010-05-01

    This paper presents a summary of the evidence review group (ERG) report into the clinical effectiveness and cost-effectiveness of alitretinoin for the treatment of adults with severe chronic hand eczema refractory to topical steroid treatment in accordance with the licensed indication, based upon the evidence submission from Basilea Pharmaceuticals Ltd to the National Institute for Health and Clinical Excellence (NICE) as part of the single technology appraisal process. The clinical evidence came from a single placebo-controlled randomised controlled trial of daily treatment with alitretinoin for 12-24 weeks, with follow-up for a further 24 weeks, in patients with severe chronic hand eczema (CHE) unresponsive to topical steroids. A statistically significantly greater proportion of patients using alitretinoin achieved the primary end point of clear or almost clear hands by week 24 than did those with placebo. Dose-dependent headache was the most commonly reported adverse event in patients treated with alitretinoin. Serious adverse events were rare, but alitretinoin was associated with increases in both total cholesterol and triglycerides, which has implications for risks of future cardiovascular events. The manufacturer submitted a de novo decision analytic model to estimate, over a time horizon of 3 years, the cost-effectiveness of alitretinoin versus the other relevant comparators identified by NICE. In response to the points of clarification put to it by the ERG regarding the initial submission, the manufacturer provided additional evidence and a revised decision analytic model with a 'placebo' arm. In the manufacturer's original submission to NICE, the base-case incremental cost-effectiveness ratios (ICERs) reported for alitretinoin were 8614 pounds per quality-adjusted life-year (QALY) versus ciclosporin, -469 pounds per QALY versus psoralen + UVA (with alitretinoin dominant) and 10,612 pounds per QALY versus azathioprine. These ICERs decreased as the time

  19. Performance of the Straumann Bone Level Implant system for anterior single-tooth replacements in augmented and nonaugmented sites : A prospective cohort study with 60 consecutive patients

    NARCIS (Netherlands)

    Santing, Hendrik J.; Raghoebar, Gerry M.; Vissink, Arjan; den Hartog, Laurens; Meijer, Henny J. A.

    2013-01-01

    Aim The purpose of this prospective study was to evaluate radiographic, clinical and aesthetic outcomes and patient satisfaction of cases treated with platform-switched single implant restorations in the aesthetic region of the maxilla. Furthermore, the influence of an augmentation procedure 3months

  20. Prevalence of MLH1 constitutional epimutations as a cause of Lynch syndrome in unselected versus selected consecutive series of patients with colorectal cancer.

    Science.gov (United States)

    Castillejo, Adela; Hernández-Illán, Eva; Rodriguez-Soler, María; Pérez-Carbonell, Lucía; Egoavil, Cecilia; Barberá, Victor M; Castillejo, María-Isabel; Guarinos, Carla; Martínez-de-Dueñas, Eduardo; Juan, María-Jose; Sánchez-Heras, Ana-Beatriz; García-Casado, Zaida; Ruiz-Ponte, Clara; Brea-Fernández, Alejandro; Juárez, Miriam; Bujanda, Luis; Clofent, Juan; Llor, Xavier; Andreu, Montserrat; Castells, Antoni; Carracedo, Angel; Alenda, Cristina; Payá, Artemio; Jover, Rodrigo; Soto, José-Luis

    2015-07-01

    The prevalence of MLH1 constitutional epimutations in the general population is unknown. We sought to analyse the prevalence of MLH1 constitutional epimutations in unselected and selected series of patients with colorectal cancer (CRC). Patients with diagnoses of CRC (n=2123) were included in the unselected group. For comparison, a group of 847 selected patients with CRC who fulfilled the revised Bethesda guidelines (rBG) were also included. Somatic and constitutional MLH1 methylation was assayed via methylation-specific multiplex ligation-dependent probe amplification of cases lacking MLH1 expression. Germline alterations in mismatch-repair (MMR) genes were assessed via Sanger sequencing and methylation-specific multiplex ligation-dependent probe amplification. Loss of MLH1 expression occurred in 5.5% of the unselected series and 12.5% of the selected series (pprevalence of MLH1 constitutional epimutations in unselected cases of CRC. Therefore, MLH1 constitutional epimutation analysis should be conducted only for patients who fulfil the rBG and who lack MLH1 expression with methylated MLH1. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  1. Anterior D-rod and titanium mesh fixation for acute mid-lumbar burst fracture with incomplete neurologic deficits A prospective study of 56 consecutive patients

    Directory of Open Access Journals (Sweden)

    Zhe-yuan Huang

    2015-01-01

    Conclusion: Good mid term clinicoradiological results of anterior decompression with D-rod and titanium mesh fixation for suitable patients with mid-lumbar burst fractures with incomplete neurologic deficits can be achieved. The incident rate of complications was low. D-rod is a reliable implant and has some potential advantages in L4 vertebral fractures.

  2. Experience with percutaneous closure of ductus arteriosus using the Amplatzer duct occluder in 243 consecutive patients and long-term results-A single centre study

    Directory of Open Access Journals (Sweden)

    Mostafa Behjati-Ardakani

    2014-01-01

    Full Text Available Background: Percutaneous closure of patent ductus arteriosus (PDA with Amplatzer duct occluder (ADO has become increasingly popular in many cardiovascular centres. This study analysed the long-term results of percutaneous closure of PDA with ADO in a single centre. Materials and Methods: Between May 2004 and January 2013, 243 patients with median age of 2.5 years (range = 30 months to 38 years and median weight of 10 Kg (range 4.5-80.5 Kg underwent percutaneous closure of PDA using the ADO. The devices were implanted under fluoroscopic guidance. Patients were followed-up for any complications. Results: The mean diameter of narrow part of PDA was 6.4 ± 2.2 mm. The mean diameter of devices was 7.8 ± 2.3 mm. The devices were successfully implanted in 239 (98.3% cases. At immediate, 1 day, 1, 6, 12 months and late follow-up, the complete occlusion rate was 33% (79 case, 97.1% (236 case, 97.5% (237 case, 98.3% (238 case, 98.3% (238 case and 98.3% (238 case, respectively. Residual shunt remained in one case at late follow-up. The device embolisation occurred in five patients. The devices were successful retrieved in three patient and second larger devices were inserted. Two other devices were surgically retrieved and PDAs were ligated. Moderate left pulmonary artery stenosis (LPA in one child and mild LPA stenosis in one infant were detected. Mild aortic obstruction occurred in one infant. Conclusions: Long-term follow-up of patients indicate that percutaneous closure of PDA using ADO is a safe and effective procedure. However, some complications, including device embolisation, left pulmonary stenosis and aortic obstruction may be observed in some cases.

  3. A new measurement for posterior tilt predicts reoperation in undisplaced femoral neck fractures: 113 consecutive patients treated by internal fixation and followed for 1 year

    DEFF Research Database (Denmark)

    Palm, Henrik; Gosvig, Kasper; Krasheninnikoff, Michael

    2009-01-01

    BACKGROUND AND PURPOSE: Preoperative posterior tilt in undisplaced (Garden I-II) femoral neck fractures is thought to influence rates of reoperation. However, an exact method for its measurement has not yet been presented. We designed a new measurement for posterior tilt on preoperative lateral......, and rate of reoperation within the first year. In a subgroup of 50 randomly selected patients, reliability tests for measurement of posterior tilt were performed. RESULTS: Intra- and interclass coefficients for the new measurement were > or = 0.94. 23% (26/113) of patients were reoperated and increased...... score, time from admission to operation, surgeon's expertise, postoperative reduction, and implant positioning, a preoperative posterior tilt of > or = 20 degrees was the only significant predictor of reoperation (p measurement for posterior tilt appears to be reliable...

  4. Complications following US-guided core-needle biopsy for thyroid lesions: a retrospective study of 6,169 consecutive patients with 6,687 thyroid nodules.

    Science.gov (United States)

    Ha, Eun Ju; Baek, Jung Hwan; Lee, Jeong Hyun; Kim, Jae Kyun; Choi, Young Jun; Sung, Tae Yon; Kim, Tae Yong

    2017-03-01

    To present the various complications of ultrasound (US)-guided core needle biopsy (CNB) of thyroid lesions in a large patient series. From January 2008 to March 2013, 6,169 patients underwent US-guided CNB of 6,687 thyroid nodules at a single institution. We assessed the number and types of major and minor complications, and evaluated the factors associated with complications. Overall, 53 complications were observed in 50 patients (0.81 %), including 4 major and 49 minor complications. The major complications were massive haematoma (n = 2), pseudoaneurysm (n = 1) and voice change leading to disability that lasted for more than 30 days (n = 1). The minor complications were small to moderate haematoma (n = 42), carotid injury (n = 2), voice change that recovered within 30 days (n = 3), tracheal puncture (n = 1) and dysphagia (n = 1). Oedema (n = 12), vertebral puncture (n = 3) and vasovagal reaction (n = 1) were recorded as side effects. The presence of a coprocedure was the only significant factor associated with complications after thyroid CNB (P = 0.023). US-guided CNB of thyroid lesions was found in a large population to be a safe procedure with a low complication rate. • The complication rate after US-guided CNB for thyroid lesions was 0.81 % (50/6,169). • The rate of major complications was 0.06 % (4/6,169). • Vascular injury was the most common complication (47/6,169; 0.76 %). • None of the patients experienced permanent problems resulting from complications.

  5. Medial Protrusio Technique in Cementless Total Hip Arthroplasty for Developmental Dysplasia of the Hip: A Prospective 6- to 9-Year Follow-Up of 43 Consecutive Patients.

    Science.gov (United States)

    Zha, Guo-Chun; Sun, Jun-Ying; Guo, Kai-Jin; Zhao, Feng-Chao; Pang, Yong; Zheng, Xin

    2016-08-01

    The medial protrusio technique may be used during total hip arthroplasty (THA) on patients with developmental dysplasia. However, studies have yet to determine whether a cementless cup can be sufficiently stable to withstand loading forces. This study aimed to assess the clinical and radiographic outcomes of this technique. Furthermore, we sought to determine the relationship between the rate of medial protrusion and the incidence of cup loosening. Thirty-nine patients (43 hips) underwent cementless THA between April 2006 and March 2009 by using the medial protrusio technique. These patients participated in a 6- to 9-year follow-up. Their clinical and radiographic data were gathered prospectively. The average Harris Hip Score improved from 43.1 ± 15.4 points preoperatively to 91.9 ± 12.8 points at the final follow-up (P hip center and the distance of hip center medialization were 2.4 ± 0.6 and 2.5 ± 0.9 cm, respectively. The rate of medial protrusion and the rate of cup coverage were 42.1 ± 12.4% and 96.8 ± 5.1%, respectively. The rate of medial protrusion ranged from 18.3% to 58.3% in 38 hips (group A) and from 61.3% to 68.9% in 5 hips (group B). None of the cups in group A loosened or failed, 2 failures occurred in group B (0% vs 40.0%; P = .011). Developmental dysplasia was treated through THA using the medial protrusio technique, which easily achieves a sufficient superolateral host bony coverage of the cup and promotes socket reconstruction at the true acetabulum. The rate of medial protrusion of <60% may be necessary to obtain excellent clinical and radiographic midterm results. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Similar long-term survival of consecutive in-hospital and out-of-hospital cardiac arrest patients treated with targeted temperature management

    DEFF Research Database (Denmark)

    Engsig, Magaly; Søholm, Helle; Folke, Fredrik

    2016-01-01

    outcome assessed using the Pittsburgh cerebral performance category (CPC). RESULTS: A total of 282 patients were included in this study; 233 (83%) OHCA and 49 (17%) IHCA. The IHCA group presented more often with asystole, received bystander cardiopulmonary resuscitation (CPR) in all cases, and had shorter...... time to return of spontaneous circulation (ROSC). Survival to hospital discharge was 54% for OHCA and 53% for IHCA (adjusted odds ratio 0.98 [95% confidence interval {CI}; 0.43-2.24]). Age ≤60 years, bystander CPR, time to ROSC ≤10 min, and shockable rhythm at presentation were associated with survival...

  7. Organizational Factors and Long-Term Mortality after Hip Fracture Surgery. A Cohort Study of 6143 Consecutive Patients Undergoing Hip Fracture Surgery

    DEFF Research Database (Denmark)

    Lund, Caterina A; Møller, Ann M; Wetterslev, Jørn

    2014-01-01

    OBJECTIVE: In hospital and health care organizational factors may be changed to reduce postoperative mortality. The aim of this study is to evaluate a possible association between mortality and 'length of hospital stay', 'priority of surgery', 'time of surgery', or 'surgical delay' in hip fracture......, anaesthetic and surgical procedures were retrieved. PARTICIPANTS: 6143 patients aged more than 65 years undergoing hip fracture surgery. MAIN OUTCOME MEASURES: All-cause mortality. RESULTS: The one year mortality was 30% (28-31%, 95% Confidence interval (CI)). In a multivariate model 'length of hospital stay...

  8. Guidelines for diagnosis, prevention and treatment of hand eczema

    DEFF Research Database (Denmark)

    Diepgen, Thomas L; Andersen, Klaus E; Chosidow, Oliver;

    2015-01-01

    The guidelines aim to provide advice on the management of hand eczema (HE), using an evidence- and consensus-based approach. The guidelines consider a systematic Cochrane review on interventions for HE, which is based on a systematic search of the published literature (including hand-searching). ......The guidelines aim to provide advice on the management of hand eczema (HE), using an evidence- and consensus-based approach. The guidelines consider a systematic Cochrane review on interventions for HE, which is based on a systematic search of the published literature (including hand...

  9. Insights into the problem of alarm fatigue with physiologic monitor devices: a comprehensive observational study of consecutive intensive care unit patients.

    Science.gov (United States)

    Drew, Barbara J; Harris, Patricia; Zègre-Hemsey, Jessica K; Mammone, Tina; Schindler, Daniel; Salas-Boni, Rebeca; Bai, Yong; Tinoco, Adelita; Ding, Quan; Hu, Xiao

    2014-01-01

    Physiologic monitors are plagued with alarms that create a cacophony of sounds and visual alerts causing "alarm fatigue" which creates an unsafe patient environment because a life-threatening event may be missed in this milieu of sensory overload. Using a state-of-the-art technology acquisition infrastructure, all monitor data including 7 ECG leads, all pressure, SpO(2), and respiration waveforms as well as user settings and alarms were stored on 461 adults treated in intensive care units. Using a well-defined alarm annotation protocol, nurse scientists with 95% inter-rater reliability annotated 12,671 arrhythmia alarms. A total of 2,558,760 unique alarms occurred in the 31-day study period: arrhythmia, 1,154,201; parameter, 612,927; technical, 791,632. There were 381,560 audible alarms for an audible alarm burden of 187/bed/day. 88.8% of the 12,671 annotated arrhythmia alarms were false positives. Conditions causing excessive alarms included inappropriate alarm settings, persistent atrial fibrillation, and non-actionable events such as PVC's and brief spikes in ST segments. Low amplitude QRS complexes in some, but not all available ECG leads caused undercounting and false arrhythmia alarms. Wide QRS complexes due to bundle branch block or ventricular pacemaker rhythm caused false alarms. 93% of the 168 true ventricular tachycardia alarms were not sustained long enough to warrant treatment. The excessive number of physiologic monitor alarms is a complex interplay of inappropriate user settings, patient conditions, and algorithm deficiencies. Device solutions should focus on use of all available ECG leads to identify non-artifact leads and leads with adequate QRS amplitude. Devices should provide prompts to aide in more appropriate tailoring of alarm settings to individual patients. Atrial fibrillation alarms should be limited to new onset and termination of the arrhythmia and delays for ST-segment and other parameter alarms should be configurable. Because computer

  10. Insights into the problem of alarm fatigue with physiologic monitor devices: a comprehensive observational study of consecutive intensive care unit patients.

    Directory of Open Access Journals (Sweden)

    Barbara J Drew

    Full Text Available PURPOSE: Physiologic monitors are plagued with alarms that create a cacophony of sounds and visual alerts causing "alarm fatigue" which creates an unsafe patient environment because a life-threatening event may be missed in this milieu of sensory overload. Using a state-of-the-art technology acquisition infrastructure, all monitor data including 7 ECG leads, all pressure, SpO(2, and respiration waveforms as well as user settings and alarms were stored on 461 adults treated in intensive care units. Using a well-defined alarm annotation protocol, nurse scientists with 95% inter-rater reliability annotated 12,671 arrhythmia alarms. RESULTS: A total of 2,558,760 unique alarms occurred in the 31-day study period: arrhythmia, 1,154,201; parameter, 612,927; technical, 791,632. There were 381,560 audible alarms for an audible alarm burden of 187/bed/day. 88.8% of the 12,671 annotated arrhythmia alarms were false positives. Conditions causing excessive alarms included inappropriate alarm settings, persistent atrial fibrillation, and non-actionable events such as PVC's and brief spikes in ST segments. Low amplitude QRS complexes in some, but not all available ECG leads caused undercounting and false arrhythmia alarms. Wide QRS complexes due to bundle branch block or ventricular pacemaker rhythm caused false alarms. 93% of the 168 true ventricular tachycardia alarms were not sustained long enough to warrant treatment. DISCUSSION: The excessive number of physiologic monitor alarms is a complex interplay of inappropriate user settings, patient conditions, and algorithm deficiencies. Device solutions should focus on use of all available ECG leads to identify non-artifact leads and leads with adequate QRS amplitude. Devices should provide prompts to aide in more appropriate tailoring of alarm settings to individual patients. Atrial fibrillation alarms should be limited to new onset and termination of the arrhythmia and delays for ST-segment and other parameter

  11. Chronic congestive heart failure. Description and survival of 190 consecutive patients with a diagnosis of chronic congestive heart failure based on clinical signs and symptoms

    DEFF Research Database (Denmark)

    Madsen, B K; Hansen, J F; Stokholm, K H;

    1994-01-01

    -year mortality was 32%. Median left ventricular ejection fraction (LVEF) was 0.30, range 0.06 to 0.74. Eight per cent were in New York Heart Association (NYHA) class I, 46% in II, 44% in III and 2% in IV. Multivariate analysis, excluding exercise test variables, revealed seven variables...... with independent, significant prognostic information, (hazard ratios for death in brackets): ln (natural logarithm) (LVEF) (3.19), NYHA class III+IV (2.72), plasma urea > 7.6 mmol.l-1 (2.22), serum creatinine > 121 mumol.l-1 (2.05), serum sodium ... exercise time 7.6 mmol.l-1 (1.9). In conclusion, patients with CHF have a high risk of death despite intensive medical treatment. LVEF is a strong predictor of mortality. Both NYHA class and exercise...

  12. The Hand Eczema Trial (HET): design of a randomised clinical trial of the effect of classification and individual counselling versus no intervention among health-care workers with hand eczema

    OpenAIRE

    2010-01-01

    Abstract Background Hand eczema is the most frequently recognized occupational disease in Denmark with an incidence of approximately 0.32 per 1000 person-years. Consequences of hand eczema include chronic severe eczema, prolonged sick leave, unemployment, and impaired quality of life. New preventive strategies are needed to reduce occupational hand eczema. Methods/Design We describe the design of a randomised clinical trial to investigate the effects of classification of hand eczema plus indi...

  13. Infection after pacemaker implantation: infection rates and risk factors associated with infection in a population-based cohort study of 46299 consecutive patients

    Science.gov (United States)

    Johansen, Jens Brock; Jørgensen, Ole Dan; Møller, Mogens; Arnsbo, Per; Mortensen, Peter Thomas; Nielsen, Jens Cosedis

    2011-01-01

    Aims Infection is a serious complication of pacemaker (PM) systems. Although the rate of infection has been debated, the figures are largely unknown. We therefore studied the incidence of PM infection and its associated risk factors in the Danish population. Methods and results Since 1982, all PM implantation and removal procedures performed in Denmark have been prospectively recorded in the Danish Pacemaker Register. All patients (n = 46299) who underwent implantation between 1982 and 2007 were included. The total length of surveillance was 236 888 PM-years. The incidence of infection was calculated according to the total number of PM-years. The incidence of surgical site infection (≤365 days after PM implantation) was compared with later infection in first implant and replacement procedures. Multiple-record and multiple-event-per-subject proportional hazards analyses were used to identify the independent risk factors of PM infection. Surgical site infection occurred in 192 cases after first implantation (incidence rate 4.82/1000 PM-years), and in 133 cases after replacement (12.12/1000 PM-years). Infections occurring more than 365 days after the first implantation occurred in 153 cases (1.02/1000 PM-years), and in 118 cases after replacement (3.26/1000 PM-years). Independent factors associated with an increased risk of PM infection were a greater number of PM operations (including replacements), male sex, younger age, implantation during the earliest part of the study period, and absence of antibiotics (P< 0.001). Conclusion The overall risk of infection after PM implantation was low. A greater number of operations augmented the risk of infection. This should be taken into account when considering revisions of PM systems. PMID:21252172

  14. 中药外洗联合光疗对急性手部湿疹患者EASI评分及复发率的影响%Influence of External Washing with Chinese Medicine Combined with Phototherapy on the Score of EASI and the Recurrence Rate of Patients with Acute Hand Eczema

    Institute of Scientific and Technical Information of China (English)

    钟萍; 徐丽红; 王鹏; 柴宝

    2016-01-01

    目的:观察中药外洗联合光疗对急性手部湿疹患者EASI评分及复发率的影响.方法:将2013年2月-2015年2月本院收治的90例急性手部湿疹患者随机分为光疗组、中药洗剂组、中药洗剂联合光疗组各30例.光疗组单纯采用光疗进行,选择304 nm中波高能紫外线进行照射治疗;中药洗剂组单纯采用中药外洗治疗;中药洗剂联合光疗组给予中药外洗联合光疗进行治疗.治疗2周后观察两组患者临床瘙瘁症状的改善情况,用EASI评估湿疹面积以及皮损严重程度,比较3组的有效率、不良反应发生率及复发情况.结果:光疗组的有效率60%低于中药洗剂组的有效率70%,两组差异性不显著(P>0.05);光疗组和中药洗剂组的有效率均明显低于中药洗剂联合光疗组的有效率93.3%,差异有统计学意义(P<0.05);治疗前3组患者的EASI各指标评分对比,差异性不显著(P>0.05);治疗后EASI评分相比治疗前下降,中药洗剂联合光疗组EASI评分变化更突出,其次为中药洗剂组,光疗组EASI评分改善明显不足其余两组,差异有统计学意义(P<0.05).光疗组不良反应发生率、复发率明显高于其余两组,而中药洗剂联合光疗组患者并无明显不良反应,随访期间亦无复发.结论:中药外洗联合光疗更利于改善急性手部湿疹患者的瘙痒症状,减少皮损面积,减轻皮损状况,疗效确切.%Objective:To observe the influence of external washing with Chinese medicine combined with phototherapy on the score of EASI and the recurrence rate of patients with acute hand eczema.Methods:Totally 90 patients with acute hand eczema hospitalized between February,2013 and February,2015 were randomized into phototherapy group,Chinese medicine washing group,Chinese medicine washing + phototherapy group,with 30 cases in each group.Phototherapy group were simply given phototherapy with 304 nm medium-high energy ultraviolet radiation.Chinese medicine

  15. Report from the fourth international consensus meeting to harmonize core outcome measures for atopic eczema/dermatitis clinical trials (HOME initiative)

    NARCIS (Netherlands)

    Chalmers, J. R.; Simpson, E.; Apfelbacher, C. J.; Thomas, K. S.; von Kobyletzki, L.; Schmitt, J.; Singh, J. A.; Svensson, A.; Williams, H. C.; Abuabara, K.; Aoki, V.; Ardeleanu, M.; Awici-Rasmussen, M.; Barbarot, S.; Berents, T. L.; Block, J.; Bragg, A.; Burton, T.; Clemmensen, K. K. Bjerring; Creswell-Melville, A.; Dinesen, M.; Drucker, A.; Eckert, L.; Flohr, C.; Garg, M.; Gerbens, L. A. A.; Graff, A. L. B.; Hanifin, J.; Heinl, D.; Humphreys, R.; Ishii, H. A.; Kataoka, Y.; Leshem, Y. A.; Marquort, B.; Massuel, M. -A.; Merhand, S.; Mizutani, H.; Murota, H.; Murrell, D. F.; Nakahara, T.; Nasr, I.; Nograles, K.; Ohya, Y.; Osterloh, I.; Pander, Jan; Prinsen, C.; Purkins, L.; Ridd, M.; Sach, T.; Schuttelaar, M. -L. A.; Shindo, S.; Smirnova, J.; Sulzer, A.; Gjerde, E. Synnove; Takaoka, R.; Talmo, H. Vestby; Tauber, M.; Torchet, F.; Volke, A.; Wahlgren, C. -F.; Weidinger, S.; Weisshaar, E.; Wollenberg, A.; Yamaga, K.; Zhao, C. Y.; Spuls, P. I.

    This article is a report of the fourth meeting of the Harmonising Outcome Measures for Eczema (HOME) initiative held in Malmo, Sweden on 23-24 April 2015 (HOME IV). The aim of the meeting was to achieve consensus over the preferred outcome instruments for measuring patient-reported symptoms and

  16. Report from the fourth international consensus meeting to harmonize core outcome measures for atopic eczema/dermatitis clinical trials (HOME initiative)

    DEFF Research Database (Denmark)

    Chalmers, J. R.; Simpson, Elizabeth M; Apfelbacher, C. J.

    2016-01-01

    This article is a report of the fourth meeting of the Harmonising Outcome Measures for Eczema (HOME) initiative held in Malmö, Sweden on 23–24 April 2015 (HOME IV). The aim of the meeting was to achieve consensus over the preferred outcome instruments for measuring patient-reported symptoms and q...

  17. A simple tool with which to study the course of chronic hand eczema in clinical practice : a reduced-item score

    NARCIS (Netherlands)

    van der Valk, Pieter G. M.; van Gils, Robin F.; Boot, Cecile R. L.; Evers, Andrea W. M.; Donders, Rogier; Alkemade, Hans A. C.; Coenraads, Pieter Jan; Rustemeyer, Thomas; van Mechelen, Willem; Anema, Johannes R.

    2013-01-01

    Background Physicians need a simple, disease-specific tool with which to assess disease severity and the effect of therapeutic intervention in patients with chronic hand eczema. The currently available clinical scoring systems include numerous items, which makes them laborious to complete and limit

  18. Report from the fourth international consensus meeting to harmonize core outcome measures for atopic eczema/dermatitis clinical trials (HOME initiative)

    NARCIS (Netherlands)

    Chalmers, J. R.; Simpson, E.; Apfelbacher, C. J.; Thomas, K. S.; von Kobyletzki, L.; Schmitt, J.; Singh, J. A.; Svensson, A.; Williams, H. C.; Abuabara, K.; Aoki, V.; Ardeleanu, M.; Awici-Rasmussen, M.; Barbarot, S.; Berents, T. L.; Block, J.; Bragg, A.; Burton, T.; Clemmensen, K. K. Bjerring; Creswell-Melville, A.; Dinesen, M.; Drucker, A.; Eckert, L.; Flohr, C.; Garg, M.; Gerbens, L. A. A.; Graff, A. L. B.; Hanifin, J.; Heinl, D.; Humphreys, R.; Ishii, H. A.; Kataoka, Y.; Leshem, Y. A.; Marquort, B.; Massuel, M. -A.; Merhand, S.; Mizutani, H.; Murota, H.; Murrell, D. F.; Nakahara, T.; Nasr, I.; Nograles, K.; Ohya, Y.; Osterloh, I.; Pander, Jan; Prinsen, C.; Purkins, L.; Ridd, M.; Sach, T.; Schuttelaar, M. -L. A.; Shindo, S.; Smirnova, J.; Sulzer, A.; Gjerde, E. Synnove; Takaoka, R.; Talmo, H. Vestby; Tauber, M.; Torchet, F.; Volke, A.; Wahlgren, C. -F.; Weidinger, S.; Weisshaar, E.; Wollenberg, A.; Yamaga, K.; Zhao, C. Y.; Spuls, P. I.

    2016-01-01

    This article is a report of the fourth meeting of the Harmonising Outcome Measures for Eczema (HOME) initiative held in Malmo, Sweden on 23-24 April 2015 (HOME IV). The aim of the meeting was to achieve consensus over the preferred outcome instruments for measuring patient-reported symptoms and qual

  19. The epidemiology of hand eczema in the general population--prevalence and main findings.

    Science.gov (United States)

    Thyssen, Jacob P; Johansen, Jeanne D; Linneberg, Allan; Menné, Torkil

    2010-02-01

    Numerous studies have investigated the prevalence and risk factors of hand eczema in the general population. These studies are of high value as they tend to be less biased than studies using clinical populations and as they are important for healthcare decision makers when they allocate resources. This study aimed to review the epidemiology of hand eczema in the general population. Literature was examined using Pubmed-Medline, Biosis, Science Citation Index, and dermatology text books. On the basis of studies performed between 1964 and 2007, the point prevalence of hand eczema was around 4%, the 1-year prevalence nearly 10%, whereas the lifetime prevalence reached 15%. Based on seven studies, the median incidence rate of hand eczema was 5.5 cases/1000 person-years (women = 9.6 and men = 4.0). A high incidence rate was associated with female sex, contact allergy, atopic dermatitis, and wet work. Atopic dermatitis was the single most important risk factor for hand eczema. Hand eczema resulted in medical consultations in 70%, sick leave (> 7 days) in about 20%, and job change in about 10%. Mean sick time was longer among those with allergic hand eczema than those with atopic and irritant hand eczema. Moderate to severe extension of hand eczema was the strongest risk factor for persistence of hand eczema. Other risk factors included early onset of hand eczema and childhood eczema. The aetiology of hand eczema is multifactorial and includes environmental as well as genetic factors. Future studies should focus on unresolved areas of hand eczema, for example, genetic predisposition.

  20. Post-operative delirium is an independent predictor of 30-day hospital readmission after spine surgery in the elderly (≥65years old): A study of 453 consecutive elderly spine surgery patients.

    Science.gov (United States)

    Elsamadicy, Aladine A; Wang, Timothy Y; Back, Adam G; Lydon, Emily; Reddy, Gireesh B; Karikari, Isaac O; Gottfried, Oren N

    2017-03-02

    In the last decade, costs of U.S. healthcare expenditures have been soaring, with billions of dollars spent on hospital readmissions. Identifying causes and risk factors can reduce soaring readmission rates and help lower healthcare costs. The aim of this is to determine if post-operative delirium in the elderly is an independent risk factor for 30-day hospital readmission after spine surgery. The medical records of 453 consecutive elderly (≥65years old) patients undergoing spine surgery at Duke University Medical Center from 2008 to 2010 were reviewed. We identified 17 (3.75%) patients who experienced post-operative delirium according to DSM-V criteria. Patient demographics, comorbidities, and post-operative complication rates were collected for each patient. Elderly patients experiencing post-operative delirium had an increased length of hospital stay (10.47days vs. 5.70days, p=0.009). Complication rates were similar between the cohorts with the post-operative delirium patients having increased UTI and superficial surgical site infections. In total, 12.14% of patients were re-admitted within 30-days of discharge, with post-operative delirium patients experiencing approximately a 4-fold increase in 30-day readmission rates (Delirium: 41.18% vs. No Delirium: 11.01%, p=0.002). In a multivariate logistic regression analysis, post-operative delirium is an independent predictor of 30-day readmission after spine surgery in the elderly (p=0.03). Elderly patients experiencing post-operative delirium after spine surgery is an independent risk factor for unplanned readmission within 30-days of discharge. Preventable measures and early awareness of post-operative delirium in the elderly may help reduce readmission rates.

  1. Guidelines for diagnosis, prevention and treatment of hand eczema

    DEFF Research Database (Denmark)

    Diepgen, Thomas L; Andersen, Klaus E; Chosidow, Oliver

    2015-01-01

    The guidelines aim to provide advice on the management of hand eczema (HE), using an evidence- and consensus-based approach. The guidelines consider a systematic Cochrane review on interventions for HE, which is based on a systematic search of the published literature (including hand-searching). ...

  2. Treatment of hand eczema, any help from classification?

    NARCIS (Netherlands)

    Schuttelaar, Marie-Louise; Christoffers, Wietske; Boonstra, Marrit; Coenraads, Pieter Jan

    2014-01-01

    Background: Intervention studies often use unclear definitions of either morphological or aetiological types of hand eczema, or there is no classification at all. These studies are not reproducible or difficult to compare. A generally accepted classification system is essential for clinical trials.

  3. Hand eczema : clinical efficacy of interventions, and burden of disease

    NARCIS (Netherlands)

    Coevorden, Anthony Marco van

    2005-01-01

    Hand eczema is considered a common disease. The exact prevalences however, are unknown. Studies estimate a point prevalence of 1 to 5% among adults in the general population, and a one-year prevalence of up to 10%, depending on whether the disease definition includes more pronounced or mild cases. H

  4. Usefulness of Rajka & Langeland Eczema Severity Score in Clinical Practice.

    Science.gov (United States)

    Gånemo, Agneta; Svensson, Åke; Svedman, Cecilia; Grönberg, Britt-Marie; Johansson, Ann-Charlotte Öhman; Wahlgren, Carl-Fredrik

    2016-05-01

    Simple, validated eczema severity scores are required for the evaluation of interventions. The Rajka & Langeland (R&L) scale is based on 3 domains (extent, course, and intensity); however, its validity is not yet confirmed. The aim of this study was to investigate the quality aspects of the R&L scale in clinical practice. In the first part of the study, experts and consumers judged the content validity of the scale. The second part of the study was performed with 87 children during a 4-month eczema school. Construct validity, internal consistency, sensitivity to change, time consumption and health-related quality of life variables were investigated. The content of the R&L scale was considered valid by 45 panellists. Inter- and intra-observer reliability was very good. Divergent construct validity was adequate, while convergent construct validity and internal consistency were inadequate. The R&L scale was able to define a significant improvement in eczema during the eczema school. The time required for completing the R&L assessment was significantly shorter than for objective Severity Scoring of Atopic Dermatitis (SCORAD). The R&L scale is a simple, fast, valid, reliable and sensitive tool for scoring of atopic dermatitis in everyday clinical practice.

  5. Treatment of hand eczema, any help from classification?

    NARCIS (Netherlands)

    Schuttelaar, Marie-Louise; Christoffers, Wietske; Boonstra, Marrit; Coenraads, Pieter Jan

    Background: Intervention studies often use unclear definitions of either morphological or aetiological types of hand eczema, or there is no classification at all. These studies are not reproducible or difficult to compare. A generally accepted classification system is essential for clinical trials.

  6. [Psychosocial factors of chronic hand eczema].

    Science.gov (United States)

    Li, Li; Liu, Panpan; Li, Ji; Xie, Hongfu; Kuang, Yehong; Li, Jie; Su, Juan; Zhu, Wu

    2017-02-28

    目的:探讨慢性手部湿疹(chronic hand eczema,CHE)患者的心理社会因素。方法:收集CHE患者240例,正常对照(normal control,NC)221例,采用一般情况问卷、艾森克人格问卷(Eysenck Personality Questionnaire,EPQ)、抑郁自评量表(Self-Rating Depression Scale,SDS)、焦虑自评量表(Self-Rating Anxiety,SAS)及湿疹患者生活质量量表(Eczema Quality of Life Scale,EQOLS)测评受试者人格特征、情绪状态、生活质量等心理社会因素及与疾病严重程度的相关性。结果:EPQ量表得分比较,CHE组内外向(E)维度得分显著低于NC组(P0.05)。CHE组的SDS量表和SAS量表得分均显著高于NC组(P<0.01)。EQOLS量表得分比较,CHE组的疾病、心理、生理、社会各维度、量表总分及总体生活质量评分均显著高于NC组(P<0.01)。CHE患者的皮损程度和与瘙痒水平与SDS,SAS,EQOLS量表的疾病、生理、心理、社会各维度、总体生活质量、总分均有显著相关性(P<0.05)。结论:CHE患者个性更偏内向,情绪不稳定;抑郁、焦虑水平较高,生活质量水平下降,且均与病情严重程度相关。.

  7. Integrated, multidisciplinary care for hand eczema: design of a randomized controlled trial and cost-effectiveness study

    Directory of Open Access Journals (Sweden)

    Boot Cécile RL

    2009-12-01

    Full Text Available Abstract Background The individual and societal burden of hand eczema is high. Literature indicates that moderate to severe hand eczema is a disease with a poor prognosis. Many patients are hampered in their daily activities, including work. High costs are related to high medical consumption, productivity loss and sick leave. Usual care is suboptimal, due to a lack of optimal instruction and coordination of care, and communication with the general practitioner/occupational physician and people involved at the workplace. Therefore, an integrated, multidisciplinary intervention involving a dermatologist, a care manager, a specialized nurse and a clinical occupational physician was developed. This paper describes the design of a study to investigate the effectiveness and cost-effectiveness of integrated care for hand eczema by a multidisciplinary team, coordinated by a care manager, consisting of instruction on avoiding relevant contact factors, both in the occupational and in the private environment, optimal skin care and treatment, compared to usual, dermatologist-led care. Methods The study is a multicentre, randomized, controlled trial with an economic evaluation alongside. The study population consists of patients with chronic, moderate to severe hand eczema, who visit an outpatient clinic of one of the participating 5 (three university and two general hospitals. Integrated, multidisciplinary care, coordinated by a care manager, including allergo-dermatological evaluation by a dermatologist, occupational intervention by a clinical occupational physician, and counselling by a specialized nurse on optimizing topical treatment and skin care will be compared with usual care by a dermatologist. The primary outcome measure is the cumulative difference in reduction of the clinical severity score HECSI between the groups. Secondary outcome measures are the patient's global assessment, specific quality of life with regard to the hands, generic quality

  8. Experience of Cnidium Powder in the Treatment of Eczema%蛇床子散加减治疗湿疹经验

    Institute of Scientific and Technical Information of China (English)

    张同彬; 刘小芳

    2016-01-01

    目的:总结蛇床子散加减治疗湿疹经验。方法采用回顾性分析法对两位湿疹患者的临床资料和治疗情况进行分析,评价治疗效果。结果采用蛇床子散对两位湿疹患者进行治疗后,两位患者均未再出现复发情况。结论蛇床子散治疗湿疹瘙痒临床疗效确切,可以借鉴。%Objective To summarize the experience of Cnidium powder in the treatment of eczema.Method To analyze the clinical data and treatment of two patients with eczema by retrospective analysis,to evaluate of therapeutic effect.Result Two eczema patients were treated after treatment by Cnidium powder,there were no recurrence for two patients. Conclusion The clinical curative effect of Osthol powder in the treatment of eczema is effective, this treatment method is worthy of reference.

  9. Outbreak of eczema and rhinitis in a group of office workers in Greenland

    Directory of Open Access Journals (Sweden)

    Niels E. Ebbehøj

    2015-07-01

    Full Text Available Introduction: Disturbed indoor climate may in some cases be associated with illness. In the present paper, we report the results from a thorough investigation of office workers in Greenland, who developed skin and/or airway problems after moving into renewed offices. Material and methods: In 2009 the office of the Bank of Greenland had a total renovation of the building, including new furniture and carpets. Symptoms developed within the first year after moving back into the renewed buildings. After removal of carpets in the building, symptoms significantly improved. Workers were examined in 2009 and re-examined in 2013, including clinical examination, patch test and when relevant also skin prick tests and histamine release test. Isothiazolinones and fumarates, both able to cause airway as well as skin symptoms, were isolated from carpets before testing, and included in the test series. Results: In total, 32 out of 80 workers (40% developed symptoms; 27 reported eczema, 20 rhinitis and 4 urticaria. Eczema was located on the hands and/or lower arms in 18 workers, on the face in 10 workers and on legs/trunk in 12 workers. After intervention in the office, 22 workers with eczema reported significant improvement, all cases of hand eczema cleared and 16 workers with rhinitis also improved. Positive patch tests to carpet extracts were found significantly more frequent in the worker cohort than in a control group comprising 47 dermatitis patients (p<0.001. Only few workers reacted with a positive response to skin prick test or in the HR test, no obvious pattern in reactions was found, and no conclusions can be made from these reactions. Conclusion: The results indicate that the reported symptoms are related to exposures from the building after renovation in 2009. A specific triggering exposure could not be identified, although chemicals from the glued carpets are suspected. The study is an example of a work place investigation, and illustrates the

  10. Improved emollient use reduces atopic eczema symptoms and is cost neutral in infants: before-and-after evaluation of a multifaceted educational support programme.

    Science.gov (United States)

    Mason, James M; Carr, Julie; Buckley, Carolyn; Hewitt, Steve; Berry, Phillip; Taylor, Josh; Cork, Michael J

    2013-05-16

    Parents and carers of children with eczema often underuse emollient therapy, essential to repairing and protecting the defective skin barrier in atopic eczema. Educational interventions delivered by specialist dermatology nurses in hospital settings have been shown to improve emollient use and reduce symptoms of atopic eczema, but benefits of community-based interventions are uncertain. Support and information about appropriate care may often be inadequate for patients and carers in the community. A multifaceted educational support programme was evaluated as a method of increasing emollient use and reducing atopic eczema in children. Support provided for parents and carers included an educational DVD, online daily diary and telephone helpline. The before and after study included 136 British children and their parents, providing baseline and 12 week follow-up data while receiving the programme. Measures included emollient use, POEM and PEST scores, and cost of care. Average emollient use increased by 87.6 g (95% CI: 81.9 to 119.5 g, p = 0.001) from baseline with the change being immediate and persistent. The POEM score reduced on average by 5.38 (95% CI: 4.36 to 6.41, p = 0.001), a 47% reduction from baseline. Similarly the PEST score reduced on average by 0.61 (95% CI: 0.47 to 0.75, p = 0.001), a 48% reduction from baseline. Sleep disturbance was reduced by 1.27 nights per week (95% CI: 0.85 to 1.68, p = 0.001) and parental feeling of control improved by 1.32 points (95% CI: 1.16 to 1.48, p = 0.001). From the NHS perspective, the programme was cost neutral overall within the study period. A community-based multifaceted educational support programme greatly increased emollient use, reducing symptoms of atopic eczema and general practitioner contacts, without increasing cost. Significant benefits may accrue to the families and carers of children with atopic eczema due to improved sleep patterns and greater feeling of control. PEST, a new simple

  11. Does Recombinant Human Bone Morphogenetic Protein-2 (rhBMP-2) Use in Adult Spinal Deformity (ASD) Increase Complications and Are Complications Associated With Location of rhBMP-2 Use?: A Prospective, Multicenter Study of 279 Consecutive Patients.

    Science.gov (United States)

    Bess, Shay; Line, Breton G; Lafarge, Virginie; Schwab, Frank; Shaffrey, Christopher I; Hart, Robert A; Boachie-Adjei, Oheneba; Akbarnia, Behrooz A; Ames, Christopher P; Burton, Douglas C; Deverin, Vedat; Fu, Kai-Ming G; Gupta, Munish; Hostin, Richard; Kebaish, Khaled; Klineberg, Eric; Mundis, Gregory; O'Brien, Michael; Shelokov, Alexis; Smith, Justin S

    2013-11-18

    Study Design. Multi-center, prospective analysis of consecutive ASD patients.Objective. Evaluate complications associated with rhBMP-2 use in ASDSummary of Background Data. Off-label rhBMP-2 use is common, however under-reporting of rhBMP-2 associated complications has been recently scrutinized.Methods. ASD patients consecutively enrolled into a prospective, multicenter database, were evaluated for type and timing of acute perioperative complications. Inclusion criteria: age ≥ 18 years, ASD, spinal arthrodesis >4 levels, and ≥3 months follow-up. Patients divided into those receiving rhBMP-2 (BMP) or no rhBMP-2 (NOBMP). BMP divided into location of use: posterior (PBMP), interbody (IBMP), and interbody + posterior spine (I+PBMP). Correlations between acute perioperative complications and rhBMP-2 use including total dose, dose/level and location of use were evaluated.Results. 279 patients (mean age 57 years, mean spinal levels fused 12.0, mean follow-up 28.8 months) met inclusion criteria. BMP (n = 172; average posterior dose = 2.5 mg/level, average interbody dose = 5 mg/level) had similar age, smoking history, previous spine surgery, total spinal levels fused, estimated blood loss, and duration of hospital stay as NOBMP (n = 107; p>0.05). BMP had greater Charlson Comorbidity Index (1.9 vs. 1.2), greater scoliosis (43° vs. 38°), longer operative time (488.2 vs. 414.6 minutes), more osteotomies/patient (4.0 vs. 1.6) and greater percentage of anteroposterior fusion (APSF; 20.9% vs. 8.4%) than NOBMP, respectively (p0.05). Multivariate analysis demonstrated small to non-existent correlations between rhBMP-2 use and complications.Conclusions. RhBMP-2 use and location of rhBMP-2 use in ASD surgery, at reported doses, does not increase acute major, neurological or wound complications. Research is needed for higher rhBMP-2 dosing and long-term follow-up.

  12. The impact of allergy on atopic eczema from data from epidemiological studies.

    Science.gov (United States)

    Schäfer, Torsten

    2008-10-01

    We aimed to review the association between atopic eczema and allergic sensitization and food allergy and its determinants on the basis of current epidemiological literature. About 50% of children with atopic eczema and about 35% of adults are sensitized to common allergens. Gender, geography (e.g. East and West Germany), and socioeconomic factors determine the proportion of atopic eczema with allergic sensitization. Allergic sensitization in addition to atopic eczema obviously increases the risk for respiratory allergies. Sensitization to house dust mites seems to be important and clinically relevant for atopic eczema. Population-based studies on the association between food allergy and atopic eczema are limited. Although, up to 40% of children in hospital settings react to certain food allergens by a flare-up of their atopic eczema, there is an indication that on a population basis, adults with atopic eczema do only react occasionally with a worsening of their skin disease due to food allergens. Atopic eczema is not necessarily associated with allergic sensitization. Sensitization to house dust mites, however, seems to be clinically relevant. The impact of food allergy on atopic eczema is difficult to assess on the basis of epidemiological studies and more detailed studies are needed.

  13. Dentoalveolar trauma and minor trauma as precipitating factors for medication-related osteonecrosis of the jaw (ONJ): a retrospective study of 149 consecutive patients from the Copenhagen ONJ Cohort.

    Science.gov (United States)

    Yazdi, Pouya Masroori; Schiodt, Morten

    2015-04-01

    Medication-related osteonecrosis of the jaw (ONJ) is often preceded by dentoalveolar trauma. The aim of this study was to examine the frequency of dentoalveolar trauma precipitated ONJ and compare trauma-precipitated ONJ with spontaneously developing ONJ. This was a retrospective study. All patients were examined according to a standard ONJ chart. Among 149 consecutive ONJ patients from the Copenhagen Cohort, 95 (64%) had a dentoalveolar trauma before referral (trauma group): dental extractions (n = 80); denture-related sore mouth (n = 12); and others (n = 3). The remaining 54 patients had spontaneous ONJ (spontaneous group). The mean time from oral trauma to referral for ONJ was 8 months. This study documented that dentoalveolar trauma precipitated ONJ in the majority of cases. However, even minor trauma, such as intubation and impression tray lesions, precipitated ONJ in a few cases (1%). Besides the occurrence of fistula to the skin and a difference in the male-to-female ratio, we found no significant difference between the spontaneous and trauma groups. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Pathogenesis of eczema herpeticum%疱疹性湿疹发病机制的研究进展

    Institute of Scientific and Technical Information of China (English)

    陈静思; 罗晓燕; 王华

    2015-01-01

    疱疹性湿疹是在患有特应性皮炎或其他湿疹样皮肤病的基础上感染单纯疱疹病毒,在原有皮损上快速出现密集或散在分布的形态单一的脐凹状水疱,是特应性皮炎的严重并发症,可损害重要脏器甚至危及生命.目前,疱疹性湿疹的发病机制尚未明确,近年来研究发现,丝聚合蛋白和紧密连接闭合蛋白claudins的减少,导致皮肤屏障功能障碍和干扰素及抗菌肽的减少,Th2型免疫反应占主导、调节性T细胞水平异常等多因素共同参与发病.%Eczema herpeticum refers to herpes simplex virus infection occurring in patients with atopic dermatitis or other eczematous dermatoses,and is clinically characterized by rapidly emerging,densely distributed or scattered monomorphic umbilicated vesicles.As a serious complication of atopic dermatitis,eczema herpeticum can damage vital organs and even threatens life.At present,the pathogenesis of eczema herpeticum is unclear.Recent studies have found that low levels of filaggrin and claudins can lead to dysfunction of skin barrier as well as reduction in interferon and antimicrobial peptides followed by the predominance of T helper type 2 immune response and abnormality in regulatory T cells,which may contribute to the development of eczema herpeticum.

  15. Metabolic Response of Lymph Nodes Immediately After RT Is Related With Survival Outcome of Patients With Pelvic Node-Positive Cervical Cancer Using Consecutive [{sup 18}F]fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Mee Sun; Ahn, Sung-Ja; Nah, Byung-Sik; Chung, Woong-Ki [Department of Radiation Oncology, Chonnam National University Medical School, Gwangju (Korea, Republic of); Song, Ho-Chun; Yoo, Su Woong [Department of Nuclear Medicine, Chonnam National University Medical School, Gwangju (Korea, Republic of); Song, Ju-Young; Jeong, Jae-Uk [Department of Radiation Oncology, Chonnam National University Medical School, Gwangju (Korea, Republic of); Nam, Taek-Keun, E-mail: tknam@chonnam.ac.kr [Department of Radiation Oncology, Chonnam National University Medical School, Gwangju (Korea, Republic of)

    2012-11-15

    Purpose: To evaluate the metabolic response of uterine cervix and pelvic lymph nodes (LNs) using consecutive {sup 18}F-fluorodeoxyglucose-positron emission tomography/computed tomography (PET/CT) immediately after RT and to correlate survival outcome with the metabolic response. Methods and Materials: We retrospectively reviewed 48 patients with cervical cancer who had positive pelvic LNs by preradiation therapy (pre-RT) PET/CT. All patients underwent PET/CT scans immediately after RT (inter-RT PET/CT) after median 63 Gy to the gross LNs. The metabolic response of the LNs was assessed quantitatively and semiquantitatively by measurement of the maximal standardized uptake value (SUV{sub max}). Results: Classifying the metabolic response of all nodal lesions, 37 patients (77%) had LNs with complete metabolic response on the inter-RT PET/CT (LNCMRi), and 11 patients had a non-LNCMRi, including 4 patients with progressive metabolic disease. The overall 3-year survival rates were 83% for the patients with LNCMRi and 73% for the non-LNCMRi group (P=.038). The disease-free survival for patients with LNCMRi were significantly better than that for the non-LNCMRi group (71% vs 18%, respectively, P<.001). The 3-year distant metastasis-free survival rates were 79% for the patients with LNCMRi and 27% for the non-LNCMRi group (P<.001). There were no statistically significant differences in overall survival (76% vs 86%, respectively, P=.954) and disease-free survival rates (58% vs 61%, respectively, P=.818) between the CMR of primary cervical tumor and the non-CMR groups. Conclusions: The results showed a significant correlation between survival outcome and the interim metabolic response of pelvic LNs. CMR of nodal lesion on inter-RT PET/CT had excellent overall survival, disease-free survival and distant metastasis-free survival rates. This suggested that PET/CT immediately after RT can be a useful tool for the evaluation of the interim response of the LNs and identify a subset

  16. Full-thickness choroidal thinning as a feature of Fuchs Uveitis Syndrome: quantitative evaluation of the choroid by Enhanced Depth Imaging Optical Coherence Tomography in a cohort of consecutive patients.

    Science.gov (United States)

    Cerquaglia, Alessio; Iaccheri, Barbara; Fiore, Tito; Lupidi, Marco; Torroni, Giovanni; Fruttini, Daniela; Giacalone, Claudia; Cagini, Carlo

    2016-10-01

    To perform a quantitative analysis of choroidal thickness in patients with Fuchs Uveitis Syndrome (FUS) using enhanced depth imaging optical coherence tomography (EDI-OCT). All patients underwent comprehensive ophthalmic examination, including best-corrected visual acuity, slit-lamp biomicroscopy, applanation tonometry, axial length measurements with a swept-source biometer (IOLMaster 700, Carl Zeiss Medic AG, Jena, Germany) and macular 30° linear EDI- B-scan SD-OCT section (Spectralis HRAII+OCT, Heidelberg Engineering, Heidelberg, Germany) in both eyes. Analysis of choroidal thickness was performed at three different locations: subfoveally, 750 μm nasally, and 750 μm temporally to the fovea. Patients having received any surgery or intravitreal injections in the last 12 months and with axial length variance ≥ 1 mm between both eyes were excluded. Sixteen eyes of eight consecutive patients with unilateral FUS were included. Segmented analysis of the choroid, separately considering Haller's layer and Sattler's-choriocapillaris layers, showed statistically significant lower values (p choroidal thickness mean values ranged from 305.62 ± 92.96 μm to 347.50 ± 91.55 μm; in FEs those values were significantly lower (p thickness choroidal thinning in FEs was observed. Considering the absence of significant axial length differences between FEs and NFEs in our patient series, these data seem to suggest that the full-thickness choroidal thinning in FEs may be due to the inflammatory process. In that way, FUS might be regarded as an inflammatory condition involving the whole uveal tunic, even the posterior part of it, definitively supplanting the early definition of "heterochromic iridociclytis".

  17. 儿童湿疹206例病理分析%Pathological analysis of the misdiagnosis of children with eczema in 206 cases

    Institute of Scientific and Technical Information of China (English)

    张晓岚; 张丹丹; 李东宁

    2015-01-01

    Objective:To summarize the clinical and pathological data of children with eczema,to analyze the related factors of misdiagnosis.Methods:206 patients with clinical diagnosis of childhood eczema were selected.The clinical manifestations and skin pathological examination of patients were analyzed and studied.Results:The pathological diagnosis of 84 patients was non eczema diseases(40.78%).The age,course of disease,onset location of children could influence the disease diagnosis.Conclusion:Because of the lack of accurate complaints and other factors,children with eczema is easy to appear clinical misdiagnosis in clinical.So the pathological examination has a certain significance on the diagnosis of children with eczema.%目的:总结儿童湿疹患者的临床及病理资料,分析其误诊的相关因素。方法:收治临床诊断儿童湿疹患者206例,对患者的临床表现及皮肤病理检查资料进行分析研究。结果:84例患者的病理诊断为非湿疹类疾病(40.78%)。患儿的年龄、病程、发病部位均可影响疾病的诊断。结论:儿童湿疹患者在临床中因缺乏准确的主诉等因素,易出现临床误诊。因此病理检查对儿童湿疹的诊断有着一定的意义。

  18. Medical consultations in relation to severity of hand eczema in the general population

    DEFF Research Database (Denmark)

    Hald, M.; Berg, N.D.; Elberling, J.

    2008-01-01

    Background Hand eczema is a common disease with a wide severity spectrum. Little information exists concerning the association between the severity of hand eczema and medical consultations. Objectives To describe the self-rated severity of hand eczema in a general population and the relationship...... to seeking medical attention. Methods A questionnaire on self-reported hypersensitivity including two questions on hand eczema was sent to a random sample of 6000 individuals, aged 18-69 years, living in Copenhagen, Denmark. A total of 4242 individuals (71%) answered the questionnaire. All individuals who...... reported hand eczema (n = 752) within the previous 12 months received a more detailed questionnaire focuse