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Sample records for hand eczema patients

  1. 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.

  2. 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.

  3. 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...

  4. 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...

  5. 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.

  6. 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...

  7. 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...

  8. 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...

  9. 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

  10. 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

  11. Hand Eczema

    NARCIS (Netherlands)

    Coenraads, Pieter-Jan

    2012-01-01

    A 33-year-old woman presents with redness of the hands and reports the intermittent occurrence of tiny vesicles, scaling, and fissuring, accompanied by itching on the palms, fingers, and dorsal sides of the hands. She has two young children and works as a nurse in a nearby hospital. She has a histor

  12. 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.

  13. 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...

  14. 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....

  15. 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...

  16. 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...

  17. 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...

  18. 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.

  19. 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...

  20. 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.

  1. 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...

  2. 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

  3. 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

  4. 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

  5. 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.

  6. 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...

  7. 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...

  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. 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...

  10. 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

  11. 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.

  12. 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...

  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. 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.

  15. 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...

  16. 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.

  17. 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...

  18. 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...

  19. 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.

  20. 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...

  1. 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...

  2. 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...

  3. 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...

  4. 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....

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. 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

  10. 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...

  11. 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...

  12. 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....

  13. 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...

  14. 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.

  15. 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.

  16. 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.

  17. 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...

  18. 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...

  19. 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.

  20. 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.

  1. 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

  2. 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

  3. 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

  4. Chronic lymphoedema caused by recurrent infections in a patient with allergic hand eczema

    Directory of Open Access Journals (Sweden)

    Beatrice Dyring-Andersen

    2011-07-01

    Full Text Available Allergic contact dermatitis is very common and may be complicated by secondary infections. Chronic lymphoedema is a potentially debilitating condition, which may occur due to secondary infections or the dermatitis itself. The problem of chronic lymphoedema following allergic contact dermatitis has been infrequently reported. We report a case of a 47-year-old woman with severe allergic contact dermatitis complicated by chronic, intractable lymphoedema of the hands and forearms. This case report reminds us that allergic hand dermatitis may be complicated by a chronic and debilitating state of lymphoedema. Also, it underlines the importance of fast and adequate treatment of both the dermatitis and the secondary infections.

  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. 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...

  7. 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...

  8. 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...

  9. 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.

  10. 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...

  11. 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....

  12. 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.

  13. 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.

  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. 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

  17. 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...

  18. 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

  19. 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

  20. 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

  1. 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

  2. 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

  3. 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...

  4. 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:

  5. [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。.

  6. 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). ...

  7. 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.

  8. 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.

  9. 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.

  10. 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

  11. 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.

  12. 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

  13. 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

  14. 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. ...

  15. 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.

  16. 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.

  17. 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

  18. 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...

  19. 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.

  20. 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.

  1. 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...

  2. 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

  3. 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 focused on hand eczema and a previously validated photographic guide with four groups of severity ranging from almost clear to very severe. Results Five hundred and sixty-four individuals (75%) returned...

  4. Xerosis is Associated with Atopic Dermatitis, Hand Eczema and Contact Sensitization Independent of Filaggrin Gene Mutations

    DEFF Research Database (Denmark)

    Thyssen, Jacob P; Johansen, Jeanne D; Zachariae, Claus

    2013-01-01

    Atopic dermatitis, hand eczema and contact sensitization are prevalent disorders, and may, in many cases, be secondary to skin barrier abnormality. The aim of this study was to investigate the association between self-reported generalized xerosis, atopic dermatitis, hand eczema and contact....... Atopic dermatitis and hand eczema were significantly associated with generalized xerosis, whereas contact sensitization (not nickel) showed only a borderline significant association. These results suggest that generalized xerosis may increase the risk of common skin disorders....

  5. 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...

  6. Heritability of hand eczema is not explained by comorbidity with atopic dermatitis

    DEFF Research Database (Denmark)

    Lerbaek, Anne; Kyvik, Kirsten O; Mortensen, Jakob;

    2007-01-01

    Genetic factors have been shown to influence the risk of hand eczema, and may theoretically influence the frequency of eruptions as well as age at onset of the disease. However, the result may be confounded by atopic dermatitis, which is a major risk factor for development of hand eczema...... and is known to be influenced by genetic factors. In this study, the importance of genetic and environmental risk factors in the etiology of hand eczema, independent of atopic dermatitis, was investigated in a population-based twin cohort. In addition, any possible genetic influence on frequency of hand eczema...

  7. 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 ...

  8. 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.

  9. 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.

  10. Knowledge, attitudes and behaviour in everyday life with chronic hand eczema - a qualitative study

    DEFF Research Database (Denmark)

    Mollerup, A; Johansen, J D; Thing, Lone Friis

    2013-01-01

    Chronic hand eczema is a common disease which may impact quality of life and have occupational and social consequences. Self-management is pivotal, both in handling acute eruptions and avoiding relapses. However, little is known about how people with hand eczema self-manage and integrate...

  11. 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

  12. Risk for hand eczema in employees with past or present atopic dermatitis

    NARCIS (Netherlands)

    Coenraads, PJ; Diepgen, TL

    1998-01-01

    Persons with atopic dermatitis run a considerable risk of developing hand eczema when exposed to occupational agents that are a burden to the skin. This also pertains to those with a history of skin atopy in childhood. This review presents estimates of the risk of developing hand eczema and examines

  13. Incidence of hand eczema in a population-based twin cohort

    DEFF Research Database (Denmark)

    Lerbaek, A; Kyvik, Kirsten Ohm; Ravn, H

    2007-01-01

    BACKGROUND: Population-based studies on the incidence of hand eczema are sparse. OBJECTIVES: The aim of this prospective follow-up study was to determine the incidence rate of hand eczema in a population-based twin cohort. Secondly, the role of genetic factors and other potential risk factors for...

  14. The epidemiology of hand eczema in the general population--prevalence and main findings

    DEFF Research Database (Denmark)

    Thyssen, Jacob P; Johansen, Jeanne D; Linneberg, Allan;

    2010-01-01

    . 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...

  15. Filaggrin null mutations increase the risk and persistence of hand eczema in subjects with atopic dermatitis: results from a general population study

    DEFF Research Database (Denmark)

    Thyssen, Jacob Pontoppidan; Carlsen, B C; Menné, Torkil

    2010-01-01

    Hand eczema is prevalent in the general population. It remains unclear whether or not filaggrin gene (FLG) null mutations increase the overall risk of hand eczema or only increase the risk of hand eczema in subjects with atopic dermatitis.......Hand eczema is prevalent in the general population. It remains unclear whether or not filaggrin gene (FLG) null mutations increase the overall risk of hand eczema or only increase the risk of hand eczema in subjects with atopic dermatitis....

  16. 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

    DEFF Research Database (Denmark)

    Ibler, Kristina Sophie; Agner, Tove; Hansen, Jane L.

    2010-01-01

    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...

  17. 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...

  18. 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.

  19. Wet work exposure and hand eczema among healthcare workers - a cross-sectional study.

    Science.gov (United States)

    Hamnerius, N; Svedman, C; Bergendorff, O; Björk, J; Bruze, M; Pontén, A

    2017-07-19

    Hand eczema is more common in healthcare workers compared to the general population. The hands are subject to changing occupational exposures due to mandatory hygiene regulations for health care workers. To describe the exposure due to hygiene procedures and investigate the associations between occupational hand washing, use of non-sterile gloves, and hand disinfectant and self-reported hand eczema. Cross-sectional study with an electronic questionnaire distributed to 28 762 hospital employees in southern Sweden. Respondents working as nurses, assistant nurses or physicians constituted the group of healthcare workers analysed. Adjustments were made for gender, age, wet work at home, life-style factors and atopic dermatitis. 12 288 (43%) responded including 9051 healthcare workers. In this group the 1-year prevalence of self-reported hand eczema was 21%. On a daily basis, 30% reported hand washing with soap >20 times at work, 45% used hand disinfectants >50 times, and 54% used non-sterile gloves > 2 hours. After adjustment for confounding factors, a dose-dependent association with self-reported hand eczema was found for the daily number of hand washes with soap at work and time working with disposable gloves, but not for alcoholic disinfectant use. Hand washing outside work was not associated with self-reported hand eczema in the adjusted multivariate analysis. In this study, we found a higher 1-year prevalence of self-reported hand eczema among Swedish healthcare workers than reported in the general population. Hand washing with soap and use of disposable gloves were associated with the occurrence of self-reported hand eczema in a dose-dependent way. Use of hand disinfectant was not associated with self-reported hand eczema. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  20. 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.

  1. Classification of hand eczema: clinical and aetiological types. Based on the guideline of the Danish Contact Dermatitis Group

    DEFF Research Database (Denmark)

    Johansen, Jeanne Duus; Hald, Marianne; Andersen, Bo Lasthein

    2011-01-01

    aetiological diagnosis. Results. Irritant contact dermatitis was most frequent in chronic, dry fissured hand eczema (44.3%), pulpitis (41.7%), and nummular hand eczema (40.9%), whereas allergic contact dermatitis dominated in vesicular types of hand eczema, with recurrent (35%) and few (24.2%) eruptions...

  2. 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 ...

  3. Association between non-atopic hand eczema and interleukin-13 gene polymorphism in Taiwanese nursing population.

    Science.gov (United States)

    Chen, Yin-Chun; Tu, Hung-Pin; Wu, Ching-Shuang; Ko, Ying-Chin; Yu, Hsin-Su; Lu, Yi-Wei; Li, Wan-Chen; Chen, Gwo-Shing; Lan, Cheng-Che E

    2012-12-01

    Chronic hand eczema is an important occupational skin disease with atopic dermatitis (AD) and wet work being the most important risk factors. This study was launched to analyse the potential association between AD-related inflammation genes and development of non-atopic hand eczema among nurses in University Hospital. Atopic eczema, non-atopic hand dermatitis and control groups were identified. The association between occurrence of non-atopic hand eczema and interleukin (IL)-13, IL-4 and IL-5 gene variants was analysed. IL13 rs20541 A allele [assuming recessive model; odds ratio (OR) = 3.38, 95% CI: (1.63-7.00)] showed association with development of non-atopic hand eczema. Additive score analyses showed combination of this gene variant with previously identified risk factors including certain SPINK5 polymorphism and more than 10 years of work experience conferred highest risk for development of non-atopic hand eczema. As non-atopic hand eczema made up significant portion of occupational skin diseases, further studies should be focused on this commonly encountered skin condition.

  4. Predictive factors of self-reported hand eczema in adult Danes

    DEFF Research Database (Denmark)

    Heede, N G; Thyssen, J P; Thuesen, B H

    2016-01-01

    . The participation rate for the follow-up study was 66·5% (29·7% of the participants originally invited to the baseline study). RESULTS: A history of atopic dermatitis (AD) was associated with both persistent and incident hand eczema [odds ratio (OR) 9·0, 95% confidence interval (95% CI) 5·6-14·4 and OR 3·0, 95% CI...... 1·7-5·2, respectively]. Thus, even in adulthood, a history of AD should be considered as a predictor of incident hand eczema. While filaggrin gene (FLG) null mutations were not associated with incident hand eczema, a statistically significant association was observed with persistent hand eczema (OR...... additionally found that a history of AD was associated with incident hand eczema in adults, in contrast to FLG mutations, which were associated only with persistent hand eczema in individuals with a history of AD, and not with incident hand eczema. Our study adds new knowledge to the interplay between AD, FLG...

  5. 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

    DEFF Research Database (Denmark)

    Ibler, Kristina Sophie; Agner, Tove; Hansen, Jane L.;

    2010-01-01

    . 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......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...

  6. 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.

  7. Filaggrin null alleles are not associated with hand eczema or contact allergy

    DEFF Research Database (Denmark)

    Jørkov, Anne Lerbæk; Bisgaard, H; Agner, T;

    2007-01-01

    association with hand eczema or contact allergy are unexplored. OBJECTIVES: To explore associations between the variant alleles, hand eczema, contact allergy and atopic dermatitis. METHODS: In total, 183 adult individuals participated in a clinical examination of the hands, patch testing and filaggrin...... genotyping. Children without any evidence of atopic dermatitis from the Copenhagen Prospective Study on Asthma in Childhood (COPSAC) study were used as controls. The chi(2) test was used for comparison of allele frequencies. RESULTS: The majority (73%) had hand eczema, 25% had contact allergy and 14% had...... a diagnosis of atopic dermatitis. The association between atopic dermatitis and the filaggrin variant alleles was confirmed (odds ratio 3.5, P = 0.015). Allele frequencies in individuals with hand eczema or contact allergy were not statistically significantly increased. CONCLUSION: There is no association...

  8. 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

  9. 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

  10. Prevention of hand eczema among Danish hairdressing apprentices: an intervention study

    DEFF Research Database (Denmark)

    Bregnhøj, Anne; Menné, Torkil; Johansen, Jeanne Duus

    2012-01-01

    ObjectivesTo investigate whether an evidence-based intervention could reduce the incidence of hand eczema in a cohort of Danish hairdressing apprentices during their training, as hairdressing apprentices are known to have a high risk of developing hand eczema.MethodsThis study was a clinically...... controlled, prospective intervention study. Within 2 weeks of starting their training, 502 hairdressing apprentices were enrolled in the study on occupational hand eczema. Approximately half of the apprentices were assigned to an intervention group and received an evidence-based training program developed...... of the intervention.ConclusionsWe were able to increase the use of gloves and reduce the incidence of hand eczema in hairdressing apprentices by implementing a training program in hairdressing schools....

  11. The epidemiology of hand eczema in the general population--prevalence and main findings

    DEFF Research Database (Denmark)

    Thyssen, Jacob P; Johansen, Jeanne D; Linneberg, Allan

    2010-01-01

    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...

  12. 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.

  13. Hand eczema and use of snus (moist snuff) - a population-based study.

    Science.gov (United States)

    Wrangsjö, Karin; Alderling, Magnus; Lindahl, Gunborg; Meding, Birgitta

    2015-03-01

    A possible association between use of snus (Swedish moist snuff) and hand eczema was studied. 27,466 individuals responded to questions regarding hand eczema, tobacco use and other life style factors in a Swedish Public Health Survey in 2006, response rate 58%. Of these persons, 12.2% reported daily snus use (men 22.0%, women 4.3%), 15.5% daily smoking (men 14.4%, women 16.5%). Of snus users 7.5 % reported hand eczema (men 6.5%, women 11.8%), of smokers 11.7% (men 8.6%, women 13.6%) and of non-tobacco-users 9.7% (men 7.9%, women 11.0%). In multivariate analysis hand eczema was significantly less common in snus users, in total prevalence proportion ratio (PPR) =  0.813, in men PPR =  0.820, but significantly more common in smoking women, PPR = 1.238. Physical exercise was a confounder; gender an effect modifier. No positive association was demonstrated between snus use and hand eczema in contrast to the positive association found between smoking and hand eczema in women.

  14. Skin care education and individual counselling versus treatment as usual in healthcare workers with hand eczema

    DEFF Research Database (Denmark)

    Ibler, K.S.; Jemec, G.B.E.; Thomsen, S.F.

    2012-01-01

    Objective: To evaluate the effect of a secondary prevention programme with education on skin care and individual counselling versus treatment as usual in healthcare workers with hand eczema. Design: Randomised, observer blinded parallel group superiority clinical trial. Setting: Three hospitals...... in Denmark. Participants: 255 healthcare workers with self reported hand eczema within the past year randomised centrally and stratified by profession, severity of eczema, and hospital. 123 were allocated to the intervention group and 132 to the control group. Interventions: Education in skin care...... and individual counselling based on patch and prick testing and assessment of work and domestic related exposures. The control was treatment as usual. Main outcome measures: The primary outcome was clinical severity of disease at five month follow-up measured by scores on the hand eczema severity index...

  15. 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

  16. Guidelines for diagnosis, prevention and treatment of hand eczema - short version

    NARCIS (Netherlands)

    Diepgen, Thomas L.; Andersen, Klaus E.; Chosidow, Oliver; Coenraads, Peter Jan; Elsner, Peter; English, John; Fartasch, Manige; Gimenez-Arnau, Ana; Nixon, Rosemary; Sasseville, Denis; Agner, Tove

    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). In a

  17. Hand eczema among hairdressing apprentices in Denmark following a nationwide prospective intervention programme

    DEFF Research Database (Denmark)

    Steengaard, Sanne S; Bregnhøj, Anne; Johansen, Jeanne D

    2016-01-01

    BACKGROUND: Hand eczema is the commonest occupational skin disease in Denmark, and hairdressing is a high-risk profession. In 2008-2010, a clinically controlled, prospective intervention study aimed at reducing the development of hand eczema was conducted at hairdressing schools in Denmark...... a questionnaire. RESULTS: No difference was seen between the intervention and control groups. This may partly be attributable to the two groups no longer being well matched, and improved work habits in the control group. Overall, there was an improvement in work habits. Participants had a 1-year prevalence...... of hand eczema of 22.4%. Reactions to hair dye were reported for 24.5%, and 35.5% had left the trade; 36.4% used gloves when shampooing, and 21.3% stated that they cut hair before colouring it. CONCLUSIONS: The effect of the intervention was not visible after 6 years, but an overall improvement in work...

  18. Hands4U : the effects of a multifaceted implementation strategy on hand eczema prevalence in a healthcare setting. Results of a randomized controlled trial

    NARCIS (Netherlands)

    van der Meer, Esther W. C.; Boot, Cecile R. L.; van der Gulden, Joost W. J.; Knol, Dirk L.; Jungbauer, Frank H. W.; Coenraads, Pieter Jan; Anema, Johannes R.

    2015-01-01

    Background. Healthcare workers have an increased risk of developing hand eczema. A multifaceted implementation strategy was developed to implement a guideline to prevent hand eczema among healthcare workers. Objectives. To investigate the effects of the implementation strategy on self-reported hand

  19. Hands4U : the effects of a multifaceted implementation strategy on hand eczema prevalence in a healthcare setting. Results of a randomized controlled trial

    NARCIS (Netherlands)

    van der Meer, Esther W. C.; Boot, Cecile R. L.; van der Gulden, Joost W. J.; Knol, Dirk L.; Jungbauer, Frank H. W.; Coenraads, Pieter Jan; Anema, Johannes R.

    Background. Healthcare workers have an increased risk of developing hand eczema. A multifaceted implementation strategy was developed to implement a guideline to prevent hand eczema among healthcare workers. Objectives. To investigate the effects of the implementation strategy on self-reported hand

  20. Hands4U: the effects of a multifaceted implementation strategy on hand eczema prevalence in a healthcare setting. Results of a randomized controlled trial

    NARCIS (Netherlands)

    Meer, E.W. van der; Boot, C.R.; Gulden, J.W.J. van der; Knol, D.L.; Jungbauer, F.H.; Coenraads, P.J.; Anema, J.R.

    2015-01-01

    BACKGROUND: Healthcare workers have an increased risk of developing hand eczema. A multifaceted implementation strategy was developed to implement a guideline to prevent hand eczema among healthcare workers. OBJECTIVES: To investigate the effects of the implementation strategy on self-reported hand

  1. 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

  2. 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.

  3. The association between contact allergy and hand eczema in 2 cross-sectional surveys 8 years apart

    DEFF Research Database (Denmark)

    Nielsen, Niels Henrik; Linneberg, Allan; Menné, Torkil;

    2002-01-01

    Hand eczema is a recurrent chronic skin disease related to contact allergy and atopic dermatitis. When possible, efforts should be redoubled to eliminate provoking factors. Our objective was to assess changes in the prevalence of self-reported hand eczema and to evaluate the association between...... contact allergy and hand eczema among adult Danes before and after nickel exposure regulation in Denmark. In 1990 and 1998, random samples of 15-41-year-old persons were examined in 2 cross-sectional studies of the general population in Copenhagen, Denmark. The studies included questionnaires, patch...... and prick testing. From 1990 to 1998 the prevalence of a history of hand eczema increased significantly. This increase did not appear to be fully explained by changes in the prevalence of flexural eczema, prick test reactivity, patch test reactivity, and nickel allergy. In 1990, nickel allergy and allergic...

  4. Prevalence, incidence and predictive factors for hand eczema in young adults – a follow-up study

    OpenAIRE

    2013-01-01

    Background Hand eczema is common in the general population and affects women twice as often as men. It is also the most frequent occupational skin disease. The economic consequences are considerable for society and for the affected individuals. Methods To investigate the prevalence and incidence of hand eczema and to evaluate risk factors for development of hand eczema in young adults. Subjects and methods; This is a prospective follow-up study of 2,403 young adults, 16 – 19 years old in 1995...

  5. 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

  6. 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.

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

    OpenAIRE

    2010-01-01

    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 effica...

  8. 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

  9. Filaggrin loss-of-function mutations and atopic dermatitis as risk factors for hand eczema in apprentice nurses: part II of a prospective cohort study

    OpenAIRE

    2013-01-01

    Summary Background/objectives Environmental exposure and personal susceptibility both contribute to the development of hand eczema. In this study, we investigated the effect of loss-of-function mutations in the filaggrin gene (FLG), atopic dermatitis and wet work exposure on the development of hand eczema in apprentice nurses. Methods Dutch apprentice nurses were genotyped for the four most common FLG mutations; atopic dermatitis and hand eczema history were assessed by questionnaire. Exposur...

  10. Guidelines for diagnosis, prevention and treatment of hand eczema

    DEFF Research Database (Denmark)

    Diepgen, Thomas L; Andersen, Klaus E; Chosidow, Oliver;

    2015-01-01

    ) for patients with severe chronic HE. Randomized control trials (RCT) are missing for other used systemic treatments and comparison of systemic drugs in “head-to-head” RCTs are needed.The guidelines development group is a working group of the European Society of Contact Dermatitis (ESCD) and has carefully tried...... to reconcile opposite views, define current optimal practice and provide specific recommendations, and meetings have been chaired by a professional moderator of the AWMF (Arbeitsgemeinschaft der Wis-senschaftlichen Medizinischen Fachgesellschaften; Association of the Scientific Medi-cal Societies in Germany...

  11. The effect of tobacco smoking and alcohol consumption on the prevalence of self-reported hand eczema: a cross-sectional population-based study

    DEFF Research Database (Denmark)

    Thyssen, J P; Linneberg, A; Menné, T

    2010-01-01

    . It has been debated whether life-style factors such as tobacco smoking and alcohol consumption are associated with hand eczema. OBJECTIVES: The current study aimed to investigate whether self-reported hand eczema was associated with smoking and alcohol consumption in the general population. METHODS...... heavy smokers (OR = 1.38; CI = 0.99-1.92) compared with never-smokers. CONCLUSIONS: Tobacco smoking was positively associated with hand eczema among adults from the general population in Denmark. Apparently, current light smokers (... smokers (> 15 g daily) but this needs to be reconfirmed. Alcohol consumption was not associated with hand eczema....

  12. Management of Atopic Hand Dermatitis

    DEFF Research Database (Denmark)

    Halling-Overgaard, Anne-Sofie; Zachariae, Claus; Thyssen, Jacob P

    2017-01-01

    This article provides an overview of clinical aspects of hand eczema in patients with atopic dermatitis. Hand eczema can be a part of atopic dermatitis itself or a comorbidity, for example, as irritant or allergic contact dermatitis. When managing hand eczema, it is important to first categorize...

  13. Review of Medicinal Remedies on Hand Eczema Based on Iranian Traditional Medicine: A Narrative Review Article

    Directory of Open Access Journals (Sweden)

    Parvin MANSOURI

    2016-10-01

    Full Text Available Background: Hand Eczema (HE is a dermatological disorder with frequent relapses and multiple causes such as atopic, allergic and irritant contact dermatitis. The management is complex because of the wide range of different pathogenesis. Efficacy of some of available treatments is not well established and it can affect patients’ quality of life significantly.Methods: Reports on HE such as diagnosis, pathophysiology, pharmacological and nonpharmacological therapy that described in medieval Iranian medicine, were gathered and analyzed from selected medical and pharmaceutical textbooks of Iranian Traditional Medicine (ITM. The search of databases such as PubMed, EMBASE/Excerpta Medica, Science direct, Scopus, Google scholar, Web of science, Sid, Iran medex, Irandoc, was performed to reconfirm the efficacy of ITM remedies in conventional medicine from 1980-Jan-1 to 2015-Dec-30.Results: According to their opinion, HE is highly associated with liver function. This disorder was categorized into two main types as wet and dry ones. Most Iranian textbook explained signs of HE, as excessive skin itching, redness, burning and dryness. Treatments recommended by Iranian scientists were lifestyle modification, dietary intervention and performing the rules of prevention as well as herbal therapy and special manipulations.Conclusion: Iranian practitioners believed that, six essential principles, diet therapy and medicinal plants have high impact on treatment of HE. These remedies based on Iranian scholar’s experiences might be useful for further studies to the management of HE. Keywords: Hand eczema, Herbal medicine, Iranian traditional medicine, Medicinal remedies, Diet therapy, Lifestyle modification

  14. Prevalence of delayed-type and immediate-type hypersensitivity in healthcare workers with hand eczema.

    Science.gov (United States)

    Ibler, Kristina S; Jemec, Gregor B E; Garvey, Lene H; Agner, Tove

    2016-10-01

    Occupational contact dermatitis is common in healthcare workers. Although irritant contact dermatitis resulting from wet work is the most frequently reported cause, healthcare workers also constitute high-risk group for the development of allergic contact dermatitis and contact urticaria. To evaluate the prevalence of delayed-type and immediate-type hypersensitivity in 120 healthcare workers with hand eczema. One hundred and twenty healthcare workers from three major hospitals in Denmark with self-reported hand eczema within the last year participated in the study. Patch tests included baseline series plus selected allergens, and prick tests included standard inhalational allergens plus natural rubber latex and chlorhexidine. Levels of IgE specific for latex, chlorhexidine and ethylene oxide were measured. Of the participants, 53% had positive patch test reactions. The most frequent positive patch test reactions were to nickel, thiomersal, fragrances, rubber chemicals, and colophonium. The prevalence of natural rubber latex allergy as diagnosed by prick testing was 2.5%, and chlorhexidine allergy (both contact allergy and IgE-mediated allergy) was found in Ethylene oxide allergy was not identified in any of the participants. Our results confirm previous reports on contact allergy patterns in healthcare workers. Testing for natural rubber latex allergy is still important, but increased risks of chlorhexidine and ethylene oxide allergy could not be confirmed. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. Hands4U: the effectiveness of a multifaceted implementation strategy on behaviour related to the prevention of hand eczema-a randomised controlled trial among healthcare workers

    NARCIS (Netherlands)

    Meer, E.W. van der; Boot, C.R.L.; Twisk, J.W.R.; Coenraads, P.J.; Jungbauer, F.H.; Gulden, J.W.J. van der; Anema, J.R.

    2014-01-01

    OBJECTIVES: To investigate the effects of a multifaceted implementation strategy on behaviour, behavioural determinants, knowledge and awareness of healthcare workers regarding the use of recommendations to prevent hand eczema. METHODS: The Hands4U study is a randomised controlled trial. A total of

  16. Hands4U : the effectiveness of a multifaceted implementation strategy on behaviour related to the prevention of hand eczema-a randomised controlled trial among healthcare workers

    NARCIS (Netherlands)

    van der Meer, Esther W. C.; Boot, Cecile R. L.; Twisk, Jos W. R.; Coenraads, Pieter Jan; Jungbauer, Frank H. W.; van der Gulden, Joost W. J.; Anema, Johannes R.

    Objectives To investigate the effects of a multifaceted implementation strategy on behaviour, behavioural determinants, knowledge and awareness of healthcare workers regarding the use of recommendations to prevent hand eczema. Methods The Hands4U study is a randomised controlled trial. A total of 48

  17. Economic Evaluation of a Multifaceted Implementation Strategy for the Prevention of Hand Eczema Among Healthcare Workers in Comparison with a Control Group: The Hands4U Study.

    Science.gov (United States)

    van der Meer, Esther W C; van Dongen, Johanna M; Boot, Cécile R L; van der Gulden, Joost W J; Bosmans, Judith E; Anema, Johannes R

    2016-05-01

    The aim of this study was to evaluate the cost-effectiveness of a multifaceted implementation strategy for the prevention of hand eczema in comparison with a control group among healthcare workers. A total of 48 departments (n=1,649) were randomly allocated to the implementation strategy or the control group. Data on hand eczema and costs were collected at baseline and every 3 months. Cost-effectiveness analyses were performed using linear multilevel analyses. The probability of the implementation strategy being cost-effective gradually increased with an increasing willingness-to-pay, to 0.84 at a ceiling ratio of €590,000 per person with hand eczema prevented (societal perspective). The implementation strategy appeared to be not cost-effective in comparison with the control group (societal perspective), nor was it cost-beneficial to the employer. However, this study had some methodological problems which should be taken into account when interpreting the results.

  18. Do hairdressers in Denmark have their hand eczema reported as an occupational disease? Results from a register-based questionnaire study

    DEFF Research Database (Denmark)

    Lysdal, Susan H; Søsted, Heidi; Johansen, Jeanne D

    2012-01-01

    Background. Occupational hand eczema is common in hairdressers, owing to wet work and chemicals. Objectives. To estimate whether hairdressers in Denmark have their hand eczema reported as an occupational disease and to clarify the reasons for not reporting. Methods. A register-based study...... was performed, comprising trained hairdressers (n = 7840), using a self-administered postal questionnaire including questions on hand eczema and it being reported as an occupational disease. A response rate of 67.9% (n = 5324) was obtained. Results. Overall, 2186 respondents ever had hand eczema; 71.3% were......-reported as an occupational disease; the perception of hand eczema among hairdressers and the lack of reporting from doctors are the main reasons for this....

  19. Alitretinoin for severe chronic hand eczema: a NICE single technology appraisal.

    Science.gov (United States)

    Rodgers, Mark; Griffin, Susan; Paulden, Mike; Slack, Russell; Duffy, Steven; Ingram, John R; Woolacott, Nerys; Sculpher, Mark

    2010-01-01

    The National Institute for Health and Clinical Excellence (NICE) invited the manufacturer of alitretinoin (Basilea Pharmaceuticals Ltd, Basel, Switzerland) to submit evidence for the clinical and cost effectiveness of this drug for the treatment of patients with severe chronic hand eczema (CHE), as part of the Institute's single technology appraisal (STA) process. The Centre for Reviews and Dissemination and the Centre for Health Economics at the University of York were commissioned to act as the Evidence Review Group (ERG). This article provides a description of the company submission, the ERG review and NICE's subsequent decisions. The ERG produced a critical review of the evidence for the clinical and cost effectiveness of the technology based upon the manufacturer's submission to NICE. The ERG also independently searched for relevant evidence and modified the manufacturer's decision analytic model to examine the impact of altering some of the key assumptions. The main clinical effectiveness data were derived from a single-placebo randomized controlled trial (RCT) of daily treatment with alitretinoin for 12-24 weeks, with follow-up for a further 24 weeks, in patients with severe CHE unresponsive to topical corticosteroids. A significantly greater proportion of patients achieved 'clear' or 'almost clear' hands by week 24 with alitretinoin than those using placebo: 48% with alitretinoin 30 mg (p < 0.001); 28% with alitretinoin 10 mg (p < 0.005); 17% with placebo. Most patients who responded remained in remission during the 24-week follow-up period. The most commonly reported adverse event was dose-dependent headache, with rates of 20% in the alitretinoin 30 mg group and 11% in the alitretinoin 10 mg group, respectively. Serious adverse events were rare, although alitretinoin was associated with increases in both total cholesterol and triglycerides. No direct or indirect comparisons of alitretinoin with any of the relevant treatment comparators (psoralen + UVA

  20. Protocol for a randomised trial on the effect of group education on skin-protective behaviour versus treatment as usual among individuals with newly notified occupational hand eczema

    DEFF Research Database (Denmark)

    Fisker, Maja Hvid; Agner, Tove; Lindschou, Jane

    2013-01-01

    The incidence of occupational hand eczema is approximately 0.32 per 1,000 person years. The burden of the disease is high, as almost 60% has eczema-related sick leave during the first year after notification, and 15% are excluded from the workforce 12 years after disease onset. New treatments...

  1. Clinical characteristics and consequences of hand eczema - an 8-year follow-up study of a population-based twin cohort

    DEFF Research Database (Denmark)

    Lerbaek, Anne; Kyvik, Kirsten Ohm; Ravn, Henrik;

    2008-01-01

    /METHODS: A total of 274 individuals with and without hand eczema were examined, patch tested, and interviewed in 1997-1998 and 2005-2006. Data on 188 individuals with hand eczema in 2005-2006 were analysed. RESULTS: Erythema and scaling were the most frequent symptoms, and fingers and palms were most often...... affected. Mean hand eczema severity index score in individuals with clinical symptoms was 12.0. Sick leave was reported by 12.4%; job change by 8.5%. Being in the lowest socio-economic group and atopic dermatitis were risk factors for sick leave [odds ratio (OR) = 5.6; 95% confidence interval (95% CI) 1...

  2. Diagnosis and assessment of hand eczema%手部湿疹的诊断与评估新进展

    Institute of Scientific and Technical Information of China (English)

    郑结成; 窦侠; 于波

    2016-01-01

    手部湿疹是皮肤科的常见病,发病率高,中青年女性多发.其病因复杂多样,刺激原、过敏原、特应性体质等是常见的发病因素.手部湿疹的临床表现多样,瘙痒及疼痛是其主要症状.目前尚无统一的分类方法,包括病因学分类及形态学分类等,临床上更多采用混合模式对手部湿疹进行分类.适当的评分系统可有效评估手部湿疹的严重程度及其疗效,目前常用的评分系统包括:手部湿疹严重指数、Osnabrueck手部湿疹严重指数、职业性接触性皮炎的疾病严重程度指数及皮肤病生活质量指数.手部湿疹主要根据详细采集病史、观察临床表现,结合必要的实验室检查进行诊断.%Hand eczema is a common disease in dermatology with a strong predilection for young and middle-aged women.Its etiology is complex,and common causative factors include irritants,allergens,atopic constitution,and so on.The clinical manifestations of hand eczema are diverse,and itching and pain are the main symptoms.It may be classified according to etiology or morphological characteristics,whereas there is still no unified classification system,and it is often classified based on mixed patterns.A suitable scoring system can be used to effectively assess the severity of and therapeutic effect on hand eczema.Currently,common scoring systems involve the hand eczema severity index,Osnabrueck hand eczema severity index,occupational contact dermatitis disease severity index and dermatology life quality index (DLQI).The diagnosis of hand eczema is mainly based on detailed medical history,clinical manifestations and laboratory test results.

  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. 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.

  5. Development and validation of a questionnaire on 'Satisfaction with dermatological treatment of hand eczema' (DermaSat

    Directory of Open Access Journals (Sweden)

    Serra Esther

    2010-11-01

    Full Text Available Abstract Objective To develop a self-administered short questionnaire to assess patient satisfaction with medical treatment for hand eczema (dermatitis with good psychometric properties. Method The content of the questionnaire was determined on the basis of clinical consultation with groups of patients, from studying the existing instruments, and from discussions with a panel of seven experts. A first draft version containing 38 items organised in six dimensions was tested on a pilot sample of patients to assess its legibility. The extended version was then tested on a sample of 217 patients of both genders enrolled at 18 hospitals representative of the national distribution. The questionnaire was supplied together with the Morisky-Green compliance questionnaire, the health-related quality of life (HRQL SF-12 questionnaire, and a visual analogue scale (VAS of perceived health status to assess concurrent validity. The dimensionality was reduced by means of exploratory factor analysis, and reliability was evaluated on the basis of internal consistency and two halves reliability estimates. Item discriminant capability and questionnaire discriminant validity with respect to known groups of patients (by gender, principal diagnosis, age, disease severity and treatment were also assessed. Results The reduction and validation sample was composed of 54% women and 46% men, of various educational levels with an average age of 43 years (SD = 13.7. Of those who responded, 26% were diagnosed with hyperkeratotic dermatitis of the palms and 27% of the fingertips, and 47% with recurring palmar dyshidrotic eczema. The questionnaire was shortened to a version containing 17 items grouped in six dimensions: effectiveness, convenience, impact on HRQL, medical follow-up, side effects, and general opinion. Cronbach's alpha coefficient reached a value of 0.9. The dimensions showed different degrees of correlation, and the scores had a normal distribution with an average

  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. [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.

  9. 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

  10. 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....

  11. Nickel sensitization in adolescents and association with ear piercing, use of dental braces and hand eczema. The Odense Adolescence Cohort Study on Atopic Diseases and Dermatitis (TOACS)

    DEFF Research Database (Denmark)

    Mørtz, Charlotte G; Lauritsen, Jens Martin; Bindslev-Jensen, Carsten;

    2002-01-01

    % of cases. Nickel allergy was found most frequently in girls and the association with ear piercing was confirmed. Application of dental braces (oral nickel exposure) prior to ear piercing (cutaneous nickel exposure) was associated with a significantly reduced prevalence of nickel allergy. In adolescents...... a significant association was found between hand eczema and nickel allergy. A follow-up study of this population is planned in order to assess the course and development of contact dermatitis, hand eczema and atopic diseases in adulthood and after choice of occupation....

  12. An analysis of gender differences in patients with hand eczema - everyday exposures, severity, and consequences

    DEFF Research Database (Denmark)

    Mollerup, Annette; Veien, Niels Kren; Johansen, Jeanne Duus

    2014-01-01

    BACKGROUND: Hand eczema is often related to high-risk occupations and aggravating exposures in everyday life. The disease is twice as frequent in women as in men, partly because of diverse exposure patterns. Other gender differences may be relevant for treatment and prevention. OBJECTIVES: To gain...... insights into the common features and differences between men and women with hand eczema. METHODS: The clinical disease severity of patients (n = 306) attending for dermatological treatment at two settings was assessed with the Hand Eczema Severity Index (HECSI). Self-reported medication adherence......, aggravating factors, hand eczema-related consequences and quality of life were obtained from a questionnaire. RESULTS: Men and women had equal clinical severities of disease, with an overall median HECSI of 43. Self-reported medication adherence was equal between the genders, but, among patients aged > 40...

  13. 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.

  14. The etiology and classification of hand eczema%手部湿疹的病因和分类

    Institute of Scientific and Technical Information of China (English)

    阮靖; 王学民

    2012-01-01

    Hand eczema (HE) is a common skin disease which is easy to relapse and difficult to treat. It is higher incidence and much more women involed mostly. The etiology of that is complicated. HE is mutti factorial skin disease. Both exogenous and endogenous factors play a significant role. The results of many studies are shown that the irritant contacte dermatitis is of the most common type of HE. There is no universal classifation of HE. The traditional classifications arc based on etiological factors, morphological features, the localization of the eczema and occupational classification,ctc.%手部湿疹是皮肤科临床常见病,发病率高、女性多见、病因复杂、容易复发、治疗困难.其病因研究主要包括外在刺激性因素和内在因素.多数文献认为原发刺激性接触性皮炎是手部湿疹的主要类型.手部湿疹在临床上尚无统一的分类标准,常见的有病因学分类、形态学分类、解剖学分类和按照职业性分类,以及其他方法分类.

  15. The hands in health and disease of individuals with filaggrin loss-of-function mutations

    DEFF Research Database (Denmark)

    Kaae, Jeanette; Menné, Torkil; Carlsen, Berit C

    2012-01-01

    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...

  16. 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.

  17. Hands4U: A multifaceted strategy to implement guideline-based recommendations to prevent hand eczema in health care workers: design of a randomised controlled trial and (cost effectiveness evaluation

    Directory of Open Access Journals (Sweden)

    van der Gulden Joost W

    2011-08-01

    Full Text Available Abstract Background Workers in wet work occupations have a risk for developing hand eczema. Prevention strategies exist, but compliance to the proposed recommendations is poor. Therefore, a multifaceted implementation strategy (MIS is developed to implement these recommendations to reduce hand eczema among health care workers performing wet work. Methods/Design This study is a randomised controlled trial in three university hospitals in the Netherlands. Randomisation to the control or intervention group is performed at department level. The control group receives a leaflet containing the recommendations only. The intervention group receives the MIS which consists of five parts: 1 within a department, a participatory working group is formed to identify problems with the implementation of the recommendations, to find solutions for it and implement these solutions; 2 role models will help their colleagues in performing the desired behaviour; 3 education to all workers will enhance knowledge about (the prevention of hand eczema; 4 reminders will be placed at the department reminding workers to use the recommendations; 5 workers receive the same leaflet as the control group containing the recommendations. Data are collected by questionnaires at baseline and after 3, 6, 9 and 12 months. The primary outcome measure is self-reported hand eczema. The most important secondary outcome measures are symptoms of hand eczema; actual use of the recommendations; sick leave; work productivity; and health care costs. Analyses will be performed according to the intention to treat principle. Cost-effectiveness of the MIS will be evaluated from both the societal and the employer's perspective. Discussion The prevention of hand eczema is important for the hospital environment. If the MIS has proven to be effective, a major improvement in the health of health care workers can be obtained. Results are expected in 2014. Trial registration number NTR2812

  18. 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....

  19. Quality of life of patients with occupational hand eczema

    NARCIS (Netherlands)

    Coenraads, PJ; Bouma, J; Diepgen, TL

    2004-01-01

    In recent years quality of life has been studied in a growing number of different dermatological diseases. Internationally validated questionnaires such the RAND-36 (identical to the SF-36) do not contain enough questions which are relevant for skin diseases. There is no publication on quality of li

  20. 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?"

  1. Hand eczema treated by acupoint injection and wrap therapy: evaluation of effectiveness and nursing care%穴位注射联合封包治疗手部湿疹疗效观察与护理

    Institute of Scientific and Technical Information of China (English)

    梁冬梅; 周新红; 刘利兴; 林惠敏; 秦春燕; 鲁东平

    2012-01-01

    Objective To investigate the effect of hand eczema treated by acupoint injection and wrap therapy. Methods Totally, 96 patients with hand eczema were randomly divided into two groups, with 48 patients in each group. The observation group were treated by acupoint injection once every two weeks, and the affected hands were wrapped in night; 2 weeks constituted 1 treatment cycle which was repeated depending on patients recovery. The control group only received wrap therapy. Results After 4-week treatment, the curative effect in the observation group was significantly better than the control group, and healing time of the observation group was significantly shorter (P<0. 01 for both). Conclusion Hand eczema treated by acupoint injection and wrap therapy is effective.%目的 探讨穴位注射联合封包治疗手部湿疹的效果.方法 将96例手部湿疹患者随机分为观察组与对照组,每组48例.观察组给予穴位注射,每2周1次,同时每晚用封包治疗1次,2周为1个疗程;对照组只用封包治疗,每晚1次.结果 治疗4周后,观察组疗效显著优于对照组,痊愈时间显著短于对照组(均P<0.01).结论 采用穴位注射联合封包治疗手部湿疹疗效可靠.

  2. 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.

  3. A mild hand cleanser, alkyl ether sulphate supplemented with alkyl ether carboxylic acid and alkyl glucoside, improves eczema on the hand and prevents the growth of Staphylococcus aureus on the skin surface.

    Science.gov (United States)

    Fukui, S; Morikawa, T; Hirahara, M; Terada, Y; Shimizu, M; Takeuchi, K; Takagi, Y

    2016-12-01

    Washing the hands using cleansers with antiseptic materials is the most popular method for hand hygiene and helps maintain health by preventing food poisoning and bacterial infections. However, repeated hand washing tends to induce eczema of the hand, such as dryness, cracking and erythema. Moreover, eczema on the hand leads to increased levels in Staphylococcus aureus (S. aureus) on the skin surface in contrast to expectations. Thus, mild hand cleansers which induce less eczema even with repeated washings are desired. Here, we evaluated the efficacy of a hand cleanser formulated with alkyl ether sulphate (AES), alkyl ether carboxylic acid (AEC) and alkyl glucoside (AG) that contains isopropyl methylphenol (IPMP) on skin symptoms and S. aureus levels. Eczema of the hand and the presence of S. aureus on the skin surface were analysed prior to and following 4 weeks of usage of the hand cleanser. A soap-based hand cleanser with IPMP was used as a reference cleanser. Eczema and cutaneous conditions were evaluated by visual grading, transepidermal water loss (TEWL), stratum corneum moisture-retention ability (MRA) and skin surface pH. The repeated use of the soap-based hand cleanser significantly worsened the hand dryness, scaling and cracks on the tips of the fingers and significantly increased the TEWL and decreased the MRA. In contrast, usage of the test cleanser only induced a significant increase in skin dryness but did not induce skin scaling or cracking and did not increase TEWL or decrease the MRA. Corresponding to these changes in skin symptoms, the presence of S. aureus increased the following use of the reference cleanser but not the test cleanser. There was no significant difference in skin surface pH between the two cleansers. Moreover, the increase in S. aureus was significantly correlated to the worsening of skin dryness and scaling. These results suggest that not only antimicrobial activity but also the mildness, which minimizes cutaneous effects

  4. 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 ...

  5. Clinical Experience With Acupoint Injection Combined With Packet Treatment of Hand Eczema%手部湿疹采用穴位注射联合封包治疗的临床体会

    Institute of Scientific and Technical Information of China (English)

    贾红玲

    2015-01-01

    目的:研究采用穴位注射联合封包治疗手部湿疹的疗效。方法选取我院收治的98例手部湿疹患者,随机分为对照组与观察组各49例。对照组单纯使用封包进行治疗,观察组在此基础上增加穴位注射进行联合治疗。结果观察组治疗后EASI分数下降情况明显高于对照组;观察组治疗总有效率明显高于对照组。结论运用穴位注射联合封包治疗手部湿疹的效果非常显著。%Objective To explore the effect of acupoint injection combined with packet treatment of hand eczema.Methods We selected 98 cases of hand eczema patients in our hospital, randomly divided into control group and observation group (49 cases in each group). The control group were treated using packet treatment, and the observation group were treated using acupoint injection combined with packet treatment.Results After treatment, the EASI scores of observation group decreased signiifcantly than those of the control group, the observation group total effective rate was signiifcantly higher than that in control group.Conclusion Hand eczema treated by acupoint injection and wrap therapy is very signiifcant.

  6. 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.)

  7. 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

  8. The importance of TCM foam washing for hand keratotic eczema%中药泡洗对手部角化性湿疹的重要性

    Institute of Scientific and Technical Information of China (English)

    付红娟; 宋晓霞; 郭建辉

    2012-01-01

      Eczema is a skin disease, a cause is unclear, the course is repeated, like related to the physical. Generally divided into acute, subacute and chronic three types. The characteristics of hand eczema: The skin lesions were subacute or chronic eczema performance, mostly occurred in the dorsal and tip of finger palm surface, spread to the back of the hand and wrist, state of confusion, or was small pieces of skin lesions, the chronic skin lesions showed infiltration hypertrophy, finger activities lead to chapped. Swelling of the skin of Jiazhou, nails can be thickened irregular. Because hands frequent contact with external substances, regardless of their etiology, often subjected to secondary factors leaving the condition changes,. generally more stubborn to treat.%  湿疹是一类病因不清、病程反复,似与一定的体质有关的一种皮肤病[1]。一般分为急性、亚急性、慢性三种类型。手部湿疹的特点:皮损呈亚急性或慢性湿疹表现,多发生于指背及指端掌面,可蔓延至手背和手腕,境界不清或呈小片状皮损,呈慢性时有浸润肥厚,因手指活动而有皲裂。甲周皮肤肿胀,指甲可变厚不规则。因两手经常接触外界物质,故手部湿疹无论其病因如何,常受继发因素影响而使病情变化,一般比较顽固难治。

  9. Nickel sensitization in adolescents and association with ear piercing, use of dental braces and hand eczema. The Odense Adolescence Cohort Study on Atopic Diseases and Dermatitis (TOACS)

    DEFF Research Database (Denmark)

    Mørtz, Charlotte G; Lauritsen, Jens Martin; Bindslev-Jensen, Carsten

    2002-01-01

    The prevalence of nickel allergy (sensitization) and the associations with ear piercing, use of dental braces and hand eczema were assessed in a cohort of 1,501 8th grade schoolchildren (aged 12-16 years) in Odense, Denmark. Nickel allergy was found in 8.6% and was clinically relevant in 69......% of cases. Nickel allergy was found most frequently in girls and the association with ear piercing was confirmed. Application of dental braces (oral nickel exposure) prior to ear piercing (cutaneous nickel exposure) was associated with a significantly reduced prevalence of nickel allergy. In adolescents...

  10. 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.

  11. 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...

  12. 玉红膏治疗手部皲裂性湿疹疗效观察%Clinical Effects of YuHongGao in Treating Hand Eczema Fissum

    Institute of Scientific and Technical Information of China (English)

    呼荟茹; 贾育蓉; 贾育新

    2012-01-01

    目的:观察玉红膏治疗手部皲裂性湿疹的临床疗效.方法:玉红膏外用治疗手部皲裂性湿疹56例,观察症状及体征改善情况.结果:治愈率42.0%,总有效率100%.结论:玉红膏外用治疗手部皲裂性湿疹疗效确切.%Objective: To observe clinical effects of YuHongGao in treating hand eczema fissum. Method: 56 cases of hand eczema fissum were given by YuHongGao. The improvements of symptom and sign were explored. Result: The cure rate was 42.0%, total effective rate was 100%. Conclusion: YuHongGao in treating hand eczema fissum can obtain definite effects.

  13. The association between hand eczema and nickel allergy has weakened among young women in the general population following the Danish nickel regulation: results from two cross-sectional studies

    DEFF Research Database (Denmark)

    Thyssen, Jacob Pontoppidan; Linneberg, Allan René; Menné, Torkil

    2009-01-01

    BACKGROUND: An association between nickel contact allergy and hand eczema has previously been demonstrated. In 1990, Denmark regulated the extent of nickel release in the ear-piercing process as well as nickel release from consumer products. OBJECTIVES: This study aimed to evaluate the effect...... of the Danish nickel regulation by comparing the prevalence of concomitant nickel allergy and hand eczema observed in two repeated cross-sectional studies performed in the same general population in Copenhagen. MATERIALS: In 1990 and 2006, 3881 18-69 year olds completed a postal questionnaire and were patch...... tested with nickel. Data were analysed by logistic regression analyses and associations were expressed as odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS: The prevalence of concomitant nickel contact allergy and a history of hand eczema decreased among 18-35-year-old women from 9...

  14. 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...

  15. 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.

  16. 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.

  17. Patient hand hygiene practices in surgical patients.

    Science.gov (United States)

    Ardizzone, Laura L; Smolowitz, Janice; Kline, Nancy; Thom, Bridgette; Larson, Elaine L

    2013-06-01

    Little is known about the hand hygiene practices of surgical patients. Most of the research has been directed at the health care worker, and this may discount the role that hand hygiene of the surgical patient might play in surgical site infections. A quasiexperimental, pretest/post-test study was conducted in which patients (n = 72) and nurses (n = 42) were interviewed to examine perceptions and knowledge about patient hand hygiene. Concurrently, observations were conducted to determine whether surgical patients were offered assistance by the nursing staff. Following an initial observation period, nursing staff received an educational session regarding general hand hygiene information and observation results. One month after the education session, patient/nurse dyads were observed for an additional 6 weeks to determine the impact of the educational intervention. Eighty observations, 72 patient interviews, and 42 nurse interviews were completed preintervention, and 83 observations were completed postintervention. In response to the survey, more than half of patients (n = 41, 55%) reported that they were not offered the opportunity to clean their hands, but a majority of the nursing staff reported (n = 25, 60%) that they offered patients the opportunity to clean their hands. Prior to the educational intervention, nursing staff assisted patients in 14 of 81 hand hygiene opportunities. Following the intervention, nursing staff assisted patients 37 out of 83 opportunities (17.3% vs 44.6%, respectively, [χ(2)1 = 13.008, P = .0003]). This study suggests that efforts to increase hand hygiene should be directed toward patients as well as health care workers. Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  18. 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.

  19. 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.

  20. 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.

  1. 穴位注射联合中药外洗治疗手部湿疹的疗效观察%Effects observation on point injection combined with herbal lotion for treating hand eczema

    Institute of Scientific and Technical Information of China (English)

    陈树钊

    2013-01-01

    Objective To observe the effect of point injection combined with herbal lotion for treating hand eczema.Methods 108 patients of hand eczema were equally divided into treatment group and control group with random comparison and blind.The control group patients were treated with point injection triamcinolone acetonide.The treatment group patients received Chinese herbal medicine washing on the.basis of point injection triamcinolone acetonide; Triamcinolone acetonide was injected once every 3 weeks.Chinese herbal medicine washed hands twice every day.We observed the effects of the two groups after a period of treatment for 12 weeks.Results After treatment,the EASI scores of treatment group decreased significantly than those of the control group (P<0.05),The effect rate of treatment group and the control group were 96.3% and 79.63% respectively (P<0.01).Conclusion Point injection of triamcinolone acetonide plus 2% lidocaine combined with traditional Chinese medicine treatment of particles lotion hand eczema is safe and effective,worthy for promoting.%目的 探讨穴位注射醋酸曲安奈德注射液加利多卡因联合中药外洗治疗手部湿疹的疗效.方法 将108例手部湿疹患者随机分为对照组和治疗组各54例.对照组采用穴位注射醋酸曲安奈德注射液1 ml加2%利多卡因1 ml的混合液,分别对双手合谷穴注射,每3周1次,6周1个疗程;治疗组在对照组的基础上加用中药浸泡患部20~30 min,2次/d,6周1个疗程.2个疗程后对两组疗效进行比较.结果 治疗组治疗后EASI评分下降比对照组明显(P<0.05).治疗组和对照组有效率分别为96.3%和79.63%,两组比较差异有统计学意义(P<0.05).结论 穴位注射醋酸曲安奈德注射液加2%利多卡因联合中药洗剂治疗手部湿疹是安全有效的,值得推广应用.

  2. 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...

  3. 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...

  4. 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.

  5. Hand Eczema and Its Risk Factors of Workers in Ferrous Metal Smelting and Calendering Processing Industry%黑色金属冶炼和压延加工业工人手部湿疹及其危险因素

    Institute of Scientific and Technical Information of China (English)

    贾宁; 秦汝莉; 李玉珍; 张雪艳; 李建国; 赵春香; 周久利; 王忠旭

    2012-01-01

    [目的]调查黑色金属冶炼和压延加工业工人手部湿疹的患病情况,探讨其相关危险因素. [方法]采用随机抽样方法,对某省11家黑色金属冶炼和压延加工企业工人手部湿疹的患病情况进行横断面调查,利用x2检验和多因素logistic回归进行手部湿疹的危险因素分析. [结果]该11家黑色金属冶炼和压延加工业工人手部湿疹的患病率为12.8%,其中从事热处理、造型和金属熔炼工序的工人手部湿疹的患病率较高,分别为26.8%、25.4%和25.0%.作业工人自诉生产性粉尘、金属及其盐类(锰及其化合物、铬及其化合物、镍化合物)、金属加工液、强酸(硫酸、硝酸、盐酸)、有机溶剂(苯及其同系物、三氯乙烯、四氯化碳)和高温为可能导致手部湿疹的危险因素.多元logistic 回归分析表明,金属加工液、男性、年龄、全身皮肤干燥、皮肤过敏史和哮喘史被选入模型.其中,金属加工液的OR值( 5.007)最高.[结论]黑色金属冶炼和压延加工业工人手部湿疹的患病率较高,应积极采取切实有效的防护措施,减少和预防该病的发生.%[ Objective ] To estimate the prevalence of hand eczema among workers of ferrous metal smelting and calendering processing industry, and to explore related risk factors. [ Methods ] A cross-sectional study was conducted among workers with hand eczema randomly selected from 11 ferrous metal smelting and calendering processing enterprises in a province of China. The x2 test and multivariate logistic regression analysis were used to analyze risk factors of hand eczema. [ Results ] Of the workers investigated, the prevalence rate of hand eczema was 12.8%, and higher prevalences of hand eczema were found in workers engaged in heat treatment, moulding and smelting procedures, being 26.8%, 25.4% and 25.0%, respectively. Their self-reported risk factors of hand eczema were productive dust, metals and their salts (manganese

  6. 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.

  7. 穴位注射联合中药颗料外洗治疗手部湿疹疗效观察%Efficacy observation of point injection combined Chinese medicine granule washing treatment of hand eczema

    Institute of Scientific and Technical Information of China (English)

    陈树钊

    2015-01-01

    目的:探讨观察穴位注射联合中药颗料外洗治疗手部湿疹的疗效。方法手部湿疹患者80例根据随机抽签方法分为治疗组与对照组各40例,对照组给予传统穴位注射治疗,治疗组在对照组治疗的基础上给予自拟中药颗粒洗剂治疗。结果治疗后治疗组的显效率分别为97.5%和85.0%,治疗组的显效率明显高于对照组(P<0.05)。两组治疗后的皮损与自觉症状评分明显低于治疗前(P<0.05),同时治疗后治疗组的皮损与自觉症状评分明显低于对照组(P<0.05)。经过观察,两组治疗后血清IL-15和IL-21值明显低于治疗前(P<0.05),同时治疗后治疗组的血清IL-15和IL-21值明显低于对照组(P<0.05)。结论穴位注射联合中药颗料外洗治疗手部湿疹能通过保护、润肤、收敛、抗过敏、止痒等综合作用改善临床症状,促进临床疗效的提高。%ObjectiveTo investigate the efficacy of point injection combined Chinese medicine granule washing treatment of hand eczema.Methods80 patients with hand eczema accorded a random draw method were equally divided into the treatment group and control group, the control group were received traditional acupuncture point injection therapy, the treatment group were added given self-made medicine particles lotion treatment on the basis of the control group.Results The effective rates of the treatment group and the control group were 97.5% and 85.0% respectively which the treatment group had significantly higher efficiency (P<0.05). After treatment, the skin lesions and symptoms scores were significantly lower than before treatment (P<0.05), while the lesions and symptoms scores in the treatment group were significantly lower than the control group (P<0.05). After treatment, the serum IL-15 and IL-21 were significantly lower than before treatment (P<0.05), while serum IL-15 and IL-21 value of the treatment group were significantly lower than

  8. 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

  9. 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

  10. 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.

  11. 双白止痒洗剂外用治疗慢性手湿疹疗效及实验研究%Efficacy and Mechanism of Shuangbai Zhiyang Lotion on Chronic Hand Eczema

    Institute of Scientific and Technical Information of China (English)

    骆伟雄

    2012-01-01

    Objective To observe the efficacy of Shuangbai Zhiyang lotion on chronic hand eczema, and to explore its mechanism. Methods A total of 60 patients with chronic hand eczema in the observation were randomly divided into two groups with a random number table, the observation group and the control group. The outcome of their symptoms were observed in follow-up three months, and then compared the first relapse time between these two groups. CD3, CD4 and CD8 lymphocytes of patients were detected by flow cytometry before and after treatment. Results 13 cases in the observation group had been cured after treatment, and total effective rate was 83.3%. And five cases in the control group had been cured, and total effective rate was 53.3%. By Ridit analysis, curative effect of observation group was better than that of control group (P=0.007 5, P<0.01). After treatment, four kinds of T-lymphocyte subsets could be detected. Compared to the mean before treatment, CD3+ and CD4+ was significantly increased in the treatment group, but it was not increased obviously in the control group. After treatment, the differences of CD3 + and CD4 + were significant. Conclusion Shuangbai Zhiyang lotion can eliminate symptoms quickly, and it can prolong or prevent the recurrence of eczema significantly. Long-term effect is good. Its mechanism may be related to the effect on immune function and inhibiting T lymphocyte activation.%目的 观察双白止痒洗剂治疗慢性手湿疹的疗效,并探讨其作用机制.方法 共60例慢性手湿疹患者纳入观察,以随机数字表法随机分为观察组和对照组.观察其症状转归情况,治疗后随访3个月,比较2组患者第1次复发的时间.治疗前后采用流式细胞仪检测2组患者的CD3、CD4、CD8淋巴细胞.结果 观察组治愈13例,显效6例,好转6例,总有效率为83.3%;对照组治愈5例,显效5例,好转6例,总有效率为53.3%.经Ridit分析,P=0.007 5,P<0.01,提示观察组疗效优于对照组.治

  12. Assessing patient awareness of proper hand hygiene.

    Science.gov (United States)

    Busby, Sunni R; Kennedy, Bryan; Davis, Stephanie C; Thompson, Heather A; Jones, Jan W

    2015-05-01

    The authors hypothesized that patients may not understand the forms of effective hand hygiene employed in the hospital environment. Multiple studies demonstrate the importance of hand hygiene in reducing healthcare-associated infections (HAIs). Extensive research about how to improve compliance has been conducted. Patients' perceptions of proper hand hygiene were evaluated when caregivers used soap and water, waterless hand cleaner, or a combination of these. No significant differences were observed, but many patients reported they did not notice whether their providers cleaned their hands. Educating patients and their caregivers about the protection afforded by proper, consistent hand hygiene practices is important. Engaging patients to monitor healthcare workers may increase compliance, reduce the spread of infection, and lead to better overall patient outcomes. This study revealed a need to investigate the effects of patient education on patient perceptions of hand hygiene. Results of this study appear to indicate a need to focus on patient education and the differences between soap and water versus alcohol-based hand sanitizers as part of proper hand hygiene. Researchers could be asking: "Why have patients not been engaged as members of the healthcare team who have the most to lose?"

  13. 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...

  14. Clinical Observation of 105 Cases of Fumigation with Chronic Hand Eczema Wudai Ointment in the Treatment of Traditional Chinese Medicine%中药熏洗联合蜈黛软膏治疗手部慢性湿疹105例临床观察

    Institute of Scientific and Technical Information of China (English)

    石孟轩; 朱芮弘

    2016-01-01

    Objective To observe effects of Chinese Fumigation and washing plus the Wudai ointment in the treatment of chronic eczema efficacy . Methods Selected 105 cases of hand chronic eczema patients according to the random number table method were divided into treatment group, control group, treatment group were treated by traditional Chinese medicine fumigation again Waicha Wudai ointment and packet 1H, and the control group were treated with compound ketoconazole ointment, efficacy were compared between the two groups. Results In the treatment group, the effective rate was 89.09%, control group, the effective rate was 64.00%, the difference was significant (P< 0.05). Conclusion The Chinese medicine fumigation washing combined with the Wudai ointment in the treatment of hand of chronic eczema is effective.%目的:观察中药熏洗联合蜈黛软膏治疗手部慢性湿疹的疗效。方法将入选的105例手部慢性湿疹患者按随机数字表法分为治疗组、对照组,治疗组予中药熏洗后再外搽蜈黛软膏并封包1 h,对照组外用复方酮康唑软膏,对比两组疗效。结果治疗组有效率89.09%,对照组有效率64.00%,差异显著(P<0.05)。结论中药熏洗联合蜈黛软膏治疗手部慢性湿疹有效。

  15. 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...

  16. 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...

  17. 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.

  18. Illness representations in patients with hand injury.

    LENUS (Irish Health Repository)

    Chan, Jeffrey C Y

    2009-07-01

    Differences in illness perception about hand injury may partly explain the variation in health behaviours such as adherence to post-operative therapy, coping strategy, emotional response and eventual clinical outcome. This study examined the illness perception of patients with hand injuries in the acute trauma setting.

  19. Telerehabilitation approach for patients with hand impairment.

    Science.gov (United States)

    Staszuk, Arleta; Wiatrak, Benita; Tadeusiewicz, Ryszard; Karuga-Kuźniewska, Ewa; Rybak, Zbigniew

    2016-01-01

    Telerehabilitation is one of the newest branches of telemedicine which has been developed because patients need regular trainings outside the medical institution but still under specialist supervision. It helps maintain regularity of exercises and reduces costs. The professional and advanced systems for telerehabilitation are presented in papers, however, there is still lack of development of minor systems which provide therapeutic values and are more accessible to people. Therefore we focus on a solution for hand telerehabilitation of poststroke patients, based solely on a personal computer and camera. We focused on the manipulative hand (fingers, metacarpus, wrist) movements trainings for patients with cerebral palsy. The contact between patient and physiotherapist is provided by using web cameras and web service. Additionally, the camera can be used to monitor the effectiveness of performed exercises. Computer vision system keeps track of the patient's hand movement. The digital image processing is used to detect if the patient performs exercises correctly. We created web service and software application TeleReh that provides therapeutic values for the hand impaired people. The system created was evaluated by three physiotherapists, one doctor and a cerebral palsy patient. Our solution applies to all patients who have undergone basic rehabilitation in hospital and need to continue hand rehabilitation at home. The main advantages are: easy adaptation to the individual needs and abilities, monitoring the progress by using automatically generated reports after each training session. It is worth noticing that discussion between IT specialists, rehabilitants and patients was necessary to achieve good results.

  20. 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

  1. Hand Hygiene Saves Lives: Patient Admission Video

    Centers for Disease Control (CDC) Podcasts

    2008-05-01

    This podcast is for hospital patients and visitors. It emphasizes two key points to help prevent infections: the importance of practicing hand hygiene while in the hospital, and that it's appropriate to ask or remind healthcare providers to practice hand hygiene.  Created: 5/1/2008 by National Center for Preparedness, Detection, and Control of Infectious Diseases (NCPDCID).   Date Released: 6/19/2008.

  2. 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

  3. Dermatoses of the hand-an observation

    Directory of Open Access Journals (Sweden)

    Kumar Pramod

    1999-01-01

    Full Text Available After going through 1000 case files of patients registered in the skin department of K.M.C. Hospital, it was found that 166 (16.6% of them had dermatoses restricted to their hands. Based on the clinical findings and clinical diagnosis recorded, the various dermatoses were tabulated and evaluated. Ninety-two males and 74 females had dermatoses of hands. Warts and eczemas formed the major chunk of cases. Females out numbered males among patients with warts and eczemas.

  4. 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.

  5. 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.

  6. Chronic lymphoedema caused by recurrent infections in a patient with allergic hand eczema

    DEFF Research Database (Denmark)

    Dyring-Andersen, Beatrice; Skov, Lone; Jensen, Peter

    2011-01-01

    Allergic contact dermatitis is very common and may be complicated by secondary infections. Chronic lymphoedema is a potentially debilitating condition, which may occur due to secondary infections or the dermatitis itself. The problem of chronic lymphoedema following allergic contact dermatitis ha...

  7. The fragrance hand immersion study - an experimental model simulating real-life exposure for allergic contact dermatitis on the hands

    DEFF Research Database (Denmark)

    Heydorn, S; Menné, T; Andersen, Klaus Ejner

    2003-01-01

    Recently, we showed that 10 x 2% of consecutively patch-tested hand eczema patients had a positive patch test to a selection of fragrances containing fragrances relevant to hand exposure. In this study, we used repeated skin exposure to a patch test-positive fragrance allergen in patients...... previously diagnosed with hand eczema to explore whether immersion of fingers in a solution with or without the patch-test-positive fragrance allergen would cause or exacerbate hand eczema on the exposed finger. The study was double blinded and randomized. All participants had a positive patch test to either...... hydroxycitronellal or Lyral (hydroxyisohexyl 3-cyclohexene carboxaldehyde). Each participant immersed a finger from each hand, once a day, in a solution containing the fragrance allergen or placebo. During the first 2 weeks, the concentration of fragrance allergen in the solution was low (approximately 10 p...

  8. Clinical efficacy of Loratadine in combination with Binghuangfule cream in the treatment of subacute and chronic hand eczema%氯雷他定联合冰黄肤乐软膏治疗亚急性及慢性手部湿疹的临床观察

    Institute of Scientific and Technical Information of China (English)

    吴实; 邓列华; 胡云峰; 刘赛君; 赵刚; 陈国瑞

    2012-01-01

    Aim:To study the clinical therapeutic efficacy of Loratadine in combination with Binghuangfule Cream in the treatment of subacute and chronic hand eczema. Methods: One hundred patients diagnosed and classified with subacute and chronic hand eczema were randomly divided into two groups, the treatment group received oral Loratadine in combination with Binghuangfule Cream while control group received oral Loratadine only. Results; in the forth week, the cure rate in treatment group was 36. 0% , effective rate was 90. 0% while the cure rate in control group is 18. 0% and effective rate was 68. 0%. The difference in cure rate and effective rate between the two groups were statistically significant ( P < 0. 05). Conclusion: Loratadine in combination with Binghuangfule Cream is effective in the treatment of subacute and chronic hand eczema, its clinical efficacy is significantly better than oral Loratadine alone, with a lower rate of adverse events.%目的:探讨口服氯雷他定片联合外用冰黄肤乐软膏治疗亚急性及慢性手部湿疹的临床效果.方法:选择亚急性及慢性手部湿疹患者100例,随机分为两组,治疗组采用口服氯雷他定与外用冰黄肤乐联合治疗,对照组单纯口服氯雷他定片治疗,观察其治疗效果.结果:总体效果评价中,第4周,治疗组痊愈率为36.0%,有效率为90.0%;对照组痊愈率为18.0%,有效率为68.0%,比较两组之间痊愈率及有效率均有显著性差异(P<0.05).结论:口服氯雷他定片与外用冰黄肤乐软膏联合治疗亚急性及慢性手部湿疹疗效好,其疗效明显优于单纯口服氯雷他定片治疗,不良反应亦轻微.

  9. 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.

  10. 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.

  11. 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.

  12. StudyofCompoundBetamethasoneInjectionCombinedwithUreaCreaminTreatmentof138CasesofHandEczema%复方倍他米松局部注射联合尿素乳膏治疗138例手部湿疹的疗效观察

    Institute of Scientific and Technical Information of China (English)

    张连清

    2013-01-01

    Objective Appraisal compound prescription betamethasone partial injection union urea cream treatment hand eczema curative effect. Method Will be selected 138 example patients divide into the treatment group and the control group stochastically, the treatment group compound prescription betamethasone partial injection unite 10%urea cream external use, Topical creams halometasone control group and 10%urea cream, were treated for 4 weeks. Records and adverse reactions during treatment. Results After the treatment had ended, the treatment group and control group effectiveness respectively are 87.32%and 56.72%, the difference has statistics signiifcance (P=0.001). Conclusion Compound prescription betamethasone partial injection union urea cream treatment hand eczema safe effective, improved patient's quality of life obviously.%  目的评价复方倍他米松局部注射联合尿素乳膏治疗手部湿疹疗效。方法将入选的138例患者随机分为治疗组和对照组,治疗组复方倍他米松局部注射联合10%尿素乳膏外用,对照组卤米松乳膏和10%尿素乳膏外用,共治疗4周,记录治疗过程及不良反应。结果治疗结束后,治疗组和对照组有效率分别为87.32%和56.72%,差异有统计学意义(P=0.001)。结论复方倍他米松局部注射联合尿素乳膏治疗手部湿疹安全有效,明显提高了患者的生活质量。

  13. 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.

  14. Nickel-induced cytokine production from mononuclear cells in nickel-sensitive individuals and controls. Cytokine profiles in nickel-sensitive individuals with nickel allergy-related hand eczema before and after nickel challenge

    DEFF Research Database (Denmark)

    Borg, L; Christensen, J M; Kristiansen, J

    2000-01-01

    Exposure to nickel is a major cause of allergic contact dermatitis which is considered to be an inflammatory response induced by antigen-specific T cells. Here we describe the in vitro analysis of the nickel-specific T-cell-derived cytokine response of peripheral blood mononuclear cells from 35...... was somewhat of a surprise, since previous studies have suggested a Th1 response in nickel-mediated allergic contact dermatitis. Subsequently, the nickel-allergic individuals were randomized to experimental exposure to nickel or vehicle in a double-blind design. A daily 10-min exposure of one finger to 10 ppm...... nickel solution for 1 week followed by 100 ppm for an additional week evoked a clinical response of hand eczema in the nickel-exposed group. Blood samples were drawn on days 7 and 14 after the start of this exposure to occupationally relevant concentrations of nickel. No statistically significant...

  15. 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.

  16. 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

  17. 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...

  18. 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

  19. 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 ...

  20. Patients' Hand Washing and Reducing Hospital-Acquired Infection.

    Science.gov (United States)

    Haverstick, Stacy; Goodrich, Cara; Freeman, Regi; James, Shandra; Kullar, Rajkiran; Ahrens, Melissa

    2017-06-01

    Hand hygiene is important to prevent hospital-acquired infections. Patients' hand hygiene is just as important as hospital workers' hand hygiene. Hospital-acquired infection rates remain a concern across health centers. To improve patients' hand hygiene through the promotion and use of hand washing with soap and water, hand sanitizer, or both and improve patients' education to reduce hospital-acquired infections. In August 2013, patients in a cardiothoracic postsurgical step-down unit were provided with individual bottles of hand sanitizer. Nurses and nursing technicians provided hand hygiene education to each patient. Patients completed a 6-question survey before the intervention, at hospital discharge and 1, 2, and 3 months after the intervention. Hospital-acquired infection data were tracked monthly by infection prevention staff. Significant correlations were found between hand hygiene and rates of infection with vancomycin-resistant enterococci (P = .003) and methicillin-resistant Staphylococcus aureus (P = .01) after the intervention. After the implementation of hand hygiene interventions, rates of both infections declined significantly and patients reported more staff offering opportunities for and encouraging hand hygiene. This quality improvement project demonstrates that increased hand hygiene compliance by patients can influence infection rates in an adult cardiothoracic step-down unit. The decreased infection rates and increased compliance with hand hygiene among the patients may be attributed to the implementation of patient education and the increased accessibility and use of hand sanitizer. ©2017 American Association of Critical-Care Nurses.

  1. 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. ...

  2. 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...

  3. 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....

  4. 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.

  5. Patients' feelings about hand washing, MRSA status and patient information.

    Science.gov (United States)

    Duncan, Christopher Paul; Dealey, Carol

    The purpose of this study was to explore patient opinion about asking healthcare professionals to wash their hands before a clinical procedure and to explore if methicillin-resistant Staphylococcus aureus (MRSA) status and access to patient information about infection control would influence the patients' anxiety about asking. A descriptive survey was undertaken using a semi-structured questionnaire. The questionnaire was distributed to a randomized convenience sample of 185 inpatients across all departments of an acute NHS Trust hospital (response rate 58.9%). Spearman's rank order and Kendall Tau-b tests were used to analyse specific correlations. Respondents were more confident than anxious about being involved in a campaign that empowered patients to ask staff to wash their hands. Patients were more anxious to ask if their previous admission episodes were fewer, if their knowledge of MRSA was high and if there was less information about infection control available. Patients who had contracted MRSA in the past were less anxious, as they had a better understanding of the disease. In addition, more patients felt less anxious about asking staff to wash their hands if staff wore a badge saying 'It's OK to ask'.

  6. 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。

  7. Patient Hand Hygiene at Home Predicts Their Hand Hygiene Practices in the Hospital

    OpenAIRE

    Barker, Anna; Sethi, Ajay; Shulkin, Emily; Caniza, Rachell; Zerbel, Sara; Safdar, Nasia

    2014-01-01

    We examine factors associated with hand hygiene practices of hospital patients. Hygiene decreased compared to at home, and home practices were strongly associated with hospital practices. Understanding and leveraging the intrinsic value some patients associate with hand hygiene may be important for improving overall hospital hygiene and decreasing healthcare-associated infections.

  8. To Observe the Curative Effect of Hand Eczema Treatment and Nursing Combined with Ultrasonic Wave Packet%超声波导入联合封包治疗手部湿疹疗效观察与护理分析

    Institute of Scientific and Technical Information of China (English)

    杜娟; 葛玮; 李少波; 李艳秋; 程晶玲; 曾山鹰

    2015-01-01

    Objective To observe clinical curative ef ect and nursing methods of ultrasoniccombined treatment of hand eczema of the packet. Methods A total of 2014 January 2014 December out-patient and 174 cases of patients in hospital and randomized divided into two groups, observation group only smear Fu Yan Ning ointment, control group Fu Yan Ning ointment daub applied immediately ultrasonic introduction for 10min. Results The ef ective rate of control group is bet er than the observation group, there was statistical y significant dif erence ( <0.05). Conclusion Ultrasonic combined treatment of handeczema packet.%目的观察超声波导入联合封包治疗手部湿疹的疗效及护理措施的疗效。方法选取2014年1月~12月我科门诊及住院部患者174例,随机对照分为两组,观察组仅涂抹扶炎宁软膏,对照组涂抹扶炎宁软膏,立即应用超声波导入治疗10min。结果对照组有效率优于观察组,统计学有显著性差异(<0.05)。结论超声波导入联合封包治疗手部湿疹疗效肯定。

  9. [Therapeutic patient education in chronic hand dermatitis].

    Science.gov (United States)

    Gelot, P; Avenel-Audran, M; Balica, S; Bensefa, L; Crépy, M-N; Debons, M; Ammari, H; Milpied, B; Raison, N; Vigan, M; Weibel, N; Stalder, J-F; Bernier, C

    2014-06-01

    Hand dermatitis (HD) is usually due to a combination of various interacting factors. It involves significant impairment of the quality of life with psychological and socioeconomic impact. A therapeutic education program in HD.was elaborated by 19 health professionals (dermatologists, occupational clinical physicians, nurses, psychologists, environmental medical advisor) with experience in therapeutic education or skills in HD, according to the recommendations of Haute Autorité de Santé. The program includes an individual medical consultation to perform educational diagnostic, two collective workshops and a medical evaluation consult. Two group workshops "the disease, irritant factors and its treatments" and "the experiences and feelings" were elaborated with learning objectives and educative tools. Different scores were proposed to evaluate the program and acquired skills. Therapeutic education is an efficient way to help patients to adopt skin protection measures essential to healing. We propose a guideline of therapeutic education in HD including skills and educative tools and intended for health professionals to serve as working basis.

  10. 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.

  11. Determinants of return to work in patients with hand disorders and hand Injuries

    NARCIS (Netherlands)

    Opsteegh, L.; Reinders-Messelink, H.A.; Schollier, D.; Groothoff, J.W.; Postema, K.; Dijkstra, P.U.; van der Sluis, C.K.

    2009-01-01

    Introduction Return to work (RTW) in patients with hand disorders and hand injuries is determined by several determinants not directly related to the physical situation. Besides biomedical determinants, work-related and psychosocial determinants may influence RTW as well. This study is conducted to

  12. 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

  13. 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.

  14. Hand dermatitis in beauticians in India

    Directory of Open Access Journals (Sweden)

    Khanna Neena

    1997-01-01

    Full Text Available One hundred and sixty-one beauticians and hairdressers (146 women and 15 men were examined for the presence of hand dermatitis and those with hand eczema were patch tested with a battery of antigens standardised for beauticians. Forty-two (26.1% subjects were found to have hand dermatitis and of these, in 31 (69.3% the patch tests were positive; the following antigens elicited a positive response; paraphenylene diamine (35.5%, rubber antigens (22.6%, nickel (22.6%, shampoos (12.9%, ammonium thioglycollate (9.7%, ammonium persulphate (3.2%, henna mixture (3.2% and detergents (6.5%. In addition, irritant reaction was seen in 7; in 5 patients it was to shampoos and in 2 to ammonium persulphate. Of the 8 patients who, on questioning, had a history of atopy, 7 (87.5% had hand eczema, while 1 (12.5% did not, and this difference was statistically significant (p < 0.001, suggesting that beauticians with a history of atopy were more likely to develop hand eczema.

  15. The single-dose pharmacokinetics of alitretinoin and its metabolites are not significantly altered in patients with cirrhosis

    DEFF Research Database (Denmark)

    Thyssen, J.P.; Vester, L.; Larsen, C.G.;

    2014-01-01

    BACKGROUND: Alitretinoin (9-cis-retinoic acid, Toctino(®) ) has been marketed recently for oral therapy for chronic hyperkeratotic hand eczema. As alitretinoin is highly lipophilic and metabolized mainly in the liver, it is currently considered to be contraindicated in patients with liver disease...... of severe hand eczema were similar in patients with cirrhosis and in healthy controls. If indicated, alitretinoin can be used in these patients with careful and close monitoring....

  16. Patient empowerment and hand hygiene, 1997-2012.

    Science.gov (United States)

    McGuckin, M; Govednik, J

    2013-07-01

    Multi-modal hand hygiene programmes that include patient empowerment are promoted as a necessary component of hand hygiene compliance. However, the question still remains, do we have enough information to determine if, and under what conditions, patients will be able to play an immediate role in healthcare workers' hand hygiene behaviour? To review the current literature on patient willingness to be empowered, barriers to empowerment, and hand hygiene programmes that include patient empowerment and hand hygiene improvement. A Medline (Ovid) search of all English-language papers for 1997-2007 and 2008-2012 was conducted using the following keywords alone and in various combinations: 'patient participation', 'involvement', 'empowerment', 'education', 'decision-making', 'professional-patient relations', 'behavioural change', 'culture of safety', 'social marketing', 'consumer awareness', 'leadership', 'institutional climate', 'hand hygiene' and 'patient reminders'. The 1997-2007 review was conducted as part of the World Health Organization's Guidelines on Hand Hygiene in Health Care, and updated with the 2008-2012 review. Several studies show that, in principle, patients are willing to be empowered. However, there is variation in the actual number of patients that practice empowerment for hand hygiene, ranging from 5% to 80%. The actual performance of patient empowerment can be increased when a patient is given explicit permission by a healthcare worker. There is ongoing support from patients that they are willing to be empowered. There is a need to develop programmes that empower both healthcare workers and patients so that they become more comfortable in their roles. Copyright © 2013 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  17. The prevalence and severity of hand eczema among nurses working in three hospitals in Harbin, as well as its possible associated risk factors%护士手部湿疹发病率及其致病因素的相关性分析和对策

    Institute of Scientific and Technical Information of China (English)

    张丹; 高敏; 刘萍; 王秀东

    2014-01-01

    目的:探讨护士手部湿疹的发病率并对致病因素进行相关性分析。方法选择黑龙江省哈尔滨市内三家有代表性的三级甲等医院,对从业护士做一次大规模的流行病学调查研究,总结分析出手部湿疹的发病率,探讨其发病相关因素;进一步和国内外的研究结果对比,并结合我省我市及我国的实际情况,提出护士手部湿疹的防治建议。结果三家医院一共随机选取了1322名来自于不同科室的护士进行问卷调查,两周后共有934名护士填写了调查问卷并返回,响应率为70.7%(934/1322)。手部湿疹的患病率大致为19.6%,自身和家族特异性体质者湿疹发病率高(68.0%:28.2%;18.5%:15.4%,P20 times per day, wearing gloves most of the time during work, no applying emollient after wet work were independent risk factors for hand eczema. Conclusion Hand eczema is common and severe among Harbin nurses. the results of this study suggest that hand eczema is an important problem for nurses and that preventive measures should be emphasized.

  18. 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.

  19. 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.

  20. Promoting Patient Safety With Perioperative Hand-off Communication.

    Science.gov (United States)

    Robinson, Nancy Leighton

    2016-06-01

    Effective perioperative hand-off communication is essential for patient safety. The purpose of this quality improvement project was to demonstrate how a structured hand-off tool and standardized process could increase effective perioperative communication of essential elements of care and assist in the timely recognition of patients at risk for clinical deterioration in the initial postoperative period. A team-based pilot project used the Iowa Model of Evidence-Based Practice and the principles of Lean Six Sigma to implement Perioperative PEARLS, a perioperative specific hand-off communication tool and a standardized framework for hand-off communication. The implementation of a structured hand-off tool and standardized process supports compliance with regulatory standards of care and eliminates waste from the hand-off process. A review of pre-implementation and post-implementation data revealed evidence of safer patient care. Evidence-based perioperative hand-off communication facilitates expedited patient evaluation, rapid interventions, reduction in adverse events, and a safer perioperative environment.

  1. 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

  2. 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。

  3. Occurrence of potentially pathogenic bacteria on the hands of hospital patients before and after the introduction of patient hand disinfection.

    Science.gov (United States)

    Hedin, Göran; Blomkvist, Annika; Janson, Marianne; Lindblom, Anders

    2012-10-01

    The leading cause of nosocomial infections and spread of multiresistant bacteria is considered to be the failure of healthcare workers to perform appropriate hand hygiene. The role of the hands of hospital patients in the spread of infection has received little attention. The aim of the present study was to investigate the occurrence of potentially pathogenic bacteria on the patients' hands. Quantitative cultures were repeatedly taken from the fingertips of patients at a rehabilitation clinic before and after an intervention in which patient hand disinfection was introduced and promoted. Before the intervention, the occurrence on the hands of Escherichia coli, Klebsiella spp., enterococci, Staphylococcus aureus and yeast was a common finding. The colony counts of S. aureus were often higher than the counts of other organisms. After the intervention, the level of hand contamination was lower. The difference was statistically significant (p < 0.05) concerning Enterobacteriaceae, both when the patients were resting and at lunch time, for enterococci and total bacterial counts at lunch time, and for yeast when they were resting. Concerning S. aureus, the difference was not statistically significant, neither while resting nor at lunch time. The role of the patients in the spread of pathogenic bacteria merits more discussion.

  4. 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.

  5. 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.

  6. Hand Hygiene Saves Lives: Patient Admission Video (Short Version)

    Centers for Disease Control (CDC) Podcasts

    2008-05-01

    This podcast is for hospital patients and visitors. It emphasizes two key points to help prevent infections: the importance of practicing hand hygiene while in the hospital, and that it's appropriate to ask or remind healthcare providers to practice hand hygiene.  Created: 5/1/2008 by National Center for Preparedness, Detection, and Control of Infectious Diseases (NCPDCID).   Date Released: 4/26/2010.

  7. 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.

  8. A Randomized Trial to Determine the Impact of an Educational Patient Hand-Hygiene Intervention on Contamination of Hospitalized Patient's Hands with Healthcare-Associated Pathogens.

    Science.gov (United States)

    Sunkesula, Venkata C K; Kundrapu, Sirisha; Knighton, Shanina; Cadnum, Jennifer L; Donskey, Curtis J

    2017-01-05

    We conducted a non-blinded randomized trial to determine the impact of a patient hand-hygiene intervention on contamination of hospitalized patients' hands with healthcare-associated pathogens. Among patients with negative hand cultures on admission, recovery of pathogens from hands was significantly reduced in those receiving the intervention versus those receiving standard care. Infect Control Hosp Epidemiol 2016;1-3.

  9. 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...

  10. 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.

  11. [Infrastructure and adherence to hand hygiene: challenges to patient safety].

    Science.gov (United States)

    Bathke, Janaína; de Cunico, Priscila Almeida; Maziero, Eliane Cristina Sanches; Cauduro, Fernanda Leticia Frates; Sarquis, Leila Maria Mansano; de Cruz, Elaine Drehmer Almeida

    2013-06-01

    Considering the importance of hands in the chain of transmission of microorganisms, this observational research investigated the material infrastructure and compliance of hand hygiene in an intensive care unit in the south of Brazil in 2010. The data was collected by direct non-participant observation and through the use of self-administered questionnaires to be completed by the 39 participants, which was analyzed with the assistance of the chi2 Test, descriptive statistics and quantitative discourse analysis. Although health professionals overestimate compliance rates, recognize the practice as relevant to the prevention of infection and refer there are no impeding factors, of the 1,277 opportunities observed, compliance was 26% and significantly lower before patient contact and the use of aseptic procedures than after patient contact: infrastructure was shown to be deficient. The results indicate risk to patient safety, and thus, the planning of corrective actions to promote hand washing is relevant.

  12. 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

  13. Tactile sensitivity on the hands skin in rheumatic patients.

    Science.gov (United States)

    Kaluga, Elżbieta; Kostiukow, Anna; Samborski, Włodzimierz; Rostkowska, Elżbieta

    2014-06-01

    Clinical symptoms of rheumatic diseases can cause changes in the level of skin tactile sensitivity. To determine the tactile threshold of the hands in female patients with rheumatic diseases. It also attempted to determine correlations between rheumatic patients' tactile sensitivity and the degree of articular movement limitations, the Barthel Index (BI) and Edinburgh Handedness Inventory (EHI) results, the level of disability of the right hand and the left hand as well as age, education and eyesight. Ninety-nine female rheumatic patients aged 19-87 years took part in the study. The control group comprised 45 healthy women aged 23-80 years. The measurement of the tactile threshold was performed using the Touch-Test™ Sensory Evaluators (Semmes-Weinstein Monofilaments Test). The tactile threshold was measured at three sites on the hand: the little finger, the index finger and the metacarpus. The patients' tactile sensitivity ranges were classified as normal, diminished light touch and diminished protective touch. The degree of their disability was correlated with tactile sensitivity. The patients' tactile sensitivity worsens with age, but it is not correlated with the level of education. The lateralization was similar to that of the control group and was not correlated with tactile sensitivity. The worsening eyesight, independent of rheumatic disease, corresponds, however, with decreasing tactile sensitivity. The patients represented a group with a medium level of functional disability and lower tactile sensitivity.

  14. 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.

  15. Improvement of tactile roughness discrimination acuity correlates with perception of improved hand function in patients after hand surgery.

    Science.gov (United States)

    Fujimoto, Shuhei; Kon, Noriko

    2016-04-01

    [Purpose] The purpose of this study was to elucidate how well patients' perceptions related to the improvements in their hand function during hospitalization. [Subjects] Sixteen patients who were hospitalized after hand surgery. [Methods] Using the Japanese Society for Surgery of the Hand edition of the Quick-Disabilities of the Arm, Shoulder, and Hand questionnaire; tactile roughness discrimination acuity, motor imagery, motor function, sensory function, and pain of the upper limb were assessed at admission and discharge. Spearman's rank-order correlation coefficients were calculated using the differences in all assessment items at admission and discharge. A multiple regression analysis (stepwise method) was performed to investigate factors that correlated with improvements in Quick-Disabilities of the Arm, Shoulder, and Hand scores. [Results] The improvement of tactile roughness discrimination acuity was significantly associated with patient perception of improved hand function. [Conclusion] The results suggest that an improvement in tactile roughness discrimination acuity was most strongly correlated with patient perception of improved hand function.

  16. 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

  17. 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

  18. Relationship between patient-reported and objective measurements of hand function in patients with rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    S.M. Günay

    2016-12-01

    Full Text Available Rheumatoid arthritis (RA often results in impairments in upper extremities, especially in the small joints of hand. Involvement of hand brings limitations in activities of daily living. However, it is commonly observed that patient-reported functional status of hand does not always corresponds to their actual physical performance in the clinical setting. The aim of this pilot study is to investigate the relationship between patient self-reported and objectively measured hand functions in patients with RA. Twenty-six patients (51±13 years with RA diagnosis participated in the study. Hand grip and pinch (lateral, bipod, tripod strengths were measured and Jebsen Hand Function Test (JHFT was performed for objective functional performance. Duruöz Hand Index and Beck Depression Inventory - Turkish version were completed by patients. Grip and all three-pinch strength results significantly correlated with Duruöz Hand Index scores (p<0.05. JHFT results except the sentence writing also correlated with the Duruöz scores (p<0.05. Our results showed that self-reported outcome scales might be used for determining functional level of hand in patients with RA in rheumatology practice. Objective quantitative functional tests are the best methods in evaluating functional level of hand, but require valid and reliable equipment with accurate calibration. Therefore, in case of unavailability of objective assessment tools, patient-reported scales may also reflect the real status of hand functions.

  19. [Prospective study of the importance of constitutional parameters in the development of eczema in hairdressers and construction workers].

    Science.gov (United States)

    Hornstein, O P; Bäurle, G; Kienlein-Kletschka, B

    1985-01-01

    The considerable rate of professional hand eczema in hairdressers, especially in young ones, emphasizes the necessity of practicable methods for early diagnosis of risk and manifestation of eczema. Therefore, we investigated different constitutional parameters of the skin (hyperhidrosis, dyshidrosis and acrocyanosis of the hands, seborrhea, sebostasis, white dermographism) in a prospective study of 210 hairdressers' and 95 bricklayers' apprentices over 3 years. In addition, the alkali resistance and the permeability of the horny layers (by nitrazine yellow) were examined every year in each of the probands. Among other results dyshidrosis and sebostasis proved to be statistically relevant in the development of hand eczema, whereas no statistic causality was seen for acrocyanosis and hyperhidrosis. Risk of eczema could not be diagnosed early by alcali resistance tests. Frequent wet-work and insufficient skin protection were further factors causing eczema, especially in atopic subjects. There was also a statistically relevant correlation between a periumbilical eczema (caused by metallic buttons on jeans), indicating allergy against nickel, and pierced earlobes. The results of this prospective study show that by simple clinical methods serious risks of eczema in hairdressers and bricklayers can be detected already in the first years of work. Several practical recommendations for prevention of occupational eczema in hairdressers are given.

  20. 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.

  1. 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, ...

  2. Predictors of stenosing tenosynovitis in the hand and hand-related activity limitations in patients with rheumatoid arthritis.

    NARCIS (Netherlands)

    Ursum, J.; Horsten, N.C.; Hoeksma, A.F.; Dijkmans, B.A.; Knol, D.L.; Schaardenburg, D. van; Dekker, J.; Roorda, L.D.

    2011-01-01

    Objectives: To identify early predictors of stenosing tenosynovitis in the hand and hand-related activity limitations in patients with rheumatoid arthritis (RA). Design: A longitudinal study of an inception cohort. Setting: A large outpatient clinic. Participants: Consecutive patients who attended t

  3. Psoralen plus ultraviolet A (PUVA soaks and UVB TL01 treatment for chronic hand dermatoses

    Directory of Open Access Journals (Sweden)

    Lisbeth Jensen

    2012-02-01

    Full Text Available Chronic eczematous hand dermatoses with and without contact allergies are complex diseases, which makes it a challenge to select the best treatment and obtain an optimal patient experience and a satisfactory treatment result. The aim of this study was to evaluate retrospectively the clinical effect and patient experience of local treatment with psoralen plus ultraviolet A (PUVA soaks and TL01 phototherapy for severe chronic hand dermatoses, and also to evaluate the quality of life for the subgroup of patients with allergic contact dermatitis including Compositae allergy. A retrospective evaluation of results for 94 consecutive patients having received a total of 121 treatment courses with local PUVA soaks or TL01 phototherapy for one of the following diagnoses (n=number of treatment courses: psoriasis (n=19, hyperkeratotic hand eczema (n=27, Pustulosis Palmoplantaris (PPP (n=22, vesicular eczema (n=16, Compositae dermatitis (n=24, and allergic contact dermatitis (n=13. Moreover, semi-structured interviews with 6 selected patients having multiple contact allergies including Compositae allergy were used to evaluate quality of life. As a result, we found that PUVA soaks has good effect in patients with psoriasis and hyperkeratotic hand eczema and local phototherapy for chronic hand dermatoses is a useful treatment option in selected cases.

  4. 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

  5. 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

  6. 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,

  7. 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.

  8. 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.

  9. 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...

  10. Treatment of patients with hand osteoarthritis : outcome measures, patient satisfaction, and economic evaluation

    NARCIS (Netherlands)

    Marks, Miriam

    2014-01-01

    The aim of this thesis was to investigate the limitations in daily life, outcome measures, clinical outcomes with the emphasis on patient satisfaction, and economic aspects of the treatment of hand osteoarthritis (OA). Patients with hand OA report severe restrictions in daily life, in particular in

  11. Changes in arm-hand function and arm-hand skill performance in patients after stroke during and after rehabilitation.

    Science.gov (United States)

    Franck, Johan Anton; Smeets, Rob Johannes Elise Marie; Seelen, Henk Alexander Maria

    2017-01-01

    Arm-hand rehabilitation programs applied in stroke rehabilitation frequently target specific populations and thus are less applicable in heterogeneous patient populations. Besides, changes in arm-hand function (AHF) and arm-hand skill performance (AHSP) during and after a specific and well-described rehabilitation treatment are often not well evaluated. This single-armed prospective cohort study featured three subgroups of stroke patients with either a severely, moderately or mildly impaired AHF. Rehabilitation treatment consisted of a Concise_Arm_and_hand_ Rehabilitation_Approach_in_Stroke (CARAS). Measurements at function and activity level were performed at admission, clinical discharge, 3, 6, 9 and 12 months after clinical discharge. Eighty-nine stroke patients (M/F:63/23; mean age:57.6yr (+/-10.6); post-stroke time:29.8 days (+/-20.1)) participated. All patients improved on AHF and arm-hand capacity during and after rehabilitation, except on grip strength in the severely affected subgroup. Largest gains occurred in patients with a moderately affected AHF. As to self-perceived AHSP, on average, all subgroups improved over time. A small percentage of patients declined regarding self-perceived AHSP post-rehabilitation. A majority of stroke patients across the whole arm-hand impairment severity spectrum significantly improved on AHF, arm-hand capacity and self-perceived AHSP. These were maintained up to one year post-rehabilitation. Results may serve as a control condition in future studies.

  12. 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...

  13. Spatially defined modulation of skin temperature and hand ownership of both hands in patients with unilateral complex regional pain syndrome.

    Science.gov (United States)

    Moseley, G Lorimer; Gallace, Alberto; Iannetti, Gian Domenico

    2012-12-01

    Numerous clinical conditions, including complex regional pain syndrome, are characterized by autonomic dysfunctions (e.g. altered thermoregulation, sometimes confined to a single limb), and disrupted cortical representation of the body and the surrounding space. The presence, in patients with complex regional pain syndrome, of a disruption in spatial perception, bodily ownership and thermoregulation led us to hypothesize that impaired spatial perception might result in a spatial-dependent modulation of thermoregulation and bodily ownership over the affected limb. In five experiments involving a total of 23 patients with complex regional pain syndrome of one arm and 10 healthy control subjects, we measured skin temperature of the hand with infrared thermal imaging, before and after experimental periods of either 9 or 10 min each, during which the hand was held on one or the other side of the body midline. Tactile processing was assessed by temporal order judgements of pairs of vibrotactile stimuli, delivered one to each hand. Pain and sense of ownership over the hand were assessed by self-report scales. Across experiments, when kept on its usual side of the body midline, the affected hand was 0.5 ± 0.3°C cooler than the healthy hand (P hand were prioritized over those delivered to the affected hand. Simply crossing both hands over the midline resulted in (i) warming of the affected hand (the affected hand became 0.4 ± 0.3°C warmer than when it was in the uncrossed position; P = 0.01); (ii) cooling of the healthy hand (by 0.3 ± 0.3°C; P = 0.02); and (iii) reversal of the prioritization of tactile processing. When only the affected hand was crossed over the midline, it became warmer (by 0.5 ± 0.3°C; P = 0.01). When only the healthy hand was crossed over the midline, it became cooler (by 0.3 ± 0.3°C; P = 0.01). The temperature change of either hand was positively related to its distance from the body midline (pooled data: r = 0.76, P hand over the body

  14. 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

  15. [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.

  16. Nummular Dermatitis (Discoid Eczema)

    Science.gov (United States)

    ... Clinical guidelines Quality measures DataDerm Awards, grants, and scholarships Question of the Week Meetings and events 2018 Annual Meeting Registration General information Housing & travel Education Exhibit hall Derm Exam Prep Course Hands on: Cosmetics Legislative Conference Agenda ...

  17. Changes in motor function in the unaffected hand of stroke patients should not be ignored

    Institute of Scientific and Technical Information of China (English)

    Lingli Zhang; Peihong Li; Zhibang Mao; Xiang Qi; Jun Zou; Zhusheng Yu

    2014-01-01

    Motor function changes in the unaffected hand of stroke patients with hemiplegia. These chang-es are often ignored by clinicians owing to the extent of motor disability of the affected hand. Finger tapping frequency and Lind-mark hand function score showed that the motor function of unaffected hands in stroke patients was poorer than that of a healthy control hand. After 2 weeks of rehabilitation treatment, motor function of the unaffected hand of stroke patients was obviously improved. Therefore, attention should also be paid to motor function in the unaffect-ed hand of stroke patients with hemiplegia during rehabilitation.

  18. Is hand bone mineral density a marker for hand function in patients with established rheumatoid arthritis? The correlation among bone mineral density of the hand, radiological findings and hand function.

    Science.gov (United States)

    Dogu, Beril; Kuran, Banu; Yilmaz, Figen; Usen, Ahmet; Sirzai, Hulya

    2013-08-01

    The objective of this study is to assess the role of hand bone mineral density (BMD) as a prospective marker for hand function and the correlation of hand BMD with X-ray findings and hand functioning in patients with established rheumatoid arthritis (RA). Eighty-three female patients diagnosed with RA were enrolled. All BMD measurements were performed on both hands. The radiological evaluation was conducted according to the van der Heijde modification of the Sharp method (Sharp/van der Heijde). Duruöz Hand Index (DHI) was used to establish the disability in the hands. Furthermore, handgrip strength (HGS), pinch strength (PS), lateral pinch (LP), tip-to-tip pinch (TTP) and three-fingered pinch (TFP) on both the dominant and the non-dominant hands was measured. A significant positive correlation between hand BMD and HGS as well as all PSs with p DHI (p > 0.05). The hand BMD and the Sharp/van der Heijde scores were significantly in reverse correlation (p DHI-related variants, HGS and PS and the total DHI scores were reversely correlated, while there was a positive significant association with radiological scores (p DHI, HGS, LP, TTP, TFP and radiographic total scores. Our study demonstrated that a one-off hand BMD measurement failed to adequately indicate a loss in hand function as measured by DHI. Ultimately, HGS and TTP were shown to be the most effective indicators for measuring hand functions.

  19. Influence of job seniority, hand hygiene education, and patient-to-nurse ratio on hand disinfection compliance.

    Science.gov (United States)

    Buffet-Bataillon, S; Leray, E; Poisson, M; Michelet, C; Bonnaure-Mallet, M; Cormier, M

    2010-09-01

    Hand hygiene compliance was evaluated by direct observation in 2006 and 2007. In 2007, data on characteristics such as job seniority, hand hygiene education, and patient-to-nurse ratio during direct observations were collected. A hand hygiene promotional programme was performed between the two evaluations. Univariate and multivariate analysis identified factors associated with improved hand hygiene compliance. Between 2006 and 2007, from 761 hand hygiene opportunities, overall and partial compliance improved from 44.9% to 58% (Phand hygiene overall or partial compliance were seen when senior healthcare workers (HCWs) were present in the clinical area under investigation (P=0.04 or P=0.08, respectively). Partial hand hygiene compliance was significantly better in 2007 after a hand hygiene educational programme had been presented (Phand hygiene compliance. Our results suggest that hand hygiene compliance is influenced by education on hand hygiene and that a senior HCW could act as a role model for other HCWs. These data should be considered when developing future hygiene interventions.

  20. 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

  1. 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

  2. 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.

  3. Hand grip strength in patients with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Jeong M

    2017-08-01

    Full Text Available Moa Jeong,1 Hyung Koo Kang,1 Pamela Song,2 Hye Kyeong Park,1 Hoon Jung,1 Sung-Soon Lee,1 Hyeon-Kyoung Koo1 1Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, 2Department of Neurology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea Purpose: Hand grip strength (HGS is a simple way of predicting the risk of cardiovascular disease and all-cause mortality in the general population. However, the practical significance of grip strength in patients with COPD is uncertain. The aim of this study was to compare HGS between subjects with and without COPD and to evaluate its clinical relevance in patients with COPD by using a national survey.Methods: Data were collected from the Korean National Health and Nutrition Examination Survey. The study included 421 adults with COPD and 2,542 controls who completed questionnaires, spirometry, and a HGS test. HGS was compared between subjects with and without COPD, and the association between grip strength, lung function, and quality of life (QoL was evaluated.Results: The mean HGS was 33.3±9.1 kg in the COPD group and 29.9±9.5 kg in the non-COPD group; adjusted HGS was 30.9±0.33 kg and 30.9±0.11 kg, respectively (P=0.99. HGS was not related to forced vital capacity (β=0.04, P=0.70 or forced expiratory volume in 1 second (β=0.11, P=0.24 in multivariable analysis. HGS was independently associated with the EQ-5D index, but the relationship was stronger in the COPD group (β=0.30, P<0.001 than in the non-COPD group (β=0.21, P<0.001. The results were similar for each component of the EQ-5D, including mobility (β=-0.25, P<0.001, daily activity (β=-0.19, P=0.01, pain/discomfort (β=-0.32, P<0.001, and anxiety/depression (β=-0.16, P=0.01.Conclusion: HGS was not different between subjects with and without COPD, but was associated with QoL – including mobility, daily activity, pain/discomfort, and anxiety/depression – in patients with COPD. The

  4. 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

  5. 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/

  6. Hand to hand.

    Science.gov (United States)

    Bedell, Susanna E; Graboys, Thomas B

    2002-08-01

    Examination of the hands has the potential to transform the encounter between physician and patient. Taking the hands conveys a sense of warmth and connectedness and is a means to communicate the physician's mindfulness. The hands can focus the examination on the individual patient as a complete human being, and not merely a disease or a collection of symptoms. The hands provide readily accessible information that may not be available through other evaluations, and they offer clues to a patient's physical and mental health. Commonplace observations, such as those revealed in the hands, can unravel medical mysteries and provide profound clinical insights.

  7. [Hand hygiene--part of patient safety from Semmelweis to the present].

    Science.gov (United States)

    Anttila, Veli-Jukka

    2014-01-01

    Hand disinfection is one of the most important part of patient safety. By adequate hand disinfection healthcare workers can prevent about 40 per cent of healthcare-associated infections and about 50 per cent of patients' MRSA contaminations in hospitals. Adherence to hand disinfection has been observed in an average of 40 per cent of patient contacts. One of the risk factors leading to poor adherence is the "doctor" status of a healthcare worker. Introduction of an alcohol-based hand rub close to the patient is one of the most significant factors for improved hand hygiene.

  8. 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。

  9. 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.

  10. Abbreviated psychologic questionnaires are valid in patients with hand conditions.

    Science.gov (United States)

    Bot, Arjan G J; Becker, Stéphanie J E; van Dijk, C Niek; Ring, David; Vranceanu, Ana-Maria

    2013-12-01

    The Pain Catastrophizing Scale (PCS) and Short Health Anxiety Inventory (SHAI) can help hand surgeons identify opportunities for psychologic support, but they are time consuming. If easier-to-use tools were available and valid, they might be widely adopted. We tested the validity of shorter versions of the PCS and SHAI, the PCS-4 and the SHAI-5, by assessing: (1) the difference in mean scaled scores of the short and long questionnaires; (2) floor and ceiling effects between the short and long questionnaires; (3) correlation between the short questionnaires and the outcome measures (an indication of construct validity); and (4) variability in disability and pain, between the short and long questionnaires. One hundred sixty-four new or followup adult patients in one hand surgery clinic completed the SHAI-18, SHAI-5, PCS-13, PCS-4, Patient Health Questionnaire (PHQ)-9, PHQ-2, DASH, and QuickDASH questionnaires, and an ordinal pain scale, as part of a prospective cross-sectional study. Mean scores for the short and long questionnaires were compared with paired t-tests. Floor and ceiling effects were calculated. Pearson's correlation was used to assess the correlation between the short and long questionnaires and with outcome measures. Regression analyses were performed to find predictors of pain and disability. There were small, but significant differences between the mean scores for the DASH and QuickDASH (QuickDASH higher), SHAI-18 and SHAI-5 (SHAI-18 higher), and PCS-13 and PCS-4 (PCS-4 higher), but not the PHQ-9 and PHQ-2. Floor effects ranged between 0% and 65% and ceiling effects between 0% and 3%. There were greater floor effects for the PHQ-2 than for the PHQ-9, but floor and ceiling effects were otherwise comparable for the other short and long questionnaires. All questionnaires showed convergent and divergent validity and criterion validity was shown in multivariable analyses. Content validity, construct convergent validity, and criterion validity were

  11. 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

  12. Interventions to improve patient hand hygiene: a systematic review.

    Science.gov (United States)

    Srigley, J A; Furness, C D; Gardam, M

    2016-09-01

    Nosocomial pathogens may be acquired by patients via their own unclean hands, but there has been relatively little emphasis on patient hand hygiene as a tool for preventing healthcare-associated infections (HCAIs). The aim of this systematic review was to determine the efficacy of patient hand hygiene interventions in reducing HCAIs and improving patient hand hygiene rates compared to usual care. Electronic databases and grey literature were searched to August 2014. Experimental and quasi-experimental studies were included if they evaluated a patient hand hygiene intervention conducted in an acute or chronic healthcare facility and included HCAI incidence and/or patient hand hygiene rates as an outcome. All steps were performed independently by two investigators. Ten studies were included, most of which were uncontrolled before-after studies (N=8). The majority of interventions (N=7) were multi-modal, with components similar to healthcare worker hand hygiene programmes, including education, reminders, audit and feedback, and provision of hand hygiene products. Six studies reported HCAI outcomes and four studies assessed patient hand hygiene rates; all demonstrated improvements but were at moderate to high risk of bias. In conclusion, interventions to improve patient hand hygiene may reduce the incidence of HCAIs and improve hand hygiene rates, but the quality of evidence is low. Future studies should use stronger designs and be more selective in their choice of outcomes.

  13. Patient-centered hand hygiene: the next step in infection prevention.

    Science.gov (United States)

    Landers, Timothy; Abusalem, Said; Coty, Mary-Beth; Bingham, James

    2012-05-01

    Hand hygiene has been recognized as the most important means of preventing the transmission of infection, and great emphasis has been placed on ways to improve hand hygiene compliance by health care workers (HCWs). Despite increasing evidence that patients' flora and the hospital environment are the primary source of many infections, little effort has been directed toward involving patients in their own hand hygiene. Most previous work involving patients has included patients as monitors or auditors of hand hygiene practices by their HCWs. This article reviews the evidence on the benefits of including patients more directly in hand hygiene initiatives, and uses the framework of patient-centered safety initiatives to provide recommendations for the timing and implementation of patient hand hygiene protocols. It also addresses key areas for further research, practice guideline development, and implications for training of HCWs.

  14. 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).

  15. The synergic effects of mirror therapy and neuromuscular electrical stimulation for hand function in stroke patients.

    Science.gov (United States)

    Yun, Gi Jeong; Chun, Min Ho; Park, Ji Young; Kim, Bo Ryun

    2011-06-01

    To investigate the synergic effects of mirror therapy and neuromuscular electrical stimulation (NMES) for hand function in stroke patients. Sixty patients with hemiparesis after stroke were included (41 males and 19 females, average age 63.3 years). Twenty patients had NMES applied and simultaneously underwent mirror therapy. Twenty patients had NMES applied only, and twenty patients underwent mirror therapy only. Each treatment was done five days per week, 30 minutes per day, for three weeks. NMES was applied on the surface of the extensor digitorum communis and extensor pollicis brevis for open-hand motion. Muscle tone, Fugl-Meyer assessment, and power of wrist and hand were evaluated before and after treatment. There were significant improvements in the Fugl-Meyer assessment score in the wrist, hand and coordination, as well as power of wrist and hand in all groups after treatment. The mirror and NMES group showed significant improvements in the Fugl-Meyer scores of hand, wrist, coordination and power of hand extension compared to the other groups. However, the power of hand flexion, wrist flexion, and wrist extension showed no significant differences among the three groups. Muscle tone also showed no significant differences in the three groups. Our results showed that there is a synergic effect of mirror therapy and NMES on hand function. Therefore, a hand rehabilitation strategy combined with NMES and mirror therapy may be more helpful for improving hand function in stroke patients than NMES or mirror therapy only.

  16. 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...

  17. 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.

  18. 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

  19. 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

  20. Occupational hand dermatoses in hospital cleaning personnel.

    Science.gov (United States)

    Singgih, S I; Lantinga, H; Nater, J P; Woest, T E; Kruyt-Gaspersz, J A

    1986-01-01

    Hospital cleaning personnel were examined for occupational dermatoses. 356 persons were included in the study. The age ranged from 20 to 63 years with a mean of 40.1 years. The period prevalence rate of moderate and severe eczema was 12% (10% in men and 19% in women). In 88%, the eczema was of a duration longer than 2 years. Positive patch tests were found in 10% of men and 53% of women with eczema. The main allergens were nickel, cobalt, chromate and rubber chemicals. Positive tests to cleaning agents were rare. One case of contact allergy to sodium dichloro-iso-cyanurate and one to lysol were diagnosed. Irritant factors played a major rôle in most cases (92%). Fungus infection as a cause or complication in hand eczema should not be left out of consideration: in 2 persons, a mycosis of hands and/or fingernails was diagnosed.

  1. Interventions to improve hand hygiene compliance in patient care.

    Science.gov (United States)

    Gould, Dinah J; Moralejo, Donna; Drey, Nicholas; Chudleigh, Jane H

    2010-09-08

    Health care-associated infection is a major cause of morbidity and mortality. Hand hygiene is regarded as an effective preventive measure. To update the review done in 2007, to assess the short and longer-term success of strategies to improve hand hygiene compliance and to determine whether a sustained increase in hand hygiene compliance can reduce rates of health care-associated infection. We conducted electronic searches of: the Cochrane Central Register of Controlled Trials; the Cochrane Effective Practice and Organisation of Care Group specialised register of trials; MEDLINE; PubMed; EMBASE; CINAHL; and the BNI. Originally searched to July 2006, for the update databases were searched from August 2006 until November 2009. Randomised controlled trials, controlled clinical trials, controlled before and after studies, and interrupted time series analyses meeting explicit entry and quality criteria used by the Cochrane Effective Practice and Organisation of Care Group were eligible for inclusion. Studies reporting indicators of hand hygiene compliance and proxy indicators such as product use were considered. Self-reported data were not considered a valid measure of compliance. Studies to promote hand hygiene compliance as part of a care bundle approach were included, providing data relating specifically to hand hygiene were presented separately. Studies were excluded if hand hygiene was assessed in simulations, non-clinical settings or the operating theatre setting. Two reviewers independently extracted data and assessed data quality. Four studies met the criteria for the review: two from the original review and two from the update. Two studies evaluated simple education initiatives, one using a randomized clinical trial design and the other a controlled before and after design. Both measured hand hygiene compliance by direct observation. The other two studies were both interrupted times series studies. One study presented three separate interventions within the

  2. 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

  3. Hand hygiene in peritoneal dialysis patients: a comparison of two techniques.

    Science.gov (United States)

    Figueiredo, Ana Elizabeth; de Siqueira, Soraia Lemos; Poli-de-Figueiredo, Carlos Eduardo; d'Avila, Domingos O

    2013-01-01

    Hand hygiene is essential for preventing peritoneal dialysis (PD)-related infections. The present study compared the effectiveness of two hygiene techniques in reducing the number of colony-forming units (CFUs) on the hands of patients undergoing PD. In this controlled clinical trial, 22 participants enrolled in the same PD program underwent a two-hand evaluation for microbiologic flora. Participants participated in two treatments: a) simple hand hygiene plus antiseptic hand hygiene, in which the patients washed their hands with water and glycerin soap for 1 minute and then rubbed and dried their hands with 70% ethyl alcohol gel; and b) antiseptic hand hygiene, in which the patients rubbed their hands with 70% ethyl alcohol gel until fully dry. To sample distal finger surfaces, we asked the participants to touch sheep blood agar plates directly. The CFU count for both hands was significantly higher in the regular hygiene group than in the gel-only group [69.0 (16.0 - 101.0) CFU vs 9.0 (2.2 - 55.5) CFU, p hand cultures from the regular hygiene group than in those from the gel-only group [69.5 (26.25 - 101.0) CFU vs 9.5 (1.0 - 41.7) CFU; p hands may be more effective than following the regular hygiene recommendations in reducing bacterial populations.

  4. Outbreak of eczema and rhinitis in a group of office workers in Greenland

    DEFF Research Database (Denmark)

    Ebbehøj, Niels E; Agner, Tove; Zimerson, Erik

    2015-01-01

    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......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......: 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...

  5. 'Moving' a paralysed hand: bimanual coupling effect in patients with anosognosia for hemiplegia.

    Science.gov (United States)

    Garbarini, Francesca; Rabuffetti, Marco; Piedimonte, Alessandro; Pia, Lorenzo; Ferrarin, Maurizio; Frassinetti, Francesca; Gindri, Patrizia; Cantagallo, Anna; Driver, Jon; Berti, Anna

    2012-05-01

    Selective neurological impairments can shed light on different aspects of motor cognition. Brain-damaged patients with anosognosia for hemiplegia deny their motor deficit and believe they can still move the paralysed limb. Here we study, for the first time, if the anomalous subjective experience that their affected hand can still move, may have objective consequences that constrain movement execution with the opposite, intact hand. Using a bimanual motor task, in which anosognosic patients were asked to simultaneously trace out lines with their unaffected hand and circles with their paralysed hand, we found that the trajectories of the intact hand were influenced by the requested movement of the paralysed hand, with the intact hand tending to assume an oval trajectory (bimanual coupling effect). This effect was comparable to that of a group of healthy subjects who actually moved both hands. By contrast, brain-damaged patients with motor neglect or actual hemiplegia but no anosognosia did not show this bimanual constraint. We suggest that anosognosic patients may have intact motor intentionality and planning for the plegic hand. Rather than being merely an inexplicable confabulation, anosognosia for the plegic hand can produce objective constraints on what the intact hand does.

  6. Crossed hand-eye dominance in male psychiatric patients.

    Science.gov (United States)

    Giotakos, Orestis

    2002-12-01

    Increased incidence of left-eye and crossed hand-eye dominance have been considered as indicating left hemispheric dysfunction in many neuropsychiatric disorders. This study investigates the incidence of left-eye and crossed hand-eye dominance in patience with schizophrenia (n = 68), panic disorder (n = 62), personality disorder (n = 35), heroin addiction (n = 54), and mental retardation (n = 33), in comparison with controls (n = 944). All psychiatric groups, except the group with panic disorder, had significantly greater frequency of left-eye dominance than the control group. Furthermore, all psychiatric groups, except the personality-disordered group, had significantly greater frequency of crossed hand-eye dominance than the control group. These findings further support the evidence of an anomaly in hemispheric lateralization among different psychiatric populations, particularly among those with psychotic symptoms and cognitive deficits.

  7. Representation of Patients' Hand Modulates Fear Reactions of Patients with Spider Phobia in Virtual Reality.

    Science.gov (United States)

    Peperkorn, Henrik M; Diemer, Julia E; Alpers, Georg W; Mühlberger, Andreas

    2016-01-01

    Embodiment (i.e., the involvement of a bodily representation) is thought to be relevant in emotional experiences. Virtual reality (VR) is a capable means of activating phobic fear in patients. The representation of the patient's body (e.g., the right hand) in VR enhances immersion and increases presence, but its effect on phobic fear is still unknown. We analyzed the influence of the presentation of the participant's hand in VR on presence and fear responses in 32 women with spider phobia and 32 matched controls. Participants sat in front of a table with an acrylic glass container within reaching distance. During the experiment this setup was concealed by a head-mounted display (HMD). The VR scenario presented via HMD showed the same setup, i.e., a table with an acrylic glass container. Participants were randomly assigned to one of two experimental groups. In one group, fear responses were triggered by fear-relevant visual input in VR (virtual spider in the virtual acrylic glass container), while information about a real but unseen neutral control animal (living snake in the acrylic glass container) was given. The second group received fear-relevant information of the real but unseen situation (living spider in the acrylic glass container), but visual input was kept neutral VR (virtual snake in the virtual acrylic glass container). Participants were instructed to touch the acrylic glass container with their right hand in 20 consecutive trials. Visibility of the hand was varied randomly in a within-subjects design. We found for all participants that visibility of the participant's hand increased presence independently of the fear trigger. However, in patients, the influence of the virtual hand on fear depended on the fear trigger. When fear was triggered perceptually, i.e., by a virtual spider, the virtual hand increased fear. When fear was triggered by information about a real spider, the virtual hand had no effect on fear. Our results shed light on the

  8. LIPOMA OF HAND AND FINGER : A 6 PATIENT CASE SERIES

    Directory of Open Access Journals (Sweden)

    Prakash Kumar

    2014-01-01

    Full Text Available INTRODUCTION: Lipoma , the ubiquitous benign tumor , is not very common in the hand and that to involving the palmar space or finger is very rare. This series of case presentation lays emphasis on consideration of lipoma in the differential diagnosis of swellings/ soft tissue tumors of the hand and the use o f imaging studies in their diagnosis. We report a ser ies of six cases of lipoma in different parts and planes of hand , involving palm and fingers . An uncommon site , size , shape , plane and age of occurrence of this common tumor warrants it’s reporting and an effort had been made to highlight the management. CONCLUSION : Hand lipoma is rare entity for a surgeon in the differential diagnosis of soft tissue tumors with radiology being an invaluable tool. Though rare but frequently seen in this pa rt of country , Precise surgical techniques with a sound anatomic knowledge helps in complete excision without damaging the vital structures and abates recurrences Lipoma , subcutaneous , mid - palmar space.

  9. Optimal Scoring Methods of Hand-Strength Tests in Patients with Stroke

    Science.gov (United States)

    Huang, Sheau-Ling; Hsieh, Ching-Lin; Lin, Jau-Hong; Chen, Hui-Mei

    2011-01-01

    The purpose of this study was to determine the optimal scoring methods for measuring strength of the more-affected hand in patients with stroke by examining the effect of reducing measurement errors. Three hand-strength tests of grip, palmar pinch, and lateral pinch were administered at two sessions in 56 patients with stroke. Five scoring methods…

  10. Patient-centred hand hygiene information in orthopaedics units: an evidence-based implementation project.

    Science.gov (United States)

    Ong, Arielle Yi Jia; Tan, Joanne; Yeo, Hui Ling; Goh, Mien Li

    2017-03-01

    This project aimed to improve patients' knowledge on the importance of hand hygiene. It involved providing patients with a patient and family education on the importance of hand hygiene using a patient information leaflet that introduces the rationale of hand hygiene, possible consequences of poor hand hygiene, and the seven steps of hand hygiene. This projected used a preimplementation and postimplementation audit strategy using the Joanna Briggs Institute Practical Application of Clinical Evidence System and Getting Research Into Practice programs. The implementation occurred in three phases over a period of 6 months from January 2014 to June 2014. The audits took place in two orthopaedic wards in a large acute care setting tertiary hospital in Singapore and involved a sample size of 54 patients. It involved going through the medical records of the cases, assessment of patient knowledge based on the audit criteria, and checking if the patients received the patient information leaflet on hand hygiene. The postimplementation audit found significant improvements in all three audit criteria. The percentage of patients who demonstrated knowledge in the importance of hand hygiene saw an improvement of 48.1%. There was an improvement of 44.5% in nurses' compliance to the documentation of patient education being carried out. The percentage of patients who received a patient information leaflet on hand hygiene saw an increase of 36.1%. This project demonstrated that a preimplementation and postimplementation audit is a viable method to implement change and translate evidence into practice. Through this project, patients gained an understanding on the importance of hand hygiene and could take better ownership of their well being. This may potentially improve hospitalization experience and benefit health outcomes. The positive results of this project are contributed by the enthusiastic involvement of all the stakeholders, from patients and their caregivers to the bedside

  11. Brain responses to acupuncture stimulation in the prosthetic hand of an amputee patient.

    Science.gov (United States)

    Lee, In-Seon; Jung, Won-Mo; Lee, Ye-Seul; Wallraven, Christian; Chae, Younbyoung

    2015-10-01

    This report describes the brain responses to acupuncture in an upper limb amputee patient. A 62-year-old male had previously undergone a lower left arm amputation following an electrical accident. Using functional MRI, we investigated brain responses to acupuncture stimulation in the aforementioned amputee under three conditions: (a) intact hand, (b) prosthetic hand (used by the patient), and (c) fake fabric hand. The patient described greater de qi sensation when he received acupuncture stimulation in his prosthetic hand compared to a fake hand, with both stimulations performed in a similar manner. We found enhanced brain activation in the insula and sensorimotor cortex in response to acupuncture stimulation in the amputee's prosthetic hand, while there was only minimal activation in the visual cortex in response to acupuncture stimulation in a fake hand. The enhanced brain responses to acupuncture stimulation of the patient's prosthetic hand might be derived from cortical reorganisation, as he has been using his prosthetic hand for over 40 years. Our findings suggest the possible use of acupuncture stimulation in a prosthetic hand as an enhanced sensory feedback mechanism, which may represent a new treatment approach for phantom limb pain.

  12. 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 ...

  13. 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 ...

  14. Early-developed hand osteoarthritis in treated HIV-positive patients: Four cases.

    Science.gov (United States)

    Larcher, Romaric; Mauboussin, Jean-Marc; Rouanet, Isabelle; Sotto, Albert

    2015-10-01

    We describe four cases of hand osteoarthritis in patients with HIV infection under antiretroviral treatment. A 36-year-old HIV-infected man came for consultation in 2007 with hand osteoarthritis. He was diagnosed HIV positive by sexual transmission in 1997. A 52-year-old HIV-infected woman came for consultation with hand osteoarthritis started in 2006. She was diagnosed HIV positive in 1986 by sexual transmission. A 57-year-old man presented hand osteoarthritis. This former IV drug user was diagnosed HIV positive in 1989. A 61-year-old HIV-infected man presented with hand osteoarthritis started in 2010. He had been contaminated with HIV in 1990 by sexual transmission. For all patients, there were neither clinical nor biological manifestations suggesting inflammatory arthritis. X-rays showed signs of hand osteoarthritis. CD4 cell count was over 500/mm(3) and the viral load was below 20 copies/mL under treatments. These four cases show osteoarthritis in HIV-infected patients. Hand osteoarthritis did not seem to be linked to aging or to an antiretroviral treatment's side effect, but rather to the HIV infection itself, and it may pass through a metabolic syndrome. We described a possible association between early-developed hand osteoarthritis and HIV-infected patients. Clinicians should consider osteoarthritis when they are confronted with HIV-infected patients with chronic hand pain.

  15. Observance of hand washing procedures performed by the medical personnel before patient contact. Part I

    Directory of Open Access Journals (Sweden)

    Anna Garus-Pakowska

    2013-02-01

    Full Text Available Introduction: According to the Centers for Disease Control and Prevention (CDC as well as the World Health Organization (WHO recommendations, medical staff are obliged to decontaminate the skin of the hands before every single patient contact. Materials and Methods: The study was performed by quasi-observation among the group of 188 medical staff (nurses and physicians working in three selected hospitals of the Łódź province. The procedure of hand washing and disinfection performed directly before the patient contact according to the CDC and WHO recommendations were observed. The results was subject to statistical analysis (p < 0.05. Results: During 1544 hours of observation 4101 activities requiring hand washing were recorded. The medical staff obeyed the hand washing procedure before the patient contact only in 5.2% of the situations. There was no activity observed before which hand hygiene was maintained in 100% of cases. Observance of hand hygiene depended signifi cantly on the type of the performed activity, the professional group, and the workload index. A decrease in percentage observance of hand hygiene according to the time of the day was found to be of statistical signifi cance. The mean time of hand washing was 8.5 s for physicians and 6.6 s for nurses. Conclusion: The level of observance of hand washing procedures among the medical staff prior to the patient contact appears to be alarmingly below the expectations.

  16. 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

  17. The use of kinesiology taping method in patients with rheumatoid hand--pilot study.

    Science.gov (United States)

    Szczegielniak, Jan; Łuniewski, Jacek; Bogacz, Katarzyna; Sliwiński, Zbigniew

    2012-01-01

    Rheumatoid arthritis (RA) most frequently affects smaller joints in the hands and feet. Among the most common deformations resulting from the progression of the disease are ulnar deviation, Boutonniere deformity, swan neck deformity, contractures and limited range of movement in the hand and wrist joints, muscular atrophy of long and short muscles. The topic of this article is the influence of using Kinesiology Taping method on the functioning of the hand of the patient suffering from rheumatoid arthritis. The research involved 20 patients suffering from rheumatoid arthritis (16 women, 4 men), treated in the Hospital in Kup. Average age of patients was 62.2. Research subjects, apart from pharmacological treatment in the hospital ward, received standard physiotherapy. In case of 10 patients additional K-Active Tape applications were used to correct ulnar positioning of the hand and improve hand functioning. Prior to physiotherapy, all patients were given a hand functioning test and a dynamometer measurement was made. The tests were repeated after the 2-week rehabilitation process has been completed. The results were subjected to statistical analysis with the use of the Wilcoxon test and the U Mann-Whitney test. The assessment of the correlation between analysed parameters was made with the use of linear correlation test. In the group where Kinesiology Tape applications were used, hand muscle strength increased significantly (p0.8). Results suggest Kinesiology Taping method useful for physiotherapy of rheumatoid hand.

  18. Effectiveness of hand washing and disinfection methods in removing transient bacteria after patient nursing.

    OpenAIRE

    1980-01-01

    The effectiveness of various hand washing and disinfection methods in removing transient skin bacteria was studied in hospital after dry or moist contamination of the hands when nursing burn patients. The results were compared with those of laboratory tests with volunteers. A fairly good correlation of the bacterial reductions existed between hospital and laboratory tests. All other methods removed Staph. aureus from the hands more effectively than liquid soap. Gram-negative bacilli were more...

  19. EFFICACY OF UNDERWATER INTERFERENTIAL CURRENT ON HAND FUNCTION IN PSORIATIC ARTHRITIS PATIENTS

    OpenAIRE

    Ahmed Fathy Samhan. PhD PT

    2014-01-01

    Background: Psoriatic arthritis is an entity of inflammatory joint disease associated with psoriasis. Purpose: The purpose of this study was to evaluate the efficacy of underwater interferential current therapy on hand function in psoriatic arthritis of both hands. Method: Thirty patients (18 females and 12 males) had psoriatic arthritis of hands, aged 42 to 50 years with 45.77 ± 3.52 mean, were assigned randomly into two groups of equal number: study group received 20 minutes ...

  20. Comparative study of metacarpophalangeal joint arthroplasty effectiveness in patients with rheumatoid hand

    Directory of Open Access Journals (Sweden)

    L. A. Rodomanova

    2015-01-01

    Full Text Available Objective - to determine the optimal implant for metacarpophalangeal joint arthroplasty in patients with rheumatoid hand. Materials and methods. 24 patients with rheumatoid hand were operated in Vreden Russian Research Institute of Traumatology and Orthopedics (St.-Petersburg, Russia. 37 MCPJ arthroplasties were performed with 129 implants of 3 types. First group consisted of 11 patients with 43 implanted NeuFlex “DePuy International Ltd.” silicone implants on 12 hands. Second group - 6 patients with 26 implants Daphne “TECRES S.p.A.” on 7 hands. Third group - 16 patients with 60 implants RM Finger “MATHYS AG Bettlach” on 17 hands. Criteria for treatment effectiveness were estimated taking into account hand function, complications and also relapse of deformation. We compared movement amplitude in MCP joins, angle of ulnar drift, strength of hand and also subjective assessment by patients with DASH. Results were fixed before surgery and 3, 6 and 12 months after. Results. Complications were recorded in I and II of patient groupsin 50% of cases:fracturesof components, dislocations of construction, relapse of ulnar drift. Complications in III group of patients were not detected. Range of motion and function improvement were increased in all groups (p>0,05, as well as strength of hand. But the most stable growth of hand strength was fixed only in III group (p<0,05. Relapse of ulnar drift occurred in I group of patients. Conclusion. RM Finger “MATHYS AG Bettlach” is more reliable for metacarpophalangeal joint arthroplasty since it provides stable long-term results of treatment.

  1. It's not all about me: motivating hand hygiene among health care professionals by focusing on patients.

    Science.gov (United States)

    Grant, Adam M; Hofmann, David A

    2011-12-01

    Diseases often spread in hospitals because health care professionals fail to wash their hands. Research suggests that to increase health and safety behaviors, it is important to highlight the personal consequences for the actor. However, because people (and health care professionals in particular) tend to be overconfident about personal immunity, the most effective messages about hand hygiene may be those that highlight its consequences for other people. In two field experiments in a hospital, we compared the effectiveness of signs about hand hygiene that emphasized personal safety ("Hand hygiene prevents you from catching diseases") or patient safety ("Hand hygiene prevents patients from catching diseases"). We assessed hand hygiene by measuring the amount of soap and hand-sanitizing gel used from dispensers (Experiment 1) and conducting covert, independent observations of health care professionals' hand-hygiene behaviors (Experiment 2). Results showed that changing a single word in messages motivated meaningful changes in behavior: The hand hygiene of health care professionals increased significantly when they were reminded of the implications for patients but not when they were reminded of the implications for themselves.

  2. 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

  3. 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.

  4. Hand Hygiene in Peritoneal Dialysis Patients: A Comparison of Two Techniques

    OpenAIRE

    Figueiredo, Ana Elizabeth; Siqueira, Soraia Lemos de; Poli-de-Figueiredo,Carlos Eduardo; d’Avila, Domingos O.

    2013-01-01

    ♦ Introduction and Objectives: Hand hygiene is essential for preventing peritoneal dialysis (PD)-related infections. The present study compared the effectiveness of two hygiene techniques in reducing the number of colony-forming units (CFUs) on the hands of patients undergoing PD.

  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. Pantomime to visual presentation of objects: left hand dyspraxia in patients with complete callosotomy.

    Science.gov (United States)

    Lausberg, Hedda; Cruz, Robyn F; Kita, Sotaro; Zaidel, Eran; Ptito, Alain

    2003-02-01

    Investigations of left hand praxis in imitation and object use in patients with callosal disconnection have yielded divergent results, inducing a debate between two theoretical positions. Whereas Liepmann suggested that the left hemisphere is motor dominant, others maintain that both hemispheres have equal motor competences and propose that left hand apraxia in patients with callosal disconnection is secondary to left hemispheric specialization for language or other task modalities. The present study aims to gain further insight into the motor competence of the right hemisphere by investigating pantomime of object use in split-brain patients. Three patients with complete callosotomy and, as control groups, five patients with partial callosotomy and nine healthy subjects were examined for their ability to pantomime object use to visual object presentation and demonstrate object manipulation. In each condition, 11 objects were presented to the subjects who pantomimed or demonstrated the object use with either hand. In addition, six object pairs were presented to test bimanual coordination. Two independent raters evaluated the videotaped movement demonstrations. While object use demonstrations were perfect in all three groups, the split-brain patients displayed apraxic errors only with their left hands in the pantomime condition. The movement analysis of concept and execution errors included the examination of ipsilateral versus contralateral motor control. As the right hand/left hemisphere performances demonstrated retrieval of the correct movement concepts, concept errors by the left hand were taken as evidence for right hemisphere control. Several types of execution errors reflected a lack of distal motor control indicating the use of ipsilateral pathways. While one split-brain patient controlled his left hand predominantly by ipsilateral pathways in the pantomime condition, the error profile in the other two split-brain patients suggested that the right hemisphere

  8. Functional outcome of patients undergoing replantation of hand at wrist level-7 year experience

    Directory of Open Access Journals (Sweden)

    Ravi Kumar Mahajan

    2013-01-01

    Full Text Available Background: Replantation is defined as reattachment of amputated limb using neurovascular and musculoskeletal structures in order to obtain recovery of limb. Re-vascularisation involves all the above steps in case of limb injuries that result in a near total amputation. Aim and Objective : To study the functional outcome of patients undergoing replantation of hand at wrist level. Material and Methods: This is a retrospective study of patients who underwent replantation of total amputation of hand at wrist level within a period of Jan 2003-June 2010. We evaluated post operative functional outcome compared to uninjured hand taking into consideration: 1. The patient′s overall satisfaction with the hand. 2. Recovery of flexor and extensor function of thumb and fingers. 3. Recovery of thumb opposition. 4. Recovery of sensations in the median and ulnar nerve distribution. 5. Ability of surviving hand to perform daily tasks. Results: There were total seventeen patients and age range was two years to 55 years. Out of 17 patients,16 were males. All the replantations were successful except for one. Summary: The results showed that, although the replanted hands were never functionally as good as the contralateral hand the patients were able to perform most of the daily activities.

  9. Development of hand rehabilitation system for paralysis patient - universal design using wire-driven mechanism.

    Science.gov (United States)

    Yamaura, Hiroshi; Matsushita, Kojiro; Kato, Ryu; Yokoi, Hiroshi

    2009-01-01

    We have developed a hand rehabilitation system for patients suffering from paralysis or contracture. It consists of two components: a hand rehabilitation machine, which moves human finger joints with motors, and a data glove, which provides control of the movement of finger joints attached to the rehabilitation machine. The machine is based on the arm structure type of hand rehabilitation machine; a motor indirectly moves a finger joint via a closed four-link mechanism. We employ a wire-driven mechanism and develop a compact design that can control all three joints (i.e., PIP, DIP and MP ) of a finger and that offers a wider range of joint motion than conventional systems. Furthermore, we demonstrate the hand rehabilitation process, finger joints of the left hand attached to the machine are controlled by the finger joints of the right hand wearing the data glove.

  10. 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

  11. [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.

  12. 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...

  13. Observation and measurement of hand hygiene and patient identification improve compliance with patient safety practices.

    Science.gov (United States)

    Rosenthal, Tom; Erbeznik, Mary; Padilla, Tony; Zaroda, Teresa; Nguyen, Daniel H; Rodriguez, Marcela

    2009-12-01

    Measurement, a crucial step in any quality improvement activity, is difficult in two important patient safety processes: hand hygiene and patient identification. This study describes a program at the UCLA Medical Center, called Measure to Achieve Patient Safety (MAPS), which uses undergraduate student volunteers to carry out observations in the hospital. This program has been an important part of UCLA's efforts for quality improvement in patient safety efforts. Since 2004, approximately 20 students per year plus two student leaders have been selected to participate in the MAPS program. They were trained in techniques of measuring and observation and in professional behavior. They participated in weekly and monthly meetings with program leadership, received continuing education from the UCLA patient safety staff, and were trained in observational measurement. The students' observational results have been systematically reported to clinicians and departmental and hospital leadership. Handwashing increased from 50% to 93%, and nurses' checking of two identifiers at the time of medication administration increased from 50% to 95%. Compliance with proper patient identification at the time of nurse-to-transporter handoffs of patients for procedures increased to >90%. This unique program has made a significant contribution to UCLA's quality, safety, and service programs. MAPS has been widely accepted by the clinical staff and has also been valuable to the student volunteers. Such an approach is easily adaptable to other academic medical centers.

  14. 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

  15. EFFICACY OF UNDERWATER INTERFERENTIAL CURRENT ON HAND FUNCTION IN PSORIATIC ARTHRITIS PATIENTS

    Directory of Open Access Journals (Sweden)

    Ahmed Fathy Samhan. PhD PT

    2014-04-01

    Full Text Available Background: Psoriatic arthritis is an entity of inflammatory joint disease associated with psoriasis. Purpose: The purpose of this study was to evaluate the efficacy of underwater interferential current therapy on hand function in psoriatic arthritis of both hands. Method: Thirty patients (18 females and 12 males had psoriatic arthritis of hands, aged 42 to 50 years with 45.77 ± 3.52 mean, were assigned randomly into two groups of equal number: study group received 20 minutes underwater interferential current for one month, 3 times per week (12 sessions and control group received placebo interferential current. Visual analogue scale for patient-reported pain, the Disability of Arm, Shoulder and Hand questionnaire score, and hand function (grip force in Pound of dominant hand were assessed pretreatment and post-treatment. Results: showed significant improvement in the 3 outcomes in study group (p 0.005. Visual analogue scale had a strong positive correlation (p < 0.001 with the disability score and a strong negative correlation (p < 0.001 with the grip force. Conclusion: Using underwater interferential current therapy in patient with psoriatic arthritis of hands was effective in improvement of hand function and quality of life.

  16. 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

  17. Observance of hand washing procedures performed by the medical personnel after the patient contact. Part II

    Directory of Open Access Journals (Sweden)

    Anna Garus-Pakowska

    2013-04-01

    Full Text Available Objectives: The Centers for Disease Control and Prevention (CDC as well as the World Health Organization (WHO state that adequate hand hygiene maintained by medical personnel is an indispensable prerequisite for controlling nosocomial infections. The recommendations of CDC and WHO emphasize the obligation to wash hands after each contact with a patient, after the exposure to a potentially infectious material or upon the contact with objects surrounding the patient. Materials and Methods: The study was performed by quasi-observation among the group of 188 medical staff members (nurses and physicians working in three selected hospitals of the Łódź Province. The procedure of hand washing/disinfection performed directly after the patient contact according to the recommendations of CDC and WHO was observed. The results were subject to statistical analysis (p < 0.05. Results: During 1544 h of observations, 4101 activities requiring hand washing were recorded. The medical personnel followed the hand hygiene procedures after the patient contact in 26.4% of the situations that require hygiene according to the guidelines. The level of observance of the hand washing procedures depended significantly on the type of performed activity, profession, degree of workload, index of activity, and time of duty hours. The mean time of hand washing after patient contact was 9.2 s for physicians and 6.7 s for nurses. Conclusion: Both the level of observance of hygienic procedures after the contact with patients as well as the time of hand washing are insufficient. There is an urgent need to work out educational programs on maintaining proper hand hygiene for medical personnel.

  18. Motivating arm-hand use for stroke patients by serious games.

    Science.gov (United States)

    Delbressine, Frank; Timmermans, Annick; Beursgens, Luuk; de Jong, Maaike; van Dam, Alexander; Verweij, David; Janssen, Maikel; Markopoulos, Panos

    2012-01-01

    We present a novel technology to support playful rehabilitation of arm-hand performance for stroke survivors. The system combines tangible tabletop interaction with wearable technology, to encourage stroke patients to train their arm-hand skills in a task-oriented manner, while a jacket supporting tilt-sensing and vibrotactile feedback guides patients regarding the correct execution of exercises and specifically to avoid compensatory movements. We present the iterative client centered development of this technology and its on going development.

  19. Helping hands: caring for the upper extremity transplant patient.

    Science.gov (United States)

    Lovasik, Darlene; Foust, Daniel E; Losee, Joseph E; Lee, W P Andrew; Brandacher, Gerald; Gorantla, Vijay S

    2011-09-01

    Caring for upper extremity transplant recipients can offer challenges and opportunities to nursing staff in combining new patient procedures, new technologies, and complex patient care needs including unique physical care, monitoring and observation, rehabilitation expectations, and psychiatric/psychosocial support. Medical professionals continue to be apprehensive about the risks of immunosuppressive therapy and the possibility of acute and chronic rejection. The sustained development and research into reliable, reduced-dose immunosuppression or immunomodulatory strategies could expand the life-enhancing benefits of reconstructive transplantation.

  20. 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.

  1. 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

  2. Patient empowerment and multimodal hand hygiene promotion: a win-win strategy.

    Science.gov (United States)

    McGuckin, Maryanne; Storr, Julie; Longtin, Yves; Allegranzi, Benedetta; Pittet, Didier

    2011-01-01

    Patient empowerment is a new concept in health care that has now been extended to the domain of patient safety. Within the framework of the development of the new World Health Organization (WHO) Guidelines on Hand Hygiene in Health Care, the authors conducted a review of the literature from 1997 to 2008 to identify the evidence supporting programs aimed at encouraging patients to take an active role in their care. Patient empowerment is an integral part of the WHO hand hygiene multimodal strategy. Hand hygiene promotion strategies that have demonstrated evidence of successfully empowering patients include one or all of the following components: educational tools, motivation and reminder tools, and role modeling. What is important is that programs and models to empower patients must be developed with an inbuilt evaluation component that includes both qualitative and quantitative measures to determine not only what works but under what conditions and within which organizational context.

  3. 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

  4. 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.

  5. Evaluation of patients undergoing removal of glass fragments from injured hands: a retrospective study.

    Science.gov (United States)

    Tuncer, Serdar; Ozcelik, Ismail Bulent; Mersa, Berkan; Kabakas, Fatih; Ozkan, Turker

    2011-08-01

    The hand is the body part most frequently injured by broken glass. Glass fragments lodged in soft tissues may result in numerous complications, such as infection, delayed healing, persistent pain, and late injury as a result of migration. Between 2005 and 2010, we removed 46 glass particles from the hands of 26 patients. The injuries were caused by the following: car windows broken during motor vehicle accidents in 11 patients (42%); fragments from broken glasses, dishes, or bottles in 9 (35%); the hand passing through glass in 5 (19%); and a fragment from a broken fluorescent lamp in 1 (4%) patient. Despite the efficacy of plain radiographs in detecting glass fragments, these are sometimes not obtained. Given the relatively low cost, accessibility, and efficacy of radiographs, and the adverse consequences of retained foreign bodies, the objections to obtaining radiographs should be few in diagnosing glass-related injuries of the hand.

  6. Evaluation of two different hand hygiene procedures during routine patient care.

    Science.gov (United States)

    Eksi, F; Mehli, M; Akgun, S; Bayram, A; Balci, I; Aydin, N

    2010-01-01

    In this study, the antimicrobial efficacy of hand washing (HW) and hand washing plus rubbing with an alcohol-based solution (HWR) on numbers of total and transient flora colonies on the hands of healthcare workers (HCWs) during routine patient care was assessed. Samples were collected, using a standard bag broth technique, from the hands of 154 HCWs, before and immediately after carrying out a hand hygiene procedure. The numbers of total and transient flora colonies per plate were counted and transient pathogens were identified. A significant statistical difference between ward speciality was detected with respect to the isolation rate of transient flora. Transient hand flora were recovered from 25.3% of HCWs before carrying out the hand hygiene procedure. With respect to the disappearance and prevention of regrowth of transient flora after hand hygiene, the HWR technique was significantly more effective than HW. In conclusion, a disinfectant should be added to the hand washing process to achieve optimum protection against nosocomial infections in routine hospital practice.

  7. Chronic hand eczema - self-management and prognosis

    DEFF Research Database (Denmark)

    Mollerup, Annette; Veien, Niels Kren; Johansen, Jeanne Duus

    2012-01-01

    , 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 well of potential observer bias. Inclusion criterions are wide in order to increase transferability of the results. Trial registration The trial...

  8. What constitutes a good hand offs in the emergency department: a patient's perspective.

    Science.gov (United States)

    Downey, La Vonne; Zun, Leslie; Burke, Trena

    2013-01-01

    The aim is to determine, from the patient's perspective, what constitutes a good hand-off procedure in the emergency department (ED). The secondary purpose is to evaluate what impact a formalized hand-off had on patient knowledge, throughput and customer service This study used a randomized controlled clinical trial involving two unique hand-off approaches and a convenience sample. The study alternated between the current hand-off process that documented the process but not specific elements (referred to as the informal process) to one using the IPASS the BATON process (considered the formal process). Consenting patients completed a 12-question validated questionnaire on how the process was perceived by patients and about their understanding why they waited in the ED. Statistical analysis using SPSS calculated descriptive frequencies and t-tests. In total 107 patients were enrolled: 50 in the informal and 57 in the formal group. Most patients had positive answers to the customer survey. There were significant differences between formal and informal groups: recalling the oncoming and outgoing physician coming to the patient's bed (p = 0.000), with more formal group recalling that than informal group patients; the oncoming physician introducing him/herself (p = 0.01), with more from the formal group answering yes and the physician discussing tests and implications with formal group patients (p = 0.02). This study was done at an urban inner city ED, a fact that may have skewed its results. A comparison of suburban and rural EDs would make the results stronger. It also reflected a very high level of customer satisfaction within the ED. This lack of variance may have meant that the correlation between customer service and handoffs was missed or underrepresented. There was no codified observation of either those using the IPASS the BATON script or those using informal procedures, so no comparison of level and types of information given between the two groups was done

  9. 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

  10. New technical design of food packaging makes the opening process easier for patients with hand disorders.

    Science.gov (United States)

    Hensler, Stefanie; Herren, Daniel B; Marks, Miriam

    2015-09-01

    Opening packaged food is a complex daily activity carried out worldwide. Peelable packaging, as used for cheese or meat, causes real problems for many consumers, especially elderly people and those with hand disorders. Our aim was to investigate the possibility of producing meat packaging that is easier for patients with hand disorders to open. One hundred patients with hand osteoarthritis were asked to open a meat package currently available in supermarkets (Type A) and a modified, newly designed version (Type B), and rate their experiences with a consumer satisfaction index (CSI). The mean CSI of the Type B packs was 68.9%, compared with 41.9% for Type A (p food packages that afford greater consumer satisfaction. Such future packaging would benefit not only people with hand disorders but also the population as a whole.

  11. Transcription factor HAND2 mutations in sporadic Chinese patients with congenital heart disease

    Institute of Scientific and Technical Information of China (English)

    SHEN Lei; LI Xiao-feng; SHEN A-dong; WANG Qiang; LIU Cai-xia; GUO Ya-jie; SONG Zhen-jiang; LI Zhong-zhi

    2010-01-01

    Background The basic helix-loop-helix transcription factor HAND2 plays an essential role in cardiac morphogenesis.However, the prevalence of HAND2 mutations in congenial heart disease (CHD) and the correlation between the HAND2 genotype and CHD phenotype have not been studied extensively. Methods We amplified the exons and the flanking intron sequences of the HAND2 gene in 131 patients diagnosed with congenital defects of the right ventricle, outflow tract, aortic artery or cardiac cushion and confirmed the mutations by sequencing.Results Seven mutations including three missense mutations (P11R, S36N and V83L), one isonymous mutation (H14H)and three mutations in untranslated region (241 A>G, 604C>T and 3237T>A) were identified in 12 out of the 131 patients.Both nonisonymous mutations are located in the transcriptional activation domain on the N-terminus. Only one mutation (S36N) was identified in 250 normal healthy controls. The distribution of 3637T>A is the unique one which was differentbetween the 2 groups.Conclusions HAND2 may be a potential candidate gene of stenosis of the right ventricle, outflow tract. Further study of those with a family history of HAND2 mutations will help convincingly relate their genotype to the pathogenesis of CHD.

  12. 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

  13. Corticomuscular coherence during hand gripping with DBS and medication in PD patients

    DEFF Research Database (Denmark)

    Sridharan, Kousik Sarathy; Højlund, Andreas; Johnsen, Erik Lisbjerg

    (MEG) from six PD patients performing hand gripping during DBS ON and medicated (levodopa, MED ON) conditions and from ten age-matched healthy controls. Participants performed isotonic contractions (hand gripping) with their right hand, and electromyography (EMG) was recorded from the extensor...... digitorum communis muscle with a belly-tendon montage. We calculated the mean-squared coherence between MEG and the rectified EMG signals. For each group and condition, we selected the maximum CMC value in the beta range (13-30 Hz) within the average of an a priori selection of nine left sensorimotor...

  14. Work-related hand dermatitis : epidemiological studies in occupational dermatology

    NARCIS (Netherlands)

    Smit, Henriette Anita

    1993-01-01

    Hand eczema or hand dermatitis is a well-known problem in occupations with regular exposure to water and irritating agents ("wet work"). It is experienced frequently by nurses, hairdressers, housewives, food handlers and metal workers. Although hand dermatitis is a relatively infrequent cause of

  15. Work-related hand dermatitis epiemiological studies in occupational dermatology

    NARCIS (Netherlands)

    Smit, H.A.

    1993-01-01

    Hand eczema or hand dermatitis is a well-known problem in occupations with regular exposure to water and irritating agents ("wet work"). It is experienced frequently by nurses, hairdressers, housewives, food handlers and metal workers. Although hand dermatitis is a relatively infrequent cause of

  16. DISABILITIES OF HANDS, FEET AND EYES IN NEWLY-DIAGNOSED LEPROSY PATIENTS IN EASTERN NEPAL

    NARCIS (Netherlands)

    SCHIPPER, A; LUBBERS, WJ; HOGEWEG, M; DESOLDENHOFF, R

    1994-01-01

    The objective of the study was to determine the magnitude of hand/feet/eye disabilities in newly diagnosed leprosy patients by examining all newly diagnosed leprosy patients who presented at the Eastern Leprosy Control Project (supported by The Netherlands Leprosy Relief Association), made up of a r

  17. DISABILITIES OF HANDS, FEET AND EYES IN NEWLY-DIAGNOSED LEPROSY PATIENTS IN EASTERN NEPAL

    NARCIS (Netherlands)

    SCHIPPER, A; LUBBERS, WJ; HOGEWEG, M; DESOLDENHOFF, R

    The objective of the study was to determine the magnitude of hand/feet/eye disabilities in newly diagnosed leprosy patients by examining all newly diagnosed leprosy patients who presented at the Eastern Leprosy Control Project (supported by The Netherlands Leprosy Relief Association), made up of a

  18. Clinical use of a neck brace to improve hands-free speech in laryngectomized patients.

    NARCIS (Netherlands)

    Dirven, R.; Kooijman, P.G.C.; Wouters, Y.; Marres, H.A.M.

    2012-01-01

    OBJECTIVES/HYPOTHESIS: Time of adherence of adhesive baseplate housings to the neck of a laryngectomized patient is one of the main problems that account for the low number of laryngectomy patients who benefit from hands-free speech. An external neck brace (ENB 1.0) was introduced to support

  19. Edema of the paretic hand in elderly post-stroke nursing patients.

    Science.gov (United States)

    Leibovitz, Arthur; Baumoehl, Yehuda; Roginsky, Yelena; Glick, Zahava; Habot, Beni; Segal, Refael

    2007-01-01

    Post-stroke edema of the paretic hand constitutes an additional, functional, and esthetic nuisance for the patient. Although often encountered in daily practice, it is not even mentioned in the stroke chapters of the various textbooks. The phenomenon is far from being elucidated and various aspects are still obscure. In this study we tried to estimate the extent of post-stroke hand edema (PSHE) in a sample of elderly patients. The study group consisted of 188 elderly post-stroke nursing patients with hemi or only hand paresis. Seventy, age matched, non-paretic patients were examined as controls. The basis of comparison was the difference in circumference between the two arms at three sites: mid-finger, hand, and wrist as measured in the control group. Values above two standard deviations (S.D.) of the mean difference in circumference of the controls, at two or three sites, were considered as edema. Edema of the paretic hand was detected in 37% of post-stroke patients. Most (about three-quarters), could be classified as simple PSHE, while the rest may have had reflex sympathetic dystrophy (RSD).

  20. The beneficial effects of rehabilitation on hand function in patients with rheumatoid arthritis

    Science.gov (United States)

    Księżopolska-Orłowska, Krystyna; Kasprzak, Katarzyna; Gaszewska, Ewa; Rodkiewicz-Bogusławska, Agnieszka; Sokołowska, Beata

    2016-01-01

    Objectives The hand is one of the main elements of the rehabilitation of patients with rheumatoid arthritis (RA) due to deformities, which occur in approximately 90% of patients. It is a serious problem, both in the psychological and functional aspect, connected with muscle strength reduction, a limited range of motion and non-acceptance of the changes in the shape of the limb. The study aimed to assess the effect of rehabilitation on the function of the hand in rheumatoid arthritis. Material and methods The study group consisted of 40 women with RA. The patients had been previously treated at the Rehabilitation Department of the National Institute of Geriatrics, Rheumatology and Rehabilitation in Warsaw. The study group underwent 3 weeks of rehabilitation involving individual therapy, exercises with equipment, patient education and physical therapy. The control group included women without a diagnosis of RA, hands pain-free and fully mobile. In both groups the hand was assessed for grip value, grip quality and manipulative ability. In the study group the basis of pain intensity was noted. The measurements were performed twice – prior to the rehabilitation and after 3 weeks of rehabilitation in women with RA and once in women without hand problems. Results The results obtained revealed marked limitation of hand function in patients with rheumatoid arthritis. The treatment resulted in an improvement of all assessed parameters except cylindrical grip, in which only a part of the findings was statistically significant. Conclusions The analysis of the study material showed that appropriately adjusted and conducted hand physiotherapy in women with rheumatoid arthritis contributed to the improvement of its function by pain reduction, improved value and quality of grip, and also increased manipulative ability. PMID:28115778

  1. The beneficial effects of rehabilitation on hand function in patients with rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Krystyna Księżopolska-Orłowska

    2016-12-01

    Full Text Available Objectives: The hand is one of the main elements of the rehabilitation of patients with rheumatoid arthritis (RA due to deformities, which occur in approximately 90% of patients. It is a serious problem, both in the psychological and functional aspect, connected with muscle strength reduction, a limited range of motion and non-acceptance of the changes in the shape of the limb. The study aimed to assess the effect of rehabilitation on the function of the hand in rheumatoid arthritis. Material and methods: The study group consisted of 40 women with RA. The patients had been previously treated at the Rehabilitation Department of the National Institute of Geriatrics, Rheumatology and Rehabilitation in Warsaw. The study group underwent 3 weeks of rehabilitation involving individual therapy, exercises with equipment, patient education and physical therapy. The control group included women without a diagnosis of RA, hands pain-free and fully mobile. In both groups the hand was assessed for grip value, grip quality and manipulative ability. In the study group the basis of pain intensity was noted. The measurements were performed twice – prior to the rehabilitation and after 3 weeks of rehabilitation in women with RA and once in women without hand problems. Results : The results obtained revealed marked limitation of hand function in patients with rheumatoid arthritis. The treatment resulted in an improvement of all assessed parameters except cylindrical grip, in which only a part of the findings was statistically significant. Conclusions : The analysis of the study material showed that appropriately adjusted and conducted hand physiotherapy in women with rheumatoid arthritis contributed to the improvement of its function by pain reduction, improved value and quality of grip, and also increased manipulative ability.

  2. Responsiveness of three Patient Report Outcome (PRO) measures in patients with hand fractures: A preliminary cohort study.

    Science.gov (United States)

    Weinstock-Zlotnick, Gwen; Page, Carol; Ghomrawi, Hassan M K; Wolff, Aviva L

    2015-01-01

    Clinical measurement. Few studies describe the responsiveness of functional outcomes measures in patients sustaining hand fractures. 1--To explore the responsiveness of three function-oriented Patient Report Outcome (PRO) measures with a cohort of hand fracture patients. 2--To examine patients' PRO preference. 60 participants with 74 hand fractures at an outpatient hospital-based hand therapy clinic consented to participate in this study. They completed the Disabilities of the Arm, Shoulder, and Hand Questionnaire (DASH), Michigan Hand Outcomes Questionnaire (MHQ), and Patient-Rated Wrist/Hand Evaluation (PRWHE) at three trials: T1 (evaluation), T2 (one month later), and T3 (two months later). Participants also identified which PRO they felt best reflected their hand use and which was easiest to complete. Descriptive statistics, analyses of variance (ANOVA), effect size, and standardized response mean (SRM) were employed to describe participants, determine functional change between trials, and examine and compare PRO responsiveness. Questionnaire preference at T1 was reported. Participants demonstrated functional improvement, as measured by the DASH, PRWHE, and MHQ. T1 scores: DASH = 41.85 (SD ± 22.78), MHQ = 50.13 (SD ± 18.36), and PRWHE = 48.18 (SD ± 22.07). T2 scores: DASH = 22.11 (SD ± 18.18), MHQ = 69.89 (SD ± 15.93), and PRWHE = 22.62 (SD ± 18.15). T3 scores: DASH = 17.56 (SD ± 18.01), MHQ = 75.37 (SD ± 19.19), and PRWHE = 22.40 (SD ± 19.04). Each PRO demonstrated significant test score differences between trials (p responsiveness (≥.80) was noted between T1 and T2: (effect size: .98-1.23; SRM: 1.31-1.49) and T1 and T3 (effect size: 1.21-1.54; SRM 1.49-1.84). Smaller responsiveness effects were noted between T2 and T3 (effect size: .35-.64, SRM: .38-.81). No significant differences between questionnaire responsiveness were found. Patients reported PRWHE easiest to complete and MHQ best reflecting their hand use. DASH, MHQ, and PRWHE were each able

  3. Self-reported cold sensitivity in normal subjects and in patients with traumatic hand injuries or hand-arm vibration syndrome

    Directory of Open Access Journals (Sweden)

    Dahlin Lars B

    2010-05-01

    Full Text Available Abstract Background Cold sensitivity is a common and disabling complaint following hand injuries. The main purpose of this study was to describe self-reported consequences of cold sensitivity and the association with disability and health-related quality of life in patients with hand injuries or hand-arm vibration syndrome (HAVS and in normal subjects. Methods Responses to the Cold Intolerance Symptom Severity (CISS questionnaire, Potential Work Exposure Scale (PWES, Disability of the Arm, Shoulder and Hand (DASH and Short-Form 36 questionnaire (SF-36 were investigated in normal subjects (n = 94, hand injured patients (amputation and nerve injuries, n = 88 and patients with HAVS (n = 30. The results are presented as median (range, percent and mean deviation from norms. The Kruskal Wallis Test or Mann-Whitney U-Test were used to identify significant differences between multiple groups or subgroups. The Spearman rank correlation was used to study the relationship between cold sensitivity and disability. Results Abnormal cold sensitivity (CISS score > 50 was seen in 75% and 45% of patients with HAVS and a traumatic hand injury, respectively. Patients were significantly more exposed to cold in their work environment than the normal population, with a consequently negative effect on work ability due to cold sensitivity. Patients with abnormal cold sensitivity were more seriously disabled and had a poorer health-related quality of life than patients with normal cold sensitivity [higher DASH scores and e.g. significantly larger mean deviation from norms in the subscales Role Physical and Bodily Pain (SF-36]. Conclusion Severe and abnormal cold sensitivity may have a profound impact on work capacity, leisure, disability and health-related quality of life. It is frequently seen in patients with traumatic hand injuries and particularly apparent in patients with HAVS.

  4. Improving healthcare worker hand hygiene adherence before patient contact: A multimodal intervention of hand hygiene practice in Three Japanese tertiary care centers.

    Science.gov (United States)

    Sakihama, Tomoko; Honda, Hitoshi; Saint, Sanjay; Fowler, Karen E; Kamiya, Toru; Sato, Yumiko; Iuchi, Ritsuko; Tokuda, Yasuharu

    2016-03-01

    Though hand hygiene is an important method of preventing healthcare-associated infection, we found suboptimal hand hygiene adherence among healthcare workers in 4 diverse Japanese hospitals (adherence rates of 11%-25%). Our goal was to assess multimodal hand hygiene intervention coupled with a contest to improve hand hygiene adherence. A total of 3 to 4 inpatient wards in 3 Japanese hospitals. Pre-post intervention study. The intervention was a multimodal hand hygiene intervention recommended by the World Health Organization that was tailored to each facility. The hospital with the highest adherence after the intervention was given $5000 US dollars and a trophy, provided by an American coinvestigator unaffiliated with any of the Japanese hospitals. We tracked hand hygiene adherence rates before patient contact for each unit and hospital and compared these to pre-intervention adherence rates. We observed 2982 postintervention provider-patient encounters in 10 units across 3 hospitals. Hand hygiene adherence rates were improved overall after the intervention (18% pre- to 33% postintervention; P hand hygiene rates among Japanese healthcare workers. Given the overall low rates, however, further improvement is necessary. © 2015 Society of Hospital Medicine.

  5. Consequences of occupational food-related hand dermatoses with a focus on protein contact dermatitis

    DEFF Research Database (Denmark)

    Vester, Lotte; Thyssen, Jacob P; Menné, Torkil

    2012-01-01

    Background. Protein contact dermatitis is a frequent disorder among hand eczema patients who have occupational food contact. Knowledge about the consequences of having protein contact dermatitis is lacking. Objectives. To investigate the consequences of having occupational skin disease on the hands...... resulting from food handling, with a focus on protein contact dermatitis. Material and methods. One hundred and seventy-eight patients who were identified as having skin disease related to occupational food exposure and who answered a questionnaire concerning the consequences of their skin disease were......%, respectively, of the patients with other occupational food-related hand dermatoses (p = 0.02). Sixty-two per cent and 43%, respectively, had to change job because of skin problems (p = 0.02). Atopic dermatitis was equally common in the two groups. Conclusion. We found that the patients with protein contact...

  6. A rehabilitation device to improve the hand grasp function of stroke patients using a patient-driven approach.

    Science.gov (United States)

    Park, Wanjoo; Jeong, Wookjin; Kwon, Gyu-Hyun; Kim, Yun-Hee; Kim, Laehyun

    2013-06-01

    This paper proposes a robotic hand rehabilitation device for grasp training. The device is designed for stroke patients to train and recover their hand grasp function in order to undertake activities of daily living (ADL). The device consists of a control unit, two small actuators, an infrared (IR) sensor, and pressure sensors in the grasp handle. The advantages of this device are that it is small in size, inexpensive, and available for use at home without specialist's supervision. In addition, a novel patient-driven strategy based on the patient's movement intention detected by the pressure sensors without bio-signals is introduced. Once the system detects a patient's movement intention, it triggers the robotic device to move the patient's hand to form the normal grasping behavior. This strategy may encourage stroke patients to participate in rehabilitation training to recover their hand grasp function and it may also enhance neural plasticity. A user study was conducted in order to investigate the usability, acceptability, satisfaction, and suggestions for improvement of the proposed device. The results of this survey included positive reviews from therapists and a stroke patient. In particular, therapists expected that the proposed patient-driven mode can motivate patients for their rehabilitation training and it can be effective to prevent a compensational strategy in active movements. It is expected that the proposed device will assist stroke patients in restoring their grasp function efficiently.

  7. Rehabilitation after bilateral hand transplantation in the quadrimembral patient: review and recommendations.

    Science.gov (United States)

    Severance, Gayle; Walsh, Laura

    2013-12-01

    The hand transplantation is a unique entity in the fields of medicine and rehabilitation. Hand therapy and rehabilitation programs are consistently reported as essential to a successful functional outcome for the hand transplant patient. In September 2011, our medical center performed their first bilateral hand and forearm transplant on a 28-year-old female 4 years after losing her lower extremities and upper extremities due to multiorgan system failure and pressure-induced extremity ischemia. She participated in 4 months of hand therapy, occupational therapy, and physical therapy at our institution, and then returned to her hometown to continue with an intensive therapy program. At 16 months after transplantation, she had sensory return to diminished protective level and motor return to all transplanted muscles except for intrinsics. Our hand therapy team established a treatment program based on literature, collaboration with other transplant centers, and clinical experience. Now, 2 years after our first hand transplant case, we assess our plan and program, offer suggestions for developing a treatment program and encourage therapist to collaborate with their own transplant team and others around the United States and the world.

  8. Health Professionals and hand hygiene: a question of pediatric patient safety

    Directory of Open Access Journals (Sweden)

    Daisy Zanchi de Abreu Botene

    Full Text Available This paper is a qualitative descriptive study, which aims to analyze how the academic education concerning hand hygiene contributes to the pediatric patient safety. This research was developed in an university hospital in Southern Brazil, in the pediatric unit, during the period of August to December, 2012. Sixteen healthcare professionals participated (doctors, nurses and physical therapists. A semi-structured interview was used to gather information. Data was organized by the software QSR Nvivo and analyzed using the content analysis technique. The results allowed us to list two thematic categories: "Hand hygiene and healthcare professionals' academic education"; and "Hand hygiene and professional life". The first thematic category will be presented in this paper. It was identified that the academic education contributes in an ineffective way to the creation of a patient safety culture. According to the professionals, there are gaps during the educational process regarding hand hygiene. The topic is treated in an ineffective and not very significant way to the learning and adhesion of hand hygiene in the professional life. It is recommended that, for the internalization of the practice by future professionals, a transversal, continuous and systematical approach is adopted during the professional's training, evaluations concerning the hand hygiene are done throughout the academic life as well as healthcare professors bethink the topic.

  9. [Health professionals and hand hygiene: a question of pediatric patient safety].

    Science.gov (United States)

    Botene, Daisy Zanchi de Abreu; Pedro, Eva Neri Rubim

    2014-09-01

    This paper is a qualitative descriptive study, which aims to analyze how the academic education concerning hand hygiene contributes to the pediatric patient safety. This research was developed in an university hospital in Southern Brazil, in the pediatric unit, during the period of August to December, 2012. Sixteen healthcare professionals participated (doctors, nurses and physical therapists). A semi-structured interview was used to gather information. Data was organized by the software QSR Nvivo and analyzed using the content analysis technique. The results allowed us to list two thematic categories:"Hand hygiene and healthcare professionals' academic education"; and "Hand hygiene and professional life". The first thematic category will be presented in this paper. It was identified that the academic education contributes in an ineffective way to the creation of a patient safety culture. According to the professionals, there are gaps during the educational process regarding hand hygiene. The topic is treated in an ineffective and not very significant way to the learning and adhesion of hand hygiene in the professional life. It is recommended that, for the internalization of the practice by future professionals, a transversal, continuous and systematical approach is adopted during the professional's training, evaluations concerning the hand hygiene are done throughout the academic life as well as healthcare professors bethink the topic.

  10. Single DoF Hand Orthosis for Rehabilitation of Stroke and SCI Patients

    Science.gov (United States)

    Kannan Megalingam, Rajesh; Apuroop, K. G. S.; Boddupalli, Sricharan

    2017-08-01

    Many stroke and spinal cord injury patients suffer from paralysis which range from severe to nominal. Some of them, after therapy, could regain most of the motor control, particularly in hands if the severity level is not so high. In this paper we propose a hand orthosis for such patients whose stroke and spinal cord injury severity is nominal and the motor control in hands can be regained by therapy as part of their rehabilitation process. The patients can wear this orthosis and the therapy can be done with simple Human Computer Interface. The physicians, the physiotherapists and the patients themselves can carry out the therapy with the help of this device. The tests conducted in the lab and the results obtained are very promising that this can be an effective mechanism for stroke and spinal cord injury patients in their rehabilitation process. The hand orthosis is designed and fabricated locally so that it can be made available to such patients at an affordable cost.

  11. 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.

  12. Intra- and inter-rater reliability of the Sollerman hand function test in patients with chronic stroke

    DEFF Research Database (Denmark)

    Brogårdh, Christina; Persson, Ann L; Sjölund, Bengt H

    2007-01-01

    PURPOSE: To examine whether the Sollerman hand function test is reliable in a test-retest situation in patients with chronic stroke. METHOD: Three independent examiners observed each patient at three experimental sessions; two days in week 1 (short-term test-retest) and one day in week 4 (long...... hand function test seems to be a reliable test in patients with chronic stroke, but we recommend that the same examiner evaluates a patient's hand function pre- and post-treatment....

  13. Hand Robotics Rehabilitation: Feasibility and Preliminary Results of a Robotic Treatment in Patients with Hemiparesis

    Directory of Open Access Journals (Sweden)

    Patrizio Sale

    2012-01-01

    Full Text Available Background. No strongly clinical evidence about the use of hand robot-assisted therapy in stroke patients was demonstrated. This preliminary observer study was aimed at evaluating the efficacy of intensive robot-assisted therapy in hand function recovery, in the early phase after a stroke onset. Methods. Seven acute ischemic stroke patients at their first-ever stroke were enrolled. Treatment was performed using Amadeo robotic system (Tyromotion GmbH Graz, Austria. Each participant received, in addition to inpatients standard rehabilitative treatment, 20 sessions of robotic treatment for 4 consecutive weeks (5 days/week. Each session lasted for 40 minutes. The exercises were carried out as follows: passive modality (5 minutes, passive/plus modality (5 minutes, assisted therapy (10 minutes, and balloon (10 minutes. The following impairment and functional evaluations, Fugl-Meyer Scale (FM, Medical Research Council Scale for Muscle Strength (hand flexor and extensor muscles (MRC, Motricity Index (MI, and modified Ashworth Scale for wrist and hand muscles (AS, were performed at the beginning (T0, after 10 sessions (T1, and at the end of the treatment (T2. The strength hand flexion and extension performed by Robot were assessed at T0 and T2. The Barthel Index and COMP (performance and satisfaction subscale were assessed at T0 and T2. Results. Clinical improvements were found in all patients. No dropouts were recorded during the treatment and all subjects fulfilled the protocol. Evidence of a significant improvement was demonstrated by the Friedman test for the MRC (P<0.0123. Evidence of an improvement was demonstrated for AS, FM, and MI. Conclusions. This original rehabilitation treatment could contribute to increase the hand motor recovery in acute stroke patients. The simplicity of the treatment, the lack of side effects, and the first positive results in acute stroke patients support the recommendations to extend the clinical trial of this

  14. Assessment of light touch sensation in the hands of systemic sclerosis patients

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    Paula Gabriel Silva

    2014-09-01

    Full Text Available INTRODUCTION: Systemic sclerosis is a relatively rare connective tissue disorder characterized by severe and progressive fibrosis of the skin. Due to the current lack of available information on this subject, the aim of the present study was to assess light touch sensations in the hands of patients with systemic sclerosis. METHODS: We completed a cross-sectional comparative study. Light touch sensations were evaluated in 30 individuals, including 15 patients with systemic sclerosis who exhibited changes in the dermis of their hands without loss of the distal phalanx and 15 subjects who did not exhibit changes in the upper limbs (control group. The groups were age- and sex-matched. Tactile sensory evaluations were performed using the Semmes-Weinstein monofilament test and the two-point discrimination test. RESULTS: Statistically significant differences were found between groups in the monofilament test. The study group had lower scores across all points of the hand when compared with the control group. Differences were also found when dominant and non-dominant hands were compared (p<0.05. Statistically significant differences were found between groups for a subset of the assessed points in the two-point discrimination test. CONCLUSIONS: The results of a monofilament test showed that tactile sensation, specifically light touch and deep pressure sensations, is altered in the hands of systemic sclerosis patients.

  15. Patients' potential role in the transmission of health care-associated infections: prevalence of contamination with bacterial pathogens and patient attitudes toward hand hygiene.

    Science.gov (United States)

    Istenes, Nancy; Bingham, James; Hazelett, Susan; Fleming, Eileen; Kirk, Jane

    2013-09-01

    Transmission of health care-associated infections (HAIs) has been primarily attributed to health care workers, and hand hygiene is considered the most important means to reduce transmission. Whereas hand hygiene research has focused on reducing health care worker hand contamination and improving hand hygiene compliance, contamination of patients' hands and their role in the transmission of HAIs remains unknown. Patients' hands were sampled by a "glove juice" recovery method and enumerated for the presence of common health care-associated pathogens. Patient demographics and other covariates were collected to determine their association with patient hand contamination. Patient attitudes and practices toward hand hygiene were also surveyed and analyzed. Of the 100 patients in the study, 39% of hands were contaminated with at least 1 pathogenic organism, and 8% were contaminated with 2 or more pathogens 48 hours after admission. Patient admission from or discharge to an outside institution and self-reported functional limitations were the only covariates that were significantly associated with hand contamination. Pathogenic organisms can be frequently detected on hands of acute care patients. Future studies are needed to better understand the relationship between patient hand contamination and the acquisition of HAIs in addition to the role patient hand hygiene can play in reducing HAIs. Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  16. Hand hygiene after touching a patient's surroundings: the opportunities most commonly missed.

    Science.gov (United States)

    FitzGerald, G; Moore, G; Wilson, A P R

    2013-05-01

    Healthcare workers generally underestimate the role of environmental surfaces in the transmission of infection, and compliance with hand hygiene following contact with the environment is generally lower than following direct patient contact. To reduce the risk of onward transmission, healthcare workers must identify the need to wash hands with specific tasks or events. To observe the movement of staff in critical care and general wards and determine the routes most commonly travelled and the surfaces most frequently touched with and without appropriate hand hygiene. Fifty-eight 90 min sessions of unobtrusive observation were made in open bays and isolation rooms. Link analysis was used to record staff movement from one location to another as well as the frequency of motion. Hand-hygiene audits were conducted using the World Health Organization 'five moments for hand hygiene' observational tool. In critical care, the majority of movement occurred within the bed space. The bedside computer and equipment trolley were the surfaces most commonly touched, often immediately after patient contact. In the general ward, movement between bed spaces was more common and observed hand hygiene ranged from 25% to 33%. Regardless of ward type, observed hand-hygiene compliance when touching the patient immediately on entering an isolation room was less than 30%. Healthcare workers must be made aware that bacterial spread can occur even during activities of perceived low risk. Education and intervention programmes should focus on the potential contamination of ward computers, case notes and door handles. Copyright © 2013 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  17. 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

  18. Effects of hand massage on anxiety in patients undergoing ophthalmology surgery using local anesthesia

    Directory of Open Access Journals (Sweden)

    Jafar Rafiei Kiasari

    2012-08-01

    Full Text Available Introduction: Anxiety is a common disorder in patients before surgery. Inappropriately managed anxiety can cause psychological and physiological reactions and will affect the process of surgery and recovery. Therefore, this study examined the effects of hand mas-sage on anxiety in patients undergoing ophthalmology surgery using local anesthesia. Methods: In this interventional study, 52 patients who were supposed to undergo oph-thalmology surgery using local anesthesia were studied. Patients were randomly as-signed to two groups of intervention, who received hand massage before surgery (n = 27 and control (n = 25. Massaging lasted for 5 minutes (2.5 minutes on each hand before surgery. Stroking and scrubbing methods were performed by 2 trained research-ers. Anxiety level, blood pressure, heart rate, and respiratory rate were measured before and after the intervention in both groups. Anxiety was evaluated using Spielberger State-Trait Anxiety Inventory. Data was analyzed by chi-square, independent samples t-test, and paired t-test. Results: There were no significant differences in mean anxiety, systolic blood pressure, diastolic blood pressure, heart rate, and respiratory rate between the two groups before the intervention (p > 0.05. However, there was a significant differenc in the mean stress level between the two groups after the intervention (p 0.05. Conclusion: Our findings suggested that 5 minutes of hand massage before ophthalmology surgery (under local anesthesia could reduce anxiety. Therefore, this method can be used to increase patient comfort and reduce anxiety before surgical interventions.

  19. The effects of mirror therapy on arm and hand function in subacute stroke in patients.

    Science.gov (United States)

    Radajewska, Alina; Opara, Józef A; Kucio, Cezary; Błaszczyszyn, Monika; Mehlich, Krzysztof; Szczygiel, Jarosław

    2013-09-01

    The aim of this study was to evaluate the effect of mirror therapy on arm and hand function in subacute stroke in patients. The study included 60 hemiparetic right-handed patients after ischemic stroke 8-10 weeks after onset. They underwent stationary comprehensive rehabilitation in the rehabilitation centre. They were divided into two randomly assigned groups: mirror (n=30) and control (n=30). For both groups, two subgroups were created: one that included patients with right arm paresis (n=15) and the other that included patients with left arm paresis (n=15). The mirror group received an additional intervention: training with a mirror for 5 days/week, 2 sessions/day, for 21 days. Each single session lasted for 15 min. The control group (n=30) underwent a conventional rehabilitation program without mirror therapy. To evaluate self-care in performing activities of daily living, the Functional Index 'Repty' was used. To evaluate hand and arm function, the Frenchay Arm Test and the Motor Status Score were used. Measurements were performed twice: before and after 21 days of applied rehabilitation. No significant improvement in hand and arm function in both subgroups in Frenchay Arm Test and Motor Status Score scales was observed. However, there was a significant improvement in self-care of activities of daily living in the right arm paresis subgroup in the mirror group measured using the Functional Index 'Repty'. Mirror therapy improves self-care of activities of daily living for patients with right arm paresis after stroke.

  20. 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.

  1. Surgical treatment results of hand deformities in patients with Apert syndrome

    Directory of Open Access Journals (Sweden)

    Ufuk Nalbantoglu

    2015-12-01

    Results: The mean age at the first operation was 2.7 years and the mean number of operations was 3 per patient. No patient developed graft-flap necrosis and no patients required amputations. All patients were able to perform grasping and pinching functions and families were satisfied with the cosmetic results. Conclusion: Using a two-stage surgical protocol, achieving satisfactory results with a minimal number of operations is possible in patients with Apert Syndrome. [Hand Microsurg 2015; 4(3.000: 53-57

  2. Detailed analysis of contrast-enhanced MRI of hands and wrists in patients with psoriatic arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Tehranzadeh, Jamshid [University of California, Department of Radiological Sciences, Irvine (United States); University of California Medical Center, Department of Radiological Sciences R-140, Orange, CA (United States); Ashikyan, Oganes; Anavim, Arash; Shin, John [University of California, Department of Radiological Sciences, Irvine (United States)

    2008-05-15

    The objective was to perform detailed analysis of the involved soft tissues, tendons, joints, and bones in the hands and wrists of patients with psoriatic arthritis (PsA). We reviewed 23 contrast-enhanced MR imaging studies (13 hands and 10 wrists) in 10 patients with the clinical diagnosis of PsA. We obtained clinical information from medical records and evaluated images for the presence of erosions, bone marrow edema, joint synovitis, tenosynovitis, carpal tunnel, and soft tissue involvement. Two board-certified musculoskeletal radiologists reviewed all images independently. Differences were resolved during a subsequent joint session. The average duration of disease was 71.3 months, ranging from 1 month to 25 years. Eight of the 10 wrists (80%) and 6 of the 13 hands demonstrated bone erosions. Bone marrow abnormalities were shown in 5 of the 10 wrists (50%) and 4 of the 14 hands (31%). Triangular fibrocartilage tears were seen in 6 of the 10 wrists (60%). Wrist and hand joint synovitis were present in all studies (67 wrist joints and 101 hand joints). Wrist soft tissue involvement was detected in 9 of the 10 wrists (90%) and hand soft tissue involvement was present in 12 of the 13 wrists (92%). Findings adjacent to the region of soft tissue involvement included synovitis (4 wrists) and tenosynovitis (3 wrists). Bone marrow edema adjacent to the region of soft tissue involvement was seen in one wrist. Bulge of the flexor retinaculum was seen in 4 of the 10 wrists (40%) and median nerve enhancement was seen in 8 of the 10 wrists (80%). Tenosynovitis was seen in all studies (all 10 of the hands and all 13 of the wrists). The 'rheumatoid' type of distribution of bony lesions was common in our study. Interobserver agreement for various findings ranged from 83% to 100%. Contrast-enhanced MRI unequivocally demonstrated bone marrow edema, erosions, tendon and soft-tissue disease, and median nerve involvement, with good interobserver reliability in patients with

  3. Occupational eczema and asthma in a hairdresser caused by hair-bleaching products

    DEFF Research Database (Denmark)

    Hougaard, Majken G; Menné, Torkil; Søsted, Heidi

    2012-01-01

    understood. The specific inhalation challenge test is considered to be the gold standard for diagnosing occupational asthma and rhinitis. However, this test is not always accessible. Therefore, the diagnosis of occupational allergic asthma caused by persulfate salts is made by combining a clinical history......, a diagnosis of asthma, and a positive skin prick test (SPT). Standardized methods for performing SPT with persulfate salts are warranted. A case of a young hairdresser with occupational asthma and hand eczema caused by persulfate salts is presented, and the procedure for performing the SPT with ammonium......Occupational allergic contact eczema and asthma caused by bleaching agents is seen in hairdressers. Bleaching agents contain persulfate salts, which are known to induce immediate reactions such as rhinitis, asthma, contact urticaria, and anaphylaxis. The immunologic mechanism is not, however, fully...

  4. Occupational eczema and asthma in a hairdresser caused by hair-bleaching products.

    Science.gov (United States)

    Hougaard, Majken G; Menné, Torkil; Søsted, Heidi

    2012-01-01

    Occupational allergic contact eczema and asthma caused by bleaching agents is seen in hairdressers. Bleaching agents contain persulfate salts, which are known to induce immediate reactions such as rhinitis, asthma, contact urticaria, and anaphylaxis. The immunologic mechanism is not, however, fully understood. The specific inhalation challenge test is considered to be the gold standard for diagnosing occupational asthma and rhinitis. However, this test is not always accessible. Therefore, the diagnosis of occupational allergic asthma caused by persulfate salts is made by combining a clinical history, a diagnosis of asthma, and a positive skin prick test (SPT). Standardized methods for performing SPT with persulfate salts are warranted. A case of a young hairdresser with occupational asthma and hand eczema caused by persulfate salts is presented, and the procedure for performing the SPT with ammonium persulfate and potassium persulfate is described in detail.

  5. The effectiveness of occupational therapy in restoring the functional state of hands in rheumatoid arthritis patients.

    Science.gov (United States)

    Rapoliene, Jolita; Krisciūnas, Aleksandras

    2006-01-01

    The aim of the study was to evaluate the effectiveness of occupational therapy in rheumatoid arthritis patients with impaired hand function. Standardized Functional Independence Measure was employed in order to evaluate the functional status of the patients and impaired activities. A dynamometer was used for the measurements of muscular strength of hands and a goniometer, for the range of motion of the wrist. Totally, we have examined 120 rheumatoid arthritis patients. They were divided into two groups: 60 patients in each. Occupational therapy was applied only to the patients of the first group. The mean age of Group 1 patients was 53.4+/-1.8 years, the mean age of Group 2 patients was 52.0+/-1.9 years. The mean duration of the disease was 11.5+/-2.6 years and 12.1+/-2.4 years, respectively. The effectiveness of therapy was considered ineffective if, after the completion of the course of occupational therapy, no increase in Functional Independence Measure score for patients with rheumatoid arthritis was observed. When the score increased from 1 to 3, we considered this as moderate effectiveness; when the score increased to 4-6, we evaluated the effectiveness of occupational therapy as good, and when the score of 7 was attained, effectiveness of occupational therapy was considered as very good. In Group 1, the moderate effectiveness of occupational therapy was determined in 31.7% of patients; good effectiveness, in 61.7%; and very good effectiveness, in 3.3% of rheumatoid arthritis patients. In Group 2, the moderate effectiveness of treatment was determined in 48.3% of patients and good effectiveness, in 5% of rheumatoid arthritis patients. CONCLUSIONS. Hand function (the strength of fingers and hands, the range of motion of the wrist) significantly improved in patients with rheumatoid arthritis after completion of a course of occupational therapy (p<0.05). The improvement of hand functions in patients with rheumatoid arthritis led to increased ability to take food

  6. A radiographic evaluation of temporomandibular and hand (Metacarpophalangeal / wrist joints of patients with adult rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Seema Kurup

    2012-01-01

    Conclusions: Although the TMJ showed osseous changes of a higher grade than the hand (MCP and wrist joints radiographically, it was observed that patients were more aware of the peripheral joint discomfort. There were no significant differences between TMJ and peripheral joints on both right and left sides.

  7. Clinical use of a neck brace to improve hands-free speech in laryngectomized patients.

    Science.gov (United States)

    Dirven, Richard; Kooijman, Piet G C; Wouters, Yannick; Marres, Henri A M

    2012-06-01

    Time of adherence of adhesive baseplate housings to the neck of a laryngectomized patient is one of the main problems that account for the low number of laryngectomy patients who benefit from hands-free speech. An external neck brace (ENB 1.0) was introduced to support peristomal fixation of adhesive baseplates. A prospective randomized controlled clinical cross-over trial. A total of 28 laryngectomy patients participated in this randomized, prospective, crossover trial. All used the Provox hands-free heat and moisture exchanger (HME) valve for 1 month: 2 weeks with an ENB and 2 weeks without. The median lifetime of an adhesive baseplate without a brace was 52.5 minutes versus 210 minutes with a brace (P = .03). Four participants considered the ENB as "a little" bit of a welcome addition, nine as "quite a bit," and six as "very much" (79%) to improve hands-free speech. The ENB significantly increases the lifetime of an adhesive baseplate and therefore contributes to achieving hands-free speech for a greater number of patients with laryngectomy. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

  8. Symptoms of Acute Posttraumatic Stress Disorder in Patients With Acute Hand Injuries

    NARCIS (Netherlands)

    Opsteegh, Lonneke; Reinders-Messelink, Heleen A.; Groothoff, Johan W.; Postema, Klass; Dijkstra, Pieter U.; van der Sluis, Corry K.

    2010-01-01

    Purpose Symptoms of posttraumatic stress disorder (PTSD) in patients with hand injuries may delay return to work, even when criteria of the Diagnostic and Statistical Manual of Mental Disorders-IV are not met. This study investigated which biomedical and psychosocial factors relate to symptoms of ac

  9. The PowerGlove: assessment of hand and finger movements in Parkinson’s disease patients

    NARCIS (Netherlands)

    Dijk, van K.J.; Verhagen, R.; Noort, van den J.; Bour, L.J.; Veltink, P.H.; Heida, T.

    2015-01-01

    Objective: The aim of the study is to test whether the PowerGlove (PG), an instrumented glove which consists of inertial (accelerometers and gyroscopes) and magnetic sensors, is a valid and reliable instrument to measure different degrees of hand motor impairments in patients with Parkinson’s diseas

  10. Mental Practice Combined with Physical Practice to Enhance Hand Recovery in Stroke Patients

    Directory of Open Access Journals (Sweden)

    Hua Liu

    2014-01-01

    Full Text Available Objectives. To evaluate whether combining mental practice with physical practice training enhances hand function in patients with stroke. Methods. 10 for treatment and 10 for control were recruited for this pre/posttraining matched case control study. In the treatment group, subjects underwent combining mental practice with physical practice for four weeks. In the control group, subjects only participated in physical practice. Change of hand function and the number of activated voxels of the contralateral somatosensory motor cortex (SMC acquired by functional magnetic resonance imaging were measured. Results. After training, the Action Research Arm Test score increased by 12.65 for treatment and by 5.20 for control. There was a significant difference in the Action Research Arm Test score between the two groups (P=0.04. The activated voxels number of the contralateral SMC increased in both groups, but the activated voxels number in the contralateral SMC and the improvement of hand function for treatment were greater than for control. In the treatment group, the number of activated voxels of the contralateral SMC was positively correlated with better hand function scores. Conclusions. Combining mental practice with physical practice may be a more effective treatment strategy than physical training alone for hand recovery in stroke patients.

  11. Effectiveness of hand washing and disinfection methods in removing transient bacteria after patient nursing.

    Science.gov (United States)

    Ojajärvi, J

    1980-10-01

    The effectiveness of various hand washing and disinfection methods in removing transient skin bacteria was studied in hospital after dry or moist contamination of the hands when nursing burn patients. The results were compared with those of laboratory tests with volunteers. A fairly good correlation of the bacterial reductions existed between hospital and laboratory tests. All other methods removed Staph. aureus from the hands more effectively than liquid soap. Gram-negative bacilli were more easily removed than staphylococci, even with soap wash alone. In hospital, none of the washing and disinfection methods always removed all patient-borne bacteria from the hands. After dry or moist contamination and subsequent washing with soap only, colonies of Staph. aureus were often detected in finger-print samples. Staphylococci were more often completely removed by a 4% chlorhexidine detergent scrub and alcoholic solutions (either with or without previous soap wash) than by liquid soap, hexachlorophene or iodophor preparations. Gram-negative bacilli were more easily removed by all the washing and disinfection methods. After moist contamination, Gram-negative bacilli were more often completely removed from the hands by ethanol than by other treatments. The results of the present study emphasize the importance of always using gloves when nursing a profuse spreader of bacteria or one who must be protected from infection.

  12. 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.

  13. 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.

  14. 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.

  15. REDUCED HAND GRIP STRENGTH IN OVERWEIGHT AND OBESE CHRONIC HEPATITIS C PATIENTS.

    Science.gov (United States)

    Bruch, Juliana Paula; Álvares-DA-Silva, Mário Reis; Alves, Bruna Cherubini; Dall'alba, Valesca

    2016-01-01

    Hepatitis C is a liver disease that causes significant changes in metabolism, and also has an impact on nutritional status. To evaluate the nutritional status and cardiovascular risk in patients with chronic hepatitis C. This cross-sectional study investigated 58 patients with chronic hepatitis C, non-cirrhotic and were not under active pharmacological treatment. Patients with significant alcohol consumption (greater than 10 g ethanol/day) were excluded. Patients underwent nutritional assessment through anthropometric measurements and functional assessment using hand grip strength by dynamometry. The physical activity was assessed using the International Physical Activity Questionnaire. Patients also underwent clinical and laboratory evaluation. Cardiovascular risk was calculated by the Framingham score. The mean age of patients was 51.6±9.7 years, 55.2% were female, and 79.3% had genotype 1. The most prevalent degree of fibrosis was F1 (37.9%) followed by F2 (27.6%) and F3 (1.7%). The prevalence of overweight/obesity considering the body mass index was 70.7%. However, 57.7% of men and 68.8% of women were considered malnourished according to hand grip strength. These patients also had waist circumference (93.5±10.7 cm) and neck circumference (37.0±3.6 cm) high. Almost 60% of patients were considered sedentary or irregularly active. In relation to cardiovascular risk, 50% of patients had high risk of suffering a cardiovascular event within 10 years. Although most patients with hepatitis C presented overweight, associated with high cardiovascular risk, they also have reduced functional capacity, indicative of protein-caloric commitment. Therefore, body mass index can not be considered the only method of assessment for nutritional diagnosis of patients with liver disease. Adopting methods such as hand grip strength can be important for a better understanding of nutritional status of these patients.

  16. Characteristics of hand tremor and postural sway in patients with fetal-type Minamata disease.

    Science.gov (United States)

    Iwata, Toyoto; Takaoka, Shigeru; Sakamoto, Mineshi; Maeda, Eri; Nakamura, Masaaki; Liu, Xiao-Jie; Murata, Katsuyuki

    2016-01-01

    About forty certified patients aged around 50 years old existed as living witnesses to fetal-type Minamata disease (methylmercury poisoning due to in utero exposure) in Minamata, Japan in 2006. Computerized hand tremor and postural sway tests with spectral analysis were conducted for 24 of them and in matched control subjects to examine the pathophysiological feature of neuromotor function. The tremor intensities of the patients with fetal-type Minamata disease were significantly larger than those of the 67 controls at every frequency band for both hands. In the patients, proportions for intensity at 1-6 Hz of both hands were larger, but those of the intensity at 6-10 Hz were smaller compared with the controls. The center frequency of a tremor was significantly lower in the patients than in the controls. Only eight males of the 24 patients were examined to evaluate postural sway because of extremely low scores in activities of daily living in the remaining. Most of the postural sway parameters obtained with eyes open and closed were significantly larger in the patients than in the male controls. Likewise, Romberg quotients of postural sway in anterior-posterior direction were significantly higher in the patients. In conclusion, the patients with fetal-type Minamata disease of our study showed a larger tremor of low frequency at less than 6 Hz and postural instability. Spectral analyses of computerized hand tremor and postural sway are suggested to be useful for assessing the pathophysiological change, related to a lesion of the cerebellum, resulting from prenatal methylmercury exposure.

  17. Functional outcome of patients undergoing replantation of hand at wrist level-7 year experience

    OpenAIRE

    Ravi Kumar Mahajan; Seema Mittal

    2013-01-01

    Background: Replantation is defined as reattachment of amputated limb using neurovascular and musculoskeletal structures in order to obtain recovery of limb. Re-vascularisation involves all the above steps in case of limb injuries that result in a near total amputation. Aim and Objective : To study the functional outcome of patients undergoing replantation of hand at wrist level. Material and Methods: This is a retrospective study of patients who underwent replantation of total amputation of ...

  18. Design and development of a hand robotic rehabilitation device for post stroke patients.

    Science.gov (United States)

    Rashedi, E; Mirbagheri, A; Taheri, B; Farahmand, F; Vossoughi, G R; Parnianpour, M

    2009-01-01

    Robot-mediated rehabilitation is a rapidly advancing discipline that seeks to develop improved treatment procedures using new technologies, e.g., robotics, coupled with modern theories in neuroscience and rehabilitation. A robotic device was designed and developed for rehabilitation of upper limbs of post stroke patients. A novel force feedback bimanual working mode provided real-time dynamic sensation of the paretic hand. Results of the preliminary clinical tests revealed a quantitative evaluation of the patient's level of paresis and disability.

  19. Arterial calcifications at the hand: Normal development and its course in patients on maintenance dialysis

    Energy Technology Data Exchange (ETDEWEB)

    Fischer, E.

    1987-03-01

    Normally, the arterial calcifications at the hand progress form proximal to distal and do not reach the fingers in the 8th decade. In patients on maintenance dialysis the arterial calcifications begin earlier and do not progress with age. The most severe arterial calcifications occur in patients with renal failure caused by diabetic nephropathy. Prognostically arterial calcifications in the finger-metacarpal region are an unfavourable sign.

  20. Sorafenib-induced hand-foot syndrome in a patient of renal cell carcinoma

    Directory of Open Access Journals (Sweden)

    Amrita Sil

    2014-01-01

    Full Text Available Sorafenib, a multikinase inhibitor, is approved for treatment of renal cell cancer and hepatocellular cancer. Hand-foot syndrome (HFD is a condition where erythema, scaling, and bullous lesion affect the hand and feet. In this case, a post-nephrectomy renal carcinoma patient prescribed sorafenib developed HFD 1 week after the drug usage. All laboratory parameters were within normal limits. The dose of sorafenib was reduced and topical corticosteroids, antihistamines, and emollients were prescribed. The reaction reduced after 2 weeks of therapy, only to reappear again when the second cycle of sorafenib-targeted therapy was started. The case was diagnosed as sorafenib-induced HFD.

  1. Peripheral Intravenous Catheterisation in Obstetric Patients in the Hand or Forearm Vein: A Randomised Trial.

    Science.gov (United States)

    Tan, Peng Chiong; Mackeen, Anjana; Khong, Su Yen; Omar, Siti Zawiah; Noor Azmi, M A

    2016-03-18

    A peripheral intravenous catheter is often inserted as part of care during labour. The catheter is inserted into the back of the hand or lower forearm vein in usual practice. There is no trial data to guide the care provider on which is the better insertion site in any clinical setting. 307 women admitted to the labour ward who required insertion of intravenous catheter were randomised to back of hand or lower forearm vein catheter insertion. Catheter insertion is by junior to mid-grade providers. We evaluated insertion success at the first attempt, pain during insertion and catheter replacement due to malfunction as main outcomes. After catheter removal, we recorded patient satisfaction with site, future site preference and insertion site swelling, bruising, tenderness, vein thrombosis and pain. Insertion of a catheter into back of hand vein is more likely to be successful at the first attempt. Insertion pain score, catheter replacement rate, patient satisfaction, patient fidelity to site in a future insertion and insertion site complications rate are not different between trial arms. In conclusion, both insertion sites are suitable; the back of the hand vein maybe easier to cannulate and seems to be preferred by our frontline providers.

  2. 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.

  3. Hand Grip Strength and Myocardial Oxygen Consumption Index among Coronary Artery Bypass Grafting Patients

    Directory of Open Access Journals (Sweden)

    Siti Nur Baait Biniti Mohd Sokran

    2015-07-01

    Full Text Available Background: Hand grip strength (HGS is a reliable indicator of peripheral muscle strength. Although, numerous studies have investigated the strength of hand grip; little attention has been given to coronary artery disease (CAD patients, exploring the relationship between HGS and myocardial oxygen consumption (MVO2 index. The current study aimed to evaluate the interaction between HGS and MVO2 index findings before and after cardiac surgery. Methods: Twenty-seven patients with CAD had HGS were assessed using handheld dynamometer. HGS for each hand were documented. MVO2 index was assessed using rate pressure product (RPP, which is the product of the heart rate (HR and systolic blood pressure (SBP. Repeated measures MANOVA were carried out to estimate the interaction between both hands HGS and MVO2 index before and after surgery. Results: There was significant interactions (P<0.001 for both HGS dominant and non-dominant with large effect sizes (HGS dominant×MVO2 index: hp2=0.44; HGS dominant×RPP: hp2=0.49. This signifies that peripheral muscle strength of the upper limb (HGS dominant and non-dominant had different effects on MVO2 index before and after surgery. The interaction graph shows that the increase in MVO2 index after surgery was significantly greater for peripheral muscle strength of the dominant hand when compared to non-dominant. Conclusion: Patients with CAD had interactions between HGS and oxygen consumption before and after surgery. Hence, HGS might be used as a predictor to assess oxygen consumption among cardiac patients.

  4. Readability and comprehensibility of patient education material in hand-related web sites.

    Science.gov (United States)

    Wang, Steve W; Capo, John T; Orillaza, Nathaniel

    2009-09-01

    As patients are more frequently referring to the Internet for information on their musculoskeletal problems, the readability and comprehensibility of these educational materials becomes increasingly more important to most of the lay public. In this study, we investigated the readability of the currently available web sites of the American Society for Surgery of the Hand (ASSH) and the American Academy of Orthopaedic Surgeons (AAOS) that pertain to hand and wrist problems, to assess their usefulness as a source for patient information. We analyzed all articles available in 2008 from the AAOS web site within the Patient Education Library under the heading, "Hand & Wrist" and from the ASSH web site under the heading, "Hand Conditions." A total of 83 articles were identified for hand conditions. Each article was analyzed by the Flesch-Kincaid program available in Microsoft Office Word software and the Dale-Chall grade-level assessor. These program models analyze all words in the specified text and return a grade level that corresponds to the difficulty level of the text. The AAOS web sites contained 34 articles with a mean Flesch-Kincaid grade level of 8.5 and a mean Dale-Chall grade level of 8.8. The ASSH web site contained 49 articles showing a mean Flesch-Kincaid grade level of 10.4 and a mean Dale-Chall grade level of 10.8. Our results suggest that the patient education materials found on the AAOS and ASSH web sites have readability scores that are higher than the recommended reading levels and thus may be too difficult to be understood by a substantial portion of the U.S. population.

  5. 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),

  6. 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

  7. The prevalence of tenosynovitis of the interosseous tendons of the hand in patients with rheumatoid arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Rowbotham, Emma L. [Leeds Teaching Hospitals NHS Trust, Musculoskeletal Radiology Department, Leeds (United Kingdom); Freeston, Jane E. [Department of Rheumatology, Leeds Teaching Hospitals NHS Trust, Leeds (United Kingdom); Emery, Paul [University of Leeds, Arthritis Research UK, Leeds Musculoskeletal Biomedical Research Unit, LTHT Leeds Institute of Rheumatic Musculoskeletal Medicine, Leeds (United Kingdom); Grainger, Andrew J. [Leeds Teaching Hospitals NHS Trust, Musculoskeletal Radiology Department, Leeds (United Kingdom); Chapel Allerton Hospital, NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds (United Kingdom)

    2016-02-15

    The aim of this study was to establish the prevalence of tenosynovitis affecting the interosseous tendons of the hand in a rheumatoid arthritis (RA) population and to assess for association with metacarpophalangeal (MCP) joint synovitis, flexor tendon tenosynovitis or ulnar drift. Forty-four patients with RA underwent hand MRI along with 20 normal controls. Coronal 3D T1 VIBE sequences pre- and post-contrast were performed and reconstructed. The presence of interosseous tendon tenosynovitis was recorded alongside MCP joint synovitis, flexor tendon tenosynovitis and ulnar drift. Twenty-one (47.7 %) patients with RA showed interosseous tendon tenosynovitis. Fifty-two (14.8 %) interosseous tendons showed tenosynovitis amongst the RA patients. Interosseous tendon tenosynovitis was more commonly seen in association with adjacent MCP joint synovitis (p < 0.001), but nine MCP joints (5.1 %) showed adjacent interosseous tenosynovitis in the absence of joint synovitis. Interosseous tendon tenosynovitis was more frequently seen in fingers which also showed flexor tendon tenosynovitis (p < 0.001) and in patients with ulnar drift of the fingers (p = 0.01). Tenosynovitis of the hand interosseous tendons was found in 47.7 % of patients with RA. In the majority of cases this was adjacent to MCP joint synovitis; however, interosseous tendon tenosynovitis was also seen in isolation. (orig.)

  8. 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.

  9. Establishment of age- and sex-adjusted reference data for hand bone mass and investigation of hand bone loss in patients with rheumatoid arthritis treated in clinical practice

    DEFF Research Database (Denmark)

    Ørnbjerg, Lykke Midtbøll; Østergaard, Mikkel; Jensen, Trine

    2016-01-01

    BACKGROUND: Rheumatoid arthritis is characterised by progressive joint destruction and loss of periarticular bone mass. Hand bone loss (HBL) has therefore been proposed as an outcome measure for treatment efficacy. A definition of increased HBL adjusted for age- and sex-related bone loss is lacking....... In this study, we aimed to: 1) establish reference values for normal hand bone mass (bone mineral density measured by digital x-ray radiogrammetry (DXR-BMD)); and 2) examine whether HBL is normalised in rheumatoid arthritis patients during treatment with tumour necrosis factor alpha inhibitors (TNFI). METHODS......: DXR-BMD was measured from hand x-rays in a reference cohort (1485 men/2541 women) without arthritis randomly selected from an urban Danish population. Sex- and age-related HBL/year was estimated. DXR-BMD was measured in rheumatoid arthritis patients (n = 350: at start of TNFI, and ~2 years after TNFI...

  10. Research progress on evaluation of hand function in patients with hand injury%手外伤病人手功能评估的研究进展

    Institute of Scientific and Technical Information of China (English)

    刘兴红; 喻姣花

    2015-01-01

    It described the research progress on evaluation index and evaluation tools of hand function in patients with hand injury.It summarized the advantages and disadvantages of objective and subjective evaluation meth-ods,and provided some guidance for the clinical and rehabilitation workers choosing appropriate assessment tools,so as to implement individualized rehabilitation measures and promote the social rehabilitation in patients with hand injury.%阐述了手外伤病人手功能评价指标以及评估工具的研究进展,总结了客观与主观评估方法的优缺点,为临床和康复工作者选择合适的评估工具提供指导以实施个性化的康复措施,促进手外伤病人的社会化康复。

  11. Measurement Properties of the Brief Michigan Hand Outcomes Questionnaire in Patients With Dupuytren Contracture.

    Science.gov (United States)

    Wehrli, Martina; Hensler, Stefanie; Schindele, Stephan; Herren, Daniel B; Marks, Miriam

    2016-09-01

    The brief Michigan Hand Outcomes Questionnaire (briefMHQ) was developed as a shorter version of the Michigan Hand Outcomes Questionnaire (MHQ), but its measurement properties have not been investigated in patients with Dupuytren contracture. The objective of the study was to investigate the reliability, validity, responsiveness, and interpretability of the briefMHQ. Fifty-seven patients diagnosed with Dupuytren contracture completed the briefMHQ as well as the full-length MHQ and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) questionnaire at baseline. Two to 14 days after baseline and 1 year after collagenase injection or surgery, patients again filled out the briefMHQ. Reliability was determined using the intraclass correlation coefficient and by calculating internal consistency (Cronbach alpha). Validity was tested by quantifying correlations with the full-length MHQ and QuickDASH. Responsiveness, based on the standardized response mean and the minimally clinically important change, was also determined. The briefMHQ had an intraclass correlation coefficient of 0.87, Cronbach alpha of 0.88, and correlations of r = 0.88 and -0.82 with the original MHQ and QuickDASH, respectively. The standardized response mean was 0.9 and the minimally clinically important change was 7 points. Overall, the briefMHQ demonstrates excellent reliability, good validity, and high responsiveness in patients with Dupuytren contracture. The briefMHQ is an accurate and time-saving tool to evaluate patients with Dupuytren contracture and the effect of a corresponding treatment. Copyright © 2016 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  12. Representation of patients’ hand modulates fear reactions of patients with spider phobia in virtual reality

    Directory of Open Access Journals (Sweden)

    Henrik Moriz Peperkorn

    2016-02-01

    Full Text Available Embodiment (i.e., the involvement of a bodily representation is thought to be relevant in emotional experiences. Virtual reality (VR is a capable means of activating phobic fear in patients. The representation of the patient’s body (e.g., the right hand in VR enhances immersion and increases presence, but its effect on phobic fear is still unknown. We analyzed the influence of the presentation of the participant’s hand in VR on presence and fear responses in 32 women with spider phobia and 32 matched controls. Participants sat in front of a table with an acrylic glass container within reaching distance. During the experiment this setup was concealed by a head-mounted display (HMD. The VR scenario presented via HMD showed the same setup, i.e. a table with an acrylic glass container. Participants were randomly assigned to one of two experimental groups. In one group, fear responses were triggered by fear-relevant visual input in VR (virtual spider in the virtual acrylic glass container, while information about a real but unseen neutral control animal (living snake in the acrylic glass container was given. The second group received fear-relevant information of the real but unseen situation (living spider in the acrylic glass container, but visual input was kept neutral VR (virtual snake in the virtual acrylic glass container. Participants were instructed to touch the acrylic glass container with their right hand in 20 consecutive trials. Visibility of the hand was varied randomly in a within-subjects design. We found for all participants that visibility of the participant’s hand increased presence independently of the fear trigger. However, in patients, the influence of the virtual hand on fear depended on the fear trigger. When fear was triggered perceptually, i.e., by a virtual spider, the virtual hand increased fear. When fear was triggered by information about a real spider, the virtual hand had no effect on fear. Our results shed light

  13. Representation of Patients’ Hand Modulates Fear Reactions of Patients with Spider Phobia in Virtual Reality

    Science.gov (United States)

    Peperkorn, Henrik M.; Diemer, Julia E.; Alpers, Georg W.; Mühlberger, Andreas

    2016-01-01

    Embodiment (i.e., the involvement of a bodily representation) is thought to be relevant in emotional experiences. Virtual reality (VR) is a capable means of activating phobic fear in patients. The representation of the patient’s body (e.g., the right hand) in VR enhances immersion and increases presence, but its effect on phobic fear is still unknown. We analyzed the influence of the presentation of the participant’s hand in VR on presence and fear responses in 32 women with spider phobia and 32 matched controls. Participants sat in front of a table with an acrylic glass container within reaching distance. During the experiment this setup was concealed by a head-mounted display (HMD). The VR scenario presented via HMD showed the same setup, i.e., a table with an acrylic glass container. Participants were randomly assigned to one of two experimental groups. In one group, fear responses were triggered by fear-relevant visual input in VR (virtual spider in the virtual acrylic glass container), while information about a real but unseen neutral control animal (living snake in the acrylic glass container) was given. The second group received fear-relevant information of the real but unseen situation (living spider in the acrylic glass container), but visual input was kept neutral VR (virtual snake in the virtual acrylic glass container). Participants were instructed to touch the acrylic glass container with their right hand in 20 consecutive trials. Visibility of the hand was varied randomly in a within-subjects design. We found for all participants that visibility of the participant’s hand increased presence independently of the fear trigger. However, in patients, the influence of the virtual hand on fear depended on the fear trigger. When fear was triggered perceptually, i.e., by a virtual spider, the virtual hand increased fear. When fear was triggered by information about a real spider, the virtual hand had no effect on fear. Our results shed light on the

  14. Hand, foot and scrotal blisters in a patient with cancer receiving oral chemotherapy.

    Science.gov (United States)

    Guerra, Jose Rodolfo; Suelves, Ana M; Bella, Archie; Lolo, Delatre

    2014-05-19

    Tyrosine kinase inhibitors are novel antineoplastic drugs that make use of the molecular abnormalities that have been discovered in certain types of tumours. These agents are associated with important dermatological side effects. This case report discusses an atypical presentation of the hand-foot syndrome in one patient treated with sorafenib. A 78-year-old man, recently started on sorafenib for the treatment of hepatocarcinoma with lung metastasis, presented to the emergency room with painful blistering lesions on the palms, soles and scrotum for 1 week. A punch biopsy was performed and sorafenib was withheld. Direct immunofluorescence study was negative for an autoimmune blistering disorder and histopathology stains did not show any microorganisms. A diagnosis of hand-foot syndrome was made. After 2 weeks, the patient showed marked improvement and the plan was to restart sorafenib at a lower dosage.

  15. 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.

  16. [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.

  17. Radiological and clinical outcome after operations in patients with congenital deficiencies of the wrist and hand

    Energy Technology Data Exchange (ETDEWEB)

    Schmelzer-Schmied, Nicole; Jung, Martin [Department of Orthopedic Surgery, University of Heidelberg (Germany); Ludwig, Karl, E-mail: karl.ludwig@klinikum-herford.de [Department of Diagnostic and Interventional Radiology, Klinikum Herford (Germany)

    2011-02-15

    Purpose: To evaluate the incidence, therapy results, complications and radiologic workup of operatively treated congenital disorders of the hand and wrist in a large university center during a 10-year period. Methods: The institutional database was retrospectively analysed for patients with congenital disorders of the hand and wrist treated operatively during a 10-year period (1998-2007). Disorders were classified according to Van Schoonhoven into 11 different entities. For each entity the incidence, the patients' age at the time of operation, the pre- and postoperative clinical and radiological workup and the frequency of complications and reoperations were evaluated. Results: A total of 278 patients was treated operatively for congenital disorders of the hand and wrist with syndactyly being present in 112, thumb hypoplasia in 15, polydactyly in 11, radial clubhand in 7, radioulnar synostosis in 6, clinodactyly in 6, thumb duplication in 6, brachydactyly in 4 and macrodactyly in 4 cases. Patients' age at the time of operation varied substantially between the different entities with a mean age between 0.9 and 6.2 years. There were 9 complications (3%, n = 278) - all of them infections. There were 28 reoperations (10%, n = 278), 13 of them (5%, n = 278) due to reoccurring webs in syndactyly. Conclusion: Congenital disorders of the hand and wrist include various rare diseases with syndactyly and thumb hypoplasia being the most frequent entities. As a rule, diagnosis is obtained clinically. Radiologic workup typically consists of plain radiography. Complications are rare, whereas reoperations are frequent, mostly due to reoccurring webs in syndactyly.

  18. Effects of hand massage and acupressure therapy for mechanically ventilated patients

    Directory of Open Access Journals (Sweden)

    Şebnem Çınar Yücel

    2015-10-01

    Results: According to the research findings, it wasn’t found significant as clinical which is the statistically significant difference in the physiological indicators of anxiety, perceived anxiety and dyspnoea except from oxygen saturation. Conclusion: In conclusion, our results suggest that hand massage and acupressure therapy might effectively relieve perceived dyspnoea and anxiety and reduce physiological indicators of anxiety in patients having mechanical ventilation support. The study provides a research-based intervention model for clinicians caring for MVP.

  19. Patient experiences of partnering with healthcare professionals for hand hygiene compliance: a systematic review.

    Science.gov (United States)

    Butenko, Samantha; Lockwood, Craig; McArthur, Alexa

    2017-06-01

    Healthcare-associated infections pose a significant risk to patients in acute healthcare settings such as hospitals. Increasingly, patients are encouraged to be active participants and partner with healthcare professionals to positively influence their own safety and overall experience throughout their healthcare journey. Patient-focused safety initiatives include the empowerment of patients to be active partners with healthcare professionals in order to influence the hand hygiene behaviors and compliance of the healthcare professionals providing care to them. Partnering within the context of healthcare, and between the patient and healthcare professional, can be considered as a general concept that involves the empowerment of patients to participate in their care. Terms used to describe patient partnering within healthcare vary and include patient participation, patient-centeredness, patient empowerment and patient engagement. Although patients appear generally to have positive attitudes and intentions about engaging in their safety and partnering in the healthcare setting, their intentions and actual behaviors vary considerably. Patients appear less likely to engage in behaviors that require questioning of the perceived or real authority of healthcare professionals. A patient's intention and subsequent act of partnering with healthcare professionals for hand hygiene compliance by the healthcare professional are influenced by complex internal, external and social factors as well as cultural, behavioral and systematic factors. To determine the best available evidence in relation to the experiences of the patient partnering with healthcare professionals for hand hygiene compliance. The current review considered qualitative (critical or interpretive) papers that included adult in-patients and healthcare professionals (medical and nursing staff), in the acute hospital-care setting. Adult was considered to be any person aged 18 years or over. It should be noted that

  20. 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.

  1. A radiographic evaluation of temporomandibular and hand (Metacarpophalangeal) / wrist joints of patients with adult rheumatoid arthritis

    Science.gov (United States)

    Kurup, Seema; Gharote, Harshkant; Jose, Renju

    2012-01-01

    Background: A review of literature revealed that, although the involvement of temporomandibular joint (TMJ) in rheumatoid arthritis (RA) patients is not uncommon, variation in presentation persist. Comparative studies of bony changes in the right and left TMJ with the right and left peripheral hand (Metacarpophalangeal-MCP)/wrist joints have not been done, to the best of our knowledge. Materials and Methods: In this cross-sectional study, the temporomandibular and hand (MCP) and wrist joints of fifteen rheumatoid arthritis patients were evaluated with questionnaires, clinical and lab assessment and radiographically using conventional radiographs and computed tomography. Students t-test was applied for the statistical analysis of the data obtained and a P value of 0.05 was considered as statistically significant. Results: Comparisons between the right TMJ with right MCP/wrist joint and left TMJ with left MCP/wrist joint did not reveal statistically significant results. Radiographically, flattening and erosions were the common manifestations. MCP joints were more affected than the wrist, but whenever the wrist was involved, it was more likely to be bilaterally affected. Conclusions: Although the TMJ showed osseous changes of a higher grade than the hand (MCP) and wrist joints radiographically, it was observed that patients were more aware of the peripheral joint discomfort. There were no significant differences between TMJ and peripheral joints on both right and left sides. PMID:23814559

  2. An exploratory study of patient's feelings about asking healthcare professionals to wash their hands.

    Science.gov (United States)

    Duncan, C

    2007-01-01

    The purpose of this study was to explore patient opinion about asking healthcare professionals to wash their hands prior to a clinical procedure and to explore if MRSA status and access to patient information about infection control would influence anxiety about asking. A descriptive survey was undertaken using a semi-structured questionnaire. The questionnaire was distributed to a randomised convenience sample of 185 in-patients across all departments of an acute NHS Trust hospital (response rate 59.4%). Spearman's rank order and Kendall Tau-b tests were used to analyse specific correlations. Respondents were more confident than anxious to be involved in a campaign that asked patients to ask staff to wash their hands. Patients were more anxious to ask if previous admission episodes were fewer, if their knowledge of MRSA was high and if there was less information about infection control available. Less anxiety was associated with patients who had MRSA in the past and the suggestion that staff wore badges saying 'It's OK to ask'.

  3. 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.

  4. 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.

  5. 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.

  6. Robot training for hand motor recovery in subacute stroke patients: A randomized controlled trial.

    Science.gov (United States)

    Orihuela-Espina, Felipe; Roldán, Giovana Femat; Sánchez-Villavicencio, Israel; Palafox, Lorena; Leder, Ronald; Sucar, Luis Enrique; Hernández-Franco, Jorge

    2016-01-01

    Evidence of superiority of robot training for the hand over classical therapies in stroke patients remains controversial. During the subacute stage, hand training is likely to be the most useful. To establish whether robot active assisted therapies provides any additional motor recovery for the hand when administered during the subacute stage (stroke. Compared to classical occupational therapy, robot based therapies for hand recovery will show significant differences at subacute stages. A randomized clinical trial. A between subjects randomized controlled trial was carried out on subacute stroke patients (n = 17) comparing robot active assisted therapy (RT) with a classical occupational therapy (OT). Both groups received 40 sessions ensuring at least 300 repetitions per session. Treatment duration was (mean ± std) 2.18 ± 1.25 months for the control group and 2.44 ± 0.88 months for the study group. The primary outcome was motor dexterity changes assessed with the Fugl-Meyer (FMA) and the Motricity Index (MI). Both groups (OT: n = 8; RT: n = 9) exhibited significant improvements over time (Non-parametric Cliff's delta-within effect sizes: dwOT-FMA = 0.5, dwOT-MI = 0.5, dwRT-FMA = 1, dwRT-MI = 1). Regarding differences between the therapies; the Fugl-Meyer score indicated a significant advantage for the hand training with the robot (FMA hand: WRS: W = 8, p Robotic therapies may be useful during the subacute stages of stroke - both endpoints (FM hand and MI prehension) showed the expected trend with bigger effect size for the robotic intervention. Additional benefit of the robotic therapy over the control therapy was only significant when the difference was measured with FM, demanding further investigation with larger samples. Implications of this study are important for decision making during therapy administration and resource allocation. Copyright © 2016 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

  7. 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

  8. 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.

  9. Attenuation of beta and gamma oscillations in schizophrenia spectrum patients following hand posture perturbation

    DEFF Research Database (Denmark)

    Arnfred, Sidse M.; Mørup, Morten; Thalbitzer, Jørgen

    2011-01-01

    spectrum traits would involve proprioceptive information processing and this has recently been supported by the finding of diminished latency of early proprioceptive evoked potentials in a sample of chronic schizophrenia patients. The proprioceptive stimulus used previously, and presently, consisted...... of an abrupt increase of weight on a hand-held load. Eighteen first-time admitted schizophrenia spectrum patients and 18 healthy matched comparison subjects were included. Proprioceptive evoked potentials were recorded as 64-channels EEG for 120 trials in two runs differing in sequence. Contra-lateral evoked...

  10. Measuring the validation of assessing the non-dominant-hand function by ALSFRS-r in Chinese ALS patients.

    Science.gov (United States)

    Hu, Fangfang; Jin, Jiaoting; Jia, Rui; Xiang, Li; Qi, Huaguang; Zhao, Xing; Dang, Jingxia

    2017-09-05

    ALSFRS-r is a widely accepted rating scale for measuring the global function of Amyotrophic Lateral Sclerosis (ALS) patients, but we found some limitations of ALSFRS-r in assessing the function of non-dominant hand in Chinese ALS patients. We reviewed 95 ALS patients who expressed upper-limb symptoms at first visit and analyzed the ALSFRS-r score and subscale. In both upper limb involved patients, the ALSFRS-r had no difference between dominant-hand and non-dominant-hand onset groups (39.15±5.55 vs 38.0±5.91, p=0.477). But in only one upper limb involved patients, the ALSFRS-r score in non-dominant-hand onset patients was higher than dominant-hand onset patients (43.94±3.44 vs 40.87±4.42, pr score was significantly lower than original ALSFRS-r (43.94±3.44 vs 42.88±3.07 p=0.001), the progression rate was slower (0.81±0.63 vs 0.64±0.63, p=0.001). So, for Chinese ALS patients, using food bowl and chopsticks should replace the item of cutting food and handling utensils to assess the non-dominant-hand function, especially in non-dominant-hand onset patients. Copyright © 2017. Published by Elsevier Ltd.

  11. Connectivity-based predictions of hand motor outcome for patients at the subacute stage after stroke

    Directory of Open Access Journals (Sweden)

    Julia eLindow

    2016-03-01

    Full Text Available Background. Connectivity-based predictions of hand motor outcome have been proposed to be useful in stroke patients. We intended to assess the prognostic value of different imaging methods on short-term (3 months and long-term (6 months motor outcome after stroke. Methods. We measured resting state functional connectivity (rsFC, diffusion weighted imaging (DWI and grip strength in 19 stroke patients within the first days (5-9 days after stroke. Outcome measurements for short-term (3 months and long-term (6 months motor function was assessed by the Motricity Index (MI of the upper limb and the Box and Block test (BB. Patients were predominantly mildly affected since signed consent was necessary at inclusion. We performed a multiple stepwise regression analysis to compare the predictive value of rsFC, DWI and clinical measurements. Results. Patients showed relevant improvement in both motor outcome tests. As expected grip strength at inclusion was a predictor for short- and long-term motor outcome as assessed by MI. Diffusion-based tract volume (DTV of the tracts between ipsilesional primary motor cortex and contralesional anterior cerebellar hemisphere showed a strong trend (p=0.05 for a predictive power for long-term motor outcome as measured by MI. DTV of the interhemispheric tracts between both primary motor cortices was predictive for both short - and long-term motor outcome in BB. rsFC was not associated with motor outcome. Conclusions. Grip strength is a good predictor of hand motor outcome concerning strength-related measurements (MI for mildly affected subacute patients. Therefore additional connectivity measurements seem to be redundant in this group. Using more complex movement recruiting bilateral motor areas as an outcome parameter, DTV and in particular interhemispheric pathways might enhance predictive value of hand motor outcome.

  12. Measurement error in grip and pinch force measurements in patients with hand injuries.

    Science.gov (United States)

    Schreuders, Ton A R; Roebroeck, Marij E; Goumans, Janine; van Nieuwenhuijzen, Johan F; Stijnen, Theo H; Stam, Henk J

    2003-09-01

    There is limited documentation of measurement error of grip and pinch force evaluation methods. The purposes of this study were (1) to determine indexes of measurement error for intraexaminer and interexaminer measurements of grip and pinch force in patients with hand injuries and (2) to investigate whether the measurement error differs between measurements of the injured and noninjured hands and between experienced and inexperienced examiners. The subjects were a consecutive sample of 33 patients with hand injuries who were seen in the Department of Rehabilitation Medicine of Erasmus MC-University Medical Center Rotterdam in the Netherlands. Repeated measurements were taken of grip and pinch force, with a short break of 2 to 3 minutes between sessions. For the grip force in 2 handle positions (distance between handles of 4.6 and 7.2 cm, respectively), tip pinch (with the index finger on top and the thumb below, with the other fingers flexed) and key pinch force (with the thumb on top and the radial side of the index finger below) data were obtained on both hands of the subjects by an experienced examiner and an inexperienced examiner. Intraclass correlation coefficients (ICCs), standard errors of measurement (SEMs), and associated smallest detectable differences (SDDs) were calculated and compared with data from previous studies. The reliability of the measurements was expressed by ICCs between .82 and .97. For grip force measurements (in the second handle position) by the experienced examiner, an SDD of 61 N was found. For tip pinch and key pinch, these values were 12 N and 11 N, respectively. For measurements by the inexperienced examiner, SDDs of 56 N for grip force and 13 N and 18 N for tip pinch and key pinch were found. Based on the SEMs and SDDs, in individual patients only relatively large differences in grip and pinch force measurements can be adequately detected between consecutive measurements. Measurement error did not differ between injured and

  13. Development of virtual reality exercise of hand motion assist robot for rehabilitation therapy by patient self-motion control.

    Science.gov (United States)

    Ueki, Satoshi; Nishimoto, Yutaka; Abe, Motoyuki; Kawasaki, Haruhisa; Ito, Satoshi; Ishigure, Yasuhiko; Mizumoto, Jun; Ojika, Takeo

    2008-01-01

    This paper presents a virtual reality-enhanced hand rehabilitation support system with a symmetric master-slave motion assistant for independent rehabilitation therapies. Our aim is to provide fine motion exercise for a hand and fingers, which allows the impaired hand of a patient to be driven by his or her healthy hand on the opposite side. Since most disabilities caused by cerebral vascular accidents or bone fractures are hemiplegic, we adopted a symmetric master-slave motion assistant system in which the impaired hand is driven by the healthy hand on the opposite side. A VR environment displaying an effective exercise was created in consideration of system's characteristic. To verify the effectiveness of this system, a clinical test was executed by applying to six patients.

  14. Haptic-based neurorehabilitation in poststroke patients: a feasibility prospective multicentre trial for robotics hand rehabilitation.

    Science.gov (United States)

    Turolla, Andrea; Daud Albasini, Omar A; Oboe, Roberto; Agostini, Michela; Tonin, Paolo; Paolucci, Stefano; Sandrini, Giorgio; Venneri, Annalena; Piron, Lamberto

    2013-01-01

    Background. Haptic robots allow the exploitation of known motor learning mechanisms, representing a valuable option for motor treatment after stroke. The aim of this feasibility multicentre study was to test the clinical efficacy of a haptic prototype, for the recovery of hand function after stroke. Methods. A prospective pilot clinical trial was planned on 15 consecutive patients enrolled in 3 rehabilitation centre in Italy. All the framework features of the haptic robot (e.g., control loop, external communication, and graphic rendering for virtual reality) were implemented into a real-time MATLAB/Simulink environment, controlling a five-bar linkage able to provide forces up to 20 [N] at the end effector, used for finger and hand rehabilitation therapies. Clinical (i.e., Fugl-Meyer upper extremity scale; nine hold pegboard test) and kinematics (i.e., time; velocity; jerk metric; normalized jerk of standard movements) outcomes were assessed before and after treatment to detect changes in patients' motor performance. Reorganization of cortical activation was detected in one patient by fMRI. Results and Conclusions. All patients showed significant improvements in both clinical and kinematic outcomes. Additionally, fMRI results suggest that the proposed approach may promote a better cortical activation in the brain.

  15. Haptic-Based Neurorehabilitation in Poststroke Patients: A Feasibility Prospective Multicentre Trial for Robotics Hand Rehabilitation

    Science.gov (United States)

    Daud Albasini, Omar A.; Oboe, Roberto; Tonin, Paolo; Paolucci, Stefano; Sandrini, Giorgio; Piron, Lamberto

    2013-01-01

    Background. Haptic robots allow the exploitation of known motor learning mechanisms, representing a valuable option for motor treatment after stroke. The aim of this feasibility multicentre study was to test the clinical efficacy of a haptic prototype, for the recovery of hand function after stroke. Methods. A prospective pilot clinical trial was planned on 15 consecutive patients enrolled in 3 rehabilitation centre in Italy. All the framework features of the haptic robot (e.g., control loop, external communication, and graphic rendering for virtual reality) were implemented into a real-time MATLAB/Simulink environment, controlling a five-bar linkage able to provide forces up to 20 [N] at the end effector, used for finger and hand rehabilitation therapies. Clinical (i.e., Fugl-Meyer upper extremity scale; nine hold pegboard test) and kinematics (i.e., time; velocity; jerk metric; normalized jerk of standard movements) outcomes were assessed before and after treatment to detect changes in patients' motor performance. Reorganization of cortical activation was detected in one patient by fMRI. Results and Conclusions. All patients showed significant improvements in both clinical and kinematic outcomes. Additionally, fMRI results suggest that the proposed approach may promote a better cortical activation in the brain. PMID:24319496

  16. Haptic-Based Neurorehabilitation in Poststroke Patients: A Feasibility Prospective Multicentre Trial for Robotics Hand Rehabilitation

    Directory of Open Access Journals (Sweden)

    Andrea Turolla

    2013-01-01

    Full Text Available Background. Haptic robots allow the exploitation of known motorlearning mechanisms, representing a valuable option for motor treatment after stroke. The aim of this feasibility multicentre study was to test the clinical efficacy of a haptic prototype, for the recovery of hand function after stroke. Methods. A prospective pilot clinical trial was planned on 15 consecutive patients enrolled in 3 rehabilitation centre in Italy. All the framework features of the haptic robot (e.g., control loop, external communication, and graphic rendering for virtual reality were implemented into a real-time MATLAB/Simulink environment, controlling a five-bar linkage able to provide forces up to 20 [N] at the end effector, used for finger and hand rehabilitation therapies. Clinical (i.e., Fugl-Meyer upper extremity scale; nine hold pegboard test and kinematics (i.e., time; velocity; jerk metric; normalized jerk of standard movements outcomes were assessed before and after treatment to detect changes in patients' motor performance. Reorganization of cortical activation was detected in one patient by fMRI. Results and Conclusions. All patients showed significant improvements in both clinical and kinematic outcomes. Additionally, fMRI results suggest that the proposed approach may promote a better cortical activation in the brain.

  17. Effect of virtual reality distraction on pain among patients with hand injury undergoing dressing change.

    Science.gov (United States)

    Guo, Chunlan; Deng, Hongyan; Yang, Jian

    2015-01-01

    To assess the effect of virtual reality distraction on pain among patients with a hand injury undergoing a dressing change. Virtual reality distraction can effectively alleviate pain among patients undergoing a dressing change. Clinical research has not addressed pain control during a dressing change. A randomised controlled trial was performed. In the first dressing change sequence, 98 patients were randomly divided into an experimental group and a control group, with 49 cases in each group. Pain levels were compared between the two groups before and after the dressing change using a visual analog scale. The sense of involvement in virtual environments was measured using the Pearson correlation coefficient analysis, which determined the relationship between the sense of involvement and pain level. The difference in visual analog scale scores between the two groups before the dressing change was not statistically significant (t = 0·196, p > 0·05), but the scores became statistically significant after the dressing change (t = -30·792, p virtual environment and pain level during the dressing was statistically significant (R(2) = 0·5538, p Virtual reality distraction can effectively alleviate pain among patients with a hand injury undergoing a dressing change. Better results can be obtained by increasing the sense of involvement in a virtual environment. Virtual reality distraction can effectively relieve pain without side effects and is not reliant on a doctor's prescription. This tool is convenient for nurses to use, especially when analgesics are unavailable. © 2014 John Wiley & Sons Ltd.

  18. The initial ultrasonographic examination of hands and feet joints in patients with early rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Monika Ponikowska

    2015-09-01

    Full Text Available Objectives : The aim was to assess of the morphology, intensity, and activity of changes in the first ultrasonographic (US examination of hands and feet in patients with early arthritis (lasting up to 12 months who were ultimately diagnosed with rheumatoid arthritis (RA. An attempt was made to demonstrate a correlation between the intensity of lesions in US and selected laboratory parameters. Material and methods : Ultrasonographic examination was performed using a LOGIC GE 500 device on a group of 60 patients with arthritis (46 women, 14 men aged 18–80, previously untreated. In total, 3120 hand and feet joints were examined. The assessment focused on the presence of joint effusion, synovial proliferation and power Doppler signals (assessed on a semi-quantitative scale. Each patient underwent laboratory tests, necessary for making a diagnosis. In order to analyze the correlations between changes in US and laboratory parameters, erythrocyte sedimentation rate (ESR, reactive protein test (CRP, rheumatoid factor (RF, and anti-citrullinated protein antibodies (ACPAs were used. Results : In the study group, the average duration of arthritis symptoms until the first US examination was 5.6 months. Among the 3120 examined hand and foot joints, deviations from the norm appeared in 1093 joints, synovial hypertrophy was found in 471 joints (grade 1 synovial hypertrophy was reported most frequently, while presence of signal in Power Doppler was revealed in 261 joints (grade 1 was observed most frequently. A statistically significant correlation was found between the intensity of changes in Power Doppler and CRP concentration. Conclusions : In patients with increased concentrations of CRP, we may expect arthritis of higher intensity, therefore, in order to prevent the progression of destructive changes, it is necessary to quickly implement effective disease-modifying antirheumatic treatment. The conducted research showed that the activity of joint

  19. Topical herbal medicines for atopic eczema: a systematic review of randomized controlled trials.

    Science.gov (United States)

    Thandar, Y; Gray, A; Botha, J; Mosam, A

    2017-02-01

    Despite the availability of medicines with proven efficacy, many patients use complementary or alternative medicines (CAMs) to manage atopic eczema (AE). Due to the lack of objective information on topical CAMs, this systematic review evaluates the current evidence for the efficacy and safety of topical herbal preparations in AE. Using Cochrane systematic review methodology, PubMed, the Cochrane Library, the Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL (via EBSCO), MEDLINE (via EBSCO), Proquest Health and Medical Complete, GREAT and CAM-QUEST were searched from inception until June 2014. Bibliographies of retrieved studies were hand searched for further relevant trials. All controlled clinical trials of topical herbal medicines for AE in humans of any age were included regardless of the control intervention or randomization. Only English-language publications were considered. Eight studies met the inclusion criteria. Seven investigated extracts of single plants and one an extract from multiple plants. Only two studies that showed a positive effect were considered to have a low risk of bias across all domains (those of liquorice gel and Hypericum perforatum). In these two, the test product was reported to be superior to placebo. Despite variations in diagnostic criteria and lack of validated tools for outcome assessments in one of these, the promising results may warrant continued research in better-designed studies. No meta-analysis was performed due to heterogeneity in all studies. There is currently insufficient evidence of efficacy for any topical herbal extract in AE. Many studies had methodological flaws and even those showing efficacy were single trials with small patient cohorts. © 2016 British Association of Dermatologists.

  20. 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.

  1. 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.

  2. Clinical application of computerized evaluation and re-education biofeedback prototype for sensorimotor control of the hand in stroke patients

    Directory of Open Access Journals (Sweden)

    Hsu Hsiu-Yun

    2012-05-01

    Full Text Available Abstract Background Hemianaesthesia patients usually exhibit awkward and inefficient finger movements of the affected hands. Conventionally, most interventions emphasize the improvement of motor deficits, but rarely address sensory capability and sensorimotor control following stroke. Thus it is critical for stroke patients with sensory problems to incorporate appropriate strategies for dealing with sensory impairment, into traditional hand function rehabilitation programs. In this study, we used a custom-designed computerized evaluation and re-education biofeedback (CERB prototype to analyze hand grasp performances, and monitor the training effects on hand coordination for stroke patients with sensory disturbance and without motor deficiency. Methods The CERB prototype was constructed to detect momentary pinch force modulation for 14 sub-acute and chronic stroke patients with sensory deficiency and 14 healthy controls. The other ten chronic stroke patients (ranges of stroke period: 6–60 months were recruited to investigate the effects of 4-weeks computerized biofeedback treatments on the hand control ability. The biofeedback procedures provide visual and auditory cues to the participants when the interactive force of hand-to-object exceeded the target latitude in a pinch-up-holding task to trigger optimal motor strategy. Follow-up measurements were conducted one month after training. The hand sensibility, grip forces and results of hand functional tests were recorded and analyzed. Results The affected hands of the 14 predominant sensory stroke patients exhibited statistically significant elevation in the magnitude of peak pinch force (p = 0.033 in pinching and lifting-up tasks, and poor results for hand function tests (p = 0.005 than sound hands did. In addition, the sound hands of patients were less efficient in force modulation (p = 0.009 than the hands of healthy subjects were. Training with the biofeedback system produced

  3. Clinical application of computerized evaluation and re-education biofeedback prototype for sensorimotor control of the hand in stroke patients.

    Science.gov (United States)

    Hsu, Hsiu-Yun; Lin, Cheng-Feng; Su, Fong-Chin; Kuo, Huan-Ting; Chiu, Haw-Yen; Kuo, Li-Chieh

    2012-05-09

    Hemianaesthesia patients usually exhibit awkward and inefficient finger movements of the affected hands. Conventionally, most interventions emphasize the improvement of motor deficits, but rarely address sensory capability and sensorimotor control following stroke. Thus it is critical for stroke patients with sensory problems to incorporate appropriate strategies for dealing with sensory impairment, into traditional hand function rehabilitation programs. In this study, we used a custom-designed computerized evaluation and re-education biofeedback (CERB) prototype to analyze hand grasp performances, and monitor the training effects on hand coordination for stroke patients with sensory disturbance and without motor deficiency. The CERB prototype was constructed to detect momentary pinch force modulation for 14 sub-acute and chronic stroke patients with sensory deficiency and 14 healthy controls. The other ten chronic stroke patients (ranges of stroke period: 6-60 months) were recruited to investigate the effects of 4-weeks computerized biofeedback treatments on the hand control ability. The biofeedback procedures provide visual and auditory cues to the participants when the interactive force of hand-to-object exceeded the target latitude in a pinch-up-holding task to trigger optimal motor strategy. Follow-up measurements were conducted one month after training. The hand sensibility, grip forces and results of hand functional tests were recorded and analyzed. The affected hands of the 14 predominant sensory stroke patients exhibited statistically significant elevation in the magnitude of peak pinch force (p = 0.033) in pinching and lifting-up tasks, and poor results for hand function tests (p = 0.005) than sound hands did. In addition, the sound hands of patients were less efficient in force modulation (p = 0.009) than the hands of healthy subjects were. Training with the biofeedback system produced significant improvements in grip force modulation (p = 0.020) and

  4. 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.

  5. EEG Event-Related Desynchronization of patients with stroke during motor imagery of hand movement

    Science.gov (United States)

    Tabernig, Carolina B.; Carrere, Lucía C.; Lopez, Camila A.; Ballario, Carlos

    2016-04-01

    Brain Computer Interfaces (BCI) can be used for therapeutic purposes to improve voluntary motor control that has been affected post stroke. For this purpose, desynchronization of sensorimotor rhythms of the electroencephalographic signal (EEG) can be used. But it is necessary to study what happens in the affected motor cortex of this people. In this article, we analyse EEG recordings of hemiplegic stroke patients to determine if it is possible to detect desynchronization in the affected motor cortex during the imagination of movements of the affected hand. Six patients were included in the study; four evidenced desynchronization in the affected hemisphere, one of them showed no results and the EEG recordings of the last patient presented high noise level. These results suggest that we could use the desynchronization of sensorimotor rhythms of the EEG signal as a BCI paradigm in a rehabilitation programme.

  6. 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

  7. 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.

  8. [Preventive measures for avoiding transmission of microorganisms between hospitalised patients. Hand hygiene].

    Science.gov (United States)

    Lupión, Carmen; López-Cortés, Luis Eduardo; Rodríguez-Baño, Jesús

    2014-11-01

    Health-care associated infections are an important public health problem worldwide. The rates of health-care associated infections are indicators of the quality of health care. The infection control activities related to prevention of transmission of hospital microorganisms can be grouped in 4 mayor areas: standard precautions, specific precautions (including isolation if appropriate), environmental cleaning and disinfection, and surveillance activities (including providing infection rates and monitoring procedures). Hand hygiene and the correct use of gloves are the most important measures to prevent health-care associated infections and to avoid the dissemination of multidrug-resistant microorganisms. Continuous educational activities aimed at improving adherence to hand hygiene are needed. Periodical assessment of adherence to hand hygiene recommendations with feed-back have been shown to provide sustained improvement. Several complementary activities are being evaluated, including skin decolonization prior to certain surgeries, a package of measures in patients with central venous catheters or mechanical ventilation, and universal body hygiene with chlorhexidine. The present area of discussion concerns in which situations and in which groups would such measures be effective and efficient. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  9. Fibroma of tendon sheath of the hand: a series of 20 patients with 23 tumours.

    Science.gov (United States)

    Al-Qattan, M M

    2014-03-01

    Fibroma of tendon sheath is an uncommon fibrous tumour that has a predilection for the hand. Large series from Histopathological Units report a local recurrence rate of 24% after surgical excision. In the hand/orthopaedic surgery literature, fibroma of tendon sheath was generally reported as isolated case reports with unusual presentations, such as triggering and carpal tunnel syndrome. The current article reports on a series of 23 tumours of the hands of 20 patients. These were all adults (mean age of 36 years) with a male to female ratio of 3:1. The thumb and index were the most common sites. A slow-growing painless mass was the clinical presentation in every case. Total surgical excision was ensured by excision of part of flexor sheath/palmar fascia to which the tumour was attached. Diagnosis was confirmed by the classic histological features of fibroma of tendon sheath. There were no recurrences at final follow-up 2-5 years after surgery.

  10. Teleneurology in patients with multiple sclerosis: EDSS ratings derived remotely and from hands-on examination.

    Science.gov (United States)

    Kane, Robert L; Bever, Christopher T; Ehrmantraut, Mary; Forte, Alan; Culpepper, William J; Wallin, Mitchell T

    2008-01-01

    We compared the telemedicine assessment of 20 patients with multiple sclerosis (MS) with the findings of a hands-on examiner. The remote specialist was a neurologist with expertise in MS; the hands-on examination was performed by an experienced mid-level practitioner. We also compared the findings of a second specialist viewing the examination in the room with the patient. The videoconference link operated at a bandwidth of 384 kbit/s. All three examiners independently completed a standardized rating scale for neurological functions. Cronbach's alpha for the three raters' total expanded disability status scale (EDSS) score was 0.99 with individual correlations ranging from 0.96-0.97. Agreement between raters for individual neurological domain scores was more variable. The most consistent assessments were for optic, bowel and bladder, and cerebral functions. The least consistent were for cerebellar and brain stem functions. Agreement between the remote and local examiners was similar to that reported for different neurological examiners directly assessing the same patient using the EDSS rating system.

  11. A new custom moldable external neck brace (ENB 2.0) to improve hands-free speech in laryngectomized patients

    NARCIS (Netherlands)

    Dirven, R.; Clark, J.R.; Wismans, J.G.; McGuiness, J.; Palme, C.E.; Blyth, K.; Baxter, C.; Stone, D.B.; Marres, H.A.M.

    2013-01-01

    OBJECTIVES/HYPOTHESIS: The majority of laryngectomy patients fail to use a hands-free valve on a daily basis, mainly due to fixation problems of the adhesive baseplate housing. To support adhesive housings during hands-free speech a new external neck brace (ENB 2.0) was developed. The effect of the

  12. Efficacy of alcohol gel for removal of methicillin-resistant Staphylococcus aureus from hands of colonized patients.

    Science.gov (United States)

    Sunkesula, Venkata; Kundrapu, Sirisha; Macinga, David R; Donskey, Curtis J

    2015-02-01

    Of 82 patients with methicillin-resistant Staphylococcus aureus (MRSA) colonization, 67 (82%) had positive hand cultures for MRSA. A single application of alcohol gel (2 mL) consistently reduced the burden of MRSA on hands. However, incomplete removal of MRSA was common, particularly in those with a high baseline level of recovery.

  13. Alexia without agraphia in a left-handed patient with prosopagnosia.

    Science.gov (United States)

    Aptman, M; Levin, H; Senelick, R C

    1977-06-01

    A left-handed patient was studied who had the acute onset of alexia without agraphia, a left homonymous hemianopia, and prosopagnosia. Neurodiagnostic tests including computerized axial tomography and angiography disclosed bilateral lesions in the posterior cerebral hemispheres involving the splenium of the corpus callosum. Neuropsychologic examination indicated marked impairment of facial discrimination, deficient naming and memory of presented visual material, and mild visual agnosia with relative preservation of other cognitive functions. These findings are consistent with a double disconnection syndrome involving disconnection of the dominant angular gyrus and right inferotemporal cortex from their bilateral visual inputs.

  14. Creeping eruption of the hand in an Iranian patient: Cutaneous larva migrans

    Directory of Open Access Journals (Sweden)

    Zabihollah Shahmoradi

    2014-01-01

    Full Text Available Cutaneous larva migrans (CLM, a serpiginous cutaneous eruption is the most commonly acquired tropical dermatosis. It is caused by infection with hookworm larvae in tropical and sub-tropical areas, and people who have a history of travel in these countries. The most frequent location of CLM is the distal lower extremities or buttocks. We describe a case of 57-year-old Iranian female patient with CLM of hand (unusual site without traveling to endemic countries that was successfully treated with oral albendazole. To the best of our knowledge, this is the first report of CLM in Iran.

  15. Unusual intraocular foreign bodies after an explosion: patient's hand bone fragments.

    Science.gov (United States)

    Sonmez, Murat; Duzgun, E; Yildirim, Y; Ayata, A; Unal, M H

    2016-04-01

    A 26-year-old Turkish Army soldier underwent full ophthalmoscopic examination after a penetrating ocular injury in the left eye due to the accidental explosion of a detonating fuse during handling. Visual acuity of the left eye was hand motion level. Funduscopy revealed foreign bodies suspended in the vitreous gel and accompanying vitreous haemorrhage. B-scan ultrasonography, CT of the orbits and microscopic examination of the intraocular foreign bodies (IOFBs) were performed prior to removal of bone fragments and pars plana vitrectomy. The IOFBs were fragments of the patients' bone tissue. Bone fragments from victim's body may cause IOFBs after an explosion in military personnel.

  16. 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.

  17. A hand-held ultrasound machine vs. conventional ultrasound machine in the bedside assessment of post-liver transplant patients.

    Science.gov (United States)

    Trinquart, Ludovic; Bruno, Onorina; Angeli, Maria Luigia; Belghiti, Jacques; Chatellier, Gilles; Vilgrain, Valérie

    2009-10-01

    The purpose was to assess the diagnostic accuracy of a hand-held Doppler ultrasound (US) machine for the bedside detection of liver and vascular abnormalities after liver transplantation in the intensive care unit. The IRB approved this study, and written informed consent was obtained from all patients or the patient's legal representative. Any liver transplant recipient at our institution who needed a bedside Doppler US examination in the intensive care unit was eligible. Patients underwent routine grey-scale, colour, and spectral Doppler US examinations of the liver with a conventional machine, which was taken as the reference method, and with a hand-held machine on the same day. Examinations followed one another and were performed in a blinded fashion by two radiologists. Over a 4-month period, 24 consecutive patients (16 men, median age 54 years old; 16 cadaveric and 8 living related right liver transplantations) underwent 43 examinations with both conventional and hand-held machines. Image quality and overall satisfaction scores of grey-scale were lower with the hand-held than with the conventional machine. The hand-held was similar to the conventional machine for assessing the patency of portal veins, hepatic veins and the IVC in all patients but one. The hand-held machine failed to detect signals in the right branch of the hepatic artery and in the hilum in two and one cases, respectively. There was no abnormal hepatic arterial flow with the conventional machine in any of the patients, and the results were the same with the hand-held machine. Total examination time was significantly longer with the hand-held machine. The hand-held US machine had a high diagnostic accuracy for both parenchymal and vascular analyses compared with a conventional US machine in the bedside assessment of post-liver transplant patients.

  18. 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

  19. 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

  20. Hand-assisted bilateral nephrectomy in a patient with adult polycystic kidney disease

    Directory of Open Access Journals (Sweden)

    Marcello Alves Pinto

    Full Text Available CONTEXT: Dominantly autosomal polycystic disease is characterized by multiple bilateral and non-functional cysts, which lead to progressive kidney failure. OBJECTIVE: Our objective was to report on a case of hand-assisted bilateral nephrectomy in a 28-year-old female patient with adult polycystic disease and recurring pyelonephritis in a kidney transplant program. CASE REPORT: A hand-assisted bilateral nephrectomy was performed through a supra-umbilical median incision of approximately 6 cm, and with 3 ports of 10 mm. The length of the surgery was 3 hours and 15 minutes. The kidneys were removed after the aspiration of some cysts through the supra-umbilical incision. Pain control was achieved via the use of analgesics. The blood loss during surgery was 160 ml. During the postoperative period, the patient developed right-side pneumothorax, which was drained with no further occurrence. This drain was kept in place for 48 hours. The length of hospitalization was 4 days.

  1. Comparison of the antibacterial efficacy and acceptability of an alcohol-based hand rinse with two alcohol-based hand gels during routine patient care.

    Science.gov (United States)

    Barbut, Frédéric; Maury, Eric; Goldwirt, Laurianne; Boëlle, Piérre-Yves; Neyme, Denis; Aman, Rubina; Rossi, Beatrice; Offenstadt, Georges

    2007-06-01

    The aims of this study were to compare the antibacterial efficacy of handrubbing with an alcoholic rinse (AHRR) and two different alcoholic gels (AHRG) in reducing hand contamination under practical use conditions. We wanted to assess the acceptability of the three products and to determine the effect of each product on overall hand hygiene compliance. A prospective alternating time-series clinical trial was performed in a medical intensive care unit. The study was divided into three six-week periods (P1, P2, P3). Handrubbing was achieved with Sterillium rinse (AHRR) during P1, sterillium gel(AHRG-1) during P2 and Manugel Plus (AHRG-2) during P3. Pre- and post-rubbing hand contaminations were assessed immediately after a direct contact with a patient, using the glove juice technique. Health care workers (HCWs) evaluated the acceptability of the products through a self-administered anonymous questionnaire. Compliance of HCWs with hand hygiene was assessed during the three periods. We studied 242 handrubbing opportunities. The mean reduction factor (expressed as the Log(10) CFU/mL) of the AHRR, AHRG-1 and AHRG-2 were 1.28+/-0.95, 1.29+/-0.84 and 0.51+/-0.73, respectively (p<0.001). Assessment of the three products by HCWs indicated that AHRR and AHRG-1 were significantly better accepted than AHRG-2. The overall compliance of HCWs to hand hygiene was better when gel was available. Under practical use conditions, AHRG-1 and AHRR were more effective than AHRG-2, although all were claimed to pass the European standard EN1500. In vivo trials are essential to compare the antimicrobial efficacy of products for handrubbing.

  2. 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.

  3. 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 ...

  4. 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.

  5. 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.

  6. The Effect of Hand Dominance on Patient-Reported Outcomes of Carpal Tunnel Release in Patients with Bilateral Carpal Tunnel Syndrome.

    Science.gov (United States)

    Tang, Qian Ying; Lai, Wei Hong; Tay, Shian Chao

    2017-09-01

    There is a paucity of studies in published literature that examines the effect of hand dominance on the resolution of symptoms following a carpal tunnel release. The objective of this study is to examine the effect of hand dominance on the resolution of symptoms following surgical decompression in patients with severe and moderate carpal tunnel syndrome. Bilateral carpal tunnel release (total 90 open and 84 endoscopic) was performed on 87 patients (11 males, 76 females) presenting with bilateral severe or moderate carpal tunnel syndrome of equal severity. Patient-reported outcome of resolution of symptoms were recorded, with patients followed up until complete resolution of symptoms or last recorded consultation (mean follow-up duration 11.4 months, range 3.1 to 32.4 months). In patients with bilateral severe carpal tunnel syndrome, a larger proportion of non-dominant hand (75.4%) achieved complete resolution compared to dominant hand (72.1%), and did so at a statistically shorter time (mean: 52.3 days) than the dominant hand (mean: 81.0 days). However, there was no statistically significant difference between proportion of patients and time taken before complete resolution of symptoms between dominant and non-dominant hand in patients with bilateral moderate carpal tunnel syndrome. Symptoms in the non-dominant hand resolved faster after carpal tunnel release in patients with severe carpal tunnel syndrome. We postulate that greater daily activity by the dominant hand compared to the non-dominant hand may be a contributing factor to its slower rate of symptoms resolution post-surgically in patients with bilateral severe carpal tunnel syndrome. This effect of hand dominance is not evident in post-surgical patients with moderate carpal tunnel syndrome.

  7. 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.

  8. 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.

  9. 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.

  10. Analysis of the effects of hospitalization on fine hand functions compared to gross grip in patients with rheumatoid arthritis

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    Zeynep Tuna

    2015-09-01

    Full Text Available Objective: Hospitalization process causes a variety of physical problems. The decrease of hand use in daily life during hospitalization brings hand dysfunction to mind in inpatients. The aim of this study is to compare the hand functions of hospitalized patients with Rheumatoid Arthritis (RA to outpatients in detail. Methods: Grip and pinch strengths of both hospitalized patients in rheumatology service and outpatients on the routine control day were measured. In addition, 9-Hole Peg Test was performed and the disability level was determined by the Turkish version of Michigan Hand Outcomes Questionnaire (MHOQ. Results: While grip strength and MHOQ scores were similar (p>0.05 in both groups, all three pinch strengths (lateral, bipod, tripod and 9HPT scores were lower (p<0.05 in hospitalized patients. Conclusion: Consequently, besides disease activity, hospitalization process also impairs fine hand functions in rheumatological patients. Evaluation of fine hand functions and appropriate rehabilitative interventions may prevent further disability in hospitalized patients. J Clin Exp Invest 2015; 6 (3: 228-232

  11. Quantitative ultrasound at the hand phalanges in patients with bisphosphonate-related osteonecrosis of the jaws

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    Ana Carolina Fragoso MOTTA

    2015-01-01

    Full Text Available Patients with bisphosphonate-related osteonecrosis of the jaws (BRONJ who received intravenous or oral bisphosphonates (BP were selected for determination of their bone microarchitecture as a risk predictor of BRONJ development. The diagnosis of BRONJ was made based on clinical and radiographic findings. The control group consisted of healthy patients. All patients underwent quantitative and qualitative ultrasound measurements of bone at the hand phalanges carried out using the DBM Sonic BP. Ultrasound bone profile index (UBPI, amplitude-dependent speed of sound (AD-SoS, bone biophysics profile (BBP, and bone transmission time (BTT were measured. The BRONJ group consisted of 17 patients (62 ± 4.24; range: 45-82; 10 (58.8% were male and seven (41.1% were female, of whom 11 (64.7% suffered from multiple myeloma, three (17.6% from osteoporosis, one (5.8% from prostate cancer, one (5.8% from kidney cancer, and one (5.8% from leukemia. Fourteen (82.3% of them received intravenous BP whereas three (17.6% received oral BP. Nine (9/17; 52.9% patients developed bone exposure: two in the maxilla and seven in the mandible. Regarding quantitative parameters, Ad-SoS was low in the BRONJ group, but not significant. The UBPI score was significantly reduced in BRONJ patients with exposed bone when compared to controls (0.47 ± 0.12 vs. 0.70 ± 0.15; p = 0.004. The present study demonstrated that quantitative ultrasound was able to show bone microarchitecture alterations in BRONJ patients, and suggests that these analyses may be an important tool for early detection of bone degeneration associated with BRONJ.

  12. Thermographic analysis and autonomic response in the hands of patients with leprosy.

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    Cavalheiro, Aretusa Lopes; Costa, Debora Tacon da; Menezes, Ana Luiza Ferro de; Pereira, Janser Moura; Carvalho, Eliane Maria de

    2016-01-01

    Low temperatures and slow blood flow may result from peripheral neuropathy caused by leprosy, and the simple detection of cold fingers could already be a preliminary classification for these patients. To investigate whether infrared thermography would be able to measure this change in temperature in the hands of people with leprosy. The study assessed 17 leprosy patients who were under treatment at the National Reference Center for Sanitary Dermatology and Leprosy, Uberlândia/MG, and 15 people without leprosy for the control group. The infrared camera FLIR A325 and Therma CAM Researcher Professional 2.9 software were used to measure the temperature. The room was air-conditioned, maintaining the temperature at 25°C; the distance between the camera and the limb was 70 cm. The vasomotor reflex of patients was tested by a cold stress on the palm. The study showed a significant interaction between the clinical form of leprosy and temperature, where the control group and the borderline-borderline form revealed a higher initial temperature, while borderline-lepromatous and lepromatous leprosy showed a lower temperature. Regarding vasomotor reflex, lepromatous leprosy patients were unable to recover the initial temperature after cold stress, while those with the borderline-tuberculoid form not only recovered but exceeded the initial temperature. Thermography proved a potential tool to assist in the early detection of neuropathies, helping in the prevention of major nerve damage and the installation of deformities and disabilities that are characteristic of leprosy.

  13. 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

  14. 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

  15. 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.

  16. Hand function in patients with Dupuytren’s disease : Assessment, results & patients’ perspectives

    OpenAIRE

    Engstrand, Christina

    2016-01-01

    Background: Dupuytren’s Disease (DD) is a soft tissue disorder that leads to finger joint contractures affecting hand function. DD can be treated with surgery or injection and hand therapy to improve finger joint extension and thereby improve hand function. However, this does not cure the disease and recurrence is common. Previous research on DD has shown improvement in finger joint extension and in self-reported disability of the upper extremity after surgery and hand therapy for DD. However...

  17. Ultrasound Findings on Hands and Wrists of Patients with Systemic Lupus Erythematosus: Relationship with Physical Examination.

    Science.gov (United States)

    Lins, Carolina Freitas; Lima de Sá Ribeiro, Daniel; Dourado Santos, Willer Gonçalves; Rosa, Genevievi; Machicado, Viviane; Pedreira, Ana Luisa; Pimenta da Fonseca, Emanuela; Mota Duque Sousa, Anna Paula; Rodrigues Silva, Carla Baleeiro; Matos, Marcos Antonio Almeida; Santiago, Mittermayer Barreto

    2017-09-01

    Diagnosis of synovitis/tenosynovitis by physical examination can be difficult. Ultrasound (US) can be an effective tool for the evaluation of joint involvement in systemic lupus erythematosus (SLE). This study will describe musculoskeletal findings by US in SLE patients and the evaluation of their correlation with physical examination. SLE patients underwent clinical/sonographic evaluation of hand/wrists. In total, 896 joints were evaluated: at least 1 change on physical examination was found in 136 joints and at least 1 US abnormality was found in 65 of 896 joints. Out of the 65 joints with US changes, only 13 had findings on physical examination. Conversely, 111 joints had tenderness on physical examination with no sonographic abnormalities. Tenosynovitis was statistically significant more frequently with joint edema (41%) (p = 0.0003). US can detect musculoskeletal changes in only a minority of symptomatic SLE patients. Clinical findings may be related to some reasons that cannot be explained using US. Copyright © 2017 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  18. Altered brain functions in HIV positive patients free of HIV- associated neurocognitive disorders: A MRI study during unilateral hand movements

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    Jing Zhao

    2015-03-01

    Full Text Available This paper aimed to investigate the brain activity of human immunodeficiency virus (HIV positive patients with normal cognition during unilateral hand movement and whether highly active antiretroviral therapy (HAART could affect the brain function. Functional magnetic resonance imaging (fMRI was performed for 60 HIV positive (HIV+ subjects and −42 healthy age-matched right-handed control subjects. Each subject was evaluated by the neuropsychological test and examined with fMRI during left and right hand movement tasks. HIV+ subjects showed greater activation in anterior cingulum, precuneus, occipital lobes, ipsilateral postcentral gyrus and contralateral cerebellum compared with control group during right hand movement task. However, during left hand movement no statistically significant difference was detected between these two groups. HAART medication for HIV+ subjects lowered the increased activity to normal level. Meanwhile patients receiving the regimen of zidovudine, lamivudine and efavirenz showed lower activity at bilateral caudate and ipsilateral inferior frontal gyrus in comparison with subjects receiving other HAART regimens. Therefore, HIV+ subjects demonstrated brain asymmetry in motor cortex, with increased activity present during right hand movement but absent during left hand movement. HAART proves effective in HIV+ subjects even with normal cognition and the specific regimen of HAART could prevent cerebral abnormal functions. Meanwhile, this study validates that during motor tasks, fMRI can detect the brain signal changes prior to the occurrences of other HIV- associated dysfunctions.

  19. Are movements necessary for the sense of body ownership? Evidence from the rubber hand illusion in pure hemiplegic patients.

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    Dalila Burin

    Full Text Available A question still debated within cognitive neuroscience is whether signals present during actions significantly contribute to the emergence of human's body ownership. In the present study, we aimed at answer this question by means of a neuropsychological approach. We administered the classical rubber hand illusion paradigm to a group of healthy participants and to a group of neurological patients affected by a complete left upper limb hemiplegia, but without any propriceptive/tactile deficits. The illusion strength was measured both subjectively (i.e., by a self-report questionnaire and behaviorally (i.e., the location of one's own hand is shifted towards the rubber hand. We aimed at examining whether, and to which extent, an enduring absence of movements related signals affects body ownership. Our results showed that patients displayed, respect to healthy participants, stronger illusory effects when the left (affected hand was stimulated and no effects when the right (unaffected hand was stimulated. In other words, hemiplegics had a weaker/more flexible sense of body ownership for the affected hand, but an enhanced/more rigid one for the healthy hand. Possible interpretations of such asymmetrical distribution of body ownership, as well as limits of our results, are discussed. Broadly speaking, our findings suggest that the alteration of the normal flow of signals present during movements impacts on human's body ownership. This in turn, means that movements have a role per se in developing and maintaining a coherent body ownership.

  20. Are movements necessary for the sense of body ownership? Evidence from the rubber hand illusion in pure hemiplegic patients.

    Science.gov (United States)

    Burin, Dalila; Livelli, Alessandro; Garbarini, Francesca; Fossataro, Carlotta; Folegatti, Alessia; Gindri, Patrizia; Pia, Lorenzo

    2015-01-01

    A question still debated within cognitive neuroscience is whether signals present during actions significantly contribute to the emergence of human's body ownership. In the present study, we aimed at answer this question by means of a neuropsychological approach. We administered the classical rubber hand illusion paradigm to a group of healthy participants and to a group of neurological patients affected by a complete left upper limb hemiplegia, but without any propriceptive/tactile deficits. The illusion strength was measured both subjectively (i.e., by a self-report questionnaire) and behaviorally (i.e., the location of one's own hand is shifted towards the rubber hand). We aimed at examining whether, and to which extent, an enduring absence of movements related signals affects body ownership. Our results showed that patients displayed, respect to healthy participants, stronger illusory effects when the left (affected) hand was stimulated and no effects when the right (unaffected) hand was stimulated. In other words, hemiplegics had a weaker/more flexible sense of body ownership for the affected hand, but