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Sample records for hand-foot skin reaction

  1. The Hand-Foot Skin Reaction and Quality of Life Questionnaire: An Assessment Tool for Oncology

    OpenAIRE

    Anderson, Roger T.; Keating, Karen N.; Doll, Helen A.; Camacho, Fabian

    2015-01-01

    This study describes the development and validation of a brief, patient self-reported questionnaire (the hand-foot skin reaction and quality of life questionnaire) supporting its suitability for use in clinical research to aid in early recognition of symptoms, to evaluate the effectiveness of agents for hand-foot skin reaction (HFSR) or hand-foot syndrome (HFS) treatment within clinical trials, and to evaluate the impact of these treatments on HFS/R-associated patients’ health-related quality...

  2. The Hand-Foot Skin Reaction and Quality of Life Questionnaire: An Assessment Tool for Oncology

    Science.gov (United States)

    Keating, Karen N.; Doll, Helen A.; Camacho, Fabian

    2015-01-01

    Background. Skin toxicity (hand-foot syndrome/hand-foot skin reaction, HFS/R) related to antineoplastic therapy is a significant issue in oncology practice, with potentially large impacts on health-related quality of life (HRQL). Materials and Methods. A patient-reported questionnaire, the hand-foot skin reaction and quality of life (HF-QoL) questionnaire was developed to measure the HFS/R symptoms associated with cancer therapeutic agents and their effect on daily activities. The validity and reliability of the HF-QoL questionnaire was tested in a randomized trial of capecitabine with sorafenib/placebo in 223 patients with locally advanced/metastatic breast cancer. Other measures completed included patient ratings of condition severity, the Functional Assessment of Cancer Therapy-Breast cancer (FACT-B), and the clinician-rated National Cancer Institute-Common Terminology Criteria for Adverse Events (NCI-CTCAE), version 3.0, hand-foot skin reaction grade. The psychometric properties of the HF-QoL tested included structural validity, internal consistency, construct validity, discriminant validity, and responsiveness. Finally, the minimal clinically important difference (MCID) was estimated. Results. The HF-QoL instrument comprises a 20-item symptom scale and an 18-item daily activity scale. Each scale demonstrated excellent measurement properties and discriminated between NCI-CTCAE grade and patient-rated condition severity with large effect sizes. The daily activity scale had excellent internal consistency and correlated with the FACT-B and HF-QoL symptom scores. Both HF-QoL scale scores increased linearly with increasing patient-rated condition severity. The MCIDs were estimated as 5 units for daily activities and 8 units for symptoms mean scores. Conclusion. The HF-QoL was sensitive to symptoms and HRQL issues associated with HFS/R among participants treated with capecitabine with and without sorafenib. The HF-QoL appears suitable for assessing the HRQL

  3. The Hand-Foot Skin Reaction and Quality of Life Questionnaire: An Assessment Tool for Oncology.

    Science.gov (United States)

    Anderson, Roger T; Keating, Karen N; Doll, Helen A; Camacho, Fabian

    2015-07-01

    Skin toxicity (hand-foot syndrome/hand-foot skin reaction, HFS/R) related to antineoplastic therapy is a significant issue in oncology practice, with potentially large impacts on health-related quality of life (HRQL). A patient-reported questionnaire, the hand-foot skin reaction and quality of life (HF-QoL) questionnaire was developed to measure the HFS/R symptoms associated with cancer therapeutic agents and their effect on daily activities. The validity and reliability of the HF-QoL questionnaire was tested in a randomized trial of capecitabine with sorafenib/placebo in 223 patients with locally advanced/metastatic breast cancer. Other measures completed included patient ratings of condition severity, the Functional Assessment of Cancer Therapy-Breast cancer (FACT-B), and the clinician-rated National Cancer Institute-Common Terminology Criteria for Adverse Events (NCI-CTCAE), version 3.0, hand-foot skin reaction grade. The psychometric properties of the HF-QoL tested included structural validity, internal consistency, construct validity, discriminant validity, and responsiveness. Finally, the minimal clinically important difference (MCID) was estimated. The HF-QoL instrument comprises a 20-item symptom scale and an 18-item daily activity scale. Each scale demonstrated excellent measurement properties and discriminated between NCI-CTCAE grade and patient-rated condition severity with large effect sizes. The daily activity scale had excellent internal consistency and correlated with the FACT-B and HF-QoL symptom scores. Both HF-QoL scale scores increased linearly with increasing patient-rated condition severity. The MCIDs were estimated as 5 units for daily activities and 8 units for symptoms mean scores. The HF-QoL was sensitive to symptoms and HRQL issues associated with HFS/R among participants treated with capecitabine with and without sorafenib. The HF-QoL appears suitable for assessing the HRQL impairment associated with HFS/R to cancer therapies. Skin

  4. Efficacy of a protocol including heparin ointment for treatment of multikinase inhibitor-induced hand-foot skin reactions.

    Science.gov (United States)

    Li, Jian-ri; Yang, Chi-rei; Cheng, Chen-li; Ho, Hao-chung; Chiu, Kun-yuan; Su, Chung-Kuang; Chen, Wen-Ming; Wang, Shian-Shiang; Chen, Chuan-Shu; Yang, Cheng-Kuang; Ou, Yen-chuan

    2013-03-01

    The purpose of this study is to evaluate the efficacy of a protocol including topical heparin therapy for hand-foot skin reactions (HFSR) during multikinase (MKI) treatment. We prospectively collected 26 patients who had HFSRs during treatment with the MKIs, sunitinib, sorafenib, or axitinib. The age distribution ranged from 46 to 87 years, with a mean of 66 years. The distribution of HFSR severity was 12 patients with grade 1, 12 with grade 2, and 2 with grade 3. A heparin-containing topical ointment treatment, combined with hand-foot shock absorbers and skin moisturizers, was used at the lesion sites. Changes in the grade of HFSR, MKI dosage, and interruptions of MKI therapy were recorded. The results showed that 66.7% of grade 1 patients were cured of disease, 83.3% of grade 2 patients had improved symptoms, and both grade 3 patients (100%) had improved symptoms and were downgraded to grade 2. Four (15.4%) patients required reduction of MKI dosage, but there were no treatment interruptions or dropouts. Our protocol is beneficial in promoting resolution of HFSRs induced by MKIs. Further validation in large control studies should be investigated.

  5. Regorafenib-associated hand-foot skin reaction: practical advice on diagnosis, prevention, and management.

    Science.gov (United States)

    McLellan, B; Ciardiello, F; Lacouture, M E; Segaert, S; Van Cutsem, E

    2015-10-01

    Regorafenib is an orally available, small-molecule multikinase inhibitor with international marketing authorizations for use in colorectal cancer and gastrointestinal stromal tumors. In clinical trials, regorafenib showed a consistent and predictable adverse-event profile, with hand-foot skin reaction (HFSR) among the most clinically significant toxicities. This review summarizes the clinical characteristics of regorafenib-related HFSR and provides practical advice on HFSR management to enable health care professionals to recognize, pre-empt, and effectively manage the symptoms, thereby allowing patients to remain on active therapy for as long as possible. This review is based on a systematic literature search of the PubMed database (using synonyms of HFSR, regorafenib, and skin toxicities associated with targeted therapies or cytotoxic chemotherapy). However, as this search identified very few articles, the authors also use their clinical experience as oncologists and dermatologists managing patients with treatment-related HFSR to provide recommendations on recognition and management of HFSR in regorafenib-treated patients. Regorafenib-related HFSR is similar to that seen with other multikinase inhibitors (e.g. sorafenib, sunitinib, cabozantinib, axitinib, and pazopanib) but differs from the hand-foot syndrome seen with cytotoxic chemotherapies (e.g. fluoropyrimidines, anthracyclines, and taxanes). There have been no controlled trials of symptomatic management of regorafenib-related HFSR, and limited good-quality evidence from randomized clinical trials of effective interventions for HFSR associated with other targeted therapies. Recommendations on prevention and management of regorafenib-related HFSR in this review are therefore based on the expert opinion of the authors (dermatologists and oncologists with expertise in the management of treatment-related skin toxicities and oncologists involved in clinical trials of regorafenib) and tried-and-tested empirical

  6. Hand-foot skin reaction with vascular endothelial growth factor receptor tyrosine kinase inhibitors in cancer patients: A systematic review and meta-analysis.

    Science.gov (United States)

    Li, Jing; Gu, Jian

    2017-11-01

    A meta-analysis was conducted to systematically review the risk of hand-foot skin reaction (HFSR) with vascular endothelial growth factor receptor tyrosine kinase inhibitors (VEGFR-TKIs) in patients with cancer. The relevant studies of the randomized controlled trials (RCTs) in cancer patients treated with VEGFR-TKIs were retrieved and the systematic evaluation was conducted. EMBASE, MEDLINE, and PubMed were searched for articles published till May 2017. Twenty-one RCTs and 9552 patients were included. The current analysis suggested that the use of VEGFR-TKIs increased the risk of all-grade HFSR (7.04;95%CI, 5.33-9.30;pcancer type, whereas the RR of high-grade HFSR did not. The risk of all-grade and high-grade HFSR did not affect by drug types, treatment line, median age and treatment duration. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Hand-foot skin reaction is a beneficial indicator of sorafenib therapy for patients with hepatocellular carcinoma: a systemic review and meta-analysis.

    Science.gov (United States)

    Wang, Ping; Tan, Gang; Zhu, Mingxin; Li, Weidong; Zhai, Bo; Sun, Xueying

    2018-01-01

    Sorafenib remains the only standard first-line drug for advanced hepatocellular carcinoma (HCC). Hand-foot skin reaction (HFSR) is a very common side-effect in patients treated with sorafenib, and also affects the treatment schedule and quality of life. However, the association of HFSR and response of HCC to sorafenib remain unclear. Databases including PubMed, EMBASE, Web of Science and Cochrane Central Register of Controlled Trials were searched up to May 7 th , 2017. Review Manager 5.3 software was adopted for performing meta-analyses, Newcastle-Ottawa Scale for assessing the bias of cohort studies, and GRADEprofler software for further assessing outcomes obtained from meta-analyses. 1478 articles were reviewed, and 12 cohort studies with 1017 participants were included in the analyses. The pooled hazard ratio (HR) of overall survival is 0.45 (95% confidence interval (CI) 0.36, 0.55; P The pooled HR of time to progression is 0.41 (95% CI 0.28, 0.60; P The results indicate that HFSR is a beneficial indicator for HCC patients receiving sorafenib therapy. However, molecular mechanisms accounting for sorafenib-induced HFSR in HCC patients remain.

  8. Hand, Foot, and Mouth Disease

    Centers for Disease Control (CDC) Podcasts

    Hand, foot, and mouth disease is a contagious illness that mainly affects children under five. In this podcast, Dr. Eileen Schneider talks about the symptoms of hand, foot, and mouth disease, how it spreads, and ways to help protect yourself and your children from getting infected with the virus.

  9. Foot Skin Ischemic Necrosis following Heel Prick in a Newborn

    Directory of Open Access Journals (Sweden)

    Esad Koklu

    2013-01-01

    Full Text Available There are only a few reports on side effects after heel prick in neonates although heel prick has been performed all over the world for many years. The medicine staff had obtained only a drop of blood by pricking the baby’s heel using a lancet without compressing the heel or foot to measure his blood glucose level 3 hours after birth. However he developed a severe and hemorrhagic skin reaction on his entire left foot, beginning 30 minutes after obtaining the drop of blood by pricking the baby’s heel using a lancet. The lesion, which was treated with topical mupirocin and povidone-iodine solution daily, slowly decreased in size and had almost fully resolved within 3 weeks. He was healthy and 9 months old at the time of writing this paper. We herein report a case of foot skin ischemic necrosis following heel prick in a newborn. To our knowledge this patient is the first case of foot skin ischemic necrosis due to heel prick in newborns.

  10. Prevalence of foot eczema and associated occupational and non-occupational factors in patients with hand eczema.

    Science.gov (United States)

    Brans, Richard; Hübner, Anja; Gediga, Günther; John, Swen M

    2015-08-01

    Foot eczema often occurs in combination with hand eczema. However, in contrast to the situation with hand eczema, knowledge about foot eczema is scarce, especially in occupational settings. To evaluate the prevalence of foot eczema and associated factors in patients with hand eczema taking part in a tertiary individual prevention programme for occupational skin diseases. In a retrospective cohort study, the medical records of 843 patients taking part in the tertiary individual prevention programme were evaluated. Seven hundred and twenty-three patients (85.8%) suffered from hand eczema. Among these, 201 patients (27.8%) had concomitant foot eczema, mainly atopic foot eczema (60.4%). An occupational irritant component was possible in 38 patients with foot eczema (18.9%). In the majority of patients, the same morphological features were found on the hands and feet (71.1%). The presence of foot eczema was significantly associated with male sex [odds ratio (OR) 1.78, 95% confidence interval (CI) 1.29-2.49], atopic hand eczema (OR 1.60, 95%CI: 1.15-2.22), hyperhidrosis (OR 1.73, 95%CI: 1.33-2.43), and the wearing of safety shoes/boots at work (OR 2.04, 95%CI: 1.46-2.87). Tobacco smoking was associated with foot eczema (OR 1.79, 95%CI: 1.25-2.57), in particular with the vesicular subtype. Foot eczema is common in patients with hand eczema, and is related to both occupational and non-occupational factors. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. Hand, Foot, and Mouth Disease

    Centers for Disease Control (CDC) Podcasts

    2013-08-08

    Hand, foot, and mouth disease is a contagious illness that mainly affects children under five. In this podcast, Dr. Eileen Schneider talks about the symptoms of hand, foot, and mouth disease, how it spreads, and ways to help protect yourself and your children from getting infected with the virus.  Created: 8/8/2013 by National Center for Immunization and Respiratory Diseases (NCIRD).   Date Released: 8/8/2013.

  12. Factors associated with combined hand and foot eczema

    DEFF Research Database (Denmark)

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

    2017-01-01

    BACKGROUND: As for hand eczema, the aetiology 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 were studied in a cross-sectional design in a cohort of hand eczema patients. Consecutive patients were recruited from nine 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. A total of 125 patients (29.8%) had...

  13. Water-displacement plethysmography: a technique for the simultaneous thermal manipulation and measurement of whole-hand and whole-foot blood flows

    International Nuclear Information System (INIS)

    Caldwell, Joanne N; Taylor, Nigel A S

    2014-01-01

    The purpose of this project was to design, construct and validate water-displacement plethysmographs for the forearm, hand and foot that could clamp segmental skin temperature whilst simultaneously measuring cutaneous blood flow. Two experiments were performed. In the first, the forearm plethysmograph was validated against a mercury-in-silastic plethysmograph under thermoneutral conditions, with and without forearm heating. Cutaneous vascular conductance was elevated almost three-fold by this treatment, however, there were no significant differences between the two forms of plethysmography in either state (P > 0.05). In study two, hand and foot blood flows were measured under clamped thermoneutral conditions, but with three local skin temperature treatments (5, 25, 40 °C). The hand had significantly higher blood flows than the foot at both 25 °C (4.07 versus 2.20 mL.100 mL  − 1 .min  − 1 ; P < 0.05) and 40 °C (8.20 versus 4.47 mL.100 mL  − 1 .min  − 1 ; P < 0.05). The foot was maximally constricted during the two lower temperatures, yet the cutaneous thermal sensitivity of the hand was almost two-fold greater (P < 0.05). This evidence supports the significant role played by these appendages in heat loss and conservation, and these plethysmographs will now be used to map cutaneous vascular responses (forearm, hand, calf, foot) across combinations of core and local skin temperatures. (paper)

  14. Unilateral Cleft Hand with Cleft Foot

    Science.gov (United States)

    Baba, Asif Nazir; Bhat, Yasmeen J.; Ahmed, Sheikh Mushtaq; Nazir, Abid

    2009-01-01

    Congenital anomalies of the hand form an important class of congenital malformations. They have a huge functional importance because of the part played by the hand in the daily activities of a person. The deformities also have significant cosmetic significance and may also be associated with other anomalies. Amongst the congenital anomalies, central deficiency or cleft hand is relatively rare. The association of cleft foot with cleft hand is an even more rare occurance. We present a case report of a 6 year old child, born of a non-consanginous marriage, having congenital central deficiency of ipsilateral hand and foot. PMID:21475543

  15. Regorafenib-associated hand–foot skin reaction: practical advice on diagnosis, prevention, and management

    Science.gov (United States)

    McLellan, B.; Ciardiello, F.; Lacouture, M. E.; Segaert, S.; Van Cutsem, E.

    2015-01-01

    Background Regorafenib is an orally available, small-molecule multikinase inhibitor with international marketing authorizations for use in colorectal cancer and gastrointestinal stromal tumors. In clinical trials, regorafenib showed a consistent and predictable adverse-event profile, with hand–foot skin reaction (HFSR) among the most clinically significant toxicities. This review summarizes the clinical characteristics of regorafenib-related HFSR and provides practical advice on HFSR management to enable health care professionals to recognize, pre-empt, and effectively manage the symptoms, thereby allowing patients to remain on active therapy for as long as possible. Design This review is based on a systematic literature search of the PubMed database (using synonyms of HFSR, regorafenib, and skin toxicities associated with targeted therapies or cytotoxic chemotherapy). However, as this search identified very few articles, the authors also use their clinical experience as oncologists and dermatologists managing patients with treatment-related HFSR to provide recommendations on recognition and management of HFSR in regorafenib-treated patients. Results Regorafenib-related HFSR is similar to that seen with other multikinase inhibitors (e.g. sorafenib, sunitinib, cabozantinib, axitinib, and pazopanib) but differs from the hand–foot syndrome seen with cytotoxic chemotherapies (e.g. fluoropyrimidines, anthracyclines, and taxanes). There have been no controlled trials of symptomatic management of regorafenib-related HFSR, and limited good-quality evidence from randomized clinical trials of effective interventions for HFSR associated with other targeted therapies. Recommendations on prevention and management of regorafenib-related HFSR in this review are therefore based on the expert opinion of the authors (dermatologists and oncologists with expertise in the management of treatment-related skin toxicities and oncologists involved in clinical trials of regorafenib) and

  16. Sex determination from hand and foot dimensions in a North Indian population.

    Science.gov (United States)

    Krishan, Kewal; Kanchan, Tanuj; Sharma, Abhilasha

    2011-03-01

    Hands and feet are often recovered from the site of natural as well as man-made disasters because of bomb blasts, train accidents, plane crashes, or mass homicides. This study is intended to establish standards for determination of sex from the dimensions of hands and feet in a North Indian population. The data for this study comprise 123 men and 123 women aged between 17 and 20 years from the "Rajput" population of Himachal Pradesh in North India. Four anthropometric measurements viz. hand length, hand breadth, foot length, and foot breadth have been taken on both sides of each subject following international anthropometric standards. The hand index (hand breadth/hand length × 100) and the foot index (foot breadth/foot length × 100) were calculated. Sectioning points and regression models are derived for the hand and foot dimensions and the derived indices. The hand and foot dimensions show a higher accuracy in sex determination by sectioning point analysis when compared to hand and foot index. Of the hand and the foot dimensions, hand breadth and foot breadth showed better accuracy in sex determination. Hand index and foot index remain poor sex discriminators in the study. © 2011 American Academy of Forensic Sciences.

  17. Touch-less interaction with medical images using hand & foot gestures

    DEFF Research Database (Denmark)

    Jalaliniya, Shahram; Smith, Jeremiah; Sousa, Miguel

    2013-01-01

    control. In this paper, we present a system for gesture-based interaction with medical images based on a single wristband sensor and capacitive floor sensors, allowing for hand and foot gesture input. The first limited evaluation of the system showed an acceptable level of accuracy for 12 different hand...... & foot gestures; also users found that our combined hand and foot based gestures are intuitive for providing input....

  18. Skin reactions amongst Greek endodontists: a national questionnaire survey.

    Science.gov (United States)

    Zarra, T; Lambrianidis, T

    2015-04-01

    To investigate amongst Greek endodontists in the past 5 years the prevalence, aetiologic factors, severity and treatment for skin reactions. One hundred and 47 endodontists met the inclusion criteria and were invited to participate in the survey. Participants were asked for personal/professional data, prevalence, aetiologic factors, symptoms, severity and treatment for skin reactions in the past 5 years. The type of gloves used and frequency of hand washing as well as information on history of atopy and eczema were also recorded. Data were analysed using chi-square test and independent samples t-test. The level of significance was set at P = 0.05. The response rate was 84%. Skin reactions were reported by 32.5% of participants. Hands were the body part most frequently affected (66% of cases); glove powder accounted for 73% of skin reactions. Medical care was sought by 28.2% of the affected participants. Endodontists with a history of atopy (P skin reactions. Replacement of powdered latex gloves with powder-free or vinyl/nitrile gloves, avoidance of potential allergens and use of pharmaceutical ointments were adopted by 48.7%, 23.1% and 2.6% of the affected endodontists, respectively, to manage skin reactions. Approximately one-third of participants reported skin reactions. History of atopy and dermal eczema as well as gender was significantly associated with such reactions. The use of powder-free latex gloves instead of powdered ones was the measure most frequently adopted to manage reactions. © 2014 International Endodontic Journal. Published by John Wiley & Sons Ltd.

  19. Estimation of stature from hand and foot dimensions in a Korean population.

    Science.gov (United States)

    Kim, Wonjoon; Kim, Yong Min; Yun, Myung Hwan

    2018-04-01

    The estimation of stature using foot and hand dimensions is essential in the process of personal identification. The shapes of feet and hands vary depending on races and gender, and it is of great importance to design an adequate equation in consideration of variances to estimate stature. This study is based on a total of 5,195 South Korean males and females, aged from 20 to 59 years. Body dimensions of stature, hand length, hand breadth, foot length, and foot breadth were measured according to standard anthropometric procedures. The independent t-test was performed in order to verify significant gender-induced differences and the results showed that there was significant difference between males and females for all the foot-hand dimensions (pfoot length showed highest correlation, whereas the hand breadth showed least correlation. The stepwise regression analysis was conducted, and the results showed that males had the highest prediction accuracy in the regression equation consisting of foot length and hand length (R 2 =0.532), whereas females had the highest accuracy in the regression model consisting of foot length and hand breadth (R 2 =0.437) The findings of this study indicated that hand and foot dimensions can be used to predict the stature of South Korean in the forensic science field. Copyright © 2018 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  20. Hand and foot contamination monitor

    International Nuclear Information System (INIS)

    Jakati, R.K.; Kaptral, R.S.; Ananthkrishnan, T.S.; Pansare, M.G.

    1989-01-01

    In order to make quick measurements of beta and gamma contaminations on hands and feet of personnel working in radioactive environments, hand and foot contamination monitors are widely used. This paper describes such a monitor system designed with Intel 8085 based microcomputer. The monitoring and warning system is designed to perform measurement of activity spread over surface of hands and soles of shoes or feet. Even though the system has many features to aid testing and maintainance operation, it is easy to use for unskilled persons. In order to check the contamination, the person stands on platform and inserts both his hands into detector assemblies thereby actuating the sensing switches. After a preset interval, annunciation of clean or contaminated status is declared by the system. (author)

  1. Hand, Foot, and Mouth Disease (HFMD)

    Science.gov (United States)

    ... feature story, podcast, and other CDC resources about personal hygiene... Prevention People infected with hand, foot, and mouth ... these countries can protect themselves by practicing good personal hygiene. Learn more . To learn more about outbreaks occurring ...

  2. Skin grafting and tissue replacement for treating foot ulcers in people with diabetes

    NARCIS (Netherlands)

    Santema, Trientje B.; Poyck, Paul P. C.; Ubbink, Dirk T.

    2016-01-01

    Foot ulceration is a major problem in people with diabetes and is the leading cause of hospitalisation and limb amputations. Skin grafts and tissue replacements can be used to reconstruct skin defects for people with diabetic foot ulcers in addition to providing them with standard care. Skin

  3. Determination of calcium in foot, hand and vertebrae of man by neutron activation

    International Nuclear Information System (INIS)

    Zajchik, V.E.; Kondrashev, A.E.; Dubrovin, A.P.; Korelo, A.M.; Morukov, B.V.; Orlov, O.I.

    1990-01-01

    Methods and devices for in vivo neutron activation determination of calcium content in human foot, hand and vertebrae were developed. It is ascertained that calcium content in skeleton is subjected to seasonal cyclicity. Bones of foot have the minimum content of the element in winter-spring period and the maximum one in summer-autumn period. For vertebrae and hand the inverse dependence is characteristic. Average level of seasonal variations in calcium content in the bones of hand and vertebrae is 10-11%, that of foot - 18-19%. Amplitudes of seasonal variations in the content of calcium in vertebrae, hand and foot are interrelated. 5 refs.; 1 tab

  4. Diagnostic values for skin temperature assessment to detect diabetes-related foot complications

    NARCIS (Netherlands)

    van Netten, Jaap J.; Prijs, Miranda; van Baal, Jeff G.; Liu, Chanjuan; van der Heijden, Ferdi; Bus, Sicco A.

    2014-01-01

    Abstract Background: Skin temperature assessment is a promising modality for early detection of diabetic foot problems, but its diagnostic value has not been studied. Our aims were to investigate the diagnostic value of different cutoff skin temperature values for detecting diabetes-related foot

  5. Validation of hand and foot anatomical feature measurements from smartphone images

    Science.gov (United States)

    Amini, Mohammad; Vasefi, Fartash; MacKinnon, Nicholas

    2018-02-01

    A smartphone mobile medical application, previously presented as a tool for individuals with hand arthritis to assess and monitor the progress of their disease, has been modified and expanded to include extraction of anatomical features from the hand (joint/finger width, and angulation) and foot (length, width, big toe angle, and arch height index) from smartphone camera images. Image processing algorithms and automated measurements were validated by performing tests on digital hand models, rigid plastic hand models, and real human hands and feet to determine accuracy and reproducibility compared to conventional measurement tools such as calipers, rulers, and goniometers. The mobile application was able to provide finger joint width measurements with accuracy better than 0.34 (+/-0.25) millimeters. Joint angulation measurement accuracy was better than 0.50 (+/-0.45) degrees. The automatically calculated foot length accuracy was 1.20 (+/-1.27) millimeters and the foot width accuracy was 1.93 (+/-1.92) millimeters. Hallux valgus angle (used in assessing bunions) accuracy was 1.30 (+/-1.29) degrees. Arch height index (AHI) measurements had an accuracy of 0.02 (+/-0.01). Combined with in-app documentation of symptoms, treatment, and lifestyle factors, the anatomical feature measurements can be used by both healthcare professionals and manufacturers. Applications include: diagnosing hand osteoarthritis; providing custom finger splint measurements; providing compression glove measurements for burn and lymphedema patients; determining foot dimensions for custom shoe sizing, insoles, orthotics, or foot splints; and assessing arch height index and bunion treatment effectiveness.

  6. Diagnostic values for skin temperature assessment to detect diabetes-related foot complications

    NARCIS (Netherlands)

    van Netten, Jaap J.; Prijs, Miranda; van Baal, Jeff G.; Liu, C.; van der Heijden, Ferdinand; Bus, Sicco A.

    2014-01-01

    Skin temperature assessment is a promising modality for early detection of diabetic foot problems, but its diagnostic value has not been studied. Our aims were to investigate the diagnostic value of different cutoff skin temperature values for detecting diabetes-related foot complications such as

  7. Hand, foot and mouth disease caused by coxsackievirus A6, Beijing, 2013.

    Science.gov (United States)

    Hongyan, Gu; Chengjie, Ma; Qiaozhi, Yang; Wenhao, Hua; Juan, Li; Lin, Pang; Yanli, Xu; Hongshan, Wei; Xingwang, Li

    2014-12-01

    Specimens and clinical data were collected from 243 hand, foot and mouth disease patients in Beijing in 2013. In total, 130 stool specimens were genotyped for enterovirus. Hand, foot and mouth disease was mainly detected in suburban areas and at the edges of urban areas between May and August. Coxsackievirus (CV) A6 replaced enterovirus (EV) 71 and CVA16, becoming the main causative agent of hand, foot and mouth disease. CVA6 infection led to significantly reduced fever duration and glucose levels compared with EV71 infection.

  8. [Repair of soft tissue defect in hand or foot with lobulated medial sural artery perforator flap].

    Science.gov (United States)

    Fengjing, Zhao; Jianmin, Yao; Xingqun, Zhang; Liang, Ma; Longchun, Zhang; Yibo, Xu; Peng, Wang; Zhen, Zhu

    2015-11-01

    To explore the clinical effect of the lobulated medial sural artery perforator flap in repairing soft tissue defect in hand or foot. Since March 2012 to September 2014, 6 cases with soft tissue defects in hands or feet were treated by lobulated medial sural artery flaps pedicled with 1st musculo-cutaneous perforator and 2st musculo-cutaneous perforator of the medial sural artery. The size of the flaps ranged from 4.5 cm x 10.0 cm to 6.0 cm x 17.0 cm. 5 cases of lobulated flap survived smoothly, only 1 lobulated flap had venous articulo, but this flap also survived after the articulo was removed by vascular exploration. All flaps had desirable appearance and sensation and the two-point discrimination was 6 mm in mean with 4 to 12 months follow-up (average, 7 months). Linear scar was left in donor sites in 3 cases and skin scar in 3 cases. There was no malfunction in donor sites. Lobulated medial sural artery perforator flap is feasible and ideal method for the treatment of soft tissue defect in hand or foot with satisfactory effect.

  9. Regular use of a hand cream can attenuate skin dryness and roughness caused by frequent hand washing

    Directory of Open Access Journals (Sweden)

    Kampf Günter

    2006-02-01

    Full Text Available Abstract Background Aim of the study was to determine the effect of the regular use of a hand cream after washing hands on skin hydration and skin roughness. Methods Twenty-five subjects washed hands and forearms with a neutral soap four times per day, for 2 minutes each time, for a total of two weeks. One part of them used a hand cream after each hand wash, the others did not (cross over design after a wash out period of two weeks. Skin roughness and skin hydration were determined on the forearms on days 2, 7, 9 and 14. For skin roughness, twelve silicon imprint per subject and time point were taken from the stratum corneum and assessed with a 3D skin analyzer for depth of the skin relief. For skin hydration, five measurements per subject and time point were taken with a corneometer. Results Washing hands lead to a gradual increase of skin roughness from 100 (baseline to a maximum of 108.5 after 9 days. Use of a hand cream after each hand wash entailed a decrease of skin roughness which the lowest means after 2 (94.5 and 14 days (94.8. Skin hydration was gradually decreased after washing hands from 79 (baseline to 65.5 after 14 days. The hand wash, followed by use of a hand cream, still decreased skin hydration after 2 days (76.1. Over the next 12 days, however, skin hydration did not change significantly (75.6 after 14 days. Conclusion Repetitive and frequent hand washing increases skin dryness and roughness. Use of a hand cream immediately after each hand wash can confine both skin dryness and skin roughness. Regular use of skin care preparations should therefore help to prevent both dry and rough skin among healthcare workers in clinical practice.

  10. [Healing of skin lesions in diabetic foot syndrome during hospitalization].

    Science.gov (United States)

    Jirkovská, A

    2006-05-01

    Wound healing during the diabetic foot disease is indicated to in-patient treatment in case of non-healing wound, in case of serious infection and/or critical ischemia and in case of necessity of surgical treatment. Diabetic foot disease is the main reason for in-patient treatment of people with diabetes, which our experience confirms. Chronic wound is characterised by non-healing for at least 4 weeks. Ischemia and recurrent trauma caused by incomplete off-loading, prolong inflammation and infection are the main reasons for difficult healing of chronic wound. Infection is also leading cause for prolonged hospitalisation of patients with diabetic foot disease. Local decrease of grow factors and increase of tissue protease are characteristics of chronic wound. The process of wound healing is characterized by a cascade of interrelated events involving infection and inflammatory factors. The results of these investigations led to the moist wound healing concept and use of growth factors and bioengineered skin substitutes. We have good experience with the use of xenotransplant skin substitues in the treatment of diabetic foot. Off loading techniques including total contact casting, local therapy by debridement and skin substitutes had the best evidence based efficacy. We are introducing new method of the treatment of diabetic foot--VAC--vacuum assisted closure. The fundamental principle in the therapy during in-patient period, is comprehensive approach; the omitting of any of the principle of the therapy--e.g. the off-loading of the ulcers, the infection and ischemia control, may contribute to its failure.

  11. Anthropometric Data of Hand, Foot and Ear of University Students in Nigeria

    Directory of Open Access Journals (Sweden)

    Olasunkanmi Salami ISMAILA

    2009-12-01

    Full Text Available Anthropometric data is needed in the design of products as it varies between individuals and nations. These data for Nigerians is presently scant and this study is an attempt to provide data on hand, foot and ear for the improvements of hand gloves, handles, shoes, pedal dimensions, ear-phones and other related products.A random sample of 500 students was taken and their ages were between 18 and 29 years (mean of 21.7 years. Two hundred and fifty of the samples were males and the same numbers were females. The dimensions measured were ▪ hand: length and breadth; ▪ foot: length, breadth and height; ▪ ear: height and breadth. The study presents the anthropometric data for the 5th, 50th and 95th percentiles for the above-presented variables.The study established that foot breadths of the females were larger than those of the males while the males had larger foot lengths. There were no significant differences between the hand dimensions of the males and those of the females. Similarly, there were no significant differences between the ear dimensions of males and the females

  12. Degloved foot sole successfully reconstructed with split thickness skin grafts

    NARCIS (Netherlands)

    Janssens, Loes; Holtslag, Herman R.; Schellekens, Pascal P A; Leenen, Luke P H

    2015-01-01

    Introduction The current opinion is that split thickness skin grafts are not suitable to reconstruct a degloved foot sole. The tissue is too fragile to carry full bodyweight; and therefore, stress lesions frequently occur. The treatment of choice is the reuse of the avulsed skin whenever possible,

  13. Control of a Supernumerary Robotic Hand by Foot: An Experimental Study in Virtual Reality.

    Science.gov (United States)

    Abdi, Elahe; Burdet, Etienne; Bouri, Mohamed; Bleuler, Hannes

    2015-01-01

    In the operational theater, the surgical team could highly benefit from a robotic supplementary hand under the surgeon's full control. The surgeon may so become more autonomous; this may reduce communication errors with the assistants and take over difficult tasks such as holding tools without tremor. In this paper, we therefore examine the possibility to control a third robotic hand with one foot's movements. Three experiments in virtual reality were designed to assess the feasibility of this control strategy, the learning curve of the subjects in different tasks and the coordination of foot movements with the two natural hands. Results show that the limbs are moved simultaneously, in parallel rather than serially. Participants' performance improved within a few minutes of practice without any specific difficulty to complete the tasks. Subjective assessment by the subjects indicated that controlling a third hand by foot has been easy and required only negligible physical and mental efforts. The sense of ownership was reported to improve through the experiments. The mental burden was not directly related to the level of motion required by a task, but depended on the type of activity and practice. The most difficult task was moving two hands and foot in opposite directions. These results suggest that a combination of practice and appropriate tasks can enhance the learning process for controlling a robotic hand by foot.

  14. Control of a Supernumerary Robotic Hand by Foot: An Experimental Study in Virtual Reality.

    Directory of Open Access Journals (Sweden)

    Elahe Abdi

    Full Text Available In the operational theater, the surgical team could highly benefit from a robotic supplementary hand under the surgeon's full control. The surgeon may so become more autonomous; this may reduce communication errors with the assistants and take over difficult tasks such as holding tools without tremor. In this paper, we therefore examine the possibility to control a third robotic hand with one foot's movements. Three experiments in virtual reality were designed to assess the feasibility of this control strategy, the learning curve of the subjects in different tasks and the coordination of foot movements with the two natural hands. Results show that the limbs are moved simultaneously, in parallel rather than serially. Participants' performance improved within a few minutes of practice without any specific difficulty to complete the tasks. Subjective assessment by the subjects indicated that controlling a third hand by foot has been easy and required only negligible physical and mental efforts. The sense of ownership was reported to improve through the experiments. The mental burden was not directly related to the level of motion required by a task, but depended on the type of activity and practice. The most difficult task was moving two hands and foot in opposite directions. These results suggest that a combination of practice and appropriate tasks can enhance the learning process for controlling a robotic hand by foot.

  15. Initial experience with visualizing hand and foot tendons by dual-energy computed tomography.

    Science.gov (United States)

    Deng, Kai; Sun, Cong; Liu, Cheng; Ma, Rui

    2009-01-01

    To assess the feasibility of visualizing hand and foot tendons by dual-energy computed tomography (CT). Twenty patients who suffered from hand or feet pains were scanned on dual-source CT (Definition, Forchheim, Germany) with dual-energy mode at tube voltages of 140 and 80 kV and a corresponding ratio of 1:4 between tube currents. The reconstructed images were postprocessed by volume rendering techniques (VRT) and multiplanar reconstruction (MPR). All of the suspected lesions were confirmed by surgery or follow-up studies. Twelve patients (total of 24 hands and feet, respectively) were found to be normal and the other eight patients (total of nine hands and feet, respectively) were found abnormal. Dual-energy techniques are very useful in visualizing tendons of the hands and feet, such as flexor pollicis longus tendon, flexor digitorum superficialis/profundus tendon, Achilles tendon, extensor hallucis longus tendon, and extensor digitorum longus tendon, etc. It can depict the whole shape of the tendons and their fixation points clearly. Peroneus longus tendon in the sole of the foot was not displayed very well. The distal ends of metacarpophalangeal joints with extensor digitoium tendon and extensor pollicis longus tendon were poorly shown. The lesions of tendons such as the circuitry, thickening, and adherence were also shown clearly. Dual-energy CT offers a new method to visualize tendons of the hand and foot. It could clearly display both anatomical structures and pathologic changes of hand and foot tendons.

  16. Skin Cancer of the Hand and Upper Extremity

    Science.gov (United States)

    ... Therapist? Media Find a Hand Surgeon Home Anatomy Skin Cancer of the Hand and Upper Extremity Email ... E – Evolving (changing in any way) How is Skin Cancer Diagnosed? Diagnosis starts with you asking your ...

  17. Accuracy of Plantar Electrodes Compared with Hand and Foot Electrodes in Fat-free-mass Measurement

    Directory of Open Access Journals (Sweden)

    Michel Y. Jaffrin

    2014-01-01

    Full Text Available This paper investigates the measurement of fat-free mass (FFM by bioimpedance using foot-to-foot impedancemeters (FFI with plantar electrodes measuring the foot-to-foot resistance R34 and hand-to-foot medical impedancemeters. FFM measurements were compared with corresponding data using Dual X-ray absorptiometry (DXA. Equations giving FFM were established using linear multiple regression on DXA data in a first group of 170 subjects. For validation, these equations were used on a second group of 86 subjects, and FFM were compared with DXA data; no significant difference was observed. The same protocol was repeated, but using electrodes on the right hand and foot in standing position to measure the hand to-foot resistance R13. Mean differences with DXA were higher for R13 than for R34. Effect of electrode size and feet position on resistance was also investigated. R34 decreased when electrode area increased or if feet were moved forward. It decreased if feet were moved backward. A proper configuration of contact electrodes can improve measurement accuracy and reproducibility of FFI.

  18. A Soft Casting Technique for Managing Pediatric Hand and Foot Burns.

    Science.gov (United States)

    Choi, Young Mee; Nederveld, Cindy; Campbell, Kristen; Moulton, Steven

    2018-04-04

    Hand and foot burns in children are difficult to dress. The authors have developed a soft casting technique to manage burns to these areas. The aim of this study is to report the outcomes using weekly dressing changes with a soft casting technique to manage pediatric hand and foot burns in the outpatient setting. A retrospective chart review was performed on children with burns to the hands or feet, who underwent dressing changes with a soft casting technique at the Children's Hospital Colorado Burn Center. Soft casting was performed by placing antibiotic ointment-impregnated nonadherent gauze over the burn wound(s), wrapping the extremity using rolled gauze, applying soft cast pad, plaster, soft cast tape, and an elastic bandage. This was changed weekly. Two hundred ninety-eight children with hand burns had a mean age of 16.8 ± 2 months. Two hundred forty-eight children had partial thickness burn injuries (83%), 50 had full thickness burn injuries (17%), and the mean total body surface area (TBSA) was 1 ± 2.4%. The mean time to heal was 10.1 ± 1.7 days for all subjects. Sixty-six children with foot burns were identified with a mean age of 24 ± 2.6 months. Forty-six children had partial thickness injuries (70%), 20 had full thickness burn injuries (30%), and the mean TBSA was 2.3 ± 2.9%. The mean time to heal was 14.1 ± 2.2 days for all subjects. Weekly dressing changes using a soft casting technique are effective for the outpatient management of pediatric hand and foot burns. This method avoids costly inpatient hospital care, reduces the number of painful dressing changes, and allows children to heal in their own environment.

  19. Multiplication factor versus regression analysis in stature estimation from hand and foot dimensions.

    Science.gov (United States)

    Krishan, Kewal; Kanchan, Tanuj; Sharma, Abhilasha

    2012-05-01

    Estimation of stature is an important parameter in identification of human remains in forensic examinations. The present study is aimed to compare the reliability and accuracy of stature estimation and to demonstrate the variability in estimated stature and actual stature using multiplication factor and regression analysis methods. The study is based on a sample of 246 subjects (123 males and 123 females) from North India aged between 17 and 20 years. Four anthropometric measurements; hand length, hand breadth, foot length and foot breadth taken on the left side in each subject were included in the study. Stature was measured using standard anthropometric techniques. Multiplication factors were calculated and linear regression models were derived for estimation of stature from hand and foot dimensions. Derived multiplication factors and regression formula were applied to the hand and foot measurements in the study sample. The estimated stature from the multiplication factors and regression analysis was compared with the actual stature to find the error in estimated stature. The results indicate that the range of error in estimation of stature from regression analysis method is less than that of multiplication factor method thus, confirming that the regression analysis method is better than multiplication factor analysis in stature estimation. Copyright © 2012 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  20. Reconstruction of bilateral tibial aplasia and split hand-foot syndrome in a father and daughter.

    Science.gov (United States)

    Al Kaissi, Ali; Ganger, Rudolf; Klaushofer, Klaus; Grill, Franz

    2014-01-01

    Tibial aplasia is of heterogeneous aetiology, the majority of reports are sporadic. We describe the reconstruction procedures in two subjects - a daughter and father manifested autosomal dominant (AD) inheritance of the bilateral tibial aplasia and split hand-foot syndrome. Reconstruction of these patients required multiple surgical procedures and orthoprosthesis was mandatory. The main goal of treatment was to achieve walking. Stabilization of the ankle joint by fibular-talar-chondrodesis on both sides, followed by bilateral Brown-procedure at the knee joint level has been applied accordingly. The outcome was with improved function of the deformed limbs and walking was achieved with simultaneous designation of orthotic fitting. This is the first study encompassing the diagnosis and management of a father and daughter with bilateral tibial aplasia associated with variable split hand/foot deformity without foot ablation. Our patients showed the typical AD pattern of inheritance of split-hand/foot and tibial aplasia.

  1. Multi-segment foot kinematics and ground reaction forces during gait of individuals with plantar fasciitis.

    Science.gov (United States)

    Chang, Ryan; Rodrigues, Pedro A; Van Emmerik, Richard E A; Hamill, Joseph

    2014-08-22

    Clinically, plantar fasciitis (PF) is believed to be a result and/or prolonged by overpronation and excessive loading, but there is little biomechanical data to support this assertion. The purpose of this study was to determine the differences between healthy individuals and those with PF in (1) rearfoot motion, (2) medial forefoot motion, (3) first metatarsal phalangeal joint (FMPJ) motion, and (4) ground reaction forces (GRF). We recruited healthy (n=22) and chronic PF individuals (n=22, symptomatic over three months) of similar age, height, weight, and foot shape (p>0.05). Retro-reflective skin markers were fixed according to a multi-segment foot and shank model. Ground reaction forces and three dimensional kinematics of the shank, rearfoot, medial forefoot, and hallux segment were captured as individuals walked at 1.35 ms(-1). Despite similarities in foot anthropometrics, when compared to healthy individuals, individuals with PF exhibited significantly (pfoot kinematics and kinetics. Consistent with the theoretical injury mechanisms of PF, we found these individuals to have greater total rearfoot eversion and peak FMPJ dorsiflexion, which may put undue loads on the plantar fascia. Meanwhile, increased medial forefoot plantar flexion at initial contact and decreased propulsive GRF are suggestive of compensatory responses, perhaps to manage pain. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. Reconstruction of bilateral tibial aplasia and split hand-foot syndrome in a father and daughter

    Directory of Open Access Journals (Sweden)

    Ali Al Kaissi

    2014-01-01

    Full Text Available Background: Tibial aplasia is of heterogeneous aetiology, the majority of reports are sporadic. We describe the reconstruction procedures in two subjects - a daughter and father manifested autosomal dominant (AD inheritance of the bilateral tibial aplasia and split hand-foot syndrome. Materials and Methods: Reconstruction of these patients required multiple surgical procedures and orthoprosthesis was mandatory. The main goal of treatment was to achieve walking. Stabilization of the ankle joint by fibular-talar-chondrodesis on both sides, followed by bilateral Brown-procedure at the knee joint level has been applied accordingly. Results: The outcome was with improved function of the deformed limbs and walking was achieved with simultaneous designation of orthotic fitting. Conclusion: This is the first study encompassing the diagnosis and management of a father and daughter with bilateral tibial aplasia associated with variable split hand/foot deformity without foot ablation. Our patients showed the typical AD pattern of inheritance of split-hand/foot and tibial aplasia.

  3. The effect of anaesthesia on the radiosensitivity of rat intestine, foot skin and R-1 tumours

    International Nuclear Information System (INIS)

    Kal, H.B.; Gaiser, J.F.

    1980-01-01

    A comparison has been made of the effects of Nembutal (sodium pentobarbital) and Ethrane (2-chloro-1,1,2-trifluoroethyldifluoromethyl ether) anaesthesia on the radiation responses of rat intestine, foot skin and R-1 rhabdomyosarcoma. Single-dose experiments under Nembutal or short-lasting Ethrane anaesthesia resulted in equivalent radiosensitivities for the R-1 sarcoma and foot skin, whereas Ethrane induced radiosensitization in the intestine. In the Ethrane anaesthesia lasting 3 hours, and in the split-dose experiments, Ethrane inhibited repair of radiation-induced damage in the R-1 sarcoma and in the foot skin. It is therefore recommended that the use of Ethrane as an anaesthetic should be avoided in experiments designed to investigate repair of damage in fractionated studies or during protracted irradiation treatments. (UK)

  4. Imaging of Charcot foot

    International Nuclear Information System (INIS)

    Erlemann, Rainer; Schmitz, Annette

    2014-01-01

    The onset of a Charcot foot ist a feared complication of a long lasting diabetes mellitus. A peripheral neuropathy and continuous weight bearing of the foot subsequent to repeated traumas depict the conditions. There exist three types of a Charcot foot, an atrophic, a hypertophic and a mixed type. In early stages a differentiation from osteoarthritis is difficult. Subluxation or luxation within the Lisfranc's joint is typical. The joints of the foot could rapidly and extensively be destroyed or may present the morphology of a 'superosteoarthritis'. Often, soft tissue infections or osteomyelitis evolve from ulcers of the skin as entry points. Diagnosis of osteomyelitis necessitate MR imaging as plain radiography offers only low sensitivity for detection of an osteomyelitis. The existence of periosteal reactions is not a proof for osteomyelitis. Bone marrow edema and soft tissue edema also appear in a non infected Charcot foot. The range of soft tissue infections goes from cellulitis over phlegmon to abscesses. The ghost sign is the most suitable diagnostic criterion for osteomyelitis. In addition, the penumbra sign or the existence of a sinus tract between a skin ulcer and the affected bone may be helpful. (orig.)

  5. Outbreak of variant hand-foot-and-mouth disease caused by coxsackievirus A6 in Auckland, New Zealand.

    Science.gov (United States)

    Hayman, Rebecca; Shepherd, Michael; Tarring, Claire; Best, Emma

    2014-10-01

    Hand-foot-and-mouth disease is a common, usually mild childhood illness caused by enteroviruses. Over the last five years, coxsackievirus A6 has been identified as a causative agent in outbreaks in Europe, South-East Asia and America. It has an atypical presentation compared with other enteroviruses, with more widespread rash, larger blisters and subsequent skin peeling and/or nail shedding. We give the first description of an outbreak of coxsackievirus A6 in New Zealand and how health-care communication networks enabled detection of and dissemination of information about this emergent strain. © 2014 The Authors. Journal of Paediatrics and Child Health © 2014 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  6. Studies on the Estimation of Stature from Hand and Foot Length of an Individual

    Directory of Open Access Journals (Sweden)

    O. S. Saka

    2016-10-01

    Full Text Available Background: Studies on the estimation of stature from hand and foot length of an individual are essential study in personal identification. Aim and Objectives: This study is to find out correlation between statures with hand and foot dimensions in both sexes and gender comparison from an individual in Lautech Staff College in Ogbomoso and College ogbomoso and College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria. Material and Methods: A sample of 140 students and staff; 70 male and 70 female Students and staff of Lautech Staff College in Ogbomoso and College ogbomoso and College of Health Sciences, Obafemi Awolowo University, Ile-Ife, between 16-35years were considered and measurements were taken for each of the parameters. Gender differences for the two parameters were determined using Student t-test. Pearson's correlation coefficient (r was used to examine the relationship between two anthropometric parameters and standing height (stature. All these measurements were done by using standard anthropometric instruments and standard anthropometric techniques. Results: The findings of the study indicated that the males mean values are not significantly difference when compared with females mean values in all measured parameters. The study showed significant (p<0.001 positive correlation between the stature with hand lengths and foot lengths. The hand and foot length provide accurate and reliable means in establishing the height of an individual. Conclusion: This study will be useful for forensic scientists and anthropologists as well as anatomists in ascertain medico-legal cases

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

    Directory of Open Access Journals (Sweden)

    Ronald B. Willemse

    2016-01-01

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

  8. Phenotypic subregions within the split-hand/foot malformation 1 locus

    DEFF Research Database (Denmark)

    Rasmussen, Malene Bøgehus; Kreiborg, Sven; Jensen, Per

    2016-01-01

    , possibly influenced by sex and imprinting. We report on a new family with five affected individuals with syndromic SHFM1 that includes split-hand/foot malformations, hearing loss, and craniofacial anomalies, and an inv(7)(q21.3q35) present both in the proband and her affected son. The proximal inversion...

  9. Regional differences in the skin blood flow at various sites of the body studied by xenon 133

    International Nuclear Information System (INIS)

    Tsuchida, Y.

    1987-01-01

    Normal skin blood flow was measured by the xenon 133 clearance method at different anatomic sites of the body and the following results were obtained. First, the skin blood flow of the face and anterior chest was significantly greater than that of the deltoid region (P less than 0.01). The skin blood flow of the dorsal side of the hand and foot was significantly lower than that of the deltoid region (P less than 0.01). A tendency was observed for the skin blood flow to decrease gradually from the upper part of the body to the lower part of the body. For example, the ratio of the highest value at the face to the lowest value at the dorsal side of the foot was about 2.5:1, indicating a remarkable difference among the various sites of the body. The skin blood flow at the dorsum of the hand was significantly higher by about 25.4 percent than that of the foot (P less than 0.01). Second, the skin blood flow at the left side of the deltoid region was higher by about 5 percent than that of the right side (P less than 0.01). Bilateral comparison of the skin blood flow at the dorsal side of the hand and foot showed that the values were almost the same on the left and right

  10. Treatment of Diabetic Foot Ulcer Using Matriderm In Comparison with a Skin Graft

    Directory of Open Access Journals (Sweden)

    Hyojin Jeon

    2013-07-01

    Full Text Available BackgroundFor patients with neuropathy, vasculopathy, and impairment of wound healing, treatment of a diabetic foot ulcer poses many challenges. A large number of dermal analogues have been invented in an effort to overcome these challenges. Matriderm, a dermal analogue, is made from bovine collagen and elastin. This study was conducted in order to evaluate the effectiveness of Matriderm for treatment of diabetic foot ulcers, in comparison with skin grafting.MethodsSixty patients with diabetic foot ulcer were included in this prospective study. The average age of the patients, who had type II diabetes mellitus, was 58 years old. The patients were allocated to an experimental or control group with their consents. The patients were selected with their consent for inclusion in an experimental group and a control group. Patients in the experimental group received a Matriderm appliance and a split-thickness skin graft, while those in the control group received only a split-thickness skin graft.ResultsA shorter hospitalization period (7.52 weeks was observed in the experimental group than in the control group (9.22 weeks, and a shorter period of time (8.61 weeks was required for complete healing, compared with the control group (12.94 weeks, with statistical significance (P<0.05. A higher elasticity ratio of the affected side to the non-affected side was observed in the experimental group, compared with the control group (P<0.01.ConclusionsMatriderm enables effective healing and improves elasticity in treatment of patients with diabetic foot ulcer.

  11. Skin grafting and tissue replacement for treating foot ulcers in people with diabetes.

    Science.gov (United States)

    Santema, Trientje B; Poyck, Paul P C; Ubbink, Dirk T

    2016-02-11

    Foot ulceration is a major problem in people with diabetes and is the leading cause of hospitalisation and limb amputations. Skin grafts and tissue replacements can be used to reconstruct skin defects for people with diabetic foot ulcers in addition to providing them with standard care. Skin substitutes can consist of bioengineered or artificial skin, autografts (taken from the patient), allografts (taken from another person) or xenografts (taken from animals). To determine the benefits and harms of skin grafting and tissue replacement for treating foot ulcers in people with diabetes. In April 2015 we searched: The Cochrane Wounds Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library); Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid EMBASE and EBSCO CINAHL. We also searched clinical trial registries to identify ongoing studies. We did not apply restrictions to language, date of publication or study setting. Randomised clinical trials (RCTs) of skin grafts or tissue replacements for treating foot ulcers in people with diabetes. Two review authors independently extracted data and assessed the quality of the included studies. We included seventeen studies with a total of 1655 randomised participants in this review. Risk of bias was variable among studies. Blinding of participants, personnel and outcome assessment was not possible in most trials because of obvious differences between the treatments. The lack of a blinded outcome assessor may have caused detection bias when ulcer healing was assessed. However, possible detection bias is hard to prevent due to the nature of the skin replacement products we assessed, and the fact that they are easily recognisable. Strikingly, nearly all studies (15/17) reported industry involvement; at least one of the authors was connected to a commercial organisation or the study was funded by a commercial organisation. In addition, the funnel plot for

  12. Hand motion segmentation against skin colour background in breast awareness applications.

    Science.gov (United States)

    Hu, Yuqin; Naguib, Raouf N G; Todman, Alison G; Amin, Saad A; Al-Omishy, Hassanein; Oikonomou, Andreas; Tucker, Nick

    2004-01-01

    Skin colour modelling and classification play significant roles in face and hand detection, recognition and tracking. A hand is an essential tool used in breast self-examination, which needs to be detected and analysed during the process of breast palpation. However, the background of a woman's moving hand is her breast that has the same or similar colour as the hand. Additionally, colour images recorded by a web camera are strongly affected by the lighting or brightness conditions. Hence, it is a challenging task to segment and track the hand against the breast without utilising any artificial markers, such as coloured nail polish. In this paper, a two-dimensional Gaussian skin colour model is employed in a particular way to identify a breast but not a hand. First, an input image is transformed to YCbCr colour space, which is less sensitive to the lighting conditions and more tolerant of skin tone. The breast, thus detected by the Gaussian skin model, is used as the baseline or framework for the hand motion. Secondly, motion cues are used to segment the hand motion against the detected baseline. Desired segmentation results have been achieved and the robustness of this algorithm is demonstrated in this paper.

  13. Stepwise surgical approach to diabetic partial foot amputations with autogenous split thickness skin grafting

    Directory of Open Access Journals (Sweden)

    Crystal L. Ramanujam

    2016-06-01

    Full Text Available In the surgical treatment of severe diabetic foot infections, substantial soft tissue loss often accompanies partial foot amputations. These sizeable soft tissue defects require extensive care with the goal of expedited closure to inhibit further infection and to provide resilient surfaces capable of withstanding long-term ambulation. Definitive wound closure management in the diabetic population is dependent on multiple factors and can have a major impact on the risk of future diabetic foot complications. In this article, the authors provide an overview of autogenous skin grafting, including anatomical considerations, clinical conditions, surgical approach, and adjunctive treatments, for diabetic partial foot amputations.

  14. Relationship between limited joint mobility of the hand and diabetic foot risk in patients with type 2 diabetes.

    Science.gov (United States)

    Mineoka, Yusuke; Ishii, Michiyo; Tsuji, Akiko; Komatsu, Yoriko; Katayama, Yuko; Yamauchi, Mitsuko; Yamashita, Aki; Hashimoto, Yoshitaka; Nakamura, Naoto; Katsumi, Yasukazu; Isono, Motohide; Fukui, Michiaki

    2017-06-01

    Foot ulceration is a serious problem for patients with type 2 diabetes (T2D), and the early detection of risks for this condition is important to prevent complications. The present cross-sectional study in T2D patients determined the relationship between limited joint mobility (LJM) of the hand and diabetic foot risk classified using the criteria of the International Working Group on the Diabetic Foot (IWGDF). Relationships between LJM of the hand and foot risk according to IWGDF category, HbA1c, age, body mass index, blood pressure, estimated glomerular filtration (eGFR), and diabetic complications (including diabetic peripheral neuropathy [DPN] and peripheral arterial disease [PAD]) were evaluated in 528 consecutive T2D patients. Poor glycemic control was defined as HbA1c ≥ 7%. Patients with LJM of the hand were older and had a longer duration of diabetes, a higher prevalence of diabetic complications, including DPN and PAD, and a higher IWDGF category (all P foot risk assessed with IWDGF category was correlated with age (odds ratio [OR] 1.04; 95% confidence interval [CI] 1.01-1.06; P = 0.001), poor glycemic control (OR 1.66; 95% CI 1.00-2.77; P = 0.04), eGFR (OR 0.98; 95% CI 0.97-0.99; P = 0.02), and the presence of LJM of the hand (OR 3.86; 95% CI 2.21-6.86; P foot risk. Diagnosis of diabetic hand is simple and non-invasive, and is thus a useful method for assessing the risk of diabetic foot in T2D patients. © 2016 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

  15. Cooling reduces the cutaneous afferent firing response to vibratory stimuli in glabrous skin of the human foot sole.

    Science.gov (United States)

    Lowrey, Catherine R; Strzalkowski, Nicholas D J; Bent, Leah R

    2013-02-01

    Skin on the foot sole plays an important role in postural control. Cooling the skin of the foot is often used to induce anesthesia to determine the role of skin in motor and balance control. The effect of cooling on the four classes of mechanoreceptor in the skin is largely unknown, and thus the aim of the present study was to characterize the effects of cooling on individual skin receptors in the foot sole. Such insight will better isolate individual receptor contributions to balance control. Using microneurography, we recorded 39 single nerve afferents innervating mechanoreceptors in the skin of the foot sole in humans. Afferents were identified as fast-adapting (FA) or slowly adapting (SA) type I or II (FA I n = 16, FA II n = 7, SA I n = 6, SA II n = 11). Receptor response to vibration was compared before and after cooling of the receptive field (2-20 min). Overall, firing response was abolished in 30% of all receptors, and this was equally distributed across receptor type (P = 0.69). Longer cooling times were more likely to reduce firing response below 50% of baseline; however, some afferent responses were abolished with shorter cooling times (2-5 min). Skin temperature was not a reliable indicator of the level of receptor activation and often became uncoupled from receptor response levels, suggesting caution in the use of this parameter as an indicator of anesthesia. When cooled, receptors preferentially coded lower frequencies in response to vibration. In response to a sustained indentation, SA receptors responded more like FA receptors, primarily coding "on-off" events.

  16. [Preparation and antimicrobial effect of aromatic, natural and bacteriostatic foot wash with skin care].

    Science.gov (United States)

    Gao, Su-Hua; Zhao, Guo-Xiang; Yang, Xiao-Dong; Xu, Ling-Ling

    2013-06-01

    To prepare the aromatic, natural and bacteriostatic foot wash with skin care and research the inhibition effect on the different bacteria and pathogenic fungus which cause dermatophytosis. It was prepared by using Sophoraflavescens and Dictamnus dasycarpus as materials with the addition of Aloe extract, essential oil, surfactant, etc. The antifungal and antibacterial activity was researched by the levitation liquid quantitative method. The foot wash smelled faintly scent. The use of this product can produce a rich foam. The inhibitory rate were all more than 90%. The preparation process of the foot wash was simple. It has obviously bacteriostatic and fungistatic effect.

  17. The Effects of Industrial Protective Gloves and Hand Skin Temperatures on Hand Grip Strength and Discomfort Rating.

    Science.gov (United States)

    Ramadan, Mohamed Z

    2017-12-04

    Daily working activities and functions require a high contribution of hand and forearm muscles in executing grip force. To study the effects of wearing different gloves on grip strength, under a variety of hand skin temperatures, an assessment of the maximum grip strength was performed with 32 healthy male workers with a mean age (standard deviation) of 30.44 (5.35) years wearing five industrial gloves at three hand skin temperatures. Their ages and anthropometric characteristics including body mass index (BMI), hand length, hand width, hand depth, hand palm, and wrist circumference were measured. The hand was exposed to different bath temperatures (5 °C, 25 °C, and 45 °C) and hand grip strength was measured using a Jamar hydraulic hand dynamometer with and without wearing the gloves (chemical protection glove, rubber insulating glove, anti-vibration impact glove, cotton yarn knitted glove, and RY-WG002 working glove). The data were analyzed using the Shapiro-Wilk test, Pearson correlation coefficient, Tukey test, and analysis of variance (ANOVA) of the within-subject design analysis. The results showed that wearing gloves significantly affected the maximum grip strength. Wearing the RY-WG002 working glove produced a greater reduction on the maximum grip when compared with the bare hand, while low temperatures (5 °C) had a significant influence on grip when compared to medium (25 °C) and high (45 °C) hand skin temperatures. In addition, participants felt more discomfort in both environmental extreme conditions. Furthermore, they reported more discomfort while wearing neoprene, rubber, and RY-WG002 working gloves.

  18. Virological investigation of hand, foot, and mouth disease in a tertiary care center in South India

    Directory of Open Access Journals (Sweden)

    Pavithra M Vijayaraghavan

    2012-01-01

    Full Text Available Context: Hand, foot, and mouth disease (HFMD remains a common problem in India, yet its etiology is largely unknown as diagnosis is based on clinical characteristics. There are very few laboratory-based molecular studies on HFMD outbreaks. Aim: The aim of this study was to characterize HFMD-related isolates by molecular techniques. Settings and Design: Between 2005 and 2008, during two documented HFMD outbreaks, 30 suspected HFMD cases presented at the Outpatient Unit of the Department of Dermatology, Christian Medical College (CMC, Vellore. Seventy-eight clinical specimens (swabs from throat, mouth, rectum, anus, buttocks, tongue, forearm, sole, and foot were received from these patients at the Department of Clinical Virology, CMC, for routine diagnosis of hand, foot, and mouth disease. Materials and Methods: Samples from these patients were cultured in Vero and rhabdomyosarcoma (RD cell lines. Isolates producing enterovirus-like cytopathogenic effect (CPE in cell culture were identified by a nested reverse transcription-based polymerase chain reaction (RT-PCR and sequenced. The nucleotide sequences were analyzed using the BioEdit sequence program. Homology searches were performed using the Basic Local Alignment Search Tool (BLAST algorithm. Statistical Analysis used: The statistical analysis was performed using Epi Info version 6.04b and Microsoft Excel 2002 (Microsoft Office XP. Results: Of the 30 suspected HFMD cases, only 17 (57% were laboratory confirmed and Coxsackievirus A16 (CVA16 was identified as the etiological agent in all these cases. Conclusions: Coxsackievirus A16 (CVA16 was identified as the virus that caused the HFMD outbreaks in Vellore between 2005 and 2008. Early confirmation of HFMD helps to initiate control measures to interrupt virus transmission. In the laboratory, classical diagnostic methods, culture and serological tests are being replaced by molecular techniques. Routine surveillance systems will help understand the

  19. Homozygous sequence variants in the WNT10B gene underlie split hand/foot malformation

    Directory of Open Access Journals (Sweden)

    Asmat Ullah

    2018-01-01

    Full Text Available Abstract Split-hand/split-foot malformation (SHFM, also known as ectrodactyly is a rare genetic disorder. It is a clinically and genetically heterogeneous group of limb malformations characterized by absence/hypoplasia and/or median cleft of hands and/or feet. To date, seven genes underlying SHFM have been identified. This study described four consanguineous families (A-D segregating SHFM in an autosomal recessive manner. Linkage in the families was established to chromosome 12p11.1–q13.13 harboring WNT10B gene. Sequence analysis identified a novel homozygous nonsense variant (p.Gln154* in exon 4 of the WNT10B gene in two families (A and B. In the other two families (C and D, a previously reported variant (c.300_306dupAGGGCGG; p.Leu103Argfs*53 was detected. This study further expands the spectrum of the sequence variants reported in the WNT10B gene, which result in the split hand/foot malformation.

  20. Late occurring lesions in the skin of rats after repeated doses of X-rays

    International Nuclear Information System (INIS)

    Hopewell, J.W.

    1985-01-01

    Late radiation damage, characterized by atrophy and necrosis in the skin and subcutaneous tissues, has been demonstrated in both the tail and feet of rats. The incidence of necrosis increased with total dose. These total doses, in the range 72-144 Gy, were given as 4-8 treatment of 18 Gy, each dose separated from the next by an interval of 28 days. This treatment protocol minimized acute epithelial skin reactions. The same regime applied to the skin on the back of rats resulted in a very severe acute reaction occurring after the second to fifth dose of 18 Gy. This was surprising since back skin, like tail skin, is less sensitive to large single doses of radiation than that of the foot. The late radiation reaction in the foot and tail of rats are compared and contrasted with other attempts to assess late effects in rodent skin and with late changes seen in pig skin. (author)

  1. Hand and finger dexterity as a function of skin temperature, EMG, and ambient condition.

    Science.gov (United States)

    Chen, Wen-Lin; Shih, Yuh-Chuan; Chi, Chia-Fen

    2010-06-01

    This article examines the changes in skin temperature (finger, hand, forearm), manual performance (hand dexterity and strength), and forearm surface electromyograph (EMG) through 40-min, 11 degrees C water cooling followed by 15-min, 34 degrees C water rewarming; additionally, it explores the relationship between dexterity and the factors of skin temperature, EMG, and ambient condition. Hand exposure in cold conditions is unavoidable and significantly affects manual performance. Two tasks requiring gross and fine dexterity were designed, namely, nut loosening and pin insertion, respectively. The nested-factorial design includes factors of gender, participant (nested within gender), immersion duration, muscle type (for EMG), and location (for skin temperature). The responses are changes in dexterity, skin temperature, normalized amplitude of EMG, and grip strength. Finally, factor analysis and stepwise regression are used to explore factors affecting hand and finger dexterity. Dexterity, EMG, and skin temperature fell with prolonged cooling, but the EMG of the flexor digitorum superficialis remained almost unchanged during the nut loosening task. All responses but the forearm skin temperature recovered to the baseline level at the end of rewarming. The three factors extracted by factor analysis are termed skin temperature, ambient condition, and EMG. They explain approximately two thirds of the variation of the linear models for both dexterities, and the factor of skin temperature is the most influential. Sustained cooling and warming significantly decreases and increases finger, hand, and forearm skin temperature. Dexterity, strength, and EMG are positively correlated to skin temperature. Therefore, keeping the finger, hand, and forearm warm is important to maintaining hand performance. The findings could be helpful to building safety guidelines for working in cold environments.

  2. The Effects of Industrial Protective Gloves and Hand Skin Temperatures on Hand Grip Strength and Discomfort Rating

    Directory of Open Access Journals (Sweden)

    Mohamed Z. Ramadan

    2017-12-01

    Full Text Available Daily working activities and functions require a high contribution of hand and forearm muscles in executing grip force. To study the effects of wearing different gloves on grip strength, under a variety of hand skin temperatures, an assessment of the maximum grip strength was performed with 32 healthy male workers with a mean age (standard deviation of 30.44 (5.35 years wearing five industrial gloves at three hand skin temperatures. Their ages and anthropometric characteristics including body mass index (BMI, hand length, hand width, hand depth, hand palm, and wrist circumference were measured. The hand was exposed to different bath temperatures (5 °C, 25 °C, and 45 °C and hand grip strength was measured using a Jamar hydraulic hand dynamometer with and without wearing the gloves (chemical protection glove, rubber insulating glove, anti-vibration impact glove, cotton yarn knitted glove, and RY-WG002 working glove. The data were analyzed using the Shapiro–Wilk test, Pearson correlation coefficient, Tukey test, and analysis of variance (ANOVA of the within-subject design analysis. The results showed that wearing gloves significantly affected the maximum grip strength. Wearing the RY-WG002 working glove produced a greater reduction on the maximum grip when compared with the bare hand, while low temperatures (5 °C had a significant influence on grip when compared to medium (25 °C and high (45 °C hand skin temperatures. In addition, participants felt more discomfort in both environmental extreme conditions. Furthermore, they reported more discomfort while wearing neoprene, rubber, and RY-WG002 working gloves.

  3. [Effects of self-foot reflexology on stress, fatigue, skin temperature and immune response in female undergraduate students].

    Science.gov (United States)

    Lee, Young-Mee

    2011-02-01

    The purpose of this study was to evaluate the effects of self-foot reflexology on stress (perceived stress, urine cortisol level, and serum cortisol level), fatigue, skin temperature and immune response in female undergraduate students. The research design was a nonequivalent control group pretest-post test design. Participants were 60 university students: 30 in the experiment group and 30 in the control group. The period of this study was from April to June 2010. The program was performed for 1 hr a session, three times a week for 6 weeks. The data were analyzed using the SPSS/WIN 17.0 program. The results showed that self-foot reflexology was effective in reducing perceived stress and fatigue, and raised skin temperature in female undergraduate students. But cortisol levels and immune response were not statistically significant different. The results of this study indicate that self-foot reflexology is an effective nursing intervention in reducing perceived stress and fatigue and, in improving skin temperature. Therefore, it is recommended that this be used in clinical practice as an effective nursing intervention for in female undergraduate students.

  4. Cold-induced vasoconstriction at forearm and hand skin sites: the effect of age

    OpenAIRE

    Kingma, B.R.M.; Frijns, A.J.H.; Saris, W.H.M.; Steenhoven, van, A.A.; Marken Lichtenbelt, van, W.D.

    2010-01-01

    During mild cold exposure, elderly are at risk of hypothermia. In humans, glabrous skin at the hands is well adapted as a heat exchanger. Evidence exists that elderly show equal vasoconstriction due to local cooling at the ventral forearm, yet no age effects on vasoconstriction at hand skin have been studied. Here, we tested the hypotheses that at hand sites (a) elderly show equal vasoconstriction due to local cooling and (b) elderly show reduced response to noradrenergic stimuli. Skin perfus...

  5. The thermoregulation of healthy individuals, overweight-obese, and diabetic from the plantar skin thermogram: a clue to predict the diabetic foot.

    Science.gov (United States)

    Renero-C, Francisco-J

    2017-01-01

    Background : Thermoregulation is a complex autonomic process to keep or to dissipate heat in the human body. Methods : In this work, by means of the thermogram of the plantar skin, the thermoregulation of healthy individuals, overweight-obese, and diabetic is discussed. Results : The thermograms of the plantar skin, for the healthy individuals, are: (1) symmetrical, the temperature distribution of the right foot being a mirror image of that of the left foot ; (2) the thermograms of women, on average, are 3°C colder than those of the men; and (3) the temperature distributions decrease distally from the medial longitudinal arch. The plantar skin thermograms of overweight-obese individuals show: (1) increased average temperature of both feet and for both genders; (2) no symmetry between the left and right feet thermograms; and (3) the temperature distribution is still decreasing from the medial longitudinal arch to the periphery of the foot. However, the standard deviation, for each averaged temperature of the angiosomes, shows greater uncertainty. Most thermograms of diabetic individuals show temperature increase on the plantar skin, and are mostly symmetric between left and right feet. Conclusions: An asymmetric thermogram of the plantar skin of diabetic individuals, where one foot is hotter than the other, may mean that the coldest foot is losing the capacity to communicate properly with the central nervous system and/or that vasoconstriction/vasodilatation is having problems in regulating the passing of blood through the vessels. Thus, the asymmetric thermograms of diabetic patients, and particularly those coldest regions of foot are of interest, because of the reduction of the local autonomic sensing and the lack of achieving properly the passing of the blood.

  6. Imaging of Charcot foot; Bildgebung des Charcot-Fusses

    Energy Technology Data Exchange (ETDEWEB)

    Erlemann, Rainer; Schmitz, Annette [Helios Klinikum Duisburg, Helios St. Johannes Klinik, Duisburg (Germany). Inst. fuer Radiologie

    2014-03-15

    The onset of a Charcot foot ist a feared complication of a long lasting diabetes mellitus. A peripheral neuropathy and continuous weight bearing of the foot subsequent to repeated traumas depict the conditions. There exist three types of a Charcot foot, an atrophic, a hypertophic and a mixed type. In early stages a differentiation from osteoarthritis is difficult. Subluxation or luxation within the Lisfranc's joint is typical. The joints of the foot could rapidly and extensively be destroyed or may present the morphology of a 'superosteoarthritis'. Often, soft tissue infections or osteomyelitis evolve from ulcers of the skin as entry points. Diagnosis of osteomyelitis necessitate MR imaging as plain radiography offers only low sensitivity for detection of an osteomyelitis. The existence of periosteal reactions is not a proof for osteomyelitis. Bone marrow edema and soft tissue edema also appear in a non infected Charcot foot. The range of soft tissue infections goes from cellulitis over phlegmon to abscesses. The ghost sign is the most suitable diagnostic criterion for osteomyelitis. In addition, the penumbra sign or the existence of a sinus tract between a skin ulcer and the affected bone may be helpful. (orig.)

  7. Design and Development of Hand and Foot Contamination Monitor

    Directory of Open Access Journals (Sweden)

    F. Akter

    2014-08-01

    Full Text Available A hand and foot contamination monitor is a health physics instrument to provide detection and measurement of beta-gamma contamination on the palm of each hand and on the bottom surface of both feet/shoes. There are four channels of detection for two hands and two feet. Four G-M detectors have been used in a single unit to cover the whole area of hand and feet. A regulated high voltage DC power supply (900 V has been designed using the PIC12F675 microcontroller to operate the pancake Geiger-Müller detectors. The reading is displayed on a linearly scaled 0-100 Bq/cm2 analog panel meter. The monitor detects beta–gamma radiation emitted by radioactive materials, and if the detected value exceeds a preset level, the monitor sounds an alarm and displays a reading in the respective panel meter. Indicator lamps are used to show the status of contamination. The performance of the system has been tested by using pulse generator and by flat surface radioactive calibration sources. Electronic linearity, detection efficiency, response to the contamination, calibration factor and percentage of error has been measured. Test results were satisfactory and the present system can be used instead of similar imported instruments.

  8. Cold-induced vasoconstriction at forearm and hand skin sites: the effect of age.

    Science.gov (United States)

    Kingma, B R M; Frijns, A J H; Saris, W H M; van Steenhoven, A A; van Marken Lichtenbelt, W D

    2010-07-01

    During mild cold exposure, elderly are at risk of hypothermia. In humans, glabrous skin at the hands is well adapted as a heat exchanger. Evidence exists that elderly show equal vasoconstriction due to local cooling at the ventral forearm, yet no age effects on vasoconstriction at hand skin have been studied. Here, we tested the hypotheses that at hand sites (a) elderly show equal vasoconstriction due to local cooling and (b) elderly show reduced response to noradrenergic stimuli. Skin perfusion and mean arterial pressure were measured in 16 young adults (Y: 18-28 years) and 16 elderly (E: 68-78 years). To study the effect of local vasoconstriction mechanisms local sympathetic nerve terminals were blocked by bretylium (BR). Baseline local skin temperature was clamped at 33 degrees C. Next, local temperature was reduced to 24 degrees C. After 15 min of local cooling, noradrenaline (NA) was administered to study the effect of neural vasoconstriction mechanisms. No significant age effect was observed in vasoconstriction due to local cooling at BR sites. After NA, vasoconstriction at the forearm showed a significant age effect; however, no significant age effect was found at the hand sites. [Change in CVC (% from baseline): Forearm Y: -76 +/- 3 vs. E: -60 +/- 5 (P forearm, elderly did not show a blunted response to local cooling and noradrenaline at hand skin sites. This indicates that at hand skin the noradrenergic mechanism of vasoconstriction is maintained with age.

  9. [Application of R-based multiple seasonal ARIMA model, in predicting the incidence of hand, foot and mouth disease in Shaanxi province].

    Science.gov (United States)

    Liu, F; Zhu, N; Qiu, L; Wang, J J; Wang, W H

    2016-08-10

    To apply the ' auto-regressive integrated moving average product seasonal model' in predicting the number of hand, foot and mouth disease in Shaanxi province. In Shaanxi province, the trend of hand, foot and mouth disease was analyzed and tested, under the use of R software, between January 2009 and June 2015. Multiple seasonal ARIMA model was then fitted under time series to predict the number of hand, foot and mouth disease in 2016 and 2017. Seasonal effect was seen in hand, foot and mouth disease in Shaanxi province. A multiple seasonal ARIMA (2,1,0)×(1,1,0)12 was established, with the equation as (1 -B)(1 -B12)Ln (Xt) =((1-1.000B)/(1-0.532B-0.363B(2))*(1-0.644B12-0.454B12(2)))*Epsilont. The mean of absolute error and the relative error were 531.535 and 0.114, respectively when compared to the simulated number of patients from Jun to Dec in 2015. RESULTS under the prediction of multiple seasonal ARIMA model showed that the numbers of patients in both 2016 and 2017 were similar to that of 2015 in Shaanxi province. Multiple seasonal ARIMA (2,1,0)×(1,1,0)12 model could be used to successfully predict the incidence of hand, foot and mouth disease in Shaanxi province.

  10. [Reconstruction of ankle and foot with combination of free perforator flaps and skin graft].

    Science.gov (United States)

    Yin, Lu; Gong, Ketong; Yin, Zhonggang; Zhang, Bo; Xu, Jianhua

    2017-03-01

    To evaluate the clinical outcomes of free perforator flaps combined with skin graft for reconstruction of ankle and foot soft tissue defects. Between June 2014 and October 2015, 20 cases of ankle and foot soft tissue defects were treated. There were 16 males and 4 females, aged from 19 to 61 years (mean, 43.3 years). Injury was caused by traffic accident in 7 cases, by crashing in 9 cases, and machine twist in 4 cases. The locations were the ankle in 6 cases, the heel in 3 cases, the dorsum pedis in 4 cases, and the plantar forefoot in 7 cases of avulsion injury after toes amputation. The size of wound ranged from 15 cm×10 cm to 27 cm×18 cm. The time from injury to treatment was from 11 to 52 days (mean, 27 days). The anterolateral thigh perforator flap was used in 11 cases, thoracodorsal antery perforator flap in 3 cases, medial sural artery perforator flap in 4 cases, deep inferior epigastric perforator flap in 1 case, and anteromedial thigh perforator flap in 1 case, including 5 chimeric perforator flaps, 5 polyfoliate perforator flaps, 3 flow-through perforator flaps, and 3 conjoined perforator flaps. The size of the perforator flap ranged from 10.0 cm×6.5 cm to 36.0 cm×8.0 cm, the size of skin graft from 5 cm×3 cm to 18 cm×12 cm. Venous crisis occurred in 2 flaps which survived after symptomatic treatment; 18 flaps survived successfully and skin grafting healed well. The follow-up time ranged 4-18 months (mean, 8.3 months). The flaps had good appearance, texture and color, without infection. The patients could walk normally and do daily activities. Only linear scars were observed at the donor sites. Free perforator flap can be used to reconstruct defects in the ankle and foot, especially in the weight-bearing area of the plantar forefoot. A combination of free perforator flap and skin graft is ideal in reconstruction of great soft tissue defects in the ankle and foot.

  11. Persistent Skin Reactions and Aluminium Hypersensitivity Induced by Childhood Vaccines.

    Science.gov (United States)

    Salik, Elaha; Løvik, Ida; Andersen, Klaus E; Bygum, Anette

    2016-11-02

    There is increasing awareness of reactions to vaccination that include persistent skin reactions. We present here a retrospective investigation of long-lasting skin reactions and aluminium hypersensitivity in children, based on medical records and questionnaires sent to the parents. In the 10-year period 2003 to 2013 we identified 47 children with persistent skin reactions caused by childhood vaccinations. Most patients had a typical presentation of persisting pruritic subcutaneous nodules. Five children had a complex diagnostic process involving paediatricians, orthopaedics and plastic surgeons. Two patients had skin biopsies performed from their skin lesions, and 2 patients had the nodules surgically removed. Forty-two children had a patch-test performed with 2% aluminium chloride hexahydrate in petrolatum and 39 of them (92%) had a positive reaction. The persistent skin reactions were treated with potent topical corticosteroids and disappeared slowly. Although we advised families to continue vaccination of their children, one-third of parents omitted or postponed further vaccinations.

  12. Diffusion tensor magnetic resonance imaging for hand and foot fibers location at the corona radiata: comparison with two lesion studies

    Directory of Open Access Journals (Sweden)

    Dong-Hoon eLee

    2014-09-01

    Full Text Available The corticospinal tract is the motor pathway in the human brain, and corona radiata is an important location to diagnose stroke. We detected hand and foot motor fiber tracts in the corona radiata to investigate accurate locations using diffusion tensor imaging and functional imaging. Ten right-handed normal volunteers participated in this study. We used a probabilistic tracking algorithm, a brain normalization method, and functional imaging results to set out ROIs. Moreover, our results were compared to previous results of lesion studies to confirm their accuracy and usefulness. The location measurements were performed in two index types; anteriority index on the basis of the anterior and posterior location of lateral ventricle, laterality index on the basis of the left and right location. The anteriority indices were 56.40/43.2 (hand/foot at the upper CR and lower CR 40.72/30.90 at the lower CR. The measurements of anteriority and laterality of motor fibers were represented as anteriority index 0.40/0.31 and laterality index 0.60/0.47 (hand/foot. Our results showed that the hand and foot fibers were in good agreements with previous lesion studies. This study and approaches can be used as a standard for diffusion tensor image combined with lesion location studies in patients who need rehabilitation or follow up.

  13. Cold-induced vasoconstriction at forearm and hand skin sites: the effect of age

    NARCIS (Netherlands)

    Kingma, B.R.M.; Frijns, A.J.H.; Saris, W.H.M.; Steenhoven, van A.A.; Marken Lichtenbelt, van W.D.

    2010-01-01

    During mild cold exposure, elderly are at risk of hypothermia. In humans, glabrous skin at the hands is well adapted as a heat exchanger. Evidence exists that elderly show equal vasoconstriction due to local cooling at the ventral forearm, yet no age effects on vasoconstriction at hand skin have

  14. Reconstruction of distal hand and foot defects with the free proximal peroneal artery perforator flap.

    Science.gov (United States)

    Scaglioni, Mario F; Kuo, Yur-Ren; Chen, Yen-Chou

    2016-03-01

    The proximal peroneal artery perforator (PPAP) flap is a reliable, thin fasciocutaneous flap. The purpose of this article was to report our experience with the use of free PPAP flaps for reconstruction of defects of the distal hand and foot. From November 2012 to September 2013, 9 patients received reconstruction with 10 free PPAP flaps. The defect locations included the big toe (2 cases), metatarsophalangeal joint (5 cases), dorsal finger (2 cases) and volar finger (1 case). Flaps were raised based on proximal peroneal perforator vessels without sacrificing the peroneal artery. The first dorsal metatarsal artery (5 cases) and digital artery (5 cases) were dissected as recipient vessels. The flap sizes varied from 2.5 x 2 cm to 9 x 5 cm. All of flaps were survival after surgery. One flap suffered from venous thrombosis and was successfully salvaged by performing a venous thrombectomy and vein graft. The donor sites were all primarily closed with minimal morbidities. Follow-up observations were conducted for 7 to 20 months, and all patients had good functional recovery with satisfying cosmetic results. Perforators arising from the peroneal artery in the proximal lateral leg can be used to design small, pliable fasciocutaneous flaps. Although the pedicle is short, the vessel diameter is adequate for microvascular anastomosis to the distal foot and hand recipient vessels. The free PPAP flap may be a good option for reconstructing distal hand and foot defects. © 2014 Wiley Periodicals, Inc.

  15. Reirradiation of healing murine skin

    International Nuclear Information System (INIS)

    Terry, N.H.A.; Aldana, M.W.; Travis, E.L.

    1987-01-01

    The most common way of assessing residual radiation damage in a tissue has been to retreat at a fixed time interval after a first treatment. Previous studies in skin have shown that the greatest proportion of remembered dose (20-40%) was seen if the retreatment interval was one month, shortly after the acute reaction caused by the first treatment has subsided. Moreover, the observed state of the foot at retreatment depended on the size of the first dose. After a priming dose of 22.5 Gy, the peak skin reaction of 0.8 returned to zero by Day 27. On retreatment at Day 30, the foot was indistinguishable from controls. After higher first doses, the feet still had significant reaction scores ranging from 0.5 to more than 1.0. Thus, in this present study, feet were retreated at a common level of healing rather than after a fixed time interval. Mice feet were irradiated with a range of X-ray doses (22.5-37.5 Gy) covering the threshold to full response. The feet were reirradiated when their skin reactions had fallen to a common value of 0.5. The time of this retreatment was therefore earlier (13 days) after the lowest priming dose (22.5 Gy) than after higher doses. In these latter instances retreatment times ranged from 18-40 days. These data are compared with those from schedules where the second irradiations were performed a fixed time after the first treatment

  16. Perception of foot temperature in young women with cold constitution: analysis of skin temperature and warm and cold sensation thresholds.

    Science.gov (United States)

    Sadakata, Mieko; Yamada, Yoshiaki

    2007-06-01

    To examine the disease state of cold constitution, physiological measurements of the foot were conducted by investigating thermal sensations under an environmental condition of 25 degrees C-26 degrees C (neutral temperature) in 29 young women with and without cold constitution. The subjects were classified into 3 groups according to their experiences with cold constitution: cold constitution, intermediate, and normal groups. Foot skin temperature was measured by thermography. Thermal sensations were measured on the dorsum of the left foot using a thermal stimulator. Cold and warm spots on the dorsum of the right foot were ascertained. Thermal stimulation was delivered by a copper probe. No significant differences in foot skin temperature among these 3 groups were identified as measured in a laboratory under neutral temperature conditions. However, the mean warm sensation threshold was +6.3+/-1.09 degrees C (mean+/-SEM) for the cold constitution group (n=14), +3.4+/-2.10 degrees C (mean+/-SEM) for the intermediate group (n=7), and -0.25+/-1.96 degrees C (mean+/-SEM) for the normal group (n=6). The difference was significant between the cold constitution and normal groups. No significant differences among the 3 groups were found in the cold sensation threshold. This may be attributable to the distribution of thermal receptors and to chronically reduced blood flow in subcutaneous tissues, where the skin temperature receptors responsible for temperature sensation are located.

  17. Changes in bacterial flora associated with skin damage on hands of health care personnel.

    Science.gov (United States)

    Larson, E L; Hughes, C A; Pyrek, J D; Sparks, S M; Cagatay, E U; Bartkus, J M

    1998-10-01

    In a prospective observational study of 40 nurses (20 with diagnosed hand irritation and 20 without), nurses with damaged hands did not have higher microbial counts (P = .63), but did have a greater number of colonizing species (means: 3.35 and 2.63, P = .03). Although numbers were small, nurses with damaged hands were significantly more likely to be colonized with Staphylococcus hominis (P = .03). Fifty-nine percent of S hominis isolates from nurses with damaged hands were resistant to methicillin compared with 27% of isolates from those with healthy skin (P = .14). Twenty percent of nurses with damaged hands were colonized with Staphylococcus aureus compared with none of the nurses with normal hands (P = .11). Nurses with damaged hands were also twice as likely to have gram-negative bacteria (P = .20), entercocci (P = .13), and Candida (P = .30) present on the hands. Antimicrobial resistance of the coagulase-negative staphylococcal flora (with the exception of S hominis) did not differ between the 2 groups, nor did a trend toward increasing resistance exist when compared with other studies during the past decade. Skin moisturizers and protectant products were used almost universally by nurses at work, primarily products brought from home. Efforts to improve hand condition are warranted because skin damage can change microbial flora. Such efforts should include assessment or monitoring of hand care practices, formal institutional policy adoption and control of use of skin protectant products or lotions, and prudent use of latex gloves or more widespread use of powder-free and nonlatex products.

  18. Buried chip skin grafting in neuropathic diabetic foot ulcers following vacuum-assisted wound bed preparation: enhancing a classic surgical tool with novel technologies.

    Science.gov (United States)

    Kopp, Jürgen; Kneser, Ulrich; Bach, Alexander D; Horch, Raymund E

    2004-09-01

    In patients with diabetes mellitus, complications such as polyneuropathy and peripheral angiopathy inevitably lead to diabetic foot complications including foot ulcers, gangrene, and osteoarthropathy. These conditions necessitate minor or major amputation as part of treatment. In patients with Charcot's arthropathy and predominant neuropathy, recurrent foot ulcers are common in areas of high pressure. Such high pressure is caused by the degrading of the architecture of the foot and inadequate footwear. These patients are a clinical challenge. A select group of such patients may benefit from free surgical tissue transfer, though free or local flap surgery is often difficult or even impossible owing to an impaired arterial circulation. In such wounds, surgical debridement followed by skin grafts often fail due to bacterial burden in the wounds. To circumvent these problems, the authors developed a therapeutic approach using buried chip skin grafting to close granulation wound beds in diabetic feet. Locally applied vacuum therapy (VAC) for wound bed preparation of chronic, nonresponsive foot ulcers and subsequent grafting using the burying technique with a minute fraction of skin was used. Firm closure was achieved. The closed wound was resistant to mechanical irritation.

  19. Functional and morphological studies of photodamaged skin on the hands of middle-aged Japanese golfers.

    Science.gov (United States)

    Kikuchi-Numagami, K; Suetake, T; Yanai, M; Takahashi, M; Tanaka, M; Tagami, H

    2000-06-01

    The skin of golfers' hands provides a suitable model to study the effect of chronic sun exposure, because one of their hands is exposed to the outer environment, especially sunlight, while the other one is always protected by a glove during play. Our purpose was to find out the influence of photodamage on the properties of the skin surface of middle-aged Japanese by using non-invasive methods. We measured hydration state, and water barrier function of the stratum corneum (SC) and the color of the skin of the dorsum of the hands. In a separate study, we evaluated the skin surface contour by using replicas taken from the skin in a slightly stretched or relaxed position. We found a significant decrease in hydration of the skin surface of the exposed skin as compared to that of the protected skin, whereas no such difference was found with transepidermal water loss, a parameter for water barrier function of the SC. Luminance of skin color was also reduced in the sun-exposed skin. Replica analysis revealed that large wrinkles developing in a relaxed position were more prominent on the exposed than on the protected skin, while fine furrows noted in a slightly stretched position were shallower on the former than the latter. The data obtained indicate that the chronically exposed skin of golfers' hands shows morphological and functional changes resulting from long time exposure to the outer environment especially sunlight. Furthermore, bioengineering non-invasive methods are found to be useful to detect early photodamage of the skin in a more quantitative fashion which is rather difficult to demonstrate clinically.

  20. Postural vascular response in human skin: passive and active reactions to alteration of transmural pressure.

    Science.gov (United States)

    Jepsen, H; Gaehtgens, P

    1993-09-01

    Laser-Doppler (LD) fluxmetry was performed in the palmar finger skin of healthy subjects to study the mechanisms contributing to the postural vascular response. Local transmural pressure in the skin blood vessels of the region studied was altered for 1 min in two experimental series either by passive movement of the arm to different vertical hand positions relative to heart level or by application of external pressure (-120-180 mmHg) to the finger. Heart and respiratory rate, arterial blood pressure, and LD flux in the contralateral finger (kept at heart level) were measured. The measurements suggest a compound reaction of local (myogenic) and systemic (neurogenic) mechanisms: the local regulatory component appears as a graded active vascular response elicited by passive vessel distension or compression. A systemic component, associated with a single deep inspiration, is frequently observed during the actual movement of the arm. In addition, prolonged holding of the test hand in a given vertical position also elicits a delayed vascular response in the control hand at heart level, which may be generated by volume receptors in the intrathoracic low-pressure system.

  1. Reduction of radiation-induced early skin damage (mouse foot) by 0-(β-hydroxyaethyl)-rutoside

    International Nuclear Information System (INIS)

    Fritz-Niggli, H.; Froehlich, E.

    1980-01-01

    The effect of a bioflavonoid, 0-(β-hydroxyethyl)-rutoside (HR) on early radiation-induced skin damage was examined, using the mouse foot system; the response to radiation is not species specific and comparison with the clinical situation is therefore possible. The aim was to see whether HR, which is highly effective in protecting against late damage, is also able to reduce early effects. Early reactions were considered to be erythema, swelling and ulceration and occurring up to 30 days after irradiation. It was found that HR significantly reduces early damage, both after a single dose and after fractionated irradiation with low doses. A single pre-treatment dose of HR and pre-treatment together with 30 days post-treatment administration were both found to be effective. The protective effect became more marked with increasing radiation dose (single irradiation). Reduction of late effects is produced iptimally by an interval of 0.25 hours between application of HR and irradiation, and this is also true for early skin damage. The early effects are partly reversible, but there is possibly an interesting correlation between these and irreversible late effects (such as loss of toes); a similar mechanism, presumably affecting the vascular system, may therefore be postulated. The protective action of this well tolesated, highly effective substance, which apparently protects normal tissues from early and late injury, is discussed. (orig.) [de

  2. Evaluation of skin surface hydration state and barrier function of stratum corneum of dorsa of hands and heels treated with PROTECT X2 skin protective cream.

    Science.gov (United States)

    Kubota, Takahiro

    2012-06-01

    Skin roughness is a term commonly used in Japan to describe a poor skin condition related to a rough and dry skin surface that develops as a result of various damaging effects from the environment or skin inflammation. Recovery from skin roughness requires skin care for a long period, thus it is important to prevent development of such skin changes. PROTECT X2 contains agents used for a protective covering of the skin from frequent hand washing or use of alcohol-based disinfectants. These unique components are also thought to be effective to treat skin roughness of the dorsa of the hands and heels. In the present study, we evaluated the effectiveness of PROTECT X2 to increase skin surface hydration state, as well as enhance the barrier function of the stratum corneum of the dorsa of the hands and heels in elderly individuals. A total of 8 elderly subjects and their caretakers without any skin diseases participated in the study. They applied PROTECT X2 by themselves to the dorsum area of 1 hand and heel 3 to 5 times daily for 1 month, while the opposite sides were left untreated. We measured stratum corneum (SC) hydration and transepidermal water loss (TEWL) before beginning treatment, then 1 week and 1 month after the start of treatment to compare between the treated and untreated skin. SC hydration state after applications of PROTECT X2 was 1.5- to 3.0-fold higher than that of the untreated skin in the dorsa of both hands and heels, indicating that the moisturizing ingredients accompanied by water were replenished in those areas where the cream was applied. Also, TEWL in the dorsum of the hands was 17.0-27.9% lower on the treated side, indicating improvement in SC barrier function. On the basis of these findings, we concluded that PROTECT X2 enhances water-holding in the SC and aids the barrier function of the skin in the dorsum of the hands. In addition, we consider that this formulation is useful for not only protecting the hands from the effects of such agents

  3. Acute skin reactions observed in fractionated proton irradiation

    International Nuclear Information System (INIS)

    Arimoto, Takuro; Maruhashi, Noboru; Takada, Yoshihisa; Hayakawa, Yoshinori; Inada, Tetsuo; Kitagawa, Toshio

    1989-01-01

    Between May 1985 and July 1987, 49 skin reactions of 43 patients treated by proton irradiation were observed at the Particle Radiation Medical Science Center (PARMS), the University of Tsukuba. Taking the peak skin score as an endpoint, the radiobiological effects [relative biological effectiveness (RBE) and time-dose relationship] of the proton beam in multi-fractionated treatments were estimated. Factors influencing the skin dose, such as the prescribed tumor dose, tumor site, and number of applied fields, were also analyzed. The following conclusions regarding acute skin reactions to the clinical use of proton irradiation were obtained: 1) the physical skin-sparing effect of proton irradiation in single-field irradiation, especially in superficial regions, is not large compared with that of high-energy photon irradiation; 2) multidirectional proton irradiation significantly reduced the skin dose and severity of acute reasons; 3) the radiobiological effects of the proton beam, RBE and the time factor, estimated in human skin in multi-fractional treatment were slightly smaller than those of X-rays, i.e., 0.92 and -0.25±0.09, respectively. (author)

  4. Onychomadesis outbreak in Valencia, Spain associated with hand, foot, and mouth disease caused by enteroviruses.

    Science.gov (United States)

    Davia, Javier López; Bel, Pablo Hernández; Ninet, Violeta Zaragoza; Bracho, María Alma; González-Candelas, Fernando; Salazar, Antonio; Gobernado, Miguel; Bosch, Isabel Febrer

    2011-01-01

    This report evaluates the June 2008 onychomadesis outbreak in Valencia, Spain. The study sample consisted of 221 onychomadesis cases and 77 nonaffected individuals who lived close to those affected. We collected data on dietary variables, hygiene products, and individual pathological histories. Feces and blood specimens were collected from 44 cases and 24 controls to evaluate exposure to infectious agents. Pathological background data revealed a high frequency (61%) of hand, foot, and mouth disease among the onychomadesis cases. Coxsackievirus A10 was the most commonly detected enterovirus in both case and control groups (49%). Other enteroviruses such as coxsackieviruses A5, A6, A16, B1, and B3; echoviruses 3, 4, and 9; and enterovirus 71 were present in low frequencies in the case and control groups (3-9%). The 2008 onychomadesis outbreak in the metropolitan area of Valencia was associated with an outbreak of hand, foot, and mouth disease primarily caused by coxsackievirus A10. © 2010 Wiley Periodicals, Inc.

  5. Muscle response to pneumatic hand tool torque reaction forces.

    Science.gov (United States)

    Radwin, R G; VanBergeijk, E; Armstrong, T J

    1989-06-01

    Surface electromyography was used for studying the effects of torque reaction force acting against the hand, on forearm muscle activity and grip force for five subjects operating right angle, air shut-off nutrunners. Four tools having increasing spindle torque were operated using short and long torque reaction times. Nutrunner spindle torque ranged between 30 Nm and 100 Nm. Short torque reaction time was considered 0.5 s while long torque reaction time was 2 s. Peak horizontal force was the greatest component of the reaction force acting against the hand and accounted for more than 97% of the peak resultant hand force. Peak hand force increased from 89 N for the smallest tool to 202 N for the largest tool. Forearm muscle rms EMG, scaled for grip force, indicated average flexor activity during the Torque-reaction phase was more than four times greater than the Pre-start and Post Shut-off phases, and two times greater than the Run-down phase. Flexor EMG activity during the Torque-reaction phase increased for increasing tool peak spindle torque. Average flexor rms EMG activity, scaled for grip force, during the Torque-reaction phase increased from 372 N for the 30 Nm nutrunner to 449 N for the 100 Nm nutrunner. Flexor rms EMG activity averaged during the Torque-reaction phase and scaled for grip force was 390 N for long torque reaction times and increased to 440 N for short torque reaction times. Flexor rms EMG integrated over the torque reaction phase was 839 Ns for long torque reaction times and decreased to 312 Ns for short torque reaction times. The average latency between tool spindle torque onset and peak initial flexor rms EMG for long torque reaction times was 294 ms which decreased to 161 ms for short torque reaction times. The average latency between peak tool spindle torque, just prior to tool shut-off, and peak final rms EMG for long torque reaction times was 97 ms for flexors and 188 ms for extensors, which decreased for short torque reaction times to 47

  6. Persistent Skin Reactions and Aluminium Hypersensitivity Induced by Childhood Vaccines

    DEFF Research Database (Denmark)

    Salik, Elaha; Løvik, Ida; Andersen, Klaus E

    2016-01-01

    There is increasing awareness of reactions to vaccination that include persistent skin reactions. We present here a retrospective investigation of long-lasting skin reactions and aluminium hypersensitivity in children, based on medical records and questionnaires sent to the parents. In the 10-year...... period 2003 to 2013 we identified 47 children with persistent skin reactions caused by childhood vaccinations. Most patients had a typical presentation of persisting pruritic subcutaneous nodules. Five children had a complex diagnostic process involving paediatricians, orthopaedics and plastic surgeons...... treated with potent topical corticosteroids and disappeared slowly. Although we advised families to continue vaccination of their children, one-third of parents omitted or postponed further vaccinations....

  7. Effects of pressure, cold and gloves on hand skin temperature and manual performance of divers.

    Science.gov (United States)

    Zander, Joanna; Morrison, James

    2008-09-01

    Cold water immersion and protective gloves are associated with decreased manual performance. Although neoprene gloves slow hand cooling, there is little information on whether they provide sufficient protection when diving in cold water. Nine divers wearing three-fingered neoprene gloves and dry suits were immersed in water at 25 and 4 degrees C, at depths of 0.4 msw (101 kPa altitude adjusted) and 40 msw (497 kPa) in a hyperbaric chamber. Skin temperatures were measured at the fingers, hand, forearm, chest and head. Grip strength, tactile sensitivity and manual dexterity were measured at three time intervals. There was an exponential decay in finger and back of hand skin temperatures with exposure time in 4 degrees C water. Finger and back of hand skin temperatures were lower at 40 msw than at 0.4 msw (P effect of pressure or temperature on grip strength. Tactile sensitivity decreased linearly with finger skin temperature at both pressures. Manual dexterity was not affected by finger skin temperature at 0.4 msw, but decreased with fall in finger skin temperature at 40 msw. Results show that neoprene gloves do not provide adequate thermal protection in 4 degrees C water and that impairment of manual performance is dependent on the type of task, depth and exposure time.

  8. An investigation into the management of acute skin reactions from tangential breast irradiation

    International Nuclear Information System (INIS)

    Meegan, M.A.; Haycocks, T.R.

    1997-01-01

    This research examined the acute skin reaction of two consecutive groups receiving tangetial breast irradiation for carcinoma of the breast. The first group used the traditional skin care advice of using warm water only within the treatment area, while the second group continued with their normal skin care regime. Data was collected on the physical manifestations of the acute reaction, medical history, the use of concurrent cytotoxic agents, treatment parameters and skin care products used. Statistical analysis using the T-test method showed no difference in the skin reaction between the two groups. The investigation has lead to a change of policy in the management of acute breast reactions. Patients receiving radiation therapy to the breast or chest wall can now use their routine skin care products with no adverse effect on skin reactions. (author)

  9. Cold hands, warm feet: sleep deprivation disrupts thermoregulation and its association with vigilance.

    Science.gov (United States)

    Romeijn, Nico; Verweij, Ilse M; Koeleman, Anne; Mooij, Anne; Steimke, Rosa; Virkkala, Jussi; van der Werf, Ysbrand; Van Someren, Eus J W

    2012-12-01

    Vigilance is affected by induced and spontaneous skin temperature fluctuations. Whereas sleep deprivation strongly affects vigilance, no previous study examined in detail its effect on human skin temperature fluctuations and their association with vigilance. In a repeated-measures constant routine design, skin temperatures were assessed continuously from 14 locations while performance was assessed using a reaction time task, including eyes-open video monitoring, performed five times a day for 2 days, after a normal sleep or sleep deprivation night. Participants were seated in a dimly lit, temperature-controlled laboratory. Eight healthy young adults (five males, age 22.0 ± 1.8 yr (mean ± standard deviation)). One night of sleep deprivation. Mixed-effect regression models were used to evaluate the effect of sleep deprivation on skin temperature gradients of the upper (ear-mastoid), middle (hand-arm), and lower (foot-leg) body, and on the association between fluctuations in performance and in temperature gradients. Sleep deprivation induced a marked dissociation of thermoregulatory skin temperature gradients, indicative of attenuated heat loss from the hands co-occurring with enhanced heat loss from the feet. Sleep deprivation moreover attenuated the association between fluctuations in performance and temperature gradients; the association was best preserved for the upper body gradient. Sleep deprivation disrupts coordination of fluctuations in thermoregulatory skin temperature gradients. The dissociation of middle and lower body temperature gradients may therefore be evaluated as a marker for sleep debt, and the upper body gradient as a possible aid in vigilance assessment when sleep debt is unknown. Importantly, our findings suggest that sleep deprivation affects the coordination between skin blood flow fluctuations and the baroreceptor-mediated cardiovascular regulation that prevents venous pooling of blood in the lower limbs when there is the orthostatic

  10. Planar covariance of upper and lower limb elevation angles during hand-foot crawling in healthy young adults.

    Science.gov (United States)

    MacLellan, M J; Catavitello, G; Ivanenko, Y P; Lacquaniti, F

    2017-11-01

    Habitual quadrupeds have been shown to display a planar covariance of segment elevation angle waveforms in the fore and hind limbs during many forms of locomotion. The purpose of the current study was to determine if humans generate similar patterns in the upper and lower limbs during hand-foot crawling. Nine healthy young adults performed hand-foot crawling on a treadmill at speeds of 1, 2, and 3 km/h. A principal component analysis (PCA) was applied to the segment elevation angle waveforms for the upper (upper arm, lower arm, and hand) and lower (thigh, shank, and foot) limbs separately. The planarity of the elevation angle waveforms was determined using the sum of the variance explained by the first two PCs and the orientation of the covariance plane was quantified using the direction cosines of the eigenvector orthogonal to the plane, projected upon each of the segmental semi-axes. Results showed that planarity of segment elevation angles was maintained in the upper and lower limbs (explained variance >97%), although a slight decrease was present in the upper limb when crawling at 3 km/h. The orientation of the covariance plane was highly limb-specific, consistent with animal studies and possibly related to the functional neural control differences between the upper and lower limbs. These results may suggest that the motor patterns stored in the central nervous system for quadrupedal locomotion may be retained through evolution and may still be exploited when humans perform such tasks.

  11. Validation of the OMERACT Psoriatic Arthritis Magnetic Resonance Imaging Score (PsAMRIS) for the Hand and Foot in a Randomized Placebo-controlled Trial.

    Science.gov (United States)

    Glinatsi, Daniel; Bird, Paul; Gandjbakhch, Frederique; Mease, Philip J; Bøyesen, Pernille; Peterfy, Charles G; Conaghan, Philip G; Østergaard, Mikkel

    2015-12-01

    To assess changes following treatment and the reliability and responsiveness to change of the Outcome Measures in Rheumatology (OMERACT) Psoriatic Arthritis Magnetic Resonance Imaging Score (PsAMRIS) in a randomized controlled trial. Forty patients with PsA randomized to either placebo or abatacept (ABA) had MRI of either 1 hand (n = 20) or 1 foot (n = 20) at baseline and after 6 months. Images were scored blindly twice by 3 independent readers according to the PsAMRIS (for synovitis, tenosynovitis, periarticular inflammation, bone edema, bone erosion, and bone proliferation). Inflammatory features improved numerically but statistically nonsignificantly in the ABA group but not the placebo group. Baseline intrareader intraclass correlation coefficients (ICC) were good (≥ 0.50) to very good (≥ 0.80) for all features in both hand and foot. Baseline interreader ICC were good (ICC 0.72-0.96) for all features, except periarticular inflammation and bone proliferation in the hand and tenosynovitis in the foot (ICC 0.25-0.44). Intrareader and interreader ICC for change scores varied. Guyatt's responsiveness index (GRI) was high for inflammatory features in the hand and metatarsophalangeal joints (GRI -0.67 to -3.13; bone edema not calculable). Minimal change and low prevalence resulted in low ICC and GRI for bone damage. PsAMRIS showed overall good intrareader agreement in the hand and foot, and inflammatory feature scores were responsive to change, suggesting that PsAMRIS may be a valid tool for MRI assessment of hands and feet in PsA clinical trials.

  12. A method for skin hand exposure by positrons during handling of 18F-FDG radiopharmaceutical

    International Nuclear Information System (INIS)

    Fueloep, M.; Hudzietzova, J.; Foltinova, L.

    2014-01-01

    By handling with radiopharmaceutical local irradiation of skin on hands of nearly 20% workers in nuclear medicine is likely to reach more than the legal dose limit for the skin. During syringe preparation and administration of positron radiopharmaceutical 18 F-FDG to patients there are operations that can lead to hand irradiation by positrons. At present, there is insufficient data available about the positron exposure of the hands, which would serve as a basis for the optimization of procedures, including the preparation and administration of positron radiopharmaceuticals. This deficiency impedes the improvement of protective shielding of relevant tools against positrons and the availability of more accurate specifications of the distribution of local exposure of the skin of hands. Presented method of positron dose evaluation is based on pair of TLDs MCP-7 and MCP-Ns with different detection sensitivity to positrons and photons. Detection sensitivities of TLD MCP-Ns and MCP-7 were calculated by Monte Carlo code MCNPX 2.7 in units of skin dose equivalent Hp(0,07).Experimentally has been verified decreasing of skin dose by about factor 5 if positron source 18 F-FDG in syringe, or infusion tube is shielded by a simple additional local shielding from 1 mm polyethylene foil. (authors)

  13. 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

    BACKGROUND: Hand eczema is a common disease, and continuous preventive skin protection and skin care must be adopted to prevent a chronic course. Hand eczema is not a uniform disease, and counselling must therefore be individually tailored. OBJECTIVES: To evaluate the effectiveness of a nurse-led...... or burden of disease were found between the two groups. CONCLUSION: A tailored nurse-led programme of skin protection counselling may be recommended as an essential part of hand eczema treatment.......BACKGROUND: Hand eczema is a common disease, and continuous preventive skin protection and skin care must be adopted to prevent a chronic course. Hand eczema is not a uniform disease, and counselling must therefore be individually tailored. OBJECTIVES: To evaluate the effectiveness of a nurse......-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...

  14. Systematic review and meta-analysis of skin substitutes in the treatment of diabetic foot ulcers: Highlights of a Cochrane systematic review

    NARCIS (Netherlands)

    Santema, T. B. Katrien; Poyck, Paul P. C.; Ubbink, Dirk T.

    2016-01-01

    Skin substitutes are increasingly used in the treatment of various types of acute and chronic wounds. The aim of this study was to perform a systematic review and meta-analysis to evaluate the effectiveness of skin substitutes on ulcer healing and limb salvage in the treatment of diabetic foot

  15. Forty-Year Follow-up of Full-Thickness Skin Graft After Thermal Burn Injury to the Volar Hand.

    Science.gov (United States)

    Weeks, Dexter; Kasdan, Morton L; Wilhelmi, Bradon J

    2016-01-01

    The hands are commonly affected in severe thermal burn injuries. Resulting contractures lead to significant loss of function. Burn contracture release and skin grafting are necessary to restore hand function. We report a case in which surgical reconstruction of a volar hand burn was performed with full-thickness skin grafting. The patient had a 40-year follow-up to assess the function and cosmesis of the repaired hand. We report a case in which a 15-month-old boy presented after receiving third-degree burns to the left volar hand, including the flexural aspects of the index, long, and ring fingers by placing it on a hot kitchen stove burner. The patient subsequently underwent scar contracture release and full-thickness skin grafting. Eleven years after reconstruction, further contractures developed associated with the patient's growth, which were reconstructed with repeat full-thickness skin graft from the inguinal region. No recurrence was witnessed afterward and 40 years after initial injury, the patient maintains full activities of daily living and use of his hand in his occupation. There is debate regarding the superiority of split-thickness versus full-thickness grafts during reconstruction. Our case strengthens the argument for durability of a full-thickness skin graft following thermal burn injury.

  16. Resurfacing glabrous skin defects in the hand: the thenar base donor site.

    Science.gov (United States)

    Milner, Chris S; Thirkannad, Sunil M

    2014-06-01

    Defects of the glabrous skin surfaces of the palm and fingers result from numerous causes including larger fingertip injuries, unhealed burns, and after surgery for diverse pathologies. The qualities of glabrous skin are specifically tailored to the functional requirements of high-shear strength and robustness. Despite these unique properties, graft reconstruction of defects in the glabrous regions of the hand is frequently achieved with skin from nonglabrous donor sites such as the medial forearm. Nonglabrous skin has a poor color and texture match for such applications and is frequently associated with tender and unsightly donor scars. We describe our experiences of harvesting full-thickness grafts from the glabrous skin centered over the proximal flexion crease at the level of the metacarpophalangeal joint of the thumb. We have utilized this site to harvest skin grafts of up to 2 cm in width for the resurfacing of small-sized to medium-sized defects on the palmar surfaces of the hands and fingers in 28 patients under both traumatic and elective circumstances. The skin has an excellent type-match to the defect and is quick and easy to harvest due to its adjacent location to the defect. The donor scar matures quickly, and as it lies along the thumb base crease, it runs along one of the least used contact surfaces, thereby limiting the potential discomfort associated with FTSG harvest sites from other areas. Patient satisfaction with the procedure has been high, and it represents a useful alternative to traditional nonglabrous skin graft donor sites for small-sized to medium-sized defects.

  17. Excretion of enterovirus 71 in persons infected with hand, foot and mouth disease

    Directory of Open Access Journals (Sweden)

    Li Jie

    2013-01-01

    Full Text Available Abstract Background Hand, foot and mouth disease (HFMD is a common illness in young children. It also can be seen in adults occasionally. Enterovirus 71 (EV71, a pathogen that causes not only HFMD but also neurological complications and even death, has caused many HFMD outbreaks in China. However, till now the data about the duration of EV71 shedding is very limited. Results A total of 136 throat swabs and fecal samples were collected from 27 children and 3 adults, which includs 7 close contacts, 9 mild cases and 14 severe cases,. The participants were divided into three groups namely, severe case group, mild case group and close contact group. All the samples were assayed with real-time polymerase chain reaction (PCR. Kruskal-Wallis Test was employed to compare the difference in duration of viral RNA shedding among three groups. The results showed that significant difference in duration of EV71 shedding was found among three groups (P  Conclusions HFMD is characterized by extended excretion of EV71. Our results suggest that the duration of EV71 shedding is correlated with the severity of the disease. EV71 shedding through feces can persist more than 54 days. Prolonged virus shedding is a potential risk factor of proliferating HFMD epidemic.

  18. Relationship between measurements of blood oxidative metabolites and skin reaction in irradiated rats

    International Nuclear Information System (INIS)

    Kaneko, Takashi; Goto, Jun; Nomiya, Takuma; Nemoto, Kenji

    2011-01-01

    Recently, oxidative metabolites have been able to be measured by simple small device. It has been reported that the value of oxidative metabolites increases under several conditions such as hypertension, smoking, diabetes mellitus, etc. Radiation used in radiotherapy also causes free radicals and oxidative metabolites, and irradiation causes dermatitis and sometimes causes skin ulcer in the irradiated site. We analyzed the relationships between the value of oxidative metabolites and skin reactions. A certain doses of radiation were irradiated to the right thigh of rats, and oxidative metabolites of rat's blood from caudal vein were measured by d-reactive oxygen metabolites (ROMs) test using an exclusive device. Skin reactions were evaluated according to a skin-reaction grading system from the day before irradiation to day 38 after irradiation. As a results, a significant correlation was shown between irradiation dose and skin grade. And a significant correlation was also shown between the value of oxidative metabolites and irradiation dose. The increase in oxidative metabolites was seen in the Day 16 after irradiation, and that corresponded with the appearance of skin reaction. It was suggested that the value of oxidative metabolites seems to be useful for estimating degree of skin reaction and time to appear skin reaction after irradiation. (author)

  19. Evaluating the consistency of location of the most severe acute skin reaction and highest skin dose measured by thermoluminescent dosimeter during radiotherapy for breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Sun, Li-Min, E-mail: limin.sun@yahoo.com [Department of Radiation Oncology, Zuoying Branch of Kaohsiung Armed Forces General Hospital, Kaohsiung City, Taiwan (China); Huang, Chih-Jen [Department of Radiation Oncology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan (China); Department of Faculty of Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan (China); Department of College of Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan (China); Chen, Hsiao-Yun [Department of Radiation Oncology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan (China); Chang, Gia-Hsin [Department of Radiation Oncology, Zuoying Branch of Kaohsiung Armed Forces General Hospital, Kaohsiung City, Taiwan (China); Tsao, Min-Jen [Department of General Surgery, Zuoying Branch of Kaohsiung Armed Forces General Hospital, Kaohsiung City, Taiwan (China)

    2016-10-01

    We conducted this prospective study to evaluate whether the location of the most severe acute skin reaction matches the highest skin dose measured by thermoluminescent dosimeter (TLD) during adjuvant radiotherapy (RT) for patients with breast cancer after breast conservative surgery. To determine whether TLD measurement can reflect the location of the most severe acute skin reaction, 80 consecutive patients were enrolled in this prospective study. We divided the irradiated field into breast, axillary, inframammary fold, and areola/nipple areas. In 1 treatment session when obvious skin reaction occurred, we placed the TLD chips onto the 4 areas and measured the skin dose. We determined whether the highest measured skin dose area is consistent with the location of the most severe skin reaction. The McNemar test revealed that the clinical skin reaction and TLD measurement are more consistent when the most severe skin reaction occurred at the axillary area, and the p = 0.0108. On the contrary, TLD measurement of skin dose is less likely consistent with clinical observation when the most severe skin reaction occurred at the inframammary fold, breast, and areola/nipple areas (all the p > 0.05). Considering the common site of severe skin reaction over the axillary area, TLD measurement may be an appropriate way to predict skin reaction during RT.

  20. Skin protection in nursing work : promoting the use of gloves and hand alcohol

    NARCIS (Netherlands)

    Jungbauer, FHW; van der Harst, J.J.; Groothoff, J.W.; Coenraads, PJ

    Nursing has been identified as a wet-work occupation, with a high prevalence of occupational irritant contact dermatitis. Reduction of exposure to skin irritants contributes to the prevention of occupational skin disease in nurses. The role of the use of soap and water, hand alcohol and gloves in

  1. The changes of fingernail microcirculation in the patients with hand skin radiation damage caused by β rays

    International Nuclear Information System (INIS)

    Wang Guoquan; Qian Jianjun; Wang Zuofa

    2000-01-01

    Objective: To observe the microcirculation changes in the patients with hand skin radiation damage caused by β rays. Methods: The XOX-1A type microcirculation microscope was used in observation of the microcirculation changes of fingernail, in 22 patients with III-IV degree hand skin radiation damage caused by β rays. Results: A series of abnormal signs were observed in all these patients and it was found that the microcirculation abnormality of the fingernail were the most clinical significant sign. Conclusion: The fingernail microcirculation changes can be used as an indicator for prognosis in the hand skin radiation damage patients

  2. Interdisciplinary management of EGFR-inhibitor-induced skin reactions: a German expert opinion.

    Science.gov (United States)

    Potthoff, K; Hofheinz, R; Hassel, J C; Volkenandt, M; Lordick, F; Hartmann, J T; Karthaus, M; Riess, H; Lipp, H P; Hauschild, A; Trarbach, T; Wollenberg, A

    2011-03-01

    Anti-epidermal growth factor receptor treatment strategies, i.e. monoclonal antibodies such as cetuximab and panitumumab, or epidermal growth factor receptor (EGFR) small molecule tyrosine kinase inhibitors, such as erlotinib and gefitinib, have expanded the treatment options for different tumor types. Dermatologic toxic effects are the most common side-effects of EGFR inhibitor therapy. They can profoundly affect the patient's quality of life. The aim of this study was to provide interdisciplinary expert recommendations on how to treat patients with skin reactions undergoing anti-EGFR treatment. An expert panel from Germany with expertise in medical oncology, dermatology or clinical pharmacology was convened to develop expert recommendations based on published peer-reviewed literature. The expert recommendations for the state-of-the-art treatment of skin reactions induced by EGFR inhibitor therapy include recommendations for diagnostics and grading as well as grade-specific and stage-adapted treatment approaches and preventive measures. It was concluded that EGFR-inhibitor-related dermatologic reactions should always be treated combining basic care of the skin and a specific therapy adapted to stage and grade of skin reaction. For grade 2 and above, specific treatment recommendations for early- and later-stage skin reactions induced by EGFR-inhibitor therapy were proposed. This paper presents a German national expert opinion for the treatment of skin reactions in patients receiving EGFR inhibitor therapy.

  3. Photodynamic therapy (PDT and waterfiltered infrared A (wIRA in patients with recalcitrant common hand and foot warts

    Directory of Open Access Journals (Sweden)

    Hoffmann, Gerd

    2004-10-01

    Full Text Available Background: Common warts (verrucae vulgares are human papilloma virus (HPV infections with a high incidence and prevalence, most often affecting hands and feet, being able to impair quality of life. About 30 different therapeutic regimens described in literature reveal a lack of a single striking strategy. Recent publications showed positive results of photodynamic therapy (PDT with 5-aminolevulinic acid (5-ALA in the treatment of HPV-induced skin diseases, especially warts, using visible light (VIS to stimulate an absorption band of endogenously formed protoporphyrin IX. Additional experiences adding waterfiltered infrared A (wIRA during 5-ALA-PDT revealed positive effects. Aim of the study: First prospective randomised controlled blind study including PDT and wIRA in the treatment of recalcitrant common hand and foot warts. Comparison of "5-ALA cream (ALA vs. placebo cream (PLC" and "irradiation with visible light and wIRA (VIS+wIRA vs. irradiation with visible light alone (VIS". Methods: Pre-treatment with keratolysis (salicylic acid and curettage. PDT treatment: topical application of 5-ALA (Medac in "unguentum emulsificans aquosum" vs. placebo; irradiation: combination of VIS and a large amount of wIRA (Hydrosun® radiator type 501, 4 mm water cuvette, waterfiltered spectrum 590-1400 nm, contact-free, typically painless vs. VIS alone. Post-treatment with retinoic acid ointment. One to three therapy cycles every 3 weeks. Main variable of interest: "Percent change of total wart area of each patient over the time" (18 weeks. Global judgement by patient and by physician and subjective rating of feeling/pain (visual analogue scales. 80 patients with therapy-resistant common hand and foot warts were assigned randomly into one of the four therapy groups with comparable numbers of warts at comparable sites in all groups. Results: The individual total wart area decreased during 18 weeks in group 1 (ALA+VIS+wIRA and in group 2 (PLC

  4. Advanced glycation end products assessed by skin autofluorescence: a new marker of diabetic foot ulceration.

    Science.gov (United States)

    Vouillarmet, Julien; Maucort-Boulch, Delphine; Michon, Paul; Thivolet, Charles

    2013-07-01

    Accumulation of advanced glycation end products (AGEs) may contribute to diabetic foot ulceration (DFU). Our goal was to determine whether AGEs measurement by skin autofluorescence (SAF) would be an additional marker for DFU management. We performed SAF analysis in 66 patients with a history of DFU prospectively included and compared the results with those of 84 control patients with diabetic peripheral neuropathy without DFU. We then assessed the prognostic value of SAF levels on the healing rate in the DFU group. Mean SAF value was significantly higher in the DFU group in comparison with the control group, even after adjustment for other diabetes complications (3.2±0.6 arbitrary units vs. 2.9±0.6 arbitrary units; P=0.001). In the DFU group, 58 (88%) patients had an active wound at inclusion. The mean DFU duration was 14±13 weeks. The healing rate was 47% after 2 months of appropriate foot care. A trend for a correlation between SAF levels and healing time in DFU subjects was observed but was not statistically significant (P=0.06). Increased SAF levels are associated with neuropathic foot complications in diabetes. Use of SAF measurement to assess foot vulnerability and to predict DFU events in high-risk patients appears to be promising.

  5. Algorithm for Primary Full-thickness Skin Grafting in Pediatric Hand Burns

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    Yang Seo Park

    2012-09-01

    Full Text Available BackgroundPediatric hand burns are a difficult problem because they lead to serious hand deformities with functional impairment due to rapid growth during childhood. Therefore, adequate management is required beginning in the acute stage. Our study aims to establish surgical guidelines for a primary full-thickness skin graft (FTSG in pediatric hand burns, based on long-term observation periods and existing studies.MethodsFrom January 2000 to May 2011, 210 patients underwent primary FTSG. We retrospectively studied the clinical course and treatment outcomes based on the patients' medical records. The patients' demographics, age, sex, injury site of the fingers, presence of web space involvement, the incidence of postoperative late deformities, and the duration of revision were critically analyzed.ResultsThe mean age of the patients was 24.4 months (range, 8 to 94 months, consisting of 141 males and 69 females. The overall observation period was 6.9 years (range, 1 to 11 years on average. At the time of the burn, 56 cases were to a single finger, 73 to two fingers, 45 to three fingers, and 22 to more than three. Among these cases, 70 were burns that included a web space (33.3%. During the observation, 25 cases underwent corrective operations with an average period of 40.6 months.ConclusionsIn the volar area, primary full-thickness skin grafting can be a good indication for an isolated injured finger, excluding the web spaces, and injuries of less than three fingers including the web spaces. Also, in the dorsal area, full-thickness skin grafting can be a good indication. However, if the donor site is insufficient and the wound is large, split-thickness skin grafting can be considered.

  6. Permanent make-up colorants may cause severe skin reactions.

    Science.gov (United States)

    Wenzel, Sabrina M; Welzel, Julia; Hafner, Christian; Landthaler, Michael; Bäumler, Wolfgang

    2010-10-01

    In recent years, cosmetic tattoos [permanent make-up (PMU)] on eyelids, eyebrows and lips have become increasingly popular. However, most colorants are manufactured for non-medical purposes, without any established history of safe use in humans. To investigate severe adverse reactions, such as swelling, burning, and the development of papules, of the lips and the surrounding area in 4 patients who had had at least two PMU procedures on their lips. Adverse skin reactions were examined with patch and prick testing of the colorants. In addition, skin biopsies were taken in the centre of the prick test for histology. One patient declined prick testing. Beauticians tended to use various PMU products, but all contained Pigment Red 181 (CI 73360). All patients tested showed a clear delayed reaction to Pigment Red 181 or the tattoo ink, or both, after prick testing. Histology indicated an allergic reaction. Each lip lesion slowly abated after several months of topical or systemic therapy with steroids in combination with tacrolimus, but none has yet completely resolved. In light of the severe and often therapy-resistant skin reactions, we strongly recommend the regulation and control of the substances used in PMU colorants. © 2010 John Wiley & Sons A/S.

  7. Radiographic findings of the hand and foot in patients with systemic lupus erythematosus

    International Nuclear Information System (INIS)

    Scutellari, P.N.; Stabellini, R.; Orzincolo, C.; Franceschini, F.; Govoni, M.; Trotta, F.

    1987-01-01

    A detail examination of the hands and feet was performed in a group of 34 patients affected by systemic lupus erythematosus (SLE), using low-dose mammographic film and Rank Xerox selenium plate, according to current diagnostic techniques. All patients presented articular symptoms (pain and arthralgia). The high incidence (38.8%) of patients with no radiographic evidence of bone damage-even though articular symptoms are present-is emphasized. In such cases, it is very difficult to distinguish SLE from rheumatoid arthritis, especially as far as therapeutic management and prognosis are concerned. The lack of any pathognomonic radiological sign of the lupus arthritis, in the hands as well as in the feet, is then stressed. Nevertheless, artropathy in SLE is defined as a deforming unerosive arthritis, with a typical symmetric distribution, affecting most commonly (according to incidence) the proximal interphalangeal and metacarpophalangeal joints. In the hand, arthropathy is referred to as Jaccoud's type arthritis, because it is characterized by joint deformities which can be corrected. In the foot, the main abnormalities include hallux valgus, subluxation of the matatarsophalangeal joints and widening of the forefoot

  8. Radiographic findings of the hand and foot in patients with systemic lupus erythematosus

    Energy Technology Data Exchange (ETDEWEB)

    Scutellari, P N; Stabellini, R; Orzincolo, C; Franceschini, F; Govoni, M; Trotta, F

    1987-01-01

    A detail examination of the hands and feet was performed in a group of 34 patients affected by systemic lupus erythematosus (SLE), using low-dose mammographic film and Rank Xerox selenium plate, according to current diagnostic techniques. All patients presented articular symptoms (pain and arthralgia). The high incidence (38.8%) of patients with no radiographic evidence of bone damage-even though articular symptoms are present-is emphasized. In such cases, it is very difficult to distinguish SLE from rheumatoid arthritis, especially as far as therapeutic management and prognosis are concerned. The lack of any pathognomonic radiological sign of the lupus arthritis, in the hands as well as in the feet, is then stressed. Nevertheless, artropathy in SLE is defined as a deforming unerosive arthritis, with a typical symmetric distribution, affecting most commonly (according to incidence) the proximal interphalangeal and metacarpophalangeal joints. In the hand, arthropathy is referred to as Jaccoud's type arthritis, because it is characterized by joint deformities which can be corrected. In the foot, the main abnormalities include hallux valgus, subluxation of the matatarsophalangeal joints and widening of the forefoot.

  9. MRI findings of neurologic complications in the enterovirus 71-infected hand-foot-mouth disease

    International Nuclear Information System (INIS)

    Chen Feng; Li Jianjun; Liu Tao; Xiang Wei; Wen Guoqiang

    2010-01-01

    Objective: To explore the imaging characteristics of neurologic complications associated with the enterovirus 71 (EV71) epidemic by analyzing 25 cases and reviewing the literature. Methods: Twenty-five cases of hand-foot-mouth disease with neurologic complications during the recent EV71 outbreaks of Hainan province were studied for the clinical features and imaging findings, and literature were reviewed. Results: In 5 cases, acute flaccid paralysis associated with EV71-infected hand-foot-mouth disease was related to the linear high signal in the spinal cord on sagittal images. Two cases showed symmetrical, well- defined hyperintense lesions in the spinal cord on T 2 WI transverse. Strong enhancement of the ventral horns and root was seen on the contrast-enhanced axial T 1 WI. In brainstem encephalitis, all lesions presented with significant hyperintensity on T 2 WI and hypointense on T 1 WI in the posterior portions of the medulla oblongata, midbrain, and pons. The manifestations of aseptic meningitis (AM) on MRI have no characteristics, but subdural effusion, meningeal enhancement and hydrocephalus can be the indirect signs of AM. Conclusions: MRI is an effective method to investigate neurologic complications associated with the EV71 epidemic. Posterior portions of the medulla oblongata and pons, bilateral ventral horns of spinal involvement are characteristic findings of enteroviral encephalomyelitis. (authors)

  10. A Consistent Orally-Infected Hamster Model for Enterovirus A71 Encephalomyelitis Demonstrates Squamous Lesions in the Paws, Skin and Oral Cavity Reminiscent of Hand-Foot-and-Mouth Disease.

    Directory of Open Access Journals (Sweden)

    Win Kyaw Phyu

    Full Text Available Enterovirus A71 (EV-A71 causes self-limiting, hand-foot-and-mouth disease (HFMD that may rarely be complicated by encephalomyelitis. Person-to-person transmission is usually by fecal-oral or oral-oral routes. To study viral replication sites in the oral cavity and other tissues, and to gain further insights into virus shedding and neuropathogenesis, we developed a consistent, orally-infected, 2-week-old hamster model of HFMD and EV-A71 encephalomyelitis. Tissues from orally-infected, 2-week-old hamsters were studied by light microscopy, immunohistochemistry and in situ hybridization to detect viral antigens and RNA, respectively, and by virus titration. Hamsters developed the disease and died after 4-8 days post infection; LD50 was 25 CCID50. Macroscopic cutaneous lesions around the oral cavity and paws were observed. Squamous epithelium in the lip, oral cavity, paw, skin, and esophagus, showed multiple small inflammatory foci around squamous cells that demonstrated viral antigens/RNA. Neurons (brainstem, spinal cord, sensory ganglia, acinar cells (salivary gland, lacrimal gland, lymphoid cells (lymph node, spleen, and muscle fibres (skeletal, cardiac and smooth muscles, liver and gastric epithelium also showed varying amounts of viral antigens/RNA. Intestinal epithelium, Peyer's patches, thymus, pancreas, lung and kidney were negative. Virus was isolated from oral washes, feces, brain, spinal cord, skeletal muscle, serum, and other tissues. Our animal model should be useful to study squamous epitheliotropism, neuropathogenesis, oral/fecal shedding in EV-A71 infection, person-to-person transmission, and to test anti-viral drugs and vaccines.

  11. Severe skin reaction secondary to concomitant radiotherapy plus cetuximab

    International Nuclear Information System (INIS)

    Berger, Bernhard; Belka, Claus

    2008-01-01

    The therapeutic use of monoclonal antibodies against the epidermal growth factor receptor (EGFR) is specifically associated with dermatologic reactions of variable severity. Recent evidence suggests superiority of the EGFR inhibitor (EGFRI) cetuximab plus radiotherapy compared to radiotherapy alone in patients with squamous cell carcinoma of the head and neck. Although not documented in a study population, several reports indicate a possible overlap between radiation dermatitis and the EGFRI-induced skin rash. We here present a case of severe skin reaction secondary to the addition of cetuximab to radiotherapy

  12. The Glasgow-Maastricht foot model, evaluation of a 26 segment kinematic model of the foot

    OpenAIRE

    Oosterwaal, Michiel; Carbes, Sylvain; Telfer, Scott; Woodburn, James; T?rholm, S?ren; Al-Munajjed, Amir A.; van Rhijn, Lodewijk; Meijer, Kenneth

    2016-01-01

    Background Accurately measuring of intrinsic foot kinematics using skin mounted markers is difficult, limited in part by the physical dimensions of the foot. Existing kinematic foot models solve this problem by combining multiple bones into idealized rigid segments. This study presents a novel foot model that allows the motion of the 26 bones to be individually estimated via a combination of partial joint constraints and coupling the motion of separate joints using kinematic rhythms. Methods ...

  13. Age influences the skin reaction pattern to mechanical stress and its repair level through skin care products.

    Science.gov (United States)

    Zouboulis, Christos C; Elewa, Rana; Ottaviani, Monica; Fluhr, Joachim; Picardo, Mauro; Bernois, Armand; Heusèle, Catherine; Camera, Emanuela

    2018-03-01

    Skin aging is associated with alterations of surface texture, sebum composition and immune response. Mechanical stress induces repair mechanisms, which may be dependent on the age and quality of the skin. The response to mechanical stress in young and aged individuals, their subjective opinion and the objective effectiveness of skin care products were evaluated by biophysical skin quality parameters (stratum corneum hydration, transepidermal water loss, skin pH, pigmentation and erythema) at baseline, 1, 6, 24h and 7days at the forearms of 2 groups of healthy volunteers, younger than 35 years (n=11) and older than 60 years (n=13). In addition, casual surface lipid composition was studied under the same conditions at the baseline and day 7 after mechanical stress induction. Evaluations were also performed in stressed skin areas treated daily with skin care products and the subjective opinion of the volunteers was additionally documented. The tested groups exhibited age-associated baseline skin functions as well as casual surface lipid composition and different reaction patterns to mechanical stress. Skin care was more effective in normalizing skin reaction to stress in the young than in the aged group. The subjective volunteer opinion correlated with the objective measurements. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Vibrotactile stimulation of fast-adapting cutaneous afferents from the foot modulates proprioception at the ankle joint.

    Science.gov (United States)

    Mildren, Robyn L; Bent, Leah R

    2016-04-15

    It has previously been shown that cutaneous sensory input from across a broad region of skin can influence proprioception at joints of the hand. The present experiment tested whether cutaneous input from different skin regions across the foot can influence proprioception at the ankle joint. The ability to passively match ankle joint position (17° and 7° plantar flexion and 7° dorsiflexion) was measured while cutaneous vibration was applied to the sole (heel, distal metatarsals) or dorsum of the target foot. Vibration was applied at two different frequencies to preferentially activate Meissner's corpuscles (45 Hz, 80 μm) or Pacinian corpuscles (255 Hz, 10 μm) at amplitudes ∼3 dB above mean perceptual thresholds. Results indicated that cutaneous input from all skin regions across the foot could influence joint-matching error and variability, although the strongest effects were observed with heel vibration. Furthermore, the influence of cutaneous input from each region was modulated by joint angle; in general, vibration had a limited effect on matching in dorsiflexion compared with matching in plantar flexion. Unlike previous results in the upper limb, we found no evidence that Pacinian input exerted a stronger influence on proprioception compared with Meissner input. Findings from this study suggest that fast-adapting cutaneous input from the foot modulates proprioception at the ankle joint in a passive joint-matching task. These results indicate that there is interplay between tactile and proprioceptive signals originating from the foot and ankle. Copyright © 2016 the American Physiological Society.

  15. Efficacy of a Hand Regimen in Skin Barrier Protection in Individuals With Occupational Irritant Contact Dermatitis.

    Science.gov (United States)

    Jordan, Laura

    2016-11-01

    Occupational irritant contact dermatitis (OICD) is a dif cult and hard to manage condition. It occurs more frequently in certain occupations where contact with harsh chemicals, use of alcohol-based disinfectants, and frequent hand washing heightens the risk. Treatment for OICD includes patient education in addition to physical, topical, and systemic therapies. To review the pathogenesis and treatment options for OICD and evaluate the ef cacy of a selective skin-care regimen involv- ing a hand protectant cream alone as well as combined with a repair cream and speci c cleanser. A single-center open study was performed comprising 42 healthy male and female adult volunteers prone to occupational irritant contact dermatitis due to frequent wet work or contact with detergents. Between day 0 and day 7, subjects applied a hand protectant cream as needed on both hands (at least twice daily). On days 7 to 14, subjects applied a hand protectant cream and cleanser as needed on both hands (at least twice daily) as well as a repair cream each evening. A diary log was given to each volunteer for application control and for a subjective evaluation of daily tolerability. In these subjects prone to occupational irritant contact dermatitis, the hand protectant cream applied during the initial 7-day period was effective in restoring the damaged skin barrier and improving the stratum corneum hydration. A regimen that combined the hand protectant and repair creams with a speci c cleanser during a further 7-day period allowed contin- ued improvement of skin hydration and additional clinical bene ts while respecting the skin barrier function. The results of this study support the use of a 3-step approach for patients who are at risk of repeated exposure to external irritants. J Drugs Dermatol. 2016;15(suppl 11):s81-85..

  16. Trench Foot or Non-Freezing Cold Injury As a Painful Vaso-Neuropathy: Clinical and Skin Biopsy Assessments

    Directory of Open Access Journals (Sweden)

    Praveen Anand

    2017-09-01

    Full Text Available BackgroundTrench foot, or non-freezing cold injury (NFCI, results from cold exposure of sufficient severity and duration above freezing point, with consequent sensory and vascular abnormalities which may persist for years. Based on observations of Trench foot in World War II, the condition was described as a vaso-neuropathy. While some reports have documented nerve damage after extreme cold exposure, sensory nerve fibres and vasculature have not been assessed with recent techniques in NFCI.ObjectiveTo assess patients with chronic sensory symptoms following cold exposure, in order to diagnose any underlying small fibre neuropathy, and provide insight into mechanisms of the persistent pain and cold hypersensitivity.MethodsThirty soldiers with cold exposure and persistent sensory symptoms (>4 months were assessed with quantitative sensory testing, nerve conduction studies, and skin biopsies. Immunohistochemistry was used to assess intraepidermal (IENF and subepidermal (SENF nerve fibres with a range of markers, including the pan-neuronal marker protein gene product 9.5 (PGP 9.5, regenerating fibres with growth-associated protein 43 (GAP43, and nociceptor fibres with transient receptor potential cation channel subfamily V member 1 (TRPV1, sensory neuron-specific receptor (SNSR, and calcitonin gene-related peptide (CGRP. von Willebrand factor (vWF, endothelial nitric oxide synthase (eNOS, and vascular endothelial growth factor (VEGF were used for assessing blood vessels, and transient receptor potential cation channel, subfamily A member 1 (TRPA1 and P2X purinoceptor 7 (P2X7 for keratinocytes, which regulate nociceptors via release of nerve growth factor.ResultsClinical examination showed pinprick sensation was abnormal in the feet of 20 patients (67%, and between 67 and 83% had abnormalities of thermal thresholds to the different modalities. 7 patients (23% showed reduced sensory action potential amplitude of plantar nerves. 27 patients (90% had

  17. Hand-foot-mouth disease

    Science.gov (United States)

    ... plenty of fluids. The best fluids are cold milk products. Do not drink juice or soda because ... of dehydration occur, such as dry skin and mucus membranes, weight loss, irritability, decreased alertness, decreased or ...

  18. Characterization of severe hand, foot, and mouth disease in Shenzhen, China, 2009-2013.

    Science.gov (United States)

    Huang, Yun; Zhou, Yuanping; Lu, Hong; Yang, Hong; Feng, Qianjin; Dai, Yingchun; Chen, Long; Yu, Shouyi; Yao, Xiangjie; Zhang, Hailong; Jiang, Ming; Wang, Yujie; Han, Ning; Hu, Guifang; He, Yaqing

    2015-09-01

    Hand, foot, and mouth disease (HFMD) is caused by human enteroviruses, especially by enterovirus 71 (EV71) and coxsackievirus A16 (CA16). Patients infected with different enteroviruses show varied clinical symptoms. The aim of this study was to determine whether the etiological spectrum of mild and severe HFMD changed, and the association between pathogens and clinical features. From 2009 to 2013, a total of 2,299 stool or rectal specimens were collected with corresponding patient data. A dynamic view of the etiological spectrum of mild and severe HFMD in Shenzhen city of China was provided. EV71 accounted for the majority proportion of severe HFMD cases and fatalities during 2009-2013. CA16 and EV71 were gradually replaced by coxsackievirus A6 (CA6) as the most common serotype for mild HFMD since 2010. Myoclonic jerk and vomiting were the most frequent severe symptoms. Nervous system complications, including aseptic encephalitis and aseptic meningitis were observed mainly in patients infected by EV71. Among EV71, CA16, CA6, and CA10 infection, fever and pharyngalgia were more likely to develop, vesicles on the hand, foot, elbow, knee and buttock were less likely to develop in patients infected with CA10. Vesicles on the mouth more frequently occurred in the patients with CA6, but less in the patient with EV71. Associations between diverse enterovirus serotypes and various clinical features were discovered in the present study, which may offer further insight into early detection, diagnosis and treatment of HFMD. © 2015 Wiley Periodicals, Inc.

  19. PREVALENCE OF HUMAN ENTEROVIRUS AMONG PATIENTS WITH HAND, FOOT, AND MOUTH DISEASE AND HERPANGINA IN THAILAND, 2013.

    Science.gov (United States)

    Mauleekoonphairoj, John; Puenpa, Jiratchaya; Korkong, Sumeth; Vongpunsawad, Sompong; Poovorawan, Yong

    2015-11-01

    Human enterovirus (EV) infection causes hand, foot, and mouth disease (HFMD) and herpangina (HA). We studied the prevalence of enterovirus (EV) among patients with HFMD and HA in Thailand during 2013. We conducted a study in archived specimens of patients sent for screening for enterovirus. A total of 203 clinical specimens from 184 individuals with painful blister in the oropharynx and on the palms, soles, knees, elbows or buttock were examined by semi-nested polymerase chain reaction (PCR) for the 5'UTR and VP1 genes of EV. Eighty-six samples were positive: EV71 was detected in 14 (30%), CV-A8 in 12 (26%) and CV-A16 in 10 (21%). Classification of EV species detected revealed that 46 specimens were EV-A, 14 specimens were EV-B, 1 specimen was EV-D, and 16 specimens were positive for unclassified enterovirus. The majority of individuals with EV infection were aged 2-6 years. Multiple EV-A serotypes were detected among HFMD and HA patients in our study.

  20. Effect of foot orthoses on magnitude and timing of rearfoot and tibial motions, ground reaction force and knee moment during running.

    Science.gov (United States)

    Eslami, Mansour; Begon, Mickaël; Hinse, Sébastien; Sadeghi, Heydar; Popov, Peter; Allard, Paul

    2009-11-01

    Changes in magnitude and timing of rearfoot eversion and tibial internal rotation by foot orthoses and their contributions to vertical ground reaction force and knee joint moments are not well understood. The objectives of this study were to test if orthoses modify the magnitude and time to peak rearfoot eversion, tibial internal rotation, active ground reaction force and knee adduction moment and determine if rearfoot eversion, tibial internal rotation magnitudes are correlated to peak active ground reaction force and knee adduction moment during the first 60% stance phase of running. Eleven healthy men ran at 170 steps per minute in shod and with foot orthoses conditions. Video and force-plate data were collected simultaneously to calculate foot joint angular displacement, ground reaction forces and knee adduction moments. Results showed that wearing semi-rigid foot orthoses significantly reduced rearfoot eversion 40% (4.1 degrees ; p=0.001) and peak active ground reaction force 6% (0.96N/kg; p=0.008). No significant time differences occurred among the peak rearfoot eversion, tibial internal rotation and peak active ground reaction force in both conditions. A positive and significant correlation was observed between peak knee adduction moment and the magnitude of rearfoot eversion during shod (r=0.59; p=0.04) and shod/orthoses running (r=0.65; p=0.02). In conclusion, foot orthoses could reduce rearfoot eversion so that this can be associated with a reduction of knee adduction moment during the first 60% stance phase of running. Finding implies that modifying rearfoot and tibial motions during running could not be related to a reduction of the ground reaction force.

  1. The Weather-Beaten Dorsal Hand Clinical Rating, Shadow Casting Optical Profilometry, and Skin Capacitance Mapping

    Directory of Open Access Journals (Sweden)

    Marie Delvenne

    2013-01-01

    Full Text Available Laypeople commonly perceive some skin xerosis and withering (roughness changes during winter on some parts of the body, particularly on the dorsal hands. The aim of the study was to assess the withered skin surface changes occurring during the four seasons. A total of 47 menopausal women completed the study. A group of 31 volunteers were on hormone replacement therapy (HRT and 16 were out of HRT. Skin xerosis and scaliness were rated clinically. In addition, skin whitening was assessed by computerized shadow casting optical profilometry and by skin capacitance mapping. The volunteers were not using topical creams and over-the-counter products on their hands. Marked changes, recorded over the successive seasons, corresponded to patchy heterogeneous stratum corneum hydration and heterogeneous skin surface roughness changing over seasons; they likely resulted from changes in the environmental temperature and atmosphere moisture. The severity of the changes revealed by clinical inspection was not supported by similar directions of fluctuations in the instrumental assessments. This seemingly contradiction was in fact due to different levels of scale observation. The clinical centimetric scale and the instrumental inframillimetric scale possibly provide distinct aspects of a given biological impact.

  2. The Glasgow-Maastricht foot model, evaluation of a 26 segment kinematic model of the foot.

    Science.gov (United States)

    Oosterwaal, Michiel; Carbes, Sylvain; Telfer, Scott; Woodburn, James; Tørholm, Søren; Al-Munajjed, Amir A; van Rhijn, Lodewijk; Meijer, Kenneth

    2016-01-01

    Accurately measuring of intrinsic foot kinematics using skin mounted markers is difficult, limited in part by the physical dimensions of the foot. Existing kinematic foot models solve this problem by combining multiple bones into idealized rigid segments. This study presents a novel foot model that allows the motion of the 26 bones to be individually estimated via a combination of partial joint constraints and coupling the motion of separate joints using kinematic rhythms. Segmented CT data from one healthy subject was used to create a template Glasgow-Maastricht foot model (GM-model). Following this, the template was scaled to produce subject-specific models for five additional healthy participants using a surface scan of the foot and ankle. Forty-three skin mounted markers, mainly positioned around the foot and ankle, were used to capture the stance phase of the right foot of the six healthy participants during walking. The GM-model was then applied to calculate the intrinsic foot kinematics. Distinct motion patterns where found for all joints. The variability in outcome depended on the location of the joint, with reasonable results for sagittal plane motions and poor results for transverse plane motions. The results of the GM-model were comparable with existing literature, including bone pin studies, with respect to the range of motion, motion pattern and timing of the motion in the studied joints. This novel model is the most complete kinematic model to date. Further evaluation of the model is warranted.

  3. Skin care education and individual counselling versus treatment as usual in healthcare workers with hand eczema: randomised clinical trial.

    Science.gov (United States)

    Ibler, Kristina Sophie; Jemec, Gregor B E; Diepgen, Thomas L; Gluud, Christian; Lindschou Hansen, Jane; Winkel, Per; Thomsen, Simon Francis; Agner, Tove

    2012-12-12

    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. Randomised, observer blinded parallel group superiority clinical trial. Three hospitals in Denmark. 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. 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. The primary outcome was clinical severity of disease at five month follow-up measured by scores on the hand eczema severity index. The secondary outcomes were scores on the dermatology life quality index, self evaluated severity of hand eczema, skin protective behaviours, and knowledge of hand eczema from onset to follow-up. Follow-up data were available for 247 of 255 participants (97%). At follow-up, the mean score on the hand eczema severity index was significantly lower (improved) in the intervention group than control group: difference of means, unadjusted -3.56 (95% confidence interval -4.92 to -2.14); adjusted -3.47 (-4.80 to -2.14), both Pgroup at follow-up: difference of means: unadjusted -0.78, non-parametric test P=0.003; adjusted -0.92, -1.48 to -0.37). Self evaluated severity and skin protective behaviour by hand washings and wearing of protective gloves were also statistically significantly better in the intervention group, whereas this was not the case for knowledge of hand eczema. A secondary prevention programme for hand eczema improved severity and quality of life and had a positive effect on self evaluated severity and skin protective behaviour by hand washings and wearing of protective gloves. ClinicalTrials.gov NCT01012453.

  4. Validation of a short questionnaire to measure symptoms and functional limitations associated with hand-foot syndrome and mucositis in patients with metastatic renal cell carcinoma.

    Science.gov (United States)

    Lai, Jin-Shei; Beaumont, Jennifer L; Diaz, Jose; Khan, Sadya; Cella, David

    2016-01-15

    Hand-foot syndrome and mucositis/stomatitis are frequent adverse events (AEs) of treatment with tyrosine kinase inhibitors in cancer therapy. Quality-of-life instruments that measure the functional consequences of these AEs are needed to assess the impact of therapeutic interventions and to guide patient care. The Hand-Foot and Mucositis Symptom and Impact Questionnaire (HAMSIQ [formerly the Supplementary Quality of Life Questionnaire]) was used in the COMPARZ trial (Pazopanib vs Sunitinib in the Treatment of Locally Advanced and/or Metastatic Renal Cell Carcinoma [national clinical trial no. NCT00720941]) and the PISCES study (Patient Preference Study of Pazopanib vs Sunitinib in Advanced or Metastatic Kidney Cancer [clinicaltrials.gov NCT01064310]) to assess mouth/throat and hand/foot soreness symptoms and subsequent limitations in patients receiving pazopanib or sunitinib for metastatic renal cell carcinoma. The objective of the current analysis was to validate the HAMSIQ using data from the PISCES study. The HAMSIQ was administered in the PISCES study at baseline and every 2 weeks over two 10-week periods to patients who were receiving pazopanib or sunitinib. Data from the first 10-week period were used to assess the feasibility, validity, and responsiveness of the HAMSIQ. In total, ≥85% of 169 patients completed the HAMSIQ (excluding the item concerning days off work). Correlations among items within the same limitation subscale generally were high (Cronbach α ≥ .80). HAMSIQ limitation scores differentiated patients according to their baseline performance status and severity of soreness. Small-to-moderate correlations were observed for the symptoms/limitation scores and for changes from baseline scores between the HAMSIQ and the Functional Assessment of Chronic Illness Therapy fatigue survey. The HAMSIQ demonstrated responsiveness to changes in clinical status and the development of hand-foot syndrome AEs over time. The HAMSIQ is a feasible, valid

  5. The response of previously irradiated mouse skin to heat alone or combined with irradiation: influence of thermotolerance

    International Nuclear Information System (INIS)

    Wondergem, J.; Haveman, J.

    1983-01-01

    The effect of previous x-irradiation on the response to hyperthermia (44 0 C), x-irradiation, and irradiation combined with hyperthermia (43 0 C or 44 0 C) was studied in mouse foot skin. Irradiation of mice feet 90 days before, with 20 Gy, increased the subsequent response to heat alone, or combined with irradiation, as well as to irradiation alone. It had little effect on the thermal enhancement ratios for both acute and late skin reactions. Memory of the previous irradiation treatment could be masked when the temperature of the subsequent heat treatment alone, or combined with irradiation, was 44 0 C. Priming heat treatment induced resistance to a subsequent heat treatment and to a subsequent combined irradiation-heat treatment in normal as well as previously irradiated skin. When late skin reaction was considered, a larger 'memory' of the previous irradiation treatment was always evident, compared to acute skin reaction: the 'remembered' dose in the late skin reaction was about twice the 'remembered' dose in the acute reaction. (U.K.)

  6. Techniques for small-bone lengthening in congenital anomalies of the hand and foot.

    Science.gov (United States)

    Minguella, J; Cabrera, M; Escolá, J

    2001-10-01

    The purpose of this study is to analyse three different lengthening techniques used in 31 small bones for congenital malformations of the hand and foot: 15 metacarpals, 12 metatarsals, 1 foot stump and 3 spaces between a previously transplanted phalanx end of the carpus or the metacarpal. Progressive lengthening with an external fixator device was performed in 23 cases: the callus distraction (callotasis) technique was used in 15 cases, whereas in the other 8 cases the speed of lengthening was faster and the defect bridged with a bone graft as a second stage. In another eight cases, a one-stage lengthening was performed. In the callotasis group, the total length gained ranged from 9 mm to 30 mm and the percentage of lengthening obtained (compared with the initial bone length) averaged 53.4%; in the fast lengthening group, the length gained ranged from 8 mm to 15 mm, and the average percentage of lengthening was 53.1%; and in the one-stage group, the length gained ranged from 7 mm to 15 mm, and the average percentage of lengthening was 43%. The overall complication rate was 22.5%.

  7. A novel Enterovirus 96 circulating in China causes hand, foot, and mouth disease.

    Science.gov (United States)

    Xu, Yi; Sun, Yisuo; Ma, Jinmin; Zhou, Shuru; Fang, Wei; Ye, Jiawei; Tan, Limei; Ji, Jingkai; Luo, Dan; Li, Liqiang; Li, Jiandong; Fang, Chunxiao; Pei, Na; Shi, Shuo; Liu, Xin; Jiang, Hui; Gong, Sitang; Xu, Xun

    2017-06-01

    Enterovirus 96 (EV-96) is a recently described member of the species Enterovirus C and is associated with paralysis and myelitis. In this study, using metagenomic sequencing, we identified a new enterovirus 96 strain (EV-96-SZ/GD/CHN/2014) as the sole pathogen causing hand, foot, and mouth disease (HFMD). A genomic comparison showed that EV-96-SZ/GD/CHN/2014 is most similar to the EV-96-05517 strain (85% identity), which has also been detected in Guangdong Province. This is the first time that metagenomic sequencing has been used to identify an EV-96 strain shown to be associated with HFMD.

  8. Temporal and spatial mapping of hand, foot and mouth disease in Sarawak, Malaysia.

    Science.gov (United States)

    Sham, Noraishah M; Krishnarajah, Isthrinayagy; Ibrahim, Noor Akma; Lye, Munn-Sann

    2014-05-01

    Hand, foot and mouth disease (HFMD) is endemic in Sarawak, Malaysia. In this study, a geographical information system (GIS) was used to investigate the relationship between the reported HFMD cases and the spatial patterns in 11 districts of Sarawak from 2006 to 2012. Within this 7-years period, the highest number of reported HFMD cases occurred in 2006, followed by 2012, 2008, 2009, 2007, 2010 and 2011, in descending order. However, while there was no significant distribution pattern or clustering in the first part of the study period (2006 to 2011) based on Moran's I statistic, spatial autocorrelation (P = 0.068) was observed in 2012.

  9. The effect of vitamin E on acute skin reaction caused by radiotherapy.

    Science.gov (United States)

    Dirier, A; Akmansu, M; Bora, H; Gurer, M

    2007-09-01

    Ionizing radiation affects healthy organs and tissues as well as diseased tissues during radiation therapy. Skin reactions varying from acute erythema to necrosis can be seen. It has been found that vitamin E can prevent mutagenic and/or carcinogenic effects of ionizing radiation in both animals and cell cultures. This study investigated the preventative effect of antioxidant vitamin E on irradiation-induced acute skin reactions. No protective effect of vitamin E was demonstrated. It is possible that the vehicle induced free radical exposure in the irradiated skin.

  10. Skin: Major target organ of allergic reactions to small molecular weight compounds

    International Nuclear Information System (INIS)

    Merk, Hans F.; Baron, Jens M.; Neis, Mark M.; Obrigkeit, Daniela Hoeller; Karlberg, Ann-Therese

    2007-01-01

    Skin is a major target organ for allergic reactions to small molecular weight compounds. Drug allergic reactions may be life-threatening such as in the case of anaphylactic reactions or bullous drug reactions and occur in about 5% of all hospitalized patients. Allergic contact dermatitis has an enormous influence on the social life of the patient because it is the most frequent reason for occupational skin diseases and the treatment and prevention of this disease cost approximately Euro 3 billion per year in Germany. The different proposed pathophysiological pathways leading to a drug eruption are discussed in this paper. All major enzymes which are involved in the metabolism of xenobiotica were shown to be present in skin. Evidence supporting the role of metabolism in the development of drug allergy and allergic contact dermatitis is demonstrated in the example of sulphonamides and fragrances

  11. Dynamically adjustable foot-ground contact model to estimate ground reaction force during walking and running.

    Science.gov (United States)

    Jung, Yihwan; Jung, Moonki; Ryu, Jiseon; Yoon, Sukhoon; Park, Sang-Kyoon; Koo, Seungbum

    2016-03-01

    Human dynamic models have been used to estimate joint kinetics during various activities. Kinetics estimation is in demand in sports and clinical applications where data on external forces, such as the ground reaction force (GRF), are not available. The purpose of this study was to estimate the GRF during gait by utilizing distance- and velocity-dependent force models between the foot and ground in an inverse-dynamics-based optimization. Ten males were tested as they walked at four different speeds on a force plate-embedded treadmill system. The full-GRF model whose foot-ground reaction elements were dynamically adjusted according to vertical displacement and anterior-posterior speed between the foot and ground was implemented in a full-body skeletal model. The model estimated the vertical and shear forces of the GRF from body kinematics. The shear-GRF model with dynamically adjustable shear reaction elements according to the input vertical force was also implemented in the foot of a full-body skeletal model. Shear forces of the GRF were estimated from body kinematics, vertical GRF, and center of pressure. The estimated full GRF had the lowest root mean square (RMS) errors at the slow walking speed (1.0m/s) with 4.2, 1.3, and 5.7% BW for anterior-posterior, medial-lateral, and vertical forces, respectively. The estimated shear forces were not significantly different between the full-GRF and shear-GRF models, but the RMS errors of the estimated knee joint kinetics were significantly lower for the shear-GRF model. Providing COP and vertical GRF with sensors, such as an insole-type pressure mat, can help estimate shear forces of the GRF and increase accuracy for estimation of joint kinetics. Copyright © 2016 Elsevier B.V. All rights reserved.

  12. Clinical categories of exaggerated skin reactions to mosquito bites and their pathophysiology.

    Science.gov (United States)

    Tatsuno, Kazuki; Fujiyama, Toshiharu; Matsuoka, Hiroyuki; Shimauchi, Takatoshi; Ito, Taisuke; Tokura, Yoshiki

    2016-06-01

    Mosquito bites are skin irritating reactions, which usually resolve spontaneously without intensive medical care. However, in certain situations, mosquito bites may form a more vicious reaction, sometimes accompanying fever and systemic symptoms. In such cases, the presence of rare hematological disorders, abnormalities in eosinophils and/or association with Epstein-Barr virus (EBV) may underlie. Importantly, hypersensitivity to mosquito bites (HMB), which is characterized by necrotic skin reactions to mosquito bites with various systemic symptoms, is often observed in association with EBV infection and natural killer (NK) cell lymphoproliferative disorder. Exaggerated skin reaction to mosquito bites is also seen in Wells' syndrome. While strong Th2-skewing immune dysregulation is apparent in the patients, they also show robust CD4(+) T cell proliferation in response to mosquito salivary gland extracts, indicating close association between Wells' syndrome and mosquito bites. Similar skin reaction to mosquito bites is also noticed in certain types of B cell neoplasm, although the role of B cells in this peculiar reaction to mosquito bites is yet to be elucidated. In this review, we will discuss the current knowledge of exaggerated reaction toward mosquito bites seen in conjunction with these unique hematological disorders, and examine the scientific studies and observations reported in previous literatures to organize our current understanding of the pathogenesis of this distinct disorder. Copyright © 2016 Japanese Society for Investigative Dermatology. Published by Elsevier Ireland Ltd. All rights reserved.

  13. Tattoo-Associated Skin Reaction: The Importance of an Early Diagnosis and Proper Treatment

    Science.gov (United States)

    Bassi, Andrea; Campolmi, Piero; Cannarozzo, Giovanni; Conti, Rossana; Bruscino, Nicola; Gola, Massimo; Ermini, Stefano; Massi, Daniela; Moretti, Silvia

    2014-01-01

    Tattoo is going to be a very common practice especially among young people and we are witnessing a gradual increase of numerous potential complications to tattoo placement which are often seen by physicians, but generally unknown to the public. The most common skin reactions to tattoo include a transient acute inflammatory reaction due to trauma of the skin with needles and medical complications such as superficial and deep local infections, systemic infections, allergic contact dermatitis, photodermatitis, granulomatous and lichenoid reactions, and skin diseases localized on tattooed area (eczema, psoriasis, lichen, and morphea). Next to these inflammatory skin reactions we have to consider also the possibility of the development of cutaneous conditions such as pseudolymphomatous reactions and pseudoepitheliomatous hyperplasia. The aim of this study is to underline the importance of an early diagnosis by performing a histological examination especially when we are in front of suspected papulonodular lesions arising from a tattoo, followed by a proper treatment, since cutaneous neoplastic evolution is known to be a rare but possible complication. PMID:25147796

  14. Oral treatments for fungal infections of the skin of the foot

    Directory of Open Access Journals (Sweden)

    Sally E. M. Bell-Syer

    Full Text Available BACKGROUND: About 15% of the world population have fungal infections of the feet (tinea pedis or athlete's foot. There are many clinical presentations of tinea pedis, and most commonly, tinea pedis is seen between the toes (interdigital and on the soles, heels, and sides of the foot (plantar. Plantar tinea pedis is known as moccasin foot. Once acquired, the infection can spread to other sites including the nails, which can be a source of re-infection. Oral therapy is usually used for chronic conditions or when topical treatment has failed. OBJECTIVE: To assess the effects of oral treatments for fungal infections of the skin of the foot (tinea pedis. METHODS: Search methods: For this update we searched the following databases to July 2012: the Cochrane Skin Group Specialized Register, CENTRAL in The Cochrane Library, MEDLINE (from 1946, EMBASE (from 1974, and CINAHL (from 1981. We checked the bibliographies of retrieved trials for further references to relevant trials, and we searched online trials registers. Selection criteria: Randomized controlled trials of oral treatments in participants who have a clinically diagnosed tinea pedis, confirmed by microscopy and growth of dermatophytes (fungi in culture. Data collection and analysis: Two review authors independently undertook study selection, "Risk of bias" assessment, and data extraction. MAIN RESULTS: We included 15 trials, involving 1,438 participants. The 2 trials (71 participants comparing terbinafine and griseofulvin produced a pooled risk ratio (RR of 2.26 (95% confidence interval (CI 1.49 to 3.44 in favors of terbinafine's ability to cure infection. No significant difference was detected between terbinafine and itraconazole, fluconazole and itraconazole, fluconazole and ketoconazole, or between griseofulvin and ketoconazole, although the trials were generally small. Two trials showed that terbinafine and itraconazole were effective compared with placebo: terbinafine (31 participants, RR

  15. 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...

  16. Nonlinear dynamics of skin blood flow response to mechanical and thermal stresses in the plantar foot of diabetics with peripheral neuropathy.

    Science.gov (United States)

    Liao, Fuyuan; Jan, Yih-Kuen

    2017-01-01

    Diabetic foot ulcers (DFU) are a major complication in diabetics. Impaired microvascular reactivity is a major contributor to the development of DFU and has been traditionally quantified by time-domain or frequency-domain measures of skin blood flow (SBF). These measures, however, are unable to characterize the changes of nonlinear dynamics of SBF associated with diabetes and peripheral neuropathy. The objective of this study was to investigate altered nonlinear dynamics of skin blood flow in the plantar foot of diabetics with peripheral neuropathy. 18 type 2 diabetics with peripheral neuropathy and 8 healthy controls were recruited. SBF at the first metatarsal head in response to a loading pressure of 300 mmHg and a local heating was measured using laser Doppler flowmetry. A sample entropy approach was used to quantify the degree of regularity of SBF. Our results showed that the regularity degree of SBF in the diabetic foot underwent only small changes during post-occlusive reactive hyperemia and thermally induced biphasic response compared to non-diabetics. SBF of the diabetic foot has higher degree of irregularity during reactive hyperemia because of attenuated myogenic activity, and demonstrated higher regularity during the biphasic response largely due to significantly enhanced cardiac activities. This study suggests that the regularity degree of SBF at the first metatarsal head could be used to assess impaired microvascular reactivity and thus may be used to assess the risk for DFU in diabetics with peripheralneuropathy.

  17. Low Cost Skin Segmentation Scheme in Videos Using Two Alternative Methods for Dynamic Hand Gesture Detection Method

    Directory of Open Access Journals (Sweden)

    Eman Thabet

    2017-01-01

    Full Text Available Recent years have witnessed renewed interest in developing skin segmentation approaches. Skin feature segmentation has been widely employed in different aspects of computer vision applications including face detection and hand gestures recognition systems. This is mostly due to the attractive characteristics of skin colour and its effectiveness to object segmentation. On the contrary, there are certain challenges in using human skin colour as a feature to segment dynamic hand gesture, due to various illumination conditions, complicated environment, and computation time or real-time method. These challenges have led to the insufficiency of many of the skin color segmentation approaches. Therefore, to produce simple, effective, and cost efficient skin segmentation, this paper has proposed a skin segmentation scheme. This scheme includes two procedures for calculating generic threshold ranges in Cb-Cr colour space. The first procedure uses threshold values trained online from nose pixels of the face region. Meanwhile, the second procedure known as the offline training procedure uses thresholds trained out of skin samples and weighted equation. The experimental results showed that the proposed scheme achieved good performance in terms of efficiency and computation time.

  18. Wound-Healing Peptides for Treatment of Chronic Diabetic Foot Ulcers and Other Infected Skin Injuries

    Directory of Open Access Journals (Sweden)

    Ana Gomes

    2017-10-01

    Full Text Available As the incidence of diabetes continues to increase in the western world, the prevalence of chronic wounds related to this condition continues to be a major focus of wound care research. Additionally, over 50% of chronic wounds exhibit signs and symptoms that are consistent with localized bacterial biofilms underlying severe infections that contribute to tissue destruction, delayed wound-healing and other serious complications. Most current biomedical approaches for advanced wound care aim at providing antimicrobial protection to the open wound together with a matrix scaffold (often collagen-based to boost reestablishment of the skin tissue. Therefore, the present review is focused on the efforts that have been made over the past years to find peptides possessing wound-healing properties, towards the development of new and effective wound care treatments for diabetic foot ulcers and other skin and soft tissue infections.

  19. Wound-Healing Peptides for Treatment of Chronic Diabetic Foot Ulcers and Other Infected Skin Injuries.

    Science.gov (United States)

    Gomes, Ana; Teixeira, Cátia; Ferraz, Ricardo; Prudêncio, Cristina; Gomes, Paula

    2017-10-18

    As the incidence of diabetes continues to increase in the western world, the prevalence of chronic wounds related to this condition continues to be a major focus of wound care research. Additionally, over 50% of chronic wounds exhibit signs and symptoms that are consistent with localized bacterial biofilms underlying severe infections that contribute to tissue destruction, delayed wound-healing and other serious complications. Most current biomedical approaches for advanced wound care aim at providing antimicrobial protection to the open wound together with a matrix scaffold (often collagen-based) to boost reestablishment of the skin tissue. Therefore, the present review is focused on the efforts that have been made over the past years to find peptides possessing wound-healing properties, towards the development of new and effective wound care treatments for diabetic foot ulcers and other skin and soft tissue infections.

  20. Radiographic appearance of Ewing sarcoma of the hands and feet: report from the Intergroup Ewing Sarcoma Study

    International Nuclear Information System (INIS)

    Reinus, W.R.; Gilula, L.A.; Shirley, S.K.; Askin, F.B.; Siegal, G.P.

    1985-01-01

    Review of current data from the Intergroup Ewing Sarcoma Study (IESS) shows that Ewing sarcoma is rare in bones of the hands and feet. The 12 patients from the IESS protocols with hand or foot Ewing sarcoma are comparable to those already reported in the literature. With the exception of lesions in the calcaneus, the prognosis for disease-free survival is excellent. The radiographic features of hand and foot Ewing sarcoma are generally those of classic Ewing sarcoma: permeation, soft-tissue mass, and often, associated sclerotic reaction. However, with the exception of sclerosis, features suggesting bone reaction and slow tumor growth in these patients were distinctly uncommon compared with Ewing sarcoma in general. Apparently location of the lesion is important, since in the reported cases in the literature and in this series, lesions of the calcaneus fared poorly. The importance of this set of patients therefore relates to awareness and early recognition of an unusual appearance and location of Ewing sarcoma

  1. Clinical features for 89 deaths of hand, foot and mouth disease in Guangxi, China, 2014

    Directory of Open Access Journals (Sweden)

    Wei Lin

    2017-11-01

    Full Text Available Objectives: The aim of this study is to summarize the risk factors of severe Hand, foot and mouth disease (HFMD and explore the clinical characteristics of pulmonary edema (PE and non-PE in the deceased patients with HFMD. Methods: We identified 89 HFMD deaths which were separated into the PE group or non-PE group. Next, patients were divided based on their initial admission to hospitals as stage 1, 2, 3, or 4; at this point, their clinical manifestations were compared. Results: There were 87 cases in the PE group, and 2 cases in the non-PE group. In the PE group, the difference in median time for patients at different stages from onset to symptoms, showed no significant difference (p > 0.05. The etiology was detected as a positive rate for enterovirus 71 (EV71 of 89.19%, which showed a more severe course than other etiologies. The white blood cell (WBC counts, lymphocyte (LYM counts and creatine kinase MB (CK-MB counts of patients admitted in different stages increased significantly with severity (p < 0.05. Conclusions: There may be two clinical subtypes, mostly PE and rarely non-PE, in the deceased patients with HMFD. EV71 and risk factors such as an increased WBC count are associated with a severe course of HMFD. Keywords: Hand, foot, and mouth disease, Pulmonary edema, Non-pulmonary edema, Death cases

  2. Electrochemical skin conductance to detect sudomotor dysfunction, peripheral neuropathy and the risk of foot ulceration among Saudi patients with diabetes mellitus.

    Science.gov (United States)

    Sheshah, Eman; Madanat, Amal; Al-Greesheh, Fahad; Al-Qaisi, Dalal; Al-Harbi, Mohammad; Aman, Reem; Al-Ghamdi, Abdul Aziz; Al-Madani, Khaled

    2015-01-01

    Sudomotor dysfunction is manifested clinically as abnormal sweating leading to dryness of feet skin and increased risk of foot ulceration. The aim of this study was to test the performance of foot electrochemical skin conductance (ESC) to detect diabetic peripheral neuropathy and the risk of foot ulceration against traditional methods in Saudi patients with diabetes mellitus. This cross-sectional study was conducted on 296 Saudi patients with diabetes mellitus. Painful neuropathic symptoms were evaluated using the neuropathy symptom score (NSS). The risk of foot ulceration and diabetic peripheral neuropathy were determined using the neuropathy disability score (NDS). Vibration perception threshold (VPT) was assessed using neurothesiometer. Neurophysiological assessment of the right and left sural, peroneal and tibial nerves was performed in 222 participants. Diabetic peripheral neuropathy was defined according to the definition of the American Academy of Neurology. ESC was measured with Sudoscan. Feet-ESC decreased as the scores of sensory and motor function tests increased. Feet-ESC decreased as the NSS, NDS and severity of diabetic peripheral neuropathy increased. Sensitivity of feet-ESC peripheral neuropathy assessed by VPT ≥ 25 V, NDS ≥ 3, NDS ≥ 6 was 90.1, 61 and 63.8 % respectively and specificity 77, 85 and 81.9 % respectively. Sensitivity of feet-ESC peripheral neuropathy assessed by VPT ≥ 25 V, NDS ≥ 3, NDS ≥ 6 was 100, 80.6 and 80.9 % respectively. Sensitivity and specificity of feet-ESC peripheral neuropathy were 67.5 and 58.9 % respectively. Sudoscan a simple and objective tool can be used to detect diabetic peripheral neuropathy and the risk of foot ulceration among patients with diabetes mellitus. Prospective studies to confirm our results are warranted.

  3. Quantitative analysis of skin reaction by reflectance spectrophotometer. Acute reaction following proton therapy

    International Nuclear Information System (INIS)

    Kawashima, Mitsuhiko; Okumura, Toshiyuki; Tatsuzaki, Hideo; Tsuji, Hiroshi; Tsujii, Hirohiko.

    1994-01-01

    Acute reactions induced by proton irradiation were measured using a reflectance spectrophotometer, which is commonly used in the printing and textile industries. In this method, the skin color was expressed by three parameters, lightness (L * ), chroma (C * ) and hue (h). At first, in order to evaluate the accuracy of this spectrophotometer, the skin color of a normal volunteer was measured 100 times. The values of the three parameters for normal skin were as follows (mean values and standard deviation), L * : 68.64±0.29, C * : 19.08±0.13, h: 69.41±0.76. The standard deviations with regard to L * and h, were considered to be sufficiently small when compared with the changes of these parameters (prefix: Δ) in the irradiated sites (ΔL * * and h values significantly decreased with time, and the L * values were highly correlated with elapsed treatment days. The h values had a relatively low linear correlation compared with L * . The C * values had no trends as the treatment period was extended. Among these parameters, the L * values were the most valuable for assessment of proton-induced skin reactions, and it was suggested that the L * values measured with this spectrophotometer were a useful index for showing biological effects induced by proton irradiation. Further experiments are needed to apply this method to quantify the biological effects induced by other forms of ionizing radiation. (author)

  4. Radiosensitization of mouse skin by oxygen and depletion of glutathione

    International Nuclear Information System (INIS)

    Stevens, Graham; Joiner, Michael; Joiner, Barbara; Johns, Helen; Denekamp, Juliana

    1995-01-01

    Purpose: To determine the oxygen enhancement ratio (OER) and shape of the oxygen sensitization curve of mouse foot skin, the extent to which glutathione (GSH) depletion radiosensitized skin, and the dependence of such sensitization on the ambient oxygen tension. Methods and Materials: The feet of WHT mice were irradiated with single doses of 240 kVp x-rays while mice were exposed to carbogen or gases with oxygen/nitrogen mixtures containing 8-100% O 2 . The anoxic response was obtained by occluding the blood supply to the leg of anesthetized mice with a tourniquet, surrounding the foot with nitrogen, and allowing the mice to breathe 10% O 2 . Further experiments were performed to assess the efficacy of this method to obtain an anoxic response. Radiosensitivity of skin was assessed using the acute skin-reaction assay. Glutathione levels were modified using two schedules of dl-buthionine sulphoximine (BSO) and diethylmaleate (DEM), which were considered to produce extensive and intermediate levels of GSH depletion in the skin of the foot during irradiation. Results: Carbogen caused the greatest radiosensitization of skin, with a reproducible enhancement of 2.2 relative to the anoxic response. The OER of 2.2 is lower than other reports for mouse skin. This may indicate that the extremes of oxygenation were not produced, although there was no direct evidence for this. When skin radiosensitivity was plotted against the logarithm of the oxygen tension in the ambient gas, a sigmoid curve with a K value of 17-21% O 2 in the ambient gas was obtained. Depletion of GSH caused minimal radiosensitization when skin was irradiated under anoxic or well-oxygenated conditions. Radiosensitization by GSH depletion was maximal at intermediate oxygen tensions of 10-21% O 2 in the ambient gas. Increasing the extent of GSH depletion led to increasing radiosensitization, with sensitization enhancement ratios of 1.2 and 1.1, respectively, for extensive and intermediate levels of GSH

  5. Chest imaging characteristics of hand-foot-mouth disease in children

    International Nuclear Information System (INIS)

    Ma Bo; Chen Ruigang; Dou Shewei; Zhu Xiaonian; Shi Dapeng

    2010-01-01

    Objective: To study radiological characteristics of hand-foot-mouth disease (HFMD) in children. Methods: The chest X-ray films of 1295 children patients of HFMD were analyzed, for the general X-ray manifestations and the evolution. Results: A total of 1427 films was obtained from all patients, in which 1203 cases were normal and 224 cases were abnormal. The interstitial changes characterized the abnormal group, mainly as increased and vague lung markings, increased hilar shadows (137 cases). The parenchyma changes appeared as patchy exudative shadows(49 cases). Short-term dynamic observation was applied in 62 cases, 38 cases pulmonary disease progression manifested as normal and the interstitial type changing into the parenchyma type and the mixed type, the localized type changing into the diffuse type. Conclusions: Most children patients of' HFMD showed normal chest films, while the abnormal patients were characterized by interstitial and parenchyma pulmonary edema. Serial chest X-ray examination and short-term dynamic observation were important to identify the severe cases and assess patients' condition. (authors)

  6. Is a multivalent hand, foot, and mouth disease vaccine feasible?

    Science.gov (United States)

    Klein, Michel; Chong, Pele

    2015-01-01

    Enterovirus A infections are the primary cause of hand, foot and mouth disease (HFMD) in infants and young children. Although enterovirus 71 (EV-A71) and coxsackievirus A16 (CV-A16) are the predominant causes of HFMD epidemics worldwide, EV-A71 has emerged as a major neurovirulent virus responsible for severe neurological complications and fatal outcomes. HFMD is a serious health threat and economic burden across the Asia-Pacific region. Inactivated EV-A71 vaccines have elicited protection against EV-A71 but not against CV-A16 infections in large efficacy trials. The current development of a bivalent inactivated EV-A71/CV-A16 vaccine is the next step toward that of multivalent HFMD vaccines. These vaccines should ultimately include other prevalent pathogenic coxsackieviruses A (CV-A6 and CV-A10), coxsackieviruses B (B3 and B5) and echovirus 30 that often co-circulate during HFMD epidemics and can cause severe HFMD, aseptic meningitis and acute viral myocarditis. The prospect and challenges for the development of such multivalent vaccines are discussed. PMID:26009802

  7. Gender-related Changes in Dorsal Hand and Foot Vein Function Following 60 Days of Head Down Bed Rest

    Science.gov (United States)

    Westby, Christian M.; Phillips, Tiffany; Stenger, Michael B.; Platts, Steven H.

    2009-01-01

    It is well known that female astronauts are more likely to experience post-flight orthostatic hypotension and presyncope compared to male astronauts. It has been suggested that the disproportionally higher incidence of presyncope (83% of female vs. 20% male crewmembers) may be due to sex-related differences in vascular function between the upper and lower limbs. However, much of this evidence is specific to changes in resistance vessels. Given that more than 70% of the circulating blood volume resides in compliance vessels, it is conceivable that even small changes in venous function may contribute to post-flight orthostatic hypotension. In spite of this, little is currently known regarding the influence of microgravity exposure on venous function between males and females. PURPOSE: To determine the influence of 60 days of HDBR on dorsal foot and hand vein function between healthy males (M) and females (F). METHODS: Using 2-D ultrasound, dorsal hand and foot vein diameter responses to intravenous infusions phenylephrine (PE), acetylcholine (ACh), and nitroglycerine (NTG) were determined in 26 adults; 10 females (age:37 +/- 2 yr ) and 16 males (age:34 +/- 2 yr ). Changes in venous function were calculated as the difference between diameter at baseline and following each venoactive drug. Differences in venous function between limb and sexes across HDBR were determined using mixed-effects linear regression. RESULTS: In response to 60 days of HDBR, the change in venousconstrictor response to PE in the dorsal hand veins was not significantly different between M and F. Interestingly, the change in constrictor response in the dorsal foot veins (compared to pre HDBR) was approximately 30% greater in the F, whereas the constrictor response was approximately 45% less in the M (p=0.026). HDBR had no influence on the change in dilator response to ACh, or NTG between M and F and between vascular beds. CONCLUSION: These results demonstrate that 60 days of HDBR contributes to sex

  8. [Minor foot amputations in diabetic foot syndrome].

    Science.gov (United States)

    Biehl, C; Eckhard, M; Szalay, G; Heiss, C

    2016-10-01

    The treatment strategy for diabetic foot syndrome must take into account protective sensibility of the foot, open wounds, infection status, and the rules of septic bone surgery. Interventions are classified as elective, prophylactic, curative, or emergency. Amputations in the forefoot and midfoot region are performed as ray amputations (including metatarsal), which can often be carried out as "inner" amputations. Gentle tissue treatment mandatory because of greater risk of revision with re-amputation compared to classical amputation. Good demarcation of infection, acute osteomyelitis, osteolytic lesions, neurotropic ulcer, arterial and venous blood flow to the other toes, gangrene of other toes with metatarsal affection. Arterial occlusive disease, infection of neighboring areas, avoidable amputations, poorly healing ulcers on the lower leg. Primary dorsal approach; minimal incisional distance (5 cm) to minimize skin necrosis risk. Atraumatic preparation, minimize hemostasis to not compromise the borderline perfusion situation. In amputations, plantar skin preparation and longer seams placed as dorsal as possible, either disarticulated and maintain cartilage, or round the cortical metatarsal bone after resection. Diabetes control. Braun splint, mobilization in a shoe with forefoot decompression and hindfoot support, physiotherapy. Antibiotics based on resistance testing. If no complications, dressing change on postoperative day 1. Optimal wound drainage by lowering foot several times a day; drainage removal after 12-24 h. Insoles and footwear optimization. Amputations require continued attention and if necessary treatment to avoid sequelae. Insufficient treatment associated with recurrent ulceration and altered anatomy.

  9. Tuberculin skin testing: Spectrum of adverse reactions.

    Science.gov (United States)

    Praveen, Ramar; Bahuguna, Amit; Dhadwal, Bhumesh Singh

    2015-01-01

    Tuberculin skin testing (TST) is one of the primary diagnostic modalities recommended by the World Health Organization (WHO) and the National Institute for Health and Care Excellence (NICE) study conducted in the United Kingdom (UK) for diagnosing tuberculosis (TB). Even after acceptance as a diagnostic modality and stern standardization, TST has its own flaws that include a spectrum of adverse reactions. We report a series of cases with a spectrum of adverse reactions occurring with a higher frequency than present in the available evidence. The study has some demerits such as being a retrospective one with interobserver variation and lack of histopathological confirmation. The observation is presented to accentuate the fact that adverse reactions are not a rarity and that further studies are required to establish the cause and exact incidence of the same.

  10. Factors that Affected Functional Outcome After a Delayed Excision and Split-Thickness Skin Graft on the Dorsal Side of Burned Hands.

    Science.gov (United States)

    Shichinohe, Ryuji; Yamamoto, Yuhei; Kawashima, Kunihiro; Kimura, Chu; Ono, Kentaro; Horiuchi, Katsumi; Yoshida, Tetsunori; Murao, Naoki; Hayashi, Toshihiko; Funayama, Emi; Oyama, Akihiko; Furukawa, Hiroshi

    Early excision and skin grafting is the principle treatment for a burned hand although there are occasions when it cannot be done such as severe general condition, delayed consultation, and the lack of a definitive assessment of burn depth. This study analyzes the factors that affected function after a delayed excision and skin graft for hands with a deep dermal burn. This study retrospectively evaluated 43 burned hands that required a delayed excision and split-thickness skin graft on the dorsal side. Cases were required to only have split-thickness skin grafting from the dorsum of the hand and fingers distally to at least the proximal interphalangeal joint at least 8 days after the injury. The hands were divided into two functional categories: Functional category A, normal or nearly normal joint movements, and functional category B, abnormal joint movements. Demographic data were assessed statistically by a univariate analysis following a multiple regression analysis by a stepwise selection. A significant difference was observed between the groups in the number of days from grafting to complete wound healing of the graft site and with or without an escharotomy in the analysis. These parameters were statistically significant predictors of functional category B. The functional outcome of a burned hand after a delayed excision and split-thickness skin graft on the dorsal side became degraded depending on the number of days from grafting to complete wound healing. Cases that underwent an escharotomy also showed deterioration in function.

  11. Nociception at the diabetic foot, an uncharted territory

    Science.gov (United States)

    Chantelau, Ernst A

    2015-01-01

    The diabetic foot is characterised by painless foot ulceration and/or arthropathy; it is a typical complication of painless diabetic neuropathy. Neuropathy depletes the foot skin of intraepidermal nerve fibre endings of the afferent A-delta and C-fibres, which are mostly nociceptors and excitable by noxious stimuli only. However, some of them are cold or warm receptors whose functions in diabetic neuropathy have frequently been reported. Hence, it is well established by quantitative sensory testing that thermal detection thresholds at the foot skin increase during the course of painless diabetic neuropathy. Pain perception (nociception), by contrast, has rarely been studied. Recent pilot studies of pinprick pain at plantar digital skinfolds showed that the perception threshold was always above the upper limit of measurement of 512 mN (equivalent to 51.2 g) at the diabetic foot. However, deep pressure pain perception threshold at musculus abductor hallucis was beyond 1400 kPa (equivalent to 14 kg; limit of measurement) only in every fifth case. These discrepancies of pain perception between forefoot and hindfoot, and between skin and muscle, demand further study. Measuring nociception at the feet in diabetes opens promising clinical perspectives. A critical nociception threshold may be quantified (probably corresponding to a critical number of intraepidermal nerve fibre endings), beyond which the individual risk of a diabetic foot rises appreciably. Staging of diabetic neuropathy according to nociception thresholds at the feet is highly desirable as guidance to an individualised injury prevention strategy. PMID:25897350

  12. Skin reactions of rat feet exposed to multiple fractions of X rays per day

    International Nuclear Information System (INIS)

    Rongen, E. van

    1983-01-01

    The right hind feet of female WAG/Rij rats were irradiated with multiple fractions per day (4 x 2 Gy daily), with daily fractions of 3 Gy and with single doses of 300 kV X-rays. Acute reactions were scored 5 times per week until the reactions disappeared. Mean scores were derived from the 7-day period encompassing the peak reaction. The mean scores for the acute reactions are presented. Tolerance doses, defined as the total doses resulting in one small area of moist desquamation in 50% of the animals, as calculated by probit analysis are 55.7 +- 0.7 Gy for the 4 x 2 Gy per day scheme and 67.3 +- 2.9 Gy for the 3 Gy per day scheme. It can be seen that, when increasing the total dose above the tolerance dose, the mean reaction to the 3 Gy per day regimen reaches a plateau (corresponding to 10 to 40% moist desquamation of the sole of the foot), while the reaction to the 4 x 2 Gy per day regimen increases to the maximum, i.e., moist desquamation of the entire foot. These differences can be attributed to differences in repair of sublethal damage and repopulation. (Auth.)

  13. Anaplerosis in Complex Treatment of Patients with Diabetic Foot Syndrome

    Directory of Open Access Journals (Sweden)

    B.G. Bezrodny

    2015-05-01

    Full Text Available The article describes the improvement of anaplerosis in patients with diabetic foot syndrome using skin flaps on vascular pedicle of the perforating vessels. The study involved patients with type 2 diabetes mellitus complicated with diabetic foot syndrome of neuroischemic form and chronic wounds of the lower extremities that do not heal for more than 21 days from the date of occurrence. The wounds were cleaned with ultrasonic cavitation. There was applied bandage with sorption antibacterial remedy base on nanodispersed silicon dioxide. There was applied a drainage vacuum bandage on a wound on the third day (VAC therapy. The flap is forming fitting to the size and configuration of a wound on a foot. Fourteen patients (93 % in the basic group were found to have survived flaps. Long-term follow up in 6 months demonstrated full maintenance of supporting function and good survived skin graft, absence of foot ulcers. In a control group 7 patients had recurrent foot ulcer. Improved techniques of autodermoplasty in patients with diabetic foot syndrome include glycemia control, preparation of a wound using vacuum apparatus bandage. Usage of split-skin graft combined with vacuum apparatus bandage allows close acute and chronic wounds effectively, maintain supporting function of an extremity, decrease in-hospital staying, and improve quality of patient’s life. Adequate foot wound closure prevents high-level amputation of low extremities in diabetic patients.

  14. Coxsackievirus A6 and enterovirus 71 causing hand, foot and mouth disease in Cuba, 2011-2013.

    Science.gov (United States)

    Fonseca, Magilé C; Sarmiento, Luis; Resik, Sonia; Martínez, Yenisleidys; Hung, Lai Heng; Morier, Luis; Piñón, Alexander; Valdéz, Odalys; Kourí, Vivian; González, Guelsys

    2014-09-01

    Hand, foot and mouth disease (HFMD) is usually caused by coxsackievirus A16 or enterovirus 71 (EV71). Between 2011 and 2013, HFMD cases were reported from different Cuban provinces. A total of 42 clinical specimens were obtained from 23 patients. Detection, identification and phylogenetic analysis of enterovirus-associated HFMD were carried out by virus isolation, specific enterovirus PCR and partial VP1 sequences. HEV was detected in 11 HFMD cases. Emerging genetic variants of coxsackievirus A6 and EV71 were identified as the causative agents of the Cuban HFMD cases.

  15. Algorithm for Primary Full-thickness Skin Grafting in Pediatric Hand Burns

    Directory of Open Access Journals (Sweden)

    Yang Seo Park

    2012-09-01

    Full Text Available Background Pediatric hand burns are a difficult problem because they lead to serious handdeformities with functional impairment due to rapid growth during childhood. Therefore,adequate management is required beginning in the acute stage. Our study aims to establishsurgical guidelines for a primary full-thickness skin graft (FTSG in pediatric hand burns, basedon long-term observation periods and existing studies.Methods From January 2000 to May 2011, 210 patients underwent primary FTSG. Weretrospectively studied the clinical course and treatment outcomes based on the patients’medical records. The patients’ demographics, age, sex, injury site of the fingers, presence ofweb space involvement, the incidence of postoperative late deformities, and the duration ofrevision were critically analyzed.Results The mean age of the patients was 24.4 months (range, 8 to 94 months, consisting of141 males and 69 females. The overall observation period was 6.9 years (range, 1 to 11 yearson average. At the time of the burn, 56 cases were to a single finger, 73 to two fingers, 45 tothree fingers, and 22 to more than three. Among these cases, 70 were burns that included aweb space (33.3%. During the observation, 25 cases underwent corrective operations withan average period of 40.6 months.Conclusions In the volar area, primary full-thickness skin grafting can be a good indicationfor an isolated injured finger, excluding the web spaces, and injuries of less than three fingersincluding the web spaces. Also, in the dorsal area, full-thickness skin grafting can be a goodindication. However, if the donor site is insufficient and the wound is large, split-thicknessskin grafting can be considered.

  16. Estimation of foot joint kinetics in three and four segment foot models using an existing proportionality scheme: Application in paediatric barefoot walking.

    Science.gov (United States)

    Deschamps, Kevin; Eerdekens, Maarten; Desmet, Dirk; Matricali, Giovanni Arnoldo; Wuite, Sander; Staes, Filip

    2017-08-16

    Recent studies which estimated foot segment kinetic patterns were found to have inconclusive data on one hand, and did not dissociate the kinetics of the chopart and lisfranc joint. The current study aimed therefore at reproducing independent, recently published three-segment foot kinetic data (Study 1) and in a second stage expand the estimation towards a four-segment model (Study 2). Concerning the reproducibility study, two recently published three segment foot models (Bruening et al., 2014; Saraswat et al., 2014) were reproduced and kinetic parameters were incorporated in order to calculate joint moments and powers of paediatric cohorts during gait. Ground reaction forces were measured with an integrated force/pressure plate measurement set-up and a recently published proportionality scheme was applied to determine subarea total ground reaction forces. Regarding Study 2, moments and powers were estimated with respect to the Instituto Ortopedico Rizzoli four-segment model. The proportionality scheme was expanded in this study and the impact of joint centre location on kinetic data was evaluated. Findings related to Study 1 showed in general good agreement with the kinetic data published by Bruening et al. (2014). Contrarily, the peak ankle, midfoot and hallux powers published by Saraswat et al. (2014) are disputed. Findings of Study 2 revealed that the chopart joint encompasses both power absorption and generation, whereas the Lisfranc joint mainly contributes to power generation. The results highlights the necessity for further studies in the field of foot kinetic models and provides a first estimation of the kinetic behaviour of the Lisfranc joint. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Recurrent Streptococcus Pneumoniae Meningitis in a Child with Split Hand and Foot Malformation and Undiagnosed Mondini Dysplasia

    OpenAIRE

    Katarzyna, Mazur-Melewska; Jaros?aw, Szyd?owski; Katarzyna, Jo?czyk-Potoczna; Wojciech, S?u?ewski; Magdalena, Figlerowicz

    2015-01-01

    Recurrent bacterial meningitis is a life-threatening infection of the central nervous system that is mostly connected with anatomical abnormalities of the skull, chronic parameningeal infections and immunodeficiencies. It?s rarely seen, but when it occurs an extensive investigation should be carried out to discover the responsible factor, so that further episodes can be prevented. We report on a child with split hand and foot (SHFM), confirmed incorrect karyotype 46, XY, t(7:12)(q21.2;q21.3) ...

  18. Two-layer optical model of skin for early, non-invasive detection of wound development on the diabetic foot

    Science.gov (United States)

    Yudovsky, Dmitry; Nouvong, Aksone; Schomacker, Kevin; Pilon, Laurent

    2010-02-01

    Foot ulceration is a debilitating comorbidity of diabetes that may result in loss of mobility and amputation. Optical detection of cutaneous tissue changes due to inflammation and necrosis at the preulcer site could constitute a preventative strategy. A commercial hyperspectral oximetry system was used to measure tissue oxygenation on the feet of diabetic patients. A previously developed predictive index was used to differentiate preulcer tissue from surrounding healthy tissue with a sensitivity of 92% and specificity of 80%. To improve prediction accuracy, an optical skin model was developed treating skin as a two-layer medium and explicitly accounting for (i) melanin content and thickness of the epidermis, (ii) blood content and hemoglobin saturation of the dermis, and (iii) tissue scattering in both layers. Using this forward model, an iterative inverse method was used to determine the skin properties from hyperspectral images of preulcerative areas. The use of this information in lowering the false positive rate was discussed.

  19. In a demanding task, three-handed manipulation is preferred to two-handed manipulation.

    Science.gov (United States)

    Abdi, Elahe; Burdet, Etienne; Bouri, Mohamed; Himidan, Sharifa; Bleuler, Hannes

    2016-02-25

    Equipped with a third hand under their direct control, surgeons may be able to perform certain surgical interventions alone; this would reduce the need for a human assistant and related coordination difficulties. However, does human performance improve with three hands compared to two hands? To evaluate this possibility, we carried out a behavioural study on the performance of naive adults catching objects with three virtual hands controlled by their two hands and right foot. The subjects could successfully control the virtual hands in a few trials. With this control strategy, the workspace of the hands was inversely correlated with the task velocity. The comparison of performance between the three and two hands control revealed no significant difference of success in catching falling objects and in average effort during the tasks. Subjects preferred the three handed control strategy, found it easier, with less physical and mental burden. Although the coordination of the foot with the natural hands increased trial after trial, about two minutes of practice was not sufficient to develop a sense of ownership towards the third arm.

  20. Children’s Caregivers and Public Playgrounds: Potential Reservoirs of Infection of Hand-foot-and-mouth Disease

    Science.gov (United States)

    Li, Pengyuan; Li, Tao; Gu, Qiuyun; Chen, Xiaomin; Li, Jiahui; Chen, Xiashi; Chen, Yan; Zhang, Danwei; Gao, Rong; He, Zhenjian; Zhu, Xun; Zhang, Wangjian; Hao, Yuantao; Zhang, Dingmei

    2016-11-01

    Hand-foot-and-mouth disease (HFMD) is a common infectious disease, which has led to millions of clinical cases and hundreds of deaths every year in China. This study aimed to exploring the effects on HFMD transmission of children’s caregivers and public area, as well as trying to locate the potential reservoirs of infections in primary cases. Total children’s 257 samples (98 children’s caregivers and 159 environmental samples) were tested for the presence of universal enterovirus, enterovirus 71, coxsackie virus A6 and A16 by real-time fluorescence quantitative polymerase chain reaction (qPCR). 5.84% (15/257, 95% confidence interval [CI]: 2.98%, 8.70%) of total samples had positive results of enterovirus. The enterovirus positive rates of children’s caregiver samples and environmental samples were respectively 7.14% (7/98, 95% CI: 2.04%, 12.24%), and 5.03% (8/159, 95% CI: 1.63%, 8.43%); 7.61% (7/92, 95% CI: 2.21%, 13.01%) of wiping samples from playgrounds and 1.49% (1/67, 95% CI: 0, 7.00%) of air samples in indoor market places had positive result of enterovirus. High positive rates of enterovirus in children’s caregivers and from playgrounds indicated that they would be potential reservoirs of HFMD infection, as children might be infected via contacting with asymptomatic-infected individuals or exposure of contaminated surface of public facilities.

  1. Prognostic factors for acute and late skin reactions in radiotherapy patients

    International Nuclear Information System (INIS)

    Turesson, Ingela; Nyman, Jan; Holmberg, Erik; Oden, Anders

    1996-01-01

    Purpose: Patients treated with identical radiotherapy schedules show a substantial variation in the degree of acute and late normal tissue reactions. To identify any possible contributing factors to this phenomenon, we have analyzed the treatments of 402 breast cancer patients. Methods and Materials: The patients received adjuvant postoperative radiotherapy between 1972 and 1985 and have been followed up since then. Multivariate analyses were performed with peak reflectance erythema and peak acute reaction score as endpoints for the acute reactions, and with progression rate of telangiectasia as well as telangiectasia score as endpoints for the late reactions. Twenty patient- and treatment-related factors were tested such as age, menopausal status, hemoglobin level, serum calcium, smoking habits, hypothyroidism, diabetes, hypertension, blood pressure, cardiovascular and autoimmune disease, the influence of hormone therapy and chemotherapy, pretreatment reflectance value, acute skin reactions, radiation quality, individual dose, bilateral fields, and the total effect (TE) for the dose schedule applied. Results: The TE was a strong prognostic factor for all endpoints. In addition to TE, blood pressure was prognostic for the peak erythema measured by reflectance spectrophotometry, and the pretreatment reflectance value was prognostic for the acute score. The only independent prognostic factors found for the progression of skin telangiectasia and telangiectasia score except for TE were the individual dose and the acute skin reactions. Conclusions: These factors explained at most about 30% of the variance describing the total patient-to-patient variability for each endpoint. The remaining variability is still unexplained but may be related to individual differences in cellular radiosensitivity, partly determined by genetic variations and partly by unknown epigenetic factors

  2. MRI findings of spine: acute flaccid paralysis associated with enterovirus 71 infected hand-foot-mouth disease

    International Nuclear Information System (INIS)

    Cheng Hua; Peng Yun; Duan Xiaomin; Wang Xu; Zeng Jinjin; Sun Guoqiang

    2008-01-01

    Objective: To investigate the characteristics of spinal MR images in acute flaccid paralysis (AFP) associated with enterovirus 71 infected hand-foot-mouth disease. Methods: The spinal MR images of eight infants with AFP and positive EV71 cultures were analyzed during an outbreak of hand-foot-mouth disease in China in 2008. Results: Acute paralysis was observed in one lower limb in 4 of the 8 patients, in four limbs in 2 patients, in one upper limb and both lower limbs in 1 patient, 2 of the 8 patients also had brain stem encephalitis. Lesions were identified in anterior horn regions of spinal cord with hyperintensity on T 2 -weighted images and hypointensity on T 1 -weighted images. Location of the lesions included C3 to C7 (1 case), T10 extending to conus medullaris (5 cases) and a combination of the above (2 cases). Five of the 8 patients presented with unilateral paralysis. Two of the 5 cases showed unilateral hyperintense lesions in anterior horn regions and the remaining 3 cases showed bilateral hyperintense lesions in anterior horn regions with a unilateral predominance. One of the 3 patients with bilateral lesions showed slight enhancement of anterior horn with prominent enhancement of ventral roots after intravenous injections of contrast medium. Three of the 8 patients with bilateral paralysis showed bilateral hyperintensity in both anterior horn regions. Conclusion: MR is the imaging modality of choice for the detection of radiculomyelitis of AFP associated with EV71 infection. (authors)

  3. Early and late radiation response of human skin following chronic exposure of the hands

    International Nuclear Information System (INIS)

    Lenz, U.; Arndt, D.; Thormann, T.

    1979-01-01

    Clinical examinations on 45 radiation workers with chronical low-level exposures to their hands revealed that accumulated doses in the range of 15 to 30 Sv (1500 to 3000 rem) may already produce macroscopically unconspicuous early alterations of the vessel system within the corium as well as epidermal hyperplasia. Therefore, the annual permissible dose equivalent of 0.75 Sv (75 rem) recommended by ICRP for the skin of the extremities appears unjustifiably high and should be reduced to 0.30 Sv (30 rem), the limit valid for the remaining areas of skin. (author)

  4. Neutron skin effect of some Mo isotopes in pre-equilibrium reactions

    Indian Academy of Sciences (India)

    It can help to investigate nuclear surface properties (and also neutron skin thickness effects) depending on the incident nucleon en- ergy PEQ reactions and it gives more information about new nuclear reaction mechanism studies [11,12]. We study molybdenum in the present work because Mo and Mo containing alloys are.

  5. Rotational foot placement specifies the lever arm of the ground reaction force during the push-off phase of walking initiation.

    Science.gov (United States)

    Erdemir, Ahmet; Piazza, Stephen J

    2002-06-01

    The lever arm of the ground reaction force (GRF) about the talocrural joint axis is a functionally important indicator of the nature of foot loading. Walking initiation experiments (ten subjects; age, 23-29 years) were completed to demonstrate that rotational foot placement is a possible strategy to specify the lever arm. Externally-rotated foot placement resulted in larger lever arms during push-off. A computer simulation of push-off revealed that a decreased lever arm reduces the plantarflexion moment necessary to maintain a constant forward velocity, while increasing the required plantarflexion velocity. Shortening of the foot thus diminishes the muscular force demand but also requires high muscle fiber shortening velocities that may limit the force generating capacity of plantar flexors. Decreased plantar flexion moment and slow walking previously noted in partial-foot amputees may result from shortened lever arms in this manner.

  6. Early detection of foot ulcers through asymmetry analysis

    Science.gov (United States)

    Kaabouch, Naima; Chen, Yi; Hu, Wen-Chen; Anderson, Julie; Ames, Forrest; Paulson, Rolf

    2009-02-01

    Foot ulcers affect millions of Americans annually. Areas that are likely to ulcerate have been associated with increased local skin temperatures due to inflammation and enzymatic autolysis of tissue. Conventional methods to assess skin, including inspection and palpation, may be valuable approaches, but usually they do not detect changes in skin integrity until an ulcer has already developed. Conversely, infrared imaging is a technology able to assess the integrity of the skin and its many layers, thus having the potential to index the cascade of physiological events in the prevention, assessment, and management of foot ulcers. In this paper, we propose a technique, asymmetry analysis, to automatically analyze the infrared images in order to detect inflammation. Preliminary results show that the proposed technique can be reliable and efficient to detect inflammation and, hence, predict potential ulceration.

  7. Effects of insulin on the skin: possible healing benefits for diabetic foot ulcers.

    Science.gov (United States)

    Emanuelli, T; Burgeiro, A; Carvalho, E

    2016-12-01

    Diabetic foot ulcers affect 15-20 % of all diabetic patients and remain an important challenge since the available therapies have limited efficacy and some of the novel therapeutic approaches, which include growth factors and stem cells, are highly expensive and their safety remains to be evaluated. Despite its low cost and safety, the interest for topical insulin as a healing agent has increased only in the last 20 years. The molecular mechanisms of insulin signaling and its metabolic effects have been well studied in its classical target tissues. However, little is known about the specific effects of insulin in healthy or even diabetic skin. In addition, the mechanisms involved in the effects of insulin on wound healing have been virtually unknown until about 10 years ago. This paper will review the most recent advances in the cellular and molecular mechanisms that underlie the beneficial effects of insulin on skin wound healing in diabetes. Emerging evidence that links dysfunction of key cellular organelles, namely the endoplasmic reticulum and the mitochondria, to changes in the autophagy response, as well as the impaired wound healing in diabetic patients will also be discussed along with the putative mechanisms whereby insulin could regulate/modulate these alterations.

  8. Does aqueous or sucralfate cream affect the severity of erythematous radiation skin reactions? A randomised controlled trial.

    Science.gov (United States)

    Wells, Mary; Macmillan, Maureen; Raab, Gillian; MacBride, Sheila; Bell, Nancy; MacKinnon, Karen; MacDougall, Hugh; Samuel, Leslie; Munro, Alastair

    2004-11-01

    Evidence on which to base decisions about the management of radiation skin reactions is lacking. The purpose of this study was to investigate whether sucralfate or aqueous cream reduced acute skin toxicity during radiotherapy to the head and neck, breast or anorectal area (phase A), and to evaluate the effect of hydrogels and dry dressings on moist desquamation (phase B). This paper presents the results of phase A. Three hundred and fifty seven patients were randomised to apply aqueous cream, sucralfate cream or no cream to the irradiated area from day one of radical radiotherapy treatment. All patients were instructed to wash using unperfumed soap. Acute skin toxicity was measured using a modified radiation therapy oncology group (RTOG) score, reflectance spectrophotometry, patient diary card and dermatology life quality index (DLQI). A cost minimisation approach was used to compare the costs of each skin care approach. No consistent differences were found in the severity of skin reactions or levels of discomfort suffered by patients in each of the randomised groups. Patients with a higher body mass index, who smoked, received concomitant chemotherapy, boost or bolus during treatment were more likely to develop skin reactions. There is no evidence to support the prophylactic application of either of the creams tested for the prevention of radiation skin reactions. Our results show that it is possible to predict which patients are at greatest risk of skin reactions. We suggest that known risk factors should be incorporated into future study protocols.

  9. Skin Cancers of the Feet

    Science.gov (United States)

    ... Foot Health Awareness Month Diabetes Awareness What Are Skin Cancers of the Feet? Skin cancer can develop anywhere on the body, including ... cell carcinoma is the most common form of cancer on the skin of the feet. Most types of early squamous ...

  10. Occupational hand eczema caused by nickel and evaluated by quantitative exposure assessment.

    Science.gov (United States)

    Jensen, Peter; Thyssen, Jacob P; Johansen, Jeanne D; Skare, Lizbet; Menné, Torkil; Lidén, Carola

    2011-01-01

    EU legislation has reduced the epidemic of nickel contact allergy affecting the consumer, and shifted the focus towards occupational exposure. The acid wipe sampling technique was developed to quantitatively determine skin exposure to metals. To assess the clinical usefulness of the acid wipe sampling technique as part of the diagnostic investigation for occupational nickel allergy-associated hand dermatitis. Six patients with vesicular dermatitis on the hands were included. Acid wipe sampling of skin and patch testing with a nickel sulfate dilution series were performed. Nickel was detected in all samples from the hands. In all patients, the nickel content on the hands was higher than on the non-exposed control area. Occupational exposure to nickel-releasing items raised the nickel content on exposed skin as compared with a non-exposed control site. Nickel-reducing measures led to complete symptom relief in all cases. In cases of a positive nickel patch test reaction and hand eczema, patients should perform the dimethylglyoxime (DMG) test on metallic items at home and at work. The acid wipe sampling technique is useful for the diagnosis of occupational hand eczema following screening with the inexpensive DMG test. © 2010 John Wiley & Sons A/S.

  11. Hand-to-Hand Model for Bioelectrical Impedance Analysis to Estimate Fat Free Mass in a Healthy Population

    Directory of Open Access Journals (Sweden)

    Hsueh-Kuan Lu

    2016-10-01

    Full Text Available This study aimed to establish a hand-to-hand (HH model for bioelectrical impedance analysis (BIA fat free mass (FFM estimation by comparing with a standing position hand-to-foot (HF BIA model and dual energy X-ray absorptiometry (DXA; we also verified the reliability of the newly developed model. A total of 704 healthy Chinese individuals (403 men and 301 women participated. FFM (FFMDXA reference variables were measured using DXA and segmental BIA. Further, regression analysis, Bland–Altman plots, and cross-validation (2/3 participants as the modeling group, 1/3 as the validation group; three turns were repeated for validation grouping were conducted to compare tests of agreement with FFMDXA reference variables. In male participants, the hand-to-hand BIA model estimation equation was calculated as follows: FFMmHH = 0.537 h2/ZHH − 0.126 year + 0.217 weight + 18.235 (r2 = 0.919, standard estimate of error (SEE = 2.164 kg, n = 269. The mean validated correlation coefficients and limits of agreement (LOAs of the Bland–Altman analysis of the calculated values for FFMmHH and FFMDXA were 0.958 and −4.369–4.343 kg, respectively, for hand-to-foot BIA model measurements for men; the FFM (FFMmHF and FFMDXA were 0.958 and −4.356–4.375 kg, respectively. The hand-to-hand BIA model estimating equation for female participants was FFMFHH = 0.615 h2/ZHH − 0.144 year + 0.132 weight + 16.507 (r2 = 0.870, SEE = 1.884 kg, n = 201; the three mean validated correlation coefficient and LOA for the hand-to-foot BIA model measurements for female participants (FFMFHH and FFMDXA were 0.929 and −3.880–3.886 kg, respectively. The FFMHF and FFMDXA were 0.942 and −3.511–3.489 kg, respectively. The results of both hand-to-hand and hand-to-foot BIA models demonstrated similar reliability, and the hand-to-hand BIA models are practical for assessing FFM.

  12. Hand-to-Hand Model for Bioelectrical Impedance Analysis to Estimate Fat Free Mass in a Healthy Population.

    Science.gov (United States)

    Lu, Hsueh-Kuan; Chiang, Li-Ming; Chen, Yu-Yawn; Chuang, Chih-Lin; Chen, Kuen-Tsann; Dwyer, Gregory B; Hsu, Ying-Lin; Chen, Chun-Hao; Hsieh, Kuen-Chang

    2016-10-21

    This study aimed to establish a hand-to-hand (HH) model for bioelectrical impedance analysis (BIA) fat free mass (FFM) estimation by comparing with a standing position hand-to-foot (HF) BIA model and dual energy X-ray absorptiometry (DXA); we also verified the reliability of the newly developed model. A total of 704 healthy Chinese individuals (403 men and 301 women) participated. FFM (FFM DXA ) reference variables were measured using DXA and segmental BIA. Further, regression analysis, Bland-Altman plots, and cross-validation (2/3 participants as the modeling group, 1/3 as the validation group; three turns were repeated for validation grouping) were conducted to compare tests of agreement with FFM DXA reference variables. In male participants, the hand-to-hand BIA model estimation equation was calculated as follows: FFM m HH = 0.537 h²/Z HH - 0.126 year + 0.217 weight + 18.235 ( r ² = 0.919, standard estimate of error (SEE) = 2.164 kg, n = 269). The mean validated correlation coefficients and limits of agreement (LOAs) of the Bland-Altman analysis of the calculated values for FFM m HH and FFM DXA were 0.958 and -4.369-4.343 kg, respectively, for hand-to-foot BIA model measurements for men; the FFM (FFM m HF ) and FFM DXA were 0.958 and -4.356-4.375 kg, respectively. The hand-to-hand BIA model estimating equation for female participants was FFM F HH = 0.615 h²/Z HH - 0.144 year + 0.132 weight + 16.507 ( r ² = 0.870, SEE = 1.884 kg, n = 201); the three mean validated correlation coefficient and LOA for the hand-to-foot BIA model measurements for female participants (FFM F HH and FFM DXA ) were 0.929 and -3.880-3.886 kg, respectively. The FFM HF and FFM DXA were 0.942 and -3.511-3.489 kg, respectively. The results of both hand-to-hand and hand-to-foot BIA models demonstrated similar reliability, and the hand-to-hand BIA models are practical for assessing FFM.

  13. Aescin-based topical formulation to prevent foot wounds and ulcerations in diabetic microangiopathy.

    Science.gov (United States)

    Hu, S; Belcaro, G; Dugall, M; Hosoi, M; Togni, S; Maramaldi, G; Giacomelli, L

    2016-10-01

    Impairment of the peripheral microcirculation in diabetic patients often leads to severe complications in the lower extremities, such as foot infections and ulcerations. In this study, a novel aescin-based formulation has been evaluated as a potential approach to prevent skin breaks and ulcerations by improving the peripheral microcirculation and skin hydration. In this registry study, 63 patients with moderate diabetic microangiopathy were recruited. Informed participants freely decided to follow either a standard management (SM) to prevent diabetic foot diseases (n = 31) or SM associated with topical application of the aescin-based cream (n = 32). Peripheral microcirculatory parameters such as resting skin flux, venoarteriolar response and transcutaneous gas tension were evaluated at inclusion and after 8 weeks. In addition, several skin parameters of the foot area, such as integrity (as number of skin breaks/patients), hydration and content of dead cells were assessed at the defined observational study periods. Improvements in cutaneous peripheral microcirculation parameters were observed at 8 weeks in both groups; however, a remarkable and significant beneficial effect resulted to be exerted by the aescin-based cream treatment. In fact, the microcirculatory parameters evaluated significantly improved in the standard management + aescin-based cream group, compared with baseline and with the standard management group. Similar findings were reported for skin parameters of the foot area. The topical formulation containing aescin could represent a valid approach to manage skin wounds and prevent skin ulcerations in patients affected by moderate diabetic microangiopathy.

  14. The incidence and features of systemic reactions to skin prick tests.

    Science.gov (United States)

    Sellaturay, Priya; Nasser, Shuaib; Ewan, Pamela

    2015-09-01

    Skin prick testing (SPT) has been regarded as a safe procedure with few systemic reactions. To evaluate the rate of systemic reactions and their associations after SPT in the largest population to date. In this study reactions were recorded prospectively in a specialist UK allergy clinic for 6 years (2007-2013). An estimated 31,000 patients underwent SPT. Twenty-four patients (age range 7 months to 56 years, mean 23.5 years, 17 female patients, 12 with asthma) had systemic reactions. The rate of systemic reactions to SPT was 0.077%. The likely allergens causing the reaction were foods (18; peanut, 7; walnut, 1; Brazil nut, 2; pistachio, 1; lupin, 1; cow's milk, 2; shrimp, 1; spinach, 1; legume, 1; soy, 1), aeroallergens (4; rabbit, 1; rat, 1; ragwort, 1; grass pollen, 1), wasp venom (1), and Tazocin (1). The causative SPT wheal was larger than 8 mm in 75%. The reaction to Tazocin was severe, with anaphylaxis occurring minutes after SPT. Reactions were treated immediately in the clinic and did not require further medical care. In this largest single-center study, the rate of systemic reactions after SPT was 77 per 100,000 patients. It is the first study to identify foods as a common and important cause (75%), with nuts posing the highest risk. This study reports the first systemic reaction to venom SPT and the first anaphylactic reaction after drug SPT. There was an association with a history of severe reactions and large skin test reaction. There are risks, albeit small, when undertaking SPT. Copyright © 2015 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  15. Less skin irritation from alcohol-based disinfectant than from detergent used for hand disinfection

    DEFF Research Database (Denmark)

    Pedersen, L K; Held, E; Johansen, J D

    2005-01-01

    and forearms of 17 healthy volunteers. A control area was included. After 4 weeks an SLS patch was applied to each area. Irritant reactions were quantified with a visual score recording and measurements of transepidermal water loss (TEWL) and skin colour were performed on days 1, 5, 11, 38 and 40. RESULTS...... was found on the disinfectant-treated area compared with the control area and detergent area, and a similar trend was found for TEWL, although it was not statistically significant. CONCLUSION: Alcohol-based disinfectant caused less visible skin irritation and less skin barrier disruption than the use...

  16. Acute skin reaction after fractionated irradiation

    International Nuclear Information System (INIS)

    Kozubek, S.

    1983-01-01

    Experimental data on acute mouse and pig skin reaction after fractionated γ or X irradiation have been analysed in terms of a new cell tissue kinetic model. The exponential-quadratic and generalized Huggett formulae have been used for cell lethality description. Fairly better results could be demonstrated with generalized Huggett formula. The speed of repopulation has been determined for fractionated regimes as well as for some irregular schedules. The repopulation is slower in the case of fractionated treatment. On considering the normal cell loss factor in the tissue, minimum cell cycle time has been calculated. Its value differs for various strains (Tsub(d)=28.8 hours for SAS/TO mice and Tsub(d) < or approximately 17 hours for WHT/Ht mice) and does not differ for plucked skin. The repopulation has been shown to follow exponential dependence after some latent period. Other factors influencing the effectiveness of radiation treatment (the length of the latent period or the changes of the survival curve during fractionated irradiation) have been considered, too

  17. Hand and foot pressures in the aye-aye (Daubentonia madagascariensis) reveal novel biomechanical trade-offs required for walking on gracile digits.

    Science.gov (United States)

    Kivell, Tracy L; Schmitt, Daniel; Wunderlich, Roshna E

    2010-05-01

    Arboreal animals with prehensile hands must balance the complex demands of bone strength, grasping and manipulation. An informative example of this problem is that of the aye-aye (Daubentonia madagascariensis), a rare lemuriform primate that is unusual in having exceptionally long, gracile fingers specialized for foraging. In addition, they are among the largest primates to engage in head-first descent on arboreal supports, a posture that should increase loads on their gracile digits. We test the hypothesis that aye-ayes will reduce pressure on their digits during locomotion by curling their fingers off the substrate. This hypothesis was tested using simultaneous videographic and pressure analysis of the hand, foot and digits for five adult aye-ayes during horizontal locomotion and during ascent and descent on a 30 degrees instrumented runway. Aye-ayes consistently curled their fingers during locomotion on all slopes. When the digits were in contact with the substrate, pressures were negligible and significantly less than those experienced by the palm or pedal digits. In addition, aye-ayes lifted their hands vertically off the substrate instead of 'toeing-off' and descended head-first at significantly slower speeds than on other slopes. Pressure on the hand increased during head-first descent relative to horizontal locomotion but not as much as the pressure increased on the foot during ascent. This distribution of pressure suggests that aye-ayes shift their weight posteriorly during head-first descent to reduce loads on their gracile fingers. This research demonstrates several novel biomechanical trade-offs to deal with complex functional demands on the mammalian skeleton.

  18. Skin reactions after photodynamic therapy are unaffected by 839 nm photobiomodulation therapy

    DEFF Research Database (Denmark)

    Bay, Christiane; Vissing, Anne-Cathrine; Thaysen-Petersen, Daniel

    2017-01-01

    BACKGROUND AND OBJECTIVE: Photodynamic therapy (PDT) is associated with erythema and edema. Photobiomodulation (PBM) therapy may stimulate the skin recovery process. We investigated the potential of PBM to reduce PDT-induced skin reactions. STUDY DESIGN AND METHODS: Healthy volunteers (n = 20) were...

  19. Hands in Systemic Disease

    Science.gov (United States)

    ... All Topics A-Z Videos Infographics Symptom Picker Anatomy Bones Joints Muscles Nerves Vessels Tendons About Hand Surgery What is ... Hand Therapist? Media Find a Hand Surgeon Home Anatomy ... hands, being composed of many types of tissue, including blood vessels, nerves, skin and skin-related tissues, bones, and muscles/tendons/ligaments, may show changes that reflect a ...

  20. Does aqueous or sucralfate cream affect the severity of erythematous radiation skin reactions? A randomised controlled trial

    International Nuclear Information System (INIS)

    Wells, Mary; Macmillan, Maureen; Raab, Gillian; MacBride, Sheila; Bell, Nancy; MacKinnon, Karen; MacDougall, Hugh; Samuel, Leslie; Munro, Alastair

    2004-01-01

    Background and purpose: Evidence on which to base decisions about the management of radiation skin reactions is lacking. The purpose of this study was to investigate whether sucralfate or aqueous cream reduced acute skin toxicity during radiotherapy to the head and neck, breast or anorectal area (phase A), and to evaluate the effect of hydrogels and dry dressings on moist desquamation (phase B). This paper presents the results of phase A. Patients and methods: Three hundred and fifty seven patients were randomised to apply aqueous cream, sucralfate cream or no cream to the irradiated area from day one of radical radiotherapy treatment. All patients were instructed to wash using unperfumed soap. Acute skin toxicity was measured using a modified radiation therapy oncology group (RTOG) score, reflectance spectrophotometry, patient diary card and dermatology life quality index (DLQI). A cost minimisation approach was used to compare the costs of each skin care approach. Results: No consistent differences were found in the severity of skin reactions or levels of discomfort suffered by patients in each of the randomised groups. Patients with a higher body mass index, who smoked, received concomitant chemotherapy, boost or bolus during treatment were more likely to develop skin reactions. Conclusions: There is no evidence to support the prophylactic application of either of the creams tested for the prevention of radiation skin reactions. Our results show that it is possible to predict which patients are at greatest risk of skin reactions. We suggest that known risk factors should be incorporated into future study protocols

  1. Ground reaction force characteristics of Tai Chi push hand.

    Science.gov (United States)

    Chang, Yao-Ting; Chang, Jia-Hao; Huang, Chen-Fu

    2014-01-01

    Push Hand is an advanced training technique for the Yang-style old frame 108 forms Tai Chi Chuan. It is performed by two practitioners. To clarify how people use forces during Push Hand training, it is important to review the ground reaction force (GRF). Here, we quantify the characteristics of the GRF during Push Hand training. Kinematic data and GRF data from 10 Tai Chi Chuan practitioners (29.9 ± 7.87 years) were synchronously recorded using a three-dimensional motion analysis system (200 frames · s(-1)) and three-dimensional force plates (1000 Hz). The resultant GRF for both feet for the 0%, 50% and 100% phases of attack and defence were compared to body weight using a paired-samples t-test. The differences in the resultant GRF between the 0%, 50% and 100% phases of attack and defence were tested by one-way repeated-measures ANOVA. The significance level was set to 0.05. The total resultant GRF was almost equal to the participant's body weight in push hand. This result was consistent throughout the entire push hand process. Our results revealed that the GRF was comparable to the body weight, implying that practitioners do not push or resist their opponents during the push hand process.

  2. Degloving injuries of the hand

    Directory of Open Access Journals (Sweden)

    R Krishnamoorthy

    2011-01-01

    Full Text Available Avulsion of skin from the hand or fingers is an injury that has a dramatic presentation. The entire musculo-skeletal unit of the finger is intact, and the patient can often move the parts of his naked hand quite normally. The challenge for the reconstructive surgeon lies in resurfacing the hand or finger with a good quality pliable sensate skin cover while preserving the movements and function of the hand. Traditionally, skin grafting has been the standard method of reconstruction in such injuries. However, skin grafting does have many disadvantages, too. This article deals with the features of such injuries, management protocols and other reconstructive options available in the armamentarium of the hand surgeon.

  3. [Stress reactions in bones of the foot in sport: diagnosis, assessment and therapy].

    Science.gov (United States)

    Miltner, O

    2013-06-01

    Stress reactions and stress fractures are defined as structural damage to bone caused by repetitive stress or stereotypical loading. The balance between loading and unloading of bone is disrupted in stress reactions and stress fractures through the sport-specific demands and by the exogenous or endogenous risk factors present. In sports orthopedics the localization of stress reactions and stress fractures are subdivided into high risk fractures and low risk fractures. Conventional diagnostic radiology can initially be inconclusive. With symptoms persisting over 2 weeks further diagnostics using magnetic resonance imaging (MRI) should be performed. In the area of the foot stress reactions and stress fractures can often occur bilaterally or multifocally and most commonly affect the second metatarsals followed by the third metatarsals. Fractures of the fifth metatarsal, second metatarsal base, medial malleolus as well as navicular and sesamoid fractures are high risk fractures requiring special clinical and radiological monitoring. Basically, conservative treatment using the 2-phase model is the treatment of choice. In delayed union or severe pain surgical treatment is indicated.

  4. Association between cumulative radiation dose, adverse skin reactions, and changes in surface hemoglobin among women undergoing breast conserving therapy

    Directory of Open Access Journals (Sweden)

    Michael S. Chin

    2017-06-01

    Conclusion: HSI demonstrates promise in the assessment of skin dose as well as an objective measure of skin reaction. The ability to easily identify adverse skin reactions and to modify the treatment plan may circumvent the need for detrimental treatment breaks.

  5. Left hand polydactyly: a case report.

    Science.gov (United States)

    Mumoli, Nicola; Gandini, Daniele; Wamala, Edris Kalanzi; Cei, Marco

    2008-11-24

    Polydactyly is a congenital anomaly with a wide range of manifestations that occurs in many forms, ranging from varying degrees of mere splitting to completely duplicated thumb. When duplication occurs alone, it is usually unilateral and sporadic. In this case report we describe an otherwise healthy 19-year-old woman of Tibetan heritage with isolated left hand preaxial polydactyly. She experienced working related difficulties in her daily yak's milking. She subsequently underwent surgical correction, and the over number thumb was removed with associated meticulous skeletal and soft tissue reconstruction. Polydactyly is the most common congenital digital anomaly of the hand and foot. It can occur in isolation or as part of a syndrome. Surgery is necessary to create a single, functioning thumb and is indicated to improve cosmesis. Skin, nail, bone, ligament, and musculoskeletal elements must be combined to reconstruct an optimal digit. In this case (Tibetan society is almost exclusively a sheep-breeding one) surgery was necessary to leave a single, functioning thumb for her work as yak milkmaid.

  6. A dielectric method for measuring early and late reactions in irradiated human skin

    International Nuclear Information System (INIS)

    Nuutinen, J.; Lahtinen, T.; Turunen, M.; Alanen, E.; Tenhunen, M.; Usenius, T.; Kolle, R.

    1998-01-01

    Background and purpose: To measure the dielectric constant of irradiated human skin in order to test the feasibility of the dielectric measurements in the quantitation of acute and late radiation reactions. Materials and methods: The dielectric constant of irradiated breast skin was measured at an electromagnetic frequency of 300 MHz in 21 patients during postmastectomy radiotherapy. The measurements were performed with an open-ended coaxial line reflection method. The irradiation technique consisted of an anterior photon field to the lymph nodes and a matched electron field to the chest wall using conventional fractionation of five fractions/week to 50 Gy. Fourteen out of the 21 patients were remeasured 2 years later and the skin was palpated for subcutaneous fibrosis. Results: At 5 weeks the dielectric constant had decreased by 31 and 39% for the investigated skin sites of the photon and electron fields, respectively. There was a statistically significant inverse correlation between the mean dielectric constant and the clinical score of erythema. An unexpected finding was a decrease of the dielectric constant of the contralateral healthy skin during radiotherapy. Two years later a statistically significant positive correlation was found between the dielectric constant at the irradiated skin sites and the clinical score of subcutaneous fibrosis. Conclusions: Dielectric measurements non-invasively yield quantitative information concerning radiation-induced skin reactions. (Copyright (c) 1998 Elsevier Science B.V., Amsterdam. All rights reserved.)

  7. A Study of Hand Back Skin Texture Patterns for Personal Identification and Gender Classification

    Directory of Open Access Journals (Sweden)

    Jin Xie

    2012-06-01

    Full Text Available Human hand back skin texture (HBST is often consistent for a person and distinctive from person to person. In this paper, we study the HBST pattern recognition problem with applications to personal identification and gender classification. A specially designed system is developed to capture HBST images, and an HBST image database was established, which consists of 1,920 images from 80 persons (160 hands. An efficient texton learning based method is then presented to classify the HBST patterns. First, textons are learned in the space of filter bank responses from a set of training images using the -minimization based sparse representation (SR technique. Then, under the SR framework, we represent the feature vector at each pixel over the learned dictionary to construct a representation coefficient histogram. Finally, the coefficient histogram is used as skin texture feature for classification. Experiments on personal identification and gender classification are performed by using the established HBST database. The results show that HBST can be used to assist human identification and gender classification.

  8. Skin irritability to sodium lauryl sulfate is associated with increased positive patch test reactions.

    Science.gov (United States)

    Schwitulla, J; Brasch, J; Löffler, H; Schnuch, A; Geier, J; Uter, W

    2014-07-01

    As previous observations have indicated an inter-relationship between irritant and allergic skin reactions we analysed data of synchronous allergen and sodium lauryl sulfate (SLS) patch tests in terms of a relationship between SLS responsiveness and allergic patch test reactions. To analyse differences in terms of allergen-specific and overall reaction profiles between patients with vs. those without an irritant reaction to SLS. Clinical data of 26 879 patients patch tested from 2008 to 2011 by members of the Information Network of Departments of Dermatology were analysed. After descriptive analyses, including the MOAHLFA index, the positivity ratio and the reaction index, a negative binomial hurdle model was adopted to investigate the correlation between SLS reactivity and positive patch test reactions. Men, patients aged ≥ 40 years and patients with an occupational dermatitis background were over-represented in the SLS-reactive group. Patients with an irritant reaction to SLS showed a higher proportion of weak positive reactions, as well as more questionable and irritant reactions to contact allergens than patients not reactive to SLS. The risk of an additional positive patch test reaction increased by 22% for SLS-reactive patients compared with those who were SLS negative. The marked association between SLS reactivity and the number of positive reactions in patch test patients may be due to nonspecific increased skin reactivity at the moment of patch testing only. However, increased SLS reactivity could also be due to longer-lasting enhanced skin irritability, which may have promoted (poly-)sensitization. Further studies, for example with longitudinal data on patients repeatedly patch tested with SLS and contact allergens, are necessary. © 2014 British Association of Dermatologists.

  9. Pilot Study: The Role of the Hemispheric Lateralization in Mental Disorders by Use of the Limb (Eye, Hand, Foot) Dominance.

    Science.gov (United States)

    Goodarzi, Naser; Dabbaghi, Parviz; Valipour, Habib; Vafadari, Behnam

    2015-04-01

    Based on the previous studies, we know that the hemispheric lateralization defects, increase the probability of psychological disorders. We also know that dominant limb is controlled by dominant hemisphere and limb preference is used as an indicator for hemisphere dominance. In this study we attempted to explore the hemispheric dominance by the use of three limbs (hand, foot and eye). We performed this survey on two samples, psychiatric patients compared with normal population. For this purpose, knowing that the organ dominance is stabilized in adolescence, and age has no effect on the people above 15, we used 48 high school girls and 65 boys as the final samples of normal population. The patient group included 57 male and 26 female who were chronic psychiatric patients. The result shows that left-eye dominance is more in patients than the normal group (P=0.000) but the handedness and footedness differences are not significance. In psychotic, bipolar and depressive disorders, eye dominance had significant difference (P=0.018). But this is not true about hand and foot dominance. Our findings proved that generally in psychiatric patients, left-eye dominance is more common, left-eye dominance is also more in psychotic and depressive disorders. It is less common in bipolar disorders.

  10. [The morphological features of skin wounds inflicted by joinery hand saws designed for different types of sawing].

    Science.gov (United States)

    Sarkisian, B A; Azarov, P A

    2014-01-01

    The objective of the present work was to study the morphological features of skin wounds inflicted by joinery hand saws designed for longitudinal, transverse, and mixed sawing. A total of 60 injuries to the thigh skin inflicted by the recurring and reciprocating saw movements were simulated. The hand saws had 5 mm high "sharp" and "blunt"-tipped teeth. The analysis of the morphological features of the wounds revealed differences in their length and depth, shape of edge cuts and defects, and the relief of the walls depending on the sawtooth sharpness and the mode of sawing. It is concluded that morphological features of the wounds may be used to determine the type of the saw, the sharpness of its teeth, the direction and frequency of its movements.

  11. [Clinical application of moving cupping therapy based on skin reaction observation and syndrome differentiation].

    Science.gov (United States)

    Deng, Xiao-Lan; Chen, Bo; Chen, Ze-Lin

    2014-12-01

    The diagnostic evidence on clinical diseases and theoretic basis of moving cupping therapy were ex- plored in the paper. By the observation of the local reaction, such as skin appearance and color, the affected location, duration of sickness and nature of disease were judged. Different moving cupping methods were selected for different disorders. It was discovered that the property of syndromes should be recognized by the palpation on skin and muscle in the moving cupping therapy so that the pathogenesis and treating principle could be carefully determined. The moving cupping therapy is the important component of body surface therapy. Skin reaction observation and syndrome differentiation is the essential guidance of the moving cupping therapy.

  12. Distally based sural neuro-fasciocutaneous perforator flap for foot and ankle reconstruction: Surgical modifications for flap pedicle and donor site closure without skin graft.

    Science.gov (United States)

    Chi, Zhenglin; Chen, Yiheng; Chu, Tinggang; Gao, Weiyang; Li, Zhijie; Yan, Hede; Song, Yonghuan

    2018-02-01

    The conventional procedure of the sural neuro-fasciocutaneous flap enables the supply of blood and venous drainage by increasing the width of the adipofascial tissue and preserving tiny venous return routes. Moreover, skin graft is a common method for donor site closure, which may lead to some complications and influence the aesthetic appearance. We report modifications for a distally based sural neuro-fasciocutaneous perforator flap and a relaying flap for donor site closure without skin graft. Twelve patients undergoing the modified flap for foot and ankle reconstruction were included in this study between 2014 and 2016. A peroneal-based perforator, a superficial vein, and the vascular axis of the sural nerve were included in the pedicle. A Z-shape skin incision was performed to explore the perforator vessels and a relaying island perforator flap was used to close the donor site. All flaps survived completely without necrosis. The area of the flaps ranged from 16 × 8 cm to 30 × 15 cm. The diameter width of the pedicle ranged from 1.0 to 2.0 cm. A relaying perforator island flap was used in 10 cases for donor site closure and no skin graft was performed. There were no serious donor site complications. All patients were satisfied with the aesthetic outcome postoperatively at the final follow-up. The distally based sural neuro-fasciocutaneous perforator flap is considered a reliable method for foot and ankle reconstruction. The modification for flap pedicle and donor site closure method without skin graft should be recommended. Copyright © 2017. Published by Elsevier Ltd.

  13. [A case of skin autograft for skin ulcers in ichthyosis].

    Science.gov (United States)

    Li, Shiwei; Yang, Xiaodong; Liu, Lijun; Tang, Xueyang

    2017-10-28

    Ichthyosis refers to a group of skin diseases characterized by abnormal keratinization of the epidermis, resulting in dryness, roughness and scale of the skin. A girl with ichthyosis, who presented with skin ulcers and infection of the right dorsal foot, was admitted to our department. An autologous razor-thin skin grafting procedure was performed to repair the skin ulcers after debridement and vacuum sealing drain. After 8 months of follow-up, both the donor and recipient site healed well and there were no newly formed ulcers or infections. Although the skin quality of ichthyosis is poor, the lesion area can still be used as donor or recipient cite.

  14. Synchrony of hand-foot coupled movements: is it attained by mutual feedback entrainment or by independent linkage of each limb to a common rhythm generator?

    Directory of Open Access Journals (Sweden)

    Esposti Roberto

    2006-10-01

    Full Text Available Abstract Background Synchrony of coupled oscillations of ipsilateral hand and foot may be achieved by controlling the interlimb phase difference through a crossed kinaesthetic feedback between the two limbs, or by an independent linkage of each limb cycle to a common clock signal. These alternative models may be experimentally challenged by comparing the behaviour of the two limbs when they oscillate following an external time giver, either alone or coupled together. Results Ten subjects oscillated their right hand and foot both alone and coupled (iso- or antidirectionally, paced by a metronome. Wrist and ankle angular position and Electromyograms (EMG from the respective flexor and extensor muscles were recorded. Three phase delays were measured: i the clk-mov delay, between the clock (metronome beat and the oscillation peak; ii the neur (neural delay, between the clock and the motoneurone excitatory input, as inferred from the EMG onset; and iii the mech (mechanical delay between the EMG onset and the corresponding point of the limb oscillation. During uncoupled oscillations (0.4 Hz to 3.0 Hz, the mech delay increased from -7° to -111° (hand and from -4° to -83° (foot. In contrast, the clk-mov delay remained constant and close to zero in either limb since a progressive advance of the motoneurone activation on the pacing beat (neur advance compensated for the increasing mech delay. Adding an inertial load to either extremity induced a frequency dependent increase of the limb mechanical delay that could not be completely compensated by the increase of the neural phase advance, resulting in a frequency dependent increment of clk-mov delay of the hampered limb. When limb oscillations were iso- or antidirectionally coupled, either in the loaded or unloaded condition, the three delays did not significantly change with respect to values measured when limbs were moved separately. Conclusion The absence of any significant effect of limb coupling on

  15. Driving reaction times in patients with foot and ankle pathology before and after image-guided injection: pain relief without improved function.

    Science.gov (United States)

    Talusan, Paul G; Miller, Christopher P; Save, Ameya V; Reach, John S

    2015-04-01

    Foot and ankle pathology is common in the driving population. Local anesthetic steroid injections are frequent ambulatory treatments. Brake reaction time (BRT) has validated importance in motor vehicle safety. There are no prior studies examining the effect of foot and ankle pathology and injection treatment on the safe operation of motor vehicles. We studied BRT in patients with foot and ankle musculoskeletal disease before and after image-guided injection treatment. A total of 37 participants were enrolled. Image-guided injections of local anesthetic and steroid were placed into the pathological anatomical location of the right or left foot and ankles. A driving reaction timer was used to measure BRTs before and after injection. Patients suffering right "driving" and left "nondriving" pathology as well as a healthy control group were studied. All patients reported >90% pain relief postinjection. All injections were confirmed to be accurate by imaging. Post hoc Bonferonni analysis demonstrated significant difference between the healthy group and the right-sided injection group (P = .008). Mean BRT for healthy controls was 0.57 ± 0.11 s. Patients suffering right foot and ankle disease displayed surprisingly high BRTs (0.80 ± 0.23 s preinjection and 0.78 ± 0.16 s postinjection, P > .99). Left nondriving foot and ankle pathology presented a driving hazard as well (BRT of 0.75 ± 0.12 s preinjection and 0.77 ± 0.12 s postinjection, P > .99). Injections relieved pain but did not significantly alter BRT (P > .99 for all). Patients suffering chronic foot and ankle pathology involving either the driving or nondriving side have impaired BRTs. This preexisting driving impairment has not previously been reported and exceeds recommended cutoff safety values in the United States. Despite symptom improvement, there was no statistically significant change in BRT following image-guided injection in either foot and ankle. Therapeutic, Level II: Prospective Comparative Study.

  16. Anterior wrist and medial malleolus as the novel sites of tissue selection: a retrospective study on electric shock death through the hand-to-foot circuit pathway.

    Science.gov (United States)

    Xu, Guangtao; Su, Ruibing; Lv, Junyao; Hu, Bo; Gu, Huan; Li, Xianxian; Gu, Jiang; Yu, Xiaojun

    2017-05-01

    Our previous work demonstrated that characteristic changes could occur in the anterior wrist and medial malleolus in electric deaths through the hand-to-foot electric circuit pathway in an electric shock rat model. However, whether the same phenomenon occurs in humans is unknown. The aim of the present retrospective study was to ascertain whether the anterior wrist and medial malleolus could also be selected as the promising and significant sites in electric death through the hand-to-foot circuit pathway. Nineteen human cases from the autopsy and one clinical survivor who sustained a severe electric shock through the hand-to-foot circuit pathway were analyzed. Additional ten autopsy patients who died from traffic accidents and sudden cardiac attacks were used as the control group. Histopathological changes in the soft tissues of the anterior wrist and medial malleolus in all autopsy patients, as well as the electric current pathway of the survivor, were observed. The results showed that the nuclear polarizations in the anterior wrist and medial malleolus soft tissues of the electric death were extremely noticeable as compared with the controls. The most severe electrical injury in the survivor occurred in the anterior wrist. These findings suggest that the soft tissues of the anterior wrist and/or the medial malleolus as the narrowest parts of the limbs could be used as the complementary sites for tissue selection and considered as necessary locations for examinations to assess the electric death in medicolegal identification.

  17. Use of mouse thigh as a radiobiological model of radiation-induced skin reactions

    International Nuclear Information System (INIS)

    Smith, A.J.; Hagkyriakou, H.; Martin, R.F.

    2000-01-01

    Full text: The effects of radiation exposure on skin have been widely studied. One of the most useful and relatively easy methods for evaluating radiation-induced skin reactions is the mouse thigh model. This model is non-invasive and has the advantage of not requiring the use of anaesthetic. In the current adaptation of the mouse thigh model, female C3H/HeJ ARC mice (from the Animal Resource Centre, W.A.) were used. The mice were restrained in specially designed jigs where the right leg was held in place by a metal hook. Lead shielding ensured that only the right ventral thigh was exposed to the radiation beam. A 6MeV electron beam from a Varian 2100 Linac (20Gy / minute) was used, thus minimising the time for which the mice were restrained. Eight to twelve days after exposure to the radiation, the first skin reactions can be seen. These are scored according to a scale ranging from 0 (no visible reaction) to 3.5 (breakdown of the entire area with severe exudation). The skin reactions (erythema and moist desquamation) peak approximately 18-22 days after radiation exposure and may remain at peak for only 1-3 days. Therefore, the reactions need to be scored daily and this continues, generally until day 35, or until all moist desquamation has healed. The maximum score in a score versus time profile for each mouse in a group of 5-6 animals are averaged. Radiation-dose response data will be presented. Using the mouse thigh model, hair loss can also be measured (usually on about day 30-35) using a scale from 0-4, where 0 depicts no evident hair loss and 4 represents complete epilation. Leg contraction can also be measured as a late effect by comparison with the length of the unirradiated leg

  18. Moist skin care can diminish acute radiation-induced skin toxicity

    International Nuclear Information System (INIS)

    Momm, F.; Weissenberger, C.; Bertelt, S.; Henke, M.

    2003-01-01

    Background: Radiation treatment may induce acute skin reactions. There are several methods of managing them. Validity of these methods, however, is not sufficiently studied. We therefore investigated, whether moist skin care with 3% urea lotion will reduce acute radiation skin toxicity. Patients and Methods: 88 patients with carcinomas of the head and neck undergoing radiotherapy with curative intent (mean total dose 60 Gy, range: 50-74 Gy) were evaluated weekly for acute skin reactions according to the RTOG-CTC score. In 63 patients, moist skin care with 3% urea lotion was performed. The control group consisted of 25 patients receiving conventional dry skin care. The incidence of grade I, II, and III reactions and the radiation dose at occurrence of a particular reaction were determined and statistically analyzed using the log-rank test. The dose-time relations of individual skin reactions are described. Results: At some point of time during radiotherapy, all patients suffered from acute skin reactions grade I, > 90% from grade II reactions. 50% of patients receiving moist skin care experienced grade I reactions at 26 Gy as compared to 22 Gy in control patients (p = 0.03). Grade II reactions occurred at 51 Gy versus 34 Gy (p = 0.006). Further, 22% of the patients treated with moist skin care suffered from acute skin toxicity grade III as compared to 56% of the controls (p = 0.0007). Conclusion: Moist skin care with 3% urea lotion delays the occurrence and reduces the grade of acute skin reactions in percutaneously irradiated patients with head and neck tumors. (orig.)

  19. Enterovirus co-infections and onychomadesis after hand, foot, and mouth disease, Spain, 2008.

    Science.gov (United States)

    Bracho, Maria A; González-Candelas, Fernando; Valero, Ana; Córdoba, Juan; Salazar, Antonio

    2011-12-01

    Hand, foot, and mouth disease (HFMD), a common disease caused by enteroviruses (EVs), usually affects children. Clustered and sporadic HFMD cases, followed by onychomadesis (nail shedding), occurred during summer and fall 2008 in Valencia, Spain. Fecal samples from onychomadesis patients, who did or did not have previous HFMD, and from healthy children exposed to onychomadesis patients tested positive for EV. The complete viral protein 1 capsid gene sequence was obtained for typing and phylogenetic analysis. Two EV serotypes, coxsackievirus A10 and coxsackievirus B1 (CVB1), were mainly detected as a monoinfection or co-infection in a childcare center where an onychomadesis outbreak occurred. On the basis of our results, and detection of CVB1 in 2 other contemporary onychomadesis outbreaks in childcare centers in Spain, we propose that mixed infection of an EV serotype that causes HFMD, plus the serotype CVB1, could explain the emergence after HFMD of onychomadesis, a rare and late complication.

  20. Reliability of infrared thermometric measurements of skin temperature in the hand.

    Science.gov (United States)

    Packham, Tara L; Fok, Diana; Frederiksen, Karen; Thabane, Lehana; Buckley, Norman

    2012-01-01

    Clinical measurement study. Skin temperature asymmetries (STAs) are used in the diagnosis of complex regional pain syndrome (CRPS), but little evidence exists for reliability of the equipment and methods. This study examined the reliability of an inexpensive infrared (IR) thermometer and measurement points in the hand for the study of STA. ST was measured three times at five points on both hands with an IR thermometer by two raters in 20 volunteers (12 normals and 8 CRPS). ST measurement results using IR thermometers support inter-rater reliability: intraclass correlation coefficient (ICC) estimate for single measures 0.80; all ST measurement points were also highly reliable (ICC single measures, 0.83-0.91). The equipment demonstrated excellent reliability, with little difference in the reliability of the five measurement sites. These preliminary findings support their use in future CRPS research. Not applicable. Copyright © 2012 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

  1. Characterizing multisegment foot kinematics during gait in diabetic foot patients

    Directory of Open Access Journals (Sweden)

    Denti Paolo

    2009-10-01

    Full Text Available Abstract Background The prevalence of diabetes mellitus has reached epidemic proportions, this condition may result in multiple and chronic invalidating long term complications. Among these, the diabetic foot, is determined by the simultaneous presence of both peripheral neuropathy and vasculopathy that alter the biomechanics of the foot with the formation of callosity and ulcerations. To diagnose and treat the diabetic foot is crucial to understand the foot complex kinematics. Most of gait analysis protocols represent the entire foot as a rigid body connected to the shank. Nevertheless the existing multisegment models cannot completely decipher the impairments associated with the diabetic foot. Methods A four segment foot and ankle model for assessing the kinematics of the diabetic foot was developed. Ten normal subjects and 10 diabetics gait patterns were collected and major sources of variability were tested. Repeatability analysis was performed both on a normal and on a diabetic subject. Direct skin marker placement was chosen in correspondence of 13 anatomical landmarks and an optoelectronic system was used to collect the data. Results Joint rotation normative bands (mean plus/minus one standard deviation were generated using the data of the control group. Three representative strides per subject were selected. The repeatability analysis on normal and pathological subjects results have been compared with literature and found comparable. Normal and pathological gait have been compared and showed major statistically significant differences in the forefoot and midfoot dorsi-plantarflexion. Conclusion Even though various biomechanical models have been developed so far to study the properties and behaviour of the foot, the present study focuses on developing a methodology for the functional assessment of the foot-ankle complex and for the definition of a functional model of the diabetic neuropathic foot. It is, of course, important to evaluate

  2. Prospective randomized study of contrast reaction management curricula: Computer-based interactive simulation versus high-fidelity hands-on simulation

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Carolyn L., E-mail: wangcl@uw.edu [Department of Radiology, University of Washington, Box 357115, 1959 NE Pacific Street, Seattle, WA 98195-7115 (United States); Schopp, Jennifer G.; Kani, Kimia [Department of Radiology, University of Washington, Box 357115, 1959 NE Pacific Street, Seattle, WA 98195-7115 (United States); Petscavage-Thomas, Jonelle M. [Penn State Hershey Medical Center, Department of Radiology, 500 University Drive, Hershey, PA 17033 (United States); Zaidi, Sadaf; Hippe, Dan S.; Paladin, Angelisa M.; Bush, William H. [Department of Radiology, University of Washington, Box 357115, 1959 NE Pacific Street, Seattle, WA 98195-7115 (United States)

    2013-12-01

    Purpose: We developed a computer-based interactive simulation program for teaching contrast reaction management to radiology trainees and compared its effectiveness to high-fidelity hands-on simulation training. Materials and methods: IRB approved HIPAA compliant prospective study of 44 radiology residents, fellows and faculty who were randomized into either the high-fidelity hands-on simulation group or computer-based simulation group. All participants took separate written tests prior to and immediately after their intervention. Four months later participants took a delayed written test and a hands-on high-fidelity severe contrast reaction scenario performance test graded on predefined critical actions. Results: There was no statistically significant difference between the computer and hands-on groups’ written pretest, immediate post-test, or delayed post-test scores (p > 0.6 for all). Both groups’ scores improved immediately following the intervention (p < 0.001). The delayed test scores 4 months later were still significantly higher than the pre-test scores (p ≤ 0.02). The computer group's performance was similar to the hands-on group on the severe contrast reaction simulation scenario test (p = 0.7). There were also no significant differences between the computer and hands-on groups in performance on the individual core competencies of contrast reaction management during the contrast reaction scenario. Conclusion: It is feasible to develop a computer-based interactive simulation program to teach contrast reaction management. Trainees that underwent computer-based simulation training scored similarly on written tests and on a hands-on high-fidelity severe contrast reaction scenario performance test as those trained with hands-on high-fidelity simulation.

  3. Prospective randomized study of contrast reaction management curricula: Computer-based interactive simulation versus high-fidelity hands-on simulation

    International Nuclear Information System (INIS)

    Wang, Carolyn L.; Schopp, Jennifer G.; Kani, Kimia; Petscavage-Thomas, Jonelle M.; Zaidi, Sadaf; Hippe, Dan S.; Paladin, Angelisa M.; Bush, William H.

    2013-01-01

    Purpose: We developed a computer-based interactive simulation program for teaching contrast reaction management to radiology trainees and compared its effectiveness to high-fidelity hands-on simulation training. Materials and methods: IRB approved HIPAA compliant prospective study of 44 radiology residents, fellows and faculty who were randomized into either the high-fidelity hands-on simulation group or computer-based simulation group. All participants took separate written tests prior to and immediately after their intervention. Four months later participants took a delayed written test and a hands-on high-fidelity severe contrast reaction scenario performance test graded on predefined critical actions. Results: There was no statistically significant difference between the computer and hands-on groups’ written pretest, immediate post-test, or delayed post-test scores (p > 0.6 for all). Both groups’ scores improved immediately following the intervention (p < 0.001). The delayed test scores 4 months later were still significantly higher than the pre-test scores (p ≤ 0.02). The computer group's performance was similar to the hands-on group on the severe contrast reaction simulation scenario test (p = 0.7). There were also no significant differences between the computer and hands-on groups in performance on the individual core competencies of contrast reaction management during the contrast reaction scenario. Conclusion: It is feasible to develop a computer-based interactive simulation program to teach contrast reaction management. Trainees that underwent computer-based simulation training scored similarly on written tests and on a hands-on high-fidelity severe contrast reaction scenario performance test as those trained with hands-on high-fidelity simulation

  4. Malignant melanoma misdiagnosed as diabetic foot ulcer: A case report.

    Science.gov (United States)

    Gao, Wei; Chen, Dawei; Ran, Xingwu

    2017-07-01

    Acral lentiginous melanoma (AML) does not exhibit the classic signs of malignant melanoma. ALM is frequently misdiagnosed because of its unusual sites and atypical clinical morphologies, which lead to poor prognosis. A female patient aged 78 years was presented to our center with two ulcers on her right foot. Diabetic foot ulcer was considered as the primary diagnosis. The ulcers failed to improve after 2 weeks' therapy. An incisional biopsy of the lesion revealed malignant melanoma. The patient received wide excision, skin grafting as well as biotherapy. The lesion was healed and no other metastasis has been founded until now. Clinicians must maintain a high level of suspicion in distinguishing malignant melanoma from other more benign skin lesions of the foot. The need for early biopsy of ulcer, even when clinical suspicion is low, can not be overemphasized. Only in this way can we reduce misdiagnosis rate and improve survival rate in patients with foot ulcer.

  5. Dermatological and musculoskeletal assessment of diabetic foot: A narrative review.

    Science.gov (United States)

    Arsanjani Shirazi, Azam; Nasiri, Morteza; Yazdanpanah, Leila

    2016-01-01

    Diabetic Foot Syndrome (DFS) is the most costly and devastating complication of diabetes mellitus (DM), which early effective assessment can reduce the severity of complications including ulceration and amputations. This study aimed to review dermatological and musculoskeletal assessment of diabetic foot. In this review article, we searched for articles published between March 1, 1980 and July 28, 2015 in PubMed, Science Direct, Embase, Web of Science, and Scopus, for both English and non-English language articles with the following keywords: "Diabetic foot syndrome", "Ulceration", "Amputation", "Foot assessment", "Skin disorders" and "Musculoskeletal deformities". In dermatological dimension, most studies focused on elucidated changes in skin temperature, color, hardiness and turgor as well as common skin disorders such as Diabetic Dermopathy (DD), Necrobiosis Lipoidica Diabeticorum (NLD) and Diabetic Bullae (DB), which are common in diabetic patients and have high potential for leading to limb-threatening problems such as ulceration and infection. In musculoskeletal dimension, most studies focused on range of motion and muscle strength, gait patterns and as well as foot deformities especially Charcot osteoarthropathy (COA), which is the most destructive musculoskeletal complication of diabetes. DFS as a common condition in DM patients lead to ulceration and lower limb amputation frequently unless a prompt and comprehensive assessment was taken. So that dermatological and musculoskeletal assessments are usually neglected in primary health care, these assessments should be done frequently to reduce the high risk of serious complications. Copyright © 2016 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  6. The clinical assessment study of the foot (CASF: study protocol for a prospective observational study of foot pain and foot osteoarthritis in the general population

    Directory of Open Access Journals (Sweden)

    Menz Hylton B

    2011-09-01

    Full Text Available Abstract Background Symptomatic osteoarthritis (OA affects approximately 10% of adults aged over 60 years. The foot joint complex is commonly affected by OA, yet there is relatively little research into OA of the foot, compared with other frequently affected sites such as the knee and hand. Existing epidemiological studies of foot OA have focussed predominantly on the first metatarsophalangeal joint at the expense of other joints. This three-year prospective population-based observational cohort study will describe the prevalence of symptomatic radiographic foot OA, relate its occurrence to symptoms, examination findings and life-style-factors, describe the natural history of foot OA, and examine how it presents to, and is diagnosed and managed in primary care. Methods All adults aged 50 years and over registered with four general practices in North Staffordshire, UK, will be invited to participate in a postal Health Survey questionnaire. Respondents to the questionnaire who indicate that they have experienced foot pain in the preceding twelve months will be invited to attend a research clinic for a detailed clinical assessment. This assessment will consist of: clinical interview; physical examination; digital photography of both feet and ankles; plain x-rays of both feet, ankles and hands; ultrasound examination of the plantar fascia; anthropometric measurement; and a further self-complete questionnaire. Follow-up will be undertaken in consenting participants by postal questionnaire at 18 months (clinic attenders only and three years (clinic attenders and survey participants, and also by review of medical records. Discussion This three-year prospective epidemiological study will combine survey data, comprehensive clinical, x-ray and ultrasound assessment, and review of primary care records to identify radiographic phenotypes of foot OA in a population of community-dwelling older adults, and describe their impact on symptoms, function and

  7. Mechanics of the foot Part 2: A coupled solid-fluid model to investigate blood transport in the pathologic foot.

    Science.gov (United States)

    Mithraratne, K; Ho, H; Hunter, P J; Fernandez, J W

    2012-10-01

    A coupled computational model of the foot consisting of a three-dimensional soft tissue continuum and a one-dimensional (1D) transient blood flow network is presented in this article. The primary aim of the model is to investigate the blood flow in major arteries of the pathologic foot where the soft tissue stiffening occurs. It has been reported in the literature that there could be up to about five-fold increase in the mechanical stiffness of the plantar soft tissues in pathologic (e.g. diabetic) feet compared with healthy ones. The increased stiffness results in higher tissue hydrostatic pressure within the plantar area of the foot when loaded. The hydrostatic pressure acts on the external surface of blood vessels and tend to reduce the flow cross-section area and hence the blood supply. The soft tissue continuum model of the foot was modelled as a tricubic Hermite finite element mesh representing all the muscles, skin and fat of the foot and treated as incompressible with transversely isotropic properties. The details of the mechanical model of soft tissue are presented in the companion paper, Part 1. The deformed state of the soft tissue continuum because of the applied ground reaction force at three foot positions (heel-strike, midstance and toe-off) was obtained by solving the Cauchy equations based on the theory of finite elasticity using the Galerkin finite element method. The geometry of the main arterial network in the foot was represented using a 1D Hermite cubic finite element mesh. The flow model consists of 1D Navier-Stokes equations and a nonlinear constitutive equation to describe vessel radius-transmural pressure relation. The latter was defined as the difference between the fluid and soft tissue hydrostatic pressure. Transient flow governing equations were numerically solved using the two-step Lax-Wendroff finite difference method. The geometry of both the soft tissue continuum and arterial network is anatomically-based and was developed using

  8. Teledermatologist expert skin advice: A unique model of care for managing skin disorders and adverse drug reactions in hepatitis C patients.

    Science.gov (United States)

    Charlston, Samuel; Siller, Gregory

    2018-03-23

    To conduct an audit of teledermatologist expert skin advice, a store and forward tele-dermatological service, to determine its effectiveness and user satisfaction in managing cutaneous adverse drug reactions in patients with hepatitis C, and to demonstrate a unique collaborative model of care for patients receiving specialised drug therapy. A retrospective analysis of data on teledermatologist expert skin advice referrals from January 2014 to December 2015 was performed. The primary outcomes assessed included number of referrals, referral locations, diagnoses, response times, quality of clinical information provided and user satisfaction ratings. Altogether 43 consultations from 29 referring sites were received from Australian metropolitan and rural settings. Of the patients, 43 were diagnosed with an adverse drug reaction related to the use of either telaprevir or simeprevir. The average time taken for the dermatologist to reply electronically with a final diagnosis and management plan was 1 h 57 min. As many as 26% of referrals required additional photos to establish a diagnosis due to poor-quality images or insufficient detail. Altogether 18 clinicians completed the customer satisfaction survey, all of whom rated teledermatologist expert skin advice nine or above on a scale of one to 10. Teledermatologist expert skin advice was regarded by clinicians as a valuable patient care service. The platform is a novel modality that supports patients undergoing specialised treatments at risk of cutaneous adverse drug reaction. © 2018 The Australasian College of Dermatologists.

  9. The effect of Mepitel Film on acute radiation-induced skin reactions in head and neck cancer patients: a feasibility study.

    Science.gov (United States)

    Wooding, Hayley; Yan, Jing; Yuan, Ling; Chyou, Te-Yu; Gao, Shanbao; Ward, Iain; Herst, Patries M

    2018-01-01

    Mepitel Film significantly decreases acute radiation-induced skin reactions in breast cancer patients. Here we investigated the feasibility of using Mepitel Film in head and neck cancer patients (ACTRN12614000932662). Out of a total of 36 head and neck cancer patients from New Zealand (NZ) (n = 24) and China (n = 12) recruited between June 2015 and December 2016, 33 patients complied with protocol. Of these, 11 NZ patients followed a management protocol; 11 NZ patients and 11 Chinese patients followed a prophylactic protocol. An area of the neck receiving a homogenous radiation dose of > 35 Gy was divided into two equal halves; one half was randomized to Film and the other to either Sorbolene cream (NZ) or Biafine cream (China). Skin reaction severity was measured by Radiation Induced Skin Reaction Assessment Scale and expanded Radiation Therapy Oncology Group toxicity criteria. Skin dose was measured by thermoluminescent dosimeters or gafchromic film. Film decreased overall skin reaction severity (combined Radiation Induced Skin Reaction Assessment Scale score) by 29% and moist desquamation rates by 37% in the Chinese cohort and by 27 and 28%, respectively in the NZ cohort. Mepitel Film did not affect head movements but did not adhere well to the skin, particularly in males with heavy beard stubble, and caused itchiness, particularly in Chinese patients. Mepitel Film reduced acute radiation-induced skin reactions in our head and neck cancer patients, particularly in patients without heavy stubble. Advances in knowledge: This is the first study to confirm the feasibility of using Mepitel Film in head and neck cancer patients.

  10. 急诊手外科中腹部任意型皮瓣的应用%Application of Abdominal Randomy Skin flap in the Acute Operation for hand

    Institute of Scientific and Technical Information of China (English)

    杨建勋; 王宁

    2002-01-01

    Objective To present the means and effect of repairing hand soft tissue defect. Methods To transplate from 45 patients'randomy skin flap to hand defect area, and cut off the peduncle. Result The survival of skin flap is satisfactory with softness and colorfamiliar to normal skin 1 ~ 3 years after operation. Conclusion Therapy is simple reliable and effective.

  11. Hand, foot and mouth disease: spatiotemporal transmission and climate.

    Science.gov (United States)

    Wang, Jin-feng; Guo, Yan-Sha; Christakos, George; Yang, Wei-Zhong; Liao, Yi-Lan; Li, Zhong-Jie; Li, Xiao-Zhou; Lai, Sheng-Jie; Chen, Hong-Yan

    2011-04-05

    The Hand-Foot-Mouth Disease (HFMD) is the most common infectious disease in China, its total incidence being around 500,000~1,000,000 cases per year. The composite space-time disease variation is the result of underlining attribute mechanisms that could provide clues about the physiologic and demographic determinants of disease transmission and also guide the appropriate allocation of medical resources to control the disease. HFMD cases were aggregated into 1456 counties and during a period of 11 months. Suspected climate attributes to HFMD were recorded monthly at 674 stations throughout the country and subsequently interpolated within 1456 × 11 cells across space-time (same as the number of HFMD cases) using the Bayesian Maximum Entropy (BME) method while taking into consideration the relevant uncertainty sources. The dimensionalities of the two datasets together with the integrated dataset combining the two previous ones are very high when the topologies of the space-time relationships between cells are taken into account. Using a self-organizing map (SOM) algorithm the dataset dimensionality was effectively reduced into 2 dimensions, while the spatiotemporal attribute structure was maintained. 16 types of spatiotemporal HFMD transmission were identified, and 3-4 high spatial incidence clusters of the HFMD types were found throughout China, which are basically within the scope of the monthly climate (precipitation) types. HFMD propagates in a composite space-time domain rather than showing a purely spatial and purely temporal variation. There is a clear relationship between HFMD occurrence and climate. HFMD cases are geographically clustered and closely linked to the monthly precipitation types of the region. The occurrence of the former depends on the later.

  12. Prevalence and characterization of enterovirus infections among pediatric patients with hand foot mouth disease, herpangina and influenza like illness in Thailand, 2012.

    Science.gov (United States)

    Puenpa, Jiratchaya; Mauleekoonphairoj, John; Linsuwanon, Piyada; Suwannakarn, Kamol; Chieochansin, Thaweesak; Korkong, Sumeth; Theamboonlers, Apiradee; Poovorawan, Yong

    2014-01-01

    Hand, foot, and mouth disease (HFMD) and herpangina are common infectious diseases caused by several genotypes of human enterovirus species A and frequently occurring in young children. This study was aimed at analyzing enteroviruses from patients with these diseases in Thailand in 2012. Detection and genotype determination of enteroviruses were accomplished by reverse transcription-polymerase chain reaction and sequencing of the VP1 region. Enterovirus-positive samples were differentiated into 17 genotypes (coxsackievirus A4 (CAV4), A5, A6, A8, A9, A10, A12, A16, A21, B1, B2, B4, B5, echovirus 7, 16, 25 and Enterovirus 71). The result showed CAV6 (33.5%), followed by CAV16 (9.4%) and EV71 (8.8%) as the most frequent genotypes in HFMD, CAV8 (19.3%) in herpangina and CAV6 (1.5%) in influenza like illness. Enterovirus infections were most prevalent during July with 34.4% in HFMD, 39.8% in herpangina and 1.6% in ILI. The higher enterovirus infection associated with HFMD and herpangina occurred in infants over one year-old. This represents the first report describing the circulation of multiple enteroviruses in Thailand.

  13. Cyclical Patterns of Hand, Foot and Mouth Disease Caused by Enterovirus A71 in Malaysia

    Science.gov (United States)

    NikNadia, NMN; Sam, I-Ching; Rampal, Sanjay; WanNorAmalina, WMZ; NurAtifah, Ghazali; Verasahib, Khebir; Ong, Chia Ching; MohdAdib, MohdAidinniza; Chan, Yoke Fun

    2016-01-01

    Enterovirus A71 (EV-A71) is an important emerging pathogen causing large epidemics of hand, foot and mouth disease (HFMD) in children. In Malaysia, since the first EV-A71 epidemic in 1997, recurrent cyclical epidemics have occurred every 2–3 years for reasons that remain unclear. We hypothesize that this cyclical pattern is due to changes in population immunity in children (measured as seroprevalence). Neutralizing antibody titers against EV-A71 were measured in 2,141 residual serum samples collected from children ≤12 years old between 1995 and 2012 to determine the seroprevalence of EV-A71. Reported national HFMD incidence was highest in children Malaysia is mainly due to the fall of population immunity accompanying the accumulation of susceptible children between epidemics. This study will impact the future planning, timing and target populations for vaccine programs. PMID:27010319

  14. Beyond the Bottom of the Foot: Topographic Organization of the Foot Dorsum in Walking.

    Science.gov (United States)

    Klarner, Taryn; Pearcey, Gregory E P; Sun, Yao; Barss, Trevor S; Kaupp, Chelsea; Munro, Bridget; Frank, Nick; Zehr, E Paul

    2017-12-01

    Sensory feedback from the foot dorsum during walking has only been studied globally by whole nerve stimulation. Stimulating the main nerve innervating the dorsal surface produces a functional stumble corrective response that is phase-dependently modulated. We speculated that effects evoked by activation of discrete skin regions on the foot dorsum would be topographically organized, as with the foot sole. Nonnoxious electrical stimulation was delivered to five discrete locations on the dorsal surface of the foot during treadmill walking. Muscle activity from muscles acting at the ankle, knee, hip, and shoulder were recorded along with ankle, knee, and hip kinematics and kinetic information from forces under the foot. All data were sorted on the basis of stimulus occurrence in 12 step cycle phases, before being averaged together within a phase for subsequent analysis. Results reveal dynamic changes in reflex amplitudes and kinematics that are site specific and phase dependent. Most responses from discrete sites on the foot dorsum were seen in the swing phase suggesting function to conform foot trajectory to maintain stability of the moving limb. In general, responses from lateral stimulation differed from medial stimulation, and effects were largest from stimulation at the distal end of the foot at the metatarsals; that is, in anatomical locations where actual impact with an object in the environment is most likely during swing. Responses to stimulation extend to include muscles at the hip and shoulder. We reveal that afferent feedback from specific cutaneous locations on the foot dorsum influences stance and swing phase corrective responses. This emphasizes the critical importance of feedback from the entire foot surface in locomotor control and has application for rehabilitation after neurological injury and in footwear development.

  15. Association between skin reactions and efficacy of summer acupoint application treatment on chronic pulmonary disease: A prospective study.

    Science.gov (United States)

    Wu, Xia-qiu; Peng, Jin; Li, Guo-qin; Su, Hui-ping; Liu, Guang-xia; Liu, Bao-yan

    2016-04-01

    To examine the variations in the prevalence of skin reactions and the association between skin reactions and efficacy of summer acupoint application treatment (SAAT) on chronic pulmonary disease (CPD). A total of 2,038 patients with CPD were enrolled at 3 independent hospitals (defined as Groups A, B and C, respectively) in China. All patients were treated by SAAT, as applying a herbal paste onto the acupoints of Fengmen (BL 12) and Feishu (BL 13) on the dog days of summer, according to the lunar calendar, in 2008. Ten days after treatment, skin reaction data (no reaction, itching, stinging, blistering, and infection) were obtained via face-to-face interviews. Patients were retreated in the same hospital one year later, thereby allowing doctors to assess treatment efficacy based on the patients' symptoms, the severity of the spirometric abnormalities, and the concomitant medications used. A large number of patients (85.3%) displayed reactive symptoms; however, the marked associations between reactive symptoms and age or gender were not observed. An increased number of patients from Group B (99.3%) and Group C (76.5%) displayed reactive symptoms due to the increased mass of crude Semen Sinapis Albae. The effective rate of SAAT was as high as 90.4% for patients of Group B, which was followed by Group A (70.9%) and Group C (42.2%). Using stratified analyses, a convincing association between reactive symptoms and therapeutic efficacy was observed for patients with asthma [itching: odds ratio (OR)=2.17, 95% confidence interval (CI): 1.49 to 3.14; blistering: OR=0.43, 95% CI: 0.25 to 0.73; and no reaction: OR=0.56, 95% CI: 0.35 to 0.90]. However, the same tendency was not observed for patients with chronic bronchitis and chronic obstructive pulmonary disease. SAAT can induce very mild skin reactions for patients with CPD, among which patients with asthma displayed a strong association between skin reactions and therapeutic efficacy. The skin reactions may be induced by

  16. Laser Doppler imaging, thermographic imaging, and tissue oxygen saturation measurements detect early skin reactions during breast radiotherapy

    Science.gov (United States)

    Harrison, David K.; Harrison, Eileen M.; Newton, David J.; Windsor, Phyllis M.

    2001-05-01

    A range of acute skin reactions, ranging from mild erythema to moist desquamation, can be seen in patients receiving standard fractionated radiotherapy to the breast for conservation therapy of breast carcinoma. In a number of cases these reactions can cause considerable discomfort and seriously affect the patient's quality of life. In previous studies we have used the techniques of laser Doppler imaging, digital thermographic imaging and lightguide spectrophotometry to study oxygen supply and blood flow in inflammatory reactions induced experimentally in forearm skin. The present study is an attempt to use the same techniques to investigate whether any or all of them can detect changes in breast skin very early on in the course of radiotherapy treatment. A further aim of the longer term study is to investigate to what extent these early changes may be able to predict the occurrence later of severe acute or delayed reactions.

  17. Mycetoma foot

    Directory of Open Access Journals (Sweden)

    Somnath Gooptu

    2013-01-01

    Full Text Available Mycetoma is an uncommon chronic granulomatous infective disease of the skin, dermis and subcutaneous tissues predominantly seen in tropical countries. A patient presented to our hospital with the swelling of the left foot with a healed sinus and a painful nodule. He gave a history of sinuses in the left foot from which there was discharge of yellow granules. Culture of the ultrasound guided fine needle aspiration cytology of the nodule revealed growths of Nocardia species. The patient was treated with a multi-drug therapy along with debridement of the painful nodule. He experienced symptomatic relief and a regression of the swelling within the three months of follow-up so far. Due to the relatively slow progression of the disease, patients are diagnosed at a late stage. Hence, emphasis should be placed on health education and the importance of wearing footwear.

  18. Reactions of neutron-rich Sn isotopes investigated at relativistic energies at R{sup 3}B

    Energy Technology Data Exchange (ETDEWEB)

    Schindler, Fabia; Aumann, Thomas; Johansen, Jacob; Schrock, Philipp [IKP, TU Darmstadt (Germany); Boretzky, Konstanze [GSI Helmholtzzentrum (Germany); Collaboration: R3B-Collaboration

    2015-07-01

    Reactions of neutron-rich tin isotopes in a mass range of A=124 to A=134 have been measured at the R{sup 3}B setup at GSI in inverse kinematics. Due to the neutron excess, which results in a weaker binding of the valence neutrons such isotopes are expected to form a neutron skin. The investigation of this phenomenon is an important goal in nuclear-structure physics. Reactions of the tin isotopes with different targets have been performed kinematically complete. The taken data set therefore allows for the extraction of the neutron-skin thickness from two independent reaction channels. These are dipole excitations on the one hand and nuclear-induced reactions on the other hand. This contribution focuses on the latter mechanism. The analysis techniques which are used to extract the total charge-changing as well as the total neutron-removal cross section are presented using the example of {sup 124}Sn. The total neutron-removal cross section is of particular interest because of its high sensitivity to the neutron-skin thickness.

  19. Filaggrin loss-of-function mutation R501X and 2282del4 carrier status is associated with fissured skin on the hands: results from a cross-sectional population study

    DEFF Research Database (Denmark)

    Thyssen, J P; Ross-Hansen, K; Johansen, J D

    2012-01-01

    Background: Filaggrin metabolites act as osmolytes and are important for skin hydration. Carriers of filaggrin loss-of-function mutations have a higher prevalence of atopic dermatitis and dry skin. There is also evidence to suggest that filaggrin mutations increase the risk of hand eczema in atopic...... whether filaggrin loss-of-function mutations are associated with skin fissures on the hands and/or fingers in the general population. Design: Participants of a population based study were questioned about skin symptom and genotyped for filaggrin mutation, patch tested for nickel allergy and skin prick...... tested. Results: In an adjusted logistic regression analysis, filaggrin mutation status was significantly associated with fissured skin on the hands and/or fingers in adults (OR=1.93; CI95%=1.05-3.55) and a near significant negative interaction with atopic dermatitis (p=0.055), suggesting the effect...

  20. Exercise improves gait, reaction time and postural stability in older adults with type 2 diabetes and neuropathy.

    Science.gov (United States)

    Morrison, Steven; Colberg, Sheri R; Parson, Henri K; Vinik, Aaron I

    2014-01-01

    For older adults with type 2 diabetes (T2DM), declines in balance and walking ability are risk factors for falls, and peripheral neuropathy magnifies this risk. Exercise training may improve balance, gait and reduce the risk of falling. This study investigated the effects of 12weeks of aerobic exercise training on walking, balance, reaction time and falls risk metrics in older T2DM individuals with/without peripheral neuropathy. Adults with T2DM, 21 without (DM; age 58.7±1.7years) and 16 with neuropathy (DM-PN; age 58.9±1.9years), engaged in either moderate or intense supervised exercise training thrice-weekly for 12weeks. Pre/post-training assessments included falls risk (using the physiological profile assessment), standing balance, walking ability and hand/foot simple reaction time. Pre-training, the DM-PN group had higher falls risk, slower (hand) reaction times (232 vs. 219ms), walked at a slower speed (108 vs. 113cm/s) with shorter strides compared to the DM group. Following training, improvements in hand/foot reaction times and faster walking speed were seen for both groups. While falls risk was not significantly reduced, the observed changes in gait, reaction time and balance metrics suggest that aerobic exercise of varying intensities is beneficial for improving dynamic postural control in older T2DM adults with/without neuropathy. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. Foot reflexology in feet impairment of people with type 2 diabetes mellitus: randomized trial

    Directory of Open Access Journals (Sweden)

    Natália Chantal Magalhães da Silva

    2015-08-01

    Full Text Available AbstractObjective: to evaluate the effect of foot reflexology on feet impairment of people with type 2 diabetes mellitus.Method: this is a randomized, controlled and blind clinical trial. The sample was comprised by people with type 2 diabetes mellitus who, after being randomized into Treated group (n = 21 and Control group (n = 24, received guidelines on foot self-care. To the Treated Group it was also provided 12 sessions of foot reflexology. The scores of impairment indicators related to skin and hair, blood circulation, tissue sensitivity and temperature were measured by means of the instrument for assessing tissue integrity of the feet of people with diabetes mellitus. Chi-square test, Fisher exact test, Mann-Whitney test and regression analyzes were applied to the data, considering a significance level of 5% (P value <0.05.Results: participants who received the therapy showed better scores in some impairment indicators related to skin and hair (hair growth, elasticity/turgor, hydration, perspiration, texture and integrity of the skin/ skin peeling.Conclusion: the foot reflexology had a beneficial effect on feet impairment of people with type 2 diabetes mellitus, which makes it a viable therapy, deserving investment. This study was registered in the Brazilian Registry of Clinical Trials - RBR-8zk8sz.

  2. Humans can integrate force feedback to toes in their sensorimotor control of a robotic hand.

    Science.gov (United States)

    Panarese, Alessandro; Edin, Benoni B; Vecchi, Fabrizio; Carrozza, Maria C; Johansson, Roland S

    2009-12-01

    Tactile sensory feedback is essential for dexterous object manipulation. Users of hand myoelectric prostheses without tactile feedback must depend essentially on vision to control their device. Indeed, improved tactile feedback is one of their main priorities. Previous research has provided evidence that conveying tactile feedback can improve prostheses control, although additional effort is required to solve problems related to pattern recognition learning, unpleasant sensations, sensory adaptation, and low spatiotemporal resolution. Still, these studies have mainly focused on providing stimulation to hairy skin regions close to the amputation site, i.e., usually to the upper arm. Here, we explored the possibility to provide tactile feedback to the glabrous skin of toes, which have mechanical and neurophysiological properties similar to the fingertips. We explored this paradigm in a grasp-and-lift task, in which healthy participants controlled two opposing digits of a robotic hand by changing the spacing of their index finger and thumb. The normal forces applied by the robotic fingertips to a test object were fed back to the right big and second toe. We show that within a few lifting trials, all the participants incorporated the force feedback received by the foot in their sensorimotor control of the robotic hand.

  3. Pneumatic tool torque reaction: reaction forces, displacement, muscle activity and discomfort in the hand-arm system.

    Science.gov (United States)

    Kihlberg, S; Kjellberg, A; Lindbeck, L

    1993-06-01

    Reaction forces, hand-arm displacement, muscle activity and discomfort ratings were studied during the securing of threaded fasteners with three angle nutrunners with different shut-off mechanisms, but with the same spindle torque (72-74 Nm). The three tools were tested according to the method specified in ISO 6544. One of the tools had an almost instantaneous shut-off. Another had a more slowly declining torque curve. For the third tool the maximum torque was maintained for a while before shut-off. Twelve male subjects participated in the study. A force platform measured the reaction force between the subject and the floor. The option of the hand-arm system and the shoulder was measured with an optoelectronic measuring system. The muscle activity (EMG) in six muscles in the arm and shoulder was measured with surface electrodes. Significant differences in the arm movements and ground reaction forces were found between the three tools. The smallest values were found with the fast shut-off tool while the delayed shut-off tool caused the largest values. The EMG measures gave inconsistent response patterns. Discomfort ratings were highly correlated with the time for which the tool torque exceeded 90% of peak preset torque, but the time for which the tool torque exceeded 90% of peak calculated by the method specified in ISO 6544. Nutrunners with a shut-off mechanism that causes a slowly decreasing torque or a torque that is maintained for a while before shut-off should be avoided. If no substitutes are available, then a torque reaction bar should be mounted on the tool.

  4. Formulation and Evaluation of Exotic Fat Based Cosmeceuticals for Skin Repair

    OpenAIRE

    Mandawgade, S. D.; Patravale, Vandana B.

    2008-01-01

    Mango butter was explored as a functional, natural supplement and active skin ingredient in skin care formulations. A foot care cream was developed with mango butter to evaluate its medicinal value and protective function in skin repair. Qualitative comparison and clinical case studies of the product were carried out. Wound healing potential of foot care cream was investigated on the rat excision and incision wound models. Results of the clinical studies demonstrated complete repair of worn a...

  5. Pressure pain perception in the diabetic Charcot foot: facts and hypotheses

    Directory of Open Access Journals (Sweden)

    Ernst A. Chantelau

    2013-05-01

    Full Text Available Background:Reduced traumatic and posttraumatic (nociceptive pain is a key feature of diabetic neuropathy. Underlying condition is a gradual degeneration of endings of pain nerves (A-delta fibers and C-fibers, which operate as receivers of noxious stimuli (nociceptors. Hence, the absence of A-delta fiber mediated sharp pain (“first” pain, and of C-fiber mediated dull pain (“second” pain. However, patients with diabetic neuropathy and acute Charcot foot often experience deep dull aching in the Charcot foot while walking on it. Aim: To create a unifying hypothesis on the kind of pain in an acute Charcot foot. Result: Absence of punctuate (pinprick pain perception at the sole of a Charcot foot, as was shown recently, likely corresponds to vanished intraepidermal A-delta fiber endings. C-fiber nociceptors are reduced, according to histopathology studies. Both types of fibers contribute to posttraumatic hyperalgesia at the skin level, as studies show. Their deficiencies likely impact on posttraumatic hyperalgesia at the skin level and, probably, also at the skeletal level. Conclusion: It is hypothesised that deep dull aching in an acute diabetic Charcot foot may represent faulty posttraumatic hyperalgesia involving cutaneous and skeletal tissues.

  6. Guideline Implementation: Hand Hygiene.

    Science.gov (United States)

    Goldberg, Judith L

    2017-02-01

    Performing proper hand hygiene and surgical hand antisepsis is essential to reducing the rates of health care-associated infections, including surgical site infections. The updated AORN "Guideline for hand hygiene" provides guidance on hand hygiene and surgical hand antisepsis, the wearing of fingernail polish and artificial nails, proper skin care to prevent dermatitis, the wearing of jewelry, hand hygiene product selection, and quality assurance and performance improvement considerations. This article focuses on key points of the guideline to help perioperative personnel make informed decisions about hand hygiene and surgical hand antisepsis. The key points address the necessity of keeping fingernails and skin healthy, not wearing jewelry on the hands or wrists in the perioperative area, properly performing hand hygiene and surgical hand antisepsis, and involving patients and visitors in hand hygiene initiatives. Perioperative RNs should review the complete guideline for additional information and for guidance when writing and updating policies and procedures. Copyright © 2017 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  7. Hand, foot and mouth disease: spatiotemporal transmission and climate

    Directory of Open Access Journals (Sweden)

    Li Xiao-Zhou

    2011-04-01

    Full Text Available Abstract Background The Hand-Foot-Mouth Disease (HFMD is the most common infectious disease in China, its total incidence being around 500,000 ~1,000,000 cases per year. The composite space-time disease variation is the result of underlining attribute mechanisms that could provide clues about the physiologic and demographic determinants of disease transmission and also guide the appropriate allocation of medical resources to control the disease. Methods and Findings HFMD cases were aggregated into 1456 counties and during a period of 11 months. Suspected climate attributes to HFMD were recorded monthly at 674 stations throughout the country and subsequently interpolated within 1456 × 11 cells across space-time (same as the number of HFMD cases using the Bayesian Maximum Entropy (BME method while taking into consideration the relevant uncertainty sources. The dimensionalities of the two datasets together with the integrated dataset combining the two previous ones are very high when the topologies of the space-time relationships between cells are taken into account. Using a self-organizing map (SOM algorithm the dataset dimensionality was effectively reduced into 2 dimensions, while the spatiotemporal attribute structure was maintained. 16 types of spatiotemporal HFMD transmission were identified, and 3-4 high spatial incidence clusters of the HFMD types were found throughout China, which are basically within the scope of the monthly climate (precipitation types. Conclusions HFMD propagates in a composite space-time domain rather than showing a purely spatial and purely temporal variation. There is a clear relationship between HFMD occurrence and climate. HFMD cases are geographically clustered and closely linked to the monthly precipitation types of the region. The occurrence of the former depends on the later.

  8. One of the problems of radiation protection in nuclear medicine: hand skin irradiation of the of workers in selected activities with radiopharmaceutical 18F-FDG

    International Nuclear Information System (INIS)

    Hudzietzova, J.; Sabol, J.; Fueloep, M.

    2014-01-01

    The paper deals with the evaluation of local irradiation of hand skin of the personnel of selected PET department on the basis of experimental measurements with TLD. Activities were considered during manipulation with a radiopharmaceutical 18 F-labeled radionuclide (radiopharmaceutical preparation and application). The paper also discussed the effects on the size of the local hand skin irradiation including the possibilities of reducing them. (authors)

  9. Vitamin E-deficiency did not exacerbate partial skin reactions in mice locally irradiated with X-rays

    International Nuclear Information System (INIS)

    Chi, C.; Hayashi, Daisuke; Nemoto, Masato; Nyui, Minako; Anzai, Kazunori; Urano, Shiro

    2011-01-01

    We previously showed that free radicals and oxidative stress are involved in radiation-induced skin reactions. Since vitamin E (VE) is a particularly important lipophilic antioxidant, VE-deficient mice were used to examine its effects on radiation-induced skin damage. The VE content of the skin was reduced to one fourth of levels of normal mice. Neither the time of onset nor the extent of the reactions quantified with a scoring system differed between normal and VE-deficient mice after local X-irradiation (50 Gy). Similarly, there was no difference in the levels of the ascorbyl radical between the groups, although they were higher in irradiated skin than non-irradiated skin. X-irradiation increased the amount of Bax protein in the skin of normal mice both in the latent and acute inflammatory stages, time- and dose-dependently. The increase was associated with an increase in cytochrome c in the cytosolic fraction, indicating that apoptosis was also promoted by the irradiation. The increase in Bax protein correlated well with the thickness of the skin. Although a deficiency in VE should lower resistance to free radicals in the mitochondrial membrane and thus enhance radiation-induced Bax expression and apoptosis, it actually attenuated the increase in Bax protein caused by irradiation. (author)

  10. Natural gaits of the non-pathological flat foot and high-arched foot.

    Science.gov (United States)

    Fan, Yifang; Fan, Yubo; Li, Zhiyu; Lv, Changsheng; Luo, Donglin

    2011-03-18

    There has been a controversy as to whether or not the non-pathological flat foot and high-arched foot have an effect on human walking activities. The 3D foot scanning system was employed to obtain static footprints from subjects adopting a half-weight-bearing stance. Based upon their footprints, the subjects were divided into two groups: the flat-footed and the high-arched. The plantar pressure measurement system was used to measure and record the subjects' successive natural gaits. Two indices were proposed: distribution of vertical ground reaction force (VGRF) of plantar and the rate of change of footprint areas. Using these two indices to compare the natural gaits of the two subject groups, we found that (1) in stance phase, there is a significant difference (pplantar; (2) in a stride cycle, there is also a significant difference (pfootprint area. Our analysis suggests that when walking, the VGRF of the plantar brings greater muscle tension to the flat-footed while a smaller rate of change of footprint area brings greater stability to the high-arched.

  11. Skin reactions to histamine of healthy subjects after hypnotically induced emotions of sadness, anger, and happiness.

    Science.gov (United States)

    Zachariae, R; Jørgensen, M M; Egekvist, H; Bjerring, P

    2001-08-01

    The severity of symptoms in asthma and other hypersensitivity-related disorders has been associated with changes in mood but little is known about the mechanisms possibly mediating such a relationship. The purpose of this study was to examine the influence of mood on skin reactivity to histamine by comparing the effects of hypnotically induced emotions on flare and wheal reactions to cutaneous histamine prick tests. Fifteen highly hypnotically susceptible volunteers had their cutaneous reactivity to histamine measured before hypnosis at 1, 2, 3, 4, 5, 10, and 15 min after the histamine prick. These measurements were repeated under three hypnotically induced emotions of sadness, anger, and happiness presented in a counterbalanced order. Skin reactions were measured as change in histamine flare and wheal area in mm2 per minute. The increase in flare reaction in the time interval from 1 to 3 min during happiness and anger was significantly smaller than flare reactions during sadness (P<0.05). No effect of emotion was found for wheal reactions. Hypnotic susceptibility scores were associated with increased flare reactions at baseline (r=0.56; P<0.05) and during the condition of happiness (r=0.56; P<0.05). Our results agree with previous studies showing mood to be a predictor of cutaneous immediate-type hypersensitivity and histamine skin reactions. The results are also in concordance with earlier findings of an association between hypnotic susceptibility and increased reactivity to an allergen.

  12. Glucose metabolism in chronic diabetic foot ulcers measured in vivo using microdialysis

    DEFF Research Database (Denmark)

    Simonsen, L; Holstein, P; Larsen, K

    1998-01-01

    Ten subjects with diabetes mellitus and unilateral chronic foot ulcer were investigated. Local tissue concentrations of glucose and lactate were measured using the microdialysis method at a distance of 0.5-1 cm from the edge of the ulcer and in normal skin in the contralateral foot. Subcutaneous...

  13. The human touch: skin temperature during the rubber hand illusion in manual and automated stroking procedures.

    Directory of Open Access Journals (Sweden)

    Marieke Rohde

    Full Text Available A difference in skin temperature between the hands has been identified as a physiological correlate of the rubber hand illusion (RHI. The RHI is an illusion of body ownership, where participants perceive body ownership over a rubber hand if they see it being stroked in synchrony with their own occluded hand. The current study set out to replicate this result, i.e., psychologically induced cooling of the stimulated hand using an automated stroking paradigm, where stimulation was delivered by a robot arm (PHANToM(TM force-feedback device. After we found no evidence for hand cooling in two experiments using this automated procedure, we reverted to a manual stroking paradigm, which is closer to the one employed in the study that first produced this effect. With this procedure, we observed a relative cooling of the stimulated hand in both the experimental and the control condition. The subjective experience of ownership, as rated by the participants, by contrast, was strictly linked to synchronous stroking in all three experiments. This implies that hand-cooling is not a strict correlate of the subjective feeling of hand ownership in the RHI. Factors associated with the differences between the two designs (differences in pressure of tactile stimulation, presence of another person that were thus far considered irrelevant to the RHI appear to play a role in bringing about this temperature effect.

  14. Sparing effect of x-ray fractionation in mammary tumours and skin reactions of mice

    International Nuclear Information System (INIS)

    Fowler, J.F.; Denekamp, J.; Sheldon, P.W.; Smith, A.M.; Begg, A.C.; Harris, S.R.; Page, A.L.

    1975-01-01

    The increase in total dose with number of fractions of x-rays between 2 and 15 was found to be similar for local control of tumours (TCD 50 ) and for skin reactions. This result could be explained if the gain from reoxygenation of hypoxic tumour cells was the same for two fractions as for larger numbers, and the dose-sparing effect of repair and repopulation was similar for the tumour and for skin. In addition, a split-dose experiment was carried out with the tumours clamped off to make them acutely hypoxic during irradiation. The resulting value of (D 2 -D 1 )sub(24h) was not significantly smaller than the value previously found for skin reactions. 1290 rad was found in anoxic conditions, corresponding to a dose increment for repair in oxygenated conditions of 430 to 520 rad, assuming an oxygen enhancement ratio of 3 to 2.5. Reduced values have been found from regrowth experiments on two other types of tumour in mice. These results are consistent with no significant difference in the sparing effect of x-ray fractionation on skin or C 3 H mammary tumours in mice for up to 15 equal fractions given in 18 days; but reduced repair plus more proliferation in tumours than in skin cannot be excluded. (author)

  15. STUDIES ON BACTERIAL INFECTIONS OF DIABETIC FOOT ULCER

    African Journals Online (AJOL)

    Dr Oboro VO

    Microbial study for aerobic organisms from 100 cases of diabetic foot ulcers was carried out to determine the ... affect 239 million people world wide. ... cause the breakdown of the skin. ... complications, such as peripheral vascular disease,.

  16. Improving the Efficacy of Conventional Therapy by Adding Andrographolide Sulfonate in the Treatment of Severe Hand, Foot, and Mouth Disease: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Xiuhui Li

    2013-01-01

    Full Text Available Background. Herb-derived compound andrographolide sulfonate (called Xiyanping injection recommended control measure for severe hand, foot, and mouth disease (HFMD by the Ministry of Health (China during the 2010 epidemic. However, there is a lack of good quality evidence directly comparing the efficacy of Andrographolide Sulfonate combination therapy with conventional therapy. Methods. 230 patients were randomly assigned to 7–10 days of Andrographolide Sulfonate 5–10 mg/Kg/day and conventional therapy, or conventional therapy alone. Results. The major complications occurred less often after Andrographolide Sulfonate (2.6% versus 12.1%; risk difference [RD], 0.94; 95% CI, 0.28–1.61; P=0.006. Median fever clearance times were 96 hours (CI, 80 to 126 for conventional therapy recipients and 48 hours (CI, 36 to 54 for Andrographolide Sulfonate combination-treated patients (χ2=16.57, P<0.001. The two groups did not differ in terms of HFMD-cause mortality (P=1.00 and duration of hospitalization (P=0.70. There was one death in conventional therapy group. No important adverse event was found in Andrographolide Sulfonate combination therapy group. Conclusions. The addition of Andrographolide Sulfonate to conventional therapy reduced the occurrence of major complications, fever clearance time, and the healing time of typical skin or oral mucosa lesions in children with severe HFMD.

  17. SU-E-J-273: Skin Temperature Recovery Rate as a Potential Predictor for Radiation-Induced Skin Reactions

    Energy Technology Data Exchange (ETDEWEB)

    Biswal, N C; Wu, Z; Chu, J [Rush University Medical Center, Chicago, IL (United States); Sun, J [Argonne National Laboratory, Lemont, IL (United States)

    2015-06-15

    Purpose: To assess the potential of dynamic infrared imaging to evaluate early skin reactions during radiation therapy in cancer patients. Methods: Thermal images were captured by our home-built system consisting of two flash lamps and an infrared (IR) camera. The surface temperature of the skin was first raised by ∼ 6 °C from ∼1 ms short flashes; the camera then captured a series of IR images for 10 seconds. For each image series, a basal temperature was recorded for 0.5 seconds before flash was triggered. The temperature gradients (ε) were calculated between a reference point (immediately after the flash) and at a time point of 2sec, 4sec and 9sec after that. A 1.0 cm region of interest (ROI) on the skin was drawn; the mean and standard deviations of the ROIs were calculated. The standard ε values for normal human skins were evaluated by imaging 3 healthy subjects with different skin colors. All of them were imaged on 3 separate days for consistency checks. Results: The temperature gradient, which is the temperature recovery rate, depends on the thermal properties of underlying tissue, i.e. thermal conductivity. The average ε for three volunteers averaged over 3 measurements were 0.64±0.1, 0.72±0.2 and 0.80±0.3 at 2sec, 4sec and 9sec respectively. The standard deviations were within 1.5%–3.2%. One of the volunteers had a prior small skin burn on the left wrist and the ε values for the burned site were around 9% (at 4sec) and 13% (at 9sec) lower than that from the nearby normal skin. Conclusion: The temperature gradients from the healthy subjects were reproducible within 1.5%–3.2 % and that from a burned skin showed a significant difference (9%–13%) from the normal skin. We have an IRB approved protocol to image head and neck patients scheduled for radiation therapy.

  18. SU-E-J-273: Skin Temperature Recovery Rate as a Potential Predictor for Radiation-Induced Skin Reactions

    International Nuclear Information System (INIS)

    Biswal, N C; Wu, Z; Chu, J; Sun, J

    2015-01-01

    Purpose: To assess the potential of dynamic infrared imaging to evaluate early skin reactions during radiation therapy in cancer patients. Methods: Thermal images were captured by our home-built system consisting of two flash lamps and an infrared (IR) camera. The surface temperature of the skin was first raised by ∼ 6 °C from ∼1 ms short flashes; the camera then captured a series of IR images for 10 seconds. For each image series, a basal temperature was recorded for 0.5 seconds before flash was triggered. The temperature gradients (ε) were calculated between a reference point (immediately after the flash) and at a time point of 2sec, 4sec and 9sec after that. A 1.0 cm region of interest (ROI) on the skin was drawn; the mean and standard deviations of the ROIs were calculated. The standard ε values for normal human skins were evaluated by imaging 3 healthy subjects with different skin colors. All of them were imaged on 3 separate days for consistency checks. Results: The temperature gradient, which is the temperature recovery rate, depends on the thermal properties of underlying tissue, i.e. thermal conductivity. The average ε for three volunteers averaged over 3 measurements were 0.64±0.1, 0.72±0.2 and 0.80±0.3 at 2sec, 4sec and 9sec respectively. The standard deviations were within 1.5%–3.2%. One of the volunteers had a prior small skin burn on the left wrist and the ε values for the burned site were around 9% (at 4sec) and 13% (at 9sec) lower than that from the nearby normal skin. Conclusion: The temperature gradients from the healthy subjects were reproducible within 1.5%–3.2 % and that from a burned skin showed a significant difference (9%–13%) from the normal skin. We have an IRB approved protocol to image head and neck patients scheduled for radiation therapy

  19. Prevalence and Characterization of Enterovirus Infections among Pediatric Patients with Hand Foot Mouth Disease, Herpangina and Influenza Like Illness in Thailand, 2012

    Science.gov (United States)

    Puenpa, Jiratchaya; Mauleekoonphairoj, John; Linsuwanon, Piyada; Suwannakarn, Kamol; Chieochansin, Thaweesak; Korkong, Sumeth; Theamboonlers, Apiradee; Poovorawan, Yong

    2014-01-01

    Hand, foot, and mouth disease (HFMD) and herpangina are common infectious diseases caused by several genotypes of human enterovirus species A and frequently occurring in young children. This study was aimed at analyzing enteroviruses from patients with these diseases in Thailand in 2012. Detection and genotype determination of enteroviruses were accomplished by reverse transcription-polymerase chain reaction and sequencing of the VP1 region. Enterovirus-positive samples were differentiated into 17 genotypes (coxsackievirus A4 (CAV4), A5, A6, A8, A9, A10, A12, A16, A21, B1, B2, B4, B5, echovirus 7, 16, 25 and Enterovirus 71). The result showed CAV6 (33.5%), followed by CAV16 (9.4%) and EV71 (8.8%) as the most frequent genotypes in HFMD, CAV8 (19.3%) in herpangina and CAV6 (1.5%) in influenza like illness. Enterovirus infections were most prevalent during July with 34.4% in HFMD, 39.8% in herpangina and 1.6% in ILI. The higher enterovirus infection associated with HFMD and herpangina occurred in infants over one year-old. This represents the first report describing the circulation of multiple enteroviruses in Thailand. PMID:24887237

  20. Cutaneous reaction associated with weekly docetaxel administration.

    Science.gov (United States)

    Chew, Lita; Chuen, Vivianne Shih Lee

    2009-03-01

    Docetaxel-based chemotherapy will remain clinically relevant and many of our patients will continue to receive the drug. In a recent phase 2 study of docetaxel 35 mg/m2 (weekly) in patients with metastatic breast cancer, the incidence of grade 3 cutaneous toxicity is 19%. The skin toxicity observed consists of limb/palmar-plantar erythematous reactions, or fixed-plaque erythrodysesthesia. Case series or reports have reported varied manifestations of skin reactions and include erythema multiforme, nail changes (onycholysis, pigmentation, paronychia), scleroderma, supravenous discoloration, radiation recall dermatitis, and flagellate erythema. We would like to report four patients with cutaneous reactions resulting from weekly administration of docetaxel. All cases are heavily pre-treated patients, receiving docetaxel as second or third line therapy. The cutaneous reactions occur at cycle 5. The time between chemotherapy to development of skin lesions is from 1 to 7 days. Lesions usually resolve with desquamation leaving behind areas with hyper-pigmentation or hypo-pigmentation over a period of 2 to 3 weeks. The management strategies include hand elevation, warm or cold compresses, topical and/or systemic antibiotics, topical and/or systemic corticosteroids, and cessation of drug. There is a need for a systematic approach to manage these cutaneous reactions. Oncology trained pharmacists play vital roles in assessing, managing, documenting and patient education.

  1. Complete genome sequence analysis of enterovirus 71 isolated from children with hand, foot, and mouth disease in Thailand, 2012-2014.

    Science.gov (United States)

    Mauleekoonphairoj, John; Vongpunsawad, Sompong; Puenpa, Jiratchaya; Korkong, Sumeth; Poovorawan, Yong

    2015-10-01

    The complete genomic sequences of 14 enterovirus 71 (EV71) strains isolated from children with hand, foot, and mouth disease in Thailand from 2012 to 2014 were determined and compared to enterovirus group A prototypes. Phylogenetic analysis revealed that 13 strains resembled the B5 subgroup, while one strain from a fatal case designated THA_1219 belonged to the C4 subgroup. Similarity plot and bootscan analyses suggested that THA_1219 underwent recombination in the P2 and P3 regions. Full-genome data from this work will contribute to the study of evolution dynamics of EV71.

  2. Magnitude and Spatial Distribution of Impact Intensity Under the Foot Relates to Initial Foot Contact Pattern.

    Science.gov (United States)

    Breine, Bastiaan; Malcolm, Philippe; Segers, Veerle; Gerlo, Joeri; Derie, Rud; Pataky, Todd; Frederick, Edward C; De Clercq, Dirk

    2017-12-01

    In running, foot contact patterns (rear-, mid-, or forefoot contact) influence impact intensity and initial ankle and foot kinematics. The aim of the study was to compare impact intensity and its spatial distribution under the foot between different foot contact patterns. Forty-nine subjects ran at 3.2 m·s -1 over a level runway while ground reaction forces (GRF) and shoe-surface pressures were recorded and foot contact pattern was determined. A 4-zone footmask (forefoot, midfoot, medial and lateral rearfoot) assessed the spatial distribution of the vertical GRF under the foot. We calculated peak vertical instantaneous loading rate of the GRF (VILR) per foot zone as the impact intensity measure. Midfoot contact patterns were shown to have the lowest, and atypical rearfoot contact patterns the highest impact intensities, respectively. The greatest local impact intensity was mainly situated under the rear- and midfoot for the typical rearfoot contact patterns, under the midfoot for the atypical rearfoot contact patterns, and under the mid- and forefoot for the midfoot contact patterns. These findings indicate that different foot contact patterns could benefit from cushioning in different shoe zones.

  3. Hydrogel-forming microneedles increase in volume during swelling in skin, but skin barrier function recovery is unaffected

    Science.gov (United States)

    Donnelly, Ryan F.; Mooney, Karen; McCrudden, Maelíosa T.C.; Vicente-Pérez, Eva M.; Belaid, Luc; González-Vázquez, Patricia; McElnay, James C.; Woolfson, A. David

    2014-01-01

    We describe, for the first time, quantification of in-skin swelling and fluid uptake by hydrogel-forming microneedle arrays (MN) and skin barrier recovery in human volunteers. Such MN, prepared from aqueous blends of hydrolysed poly(methylvinylether/maleicanhydride) (15% w/w) and the crosslinker poly(ethyleneglycol) 10,000 daltons (7.5% w/w), were inserted into the skin of human volunteers (n = 15) to depths of approximately 300 μm by gentle hand pressure. The MN swelled in skin, taking up skin interstitial fluid, such that their mass had increased by approximately 30% after 6 hours in skin. Importantly, however, skin barrier function recovered within 24 hours post microneedle removal, regardless of how long the MN had been in skin or how much their volume had increased with swelling. Further research on closure of MN-induced micropores is required, since transepidermal water loss measurements suggested micropore closure, while optical coherence tomography indicated that MN-induced micropores had not closed over, even 24 hours after MN had been removed. There were no complaints of skin reactions, adverse events or strong views against MN use by any of the volunteers. Only some minor erythema was noted after patch removal, although this always resolved within 48 hours and no adverse events were present on follow-up. PMID:24633895

  4. Natural gaits of the non-pathological flat foot and high-arched foot.

    Directory of Open Access Journals (Sweden)

    Yifang Fan

    Full Text Available There has been a controversy as to whether or not the non-pathological flat foot and high-arched foot have an effect on human walking activities. The 3D foot scanning system was employed to obtain static footprints from subjects adopting a half-weight-bearing stance. Based upon their footprints, the subjects were divided into two groups: the flat-footed and the high-arched. The plantar pressure measurement system was used to measure and record the subjects' successive natural gaits. Two indices were proposed: distribution of vertical ground reaction force (VGRF of plantar and the rate of change of footprint areas. Using these two indices to compare the natural gaits of the two subject groups, we found that (1 in stance phase, there is a significant difference (p<0.01 in the distributions of VGRF of plantar; (2 in a stride cycle, there is also a significant difference (p<0.01 in the rate of change of footprint area. Our analysis suggests that when walking, the VGRF of the plantar brings greater muscle tension to the flat-footed while a smaller rate of change of footprint area brings greater stability to the high-arched.

  5. Effects of combined radiation-burn injury on survival rate of allogeneic skin grafts and immune reaction in rats

    International Nuclear Information System (INIS)

    Ran Xinze; Yan Yongtang; Cheng Tianmin; Li Yuan; Wei Shuqing

    1996-01-01

    The effects of combined radiation-burn injury on survival rate of allogeneic skin grafts and immune reaction were studied in rats with combined injury of 3-8 Gy 60 Co γ-ray irradiation plus 15% total body surface area full thickness burn induced by exposure to a 5 kw bromotungsten lamp. The allogeneic skin was transplanted 24 hours after injury. It was found that all the skin grafts failed to survive in 10 days and the immune reaction significantly increased in the early stage of burn injury. But the immune reaction was obviously suppressed by the combined radiation-burn injury. The survival rates of skin grafts were 20% and 30% in the combined injury of burn plus 3 and 4 Gy irradiation respectively. When the radiation doses increased to 5,6 and 8 Gy, the survival rates elevated to 69%, 88% and 100% respectively (in the group of 8 Gy, bone marrow transplantation was conducted before receiving skin graft). At day 30 post-transplantation the survival rates were still 36%, 42% and 100% respectively. Compared with burn group, there was a significant difference in survival rate when the radiation doses were higher than 5 Gy. These results indicate that the survival rate of the allogeneic skin graft increases concurrently with the increase in radiation dose and decreases with the elapse of the post-transplantation time

  6. Fourteen types of co-circulating recombinant enterovirus were associated with hand, foot, and mouth disease in children from Wenzhou, China.

    Science.gov (United States)

    Guo, Wen-Ping; Lin, Xian-Dan; Chen, Yi-Ping; Liu, Qi; Wang, Wen; Wang, Cai-Qiao; Li, Ming-Hui; Sun, Xiao-Yu; Shi, Mang; Holmes, Edward C; Zhang, Yong-Zhen

    2015-09-01

    Although hand, foot, and mouth disease (HFMD) is a major public concern in China, the prevalence and clinical symptoms associated with the different agents of HFMD in this country remain poorly understood. We investigated the clinical and molecular characteristics of enteroviruses in patients with HFMD from Wenzhou, China. Patients with laboratory-confirmed HFMD admitted to the Yuying Children's Hospital in Wenzhou, China during 2013 were included in this study. Viral RNA sequences were amplified using RT-PCR, determined by sequencing, and compared by phylogenetic analysis. A total of 955 clinically diagnosed HFMD cases were determined using PCR, with whole viral genomes obtained for each enterovirus type. 14 types of enterovirus belonging to two viral species were identified. Notably, Coxsackievirus A6 (CV-A6) was the most common species detected (77.8%), followed by EV-A71 (8.2%) and CV-A10 (8.1%). Phylogenetic analysis revealed multiple independent introductions of these viruses into Wenzhou. In addition, the enterovirus observed in Wenzhou had a recombinant history, with two or three recombination breakpoints. Although the illness associated with CV-A6 was milder than that of EV-A71, CV-A6 infection caused more widespread rash, larger blisters, and subsequent skin peeling and/or nail shedding. Our study revealed the co-circulation of 14 types of enteroviruses in a single location - Wenzhou, China - with CV-A6 virus the predominant agent of HFMD. This work highlights the need to perform larger-scale surveillance to fully understand the epidemiology of enteroviruses in China and the wider Asia-Pacific region. Copyright © 2015 Elsevier B.V. All rights reserved.

  7. Skin protection creams in medical settings: successful or evil?

    Directory of Open Access Journals (Sweden)

    Charlier Corinne

    2008-07-01

    Full Text Available Abstract Background Chronic exposure to mild irritants including cleansing and antiseptic products used for hand hygiene generates insults to the skin. To avoid unpleasant reactions, skin protection creams are commonly employed, but some fail to afford protection against a variety of xenobiotics. In this study, two skin protection creams were assayed comparatively looking for a protective effect if any against a liquid soap and an alcohol-based gel designed for hand hygiene in medical settings. Methods Corneosurfametry and corneoxenometry are two in vitro bioessays which were selected for their good reproducibility, sensitivity and ease of use. A Kruskal-Wallis ANOVA test followed by the Dunn test was realized to compare series of data obtained. Results Significant differences in efficacy were obtained between the two assayed skin protection creams. One of the two tested creams showed a real protective effect against mild irritants, but the other tested cream presented an irritant potential in its application with mild irritants. Conclusion The differences observed for the two tested skin protection creams were probably due to their galenic composition and their possible interactions with the offending products. As a result, the present in vitro bioassays showed contrasted effects of the creams corresponding to either a protective or an irritant effect on human stratum corneum.

  8. Hand-foot syndrome in a patient with metastatic lung adenocarcinoma induced by high-dose icotinib: A case report and review of the literature

    OpenAIRE

    ZHENG, YULONG; FANG, WEIJIA; XU, NONG

    2012-01-01

    Icotinib is a new oral epidermal growth factor tyrosine kinase inhibitor (EGFR-TKI). The most frequent side-effects of icotinib include rash and diarrhea. Hand-foot syndrome (HFS) induced by EGFR-TKI is rare. The present study describes, for the first time, HFS induced by high-dose icotinib in a 65-year old female with metastatic lung adenocarcinoma. The patient developed HFS during the first week of icotinib treatment with characteristic clinical presentation. HFS regressed after icotinib do...

  9. MR Imaging of the Diabetic Foot.

    Science.gov (United States)

    McCarthy, Eoghan; Morrison, William B; Zoga, Adam C

    2017-02-01

    Abnormalities of the peripheral nervous, vascular, and immune systems contribute to the development of numerous foot and ankle pathologies in the diabetic population. Although radiographs remain the most practical first-line imaging tool, magnetic resonance (MR) is the tertiary imaging modality of choice, allowing for optimal assessment of bone and soft tissue abnormalities. MR allows for the accurate distinction between osteomyelitis/septic arthritis and neuropathic osteoarthropathy. Furthermore, it provides an excellent presurgical anatomic road map of involved tissues and devitalized skin to ensure successful limited amputations when required. Signal abnormality in the postoperative foot aids in the diagnosis of recurrent infection. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Diabetic foot ulcers: Part II. Management.

    Science.gov (United States)

    Alavi, Afsaneh; Sibbald, R Gary; Mayer, Dieter; Goodman, Laurie; Botros, Mariam; Armstrong, David G; Woo, Kevin; Boeni, Thomas; Ayello, Elizabeth A; Kirsner, Robert S

    2014-01-01

    The management of diabetic foot ulcers can be optimized by using an interdisciplinary team approach addressing the correctable risk factors (ie, poor vascular supply, infection control and treatment, and plantar pressure redistribution) along with optimizing local wound care. Dermatologists can initiate diabetic foot care. The first step is recognizing that a loss of skin integrity (ie, a callus, blister, or ulcer) considerably increases the risk of preventable amputations. A holistic approach to wound assessment is required. Early detection and effective management of these ulcers can reduce complications, including preventable amputations and possible mortality. Copyright © 2013 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  11. Effects of Na-sucrose Octasulfate on skin and mucosa reactions during radiotherapy of head and neck cancers - A randomized prospective study

    Energy Technology Data Exchange (ETDEWEB)

    Evensen, Jan F.; Bjordal, K.; Jacobsen, Anne-Birgitte; Loekkevik, E.; Tausjoe, J.E. [Norwegian Radium Hospital, Oslo (Norway). Dept. of Medical Oncology and Radiotherapy

    2001-11-01

    Na sucrose octasulfate (Na SOS) was tested for ability to relieve radiation-induced acute skin and mucosal reactions in patients with head and neck cancer. Sixty patients were included in this prospective, double-blind, randomized study. Skin and mucosal reactions were scored using several variables. No statistically significant difference was found between the results with Na SOS and those with placebo for any of the variables, with the exception of skin desquamation, which showed a significant difference in the placebo group. The most likely explanation for this is that the Na SOS gel itself left behind a flaky layer that was difficult to distinguish from radiation-induced flaking. In conclusion, we cannot recommend Na SOS in the routine management of radiation-induced skin and mucosal reactions.

  12. Foot Pedals for Spacecraft Manual Control

    Science.gov (United States)

    Love, Stanley G.; Morin, Lee M.; McCabe, Mary

    2010-01-01

    Fifty years ago, NASA decided that the cockpit controls in spacecraft should be like the ones in airplanes. But controls based on the stick and rudder may not be best way to manually control a vehicle in space. A different method is based on submersible vehicles controlled with foot pedals. A new pilot can learn the sub's control scheme in minutes and drive it hands-free. We are building a pair of foot pedals for spacecraft control, and will test them in a spacecraft flight simulator.

  13. A split hand-split foot (SHFM3) gene is located at 10q24{yields}25

    Energy Technology Data Exchange (ETDEWEB)

    Gurrieri, F.; Genuardi, M.; Nanni, L.; Sangiorgi, E.; Garofalo, G. [Catholic Univ. of Rome (Italy)] [and others

    1996-04-24

    The split hand-split foot (SHSF) malformation affects the central rays of the upper and lower limbs. It presents either as an isolated defect or in association with other skeletal or non-skeletal abnormalities. An autosomal SHSF locus (SHFM1) was previously mapped to 7q22.1. We report the mapping of a second autosomal SHSF locus to 10q24{yields}25 region. Maximum lod scores of 3.73, 4.33 and 4.33 at a recombination fraction of zero were obtained for the loci D10S198, PAX2 and D10S1239, respectively. An 19 cM critical region could be defined by haplotype analysis and several genes with a potential role in limb morphogenesis are located in this region. Heterogeneity testing indicates the existence of at least one additional autosomal SHSF locus. 36 refs., 3 figs., 3 tabs.

  14. [The Effectiveness of Cooling Packaging Care in Relieving Chemotherapy-Induced Skin Toxicity Reactions in Cancer Patients Receiving Chemotherapy: A Systematic Review].

    Science.gov (United States)

    Hsu, Ya-Hui; Hung, Hsing-Wei; Chen, Shu-Ching

    2017-08-01

    Anti-cancer chemotherapy may cause skin-toxicity reactions. Different types of cooling packages affect chemotherapy-induced skin toxicity reactions differently. To evaluate the effects of cooling packing care on chemotherapy-induced skin toxicity reactions in cancer patients receiving chemotherapy. A systematic review approach was used. Searches were conducted in databases including Cochrane Library, Embase, MEDLINE, PubMed and Airiti Library using the keywords "chemotherapy cutaneous toxicity", "chemotherapy skin reaction", "chemotherapy skin toxicity", "frozen glove", "frozen sock", "cooling packaging care", "ice gloves", "ice socks", "usual care", "severity", "comfort", "satisfaction", "severity", and "comfort". The search focused on articles published before December 2016. Based on the inclusion and exclusion criteria, 5 articles involving relevant randomized controlled trials were extracted for review. Elasto-Gel ice gloves or ice socks that were chilled to -25°C- -30°C and used for 15 mins during initial chemotherapy, for one hour during chemotherapy infusion, and for 15 mins after chemotherapy were shown to improve the frequency and severity of chemotherapy-induced skin toxicity reactions. Several studies were limited by small sample sizes and different types of cooling packing programs, temperature, timing, and frequency. Thus, further research is recommended to verify the effects of cooling packing care. Cancer patients who were treated with docetaxel or PLD and who used ice gloves or ice socks that were chilled to -25°C- -30°C for 15 mins during initial chemotherapy, for one hour during chemotherapy infusion, and for 15 mins after chemotherapy improved significantly in terms of the frequency and severity of their chemotherapy-induced skin toxicity reactions. Local cooling packing care is a non-pharmacotherapy approach that is low cost and free of side effects. This review is intended to provide a reference for clinical care.

  15. Skin protection in the food industry.

    Science.gov (United States)

    Bauer, A; Kelterer, D; Bartsch, R; Stadeler, M; Elsner, P

    2007-01-01

    In food occupations, like in many other skin risk occupations, the regular use of personal protection equipment, i.e. of skin protection ointments and protective gloves, is recommended as well as regular skin care for the prevention of occupational hand dermatitis. We investigated the uptake and maintenance of different prevention strategies (instructions for skin protection and skin care, prevocational skin hardening with UV light) in food occupations and their efficacy in the primary prevention of vocationally caused hand dermatitis. We could show that the acceptance and regular use of skin protection and care measures could be significantly increased by theoretical and practical instructions in food industry trainees. The highest acceptance was seen with skin protection ointment (100%) and skin care (90%). Protective gloves (43.3%) were used to a lesser extent. The hand dermatitis point prevalence in the groups after 6 months was 13.3% (skin protection), 19.4% (UV hardening) and 29.1% (controls). These clinical trends were supported by statistically significant differences in the basal TEWL values. Adequate skin protection and regular skin care seem to be promising for the prevention of occupationally caused hand dermatitis. The experimental approach using UV hardening prevocationally did not fulfil the expectations.

  16. A methodological framework for detecting ulcers' risk in diabetic foot subjects by combining gait analysis, a new musculoskeletal foot model and a foot finite element model.

    Science.gov (United States)

    Scarton, Alessandra; Guiotto, Annamaria; Malaquias, Tiago; Spolaor, Fabiola; Sinigaglia, Giacomo; Cobelli, Claudio; Jonkers, Ilse; Sawacha, Zimi

    2018-02-01

    Diabetic foot is one of the most debilitating complications of diabetes and may lead to plantar ulcers. In the last decade, gait analysis, musculoskeletal modelling (MSM) and finite element modelling (FEM) have shown their ability to contribute to diabetic foot prevention and suggested that the origin of the plantar ulcers is in deeper tissue layers rather than on the plantar surface. Hence the aim of the current work is to develop a methodology that improves FEM-derived foot internal stresses prediction, for diabetic foot prevention applications. A 3D foot FEM was combined with MSM derived force to predict the sites of excessive internal stresses on the foot. In vivo gait analysis data, and an MRI scan of a foot from a healthy subject were acquired and used to develop a six degrees of freedom (6 DOF) foot MSM and a 3D subject-specific foot FEM. Ankle kinematics were applied as boundary conditions to the FEM together with: 1. only Ground Reaction Forces (GRFs); 2. OpenSim derived extrinsic muscles forces estimated with a standard OpenSim MSM; 3. extrinsic muscle forces derived through the (6 DOF) foot MSM; 4. intrinsic and extrinsic muscles forces derived through the 6 DOF foot MSM. For model validation purposes, simulated peak pressures were extracted and compared with those measured experimentally. The importance of foot muscles in controlling plantar pressure distribution and internal stresses is confirmed by the improved accuracy in the estimation of the peak pressures obtained with the inclusion of intrinsic and extrinsic muscle forces. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Chemical kinetics of multiphase reactions between ozone and human skin lipids: Implications for indoor air quality and health effects.

    Science.gov (United States)

    Lakey, P S J; Wisthaler, A; Berkemeier, T; Mikoviny, T; Pöschl, U; Shiraiwa, M

    2017-07-01

    Ozone reacts with skin lipids such as squalene, generating an array of organic compounds, some of which can act as respiratory or skin irritants. Thus, it is important to quantify and predict the formation of these products under different conditions in indoor environments. We developed the kinetic multilayer model that explicitly resolves mass transport and chemical reactions at the skin and in the gas phase (KM-SUB-Skin). It can reproduce the concentrations of ozone and organic compounds in previous measurements and new experiments. This enabled the spatial and temporal concentration profiles in the skin oil and underlying skin layers to be resolved. Upon exposure to ~30 ppb ozone, the concentrations of squalene ozonolysis products in the gas phase and in the skin reach up to several ppb and on the order of ~10 mmol m -3 . Depending on various factors including the number of people, room size, and air exchange rates, concentrations of ozone can decrease substantially due to reactions with skin lipids. Ozone and dicarbonyls quickly react away in the upper layers of the skin, preventing them from penetrating deeply into the skin and hence reaching the blood. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  18. Ultra-weak photon emission as a non-invasive tool for monitoring of oxidative processes in the epidermal cells of human skin: comparative study on the dorsal and the palm side of the hand.

    Science.gov (United States)

    Rastogi, Anshu; Pospísil, Pavel

    2010-08-01

    All living organisms emit spontaneous ultra-weak photon emission as a result of cellular metabolic processes. Exposure of living organisms to exogenous factors results in oxidative processes and enhancement in ultra-weak photon emission. Here, hydrogen peroxide (H(2)O(2)), as a strongly oxidizing molecule, was used to induce oxidative processes and enhance ultra-weak photon emission in human hand skin. The presented work intends to compare both spontaneous and peroxide-induced ultra-weak photon emission from the epidermal cells on the dorsal and the palm side of the hand. A highly sensitive photomultiplier tube and a charge-coupled device camera were used to detect ultra-weak photon emission from human hand skin. Spontaneous ultra-weak photon emission from the epidermal cells on the dorsal side of the hand was 4 counts/s. Topical application of 500 mM H(2)O(2) to the dorsal side of the hand caused enhancement in ultra-weak photon emission to 40 counts/s. Interestingly, both spontaneous and peroxide-induced ultra-weak photon emission from the epidermal cells on the palm side of the hand were observed to increase twice their values, i.e. 8 and 80 counts/s, respectively. Similarly, the two-dimensional image of ultra-weak photon emission observed after topical application of H(2)O(2) to human skin reveals that photon emission from the palm side exceeds the photon emission from the dorsal side of the hand. The results presented indicate that the ultra-weak photon emission originating from the epidermal cells on the dorsal and the palm side of the hand is related to the histological structure of the human hand skin. Ultra-weak photon emission is shown as a non-destructive technique for monitoring of oxidative processes in the epidermal cells of the human hand skin and as a diagnostic tool for skin diseases.

  19. The defence technique in Tai Chi Push Hands: a case study.

    Science.gov (United States)

    Chen, Hui-Chuan; Cheng, Kuang-You B; Liu, Yu-Jen; Chiu, Hung-Ta; Cheng, Kuang-Yu

    2010-12-01

    Developed from traditional Chinese martial arts, Tai Chi exercise includes different forms and interactive Push Hands but biomechanical analyses have focused on the former only. To analyse the techniques of Push Hands, an experienced master was asked to defend pushing by four opponents. Movements were videotaped and digitized using a motion analysis system. Surface electrodes were used to record the electromyographic activity of ten muscle groups. Two force plates were used to measure the ground reaction force on each foot. Inexperienced individuals performed the same procedure to serve as the control group. The results indicate that the master adopted a postural adjustment to maintain balance. A clear shift of body weight from the front to the rear foot and mediolateral displacement of the centre of gravity was observed. Low electromyographic activity was observed in the upper body muscle groups, while high electromyographic activity was observed in the right rectus femoris and very high activity in the left rectus femoris during the defence. All inexperienced participants lost their balance in resisting pushing. It is concluded that the Tai Chi defensive technique includes a subtle postural adjustment that slightly changes the pushing force direction, and allows the rear leg to resist the incoming force.

  20. The Epidemiology of Hand, Foot and Mouth Disease in Asia

    Science.gov (United States)

    Koh, Wee Ming; Bogich, Tiffany; Siegel, Karen; Jin, Jing; Chong, Elizabeth Y.; Tan, Chong Yew; Chen, Mark IC; Horby, Peter

    2016-01-01

    Context: Hand, foot and mouth disease (HFMD) is a widespread pediatric disease caused primarily by human enterovirus 71 (EV-A71) and Coxsackievirus A16 (CV-A16). Objective: This study reports a systematic review of the epidemiology of HFMD in Asia. Data Sources: PubMed, Web of Science and Google Scholar were searched up to December 2014. Study Selection: Two reviewers independently assessed studies for epidemiologic and serologic information about prevalence and incidence of HFMD against predetermined inclusion/exclusion criteria. Data Extraction: Two reviewers extracted answers for 8 specific research questions on HFMD epidemiology. The results are checked by 3 others. Results: HFMD is found to be seasonal in temperate Asia with a summer peak and in subtropical Asia with spring and fall peaks, but not in tropical Asia; evidence of a climatic role was identified for temperate Japan. Risk factors for HFMD include hygiene, age, gender and social contacts, but most studies were underpowered to adjust rigorously for confounding variables. Both community-level and school-level transmission have been implicated, but their relative importance for HFMD is inconclusive. Epidemiologic indices are poorly understood: No supporting quantitative evidence was found for the incubation period of EV-A71; the symptomatic rate of EV-A71/Coxsackievirus A16 infection was from 10% to 71% in 4 studies; while the basic reproduction number was between 1.1 and 5.5 in 3 studies. The uncertainty in these estimates inhibits their use for further analysis. Limitations: Diversity of study designs complicates attempts to identify features of HFMD epidemiology. Conclusions: Knowledge on HFMD remains insufficient to guide interventions such as the incorporation of an EV-A71 vaccine in pediatric vaccination schedules. Research is urgently needed to fill these gaps. PMID:27273688

  1. Skin temperature in the extremities of healthy and neurologically impaired children.

    Science.gov (United States)

    Svedberg, Lena E; Stener-Victorin, Elisabet; Nordahl, Gunnar; Lundeberg, Thomas

    2005-01-01

    Little emphasis has been accorded to peripheral skin temperature impairments in children with neurological disorders but attention has been paid to the significance of cold extremities (autonomic failure) for well-being and quality of life in adults stroke patients. Therefore, it seems important to investigate skin temperature in children with neurological disorder, especially when their communication is impaired. In the present study, we wanted to objectively verify any skin temperature differences between pre-school children with and without neurological disorders and also ascertain if any correlation existed between skin temperature and physical activity. Skin temperatures in 25 healthy children and 15 children with cerebral or spinal cord damages were assessed using infrared radiation. The temperatures were recorded on the palm and the dorsal surface of the hands and on the sole and dorsal surface of the feet three times at 15-minute intervals over 30min. A significant lower mean skin temperature in all measurement points was seen in non-walking children with cerebral damages compared to healthy controls. Also, the mean skin temperature was significantly lower in all foot measuring points in the children with cerebral damages that were unable to walk compared to those walking. In conclusion, as cold extremities may result in impaired well-being and hypothetically may be associated with other symptoms born by the child, further investigations of thermal dysfunction and autonomic function are of importance and treatment may be warranted.

  2. The Effects of Weather Factors on Hand, Foot and Mouth Disease in Beijing

    Science.gov (United States)

    Dong, Weihua; Li, Xian'En; Yang, Peng; Liao, Hua; Wang, Xiaoli; Wang, Quanyi

    2016-01-01

    The morbidity and mortality of hand, foot and mouth disease (HFMD) are increasing in Beijing, China. Previous studies have indicated an association between incidents of HFMD and weather factors. However, the seasonal influence of these factors on the disease is not yet understood, and their relationship with the enterovirus 71 (EV71) and Coxsackie virus A16 (CV-A16) viruses are not well documented. We analysed 84,502 HFMD cases from 2008 to 2011 in Beijing to explore the seasonal influence of weather factors (average temperature [AT], average relative humidity [ARH], total precipitation [TP] and average wind speed [AWS]) on incidents of HFMD by using a geographically weighted regression (GWR) model. The results indicated that weather factors differ significantly in their influence on HFMD depending on the season. AT had the greatest effect among the four weather factors, and while the influence of AT and AWS was greater in the summer than in the winter, the influence of TP was positive in the summer and negative in the winter. ARH was negatively correlated with HFMD. Also, we observed more EV71-associated cases than CV-A16 but there is no convincing evidence to show significant differences between the influences of the weather factors on EV71 and CV-A16.

  3. GIANT HAND LIPOMA-CASE REPORT OF A RARE LOCALIZATION OF A COMMON TYPE OF TUMOR

    Directory of Open Access Journals (Sweden)

    Radivojcevic Uros

    2016-07-01

    Full Text Available Introduction: A lipoma is a benign tumor of the adipose tissue and the most common tumor of the subcutaneous tissue which is most commonly found on the trunk. It appears as a round or oval subcutaneous mass of soft consistency, which is not attached to the skin or to the deeper tissues. Its growth can cause compressive symptoms, the most common being pain and paresthesia. Case report: Considering the fact that lipomas very rarely occur in the hand and foot, in this paper we present a case of a large lipoma in the hand of a 70-year-old female patient, with a subcutaneous tumor, in the area of the ulnar side of the left palm, and the pain and tingling in the fourth and fifth finger. Longitudinal incision on the medial side of the palm and transversal incision up to the proximal palmar crease were performed under general endotracheal anesthesia. The extirpated tumor was, due to its dimensions (5.6 x 3.4 x 2.5 cm, categorized as a giant hand lipoma. A histopathological analysis confirmed the diagnosis of lipoma. Conclusion: A hand lipoma requires surgical treatment exclusively, involving a qualified hand surgeon, which is important because of the high functional and aesthetic importance of the hand.

  4. Diabetic foot--what can we learn from leprosy? Legacy of Dr Paul W. Brand.

    Science.gov (United States)

    Boulton, Andrew J M

    2012-02-01

    Leprosy and diabetes, though two very different conditions, may both result in severe loss of sensation in the feet, which are then a great risk of painless injury and ulceration. Seminal observations made by the late Dr Paul W. Brand, a surgeon working with leprosy patients in South India in the mid-20th century, resulted in the subsequent development of treatments to manage insensitive foot ulcers that are today entirely applicable to patients with diabetes. As a consequence of his research, the recognition of the relationship between insensitivity, repetitive pressures and skin breakdown has helped our understanding of the aetiopathogenesis of neuropathic foot lesions in diabetes: the development of the total contact cast and other casting devices to treat such lesions forms the basis of management of diabetic foot lesions with off-loading devices that are widely used in the 21st century in diabetic foot clinics around the world. Moreover, observations by Brand that the foot 'heats up before it breaks down' resulted in more recent research showing that self-skin temperature monitoring might help reduce the incidence of recurrent neuropathic foot ulcers in diabetes. In summary, Brand's understanding of 'the gift of pain' that, when lost, results in the late complications of diabetic neuropathy has guided the prevention, diagnosis and management of diabetic foot problems in the 21st century. Copyright © 2012 John Wiley & Sons, Ltd.

  5. The role of repopulation in early and late radiation reactions in pig skin

    International Nuclear Information System (INIS)

    Redpath, J.L.; Peel, D.M.; Dodd, P.; Simmonds, R.H.; Hopewell, J.W.

    1984-01-01

    The role of repopulation in early and late radiation reactions in pig skin has been assessed by comparing split dose recovery doses (D/sub 2/-D/sub 1/) for a 1-day interval and a 28-day interval. For a 1-day interval, repair of sublethal damage is the major contribution to any recovery observed, whereas for a 28-day interval, repopulation may also play a role. The early reaction studied was moist desquamation and the late reactions studied were a later dermal erythema and necrosis. The data show that over a 28-day interval, repopulation contributes -- 7.0 Gy to a total D/sub 2/-D/sub 1/, of --14.0 Gy for the early moist desquamation (epidermal) reaction. Data for the role of repopulation in the late (dermal) reactions are also presented

  6. The chicken foot digital replant training model.

    Science.gov (United States)

    Athanassopoulos, Thanassi; Loh, Charles Yuen Yung

    2015-01-01

    A simple, readily available digital replantation model in the chicken foot is described. This high fidelity model will hopefully allow trainees in hand surgery to gain further experience in replant surgery prior to clinical application.

  7. Relationship between serologic response and clinical symptoms in children with enterovirus 71-infected hand-foot-mouth disease.

    Science.gov (United States)

    Shen, Jun; Zhao, Chao; Cao, Ping; Shi, Peng; Cao, Lingfeng; Zhu, Qirong

    2015-01-01

    This study aimed to explore the correlation between clinical symptoms, including rash and fever, and serum antibody reaction to enterovirus 71 (EV71) infection in children hospitalized due to hand-foot-mouth disease (HFMD). From May 2014 to July 2014, a total of 547 children hospitalized due to HFMD in Children's Hospital of Fudan University were enrolled retrospectively. RNA levels of EV71 and CA16 in fecal, serum, and cerebrospinal fluid specimens were measured using quantitative real-time RT-PCR, and EV71-IgM antibody in the serum was detected using immune colloidal gold assays. Of the 547 fecal specimens, 296 were EV71 RNA positive, 109 were CA16 RNA positive, and 8 were positive for both EV71 RNA and CA16 RNA. The total positive rate for either EV71 or CA16 in feces was 72.58% (397/547). Additionally, 544 serum specimens were collected, and 409 were EV71-IgM positive (75.18%). The duration of rash and fever was found to be correlated to the positive rate of serum EV71-IgM, and the positive rate of serum EV71-IgM plus EV71 RNA in feces. The positive rates of serum EV71-IgM and serum EV71-IgM plus EV71 RNA in fecal collected at day 3 of fever were 79.7% and 52.8%, respectively. In conclusion, EV71 and CA16 were found to be the major pathogens responsible for the epidemics of HFMD in children during May to July 2014 in Shanghai, China. There is a close relationship between the positive rate of serum EV71-IgM and the duration of fever and rash.

  8. Reações cutâneas desencadeadas por drogas Skin reactions to drugs

    Directory of Open Access Journals (Sweden)

    Maria Regina Cavariani Silvares

    2008-06-01

    Full Text Available FUNDAMENTOS: Drogas podem desencadear reações adversas. As manifestações cutâneas são as mais comuns. OBJETIVO: Analisar as farmacodermias e relacionar as drogas envolvidas e os tipos de reações cutâneas mais freqüentes. MÉTODOS: Estudo retrospectivo e descritivo. Avaliados pacientes com diagnóstico inicial de farmacodermia internados na Enfermaria de Dermatologia, no período de janeiro de 1999 a junho de 2004. Incluídos no estudo os pacientes que confirmaram o diagnóstico de farmacodermia, com base em critérios clínicos e histopatológicos, após a análise dos prontuários. RESULTADOS: Tiveram diagnóstico inicial de farmacodermia 121 pacientes. Incluídos 43 pacientes, dos quais 51,2% eram do sexo feminino, e 86% da raça branca. Destes, 48,8% faziam uso de apenas uma medicação, sendo o grupo dos antibióticos o mais utilizado (20,9% e o principal responsável pela farmacodermia(33,3%. O segundo grupo de drogas mais envolvido foi o dos antiinflamatórios (16,7%, seguido pelo dos anticonvulsivantes (13%, e analgésicos/antipiréticos (13%. A forma clínica da erupção cutânea foi exantema maculopapular em 41,9% dos pacientes, eritrodermia em 25,6% e urticária em 23,3%. CONCLUSÃO: O exantema maculopapular foi a principal forma de reação cutânea desencadeada por drogas, e os antibióticos, os medicamentos que mais freqüentemente desencadearam essas reações.BACKGROUND: Drugs may trigger adverse reactions and skin manifestations are the most frequent ones. OBJECTIVE: To assess drug reactions and report the drugs involved and the most frequent types of skin reactions. METHODS: A retrospective and descriptive study. Data of inpatients at the Dermatology Ward with initial diagnosis of adverse drug reactions were evaluated from January 1999 to June 2004. Patients with confirmed diagnosis were included in the study based on clinical and histopathological criteria, after analysis of medical charts. RESULTS: Initial diagnosis

  9. Outbreak of mesotherapy-associated skin reactions--District of Columbia area, January-February 2005.

    Science.gov (United States)

    2005-11-11

    Mesotherapy is a treatment involving local subcutaneous injections of minute quantities of various substances (e.g., vitamins or plant extracts) for cosmetic purposes (e.g., fat and wrinkle reduction or body contouring) or relief of musculoskeletal pain. In February 2005, the Virginia Department of Health and CDC were notified of a cluster of skin reactions unresponsive to antimicrobial therapy among patients who had been administered mesotherapy by an unlicensed practitioner in the District of Columbia (DC) area. This report 1) summarizes the subsequent investigation by CDC and state and local health departments in Virginia, Maryland, and DC, which identified prolonged skin reactions in 14 patients, and 2) provides recommendations for practices related to mesotherapy. Patients should accept medical therapy only from licensed practitioners and should not permit injection of substances that have not been approved by the Food and Drug Administration (FDA). Licensed practitioners should follow safe-injection practices when practicing mesotherapy and patients should observe that safe-injection practices are followed.

  10. Skin disorders affecting the feet | Motswaledi | South African Family ...

    African Journals Online (AJOL)

    Skin disorders of the feet can affect the glabrous skin on the dorsal aspects, or the thick skin on the plantar aspects, thereof, or both. Some can affect one foot, and others both of them. These diseases can be inflammatory, genetically inherited, infectious and neoplastic in origin. It is important to identify them and to start ...

  11. Radiotherapy-Induced Skin Reactions Induce Fibrosis Mediated by TGF-β1 Cytokine

    Directory of Open Access Journals (Sweden)

    Cherley Borba Vieira de Andrade

    2017-04-01

    Full Text Available Purpose: This study aimed to investigate radiation-induced lesions on the skin in an experimental animal model. Methods and Materials: Cutaneous wounds were induced in Wistar rats by 4 MeV energy electron beam irradiation, using a dose rate of 240 cGy/min, for 3 different doses (10 Gy, 40 Gy, and 60 Gy. The skin was observed 5, 10, and 25 days (D after ionizing radiation exposition. Results: Infiltrate inflammatory process was observed in D5 and D10, for the 40 Gy and 60 Gy groups, and a progressive increase of transforming growth factor β1 is associated with this process. It could also be noted a mischaracterization of collagen fibers at the high-dose groups. Conclusion: It was observed that the lesions caused by ionizing radiation in rats were very similar to radiodermatitis in patients under radiotherapy treatment. Advances in Knowledge: This study is important to develop strategies to prevent radiation-induced skin reactions.

  12. Skin necrosis following extravasation of water soluble contrast media-report of 2 cases

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jae Hyung; Kim, Seung Hyup; Shin, Myung Jin; Minn, Kyung Won; Park, Chul Kyu [College of Medicine, Seoul National University, Seoul (Korea, Republic of); Kim, Jong Chul [Kyung Sang Medical College, Jinju (Korea, Republic of)

    1987-08-15

    Two cases of skin necrosis following extravasation of contrast media for intravenous pyelography and computed tomography were experienced in the Department of Radiology, Seoul National University Hospital. The first case was 4 years old girl who suffered from known nephrotic syndrome. About 15cc of meglumine ioxitalamate (Telebrix 30) was injected through 25G needle at dorsum of left foot to visualize the urinary tract for renal biopsy. The 2nd case was 3 years old girl who suffered from seizure. About 12cc of meglumine ioxitalamate (Telebrix 30) was injected through 25G needle at dorsum of left foot. In both cases the dorsum of foot was swollen immediately after the extravastion of the contrast media. Following discoloration the skin showed vesicles with erythema. Consequently the skin showed white discoloration and ulcerated to form crust. In the former case, skin graft was applied successfully. However, in the latter, the lesion healed with only supportive dressings.

  13. Predicting chemically-induced skin reactions. Part I: QSAR models of skin sensitization and their application to identify potentially hazardous compounds

    Energy Technology Data Exchange (ETDEWEB)

    Alves, Vinicius M. [Laboratory of Molecular Modeling and Design, Faculty of Pharmacy, Federal University of Goiás, Goiânia, GO 74605-220 (Brazil); Laboratory for Molecular Modeling, Division of Chemical Biology and Medicinal Chemistry, Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC 27599 (United States); Muratov, Eugene [Laboratory for Molecular Modeling, Division of Chemical Biology and Medicinal Chemistry, Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC 27599 (United States); Laboratory of Theoretical Chemistry, A.V. Bogatsky Physical-Chemical Institute NAS of Ukraine, Odessa 65080 (Ukraine); Fourches, Denis [Laboratory for Molecular Modeling, Division of Chemical Biology and Medicinal Chemistry, Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC 27599 (United States); Strickland, Judy; Kleinstreuer, Nicole [ILS/Contractor Supporting the NTP Interagency Center for the Evaluation of Alternative Toxicological Methods (NICEATM), P.O. Box 13501, Research Triangle Park, NC 27709 (United States); Andrade, Carolina H. [Laboratory of Molecular Modeling and Design, Faculty of Pharmacy, Federal University of Goiás, Goiânia, GO 74605-220 (Brazil); Tropsha, Alexander, E-mail: alex_tropsha@unc.edu [Laboratory for Molecular Modeling, Division of Chemical Biology and Medicinal Chemistry, Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC 27599 (United States)

    2015-04-15

    Repetitive exposure to a chemical agent can induce an immune reaction in inherently susceptible individuals that leads to skin sensitization. Although many chemicals have been reported as skin sensitizers, there have been very few rigorously validated QSAR models with defined applicability domains (AD) that were developed using a large group of chemically diverse compounds. In this study, we have aimed to compile, curate, and integrate the largest publicly available dataset related to chemically-induced skin sensitization, use this data to generate rigorously validated and QSAR models for skin sensitization, and employ these models as a virtual screening tool for identifying putative sensitizers among environmental chemicals. We followed best practices for model building and validation implemented with our predictive QSAR workflow using Random Forest modeling technique in combination with SiRMS and Dragon descriptors. The Correct Classification Rate (CCR) for QSAR models discriminating sensitizers from non-sensitizers was 71–88% when evaluated on several external validation sets, within a broad AD, with positive (for sensitizers) and negative (for non-sensitizers) predicted rates of 85% and 79% respectively. When compared to the skin sensitization module included in the OECD QSAR Toolbox as well as to the skin sensitization model in publicly available VEGA software, our models showed a significantly higher prediction accuracy for the same sets of external compounds as evaluated by Positive Predicted Rate, Negative Predicted Rate, and CCR. These models were applied to identify putative chemical hazards in the Scorecard database of possible skin or sense organ toxicants as primary candidates for experimental validation. - Highlights: • It was compiled the largest publicly-available skin sensitization dataset. • Predictive QSAR models were developed for skin sensitization. • Developed models have higher prediction accuracy than OECD QSAR Toolbox. • Putative

  14. Predicting chemically-induced skin reactions. Part I: QSAR models of skin sensitization and their application to identify potentially hazardous compounds

    International Nuclear Information System (INIS)

    Alves, Vinicius M.; Muratov, Eugene; Fourches, Denis; Strickland, Judy; Kleinstreuer, Nicole; Andrade, Carolina H.; Tropsha, Alexander

    2015-01-01

    Repetitive exposure to a chemical agent can induce an immune reaction in inherently susceptible individuals that leads to skin sensitization. Although many chemicals have been reported as skin sensitizers, there have been very few rigorously validated QSAR models with defined applicability domains (AD) that were developed using a large group of chemically diverse compounds. In this study, we have aimed to compile, curate, and integrate the largest publicly available dataset related to chemically-induced skin sensitization, use this data to generate rigorously validated and QSAR models for skin sensitization, and employ these models as a virtual screening tool for identifying putative sensitizers among environmental chemicals. We followed best practices for model building and validation implemented with our predictive QSAR workflow using Random Forest modeling technique in combination with SiRMS and Dragon descriptors. The Correct Classification Rate (CCR) for QSAR models discriminating sensitizers from non-sensitizers was 71–88% when evaluated on several external validation sets, within a broad AD, with positive (for sensitizers) and negative (for non-sensitizers) predicted rates of 85% and 79% respectively. When compared to the skin sensitization module included in the OECD QSAR Toolbox as well as to the skin sensitization model in publicly available VEGA software, our models showed a significantly higher prediction accuracy for the same sets of external compounds as evaluated by Positive Predicted Rate, Negative Predicted Rate, and CCR. These models were applied to identify putative chemical hazards in the Scorecard database of possible skin or sense organ toxicants as primary candidates for experimental validation. - Highlights: • It was compiled the largest publicly-available skin sensitization dataset. • Predictive QSAR models were developed for skin sensitization. • Developed models have higher prediction accuracy than OECD QSAR Toolbox. • Putative

  15. Skin reaction and regeneration after single sodium lauryl sulfate exposure stratified by filaggrin genotype and atopic dermatitis phenotype

    DEFF Research Database (Denmark)

    Bandier, J; Carlsen, B C; Rasmussen, M A

    2015-01-01

    and AD phenotype on irritant response and skin regeneration. OBJECTIVES: To investigate the role of FLGnull and AD groups for skin reaction and recovery after sodium lauryl sulfate (SLS) irritation. METHODS: This is a case-control study comprising 67 subjects, including healthy controls and patients...

  16. Skin Cancer

    Science.gov (United States)

    Skin cancer is the most common form of cancer in the United States. The two most common types ... face, neck, hands, and arms. Another type of skin cancer, melanoma, is more dangerous but less common. Anyone ...

  17. Portable System for Monitoring the Microclimate in the Footwear-Foot Interface

    Directory of Open Access Journals (Sweden)

    José de Jesús Sandoval-Palomares

    2016-07-01

    Full Text Available A new, continuously-monitoring portable device that monitors the diabetic foot has shown to help in reduction of diabetic foot complications. Persons affected by diabetic foot have shown to be particularly sensitive in the plantar surface; this sensitivity coupled with certain ambient conditions may cause dry skin. This dry skin leads to the formation of fissures that may eventually result in a foot ulceration and subsequent hospitalization. This new device monitors the micro-climate temperature and humidity areas between the insole and sole of the footwear. The monitoring system consists of an array of ten sensors that take readings of relative humidity within the range of 100% ± 2% and temperature within the range of −40 °C to 123.8 ± 0.3 °C. Continuous data is collected using embedded C software and the recorded data is processed in Matlab. This allows for the display of data; the implementation of the iterative Gauss-Newton algorithm method was used to display an exponential response curve. Therefore, the aim of our system is to obtain feedback data and provide the critical information to various footwear manufacturers. The footwear manufactures will utilize this critical information to design and manufacture diabetic footwear that reduce the risk of ulcers in diabetic feet.

  18. The design of hands and feet contamination monitor

    International Nuclear Information System (INIS)

    Song Jiangxue; Shen Yang; Deng Changming; Zhang Jia; Hou Lei; Meng Dan

    2011-01-01

    In order to protect the hands and feet of personnel engaged in nuclear, draw on advanced hands and feet contamination monitor, we design a new radiation protection instrumentation. It describes the composition of the hands and feet contamination monitor, and software program design. It describes the hardware monitor software, firmware and computer programming techniques. If device found your hand and foot surface is contamination, it will prompt you to decontamination, to protect your hands and feet of safety. (authors)

  19. Predicting chemically-induced skin reactions. Part I: QSAR models of skin sensitization and their application to identify potentially hazardous compounds

    Science.gov (United States)

    Alves, Vinicius M.; Muratov, Eugene; Fourches, Denis; Strickland, Judy; Kleinstreuer, Nicole; Andrade, Carolina H.; Tropsha, Alexander

    2015-01-01

    Repetitive exposure to a chemical agent can induce an immune reaction in inherently susceptible individuals that leads to skin sensitization. Although many chemicals have been reported as skin sensitizers, there have been very few rigorously validated QSAR models with defined applicability domains (AD) that were developed using a large group of chemically diverse compounds. In this study, we have aimed to compile, curate, and integrate the largest publicly available dataset related to chemically-induced skin sensitization, use this data to generate rigorously validated and QSAR models for skin sensitization, and employ these models as a virtual screening tool for identifying putative sensitizers among environmental chemicals. We followed best practices for model building and validation implemented with our predictive QSAR workflow using random forest modeling technique in combination with SiRMS and Dragon descriptors. The Correct Classification Rate (CCR) for QSAR models discriminating sensitizers from non-sensitizers were 71–88% when evaluated on several external validation sets, within a broad AD, with positive (for sensitizers) and negative (for non-sensitizers) predicted rates of 85% and 79% respectively. When compared to the skin sensitization module included in the OECD QSAR toolbox as well as to the skin sensitization model in publicly available VEGA software, our models showed a significantly higher prediction accuracy for the same sets of external compounds as evaluated by Positive Predicted Rate, Negative Predicted Rate, and CCR. These models were applied to identify putative chemical hazards in the ScoreCard database of possible skin or sense organ toxicants as primary candidates for experimental validation. PMID:25560674

  20. Development of a Subject-Specific Foot-Ground Contact Model for Walking.

    Science.gov (United States)

    Jackson, Jennifer N; Hass, Chris J; Fregly, Benjamin J

    2016-09-01

    Computational walking simulations could facilitate the development of improved treatments for clinical conditions affecting walking ability. Since an effective treatment is likely to change a patient's foot-ground contact pattern and timing, such simulations should ideally utilize deformable foot-ground contact models tailored to the patient's foot anatomy and footwear. However, no study has reported a deformable modeling approach that can reproduce all six ground reaction quantities (expressed as three reaction force components, two center of pressure (CoP) coordinates, and a free reaction moment) for an individual subject during walking. This study proposes such an approach for use in predictive optimizations of walking. To minimize complexity, we modeled each foot as two rigid segments-a hindfoot (HF) segment and a forefoot (FF) segment-connected by a pin joint representing the toes flexion-extension axis. Ground reaction forces (GRFs) and moments acting on each segment were generated by a grid of linear springs with nonlinear damping and Coulomb friction spread across the bottom of each segment. The stiffness and damping of each spring and common friction parameter values for all springs were calibrated for both feet simultaneously via a novel three-stage optimization process that used motion capture and ground reaction data collected from a single walking trial. The sequential three-stage process involved matching (1) the vertical force component, (2) all three force components, and finally (3) all six ground reaction quantities. The calibrated model was tested using four additional walking trials excluded from calibration. With only small changes in input kinematics, the calibrated model reproduced all six ground reaction quantities closely (root mean square (RMS) errors less than 13 N for all three forces, 25 mm for anterior-posterior (AP) CoP, 8 mm for medial-lateral (ML) CoP, and 2 N·m for the free moment) for both feet in all walking trials. The

  1. Contemporary Evaluation and Management of the Diabetic Foot

    Science.gov (United States)

    Sumpio, Bauer E.

    2012-01-01

    Foot problems in patients with diabetes remain a major public health issue and are the commonest reason for hospitalization of patients with diabetes with prevalence as high as 25%. Ulcers are breaks in the dermal barrier with subsequent erosion of underlying subcutaneous tissue that may extend to muscle and bone, and superimposed infection is a frequent and costly complication. The pathophysiology of diabetic foot disease is multifactorial and includes neuropathy, infection, ischemia, and abnormal foot structure and biomechanics. Early recognition of the etiology of these foot lesions is essential for good functional outcome. Managing the diabetic foot is a complex clinical problem requiring a multidisciplinary collaboration of health care workers to achieve limb salvage. Adequate off-loading, frequent debridement, moist wound care, treatment of infection, and revascularization of ischemic limbs are the mainstays of therapy. Even when properly managed, some of the foot ulcers do not heal and are arrested in a state of chronic inflammation. These wounds can frequently benefit from various adjuvants, such as aggressive debridement, growth factors, bioactive skin equivalents, and negative pressure wound therapy. While these, increasingly expensive, therapies have shown promising results in clinical trials, the results have yet to be translated into widespread clinical practice leaving a huge scope for further research in this field. PMID:24278695

  2. The Marble-Hand Illusion.

    Science.gov (United States)

    Senna, Irene; Maravita, Angelo; Bolognini, Nadia; Parise, Cesare V

    2014-01-01

    Our body is made of flesh and bones. We know it, and in our daily lives all the senses constantly provide converging information about this simple, factual truth. But is this always the case? Here we report a surprising bodily illusion demonstrating that humans rapidly update their assumptions about the material qualities of their body, based on their recent multisensory perceptual experience. To induce a misperception of the material properties of the hand, we repeatedly gently hit participants' hand with a small hammer, while progressively replacing the natural sound of the hammer against the skin with the sound of a hammer hitting a piece of marble. After five minutes, the hand started feeling stiffer, heavier, harder, less sensitive, unnatural, and showed enhanced Galvanic skin response (GSR) to threatening stimuli. Notably, such a change in skin conductivity positively correlated with changes in perceived hand stiffness. Conversely, when hammer hits and impact sounds were temporally uncorrelated, participants did not spontaneously report any changes in the perceived properties of the hand, nor did they show any modulation in GSR. In two further experiments, we ruled out that mere audio-tactile synchrony is the causal factor triggering the illusion, further demonstrating the key role of material information conveyed by impact sounds in modulating the perceived material properties of the hand. This novel bodily illusion, the 'Marble-Hand Illusion', demonstrates that the perceived material of our body, surely the most stable attribute of our bodily self, can be quickly updated through multisensory integration.

  3. Expression of CD73 slows down migration of skin dendritic cells, affecting the sensitization phase of contact hypersensitivity reactions in mice.

    Science.gov (United States)

    Neuberger, A; Ring, S; Silva-Vilches, C; Schrader, J; Enk, A; Mahnke, K

    2017-09-01

    Application of haptens to the skin induces release of immune stimulatory ATP into the extracellular space. This "danger" signal can be converted to immunosuppressive adenosine (ADO) by the action of the ectonucleotidases CD39 and CD73, expressed by skin and immune cells. Thus, the expression and regulation of CD73 by skin derived cells may have crucial influence on the outcome of contact hypersensitivity (CHS) reactions. To investigate the role of CD73 expression during 2,4,6-trinitrochlorobenzene (TNCB) induced CHS reactions. Wild type (wt) and CD73 deficient mice were subjected to TNCB induced CHS. In the different mouse strains the resulting ear swelling reaction was recorded along with a detailed phenotypic analysis of the skin migrating subsets of dendritic cells (DC). In CD73 deficient animals the motility of DC was higher as compared to wt animals and in particular after sensitization we found increased migration of Langerin + DC from skin to draining lymph nodes (LN). In the TNCB model this led to a stronger sensitization as indicated by increased frequency of interferon-γ producing T cells in the LN and an increased ear thickness after challenge. CD73 derived ADO production slows down migration of Langerin + DC from skin to LN. This may be a crucial mechanism to avoid over boarding immune reactions against haptens. Copyright © 2017 Japanese Society for Investigative Dermatology. Published by Elsevier B.V. All rights reserved.

  4. Human atopic dermatitis skin-derived T cells can induce a reaction in mouse keratinocytes in vivo

    DEFF Research Database (Denmark)

    Martel, Britta C; Blom, Lars; Dyring-Andersen, Beatrice

    2015-01-01

    . In comparison, blood -derived in vitro differentiated Th2 cells only induced a weak response in a few of the mice. Thus, we conclude that human AD skin-derived T cells can induce a reaction in mouse skin through induction of a proliferative response in the mouse keratinocytes. This article is protected......In atopic dermatitis (AD), the inflammatory response between skin infiltrating T cells and keratinocytes is fundamental to the development of chronic lesional eczema. The aim of this study was to investigate whether skin-derived T cells from AD patients could induce an inflammatory response in mice...... through keratinocyte activation and consequently cause development of eczematous lesions. Punch biopsies of lesional skin from AD patients were used to establish skin-derived T cell cultures and which were transferred into NOD.Cg-Prkd(scid) Il2rg(tm1Sug) /JicTac (NOG) mice. We found that subcutaneous...

  5. The Diabetic Foot Attack: "'Tis Too Late to Retreat!"

    Science.gov (United States)

    Vas, Prashanth R J; Edmonds, Michael; Kavarthapu, Venu; Rashid, Hisham; Ahluwalia, Raju; Pankhurst, Christian; Papanas, Nikolaos

    2018-03-01

    The "diabetic foot attack" is one of the most devastating presentations of diabetic foot disease, typically presenting as an acutely inflamed foot with rapidly progressive skin and tissue necrosis, at times associated with significant systemic symptoms. Without intervention, it may escalate over hours to limb-threatening proportions and poses a high amputation risk. There are only best practice approaches but no international protocols to guide management. Immediate recognition of a typical infected diabetic foot attack, predominated by severe infection, with prompt surgical intervention to debride all infected tissue alongside broad-spectrum antibiotic therapy is vital to ensure both limb and patient survival. Postoperative access to multidisciplinary and advanced wound care therapies is also necessary. More subtle forms exist: these include the ischemic diabetic foot attack and, possibly, in a contemporary categorization, acute Charcot neuroarthropathy. To emphasize the importance of timely action especially in the infected and ischemic diabetic foot attack, we revisit the concept of "time is tissue" and draw parallels with advances in acute myocardial infarction and stroke care. At the moment, international protocols to guide management of severe diabetic foot presentations do not specifically use the term. However, we believe that it may help increase awareness of the urgent actions required in some situations.

  6. Hand-foot syndrome in a patient with metastatic lung adenocarcinoma induced by high-dose icotinib: A case report and review of the literature.

    Science.gov (United States)

    Zheng, Yulong; Fang, Weijia; Xu, Nong

    2012-12-01

    Icotinib is a new oral epidermal growth factor tyrosine kinase inhibitor (EGFR-TKI). The most frequent side-effects of icotinib include rash and diarrhea. Hand-foot syndrome (HFS) induced by EGFR-TKI is rare. The present study describes, for the first time, HFS induced by high-dose icotinib in a 65-year old female with metastatic lung adenocarcinoma. The patient developed HFS during the first week of icotinib treatment with characteristic clinical presentation. HFS regressed after icotinib dose-reduction was initiated. HFS may occur with icotinib, especially when administered in high doses.

  7. Validation of the OMERACT Psoriatic Arthritis Magnetic Resonance Imaging Score (PsAMRIS) for the Hand and Foot in a Randomized Placebo-controlled Trial

    DEFF Research Database (Denmark)

    Glinatsi, Daniel; Bird, Paul; Gandjbakhch, Frederique

    2015-01-01

    Objective. To assess changes following treatment and the reliability and responsiveness to change of the Outcome Measures in Rheumatology (OMERACT) Psoriatic Arthritis Magnetic Resonance Imaging Score (PsAMRIS) in a randomized controlled trial. Methods. Forty patients with PsA randomized to either...... placebo or abatacept (ABA) had MRI of either 1 hand (n = 20) or 1 foot (n = 20) at baseline and after 6 months. Images were scored blindly twice by 3 independent readers according to the PsAMRIS (for synovitis, tenosynovitis, periarticular inflammation, bone edema, bone erosion, and bone proliferation...

  8. Self-efficacy of foot care behaviour of elderly patients with diabetes

    Directory of Open Access Journals (Sweden)

    Maizatul Nadwa Mohd Razi

    2017-08-01

    Full Text Available Introduction: Elderly patients with diabetes are at a high risk of contracting diabetic foot problems. Self-efficacy is essential to help improve foot care behaviour. Aim: To identify levels of self-efficacy and foot care behaviour and their relationship with demographic characteristics in elderly patients with diabetes Methods: A cross-sectional study was conducted in two general hospitals in Malaysia from May to June 2015. Diabetes patients aged 60 years with specific inclusion criteria were invited to participate in this study. The respondents were interviewed using a set of validated questionnaires. Data were analysed with descriptive and inferential statistics (multiple linear regression using Statistical Package for the Social Sciences version 20.0. Results: Levels of foot self-efficacy (mean+31.39; standard deviation=7.76 and foot care behaviour (mean=25.37; SD=5.88 were high. There was a positive significant relationship between foot selfefficacy (β = 0.41, p < 0.001 and gender (β = 0.30, p < 0.001 with foot care behaviour. Conclusion: Self-efficacy can be incorporated in diabetes education to improve foot care behaviour. High-risk patients should be taught proper foot inspection and protection as well as the merits of skin care to prevent the occurrence of diabetic foot problems.

  9. Application of vibration to wrist and hand skin affects fingertip tactile sensation

    Science.gov (United States)

    Lakshminarayanan, Kishor; Lauer, Abigail W; Ramakrishnan, Viswanathan; Webster, John G; Seo, Na Jin

    2015-01-01

    A recent study showed that fingertip pads’ tactile sensation can improve by applying imperceptible white-noise vibration to the skin at the wrist or dorsum of the hand in stroke patients. This study further examined this behavior by investigating the effect of both imperceptible and perceptible white-noise vibration applied to different locations within the distal upper extremity on the fingertip pads’ tactile sensation in healthy adults. In 12 healthy adults, white-noise vibration was applied to one of four locations (dorsum hand by the second knuckle, thenar and hypothenar areas, and volar wrist) at one of four intensities (zero, 60%, 80%, and 120% of the sensory threshold for each vibration location), while the fingertip sensation, the smallest vibratory signal that could be perceived on the thumb and index fingertip pads, was assessed. Vibration intensities significantly affected the fingertip sensation (P sensation (P sensation (P sensation (P > 0.01), all compared with the zero vibration condition. This effect with vibration intensity conforms to the stochastic resonance behavior. Nonspecificity to the vibration location suggests the white-noise vibration affects higher level neuronal processing for fingertip sensing. Further studies are needed to elucidate the neural pathways for distal upper extremity vibration to impact fingertip pad tactile sensation. PMID:26177959

  10. The Effect of Hand and Foot Massage on Post-Cesarean Pain and Anxiety

    Directory of Open Access Journals (Sweden)

    morvarid Irani

    1999-11-01

    Full Text Available Background & aim:  Pain and anxiety are the most common complications after cesarean section. The use of medications is the most common strategy for alleviating these problems. However, the adverse effects of these drugs and lack of access to them for some patients, has led to an increase in application of non-drug methods such as massage. Methods:This blind clinical trial was performed in Omolbanin Hospital of Mashhad, Iran. A total of 80 pregnant women referring to maternity ward for elective cesarean, who had the inclusion criteria were selected through convenience sampling method. Subsequently, the participants were randomly assigned to two groups, and the visual analog scale was used to determine the level of pain and anxiety. Each foot and hand was massaged for five minutes, and then the levels of pain and anxiety were evaluated before the intervention and immediately, 60 and 90 minutes after the intervention. Data were analyzed performing Mann-Whitney, Chi-square, repeated measures ANOVA and Bonferroni test using SPSS, version 16. Results: The findings of this study showed that there was no significant difference between the two groups concerning their levels of pain and anxiety before the massage (P>0.05. However, the levels of pain and anxiety significantly decreased in the intervention group, immediately, 60 and 90 minutes after the intervention (P

  11. Predicting chemically-induced skin reactions. Part II: QSAR models of skin permeability and the relationships between skin permeability and skin sensitization

    Energy Technology Data Exchange (ETDEWEB)

    Alves, Vinicius M. [Laboratory of Molecular Modeling and Design, Faculty of Pharmacy, Federal University of Goiás, Goiânia, GO 74605-220 (Brazil); Laboratory for Molecular Modeling, Division of Chemical Biology and Medicinal Chemistry, Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC 27599 (United States); Muratov, Eugene [Laboratory for Molecular Modeling, Division of Chemical Biology and Medicinal Chemistry, Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC 27599 (United States); Laboratory of Theoretical Chemistry, A.V. Bogatsky Physical–Chemical Institute NAS of Ukraine, Odessa 65080 (Ukraine); Fourches, Denis [Laboratory for Molecular Modeling, Division of Chemical Biology and Medicinal Chemistry, Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC 27599 (United States); Strickland, Judy; Kleinstreuer, Nicole [ILS/Contractor supporting the NTP Interagency Center for the Evaluation of Alternative Toxicological Methods (NICEATM), P.O. Box 13501, Research Triangle Park, NC 27709 (United States); Andrade, Carolina H. [Laboratory of Molecular Modeling and Design, Faculty of Pharmacy, Federal University of Goiás, Goiânia, GO 74605-220 (Brazil); Tropsha, Alexander, E-mail: alex_tropsha@unc.edu [Laboratory for Molecular Modeling, Division of Chemical Biology and Medicinal Chemistry, Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC 27599 (United States)

    2015-04-15

    Skin permeability is widely considered to be mechanistically implicated in chemically-induced skin sensitization. Although many chemicals have been identified as skin sensitizers, there have been very few reports analyzing the relationships between molecular structure and skin permeability of sensitizers and non-sensitizers. The goals of this study were to: (i) compile, curate, and integrate the largest publicly available dataset of chemicals studied for their skin permeability; (ii) develop and rigorously validate QSAR models to predict skin permeability; and (iii) explore the complex relationships between skin sensitization and skin permeability. Based on the largest publicly available dataset compiled in this study, we found no overall correlation between skin permeability and skin sensitization. In addition, cross-species correlation coefficient between human and rodent permeability data was found to be as low as R{sup 2} = 0.44. Human skin permeability models based on the random forest method have been developed and validated using OECD-compliant QSAR modeling workflow. Their external accuracy was high (Q{sup 2}{sub ext} = 0.73 for 63% of external compounds inside the applicability domain). The extended analysis using both experimentally-measured and QSAR-imputed data still confirmed the absence of any overall concordance between skin permeability and skin sensitization. This observation suggests that chemical modifications that affect skin permeability should not be presumed a priori to modulate the sensitization potential of chemicals. The models reported herein as well as those developed in the companion paper on skin sensitization suggest that it may be possible to rationally design compounds with the desired high skin permeability but low sensitization potential. - Highlights: • It was compiled the largest publicly-available skin permeability dataset. • Predictive QSAR models were developed for skin permeability. • No concordance between skin

  12. Predicting chemically-induced skin reactions. Part II: QSAR models of skin permeability and the relationships between skin permeability and skin sensitization

    International Nuclear Information System (INIS)

    Alves, Vinicius M.; Muratov, Eugene; Fourches, Denis; Strickland, Judy; Kleinstreuer, Nicole; Andrade, Carolina H.; Tropsha, Alexander

    2015-01-01

    Skin permeability is widely considered to be mechanistically implicated in chemically-induced skin sensitization. Although many chemicals have been identified as skin sensitizers, there have been very few reports analyzing the relationships between molecular structure and skin permeability of sensitizers and non-sensitizers. The goals of this study were to: (i) compile, curate, and integrate the largest publicly available dataset of chemicals studied for their skin permeability; (ii) develop and rigorously validate QSAR models to predict skin permeability; and (iii) explore the complex relationships between skin sensitization and skin permeability. Based on the largest publicly available dataset compiled in this study, we found no overall correlation between skin permeability and skin sensitization. In addition, cross-species correlation coefficient between human and rodent permeability data was found to be as low as R 2 = 0.44. Human skin permeability models based on the random forest method have been developed and validated using OECD-compliant QSAR modeling workflow. Their external accuracy was high (Q 2 ext = 0.73 for 63% of external compounds inside the applicability domain). The extended analysis using both experimentally-measured and QSAR-imputed data still confirmed the absence of any overall concordance between skin permeability and skin sensitization. This observation suggests that chemical modifications that affect skin permeability should not be presumed a priori to modulate the sensitization potential of chemicals. The models reported herein as well as those developed in the companion paper on skin sensitization suggest that it may be possible to rationally design compounds with the desired high skin permeability but low sensitization potential. - Highlights: • It was compiled the largest publicly-available skin permeability dataset. • Predictive QSAR models were developed for skin permeability. • No concordance between skin sensitization and

  13. Caffeine ameliorates radiation-induced skin reactions in mice but does not influence tumour radiation response

    Energy Technology Data Exchange (ETDEWEB)

    Hebbar, S.A.; Mitra, A.K.; George, K.C.; Verma, N.C. [Radiation Biology Division, Bhabha Atomic Research Centre, Trombay, Mumbai (India)]. E-mail: ncverma@apsara.barc.ernet.in

    2002-03-01

    Intramuscular administration of caffeine at a dose of 80 mg kg{sup -1} body weight to the gastrocnemius muscles of Swiss mice 5 min prior to local irradiation (35 Gy) of the leg delayed the progression of radiation-induced skin reactions in such animals. While 90% epilation with reddening of the skin was noted in animals treated with radiation alone, animals pretreated with caffeine suffered only partial hair loss with slight reddening of the skin on the 16th and 20th days post-irradiation. Beyond the 28th day, damage scores in irradiated feet for both the groups were similar (score 3) and remained unchanged until the 32nd day and then decreased and disappeared completely in both treatment groups by the 40th day after irradiation. In addition, the effect of caffeine on the radiation response of a mouse fibrosarcoma was investigated. Results showed that intratumoral administration of caffeine at a dose of 80 mg kg{sup -1} body weight 5 min prior to local exposure of tumours to 10 Gy of {sup 60}Co {gamma}-rays did not influence the response of tumours to radiation. The present study thus showed that although caffeine ameliorated radiation-induced skin reactions in the mouse leg, it did not affect the tumour radiation response, indicating its potential application in cancer radiotherapy. (author)

  14. TIME Of Diabetic Ulcer Foot Suffering And Depression Symptoms In Ulin General Hospital Banjarmasin

    OpenAIRE

    Puteri, Rizka Dwi; Darwis, Yulizar; Heriyani, Farida

    2017-01-01

    Diabetic foot ulcers are one kind of chronic complication of diabetes mellitus in the form of an open wound on the skin's surface and may be accompanied by local tissue death. Long term suffering of diabetic foot ulcers with physical and psychological changes may cause symptoms of depression. The aim of this study was to determine the correlation between long term suffering of diabetic foot ulcers and symptoms of depression in RSUD Ulin Banjarmasin. This was an analytic observational study w...

  15. Effect of local allergen priming on early, late, delayed-phase, and epicutaneous skin reactions

    NARCIS (Netherlands)

    Weller, F. R.; Weller, M. S.; Jansen, H. M.; de Monchy, J. G.

    1996-01-01

    Allergic disease is reflected in a chronic inflammatory response to an allergen. It is thought that local allergen priming underlies this chronicity. To assess the effect of allergen priming on the amplitude and histologic effect of the allergic reaction, four sequential, intracutaneous skin tests

  16. Effect of local allergen priming on early, late, delayed-phase, and epicutaneous skin reactions

    NARCIS (Netherlands)

    Weller, FR; Weller, MS; Jansen, HM; deMonchy, JGR

    1996-01-01

    Allergic disease is renected in a chronic inflammatory response to an allergen. It is thought that local allergen priming underlies this chronicity. To assess the effect of allergen priming on the amplitude and histologic effect of the allergic reaction, four sequential, intracutaneous skin tests

  17. Skin reactions to thimerosal and Leishmania in dogs from a leishmaniasis endemic area: it is better to keep them apart

    Directory of Open Access Journals (Sweden)

    Moacir Paranhos-Silva

    2001-07-01

    Full Text Available Positive Montenegro's skin test is a delayed type hypersensitivity reaction widely used as indicative of previous infection with Leishmania in both humans and dogs. Montenegro's antigen consists of a crude Leishmania antigen solution, usually containing thimerosal as preserving agent. In this work it is shown that a large proportion of dogs (11 out of 56 examined in an endemic area of leishmaniasis presented induration at the site of injection of a diluent containing thimerosal alone. This clearly demonstrates that thimerosal leads to a high number of false positive skin reactions in dogs and that its use in Montenegro's skin test antigenic preparations should be avoided.

  18. Foot Function, Foot Pain, and Falls in Older Adults: The Framingham Foot Study.

    Science.gov (United States)

    Awale, Arunima; Hagedorn, Thomas J; Dufour, Alyssa B; Menz, Hylton B; Casey, Virginia A; Hannan, Marian T

    2017-01-01

    Although foot pain has been linked to fall risk, contributions of pain severity, foot posture, or foot function are unclear. These factors were examined in a cohort of older adults. The purpose of this study was to examine the associations of foot pain, severity of foot pain, and measures of foot posture and dynamic foot function with reported falls in a large, well-described cohort of older adults from the Framingham Foot Study. Foot pain, posture, and function were collected from Framingham Foot Study participants who were queried about falls over the past year (0, 1, and ≥2 falls). Logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for the relation of falls with foot pain, pain severity, foot posture, and foot function adjusting for covariates. The mean age of the 1,375 participants was 69 years; 57% were female, and 21% reported foot pain (40% mild pain, 47% moderate pain, and 13% severe pain). One-third reported falls in the past year (1 fall: n = 263, ≥2 falls: n = 152). Foot pain was associated with a 62% increased odds of recurrent falls. Those with moderate and severe foot pain showed increased odds of ≥2 falls (OR 1.78, CI 1.06-2.99, and OR 3.25, CI 1.65-7.48, respectively) compared to those with no foot pain. Foot function was not associated with falls. Compared to normal foot posture, those with planus foot posture had 78% higher odds of ≥2 falls. Higher odds of recurrent falls were observed in individuals with foot pain, especially severe foot pain, as well as in individuals with planus foot posture, indicating that both foot pain and foot posture may play a role in increasing the risk of falls among older adults. © 2017 S. Karger AG, Basel.

  19. Enterovirus-related diarrhoea in Guangdong, China: clinical features and implications in hand, foot and mouth disease and herpangina.

    Science.gov (United States)

    Zhou, Hong-Tao; Yi, Hai-Su; Guo, Yong-Hui; Pan, Yu-Xian; Tao, Shao-Hua; Wang, Bin; Chen, Man-Jun; Yang, Mei; Yu, Nan

    2016-03-16

    A series of complications caused by enteroviruses, including meningitis, encephalitis, acute flaccid paralysis, acute cardiopulmonary failure, respiratory infection, and myocardial injury have been reported in hand, foot and mouth disease/herpangina (HFMD/HA). However, the complication of diarrhoea caused by enteroviruses has been neglected, and a summary of its clinical features and impact on HFMD/HA is unavailable. We included inpatients with HFMD/HA admitted to the Paediatric Department of Zhujiang Hospital during 2009-2012. We summarised and compared clinical data for cases with and without diarrhoea, and determined enterovirus serotypes by reverse transcriptase polymerase chain reaction and genotyping based on a partial-length fragment of viral protein 1 or the 5'-untranslated region. There were 804 inpatients with HFMD/HA and 28 (3.5%) presented with diarrhoea. Gastrointestinal symptoms were mild in most cases of diarrhoea (82.1%), with high prevalence of no dehydration (82.1%), short duration of diarrhoea (78.6%) and watery stools (75.0%). The prevalence of multi-organ dysfunction syndrome (10.7 vs 0.40%) (p = 0.001), hepatic injury (14.3 vs 3.4%) (p = 0.019), myocardial injury (21.4 vs 6.1%) (p = 0.002) and convulsion (21.4 vs 7.2%) (p = 0.016) was significantly higher in the diarrhoea than no diarrhoea group. There was no significant difference between the two groups regarding prevalence of death, altered consciousness, paralysis, central nervous system involvement, or acute respiratory infection. Most patients with diarrhoea caused by enteroviruses circulating in Guangdong Province in 2009-2012 had mild or moderate gastrointestinal symptoms. Although enterovirus-related diarrhoea caused additional multi-organ dysfunction syndrome, hepatic injury and myocardial injury in children with HFMD/HA, timely intervention efficiently reduced disease severity and improved outcome.

  20. Predicting chemically-induced skin reactions. Part II: QSAR models of skin permeability and the relationships between skin permeability and skin sensitization

    Science.gov (United States)

    Alves, Vinicius M.; Muratov, Eugene; Fourches, Denis; Strickland, Judy; Kleinstreuer, Nicole; Andrade, Carolina H.; Tropsha, Alexander

    2015-01-01

    Skin permeability is widely considered to be mechanistically implicated in chemically-induced skin sensitization. Although many chemicals have been identified as skin sensitizers, there have been very few reports analyzing the relationships between molecular structure and skin permeability of sensitizers and non-sensitizers. The goals of this study were to: (i) compile, curate, and integrate the largest publicly available dataset of chemicals studied for their skin permeability; (ii) develop and rigorously validate QSAR models to predict skin permeability; and (iii) explore the complex relationships between skin sensitization and skin permeability. Based on the largest publicly available dataset compiled in this study, we found no overall correlation between skin permeability and skin sensitization. In addition, cross-species correlation coefficient between human and rodent permeability data was found to be as low as R2=0.44. Human skin permeability models based on the random forest method have been developed and validated using OECD-compliant QSAR modeling workflow. Their external accuracy was high (Q2ext = 0.73 for 63% of external compounds inside the applicability domain). The extended analysis using both experimentally-measured and QSAR-imputed data still confirmed the absence of any overall concordance between skin permeability and skin sensitization. This observation suggests that chemical modifications that affect skin permeability should not be presumed a priori to modulate the sensitization potential of chemicals. The models reported herein as well as those developed in the companion paper on skin sensitization suggest that it may be possible to rationally design compounds with the desired high skin permeability but low sensitization potential. PMID:25560673

  1. Sunscreen Use on the Dorsal Hands at the Beach

    International Nuclear Information System (INIS)

    Warren, D. B.; Hobbs, J. B.; Jr, R. F. W.; Riahi, R. R.

    2013-01-01

    Since skin of the dorsal hands is a known site for the development of cutaneous squamous cell carcinoma, an epidemiologic investigation was needed to determine if beachgoers apply sunscreen to the dorsal aspect of their hands as frequently as they apply it to other skin sites. Aim. The aim of the current study was to compare the use of sunscreen on the dorsal hands to other areas of the body during subtropical late spring and summer sunlight exposure at the beach. Materials and Methods. A cross-sectional survey from a convenience sample of beachgoers was designed to evaluate responded understanding and protective measures concerning skin cancer on the dorsal hands in an environment with high natural UVR exposure. Results. A total of 214 surveys were completed and analyzed. Less than half of subjects (105, 49%) applied sunscreen to their dorsal hands. Women applied sunscreen to the dorsal hands more than men (55% women versus 40% men, ρ=0.04 ). Higher Fitzpatrick Skin Type respondents were less likely to protect their dorsal hands from ultraviolet radiation (ρ=0.001 ). Conclusions. More public education focused on dorsal hand protection from ultraviolet radiation damage is necessary to reduce the risk for squamous cell carcinomas of the hands.

  2. 17p13.3 microduplications are associated with split-hand/foot malformation and long-bone deficiency (SHFLD).

    Science.gov (United States)

    Armour, Christine M; Bulman, Dennis E; Jarinova, Olga; Rogers, Richard Curtis; Clarkson, Kate B; DuPont, Barbara R; Dwivedi, Alka; Bartel, Frank O; McDonell, Laura; Schwartz, Charles E; Boycott, Kym M; Everman, David B; Graham, Gail E

    2011-11-01

    Split-hand/foot malformation with long-bone deficiency (SHFLD) is a relatively rare autosomal-dominant skeletal disorder, characterized by variable expressivity and incomplete penetrance. Although several chromosomal loci for SHFLD have been identified, the molecular basis and pathogenesis of most SHFLD cases are unknown. In this study we describe three unrelated kindreds, in which SHFLD segregated with distinct but overlapping duplications in 17p13.3, a region previously linked to SHFLD. In a large three-generation family, the disorder was found to segregate with a 254 kb microduplication; a second microduplication of 527 kb was identified in an affected female and her unaffected mother, and a 430 kb microduplication versus microtriplication was identified in three affected members of a multi-generational family. These findings, along with previously published data, suggest that one locus responsible for this form of SHFLD is located within a 173 kb overlapping critical region, and that the copy gains are incompletely penetrant.

  3. Hand, Foot and Mouth Disease Complicated with Central Nervous System Involvement in Taiwan in 1980–1981

    Directory of Open Access Journals (Sweden)

    Luan-Yin Chang

    2007-01-01

    Full Text Available Sixteen cases from the 1980-1981 Taiwan outbreak of hand, foot and mouth disease (HFMD associated with central nervous system involvement were identified: nine had polio-like syndrome, four had encephalitis or encephalomyelitis, one had cerebellitis, and two had aseptic meningitis. They all had fever, five (31% had documented myoclonic jerk, and 15 (93% had HFMD. Their mean blood leukocyte count was 12,490/mL, and five (31% had leukocytosis (> 15,000/mL; mean cerebrospinal fluid (CSF leukocyte count was 156/mL, CSF protein was 57 mg/dL and CSF glucose was 57 mg/dL. Two patients with HFMD plus encephalitis died within 1 day of hospitalization, and one of them had acute cardiopulmonary failure mimicking myocarditis. Twenty years later, at least one male patient had sequelae of polio-like syndrome and was therefore exempted from military service. Clinical severity was comparable to the 1998 EV71 epidemic. [J Formos Med Assoc 2007;106(2:173-176

  4. Assessment of eye, hand and male gonadal skin dose in radiotherapy

    International Nuclear Information System (INIS)

    Pushap, M.P.S.

    1979-01-01

    An attempt has been made to gauge the dose to (1) the eye, (2) the skin of the hands and (3) the gonads from radiotherapy of other parts of the body. The study has been done on actual male patients at the Jorjani Medical Centre, Tehran. The study, indicated high dose to the eye lid i.e. about 3% of the tumour dose in the case of head irradiation. The eyes and gonads lie at unequal distances from thorax, so are their doses. It is further emphasised that a minimum dose of 400 rad in three weeks to one month has been reported to be cataractogenic in man. A 50% incidence of progressive loss of vision with a dose of 750 rad to 1000 rad in three weeks to three months time has been observed. If appropriate techniques are not employed to shield the eye, even from stray radiation, such limits may easily be reached. (K.B.)

  5. Mesenchymal stem cells ameliorate impaired wound healing through enhancing keratinocyte functions in diabetic foot ulcerations on the plantar skin of rats.

    Science.gov (United States)

    Kato, Jiro; Kamiya, Hideki; Himeno, Tatsuhito; Shibata, Taiga; Kondo, Masaki; Okawa, Tetsuji; Fujiya, Atsushi; Fukami, Ayako; Uenishi, Eita; Seino, Yusuke; Tsunekawa, Shin; Hamada, Yoji; Naruse, Keiko; Oiso, Yutaka; Nakamura, Jiro

    2014-01-01

    Although the initial healing stage involves a re-epithelialization in humans, diabetic foot ulceration (DFU) has been investigated using rodent models with wounds on the thigh skin, in which a wound contraction is initiated. In this study, we established a rodent model of DFU on the plantar skin and evaluated the therapeutic efficacy of bone-marrow-derived mesenchymal stem cells (BM-MSCs) in this model. The wounds made on the hind paws or thighs of streptozotocin induced diabetic or control rats were treated with BM-MSCs. Expression levels of phosphorylated focal adhesion kinase (pFAK), matrix metaroprotease (MMP)-2, EGF, and IGF-1, were evaluated in human keratinocytes, which were cultured in conditioned media of BM-MSCs (MSC-CM) with high glucose levels. Re-epithelialization initiated the healing process on the plantar, but not on the thigh, skin. The therapy utilizing BM-MSCs ameliorated the delayed healing in diabetic rats. In the keratinocytes cultured with MSC-CM, the decreased pFAK levels in the high glucose condition were restored, and the MMP2, EGF, and IGF-1 levels increased. Our study established a novel rat DFU model. The impaired healing process in diabetic rats was ameliorated by transplantation of BM-MSCs. This amelioration might be accounted for by the modification of keratinocyte functions. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Immunopathogenesis and Virus–Host Interactions of Enterovirus 71 in Patients with Hand, Foot and Mouth Disease

    Science.gov (United States)

    Cox, Jonathan A.; Hiscox, Julian A.; Solomon, Tom; Ooi, Mong-How; Ng, Lisa F. P.

    2017-01-01

    Enterovirus 71 (EV71) is a global infectious disease that affects millions of people. The virus is the main etiological agent for hand, foot, and mouth disease with outbreaks and epidemics being reported globally. Infection can cause severe neurological, cardiac, and respiratory problems in children under the age of 5. Despite on-going efforts, little is known about the pathogenesis of EV71, how the host immune system responds to the virus and the molecular mechanisms behind these responses. Moreover, current animal models remain limited, because they do not recapitulate similar disease patterns and symptoms observed in humans. In this review the role of the host–viral interactions of EV71 are discussed together with the various models available to examine: how EV71 utilizes its proteins to cleave host factors and proteins, aiding virus replication; how EV71 uses its own viral proteins to disrupt host immune responses and aid in its immune evasion. These discoveries along with others, such as the EV71 crystal structure, have provided possible targets for treatment and drug interventions. PMID:29238324

  7. EV71 vaccine, a new tool to control outbreaks of hand, foot and mouth disease (HFMD).

    Science.gov (United States)

    Mao, Qun-ying; Wang, Yiping; Bian, Lianlian; Xu, Miao; Liang, Zhenglun

    2016-05-01

    On December 3rd 2015, the China Food and Drug Administration (CFDA) approved the first inactivated Enterovirus 71 (EV71) whole virus vaccine for preventing severe hand, foot and mouth disease (HFMD). As one of the few preventive vaccines for children's infectious diseases generated by the developing countries in recent years, EV71 vaccine is a blessing to children's health in China and worldwide. However, there are still a few challenges facing the worldwide use of EV71 vaccine, including the applicability against various EV71 pandemic strains in other countries, international requirements on vaccine production and quality control, standardization and harmonization on different pathogen monitoring and detecting methods, etc. In addition, the affordability of EV71 vaccine in other countries is a factor to be considered in HFMD prevention. Therefore, with EV71 vaccine commercially available, there is still a long way to go before reaching effective protection against severe HFMD after EV71 vaccines enter the market. In this paper, the bottlenecks and prospects for the wide use of EV71 vaccine after its approval are evaluated.

  8. Estimation of Tri-Axial Walking Ground Reaction Forces of Left and Right Foot from Total Forces in Real-Life Environments

    Directory of Open Access Journals (Sweden)

    Erfan Shahabpoor

    2018-06-01

    Full Text Available Continuous monitoring of natural human gait in real-life environments is essential in many applications including disease monitoring, rehabilitation, and professional sports. Wearable inertial measurement units are successfully used to measure body kinematics in real-life environments and to estimate total walking ground reaction forces GRF(t using equations of motion. However, for inverse dynamics and clinical gait analysis, the GRF(t of each foot is required separately. Using an experimental dataset of 1243 tri-axial separate-foot GRF(t time histories measured by the authors across eight years, this study proposes the ‘Twin Polynomial Method’ (TPM to estimate the tri-axial left and right foot GRF(t signals from the total GRF(t signals. For each gait cycle, TPM fits polynomials of degree five, eight, and nine to the known single-support part of the left and right foot vertical, anterior-posterior, and medial-lateral GRF(t signals, respectively, to extrapolate the unknown double-support parts of the corresponding GRF(t signals. Validation of the proposed method both with force plate measurements (gold standard in the laboratory, and in real-life environment showed a peak-to-peak normalized root mean square error of less than 2.5%, 6.5% and 7.5% for the estimated GRF(t signals in the vertical, anterior-posterior and medial-lateral directions, respectively. These values show considerable improvement compared with the currently available GRF(t decomposition methods in the literature.

  9. Skin reactions and quality of life after x-ray therapy of Basal cell carcinoma

    DEFF Research Database (Denmark)

    Skiveren, Jette; Mikkelsen, Maria Rudkjaer; Daugbjerg, Helle

    2012-01-01

    controls (P = 0.819). Three months after X-ray therapy eight patients had no skin reactions, 11 had slight atrophy, pigmentation change, and/or some hair loss, four had patch atrophy, moderate telangiectasia, and/or total hair loss. Conclusions. BCC has a negative effect on patients' quality of life...

  10. Effects of Gloves, Temperature and Their Interaction on Finger, Hand, and Arm Blood Flow and Skin Temperature: A Pilot Study

    Science.gov (United States)

    Hallbech, M. Susan

    1996-01-01

    The objective of this study is to investigate the effects of cold only, commercially available gloves only, and the combination of gloves and cold on the blood flow and surface (skin) temperature of the medial and proximal phalanxes of digit 3, the metacarpal region of the hand, and the forearm.

  11. Back to basics: hand hygiene and surgical hand antisepsis.

    Science.gov (United States)

    Spruce, Lisa

    2013-11-01

    Health care-associated infections (HAIs) are a significant issue in the United States and throughout the world, but following proper hand hygiene practices is the most effective and least expensive way to prevent HAIs. Hand hygiene is inexpensive and protects patients and health care personnel alike. The four general types of hand hygiene that should be performed in the perioperative environment are washing hands that are visibly soiled, hand hygiene using alcohol-based products, surgical hand scrubs, and surgical hand scrubs using an alcohol-based surgical hand rub product. Barriers to proper hand hygiene may include not thinking about it, forgetting, skin irritation, a lack of role models, or a lack of a safety culture. One strategy for improving hand hygiene practices is monitoring hand hygiene as part of a quality improvement project, but the most important aspect for perioperative team members is to set an example for other team members by following proper hand hygiene practices and reminding each other to perform hand hygiene. Copyright © 2013 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  12. Chronic tattoo reactions cause reduced quality of life equaling cumbersome skin diseases

    DEFF Research Database (Denmark)

    Carlsen, Katrina Hutton; Serup, Jørgen

    2015-01-01

    applied to patients with chronic tattoo reactions, tattoo complaints and impact on quality of life that were comparable to patients presenting cumbersome dermatological disease such as psoriasis, eczema and pruritus, which often show widespread effects to the skin, were uncovered. In conclusion, chronic...... impacts, including the effect on quality of life, should be studied. Itch severity and influence on quality of life can be measured objectively. The Itch Severity Scale and Dermatology Life Quality Index scoring systems have been applied to different dermatological diseases. When ISS and DLQI scores were...... tattoo reactions should be ranked as a cumbersome dermatological disease and, accordingly, given priority attention and qualified treatment by the public health care system....

  13. Wound bed preparation for ischemic diabetic foot ulcer.

    Science.gov (United States)

    Zhang, Zhaoxin; Lv, Lei; Guan, Sheng

    2015-01-01

    This study is to evaluate the effect of allograft skin on wound angiogenesis and wound bed preparation of ischemic diabetic foot ulcer. A total of 60 cases of patients with diabetic foot ulcer were randomly divided into the experimental group (n = 30) and the control group (n = 30). After debridement, in the experimental group, allograft skin was used to cover the wound while in the control group, vaseline and gauze was used to cover the wound. The wound was opened and dressed at 3, 5, 7, 14 days after operation and the growth condition of the granulation tissue was observed and recorded. The wound bed preparation time of the experimental group was 14.37 ± 1.06 days, compared with the control group 25.99 ± 4.03 days, there was statistically significant difference (t = 14.78, P cure time of the experimental group was 32 ± 1.93 days and this time was significantly shortened than the control group 39.73 ± 2.55 days (t = 12.521, P ulcer and shorten the wound bed preparation time and treatment cycle.

  14. [Association between S100B gene polymorphisms and hand, foot and mouth disease caused by enterovirus 71 infection].

    Science.gov (United States)

    Li, Jing; Shan, Ruo-Bing; Liu, Rui-Hai; Xu, Ying-Jun; Qu, Ni-Yan; Pan, Gui-Mei; Zhang, Na; Yang, Na; Chen, Zhen-Zhen; Zhang, Wen-Xiang; Li, Zi-Pu

    2017-08-01

    To investigate the association between rs9722 polymorphisms in the S100B gene and hand, foot and mouth disease (HFMD) caused by enterovirus 71. A total of 124 HFMD children with enterovirus 71 infection were enrolled as subjects, and 56 healthy children were enrolled as control group. The rs9722 polymorphisms in the S100B gene were detected for both groups, and the serum level of S100B protein was measured for 74 HFMD children. The rs9722 locus of the S100B gene had three genotypes, CC, CT, and TT, and the genotype frequencies were in accordance with Hardy-Weinberg equilibrium. Compared with the control group, the HFMD group had significant increases in the frequencies of TT genotype and T allele (Penterovirus 71 infection had significantly higher frequencies of TT genotype and T allele than those with moderate or mild HFMD (Penterovirus 71 infection.

  15. [Effects of foot reflexology on essential hypertension patients].

    Science.gov (United States)

    Park, Hyoung-Sook; Cho, Gyoo-Yeong

    2004-08-01

    This study was to evaluate the effects of foot reflexology on blood pressure, serum lipids level and life satisfaction in essential hypertension patients. The research design used was a nonequivalent control group pretest-posttest design. Foot Reflexology was used as the experimental treatment from June 23rd, 2003 until August 31st, 2003. Thirty-four subjects were assigned to an experimental group(18) and control group(16). Foot Reflexology was administered twice a week for 6 weeks and self foot Reflexology was administered twice a week for 4 weeks on the experimental group. There was a significant decrease in systolic blood pressure but no significant decrease in diastolic pressure in the experimental group compared to the control group. The total cholesterol level in the experimental group compared to the control group was not significantly decreased after foot reflexology. However, the triglyceride level in the experimental group compared to the control group was significantly decreased after foot reflexology. On the other hand, high density lipoprotein and low density lipoprotein levels in the experimental group compared to the control group was not significantly decreased after foot reflexology. Life satisfaction in the experimental group compared to the control group was significantly improved after foot reflexology. The results proved that foot reflexology was an effective nursing intervention to decrease systolic pressure, and triglyceride but not for the blood cholesterol and to improve life satisfaction. Therefore, blood cholesterol should be further evaluated in a larger group of subjects and for a longer period. Further research is regarded as necessary to evaluate and to compare effects of self-foot reflexology and foot reflexology.

  16. Diabetes: foot ulcers and amputations.

    Science.gov (United States)

    Hunt, Dereck L

    2011-08-26

    Diabetic foot ulceration is full-thickness penetration of the dermis of the foot in a person with diabetes. Severity is classified using the Wagner system, which grades it from 1 to 5. The annual incidence of ulcers among people with diabetes is 2.5% to 10.7% in resource-rich countries, and the annual incidence of amputation for any reason is 0.25% to 1.8%. We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of interventions to prevent foot ulcers and amputations in people with diabetes? What are the effects of treatments in people with diabetes with foot ulceration? We searched: Medline, Embase, The Cochrane Library, and other important databases up to September 2010 (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). We found 50 systematic reviews and RCTs that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. In this systematic review, we present information relating to the effectiveness and safety of the following interventions: debridement, human cultured dermis, human skin equivalent, patient education, pressure off-loading with felted foam or pressure-relief half-shoe, pressure off-loading with total-contact or non-removable casts, screening and referral to foot-care clinics, systemic hyperbaric oxygen for non-infected ulcers, systemic hyperbaric oxygen in infected ulcers, therapeutic footwear, topical growth factors, and wound dressings.

  17. 389 Allergic Reactions to Local Anesthetics: Detection by Skin Tests and Subcutaneous Provocation. Analysis of 160 Cases

    Science.gov (United States)

    Arcanjo, Luiz; Gonçalves Tavares, Tania Maria; Delcourt, Nathalia; Baroni, Juliana; Rios, João; Rios, José Luiz

    2012-01-01

    Background Adverse reactions to local anesthetics (LA) are frequent and often referred to as allergic. Although immune-mediated reactions are rare, it should be investigated for suspected cases. The objective of this study was to determine the frequency of positive skin test to these drugs in patients with a suspected history of allergic reactions and describe the main socio-demographic characteristics of these individuals. Methods Retrospective study of medical records of patients attended at Policlínica Geral do Rio de Janeiro Allergic Clinic, between 2008 and 2011. The parameters evaluated were the test indication and the patient ages and gender. The drug tested was that the patient had a history of suspicion. Patients underwent skin prick and intradermal tests and subcutaneous provocation. Descriptive statistical analysis of the data was performed. Results It was performed 160 tests (125 female). Three of this total was excluded due to inconclusive results. In women, the highest proportion of tests was in the age group from 41 to 60 years (43%), while in males the higher concentration was at a youngest age group: 21 to 40 years (41%). The most common indication (103 cases, 65%) for the tests was a previous suspected anaphylactic reaction by LA. Seven of 157 tests had a positive result (4.4%), 6 of them occurred in women (4.8%). Only one test resulted in a type of anaphylactic reaction response (0.67%). All patients who presented positive response to the test had a history of per-anesthetic reaction that suggested an immune-mediated mechanism. Conclusions In patients with a history of previous reaction to local anesthetics, the skin tests with these drugs have a key role in the prevention of anaphylaxis, and on guidance for adequate anesthetic procedures.

  18. Liposomalization of oxaliplatin induces skin accumulation of it, but negligible skin toxicity.

    Science.gov (United States)

    Nishida, Kentaro; Kashiwagi, Misaki; Shiba, Shunsuke; Muroki, Kiwamu; Ohishi, Akihiro; Doi, Yusuke; Ando, Hidenori; Ishida, Tatsuhiro; Nagasawa, Kazuki

    2017-12-15

    Liposomalization causes alteration of the pharmacokinetics of encapsulated drugs, and allows delivery to tumor tissues through passive targeting via an enhanced permeation and retention (EPR) effect. PEGylated liposomal doxorubicin (Doxil ® , Lipo-DXR), a representative liposomal drug, is well-known to reduce cardiotoxicity and increase the anti-tumor activity of DXR, but to induce the hand-foot syndrome (HFS) as a result of skin DXR accumulation, which is one of its severe adverse effects. We have developed a new liposomal preparation of oxaliplatin (l-OHP), an important anti-tumor drug for treatment of colorectal cancer, using PEGylated liposomes (Lipo-l-OHP), and showed that Lipo-l-OHP exhibits increased anti-tumor activity in tumor-bearing mice compared to the original preparation of l-OHP. However, whether Lipo-l-OHP causes HFS-like skin toxicity similar to Lipo-DXR remains to be determined. Administration of Lipo-l-OHP promoted accumulation of platinum in rat hind paws, however, it caused negligible morphological and histological alterations on the plantar surface of the paws. Administration of DiI-labeled empty PEGylated liposomes gave almost the same distribution profile of dyes into the dermis of hind paws with DXR as in the case of Lipo-DXR. Treatment with Lipo-l-OHP, Lipo-DXR, DiI-labeled empty PEGylated liposomes or empty PEGylated liposomes caused migration of CD68 + macrophages into the dermis of hind paws. These findings suggest that the skin toxicity on administration of liposomalized drugs is reflected in the proinflammatory characteristics of encapsulated drugs, and indicate that Lipo-l-OHP with a higher anti-cancer effect and no HFS may be an outstanding l-OHP preparation leading to an improved quality of life of cancer patients. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Warm hands, cold heart: progressive whole-body cooling increases warm thermosensitivity of human hands and feet in a dose-dependent fashion.

    Science.gov (United States)

    Filingeri, Davide; Morris, Nathan B; Jay, Ollie

    2017-01-01

    What is the central question of this study? Investigations on inhibitory/facilitatory modulation of vision, touch and pain show that conditioning stimuli outside the receptive field of testing stimuli modulate the central processing of visual, touch and painful stimuli. We asked whether contextual modulation also exists in human temperature integration. What is the main finding and its importance? Progressive decreases in whole-body mean skin temperature (the conditioning stimulus) significantly increased local thermosensitivity to skin warming but not cooling (the testing stimuli) in a dose-dependent fashion. In resembling the central mechanisms underlying endogenous analgesia, our findings point to the existence of an endogenous thermosensory system in humans that could modulate local skin thermal sensitivity to facilitate thermal behaviour. Although inhibitory/facilitatory central modulation of vision and pain has been investigated, contextual modulation of skin temperature integration has not been explored. Hence, we tested whether progressive decreases in whole-body mean skin temperature (T sk ; a large conditioning stimulus) alter the magnitude estimation of local warming and cooling stimuli applied to hairy and glabrous skin. On four separate occasions, eight men (27 ± 5 years old) underwent a 30 min whole-body cooling protocol (water-perfused suit; temperature, 5°C), during which a quantitative thermosensory test, consisting of reporting the perceived magnitude of warming and cooling stimuli (±8°C from 30°C baseline) applied to the hand (palm/dorsum) and foot (sole/dorsum), was performed before cooling and every 10 min thereafter. The cooling protocol resulted in large progressive reductions in T sk [10 min, -3.36°C (95% confidence interval -2.62 to -4.10); 20 min, -5.21°C (-4.47 to -5.95); and 30 min, -6.32°C (-5.58 to -7.05); P fashion. In highlighting a novel feature of human temperature integration, these findings point to the existence

  20. Prevalence of Coxsackievirus A6 and Enterovirus 71 in Hand, Foot and Mouth Disease in Nanjing, China in 2013.

    Science.gov (United States)

    Hu, Ya-Qian; Xie, Guang-Cheng; Li, Dan-Di; Pang, Li-Li; Xie, Jing; Wang, Peng; Chen, Ying; Yang, Jing; Cheng, Wei-Xia; Zhang, Qing; Jin, Yu; Duan, Zhao-Jun

    2015-09-01

    Although hand, foot and mouth disease (HFMD) has been strongly associated with enterovirus 71 (EV71), coxsackievirus A16 (CVA16) and other enteroviruses, studies regarding coxsackievirus A6 (CVA6) infection in HFMD are limited. The aim of this study was to identify the major etiological agents causing HFMD in Nanjing in 2013 and explore the clinical and genetic characteristics of the prevalent enterovirus (EV) types in HFMD. A total of 394 throat swabs were collected from hospitalized children diagnosed with HFMD from April to July 2013. EVs were detected by reverse transcription polymerase chain reaction of 5' UTR sequences. Genotyping and phylogenetic analysis were based on VP4 sequences. Demographic and clinical data were obtained. Of the specimens, 68.5% (270/394) were positive for EVs. The genotypes and detection rates were CVA6, 30.00% (81/270); EV71, 17.41% (47/270); HRV, 11.11% (30/270); CVA10, 3.33% (9/270); CVA2, 1.11% (3/270); CVA16, 0.74% (2/270); EV68, 0.37% (1/270); echovirus 6, 0.37% (1/270); echovirus 9, 0.37% (1/270), respectively. Patients infected with CVA6 displayed symptoms atypical of HFMD, including larger vesicles on their limbs and buttocks. Phylogenetic analysis revealed 2 genetically distinct CVA6 strains that circulated independently within the region. Patients infected with CVA6 were more likely to have abnormal periphery blood white blood cell and C-reactive protein levels, while EV71 was more likely to infect the central nervous system, as indicated by clinical manifestations and white blood cell analysis of cerebrospinal fluid. Multiple EV genotypes contributed to HFMD in Nanjing in 2013, and CVA6 was the dominant genotype. The clinical presentation of CVA6 infection differs from that of EV71 infection in HFMD.

  1. The Diabetic Foot - A Review | Ekere | Nigerian Journal of ...

    African Journals Online (AJOL)

    High risk patients should be advised to wash and inspect their feet daily, use creams and lotions to prevent dry skin and callus formation, use adequate foot wear, avoid barefoot gait and thermal injury, and seek early medical attention in the event of injury, however trivial. Pedicure must be done by another person

  2. Advances in allergic skin disease, anaphylaxis, and hypersensitivity reactions to foods, drugs, and insects.

    Science.gov (United States)

    Sicherer, Scott H; Leung, Donald Y M

    2006-07-01

    This review highlights some of the research advances in anaphylaxis; hypersensitivity reactions to foods, drugs, and insects; and allergic skin disease that were reported primarily in the Journal in 2005. Although studies documented deficiencies in community management of anaphylaxis, guidelines and National Institutes of Health summary reports provide direction toward improved research and education. At least 9% of young children "outgrow" a tree nut allergy. Advances in food allergy diagnosis include reports of probability of reactions to peanut at various peanut-specific IgE concentrations and skin test response size and the utility of evaluating IgE binding to specific epitopes. Future food allergy treatments might include selection of "less allergenic" fruit cultivars, genetic silencing of major allergens, and treatment of allergic patients with Chinese herbal remedies. Osteopontin might be a useful biomarker for success of venom immunotherapy. Progress in our understanding of the immunology of atopic dermatitis and autoimmune urticaria has also been made. These observations will likely contribute toward optimizing management of these common allergic disorders.

  3. [Vacuum-assisted therapy for various wound types including diabetic foot ulcer].

    Science.gov (United States)

    Farah, Raymond; Gantus, Maher; Kogan, Leonid

    2011-03-01

    Vacuum is a noninvasive system that creates a localized controlled negative pressure environment. In this study, vacuum was provided by the V.A.C. Therapy system, which promotes wound healing by delayed primary or secondary intention through creating a moist wound environment, preparing the wound bed for closure, reducing edema, and promoting formation and perfusion of granulation tissue. Vacuum-assisted closure therapy is indicated for use in all care settings and for a variety of wound types including diabetic foot ulcers. The purpose of this study was to evaluate safety and clinical efficacy of negative pressure wound therapy (NPWT) compared with advanced moist wound therapy and standard treatment to treat foot ulcers in diabetic patients. This trial enrolled 43 patients; most of them were diabetic patients at any age with various skin ulcers and diabetic foot. These patients were divided into two groups, 17 patients were treated with vacuum and the 26 patients in the control group were treated with standard therapy including debridement. A greater proportion of foot and skin ulcers achieved complete ulcer closure with vacuum-assisted therapy p<0.001 compared with the standard therapy. Vacuum therapy significantly decreased the duration and frequency of admission p=0.032 and decreased the rate of amputation p<0.001. Results of our trial support other studies and demonstrate that vacuum is as safe as and more efficacious than standard therapy in the treatment of diabetic foot ulcers. A significantly greater number of patients achieved complete ulcer closure and granulation tissue formation with this therapy. The study group showed a significant reduction in the median time needed to heal ulcers, reduction of the number of admissions and amputation frequency.

  4. Laterality in the rubber hand illusion.

    Science.gov (United States)

    Ocklenburg, Sebastian; Rüther, Naima; Peterburs, Jutta; Pinnow, Marlies; Güntürkün, Onur

    2011-03-01

    In patient studies, impairments of sense of body ownership have repeatedly been linked to right-hemispheric brain damage. To test whether a right-hemispheric dominance for sense of body ownership could also be observed in healthy adults, the rubber hand illusion was elicited on both hands of 21 left-handers and 22 right-handers. In this illusion, a participant's real hand is stroked while hidden from view behind an occluder, and a nearby visible hand prosthesis is repeatedly stroked in synchrony. Most participants experience the illusionary perception of touch sensations arising from the prosthesis. The vividness of the illusion was measured by subjective self-reports as well as by skin conductance responses to watching the rubber hand being harmed. Handedness did not affect the vividness of the illusion, but a stronger skin conductance response was observed, when the illusion was elicited on the left hand. These findings suggest a right-hemispheric dominance for sense of body ownership in healthy adults.

  5. Reconstruction of soft-tissue lesions of the foot with the use of the medial plantar flap

    Directory of Open Access Journals (Sweden)

    Jefferson Lessa Soares de Macedo

    Full Text Available ABSTRACT OBJECTIVE: To study use of the medial plantar flap for reconstruction of the heel and foot. METHOD: The authors share their clinical experience with the use of the medial plantar artery flap for coverage of tissue defects around the foot and heel after trauma. Twelve cases of medial plantar artery flap performed from January 2001 to December 2013 were included. RESULTS: Of the 12 patients, ten were male and two were female. The indications were traumatic loss of the heel pad in ten cases and the dorsal foot in two cases. All the flaps healed uneventfully without major complications, except one case with partial flap loss. The donor site was covered with a split-thickness skin graft. The flaps had slightly inferior protective sensation compared with the normal side. CONCLUSION: From these results, the authors suggest that the medial plantar artery flap is a good addition to the existing armamentarium for coverage of the foot and heel. It is versatile flap that can cover defects on the heel, over the Achilles tendon and plantar surface, as well as the dorsal foot. It provides tissue to the plantar skin with a similar texture and intact protective sensation.

  6. Acute fractures of the pediatric foot and ankle.

    Science.gov (United States)

    Halai, Mansur; Jamal, Bilal; Rea, Paul; Qureshi, Mobeen; Pillai, Anand

    2015-02-01

    Injuries around the foot and ankle are challenging. There is a paucity of literature, outside that of specialist orthopedic journals, that focuses on this subject in the pediatric population. In this review, we outline pediatric foot and ankle fractures in an anatomically oriented manner from the current literature. Our aim is to aid the emergency department doctor to manage these challenging injuries more effectively in the acute setting. These injuries require a detailed history and examination to aid the diagnosis. Often, plain radiographs are sufficient, but more complex injuries require the use of magnetic resonance imaging. Treatment is dependent on the proximity to skeletal maturity and the degree of displacement of fracture. Children have a marked ability to remodel after fractures and therefore mainstay treatment is immobilization by a cast or splint. Operative fixation, although uncommon in this population, may be necessary with adolescents, certain unstable injuries or in cases with displaced articular surface. In the setting of severe foot trauma, skin compromise and compartment syndrome of the foot must be excluded. The integrity of the physis, articular surface and soft tissues are all equally important in treating these injuries.

  7. WE-FG-202-01: Early Prediction of Radiotherapy Induced Skin Reactions Using Dynamic Infrared Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Biswal, N [Rutgers Cancer Institute of New Jersey, New Brunswick, NJ (United States); Cifter, G [Boston, MA (United States); Sun, J [Argonne National Laboratory, Lemont, IL (United States); Sen, N; Wang, D; Diaz, A; Griem, K [Rush University Medical Center, Chicago, IL (United States); Chu, J [Rush University Medical Center, Oak Brook, IL (United States)

    2016-06-15

    Purpose: To predict radiotherapy induced skin reactions using dynamic infrared imaging. Methods: Thermal images were captured by our homebuilt system consisting of two flash lamps and an infrared (IR) camera. The surface temperature of the skin was first raised by ∼ 6 oC from ∼1 ms flashes. The camera then captured a series of IR images for 10 seconds. For each image, a baseline skin temperature was recorded for 0.5sec before heat impulse. The temporal temperature gradients were calculated between a reference point (immediately after the flash) and at a time point 9sec after that. Thermal effusivity, an intrinsic thermal property of a material, was calculated from the surface temperature decay of skin. We present experimental data in five patients undergoing radiation therapy, of which 2 were Head & Neck, 1 was Sarcoma and 2 were Breast cancer patients. The prescribed doses were 45 – 60 Gy in 25 – 30 fractions. Each patient was imaged before treatment and after every fifth fraction until end of the treatment course. An area on the skin, outside the radiation field, was imaged as control region. During imaging, each patient’s irradiated skins were scored based on RTOG skin morbidity scoring criteria. Results: Temperature gradient, which is the temperature recovery rate, depends on the thermal properties of underlying tissue. It was observed that, the skin temperature and temporal temperature gradient increases with delivered radiation dose and skin RTOG score. The treatment does not change effusivity of superficial skin layer, however there was a significant difference in effusivity between treated and control areas at depth of ∼ 1.5 – 1.8 mm, increases with dose. Conclusion: The higher temporal temperature gradient and effusivity from irradiated areas suggest that there is more fluid under the irradiated skin, which causes faster temperature recovery. The mentioned effects may be predictors of Moist Desquamation.

  8. Herbal medicine for hand-foot syndrome induced by fluoropyrimidines: A systematic review and meta-analysis.

    Science.gov (United States)

    Deng, Bo; Sun, Wei

    2018-04-16

    The aims of this study were to evaluate the efficacy of herbal medicine for the prevention and management of hand-foot syndrome (HFS) induced by fluoropyrimidines and to identify herbs associated with HFS alleviation for further research. The PubMed, Cochrane, Springer, China National Knowledge Infrastructure, and Wanfang databases were searched up to May 2017 for randomized controlled trials (RCTs) that evaluated herbal medicine for relieving HFS in patients undergoing fluoropyrimidine-based chemotherapy. Study evaluation and synthesis methods were in accordance with the Cochrane Handbook, and data were analyzed using RevMan 5.3. In total, 35 RCTs (2,668 participants) were included. Meta-analysis showed that the addition of herbal medicine significantly reduced the incidences of all-grade and high-grade HFS. The total effective rate and complete remission rate of HFS patients increased significantly with herbal medicine arm. Further sensitivity analysis identified Paeoniae Radix Alba, Carthami Flos, Cinnamomi Ramulus, and Glycyrrhizae Radix et Rhizoma as being consistently associated with significant reductions in HFS incidence without important heterogeneity. However, the lack of blinding in most studies may have led to overestimation of these effects. More high-quality RCTs and experimental research are needed to confirm and investigate the efficacy of the herbs identified in this study. Copyright © 2018 John Wiley & Sons, Ltd.

  9. Quantitative Sasang Constitution Diagnosis Method for Distinguishing between Tae-eumin and Soeumin Types Based on Elasticity Measurements of the Skin of the Human Hand.

    Science.gov (United States)

    Song, Han Wook; Lee, Sungjun; Park, Yon Kyu; Woo, Sam Yong

    2009-09-01

    The usefulness of constitutional diagnoses based on skin measurements has been established in oriental medicine. However, it is very difficult to standardize traditional diagnosis methods. According to Sasang constitutional medicine, humans can be distinguished based on properties of the skin, including its texture, roughness, hardness and elasticity. The elasticity of the skin was previously used to distinguish between people with Tae-eumin (TE) and Soeumin (SE) constitutions. The present study designed a system that uses a compression method to measure the elasticity of hand skin and evaluated its measurement repeatability. The proposed system was used to compare the skin elasticity between SE and TE subjects, which produced a measurement repeatability error of <3%. The proposed system is suitable for use as a quantitative constitution diagnosis method for distinguishing between TE and SE subjects with an acceptable level of uncertainty.

  10. 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.

    Science.gov (United States)

    Ibler, Kristina Sophie; Agner, Tove; Hansen, Jane Lindschou; Gluud, Christian

    2010-08-31

    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. 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. The trial is registered in ClinicalTrials.Gov, NCT01012453.

  11. Research on the Influence of Orthopaedic Inserts on Pressure Distribution in the Foot

    Directory of Open Access Journals (Sweden)

    Ignas Rutulys

    2011-02-01

    Full Text Available The article examines the influence of individual orthopaedic inserts on pressure distribution in the foot. Feet deformations, types of orthopaedic inserts, materials and pressure in the foot testing methods are discussed. Experimental computer measurements of pressure in the foot before and after the use of inserts have been done. During research, the inserts made of different kinds of materials selected according to human weight, pathology, skin sensitivity and many other reasons has been used. It has been determinated that orthopaedic inserts have a more noticeable impact on children whose feet is adjusted easier if compared with those of adults.Article in Lithuanian

  12. Modelling foot height and foot shape-related dimensions.

    Science.gov (United States)

    Xiong, Shuping; Goonetilleke, Ravindra S; Witana, Channa P; Lee Au, Emily Yim

    2008-08-01

    The application of foot anthropometry to design good-fitting footwear has been difficult due to the lack of generalised models. This study seeks to model foot dimensions so that the characteristic shapes of feet, especially in the midfoot region, can be understood. Fifty Hong Kong Chinese adults (26 males and 24 females) participated in this study. Their foot lengths, foot widths, ball girths and foot heights were measured and then evaluated using mathematical models. The results showed that there were no significant allometry (p > 0.05) effects of foot length on ball girth and foot width. Foot height showed no direct relationship with foot length. However, a normalisation with respect to foot length and foot height resulted in a significant relationship for both males and females with R(2) greater than 0.97. Due to the lack of a direct relationship between foot height and foot length, the current practice of grading shoes with a constant increase in height or proportionate scaling in response to foot length is less than ideal. The results when validated with other populations can be a significant way forward in the design of footwear that has an improved fit in the height dimension.

  13. Clinical efficacy of artificial skin combined with vacuum sealing drainage in treating large-area skin defects

    Institute of Scientific and Technical Information of China (English)

    TANG Jin; GUO Wei-chun; YU Ling; ZHAO Sheng-hao

    2010-01-01

    Objective: To observe the clinical efficacy of artificial skin combined with vacuum sealing drainage (VSD) in treating large-area skin defects.Methods: Totally 18 patients with skin defects, treated with artificial skin combined with VSD from September 2008to May 2009 in our hospital, were retrospectively analyzed in this study. There were 15 males and 3 females, aged 7-66years, 34.3 years on average. Among them, 10 cases had skin laceration caused by traffic accidents (7 with open fractures), 1 mangled injury, 1 blast injury, 1 stump infection combined with skin defects after amputation and 5 heel ulcers.Results: All skin grafts in 16 cases survived after being controlled by VSD for one time. For the rest 2 patients,one with skin avulsion on the left foot was given median thickness skin grafts after three times of VSD, the other with open fractures in the left tibia and fibula caused by a traffic accident was given free flap transplantation. Skin grafts of both patients survived, with normal color and rich blood supply.Conclusion: Skin grafting in conjunction with artificial skin and VSD is much more effective than traditional dressing treatment and worth wide application in clinic.

  14. The effect of compressed air massage on skin blood flow and temperature.

    Science.gov (United States)

    Mars, Maurice; Maharaj, Sunil S; Tufts, Mark

    2005-01-01

    Compressed air massage is a new treatment modality that uses air under pressure to massage skin and muscle. It is claimed to improve skin blood flow but this has not been verified. Several pilot studies were undertaken to determine the effects of compressed air massage on skin blood flow and temperature. Skin blood flow (SBF), measured using laser Doppler fluxmetry and skin temperature was recorded under several different situations: (i) treatment, at 1 Bar pressure using a single-hole (5-mm) applicator head, for 1 min at each of several sites on the right and left lower legs, with SBF measured on the dorsum of the left foot; (ii) at the same treatment pressure, SBF was measured over the left tibialis anterior when treatment was performed at different distances from the probe; (iii) SBF and skin temperature of the lower leg were measured with treatment at 0 or 1 Bar for 45 min, using two different applicator heads; (iv) SBF was measured on the dorsum of the foot of 10 subjects with treatment for 1 min at 0, 0.5, 1, 1.5 and 2 Bar using three different applicator heads. (i) SBF of the left foot was not altered by treatment of the right leg or chest, but was significantly increased during treatment of the left sole and first web, p Compressed air massage causes an immediate increase in SBF, and an immediate fall in SBF when treatment is stopped. The effect appears to be locally and not centrally mediated and is related to the pressure used. Treatment cools the skin for at least 15 min after a 45-min treatment.

  15. Supplemental tests in the evaluation of occupational hand dermatitis in soldiers.

    Science.gov (United States)

    Wolf, R; Movshowitz, M; Brenner, S

    1996-03-01

    Hand dermatitis in soldiers is a considerable problem. The purpose of the study was to evaluate appropriate screening tests to improve the diagnosis of hand dermatitis in soldiers. A group of 111 soldiers with occupational dermatitis from contact with fuels and oils underwent "tailored patch tests" with allergens relevant to their field of work and their environment. The control group consisted of 24 soldiers with various jobs similar to those of civilian life, who had not been exposed to oils and fuels. Seventy-three civilian patients, attending the clinic for patch testing, were also included. Twenty soldiers, who had a history of intensive contact with oil and fuels, but no contact dermatitis, and who were admitted because of various skin diseases (fungal infections, acne, etc.) also underwent the supplemental testing and served as an additional control group. Of the soldiers, 31 (29%) showed one or more positive skin tests of the oil series and 30 patients of this group one or more positive reactions to the standard patch tests trays. No patient of the control groups had a positive test to the oil series. Our results show the value of the supplementary tests as a first-step screening test for detection of oil allergy in soldiers and automobile-mechanics or in workers handling other gasoline- or diesel-powered engineering equipment. The test method appears to be practical, easy to perform, reliable and giving clear and accurate results, with a negligible rate of false positive reactions.

  16. Cytokine and Protein Markers of Leprosy Reactions in Skin and Nerves: Baseline Results for the North Indian INFIR Cohort

    Science.gov (United States)

    Lockwood, Diana N. J.; Suneetha, Lavanya; Sagili, Karuna Devi; Chaduvula, Meher Vani; Mohammed, Ismail; van Brakel, Wim; Smith, W. C.; Nicholls, Peter; Suneetha, Sujai

    2011-01-01

    Background Previous studies investigating the role of cytokines in the pathogenesis of leprosy have either been on only small numbers of patients or have not combined clinical and histological data. The INFIR Cohort study is a prospective study of 303 new multibacillary leprosy patients to identify risk factors for reaction and nerve damage. This study characterised the cellular infiltrate in skin and nerve biopsies using light microscopic and immunohistochemical techniques to identify any association of cytokine markers, nerve and cell markers with leprosy reactions. Methodology/Principal Findings TNF-α, TGF-β and iNOS protein in skin and nerve biopsies were detected using monoclonal antibody detection immunohistochemistry techniques in 299 skin biopsies and 68 nerve biopsies taken from patients at recruitment. The tissues were stained with hematoxylin and eosin, modified Fite Faraco, CD68 macrophage cell marker and S100. Conclusions/Significance Histological analysis of the biopsies showed that 43% had borderline tuberculoid (BT) leprosy, 27% borderline lepromatous leprosy, 9% lepromatous leprosy, 13% indeterminate leprosy types and 7% had no inflammation. Forty-six percent had histological evidence of a Type 1 Reaction (T1R) and 10% of Erythema Nodosum Leprosum. TNF-α was detected in 78% of skin biopsies (181/232), iNOS in 78% and TGF-β in 94%. All three molecules were detected at higher levels in patients with BT leprosy. TNF-α was localised within macrophages and epithelioid cells in the granuloma, in the epidermis and in dermal nerves in a few cases. TNF-α, iNOS and TGF-β were all significantly associated with T1R (p<0.001). Sixty-eight nerve biopsies were analysed. CD68, TNF-α and iNOS staining were detectable in 88%, 38% and 28% of the biopsies respectively. The three cytokines TNF-α, iNOS and TGF-β detected by immunohistochemistry showed a significant association with the presence of skin reaction. This study is the first to demonstrate an

  17. Factors influencing power hand tool fastening accuracy and reaction forces.

    Science.gov (United States)

    Radwin, Robert G; Chourasia, Amrish O; Howery, Robert S; Fronczak, Frank J; Yen, Thomas Y; Subedi, Yashpal; Sesto, Mary E

    2014-06-01

    A laboratory study investigated the relationship between power hand tool and task-related factors affecting threaded fastener torque accuracy and associated handle reaction force. We previously developed a biodynamic model to predict handle reaction forces. We hypothesized that torque accuracy was related to the same factors that affect operator capacity to react against impulsive tool forces, as predicted by the model. The independent variables included tool (pistol grip on a vertical surface, right angle on a horizontal surface), fastener torque rate (hard, soft), horizontal distance (30 cm and 60 cm), and vertical distance (80 cm, 110 cm, and 140 cm). Ten participants (five male and five female) fastened 12 similar bolts for each experimental condition. Average torque error (audited - target torque) was affected by fastener torque rate and operator position. Torque error decreased 33% for soft torque rates, whereas handle forces greatly increased (170%). Torque error also decreased for the far horizontal distance 7% to 14%, when vertical distance was in the middle or high, but handle force decreased slightly 3% to 5%. The evidence suggests that although both tool and task factors affect fastening accuracy, they each influence handle reaction forces differently. We conclude that these differences are attributed to different parameters each factor influences affecting the dynamics of threaded faster tool operation. Fastener torque rate affects the tool dynamics, whereas posture affects the spring-mass-damping biodynamic properties of the human operator. The prediction of handle reaction force using an operator biodynamic model may be useful for codifying complex and unobvious relationships between tool and task factors for minimizing torque error while controlling handle force.

  18. The effectiveness of non-surgical interventions in the treatment of Charcot foot.

    Science.gov (United States)

    Smith, Caroline; Kumar, Saravana; Causby, Ryan

    2007-12-01

    trials evaluating bisphosphonates reported greater reduction in foot temperature and disease activity for intervention subjects compared with controls. Another outcome of this review indicated additional beneficial effects of bisphosphonates in reducing pain and discomfort. The trial evaluating palliative radiotherapy found no difference between groups on any outcome. A significant reduction in the amount of deformity and reduced healing time to consolidation was found after treatment in the group receiving magnetic therapy treatment. Discussion  There is a lack of clinical trials evaluating the effectiveness of non-operative interventions for the management of Charcot foot (immobilisation, removable cast walkers, advice/dispensing of footwear and prescribing of orthotics). Bisphosphonates may be useful adjuncts to standard management of Charcot foot by improved healing demonstrated by a reduction in disease activity indicated by skin temperature and bone destruction. Magnetic therapy may reduce deformity, joint destruction and improve mobility. Conclusion  There is a lack of evidence supporting the use of pharmacological or non-surgical interventions with reducing lesions, ulceration, rate of surgical intervention, hospital admissions and improving the quality of life of subjects with Charcot foot. Bisphosphonates may improve the healing of Charcot foot by reducing skin temperature and disease activity of Charcot foot, when applied in addition to standard interventions to control the position and shape of the foot.

  19. Assessment of local skin reactions with a sequential regimen of cryosurgery followed by ingenol mebutate gel, 0.015%, in patients with actinic keratosis

    Directory of Open Access Journals (Sweden)

    Goldenberg G

    2014-12-01

    Full Text Available Gary Goldenberg,1 Brian Berman2,3 1Department of Dermatology, Mount Sinai School of Medicine, New York, NY, 2Center for Clinical and Cosmetic Research, Aventura, FL, 3Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA Abstract: Lesion-directed and field-directed therapies are used to treat actinic keratosis (AK. Therapeutic approaches that combine both types of therapies may improve the successful elimination of AKs. A randomized, double-blind, vehicle-controlled study evaluated the safety, tolerability, and efficacy of topical field treatment with ingenol mebutate gel, 0.015%, after cryosurgery to AKs on the face and scalp. Patients with 4–8 visible discrete AKs in a 25-cm2 contiguous area received cryosurgery of all AKs at baseline. After a 3-week healing period, patients applied ingenol mebutate gel, 0.015%, or vehicle gel once daily for 3 consecutive days to the treatment area. The incidence, severity, and time course of the development and resolution of local skin reactions were measured from baseline to week 11. Local skin reactions peaked shortly after completion of ingenol mebutate treatment and generally resolved within 2 weeks. The mean (95% confidence interval composite score (maximum range, 0–24 for these reactions was higher in patients with treatment of AKs on the face, 9.3 (8.5–10.1, as compared with the scalp, 5.8 (4.3–7.4. Erythema and flaking/scaling were the major contributors to the composite local skin reaction score. These results show that local skin reactions associated with ingenol mebutate treatment of the face or scalp are well tolerated after recent cryosurgery. Keywords: ingenol mebutate gel, actinic keratosis, field therapy, local skin reaction

  20. Canadian hand dermatitis management guidelines

    DEFF Research Database (Denmark)

    Lynde, Charles; Guenther, Lyn; Diepgen, Thomas L

    2010-01-01

    Hand dermatitis (HD) is one of the most common skin conditions; however, it is not a homogeneous disease entity. The severity of HD may range from very mild cases to severe chronic forms, which may result in prolonged disability and, occasionally, refractory HD. Chronic hand dermatitis (CHD...

  1. Hand-foot-and-mouth disease and weather factors in Guangzhou, southern China.

    Science.gov (United States)

    Li, T; Yang, Z; DI, B; Wang, M

    2014-08-01

    Hand-foot-and-mouth disease (HFMD) is becoming one of the common airborne and contact transmission diseases in Guangzhou, southern China, leading public health authorities to be concerned about its increased incidence. In this study, we aimed to examine the effect of weather patterns on the incidence of HFMD in the subtropical city of Guangzhou for the period 2009-2012, and assist public health prevention and control measures. A negative binomial multivariable regression was used to identify the relationship between meteorological variables and HFMD. During the study period, a total of 166,770 HFMD-confirmed cases were reported, of which 11 died, yielding a fatality rate of 0·66/10,000. Annual incidence rates from 2009 to 2012 were 132·44, 311·40, 402·76, and 468·59/100,000 respectively. Each 1°C rise in temperature corresponded to an increase of 9·38% (95% CI 8·17-10·51) in the weekly number of HFMD cases, while a 1 hPa rise in atmospheric pressure corresponded to a decrease in the number of cases by 6·80% (95% CI -6·99 to -6·65), having an opposite effect. Similarly, a 1% rise in relative humidity corresponded to an increase of 0·67% or 0·51%, a 1 m/h rise in wind velocity corresponded to an increase of 4·01% or 2·65%, and a 1 day addition in the number of windy days corresponded to an increase of 24·73% or 25·87%, in the weekly number of HFMD cases, depending on the variables considered in the model. Our findings revealed that the epidemic status of HFMD in Guangzhou is characterized by high morbidity but low fatality. Weather factors had a significant influence on occurrence and transmission of HFMD.

  2. [Rash and fever illness caused by herpes simplex virus type 1 needs to be distinguished from hand, foot and mouth disease].

    Science.gov (United States)

    Zhu, Shuang-Li; Liu, Jian-Feng; Sun, Qiang; Li, Jing; Li, Xiao-Lei; Zhang, Yong; Chen, Ying; Wen, Xiao-Yun; Yan, Dong-Mei; Huang, Guo-Hong; Zhang, Bao-Min; Zhang, Bo; An, Hong-Qiu; Li, Hui; Xu, Wen-Bo

    2013-06-01

    An epidemic of rash and fever illnesses suspected of hand, foot and mouth disease (HFMD) occurred in Gansu Province of China in 2008, laboratory tests were performed in order to identify the pathogen that caused this epidemic. Eight clinical specimens collected from the 4 patients (each patient has throat swab and herpes fluid specimens) with rash and febrile illness, were inoculated onto RD and HEp-2 cells for virus isolation, and the viral nucleic acid was then extracted with the positive virus isolates, the dual-channel real-time reverse transcript-polymerase chain reaction (RT-PCR) was performed to detect the nucleic acid of human enterovirus (HEV) in the viral isolates at the same time. For the viral isolates with the negative results of HEV, a sequence independent single primer amplification technique (SISPA) was used for "unknown pathogen" identification. Totally, 6 viral isolates were identified as herpes simplex virus type 1 (HSV-1). Comprehensive analyses results of the clinical manifestations of the patients, epidemiological findings and laboratory test indicated that this epidemic of rash and febrile illness was caused by HSV-1. The differences among the gG region of 6 HSV-1 isolates at nucleotide level and amino acid level were all small, and the identities were up to 98. 8% and 97.9%, respectively, showing that this outbreak was caused by only one viral transmission chain of HSV-1. HSV-1 and other viruses that cause rash and febrile illnesses need differential diagnosis with HFMD. The etiology of rash and febrile illness is sometimes difficult to distinguish from the clinical symptoms and epidemiological data, the laboratory diagnosis is therefore critical.

  3. Kinematic and kinetic differences between left-and right-handed professional baseball pitchers.

    Science.gov (United States)

    Diffendaffer, Alek Z; Fleisig, Glenn S; Ivey, Brett; Aune, Kyle T

    2018-03-21

    While 10% of the general population is left-handed, 27% of professional baseball pitchers are left-handed. Biomechanical differences between left- and right-handed college pitchers have been previously reported, but these differences have yet to be examined at the professional level. Therefore, the purpose of this study was to compare pitching biomechanics between left- and right-handed professional pitchers. It was hypothesised that there would be significant kinematic and kinetic differences between these two groups. Pitching biomechanics were collected on 96 left-handed pitchers and a group of 96 right-handed pitchers matched for age, height, mass and ball velocity. Student t-tests were used to identify kinematic and kinetic differences (p different between the groups. Landing position of the stride foot, trunk separation at foot contact, maximum shoulder external rotation and trunk forward tilt at ball release were all significantly greater in right-handed pitchers. The magnitude of the statistical differences found were small and not consistent with differences in the two previous, smaller studies. Thus, the differences found may be of minimal practical significance and mechanics can be taught the same to all pitchers, regardless of throwing hand.

  4. Single treatment with ethanol hand rub is ineffective against human rhinovirus--hand washing with soap and water removes the virus efficiently.

    Science.gov (United States)

    Savolainen-Kopra, Carita; Korpela, Terttu; Simonen-Tikka, Marja-Leena; Amiryousefi, Ali; Ziegler, Thedi; Roivainen, Merja; Hovi, Tapani

    2012-03-01

    Ethanol-containing hand rubs are used frequently as a substitute for hand washing with water and soap. However, not all viruses are inactivated by a short term rubbing with alcohol. The capacity of a single round of instructed and controlled hand cleaning with water and soap or ethanol-containing hand rub, respectively, was tested for removal of human rhinovirus administered onto the skin of healthy volunteers on the back of the hands. Hand washing with soap and water appeared to be much more efficient for removing rhinoviruses from skin than rubbing hands with an ethanol-containing disinfectant. After washing with soap and water the virus was detected in 3/9 (33.3%) test persons from the left hand and 1/9 (11.1%) cases from the right hand, whereas the virus was detected invariably by real-time RT-PCR from both hands after cleaning with alcohol hand rub (P-value soap can clean efficiently hands contaminated with the virus responsible for an extensive share of common cold episodes. Copyright © 2012 Wiley Periodicals, Inc.

  5. Survey of enterovirus infections from hand, foot and mouth disease outbreak in china, 2009

    Directory of Open Access Journals (Sweden)

    Yang Fan

    2011-11-01

    Full Text Available Abstract Background In China, a rapid expansion of Hand, foot, and mouth disease (HFMD outbreaks has occurred since 2004 and HFMD has become an important issue for China. However, people are still only concerned with human enterovirus 71(HEV-71 and coxsackie virus A16 (CV-A16. Much of what is known about the other enterovirus infections relies on fractional evidence and old epidemic data, with little knowledge concerning their distribution. To alert potential threatens of the other enteroviruses, our study genetically characterized specimens from different regions of China and yielded novel information concerning the circulating and phylogenetic characteristics of enteroviral strains from HFMD cases. Findings A total of 301 clinical throat swabs were randomly obtained from patients suffering from HFMD from the southern, northern and central regions of China during outbreaks in 2009. 266 of 301 (88.4% HFMD cases were found positive for HEV and seven genotypes, HEV-71, CV-A16, -B5, -A4, -A6, -A10, and -A12, were detected. Conclusions The HFMD pathogen compositions in the different regions of China were significantly different. HFMD epidemics might persist for a long time in China due to the multiple pathogen compositions, the enteroviral characteristic of recombination and co-infection, the ever-increasing travel and migration and the deficiency of effective vaccine. Our study deserves the attention on HFMD control and vaccine development.

  6. A large extraskeletal osteochondroma of the foot.

    Science.gov (United States)

    Estil, Jose Carlos C; Yeo, Eui-Dong; Kim, Hak Jun; Cho, Won Tae; Lee, Jeong-Ju

    2013-01-01

    Osteochondromas are very common benign tumors composed of cartilage and bone. They are usually found at the end of the growth plate of long bones, most often at the area of the joints, and are contiguous with the medullary cavity. Extraskeletal osteochondromas, the same as their namesake, are composed of cartilage and bone. However, unlike typical osteochondromas, extraskeletal osteochondromas are not contiguous with bone, as their name implies. They usually arise from the synovial tissue and tendon sheaths. Although rare, extraskeletal osteochondromas have been reported to occur within the knee and around the hip; however, they are more commonly reported to occur in the hands and feet. When found in the hands or feet, these new growths are often very small and only occasionally symptomatic. We present the case of a 49-year-old female who had a slow-growing mass of 4 years' duration, located on the plantar aspect of her left foot. The mass was slowly becoming more palpable as it increased in size and was progressively causing pain and discomfort during ambulation. Imaging studies revealed an ossified mass bearing no connection to any other structure on the plantar aspect of her foot. An excision biopsy was performed, and the easily dissectible mass, although much larger than its usual presentation, proved to be an extraskeletal osteochondroma. Copyright © 2013 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  7. The first step in infection control is hand hygiene.

    Science.gov (United States)

    Canham, Leslie

    2011-01-01

    A dental health care worker (DHCW) has an obligation to prevent the spread of health care associated infections. Adhering to proper hand hygiene procedures, selecting appropriate hand hygiene products and the use of gloves are all important elements of infection control. The CDC Guidelines for Hand Hygiene state that improved hand hygiene practices can reduce transmission of pathogenic microorganisms to patients and personnel in health care settings. DHCWs must also protect themselves by recognizing pitfalls such as irritants or allergies that may pose obstacles to proper hand hygiene. Occupational irritants and allergies can be caused by frequent hand washing, exposure to hand hygiene products, exposure to chemicals and shear forces associated with wearing or removing gloves. Since the primary defense against infection and transmission of pathogens is healthy, unbroken skin, DHCWs must take steps to ensure that their skin remains healthy and intact. These steps include evaluating different types of hand hygiene products, lotions and gloves for the best compatibility. If the DHCW sees a breakdown of his or her skin barrier, steps should be taken to determine the cause and remedy. Remedies can include the use of alcohol-based hand sanitizers containing emollients and moisturizers and regular use of a medical grade hand lotion. The bottom line: healthy skin protects you at work and at home. Selection and use of appropriate hand hygiene products, including moisturizers, are an essential part ofa dental office infection control program. My coworker lost the use of her thumb for several months due to complications of a staph infection. She was unable to work and found even simple tasks such as closing a button hard to do. Think of how difficult your work would be if something happened to your hands. Injury, irritation or allergies could alter your ability to work or even perform routine tasks. Our hands provide us with the ability to work in clinical dentistry. It makes

  8. Skin acceptability of a cosmetic moisturizer formulation in female subjects with sensitive skin

    Directory of Open Access Journals (Sweden)

    Nisbet SJ

    2018-04-01

    Full Text Available Stephanie J Nisbet Skin Health Medical Affairs, GSK Consumer Healthcare, Weybridge, Surrey, UK Purpose: This 3-week, open-label, noncomparative clinical study evaluated the skin acceptability of a cosmetic moisturizer in subjects with sensitive skin, by monitoring adverse events (AEs and cutaneous discomfort related to normal usage.Materials and methods: Female subjects aged between 18–60 years, with Fitzpatrick phototype classification I–IV and sensitive skin, verified by a positive reaction on the stinging test at screening, were included. Subjects applied the moisturizer to their face and body twice daily for 21±2 days at home and recorded study product usage and feelings of cutaneous discomfort (eg, dryness, prickling, stinging, and itching in a diary; any AEs were reported to the clinic. At study end, skin acceptability of the moisturizer was investigator-assessed based on the nature of AEs and subjects’ self-reported feelings of discomfort, and by clinical evaluation of skin reactions in the area of moisturizer application (appearance of erythema, formation of edema, and skin desquamation; scored according to an adapted Draize and Kligman scale. Only subjects with a treatment compliance of ≥80% were included in the final analysis.Results: In total, 35 subjects initiated and completed the study; all were compliant to the minimum study product usage. Per investigator clinical dermatological assessment at study end, none of the 35 subjects had skin reactions in the area of moisturizer application and there were no reported AEs. One subject reported sensations of mild prickling and itching immediately after applying the moisturizer (not classified as AEs, which spontaneously remitted after complete absorption of the product and were noted only in exposed areas. These events were considered by the investigator as being possibly/probably related to the use of study product; however, no clinical signs of skin reaction were observed in

  9. Impaired skin integrity related to radiation therapy

    International Nuclear Information System (INIS)

    Ratliff, C.

    1990-01-01

    Skin reactions associated with radiation therapy require frequent nursing assessment and intervention. Preventive interventions and early management can minimize the severity of the skin reaction. With the understanding of the pathogenesis of radiation skin reactions, the ET nurse can determine who is at risk and then implement preventive measures. Because radiation treatment is fractionated, skin reactions do not usually occur until midway through the course of therapy and will subside within a few weeks after completion of radiation. Many patients and their families still fear that radiation causes severe burns. Teaching and anticipatory guidance by the ET nurse is needed to assist patients and their families to overcome this fear, and to educate them on preventive skin care regimens

  10. MR Imaging Features of Acute Enterovirus 71 Encephalitis in a Patient with Hand-Foot-Mouth Disease: A Case Report

    International Nuclear Information System (INIS)

    Park, Byung Sa; Yu, In Kyu; Lee, Byung Hee

    2011-01-01

    We report here on the MR findings of the first Korean case of hand-foot-mouth disease (HFMD) complicated by acute enterovirus 71 (EV 71) encephalitis in a 33-month old girl. Conventional MR images of the patient showed the increased signal intensity (SI) on a T2-weighted image (WI) at the posterior aspect of the medulla, the pontine tegmen, the bilateral dentate nuclei of the cerebellum and the midbrain. There was no evidence of abnormal SI or contrast enhancement at the same areas of the brain on the pre- and post-contrast T1-WI. The diffusion weighted images (DWI) also revealed the bilateral symmetrical strong high SI at the posterior aspect of the medulla and pontine tegmen and there was low SI at the same areas on the apparent diffusion coefficient (ADC) map. DWI in addition to the conventional MR imaging may be helpful for the early detection of acute EV 71 encephalitis in a patient with HFMD

  11. MR Imaging Features of Acute Enterovirus 71 Encephalitis in a Patient with Hand-Foot-Mouth Disease: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Park, Byung Sa; Yu, In Kyu; Lee, Byung Hee [Eulji University Hospital, Daejeon (Korea, Republic of)

    2011-02-15

    We report here on the MR findings of the first Korean case of hand-foot-mouth disease (HFMD) complicated by acute enterovirus 71 (EV 71) encephalitis in a 33-month old girl. Conventional MR images of the patient showed the increased signal intensity (SI) on a T2-weighted image (WI) at the posterior aspect of the medulla, the pontine tegmen, the bilateral dentate nuclei of the cerebellum and the midbrain. There was no evidence of abnormal SI or contrast enhancement at the same areas of the brain on the pre- and post-contrast T1-WI. The diffusion weighted images (DWI) also revealed the bilateral symmetrical strong high SI at the posterior aspect of the medulla and pontine tegmen and there was low SI at the same areas on the apparent diffusion coefficient (ADC) map. DWI in addition to the conventional MR imaging may be helpful for the early detection of acute EV 71 encephalitis in a patient with HFMD

  12. Differences in Cortical Representation and Structural Connectivity of Hands and Feet between Professional Handball Players and Ballet Dancers

    Science.gov (United States)

    Meier, Jessica; Topka, Marlene Sofie; Hänggi, Jürgen

    2016-01-01

    It is known that intensive training and expertise are associated with functional and structural neuroadaptations. Most studies, however, compared experts with nonexperts; hence it is, specifically for sports, unclear whether the neuroplastic adaptations reported are sport-specific or sport-general. Here we aimed at investigating sport-specific adaptations in professional handball players and ballet dancers by focusing on the primary motor and somatosensory grey matter (GM) representation of hands and feet using voxel-based morphometry as well as on fractional anisotropy (FA) of the corticospinal tract by means of diffusion tensor imaging-based fibre tractography. As predicted, GM volume was increased in hand areas of handball players, whereas ballet dancers showed increased GM volume in foot areas. Compared to handball players, ballet dancers showed decreased FA in both fibres connecting the foot and hand areas, but they showed lower FA in fibres connecting the foot compared to their hand areas, whereas handball players showed lower FA in fibres connecting the hand compared to their foot areas. Our results suggest that structural adaptations are sport-specific and are manifested in brain regions associated with the neural processing of sport-specific skills. We believe this enriches the plasticity research in general and extends our knowledge of sport expertise in particular. PMID:27247805

  13. Differences in Cortical Representation and Structural Connectivity of Hands and Feet between Professional Handball Players and Ballet Dancers.

    Science.gov (United States)

    Meier, Jessica; Topka, Marlene Sofie; Hänggi, Jürgen

    2016-01-01

    It is known that intensive training and expertise are associated with functional and structural neuroadaptations. Most studies, however, compared experts with nonexperts; hence it is, specifically for sports, unclear whether the neuroplastic adaptations reported are sport-specific or sport-general. Here we aimed at investigating sport-specific adaptations in professional handball players and ballet dancers by focusing on the primary motor and somatosensory grey matter (GM) representation of hands and feet using voxel-based morphometry as well as on fractional anisotropy (FA) of the corticospinal tract by means of diffusion tensor imaging-based fibre tractography. As predicted, GM volume was increased in hand areas of handball players, whereas ballet dancers showed increased GM volume in foot areas. Compared to handball players, ballet dancers showed decreased FA in both fibres connecting the foot and hand areas, but they showed lower FA in fibres connecting the foot compared to their hand areas, whereas handball players showed lower FA in fibres connecting the hand compared to their foot areas. Our results suggest that structural adaptations are sport-specific and are manifested in brain regions associated with the neural processing of sport-specific skills. We believe this enriches the plasticity research in general and extends our knowledge of sport expertise in particular.

  14. Differences in Cortical Representation and Structural Connectivity of Hands and Feet between Professional Handball Players and Ballet Dancers

    Directory of Open Access Journals (Sweden)

    Jessica Meier

    2016-01-01

    Full Text Available It is known that intensive training and expertise are associated with functional and structural neuroadaptations. Most studies, however, compared experts with nonexperts; hence it is, specifically for sports, unclear whether the neuroplastic adaptations reported are sport-specific or sport-general. Here we aimed at investigating sport-specific adaptations in professional handball players and ballet dancers by focusing on the primary motor and somatosensory grey matter (GM representation of hands and feet using voxel-based morphometry as well as on fractional anisotropy (FA of the corticospinal tract by means of diffusion tensor imaging-based fibre tractography. As predicted, GM volume was increased in hand areas of handball players, whereas ballet dancers showed increased GM volume in foot areas. Compared to handball players, ballet dancers showed decreased FA in both fibres connecting the foot and hand areas, but they showed lower FA in fibres connecting the foot compared to their hand areas, whereas handball players showed lower FA in fibres connecting the hand compared to their foot areas. Our results suggest that structural adaptations are sport-specific and are manifested in brain regions associated with the neural processing of sport-specific skills. We believe this enriches the plasticity research in general and extends our knowledge of sport expertise in particular.

  15. [Prevention of hand dermatoses in small catering enterprises].

    Science.gov (United States)

    Kurpiewska, Joanna; Liwkowicz, Jolanta; Padlewska, Kamila

    2013-01-01

    Work in catering and food processing is mostly performed by hands. Mechanical, thermal and chemical agents, as well as damp working conditions and frequent hand washing aggravate skin irritation. The aim of the study was to test the efficacy of hydrophobic skin protection measure at these workplaces. We recommended the prevention of contact skin disorders by using hydrophobic skin protection measure. The study was conducted in a group of 20 food service sector workers, They were interviewed about skin problems and skin protection measures. Tolb assess the effect of the protective preparation on the skin dermatological test procedures, corneometry and sebumetry, were applied, as well as the level of transepidermal water loss (TEWL) was measured. The same survey was performed in the control group composed of 10 workers who used and 10 who did not use barrier preparation. The respondents declared dryness, roughness, peeling, burning, redness, erythema of the skin. All who had applied barrier cream observed a significant improvement of the skin hydration increased by about 30%, and lubrication of the skin - by 11 times on average. Also the level of TEWL decreased by about 25%. The improvement of skin conditions and reduction of skin disorders were observed confirming the effectiveness of the protection of the skin from exposure to harmful factors. Knowledge about prevention of skin diseases should be promoted among employees of catering enterprises.

  16. Transcutaneous oxygen pressure measurement in diabetic foot ulcers: mean values and cut-point for wound healing.

    Science.gov (United States)

    Yang, Chuan; Weng, Huan; Chen, Lihong; Yang, Haiyun; Luo, Guangming; Mai, Lifang; Jin, Guoshu; Yan, Li

    2013-01-01

    The purpose of this study was to investigate mean values and cut-point of transcutaneous oxygen pressure (TcPO2) measurement in patients with diabetic foot ulcers. Prospective, descriptive study. Sixty-one patients with diabetes mellitus and foot ulcers comprised the sample. The research setting was Sun Yat-sen Memorial Hospital of SunYat-sen University, Guangzhou, China. Participants underwent transcutaneous oxygen (TcPO2) measurement at the dorsum of foot. Patients were classified into 3 groups according to clinical outcomes: (1) ulcers healed with intact skin group, (2) ulcer improved, and (3) ulcer failed to improve. TcPO2 was assessed and cut-points for predicting diabetic foot ulcer healing were calculated. Thirty-six patients healed with intact skin, 8 experienced improvement, and 17 showed no improvement. Mean TcPO2 levels were significantly higher (Pfoot ulcers. In contrast, all patients with TcPO2≥ 40 mmHg achieved wound closure. Measurement of TcPO2 in the supine position revealed a cut-point value of 25 mmHg as the best threshold for predicting diabetic foot ulcer healing; the area under the curve using this cut-point was 0.838 (95% confidence interval = 0.700-0.976). The sensitivity, specificity, positive predictive value, and negative predictive value for TxPO2 were 88.6%, 82.4%, 90.7%, and 72.2%, respectively. TcPO2≥ 40 mmHg was associated with diabetic foot ulcer healing, but a TcPO2≤ 10 mmHg was associated with failure of wound healing. We found that a cut-point of 25 mmHg was most predictive of diabetic foot ulcer healing.

  17. Spatio-Temporal Distribution and Hotspots of Hand, Foot and Mouth Disease (HFMD in Northern Thailand

    Directory of Open Access Journals (Sweden)

    Ratchaphon Samphutthanon

    2013-12-01

    Full Text Available Hand, Foot and Mouth Disease (HFMD is an emerging viral disease, and at present, there are no antiviral drugs or vaccines available to control it. Outbreaks have persisted for the past 10 years, particularly in northern Thailand. This study aimed to elucidate the phenomenon of HFMD outbreaks from 2003 to 2012 using general statistics and spatial-temporal analysis employing a GIS-based method. The spatial analysis examined data at the village level to create a map representing the distribution pattern, mean center, standard deviation ellipse and hotspots for each outbreak. A temporal analysis was used to analyze the correlation between monthly case data and meteorological factors. The results indicate that the disease can occur at any time of the year, but appears to peak in the rainy and cold seasons. The distribution of outbreaks exhibited a clustered pattern. Most mean centers and standard deviation ellipses occurred in similar areas. The linear directional mean values of the outbreaks were oriented toward the south. When separated by season, it was found that there was a significant correlation with the direction of the southwest monsoon at the same time. An autocorrelation analysis revealed that hotspots tended to increase even when patient cases subsided. In particular, a new hotspot was found in the recent year in Mae Hong Son province.

  18. Foot orgasm syndrome: a case report in a woman.

    Science.gov (United States)

    Waldinger, Marcel D; de Lint, Govert J; van Gils, Ad P G; Masir, Farhad; Lakke, Egbert; van Coevorden, Ruben S; Schweitzer, Dave H

    2013-08-01

    Spontaneous orgasm triggered from inside the foot has so far not been reported in medical literature. The study aims to report orgasmic feelings in the left foot of a woman. A woman presented with complaints of undesired orgasmic sensations originating in her left foot. In-depth interview, physical examination, sensory testing, magnetic resonance imaging (MRI-scan), electromyography (EMG), transcutaneous electrical nerve stimulation (TENS), and blockade of the left S1 dorsal root ganglion were performed. The main outcomes are description of this clinical syndrome, results of TENS application, and S1 dorsal root ganglion blockade. Subtle attenuation of sensory amplitudes of the left suralis, and the left medial and lateral plantar nerve tracts was found at EMG. MRI-scan disclosed no foot abnormalities. TENS at the left metatarso-phalangeal joint-III of the left foot elicited an instant orgasmic sensation that radiated from plantar toward the vagina. TENS applied to the left side of the vagina elicited an orgasm that radiated to the left foot. Diagnostic blockade of the left S1 dorsal root ganglion with 0.8 mL bupivacaine 0.25 mg attenuated the frequency and intensity of orgasmic sensation in the left foot with 50% and 80%, respectively. Additional therapeutic blockade of the same ganglion with 0.8 mL bupivacaine 0.50 mg combined with pulsed radiofrequency treatment resulted in a complete disappearance of the foot-induced orgasmic sensations. Foot orgasm syndrome (FOS) is descibed in a woman. Blockade of the left S1 dorsal root ganglion alleviated FOS. It is hypothesized that FOS, occurring 1.5 years after an intensive care emergency, was caused by partial nerve regeneration (axonotmesis), after which afferent (C-fiber) information from a small reinnervated skin area of the left foot and afferent somatic and autonomous (visceral) information from the vagina on at least S1 spinal level is misinterpreted by the brain as being solely information originating from

  19. Age-related changes in cutaneous sensation in the healthy human hand.

    Science.gov (United States)

    Bowden, Jocelyn L; McNulty, Penelope A

    2013-08-01

    Cutaneous sensation deteriorates with age. It is not known if this change is consistent over the entire hand or if sensation is affected by changes in skin mechanics. Cutaneous perceptual thresholds were tested at eight sites in the glabrous skin and two in the hairy skin of both hands in 70 subjects (20-88 years), five male and five female per decade, using calibrated von Frey filaments, two-point discrimination, and texture discrimination. Venous occlusion at the wrist (40 ± 10 mmHg) and moisturizer were used to alter skin mechanics. Cutaneous thresholds increased significantly with age (p sensation varied according to the site tested with smaller changes on the fingers compared to the palm. Two-point discrimination deteriorated with age (p = 0.046), but with no interaction between sex, handedness, or changes in skin mechanics. There were no significant differences for texture discrimination. Changes in skin mechanics improved cutaneous thresholds in the oldest males after moisturizing (p = 0.001) but not otherwise. These results emphasize the complex pattern of age-related deterioration in cutaneous sensation with differences between sexes, the hands, sites on the hand, and the mode of testing. As the index fingertip is not a sensitive indicator of sensory decline, the minimum assessment of age-related changes in cutaneous sensation should include both hands, and sites on the palm.

  20. Increased Number of Langerhans Cells in the Epidermis of Diabetic Foot Ulcers Correlates with Healing Outcome

    Science.gov (United States)

    Stojadinovic, Olivera; Yin, Natalie; Lehmann, Janin; Pastar, Irena; Kirsner, Robert S.; Tomic-Canic, Marjana

    2015-01-01

    Langerhans cells (LCs) are a specialized subset of epidermal dendritic cells. They represent one of the first cells of immunological barrier and play an important role during the inflammatory phase of acute wound healing. Despite considerable progress in our understanding of the immunopathology of diabetes mellitus and its associated co-morbidities such as diabetic foot ulcers (DFUs), considerable gaps in our knowledge exist. In this study, we utilized the human ex vivo wound model and confirmed the increased epidermal LCs at wound edges during early phases of wound healing. Next, we aimed to determine differences in quantity of LCs between normal human and diabetic foot skin and to learn if the presence of LCs correlates with the healing outcome in DFUs. We utilized immunofluorescence to detect CD207+ LCs in specimens from normal and diabetic foot skin and DFU wound edges. Specimens from DFUs were collected at the initial visit and 4 weeks at the time when the healing outcome was determined. DFUs that decreased in size by >50% were considered to be healing, while DFUs with a size reduction of healing. Quantitative assessment of LCs showed a higher number of LCs in healing when compared to non–healing DFU’s. Our findings provide evidence that LCs are present in higher number in diabetic feet than normal foot skin. Healing DFUs show a higher number of LCs compared to non-healing DFUs. These findings indicate that the epidermal immune barrier plays an important role in the DFU healing outcome and may offer new therapeutic avenues targeting LC in non-healing DFUs. PMID:24277309

  1. Contact Dermatitis Associated With Skin Cleansers: Retrospective Analysis of North American Contact Dermatitis Group Data 2000-2014.

    Science.gov (United States)

    Warshaw, Erin M; Goodier, Molly C; DeKoven, Joel G; Maibach, Howard I; Taylor, James S; Sasseville, Denis; Belsito, Donald V; Fowler, Joseph F; Fransway, Anthony F; DeLeo, Vincent A; Marks, James G; Pratt, Melanie D; Mathias, Toby; Zirwas, Matthew J; Zug, Kathryn A

    There is limited information regarding contact dermatitis (CD) associated with skin cleansers (SCs). The aim of the study was to evaluate the prevalence of allergic patch test (APT) reactions and irritant CD (ICD) associated with SCs. A retrospective cross-sectional analysis was performed using North American Contact Dermatitis Group data, 2000-2014. Of 32,945 tested patients, 1069 (3.24%) had either APT reaction or ICD associated with SCs. Of these, 692 (64.7%) had APT reaction only, 350 (32.7%) had ICD only, and 27 (2.5%) had both. Individuals with APT reaction and/or ICD were more likely to have occupationally related skin disease (relative risk [RR] = 3.8 [95% confidence interval {CI} = 3.3-4.5] for APT reaction and 10.0 [95% CI = 8.2-12.2] for ICD, respectively, P dermatitis (RR = 1.3 [95% CI = 1.1-1.6], P ≤ 0.001). Irritant CD was strongly associated with hand dermatitis (RR = 6.2 [95% CI = 5.2-7.3], P < 0.0001). More than 50 allergens were associated with SCs including quaternium-15 (11.2%), cocamidopropyl betaine (9.5%), methylchloroisothiazolinone/methylisothiazolinone (8.4%), coconut diethanolamide (7.9%), fragrance mix I (7.7%), Myroxylon pereirae (5.9%), 4-chloro-3,5-xylenol (5.8%), amidoamine (5.5%), and formaldehyde (4.4%). Many allergens, especially preservatives and surfactants, were associated with SCs. Most cases involved the hands and were occupationally related.

  2. Effects of a synthetic retinoid on skin structure, matrix metalloproteinases, and procollagen in healthy and high-risk subjects with diabetes.

    Science.gov (United States)

    Zeng, Wei; Tahrani, Abd; Shakher, Jayadave; Varani, James; Hughes, Sharon; Dubb, Kiran; Stevens, Martin J

    2011-01-01

    In diabetes, foot ulceration may result from increased skin fragility. Retinoids can reverse some diabetes-induced deficits of skin structure and function, but their clinical utility is limited by skin irritation. The effects of diabetes and MDI 301, a nonirritating synthetic retinoid, and retinoic acid have been evaluated on matrix metalloproteinases (MMPs), procollagen expression, and skin structure in skin biopsies from nondiabetic volunteers and diabetic subjects at risk of foot ulceration using organ culture techniques. Zymography and enzyme-linked immunosorbent assay were utilized for analysis of MMP-1, -2, and -9 and tissue inhibitor of metalloproteinase-1 (TIMP-1) and immunohistochemistry for type I procollagen protein abundance. Collagen structure parameters were assessed in formalin-fixed, paraffin-embedded tissue sections. The % of active MMP-1 and -9 was higher and TIMP-1 abundance was lower in subjects with diabetes. Type 1 procollagen abundance was reduced and skin structural deficits were increased in diabetes. Three μM MDI 301 reduced active MMP-1 and -9 abundance by 29% (P structural deficit scores. Two μM retinoic acid reduced MMP-1 but did not significantly affect skin structure. These data indicate that diabetic patients at risk of foot ulceration have deficits of skin structure and function. MDI 301 offers potential for repairing this skin damage complicating diabetes. Copyright © 2011 Elsevier Inc. All rights reserved.

  3. Prevention of hand eczema

    DEFF Research Database (Denmark)

    Fisker, Maja H; Ebbehøj, Niels E; Vejlstrup, Søren Grove

    2018-01-01

    Objective Occupational hand eczema has adverse health and socioeconomic impacts for the afflicted individuals and society. Prevention and treatment strategies are needed. This study aimed to assess the effectiveness of an educational intervention on sickness absence, quality of life and severity...... of hand eczema. Methods PREVEX (PreVention of EXema) is an individually randomized, parallel-group superiority trial investigating the pros and cons of one-time, 2-hour, group-based education in skin-protective behavior versus treatment as usual among patients with newly notified occupational hand eczema...

  4. Cr(III) reactivity and foot dermatitis in Cr(VI) positive patients

    DEFF Research Database (Denmark)

    Hansen, Malene Barré; Menné, Torkil; Johansen, Jeanne Duus

    2006-01-01

    Chromium allergy has become synonymous with Cr(VI) allergy. However, real exposure to chromium from leather products may include both Cr(III) and Cr(VI). In this study, we investigate the reactivity to both Cr(VI) and Cr(III) in consecutive patients to analyse the relation between foot eczema/leather...... to Cr(III). The increased risk was not due to a higher degree of sensitivity to Cr(VI). Leather was reported most frequently as the suspected cause of chromium dermatitis (54%). However, Cr(VI) allergics having foot eczema and positive or doubtful Cr(III) reactions often had positive reactions to other...

  5. Quantifying the influence of temperature on hand, foot and mouth disease incidence in Wuhan, Central China.

    Science.gov (United States)

    Huang, Jiao; Chen, Shi; Wu, Yang; Tong, Yeqing; Wang, Lei; Zhu, Min; Hu, Shuhua; Guan, Xuhua; Wei, Sheng

    2018-01-31

    Hand, foot and mouth disease (HFMD) is a substantial burden throughout Asia, but the effects of temperature pattern on HFMD risk are inconsistent. To quantify the effect of temperature on HFMD incidence, Wuhan was chosen as the study site because of its high temperature variability and high HFMD incidence. Daily series of HFMD counts and meteorological variables during 2010-2015 were obtained. Distributed lag non-linear models were applied to characterize the temperature-HFMD relationship and to assess its variability across different ages, genders, and types of child care. Totally, 80,219 patients of 0-5 years experienced HFMD in 2010-2015 in Wuhan. The cumulative relative risk of HFMD increased linearly with temperature over 7 days (lag0-7), while it presented as an approximately inverted V-shape over 14 days (lag0-14). The cumulative relative risk at lag0-14 peaked at 26.4 °C with value of 2.78 (95%CI: 2.08-3.72) compared with the 5 th percentile temperature (1.7 °C). Subgroup analyses revealed that children attended daycare were more vulnerable to temperature variation than those cared for at home. This study suggests that public health actions should take into consideration local weather conditions and demographic characteristics.

  6. Recurrent Streptococcus Pneumoniae Meningitis in a Child with Split Hand and Foot Malformation and Undiagnosed Mondini Dysplasia.

    Science.gov (United States)

    Katarzyna, Mazur-Melewska; Jarosław, Szydłowski; Katarzyna, Jończyk-Potoczna; Wojciech, Służewski; Magdalena, Figlerowicz

    Recurrent bacterial meningitis is a life-threatening infection of the central nervous system that is mostly connected with anatomical abnormalities of the skull, chronic parameningeal infections and immunodeficiencies. It's rarely seen, but when it occurs an extensive investigation should be carried out to discover the responsible factor, so that further episodes can be prevented. We report on a child with split hand and foot (SHFM), confirmed incorrect karyotype 46, XY, t(7:12)(q21.2;q21.3) and a fourth episode of fulminant meningitis caused by penicillin-resistant Streptococcus pneumoniae . After a broad evaluation of factors predisposing to recurrent meningitis, the undiagnosed malformation of his inner and middle ears - Mondini dysplasia was found. We suggest examining all children with SHFM for hearing impairment before they develop recurrent meningitis. The time when the radiological procedure for searching for inner ear dysplasia should be performed could be a controversial issue: before or after the first episode of meningitis. From the epidemiological point of view, high-resolution computer tomography scanning of the temporal bones should be considered after the diagnosis of deafness in a child with SHFM related to 7q21 deletion.

  7. Elevated levels of circulating histones indicate disease activity in patients with hand, foot, and mouth disease (HFMD).

    Science.gov (United States)

    Li, Xiuhui; Li, Qin; Li, Junhong; Li, Ying; Chen, Yuping; Lv, Aiping; Zhang, Jian; Ding, Jianbo; Von Maltzan, Kristine; Wen, Tao

    2014-12-01

    Hand, foot, and mouth disease (HFMD) is a common infectious disease in children, characterized by acute viral infection accompanying acute inflammatory responses. Circulating histones are leading mediators of the inflammatory processes. This study aimed to elucidate whether circulating histones play a contributory role during HFMD. We measured plasma levels of histones, myeloperoxidase (MPO), lactate dehydrogenase (LDH), and cytokines in HFMD patients (n = 126) and compared the results with those of a control group (n = 30). Circulating histone levels were significantly increased in HFMD patients (3.794 ± 0.156 μg/ml) compared with healthy controls (0.238 ± 0.023 μg/ml, p histones correlated positively with plasma IL-6 and IL-10, whereas in severe HFMD, histones were associated with elevated IL-6 and TNF-ɑ levels. These data demonstrate that circulating histones are excessively released in patients with HFMD, which may indicate disease severity and contribute to systemic inflammation by promoting cytokine production (e.g. IL-6). We suggest that in mild HFMD, circulating histones may originate largely from neutrophil activation, whereas in severe HFMD, dying tissue cells and neutrophil activation may be synergistically involved in the increased levels of histones.

  8. Response of pig skin to fractionated radiation doses

    International Nuclear Information System (INIS)

    Wiernik, G.; Hopewell, J.W.; Patterson, T.J.S.; Young, C.M.A.; Foster, J.L.

    1977-01-01

    The individual components of a fractionated course of irradiation treatment have been considered separately. Methods of accurate measurement of individual parameters has brought to light different interpretations of the observations. Reasons are given for the necessity of having a radiobiological model which has a direct relevance to the clinical situation. Results are reported for fractionated regimes of irradiation in which the dose has been varied above and below normal tissue tolerance which has been equated with clinical skin necrosis. The components of the acute skin reaction, erythema, pigmentation and desquamation have been analysed separately and their contribution as a method of measurement assessed. Initially, the range of numerical scores attributed to erythema did not reach the scores attributed to necrosis but we now believe that radiation damage expressed as erythema can move directly into necrosis without passing through desquamation. Desquamation, on the other hand, only became a useful parameter at higher dose levels; it has also been shown to be a component associated with skin breakdown. Pigmentation showed no dose response at the dose levels employed in our experiments and it is our belief that this is due to this system being fully saturated under these circumstances. Measurement of the late radiation reaction in the skin has been considered in detail and our results have been expressed by comparing the relative lengths of irradiated and control fields in the same pig. From these findings iso-effect graphs have been constructed and time and fractionation factors have been derived. (author)

  9. Diminution of acute radiation reaction of mouse skin with low-intensity infrared laser/red diodes-emitted light

    International Nuclear Information System (INIS)

    Meshcherikova, V.V.; Klimakov, B.D.; Goldobenko, G.V.; Vajnson, A.A.

    2000-01-01

    Efficiency of the application of different regimes of laser treatment of radiation-induced skin reactions in mice feet is compared. Posterior limb feet of mice were exposed to acute X radiation at 30-36 Gy dose or fractionated radiation at 45 Gy dose. In the day of primary irradiation or different time later the feet were treated using magnetic infrared laser therapeutic MILTA-01 apparatus. Magnetic and light components of the MILTA-01 apparatus reduce the effect of radiation on mice skin corresponding two time decrease in X-radiation dose [ru

  10. Secondary changes in the skeleton of the foot in Lupus vulgaris

    Energy Technology Data Exchange (ETDEWEB)

    Triebel, H J; Oesterreich, F U

    1986-04-01

    The case of a seventy-year old lady is presented who, fortyfive years ago, had dermal tuberculosis of the left lower limb and foot. After removal of the infected skin areas with an electric cauter the patient developed massive skin indurations, besides the typical scarification. Actual X-rays showed a decrease in seize of metatarsal bones and digits without lytic or porotic signs. Furthermore, dorsal luxation of the digits was visible. These alterations were interpreted as secondary bone remodelling resulting from long-term traction due to the extensive scarring.

  11. Secondary changes in the skeleton of the foot in Lupus vulgaris

    International Nuclear Information System (INIS)

    Triebel, H.J.; Oesterreich, F.U.

    1986-01-01

    The case of a seventy-year old lady is presented who, fortyfive years ago, had dermal tuberculosis of the left lower limb and foot. After removal of the infected skin areas with an electric cauter the patient developed massive skin indurations, besides the typical scarification. Actual X-rays showed a decrease in seize of metatarsal bones and digits without lytic or porotic signs. Furthermore, dorsal luxation of the digits was visible. These alterations were interpreted as secondary bone remodelling resulting from long-term traction due to the extensive scarring. (orig.) [de

  12. Self-powered gustation electronic skin for mimicking taste buds based on piezoelectric-enzymatic reaction coupling process

    Science.gov (United States)

    Zhao, Tianming; Fu, Yongming; He, Haoxuan; Dong, Chuanyi; Zhang, Linlin; Zeng, Hui; Xing, Lili; Xue, Xinyu

    2018-02-01

    A new self-powered wearable gustation electronic skin for mimicking taste buds has been realized based on enzyme-modified/ZnO nanowire arrays on patterned-electrode flexible substrate. The e-skin can actively taste beverages or fruits without any external electric power. Through the piezoelectric-enzymatic reaction coupling effect, the nanowires can harvest the mechanical energy of body movement and output piezoelectric signal. The piezoelectric output is significantly dependent on the concentration of target analyte. The response for detecting 2 × 10-2 M ascorbic acid (ascorbate acid oxidase@ZnO) is up to 171.747, and the selectivity is high. The response for detecting 50% alcohol (alcohol oxidase@ZnO) is up to 45.867. Our results provide a new research direction for the development of multifunctional e-skin and expand the study scope for self-powered bionic systems.

  13. Leonardo da Vinci's foot: historical evidence of concept.

    Science.gov (United States)

    Jastifer, James R; Toledo-Pereyra, Luis H

    2012-10-01

    Leonardo da Vinci (1452-1519), world-renowned Italian renaissance master, is known for his contributions to, and broad interests in science and art. The objective of this work is to demonstrate the extent of his science by applying the use of his concepts to current models of foot and ankle mechanics. The art and science of Leonardo Da Vinci were extensively analyzed by reviewing his original drawings and hand written notebooks as well as their English translation. Current medical journals including the topics of foot, ankle, and biomechanics were reviewed for modern evidence and application of his concepts. The library of Michigan State University and the electronic library of the Royal Library at Windsor Castle were extensively utilized. From the depths of Santa Maria Nuova Hospital in Florence and Santo Spirito Hospital in Rome, through his commentary and anatomical drawings of around 30 cadaver dissections he performed, Leonardo da Vinci expressed his concept of foot and ankle anatomy and mechanics. He laid forth concepts, which vary little from current theories including those of proportion, statics and joint stability, sesamoid biomechanics, and structural support of the foot. Leonardo da Vinci, by combining an interest in anatomy and a gift of genius and artistic ability laid a foundation of foot and ankle anatomy and mechanics that have been applied in modern clinical sciences. Leonardo in this way made important contributions to the practice of foot and ankle orthopedics.

  14. Radiodermatitis of the hands in a dental practitioner

    International Nuclear Information System (INIS)

    Warin, A.P.

    1979-01-01

    A man aged 43, presented with a 4 year history of a rash affecting his hands. He had been a dental practitioner for 20 years and admitted to lack of care with X-rays, especially in holding the X-ray film within the patient's mouth himself. He never withdrew behind a lead screen and so had been constantly exposed to X-rays over a prolonged period. Shortly prior to presentation, he had been using a cream containing amethocaine in an attempt to relieve the pain in his hands. On examination he had a weeping eczema of his hands but he was also noted to have atrophy and sclerosis of the skin of the fingers with telangiectasia and some erosions. A diagnosis of radiodermatitis was made, with superimposed contact eczema. Patch testing showed a positive reaction to amethocaine, and with the use of topical corticosteroids, the eczema settled quickly, leaving the typical signs of chronic radiodermatitis. Histopathology during the eczematous phase showed spongiosis with an eroded epidermis. The dermis showed telangiectasis and scarring of collagen. Although the epidermis showed some basal cell proliferation and acanthosis, there was no epidermal dysplasia. (author)

  15. Radiodermatitis of the hands in a dental practitioner

    Energy Technology Data Exchange (ETDEWEB)

    Warin, A P [Saint John' s Hospital for Diseases of the Skin, London (UK)

    1979-03-01

    A man aged 43, presented with a 4 year history of a rash affecting his hands. He had been a dental practitioner for 20 years and admitted to lack of care with X-rays, especially in holding the X-ray film within the patient's mouth himself. He never withdrew behind a lead screen and so had been constantly exposed to X-rays over a prolonged period. Shortly prior to presentation, he had been using a cream containing amethocaine in an attempt to relieve the pain in his hands. On examination he had a weeping eczema of his hands but he was also noted to have atrophy and sclerosis of the skin of the fingers with telangiectasia and some erosions. A diagnosis of radiodermatitis was made, with superimposed contact eczema. Patch testing showed a positive reaction to amethocaine, and with the use of topical corticosteroids, the eczema settled quickly, leaving the typical signs of chronic radiodermatitis. Histopathology during the eczematous phase showed spongiosis with an eroded epidermis. The dermis showed telangiectasis and scarring of collagen. Although the epidermis showed some basal cell proliferation and acanthosis, there was no epidermal dysplasia.

  16. Landing Control of Foot with Springs for Walking Robots on Rough Terrain

    Directory of Open Access Journals (Sweden)

    Moyuru Yamada

    2009-09-01

    Full Text Available Landing control is one of the important issues for biped walking robot, because robots are expected to walk on not only known flat surfaces but also unknown and uneven terrain for working at various fields. This paper presents a new controller design for a robotic foot to land on unknown terrain. The robotic foot considered in this study equips springs to reduce the impact force at the foot landing. There are two objectives in the landing control; achieving the desired ground reaction force and positioning the foot on unknown terrain. To achieve these two objectives simultaneously by adjusting the foot position, we propose a PI force controller with a desired foot position, which guarantees the robust stability of control system with respect to terrain variance, and exact positioning of the foot to unknown terrain. Simulation results using the Open Dynamics Engine demonstrate the effectiveness of the proposed controller.

  17. Direct molecular versus culture-based assessment of Gram-positive cocci in biopsies of patients with major abscesses and diabetic foot infections

    NARCIS (Netherlands)

    M.H.T. Stappers (Mark H. T.); F. Hagen (Ferry); P. Reimnitz (Peter); J.W. Mouton (Johan); J.F. Meis (Jacques F.); I.C. Gyssens (Inge)

    2015-01-01

    textabstractMajor abscesses and diabetic foot infections (DFIs) are predominant subtypes of complicated skin and skin structure infections (cSSSIs), and are mainly caused by Staphylococcus aureus and β-hemolytic streptococci. This study evaluates the potential benefit of direct pathogen-specific

  18. Managing Occupational Irritant Contact Dermatitis Using a Two-Step Skincare Regimen Designed to Prevent Skin Damage and Support Skin Recovery.

    Science.gov (United States)

    von Grote, Erika C; Palaniswarmy, Kiruthi; Meckfessel, Matthew H

    2016-12-01

    Occupational irritant contact dermatitis (ICD) affecting the hands is a common and difficult-to-manage condition. Occupations that necessitate contact with harsh chemicals, use of alcohol-based disinfectants, and frequent hand washing elevate the risk of ICD. Management strategies that do not adequately prevent accumulated damage and repair skin, can develop into chronic dermatoses which negatively impact work productivity and quality of life. A 2-step skin-care regimen (Excipial Daily Protection Hand Cream (EP) and Excipial Rapid Repair Hand Cream (ER), Galderma Laboratories, L.P.) has been developed as a daily-use management strategy to protect and repair vulnerable hands. The protective barrier cream is formulated with aluminum chlorohydrate and designed for pre-exposure application to enhance the skin's natural protective barrier and minimize excessive moisture while wearing protective gloves. The repair cream, a lipid-rich formulation, is intended for post-exposure application to rehydrate and facilitate the skin's natural healing process. The results of 3 clinical studies highlighted in this review demonstrate how the use of a 2-step skin-care regimen offers a greater protective effect against ICD than the use of barrier cream alone, and also how the formulation of the barrier cream used in these studies helps minimize the occlusion effect caused by gloves and does not interfere with the antibacterial efficacy of an alcohol-based hand sanitizer. This 2-step skin-care regimen is effectively designed to manage and minimize the risk of ICD development in a variety of patients and provides clinicians an additional tool for helping patients manage ICD. J Drugs Dermatol. 2016;15(12):1504-1510.

  19. Hand involvement in children with Charcot-Marie-Tooth disease type 1A

    NARCIS (Netherlands)

    Burns, Joshua; Bray, Paula; Cross, Lauren A.; North, Kathryn N.; Ryan, Monique M.; Ouvrier, Robert A.

    2008-01-01

    Charcot-Marie-Tooth disease type 1A (CMT1A), a demyelinating neuropathy characterised by progressive length-dependent muscle weakness and atrophy, is thought to affect the foot and leg first followed some time later by hand weakness and dysfunction. We aimed to characterise hand Strength, function

  20. Prevention of hand dermatoses in small catering enterprises

    Directory of Open Access Journals (Sweden)

    Joanna Kurpiewska

    2013-08-01

    Full Text Available Background: Work in catering and food processing is mostly performed by hands. Mechanical, thermal and chemical agents, as well as damp working conditions and frequent hand washing aggravate skin irritation. The aim of the study was to test the efficacy of hydrophobic skin protection measure at these workplaces. Materials and Methods: We recommended the prevention of contact skin disorders by using hydrophobic skin protection measure. The study was conducted in a group of 20 food service sector workers. They were interviewed about skin problems and skin protection measures. To assess the effect of the protective preparation on the skin dermatological test procedures, corneometry and sebumetry, were applied, as well as the level of transepidermal water loss (TEWL was measured. The same survey was performed in the control group composed of 10 workers who used and 10 who did not use barrier preparation. Results: The respondents declared dryness, roughness, peeling, burning, redness, erythema of the skin. All who had applied barrier cream observed a significant improvement of the skin - hydration increased by about 30%, and lubrication of the skin - by 11 times on average. Also the level of TEWL decreased by about 25%. Conclusions: The improvement of skin conditions and reduction of skin disorders were observed confirming the effectiveness of the protection of the skin from exposure to harmful factors. Knowledge about prevention of skin diseases should be promoted among employees of catering enterprises. Med Pr 2013;64(4:521–525

  1. Imatinib induced severe skin reactions and neutropenia in a patient with gastrointestinal stromal tumor

    International Nuclear Information System (INIS)

    Hwang, Jun-Eul; Yoon, Ju-Young; Bae, Woo-Kyun; Shim, Hyun-Jeong; Cho, Sang-Hee; Chung, Ik-Joo

    2010-01-01

    Imatinib mesylate has been used for the treatment of unresectable or metastatic gastrointestinal stromal tumors (GIST). The current recommended dose of imatinib is 400 mg/day that is increased to 800 mg/day in cases with disease progression. However, imatinib can be associated with diverse adverse events, which has limited its use. We report a case of severe adverse skin reactions with neutropenic fever during imatinib treatment in a patient with GIST. A 71-year-old man was admitted with a one month history of epigastric pain and a palpable mass in the right upper quadrant. An abdominal CT scan revealed a 20 × 19 cm intraabdominal mass with tumor invasion into the peritoneum. Needle biopsy was performed and the results showed spindle shaped tumor cells that were positive for c-KIT. The patient was diagnosed with unresectable GIST. Imatinib 400 mg/day was started. The patient tolerated the first eight weeks of treatment. However, about three months later, the patient developed a grade 4 febrile neutropenia and a grade 3 exfoliative skin rash. The patient recovered from this serious adverse events after discontinuation of imatinib with supportive care. However, the skin lesions recurred whenever the patient received imatinib over 100 mg/day. Therefore, imatinib 100 mg/day was maintained. Despite the low dose imatinib, follow up CT showed a marked partial response without grade 3 or 4 toxicities. The recommended dose of imatinib for the treatment of GIST is 400 mg/day but patients at risk for adverse drug reaction may benefit from lower doses. Individualized treatment is needed for such patients, and we may also try sunitinib as a alternative drug

  2. Ambulatory assessment of ankle and foot dynamics

    NARCIS (Netherlands)

    Schepers, H. Martin; Koopman, Hubertus F.J.M.; Veltink, Petrus H.

    Ground reaction force (GRF) measurement is important in the analysis of human body movements. The main drawback of the existing measurement systems is the restriction to a laboratory environment. This paper proposes an ambulatory system for assessing the dynamics of ankle and foot, which integrates

  3. Experimental testing of skin reactions to insulin detemir in diabetes patients naïve to insulin detemir

    DEFF Research Database (Denmark)

    O'goshi, Kenichiro; Serup, Jørgen; Blaaholm, Bente

    2011-01-01

    in accordance with ICH-GCP guidelines. Blood flow was recorded with the Periflux PF5010, and skin colour (a*) with the DSMII colorimeter. RESULTS: Clinical reading, flowmetry and colorimetry consistently showed delayed reactions after intradermal insulin injection (35 of 40 patients reacted with mainly weak...

  4. Hypersensitivity reactions to penicillins: studies in a group of patients with negative benzylpenicillin G skin test.

    Science.gov (United States)

    Qiao, H-L; Li, Z; Yang, J; Tian, X; Gao, N; Jia, L-J

    2009-06-01

    Although skin tests are usually employed to evaluate current penicillin allergy status, a negative result does not exclude hypersensitivity. There is a need for accurate in vitro tests to exclude hypersensitivity. A radioallergosorbent test (RAST) is a potentially good supplementary approach, but there is little information on the suitability of this method to diagnose penicillin hypersensitivity in subjects with a negative skin test to benzylpenicillin. A total of 133 patients with a negative skin test to benzylpenicillin G (PG) and all of whom developed allergic reactions to PG were studied. RAST was used to detect eight kinds of specific IgE antibodies to penicillins in serum, which included four kinds of major and minor antigenic determinants to four penicillin drugs. The combination sites for the specific IgE antibodies were studied by RAST inhibition test. The rate of positive reactions for the specific IgE antibodies was 59.40% (79/133). Of the eight kinds of antigenic determinants, the positive rates for specific IgE against the major and minor determinants were 39.10% (52) and 42.86% (57) respectively. Of the four drugs, positive cases only to PG were 10 (7.5%), were significantly fewer than the cross-reacting positive cases (36) to PG (P penicillins could induce specific responses with a variable degree of cross-reactivity among the different penicillins. Radioallergosorbent test is a good complementary test in persons who are skin-test negative with PG, and the sensitivity of RAST increases with increasing specificity of IgE antibodies to be detected. 6-APA and the groups, making part of the different side-chains on penicillins, all contributed to the cross-reactivity.

  5. Using a Negative Binomial Regression Model for Early Warning at the Start of a Hand Foot Mouth Disease Epidemic in Dalian, Liaoning Province, China.

    Science.gov (United States)

    An, Qingyu; Wu, Jun; Fan, Xuesong; Pan, Liyang; Sun, Wei

    2016-01-01

    The hand foot and mouth disease (HFMD) is a human syndrome caused by intestinal viruses like that coxsackie A virus 16, enterovirus 71 and easily developed into outbreak in kindergarten and school. Scientifically and accurately early detection of the start time of HFMD epidemic is a key principle in planning of control measures and minimizing the impact of HFMD. The objective of this study was to establish a reliable early detection model for start timing of hand foot mouth disease epidemic in Dalian and to evaluate the performance of model by analyzing the sensitivity in detectability. The negative binomial regression model was used to estimate the weekly baseline case number of HFMD and identified the optimal alerting threshold between tested difference threshold values during the epidemic and non-epidemic year. Circular distribution method was used to calculate the gold standard of start timing of HFMD epidemic. From 2009 to 2014, a total of 62022 HFMD cases were reported (36879 males and 25143 females) in Dalian, Liaoning Province, China, including 15 fatal cases. The median age of the patients was 3 years. The incidence rate of epidemic year ranged from 137.54 per 100,000 population to 231.44 per 100,000population, the incidence rate of non-epidemic year was lower than 112 per 100,000 population. The negative binomial regression model with AIC value 147.28 was finally selected to construct the baseline level. The threshold value was 100 for the epidemic year and 50 for the non- epidemic year had the highest sensitivity(100%) both in retrospective and prospective early warning and the detection time-consuming was 2 weeks before the actual starting of HFMD epidemic. The negative binomial regression model could early warning the start of a HFMD epidemic with good sensitivity and appropriate detection time in Dalian.

  6. The effectiveness of a skin care program for the prevention of contact dermatitis in health care workers (the Healthy Hands Project): study protocol for a cluster randomized controlled trial.

    Science.gov (United States)

    Soltanipoor, Maryam; Kezic, Sanja; Sluiter, Judith K; Rustemeyer, Thomas

    2017-02-28

    Health care workers (HCW) are at high risk for developing occupational hand dermatitis (HD) due to frequent exposure to 'wet work'. Amongst HCWs, nurses are at highest risk, with an estimated point prevalence of HD ranging between 12 and 30%. The burden of disease is high with chronicity, sick leave, risk of unemployment and impaired quality of life. Despite evidence from the medical literature on the risk factors and the importance of skin care in the prevention of HD, in practice, compliance to skin care protocols are below 30%. New preventive strategies are obviously needed. This is a cluster randomized controlled trial, focusing on nurses performing wet work. In total, 20 wards are recruited to include 504 participating nurses in the study at baseline. The wards will be randomized to an intervention or a control group and followed up for 18 months. The intervention consists of the facilitation of creams being available at the wards combined with the continuous electronic monitoring of their consumption with regular feedback on skin care performance in teams of HCWs. Both the intervention and the control group receive basic education on skin protection (as 'care as usual'). Every 6 months, participants of both groups will fill in the questionnaires regarding exposure to wet work and skin protective behavior. Furthermore, skin condition will be assessed and samples of the stratum corneum collected. The effect of the intervention will be measured by comparing the change in Hand Eczema Severity Index (HECSI score) from baseline to 12 months. The Natural Moisturizing Factor (NMF) levels, measured in the stratum corneum as an early biomarker of skin barrier damage, and the total consumption of creams per ward will be assessed as a secondary outcome. This trial will assess the clinical effectiveness of an intervention program to prevent hand dermatitis among health care workers TRIAL REGISTRATION: Netherlands Trial Register (NTR), identification number NTR5564

  7. The use of a measure of acute irritation to predict the outcome of repeated usage of hand soap products.

    Science.gov (United States)

    Williams, C; Wilkinson, M; McShane, P; Pennington, D; Fernandez, C; Pierce, S

    2011-06-01

    Healthcare-associated infection is an important worldwide problem that could be reduced by better hand hygiene practice. However, an increasing number of healthcare workers are experiencing irritant contact dermatitis of the hands as a result of repeated hand washing. This may lead to a reduced level of compliance with regard to hand hygiene. To assess whether a measure of acute irritation by hand soaps could predict the effects of repeated usage over a 2-week period. In a double-blind, randomized comparison study, the comparative irritation potential of four different hand soaps was assessed over a 24-h treatment period. The effect of repeated hand washing with the hand soap products over a 2-week period in healthy adult volunteers on skin barrier function was then determined by assessment of transepidermal water loss (TEWL), epidermal hydration and a visual assessment using the Hand Eczema Severity Index (HECSI) at days 0, 7 and 14. A total of 121 subjects from the 123 recruited completed phase 1 of the study. All four products were seen to be significantly different from each other in terms of the irritant reaction observed and all products resulted in a significantly higher irritation compared with the no-treatment control. Seventy-nine of the initial 121 subjects were then enrolled into the repeated usage study. A statistically significant worsening of the clinical condition of the skin as measured by HECSI was seen from baseline to day 14 in those subjects repeatedly washing their hands with two of the four soap products (products C and D) with P-values of 0·02 and 0·01, respectively. Subclinical assessment of the skin barrier function by measuring epidermal hydration was significantly increased from baseline to day 7 after repeated hand washing with products A, B and D but overall no significant change was seen in all four products tested by day 14. A statistically significant increase in TEWL at day 14 was seen for product A (P = 0·02) indicating a

  8. Curcuma longa (Turmeric) for Prevention of Capecitabine-Induced Hand-Foot Syndrome: A Pilot Study.

    Science.gov (United States)

    Scontre, Vanessa Armenio; Martins, Janine Capobiango; de Melo Sette, Claudia Vaz; Mutti, Haila; Cubero, Daniel; Fonseca, Fernando; Del Giglio, Auro

    2017-11-02

    Hand-foot syndrome (HFS) is common and frequently occurs in the first cycle of treatment in approximately 40% to 50% of patients who receive capecitabine. Turmeric (Curcuma longa) is a plant used in Ayurvedic medicine with clinical activity in various inflammatory conditions. Our objective was to evaluate whether turmeric was active for the prevention of capecitabine-induced HFS. We included patients older than 18 years of age without previous exposure to capecitabine who were scheduled to receive this medication. Before starting treatment, after three weeks and at the end of six weeks, we evaluated dermatologic toxicity, conducted quality-of-life questionnaires (EORTC-QLQC30 and DLQI) and collected serum inflammatory biomarkers (inerleukin-6 (IL-6), tumor necrosis factor-a (TNF-a), C-reactive protein (CRP), and albumin). We administered turmeric at a dose of 4 g/day (2 pills 12 hours apart) starting at the beginning of capecitabine treatment and lasting six weeks. We included 40 patients whose mean age was 62 years. Most were female (80%), 52% had breast cancer, and 47.5% had GI tumors. After the first cycle of capecitabine treatment, we observed that 11 of 40 patients developed HFS (27.5%; 95% CI [15, 42]), whereas four patients developed HFS equal or superior to grade 2 (10%; 95% CI [3.3, 23]). We did not find any correlations between the inflammatory markers tested and HFS. We show that turmeric combined with capecitabine seems to produce a lower rate of HFS, especially grade 2 or higher. These findings need to be reproduced in larger controlled studies.

  9. Development of a patient-specific anatomical foot model from structured light scan data.

    Science.gov (United States)

    Lochner, Samuel J; Huissoon, Jan P; Bedi, Sanjeev S

    2014-01-01

    The use of anatomically accurate finite element (FE) models of the human foot in research studies has increased rapidly in recent years. Uses for FE foot models include advancing knowledge of orthotic design, shoe design, ankle-foot orthoses, pathomechanics, locomotion, plantar pressure, tissue mechanics, plantar fasciitis, joint stress and surgical interventions. Similar applications but for clinical use on a per-patient basis would also be on the rise if it were not for the high costs associated with developing patient-specific anatomical foot models. High costs arise primarily from the expense and challenges of acquiring anatomical data via magnetic resonance imaging (MRI) or computed tomography (CT) and reconstructing the three-dimensional models. The proposed solution morphs detailed anatomy from skin surface geometry and anatomical landmarks of a generic foot model (developed from CT or MRI) to surface geometry and anatomical landmarks acquired from an inexpensive structured light scan of a foot. The method yields a patient-specific anatomical foot model at a fraction of the cost of standard methods. Average error for bone surfaces was 2.53 mm for the six experiments completed. Highest accuracy occurred in the mid-foot and lowest in the forefoot due to the small, irregular bones of the toes. The method must be validated in the intended application to determine if the resulting errors are acceptable.

  10. Anatomical aspects of the nerves of the leg and foot of the giant anteater (Myrmecophaga tridactyla, Linnaeus, 1758

    Directory of Open Access Journals (Sweden)

    V.S. Cruz

    2014-10-01

    Full Text Available Although distal stifle joint nerve distribution has been well established in domestic animals, this approach is scarcely reported in wild animals. Therefore, the aim of this study was to describe the nerves of the leg and foot of Myrmecophaga tridactyla with emphasis on their ramification, distribution, topography and territory of innervation. For this purpose, six adult cadavers fixed and preserved in 10% formalin solution were used. The nerves of the leg and foot of the M. tridactyla were the saphenous nerve (femoral nerve branch, fibular and tibial nerves and lateral sural cutaneous nerve (branches of the sciatic nerve and caudal sural cutaneous nerve (tibial nerve branch. The saphenous nerve branches to the skin, the craniomedial surface of the leg, the medial surface of the tarsal and metatarsal regions and the dorsomedial surface of the digits I and II (100% of cases, III (50% of cases and IV (25% of cases. The lateral sural cutaneous nerve innervates the skin of the craniolateral region of the knee and leg. The fibular nerve innervates the flexor and extensor muscles of the tarsal region of the digits and skin of the craniolateral surface of the leg and dorsolateral surface of the foot. The tibial nerve innervates the extensor muscles of the tarsal joint and flexor, adductor and abductor muscles of the digits and the skin of the plantar surface. The caudal sural cutaneous nerve innervates the skin of the caudal surface of the leg. The nerves responsible for the leg and foot innervation were the same as reported in domestic and wild animals, but with some differences, such as the more distal division of the common fibular nerve, the absence of dorsal metatarsal branches of the deep fibular nerve and a greater involvement of the saphenous nerve in the digital innervation with branches to the digits III and IV, in addition to digits I and II.

  11. Detection of capecitabine (Xeloda®) on the skin surface after oral administration

    Science.gov (United States)

    Huang, Mao-Dong; Fuss, Harald; Lademann, Jürgen; Florek, Stefan; Patzelt, Alexa; Meinke, Martina C.; Jung, Sora

    2016-04-01

    Palmoplantar erythrodysesthesia (PPE), or hand-foot syndrome, is a cutaneous toxicity under various chemotherapeutics contributing to the most frequent side effects in patients treated with capecitabine (Xeloda®). The pathomechanism of PPE has been unclear. Here, the topical detection of capecitabine in the skin after oral application was shown in 10 patients receiving 2500 mg/m2/day capecitabine. Sweat samples were taken prior to and one week after oral administration of capecitabine. Using high-resolution continuum source absorption spectrometry, the changes in concentrations of fluorine, which is an ingredient of capecitabine, were quantified and statistically analyzed. Here, we show an increase in fluorine concentrations from 40±10 ppb (2±0.5 pM) before capecitabine administration to 27.7±11.8 ppm (14.6±6.5 nM) after application, ptoxic effect as a possible pathomechanism of PPE.

  12. Direct molecular versus culture-based assessment of Gram-positive cocci in biopsies of patients with major abscesses and diabetic foot infections

    NARCIS (Netherlands)

    Stappers, M.H.T.; Hagen, F.; Reimnitz, P.; Mouton, J.W.; Meis, J.F.; Gyssens, I.C.J.

    2015-01-01

    Major abscesses and diabetic foot infections (DFIs) are predominant subtypes of complicated skin and skin structure infections (cSSSIs), and are mainly caused by Staphylococcus aureus and beta-hemolytic streptococci. This study evaluates the potential benefit of direct pathogen-specific real-time

  13. [Pathophysiological aspects of wound healing in normal and diabetic foot].

    Science.gov (United States)

    Maksimova, N V; Lyundup, A V; Lubimov, R O; Melnichenko, G A; Nikolenko, V N

    2014-01-01

    The main cause of long-term healing of ulcers in patients with diabetic foot is considered to be direct mechanical damage when walking due to reduced sensitivity to due to neuropathy, hyperglycemia, infection and peripheral artery disease. These factors determine the standard approaches to the treatment of diabeticfoot, which include: offloading, glycemic control, debridement of ulcers, antibiotic therapy and revascularization. Recently, however, disturbances in the healing process of the skin in diabetes recognized an additional factor affecting the timing of healing patients with diabetic foot. Improved understanding and correction of cellular, molecular and biochemical abnormalities in chronic wound in combination with standard of care for affords new ground for solving the problem of ulcer healing in diabetes.

  14. Reconstruction of soft tissue defects around the ankle and foot

    Directory of Open Access Journals (Sweden)

    Bharat Bhushan Dogra

    2014-01-01

    Full Text Available Introduction: Soft tissue defects over ankle and foot region are encountered quite frequently following road traffic trauma and surgery. Management of such cases is a challenging task for any reconstructive surgeon because of paucity of skin and relative poor vascular status of skin in this region. Hence, invariably such cases require microsurgical free flap coverage, expertise for which may not be available at all the centers, such procedures require long operating hours and suitable recipient vessel may not be available in crush injuries. Materials and Methods: Thirty consecutive patients having soft tissue defects around ankle and foot region who underwent various reconstructive procedures in a medical college hospital during last 2 years form the basis of this study. This study was carried out to enlist various etiological factors and reconstructive surgical procedures employed to manage such cases without microsurgery. Results: The age of these patients ranged from 9 to 72 years. Twenty-five patients were males while 05 were females, with a mean age of 25 years. Road traffic accidents happened to be the primary cause of such defects in as many as 15 patients, cycle spoke trauma in 02 patients, implant exposure following orthopedic surgery in 6 patients, diabetic angiopathy in 4 patients and chronic osteomyelitis in 3 patients. The site of the defect was lower fourth of tibia in 16 patients, dorsum of foot in 2 patients, sole in 5 patients, medial aspect of ankle in 02 cases, lateral aspect in 02 cases and retro calcaneal region in 03 cases. In 10 cases distally based superficial sural artery flap was used to reconstruct the defect. In step rotation flap was used to provide sensory flap cover in the weight bearing heel in 04 cases. Inferiorly based fasciocutanenous flaps in 09 cases and muscle flaps were used in 07 cases. Conclusion: Distally based sural artery based flaps are very handy to provide skin cover around ankle and malleolar

  15. Relationship between static foot posture and foot mobility

    Directory of Open Access Journals (Sweden)

    McPoil Thomas G

    2011-01-01

    Full Text Available Abstract Background It is not uncommon for a person's foot posture and/or mobility to be assessed during a clinical examination. The exact relationship, however, between static posture and mobility is not known. Objective The purpose of this study was to determine the degree of association between static foot posture and mobility. Method The static foot posture and foot mobility of 203 healthy individuals was assessed and then analyzed to determine if low arched or "pronated" feet are more mobile than high arched or "supinated" feet. Results The study demonstrated that those individuals with a lower standing dorsal arch height and/or a wider standing midfoot width had greater mobility in their foot. In addition, those individuals with higher Foot Posture Index (FPI values demonstrated greater mobility and those with lower FPI values demonstrated less mobility. Finally, the amount of foot mobility that an individual has can be predicted reasonably well using either a 3 or 4 variable linear regression model. Conclusions Because of the relationship between static foot posture and mobility, it is recommended that both be assessed as part of a comprehensive evaluation of a individual with foot problems.

  16. Custom-made silicone hand prosthesis: A case study.

    Science.gov (United States)

    Nayak, S; Lenka, P K; Equebal, A; Biswas, A

    2016-09-01

    Up to now, a cosmetic glove was the most common method for managing transmetacarpal (TMC) and carpometacarpal (CMC) amputations, but it is devoid of markings and body color. At this amputation level, it is very difficult to fit a functional prosthesis because of the short available length, unsightly shape, grafted skin, contracture and lack of functional prosthetic options. A 30-year-old male came to our clinic with amputation at the 1st to 4th carpometacarpal level and a 5th metacarpal that was projected laterally and fused with the carpal bone. The stump had grafted skin, redness, and an unhealed suture line. He complained of pain projected over the metacarpal and suture area. The clinical team members decided to fabricate a custom-made silicone hand prosthesis to accommodate the stump, protect the grafted skin, improve the hand's appearance and provide some passive function. The custom silicone hand prosthesis was fabricated with modified flexible wires to provide passive interphalangeal movement. Basic training, care and maintenance instructions for the prosthesis were given to the patient. The silicone hand prosthesis was able to restore the appearance of the lost digits and provide some passive function. His pain (VAS score) was reduced. Improvement in activities of daily living was found in the DASH questionnaire and Jebsen-Taylor Hand Function test. A silicone glove is a good option for more distal amputations, as it can accommodate any deformity, protect the skin, enhance the appearance and provide functional assistance. This case study provides a simple method to get passively movable fingers after proximal hand amputation. Copyright © 2016. Published by Elsevier Masson SAS.

  17. Analysis of risk factors for neuropathic foot ulceration in diabetes mellitus.

    Science.gov (United States)

    Bennett, P J; Stocks, A E; Whittam, D J

    1996-03-01

    Diabetes mellitus affects about one in 25 Australians. Neuropathic foot ulceration is a frequent complication in persons with diabetes. This study evaluates the importance of different risk factors for the development of this condition. The role of nonenzymatic glycosylation and pressure beneath the sole of the foot in the pathogenesis of neuropathic foot ulcers was investigated. Twenty-seven subjects with diabetes with a recent history of neuropathic foot ulceration were matched by age and sex with a group of 50 control subjects without neuropathy or history of foot ulceration. The degree of nonenzymatic glycosylation was assessed by analyzing the average level of glycosylated hemoglobin in the 3 years prior to the development of the foot ulcer and a goniometer assessment of peripheral joint (hand and ankle) flexibility. Dynamic pressure of the plantar aspect of the foot was recorded using a Musgrave Footprint System pedobarograph during a normal gait cycle. There was no significant difference in age, sex, body mass index, and duration or type of diabetes between the ulcer and control groups. The pressure of the plantar aspect of the foot was significantly elevated (p < 0.01). Ankle joint flexibility was reduced (p < 0.01) in cases with neuropathic foot ulceration compared with the control group. There was a trend toward elevation of glycosylated hemoglobin (HbA1c fraction) or HbA1c in the ulcer group (p = 0.06). The results suggested that nonenzymatic glycosylation occurs at a more significant level in patients with diabetes with a history of neuropathic foot ulceration.

  18. Postoperative irradiation after reconstructive surgery: comparative study of radiosensitivity between free-skin grafts and skin flaps

    International Nuclear Information System (INIS)

    Sumi, Y.; Ueda, M.; Kaneda, T.; Oka, T.; Torii, S.; Sakuma, S.

    1984-01-01

    Radiation effects after reconstructive surgery (free-skin grafts and skin flaps) were studied in the rat, and the optimum time for irradiation was determined. The radiosensitivity of both free-skin grafts and skin flaps showed the same trend depending on time of irradiation after operation. The grafts or flaps irradiated in the hypervascular stage showed severe reactions to irradiation, whereas those irradiated in the hypovascular stage showed milder reactions in gross and microangiographic observation. Vascular damage should be given primary consideration when deciding the proper time for irradiation after reconstructive surgery. In general, free-skin grafts showed more severe reactions than skin flaps, especially in the grafts irradiated in the early stage after operation. The experimental results of this study cannot be readily transferred to a clinical setting, but they suggest that postoperative irradiation could be begun 3 to 4 weeks after operation with respect to graft or flap survival, and the results of the clinical cases almost coincide with these experimental results

  19. Aerobic training increases skin perfusion by a nitric oxide mechanism in type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Sheri R Colberg

    2010-08-01

    Full Text Available Sheri R Colberg1, Laura C Hill2, Henri K Parson3, Kathleen S Thomas1, Aaron I Vinik31Old Dominion University, Norfolk; 2State University of New York at Cortland, New York; 3Eastern Virginia Medical School, Norfolk, VirginiaAbstract: It is well known that a number of locally released vasodilatory and ­vasoconstrictive ­compounds can affect skin perfusion. This study investigated the effects of aerobic training on the contribution of nitric oxide (NO, prostaglandins (PG, and endothelial-derived ­hyperpolarizing factor (EDHF in stimulated dorsal foot skin perfusion in individuals with type 2 diabetes (T2DM. Ten previously sedentary, older individuals with T2DM (57.0 ± 3.1 years and nine sedentary controls (53.5 ± 3.2 years were tested before and after undertaking six months of moderate a­erobic training three times weekly in a supervised setting. All subjects underwent measurement of ­baseline (32°C and heat-stimulated (40°C and 44°C dorsal foot skin perfusion starting one hour after ­ingestion of a single, oral 325 mg dose of aspirin, a known inhibitor of PG synthesis. Before aspirin ­ingestion, a subcutaneous microdialysis probe was inserted into each foot dorsum to administer either saline (PG pathway only blocked by aspirin in the left foot or L-NAME (N(G-nitro-l-arginine methyl ester; thereby inhibiting both PG and NO pathways in the right foot. Normative data collected previously on subjects undergoing saline administration via ­microdialysis without aspirin ingestion served as a control group. Significantly lower responsiveness of maximal perfusion was found with the EDHF pathway alone unblocked compared with NO and EDHF unblocked after training. Maximal suppression attributable directly to NO, PG, and EDHF was not significantly different when examined by subject group and training status. However, ­contributions of NO, PG, and EDHF to maximal perfusion were significantly increased, decreased, and unchanged by aerobic training

  20. Maintenance experiences with hand and foot monitor for monitoring alpha and beta radiation of personnel in NFC

    International Nuclear Information System (INIS)

    Ramachandra Rao, A.; Kulkarni, R.S.; Banerjee, P.K.

    2010-01-01

    NFC is producing natural uranium and enriched uranium fuels for various reactors including PHWR etc. Monitoring of α and β radiations in the active plants of NFC is very much essential in many aspects. The personnel who are handling radiation materials have to be monitored for α radiation of hands and cloths and β radiation of feet. So the Alpha and Beta Monitor became important monitoring equipment for monitoring α and β radiations of persons working in active plants of NFC. Many Alpha and Beta Monitors of make, ECIL, PLA, and Nucleonix etc. were being used in active plants in NFC. Basically α and β radiation monitors consists of four PMT (Photo Multiplier Tubes) for detection of radiation of hands and one PMT for monitoring clothes. The PMT use ZnS (Ag) as the scintillator for detection of α radiation. GM tubes are used to detect β radiation of feet. The latest Hand and Foot Monitors have been incorporated with PC based monitoring system along with software for making the monitoring process more efficient and user friendly. As an instrumentation maintenance team for these monitors, our experiences are varied. These monitors are to be periodically maintained and tested for its effective functioning in monitoring the nuclear radiation. The monitors procured from M/s. ECIL were being used since long time in these areas. The instrumentation maintenance had faced some problems with these monitors such as frequent failure of High Voltage cards, Amplifier and Counter PCB cards. Modifications were made in the circuits of High Voltage and Counter cards to minimize the failure rate and for loading of Display and Monitoring Software through Hard disk instead of from floppy disk. So the availability of monitors for monitoring radiation got improved. Later the introduction of more sophisticated α and β radiation monitors of M/s. PLA make in these areas further improved monitoring of radiation of personnel working in active areas. These monitors are more user

  1. Release of hand burn contracture: comparing the ALT perforator flap with the gracilis free flap with split skin graft.

    Science.gov (United States)

    Misani, M; Zirak, C; Hau, Lê Thua Trung; De Mey, A; Boeckx, W

    2013-08-01

    The use of microsurgery in the management of burn sequelae is not a new idea. According to the properties of various types of free flaps different goals can be achieved or various additional procedures have to be combined. We report the comparison of two different free flaps on a single patient for reconstruction of both upper extremities for burn sequelae. A 1-year-old child sustained severe burns on both hands, arms and thorax and was initially only treated conservatively. This resulted in severe contractures. At the age of 4-years a free gracilis flap was selected for reconstruction of his left hand and a free anterolateral thigh flap for the right hand. We noticed a better functional and esthetic result for the gracilis flap associated with a shorter operative time and a minor donor site morbidity. The intraoperative technique and time, postoperative complications, functional and esthetic results and donor site morbidities were studied in the two types of flaps chosen. A review of literature was also performed. Our experience reported a better success of the gracilis muscle flap covered with a split skin graft compared to the anterolateral thigh flap in the reconstruction of hand function after severe burn sequelae. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

  2. Circadian rhythm disruption was observed in hand, foot, and mouth disease patients.

    Science.gov (United States)

    Zhu, Yu; Jiang, Zhou; Xiao, Guoguang; Cheng, Suting; Wen, Yang; Wan, Chaomin

    2015-03-01

    Hand, foot, and mouth disease (HFMD) with central nerve system complications may rapidly progress to fulminated cardiorespiratory failure, with higher mortality and worse prognosis. It has been reported that circadian rhythms of heart rate (HR) and respiratory rate are useful in predicting prognosis of severe cardiovascular and neurological diseases. The present study aims to investigate the characteristics of the circadian rhythms of HR, respiratory rate, and temperature in HFMD patients with neurological complications. Hospitalized HFMD patients including 33 common cases (common group), 61 severe cases (severe group), and 9 critical cases (critical group) were contrasted retrospectively. Their HR, respiratory rate, and temperatures were measured every 4 hours during the first 48-hour in the hospital. Data were analyzed with the least-squares fit of a 24-hour cosine function by the single cosinor and population-mean cosinor method. Results of population-mean cosinor analysis demonstrated that the circadian rhythm of HR, respiratory rate, and temperature was present in the common and severe group, but absent in the critical group. The midline-estimating statistic of rhythm (MESOR) (P = 0.016) and acrophase (P circadian characteristics of HR among 3 groups. Compared with the common group, the MESOR of temperature and respiratory rate was significantly higher, and acrophase of temperature and respiratory rate was 2 hours ahead in the severe group, critical HFMD patients lost their population-circadian rhythm of temperature, HR, and respiratory rate. The high values of temperature and respiratory rate for the common group were concentrated between 3 and 9 PM, whereas those for the severe group were more dispersive. And the high values for the critical group were equally distributed in 24 hours of the day. Circadian rhythm of patients' temperature in the common group was the same as the normal rhythm of human body temperature. Circadian rhythm of patients

  3. Temporal predictive mechanisms modulate motor reaction time during initiation and inhibition of speech and hand movement.

    Science.gov (United States)

    Johari, Karim; Behroozmand, Roozbeh

    2017-08-01

    Skilled movement is mediated by motor commands executed with extremely fine temporal precision. The question of how the brain incorporates temporal information to perform motor actions has remained unanswered. This study investigated the effect of stimulus temporal predictability on response timing of speech and hand movement. Subjects performed a randomized vowel vocalization or button press task in two counterbalanced blocks in response to temporally-predictable and unpredictable visual cues. Results indicated that speech and hand reaction time was decreased for predictable compared with unpredictable stimuli. This finding suggests that a temporal predictive code is established to capture temporal dynamics of sensory cues in order to produce faster movements in responses to predictable stimuli. In addition, results revealed a main effect of modality, indicating faster hand movement compared with speech. We suggest that this effect is accounted for by the inherent complexity of speech production compared with hand movement. Lastly, we found that movement inhibition was faster than initiation for both hand and speech, suggesting that movement initiation requires a longer processing time to coordinate activities across multiple regions in the brain. These findings provide new insights into the mechanisms of temporal information processing during initiation and inhibition of speech and hand movement. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. More attention on the application of interventional management in patients with diabetic foot

    International Nuclear Information System (INIS)

    Teng Gaojun; Qin Yonglin

    2008-01-01

    Arterial stenotic and occlusive disorders of low limb are commonly the most important factors associated with the prognosis of diabetic foot. The effect of traditional bypass operation is unpredictable for lack of runoff artery. On the other hand, the contributions of special interventional devices and techniques targeted at infrapopliteal artery show unique therapeutic outcomes of interventional management; together with furthermore stem cell thansplantation would present a promising future for the treatment of diabetic foot. (authors)

  5. Enterovirus genotypes causing hand foot and mouth disease in Shanghai, China: a molecular epidemiological analysis.

    Science.gov (United States)

    Xu, Menghua; Su, Liyun; Cao, Lingfeng; Zhong, Huaqing; Dong, Niuniu; Xu, Jin

    2013-10-22

    A rapid expansion of hand, foot, and mouth disease (HFMD) outbreaks has occurred and caused deaths in China in recent years, but little is known about the other etiologic agents except enterovirus 71 (EV71) and coxsackievirus A 16 (CA16). The objective of this study is to determine the genotype compositions of enterovirus causing HFMD in Shanghai and identify any associations between enterovirus types and clinical manifestations. Stool specimens were collected from patients hospitalized for treatment of HFMD, from May 2010 to April 2011. Enterovirus was detected by reverse transcription PCR and directly genotyped by sequencing the PCR products. Phylogenetic analysis was based on the VP1 partial gene. Of 290 specimens, 277 (95.5%) tested positive for enterovirus. The major genotypes were EV71 (63.8%), CA10 (9.0%), CA6 (8.3%), CA16 (6.9%), CA12 (2.4%), and CA4 (1.4%). The EV71 strains belonged to the C4a subtype and CA16 belonged to the B subtype. CA6 was closely related to strains detected in Japan, Taiwan and China, and CA10, CA12 and CA4 were phylogenetically similar to other strains circulating in China. Mean hospital stays and the prevalence of complications in patients with EV71 infection were higher than those in patients in CA6, CA10 or CA16 infection (P treatment of HFMD patients.

  6. Positioning the endoscope in laparoscopic surgery by foot: Influential factors on surgeons' performance in virtual trainer.

    Science.gov (United States)

    Abdi, Elahe; Bouri, Mohamed; Burdet, Etienne; Himidan, Sharifa; Bleuler, Hannes

    2017-07-01

    We have investigated how surgeons can use the foot to position a laparoscopic endoscope, a task that normally requires an extra assistant. Surgeons need to train in order to exploit the possibilities offered by this new technique and safely manipulate the endoscope together with the hands movements. A realistic abdominal cavity has been developed as training simulator to investigate this multi-arm manipulation. In this virtual environment, the surgeon's biological hands are modelled as laparoscopic graspers while the viewpoint is controlled by the dominant foot. 23 surgeons and medical students performed single-handed and bimanual manipulation in this environment. The results show that residents had superior performance compared to both medical students and more experienced surgeons, suggesting that residency is an ideal period for this training. Performing the single-handed task improves the performance in the bimanual task, whereas the converse was not true.

  7. Nickel deposited on the skin-visualization by DMG test.

    Science.gov (United States)

    Julander, Anneli; Skare, Lizbet; Vahter, Marie; Lidén, Carola

    2011-03-01

    Nickel is the most common cause of contact allergy and an important risk factor for hand eczema. Visualization techniques may be powerful in showing exposures. The dimethylglyoxime (DMG) test might be used to establish skin exposure to nickel. To develop and evaluate methods for visualization of nickel on the skin by the DMG test and hand imprints. Nickel solutions at different concentrations were applied in duplicate on the hands in healthy subjects (n = 5). The DMG test and acid wipe sampling for quantification were then performed. Hand imprints were taken after manipulation of nickel-releasing tools (n = 1), and in workers performing their normal tasks (n = 7). The imprints were developed by the DMG test. The DMG test on hands gave positive results in all subjects. The lowest concentration giving rise to a colour change was set to 0.13 µg/cm(2) for DMG testing on skin. DMG test-developed imprints worked well except when hands were heavily contaminated by other particles/dust. The DMG test may be used as a simple and powerful tool for visualization of nickel on skin. DMG test-developed hand imprints may, in the future, be used for semi-quantitative or quantitative exposure assessment. © 2011 John Wiley & Sons A/S.

  8. Pain (PDQ)

    Science.gov (United States)

    ... intravenous chemotherapy. Mucositis (sores or inflammation in the mouth or other parts of the digestive system ) caused by chemotherapy or targeted therapy. Skin pain, rash, or hand-foot syndrome (redness, tingling, or burning in the palms of the hands and/or ...

  9. Research on corrosion mechanism of suspension insulator steel foot of direct current system and measures for corrosion inhibition

    Science.gov (United States)

    Chen, He; Yang, Yueguang; Su, Guolei; Wang, Xiaoqing; Zhang, Hourong; Sun, Xiaoyu; Fan, Youping

    2017-09-01

    There are increasingly serious electrocorrosion phenomena on insulator hardware caused by direct current transmission due to the wide-range popularization of extra high voltage direct current transmission engineering in our country. Steel foot corrosion is the main corrosion for insulators on positive polarity side of transmission lines. On one hand, the corrosion leads to the tapering off of steel foot diameter, having a direct influence on mechanical property of insulators; on the other hand, in condition of corrosion on steel foot wrapped in porcelain ware, the volume of the corrosion product is at least 50% more than that of the original steel foot, leading to bursting of porcelain ware, threatening safe operation of transmission lines. Therefore, it is necessary to conduct research on the phenomenon and propose feasible measures for corrosion inhibition. Starting with the corrosion mechanism, this article proposes two measures for corrosion inhibition, and verifies the inhibition effect in laboratory conditions, providing reference for application in engineering.

  10. Effects of irradiation of skin flaps

    International Nuclear Information System (INIS)

    Sumi, Y.; Ueda, M.; Oka, T.; Torii, S.

    1984-01-01

    The reaction of skin flaps to irradiation and the optimum postoperative time for irradiation was studied in the rat. Flaps showed different reactions depending on the time of irradiation. There was a correlation between the radiosensitivity and the vascularity of the flap. Those flaps in the marginal hypovascular stage of revascularization showed reactions similar to normal skin. However, severe adverse reactions were observed in the marginal hypervascular stage

  11. Basal Cell Carcinoma of the Dorsal Foot: An Update and Comprehensive Review of the Literature.

    Science.gov (United States)

    Loh, Tiffany Y; Rubin, Ashley G; Jiang, Shang I Brian

    2017-01-01

    Ultraviolet radiation is a well-known risk factor for basal cell carcinoma (BCC). Therefore, the high incidence of BCCs in sun-exposed areas such as the head and neck is unsurprising. However, unexpectedly, BCCs on the sun-protected dorsal foot have also been reported, and tumor occurrence here suggests that other factors besides ultraviolet radiation may play a role in BCC pathogenesis. Because only few dorsal foot BCCs have been reported, data on their clinical features and management are limited. To perform an updated review of the literature on clinical characteristics and treatment of dorsal foot BCCs. We conducted a comprehensive literature review by searching the PubMed database with the key phrases "basal cell carcinoma dorsal foot," "basal cell carcinoma foot," and "basal cell carcinoma toe." We identified 20 cases of dorsal foot BCCs in the literature, 17 of which had sufficient data for analysis. Only 1 case was treated with Mohs micrographic surgery. We present 8 additional cases of dorsal foot BCCs treated with Mohs micrographic surgery. Basal cell carcinomas on the dorsal foot are rare, and potential risk factors include Caucasian descent and personal history of skin cancer. Mohs micrographic surgery seems to be an effective treatment option.

  12. Comparing negative pressure wound treatment with honey dressing in healing of foot ulcers in diabetics

    International Nuclear Information System (INIS)

    Bashir, U.; Maqsood, R.; Shabbir, H.

    2018-01-01

    To evaluate and compare the effectiveness of vacuum assisted treatment with that of honey dressing in duration of healing of foot ulcers in diabetics. Study Design: Randomized control study. Place and Duration of Study: Combined Military Hospital Multan and Nishtar Hospital Multan, from Aug 2016 till Feb 2017. Patients and Methods: A total of 95 patients with ages between 30-60 years of both sexes, who presented with diabetic ulcers of foot involving subcutaneous tissue and skin. Patients were divided randomly into two groups; Group V and H. Group V was subjected to Vacuum Pack closure (negative pressure wound treatment) and group H was treated with honey dressing, follow up was done till the appearance of healthy tissue after initial debridement, suitable for STSG (Split Thickness Skin Graft) or primary closure. Results: Healthy tissue appeared much faster in Vacuum assisted treatment, then with honey dressing with mean of 18.2 days for V.A.C and 28.8 days for honey dressing. Conclusion: Vacuum assisted closure was more effective in the treatment of foot ulcers in diabetics. It promotes healthy granulation tissue in the wound bed at a faster rate in comparison to honey dressing. (author)

  13. Effect of field size on the reaction of pig skin to single doses of X rays

    Energy Technology Data Exchange (ETDEWEB)

    Hopewell, J W; Young, C M.A. [Churchill Hospital, Oxford (UK)

    1982-05-01

    The importance of the size of the treatment area for the response of the skin to radiation has been studied in the pig. The responses of skin areas of 16 cm/sup 2/ (4 x 4 cm) and 64cm/sup 2/ (16 x 4 cm) were compared after single doses of X rays. In the initial 3-9-week period after irradiation the severity of the erythema reaction, which is associated with epidermal cell death, was not influenced by the area of skin irradiated. For the later dermal response (10-16 weeks) a similar result was obtained. The dose required to produce dermal necrosis in 50% of the fields treated (ED/sub 50/) was approximately 2070 cGy for both field sizes. Additional studies have shown that the ED/sub 50/ for dermal necrosis was not influenced by the age of animals at the time of irradiation. This was despite considerable differences in the vascular density and blood flow in pig skin with increasing age. The apparent contradiction between the results of this experimental study in the pig, which shows no effect of field size, and currently accepted clinical practice is discussed.

  14. S1 guideline on occupational skin products: protective creams, skin cleansers, skin care products (ICD 10: L23, L24)--short version.

    Science.gov (United States)

    Fartasch, Manigé; Diepgen, Thomas L; Drexler, Hans; Elsner, Peter; John, Swen Malte; Schliemann, Sibylle

    2015-06-01

    Job-related hand dermatitis heads up the list of reported occupational diseases. So-called skin products - understood to mean protective creams, skin cleansers and skin care products - are used for the primary and secondary prevention of job- related hand dermatitis. In the interests of evidence-based medicine, the only preventive measures and/or occupational skin products that should be used are those whose potential uses and efficacy are underpinned by scientific research. To this end, the Arbeitsgemeinschaft für Berufs- und Umweltdermatologie e.V. (Working Group for Occupational and Environmental Dermatology, ABD) of the DDG (German Dermatological Society) and the Deutsche Gesellschaft für Arbeits- und Umweltmedizin (German Society for Occupational and Environmental Medicine, DGAUM) have summed up the latest scientific findings and recommendations in the updated guideline. The benefit of the combined application of protective creams and skin care products in the primary and secondary prevention of work-related contact dermatitis has been widely confirmed by recent clinical-epidemiological studies. The guideline clearly explains the necessity of demonstrating the efficacy of protective creams and cleansing products by means of in vivo methods in the sense of repetitive applications. Transferable standardised testing systems designed to examine the irritation potential and thus the compatibility of occupational skin cleansers and the reduction of irritation by protective skin creams have now been developed and validated by multicentre studies for skin protection creams and cleansers. The status of the current assessment of the safety of occupational skin products is also summarised. © 2015 The Authors | Journal compilation © Blackwell Verlag GmbH, Berlin.

  15. Unique microRNAs appear at different times during the course of a delayed-type hypersensitivity reaction in human skin

    DEFF Research Database (Denmark)

    Gulati, Nicholas; Løvendorf, Marianne B; Zibert, John R

    2015-01-01

    Diphencyprone (DPCP) is a hapten that induces delayed-type hypersensitivity (DTH) reactions. MicroRNAs (miRNAs) are short non-coding RNAs that negatively regulate gene expression and have been implicated in various inflammatory skin diseases, but their role in DTH reactions is not well understood......, and therefore, may inform on the paradoxical ability of DPCP to treat both autoimmune conditions (alopecia areata) and conditions of ineffective immunity (melanoma)....

  16. Tattoo reaction: Case series

    Directory of Open Access Journals (Sweden)

    Muneer Mohamed

    2018-04-01

    Full Text Available Tattoo is going to be a very common practice especially among young people and we are witnessing a gradual increase of numerous potential complications to tattoo placement which are often seen by physicians, but generally unknown to the public. The most common skin reactions to tattoo include a transient acute inflammatory reaction due to trauma of the skin with needles and medical complications such as superficial and deep local infections, systemic infections, allergic contact dermatitis, photodermatitis, granulomatous and lichenoid reactions, and skin diseases localized on tattooed area (eczema, psoriasis, lichen, and morphea. In this series we present three cases of tattoo reaction.

  17. Foot morphometric phenomena.

    Science.gov (United States)

    Agić, Ante

    2007-06-01

    Knowledge of the foot morphometry is important for proper foot structure and function. Foot structure as a vital part of human body is important for many reasons. The foot anthropometric and morphology phenomena are analyzed together with hidden biomechanical descriptors in order to fully characterize foot functionality. For Croatian student population the scatter data of the individual foot variables were interpolated by multivariate statistics. Foot morphometric descriptors are influenced by many factors, such as life style, climate, and things of great importance in human society. Dominant descriptors related to fit and comfort are determined by the use 3D foot shape and advanced foot biomechanics. Some practical recommendations and conclusions for medical, sportswear and footwear practice are highlighted.

  18. Skin test of radiosensitivity. Application to Fanconi anemia

    International Nuclear Information System (INIS)

    Dutreix, J.; Gluckman, E.

    1983-01-01

    A test of skin radiosensitivity is described. It is achieved by irradiating small skin fields (15 mm in diameter) with 50 kV X-rays. The radiosensitivity is evaluated from the skin reaction observed for a single acute dose of 8 and 10 Gy; it is considered increased if the reaction for 10 Gy exceeds the desquamation threshold, and scored according to the observed reaction. The test includes an evaluation of the cellular repair, assessed on the comparison of the reactions for single dose and split irradiation. The time of the reaction peak is also reported. Abnormal reactions have been observed on 4 out of 8 patients with Fanconi Anemia

  19. Skin test of radiosensitivity. Application to Fanconi anemia

    Energy Technology Data Exchange (ETDEWEB)

    Dutreix, J. (Institut Gustave-Roussy, 94 - Villejuif (France)); Gluckman, E. (Centre Hayem, Hopital St.-Louis, 75 Paris (France))

    1983-01-01

    A test of skin radiosensitivity is described. It is achieved by irradiating small skin fields (15 mm in diameter) with 50 kV X-rays. The radiosensitivity is evaluated from the skin reaction observed for a single acute dose of 8 and 10 Gy; it is considered increased if the reaction for 10 Gy exceeds the desquamation threshold, and scored according to the observed reaction. The test includes an evaluation of the cellular repair, assessed on the comparison of the reactions for single dose and split irradiation. The time of the reaction peak is also reported. Abnormal reactions have been observed on 4 out of 8 patients with Fanconi Anemia.

  20. [Relationships between foot problems, fall experience and fear of falling among Japanese community-dwelling elderly].

    Science.gov (United States)

    Harada, Kazuhiro; Oka, Koichiro; Shibata, Ai; Kaburagi, Hironobu; Nakamura, Yoshio

    2010-08-01

    Although a foot care program for long-term care prevention has been launched in Japan, few studies have examined its effectiveness. The purpose of the present investigation was to examine the association of foot problems with fall experience and fear of falling among Japanese community-dwelling elderly people. The participants were 10,581 community-dwelling elderly people (75.2 +/- 5.6 years) and the study design was cross-sectional using a questionnaire. Self-reported tinea pedis, skin problems (inflammation, swelling, or discoloration), nail problems (thickening or deformities), impairment (in function or blood flow), regular foot care, and wearing of appropriate shoes were selected as parameters of foot problems and their care. Logistic regression analysis was conducted to examine whether these were related to fall experience (in the past 1 year) and fear of falling adjusted for age, the Tokyo Metropolitan institute of gerontology index of competence, medical conditions, and lower limb functions. Forty-six percents of males and 39.0% of females reported at least one foot problem. After adjusting for covariates, tinea pedis (male: adjusted odds ratio = 1.37[95% confidence interval= 1.15-1.63], female: 1.29[1.08-1.53]), skin problems (male: 1.66[1.32-2.101, female: 1.37[1.13-1.66]), nail problems (male: 1.72[1.45-2.051, female: 1.48[1.26-1.74]), and functional impairment (male: 2.42[1.91-3.05], female: 1.66[1.36-2.04]) were significantly associated with fall experience. Also, each problem was negatively associated with fear of falling (tinea pedis[male: 1.37 [1.15-1.62], female: 1.25[1.07-1.47

  1. Foot morphology of Turkish football players according to foot ...

    African Journals Online (AJOL)

    Football is the most popular sport in the world. Foot morphology and foot preference are important factors in football player's performance. The aim of this cross-sectional study was to evaluate the foot morphology of elite football players with different foot preferences. 407 male football players participated in this study. 328 of ...

  2. Effectiveness of vacuum-assisted closure (VAC) therapy in the healing of chronic diabetic foot ulcers.

    Science.gov (United States)

    Nather, Aziz; Chionh, Siok Bee; Han, Audrey Y Y; Chan, Pauline P L; Nambiar, Ajay

    2010-05-01

    This is the fi rst prospective study done locally to determine the effectiveness of vacuum-assisted closure (VAC) therapy in the healing of chronic diabetic foot ulcers. An electronic vacuum pump was used to apply controlled negative pressure evenly across the wound surface. Changes in wound dimension, presence of wound granulation and infection status of diabetic foot ulcers in 11 consecutive patients with diabetes were followed over the course of VAC therapy. Healing was achieved in all wounds. Nine wounds were closed by split-skin grafting and 2 by secondary closure. The average length of treatment with VAC therapy was 23.3 days. Ten wounds showed reduction in wound size. All wounds were satisfactorily granulated and cleared of bacterial infection at the end of VAC therapy. VAC therapy was useful in the treatment of diabetic foot infection and ulcers, which after debridement, may present with exposed tendon, fascia and/or bone. These included ray amputation wounds, wounds post-debridement for necrotising fasciitis, wounds post-drainage for abscess, a heel ulcer and a sole ulcer. It was able to prepare ulcers well for closure via split-skin grafting or secondary closure in good time. This reduced cost of VAC therapy, as therapy was not prolonged to attain greater reduction in wound area. VAC therapy also provides a sterile, more controlled resting environment to large, exudating wound surfaces. Large diabetic foot ulcers were thus made more manageable.

  3. The influence of cooling forearm/hand and gender on estimation of handgrip strength.

    Science.gov (United States)

    Cheng, Chih-Chan; Shih, Yuh-Chuan; Tsai, Yue-Jin; Chi, Chia-Fen

    2014-01-01

    Handgrip strength is essential in manual operations and activities of daily life, but the influence of forearm/hand skin temperature on estimation of handgrip strength is not well documented. Therefore, the present study intended to investigate the effect of local cooling of the forearm/hand on estimation of handgrip strength at various target force levels (TFLs, in percentage of MVC) for both genders. A cold pressor test was used to lower and maintain the hand skin temperature at 14°C for comparison with the uncooled condition. A total of 10 male and 10 female participants were recruited. The results indicated that females had greater absolute estimation deviations. In addition, both genders had greater absolute deviations in the middle range of TFLs. Cooling caused an underestimation of grip strength. Furthermore, a power function is recommended for establishing the relationship between actual and estimated handgrip force. Statement of relevance: Manipulation with grip strength is essential in daily life and the workplace, so it is important to understand the influence of lowering the forearm/hand skin temperature on grip-strength estimation. Females and the middle range of TFL had greater deviations. Cooling the forearm/hand tended to cause underestimation, and a power function is recommended for establishing the relationship between actual and estimated handgrip force. Practitioner Summary: It is important to understand the effect of lowering the forearm/hand skin temperature on grip-strength estimation. A cold pressor was used to cool the hand. The cooling caused underestimation, and a power function is recommended for establishing the relationship between actual and estimated handgrip force. Manipulation with grip strength is essential in daily life and the workplace, so it is important to understand the influence of lowering the forearm/hand skin temperature on grip-strength estimation. Females and the middle range of TFL had greater deviations. Cooling the

  4. Enterovirus genotypes causing hand foot and mouth disease in Shanghai, China: a molecular epidemiological analysis

    Science.gov (United States)

    2013-01-01

    Background A rapid expansion of hand, foot, and mouth disease (HFMD) outbreaks has occurred and caused deaths in China in recent years, but little is known about the other etiologic agents except enterovirus 71 (EV71) and coxsackievirus A 16 (CA16). The objective of this study is to determine the genotype compositions of enterovirus causing HFMD in Shanghai and identify any associations between enterovirus types and clinical manifestations. Methods Stool specimens were collected from patients hospitalized for treatment of HFMD, from May 2010 to April 2011. Enterovirus was detected by reverse transcription PCR and directly genotyped by sequencing the PCR products. Phylogenetic analysis was based on the VP1 partial gene. Results Of 290 specimens, 277 (95.5%) tested positive for enterovirus. The major genotypes were EV71 (63.8%), CA10 (9.0%), CA6 (8.3%), CA16 (6.9%), CA12 (2.4%), and CA4 (1.4%). The EV71 strains belonged to the C4a subtype and CA16 belonged to the B subtype. CA6 was closely related to strains detected in Japan, Taiwan and China, and CA10, CA12 and CA4 were phylogenetically similar to other strains circulating in China. Mean hospital stays and the prevalence of complications in patients with EV71 infection were higher than those in patients in CA6, CA10 or CA16 infection (P enterovirus genotypes. It deserves our attention as early identification of enterovirus genotypes is important for diagnosis and treatment of HFMD patients. PMID:24148902

  5. Ambient temperature, humidity and hand, foot, and mouth disease: A systematic review and meta-analysis.

    Science.gov (United States)

    Cheng, Qiang; Bai, Lijun; Zhang, Yanwu; Zhang, Heng; Wang, Shusi; Xie, Mingyu; Zhao, Desheng; Su, Hong

    2018-06-01

    The relationship between ambient temperature, humidity and hand, foot, and mouth disease (HFMD) has been highlighted in East and Southeast Asia, which showed multiple different results. Therefore, our goal is to conduct a meta-analysis to further clarify this relationship and to quantify the size of these effects as well as the susceptible populations. PubMed, Web of science, and Cochrane library were searched up to November 22, 2017 for articles analyzing the relationships between ambient temperature, humidity and incidence of HFMD. We assessed sources of heterogeneity by study design (temperature measure and exposed time resolution), population vulnerability (national income level and regional climate) and evaluated pooled effect estimates for the subgroups identified in the heterogeneity analysis. We identified 11 studies with 19 estimates of the relationship between ambient temperature, humidity and incidence of HFMD. It was found that per 1°C increase in the temperature and per 1% increase in the relative humidity were both significantly associated with increased incidence of HFMD (temperature: IRR, 1.05; 95% CI, 1.02-1.08; relative humidity: IRR, 1.01; 95% CI, 1.00-1.02). Subgroup analysis showed that people living in subtropical and middle income areas had a higher risk of incidence of HFMD. Ambient temperature and humidity may increase the incidence of HFMD in Asia-Pacific regions. Further studies are needed to clarify the relationship between ambient temperature, humidity and incidence of HFMD in various settings with distinct climate, socioeconomic, and demographic features. Copyright © 2018. Published by Elsevier B.V.

  6. Chemical burn or reaction

    Science.gov (United States)

    Chemicals that touch skin can lead to a reaction on the skin, throughout the body, or both. ... leave the person alone and watch carefully for reactions affecting the entire body. Note: If a chemical gets into the eyes, the eyes should be ...

  7. The abdominal skin of female Sprague-Dawley rats is more sensitive than the back skin to drug-induced phototoxicity.

    Science.gov (United States)

    Kuga, Kazuhiro; Yasuno, Hironobu; Sakai, Yumi; Harada, Yumiko; Shimizu, Fumi; Miyamoto, Yumiko; Takamatsu, Yuki; Miyamoto, Makoto; Sato, Keiichiro

    2017-11-01

    In vivo phototoxicity studies are important to predict drug-induced phototoxicity in humans; however, a standard methodology has not established. To determine differences in sensitivity to drug-induced phototoxicity among various skin sites, we evaluated phototoxic reactions in the back and abdominal skin of female Sprague-Dawley rats orally dosed with phototoxic drugs (pirfenidone, 8-methoxysoraren, doxycycline, and lomefloxacin) or a non-phototoxic drug (gatifloxacin) followed by solar-simulated light irradiation comprising 18J/cm 2 ultraviolet A. Tissue reactions were evaluated by macroscopic and microscopic examination and immunohistochemistry for γ-H2AX, and tissue concentrations of pirfenidone, doxycycline, and lomefloxacin were measured by tandem mass spectrometry. In addition, the thicknesses of the skin layers at both sites were measured in drug-naïve rats. The abdominal skin showed more severe reactions to all phototoxic drugs than the back skin, whereas the minimal erythema dose in drug-naïve rats and skin concentrations of each drug were comparable between the sites. Furthermore, histopathological lesions and γ-H2AX-positive cells in the abdominal skin were detected in deeper layers than in the back skin. The stratum corneum and dermis in the abdominal skin were significantly thinner than in the back skin, indicating a difference in the depth of light penetration and potentially contributing to the site differences observed in sensitivity to phototoxicity. Gatifloxacin did not induce any phototoxic reactions at either site. In conclusion, the abdominal skin is more sensitive to drug-induced phototoxicity than the back skin and may represent a preferable site for irradiation in this rat phototoxicity model. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. The response of previously irradiated mouse skin to heat alone or combined with irradiation: influence of thermotolerance

    NARCIS (Netherlands)

    Wondergem, J.; Haveman, J.

    1983-01-01

    The skin of the mouse foot was used to study the effects of previous irradiation on the response to hyperthermia (44 degrees C), to irradiation, or to irradiation combined with hyperthermia (43 degrees C or 44 degrees C). Hyperthermia was applied by immersing the mouse foot into a hot waterbath and

  9. Development of single-step multiplex real-time RT-PCR assays for rapid diagnosis of enterovirus 71, coxsackievirus A6, and A16 in patients with hand, foot, and mouth disease.

    Science.gov (United States)

    Puenpa, Jiratchaya; Suwannakarn, Kamol; Chansaenroj, Jira; Vongpunsawad, Sompong; Poovorawan, Yong

    2017-10-01

    Real-time reverse-transcription polymerase chain reaction (rRT-PCR) to detect enterovirus 71 (EV-A71) and coxsackievirus A16 (CV-A16) has facilitated the rapid and accurate identification of the two most common etiological agents underlying hand, foot, and mouth disease (HFMD). However, the worldwide emergence of CV-A6 infection in HFMD necessitates development of an improved multiplex rRT-PCR method. To rapidly determine the etiology of HFMD, two rRT-PCR assays using TaqMan probes were developed to differentiate among three selected common enteroviruses (EV-A71, CV-A16 and CV-A6) and to enable broad detection of enteroviruses (pan-enterovirus assay). No cross-reactions were observed with other RNA viruses examined. The detection limits of both assays were 10 copies per microliter for EV-A71, CV-A6 and CV-A16, and pan-enterovirus. The methods showed high accuracy (EV-A71, 90.6%; CV-A6, 92.0%; CV-A16, 100%), sensitivity (EV-A71, 96.5%; CV-A6, 95.8%; CV-A16, 99.0%), and specificity (EV-A71, 100%; CV-A6, 99.9%; CV-A16, 99.9%) in testing clinical specimens (n=1049) during 2014-2016, superior to those of conventional RT-PCR. Overall, the multiplex rRT-PCR assays enabled highly sensitive detection and rapid simultaneous typing of EV-A71, CV-A6 and CV-A16, and enteroviruses, rendering them feasible and attractive methods for large-scale surveillance of enteroviruses associated with HFMD outbreaks. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. Quantifying skin motion artifact error of the hindfoot and forefoot marker clusters with the optical tracking of a multi-segment foot model using single-plane fluoroscopy.

    Science.gov (United States)

    Shultz, R; Kedgley, A E; Jenkyn, T R

    2011-05-01

    The trajectories of skin-mounted markers tracked with optical motion capture are assumed to be an adequate representation of the underlying bone motions. However, it is well known that soft tissue artifact (STA) exists between marker and bone. This study quantifies the STA associated with the hindfoot and midfoot marker clusters of a multi-segment foot model. To quantify STA of the hindfoot and midfoot marker clusters with respect to the calcaneus and navicular respectively, fluoroscopic images were collected on 27 subjects during four quasi-static positions, (1) quiet standing (non-weight bearing), (2) at heel strike (weight-bearing), (3) at midstance (weight-bearing) and (4) at toe-off (weight-bearing). The translation and rotation components of STA were calculated in the sagittal plane. Translational STA at the calcaneus varied from 5.9±7.3mm at heel-strike to 12.1±0.3mm at toe-off. For the navicular the translational STA ranged from 7.6±7.6mm at heel strike to 16.4±16.7mm at toe-off. Rotational STA was relatively smaller for both bones at all foot positions. For the calcaneus they varied between 0.1±2.2° at heel-strike to 0.2±0.6° at toe-off. For the navicular, the rotational STA ranged from 0.6±0.9° at heel-strike to 0.7±0.7° at toe-off. The largest translational STA found in this study (16mm for the navicular) was smaller than those reported in the literature for the thigh and the lower leg, but was larger than the STA of individual spherical markers affixed to the foot. The largest errors occurred at toe-off position for all subjects for both the hindfoot and midfoot clusters. Future studies are recommended to quantify true three-dimensional STA of the entire foot during gait. Copyright © 2011. Published by Elsevier B.V.

  11. Obese older adults suffer foot pain and foot-related functional limitation.

    Science.gov (United States)

    Mickle, Karen J; Steele, Julie R

    2015-10-01

    There is evidence to suggest being overweight or obese places adults at greater risk of developing foot complications such as osteoarthritis, tendonitis and plantar fasciitis. However, no research has comprehensively examined the effects of overweight or obesity on the feet of individuals older than 60 years of age. Therefore we investigated whether foot pain, foot structure, and/or foot function is affected by obesity in older adults. Three hundred and twelve Australian men and women, aged over 60 years, completed validated questionnaires to establish the presence of foot pain and health related quality of life. Foot structure (anthropometrics and soft tissue thickness) and foot function (ankle dorsiflexion strength and flexibility, toe flexor strength, plantar pressures and spatiotemporal gait parameters) were also measured. Obese participants (BMI >30) were compared to those who were overweight (BMI=25-30) and not overweight (BMI foot pain and scored significantly lower on the SF-36. Obesity was also associated with foot-related functional limitation whereby ankle dorsiflexion strength, hallux and lesser toe strength, stride/step length and walking speed were significantly reduced in obese participants compared to their leaner counterparts. Therefore, disabling foot pain and altered foot structure and foot function are consequences of obesity for older adults, and impact upon their quality of life. Interventions designed to reduce excess fat mass may relieve loading of the foot structures and, in turn, improve foot pain and quality of life for older obese individuals. Copyright © 2015 Elsevier B.V. All rights reserved.

  12. Skin health and safety at work in Croatian hairdressing apprentices.

    Science.gov (United States)

    Samardžić, Tea; Varnai, Veda Marija; Bakotić, Marija; Babić, Željka; Brans, Richard; Cvijetić Avdagić, Selma; Štampar Šmaguc, Darinka; Kovačević, Iva; Macan, Jelena

    2016-07-01

    The risk of developing occupational skin disease (OSD) is high in hairdressers, but may differ between countries. To evaluate safety at work measures, and the prevalence and severity of skin symptoms and their impact on quality of life (QoL), among Croatian hairdressing apprentices. Data on self-reported skin symptoms, safety measures and QoL were collected for 101 final-year apprentices. The presence and severity of skin lesions were assessed with the Osnabrueck Hand Eczema Severity Index (OHSI). Transepidermal water loss (TEWL) was measured on the forearm and hand. Ninety-one percent of apprentices reported wearing gloves while dyeing hair, 45% while rinsing hair dyes, and 4% while washing hair. A history of skin symptoms was found in 35% of apprentices, and a history of dry hands in 37%. Skin changes were clinically observed in 40% of apprentices, most frequently erythema, infiltration, and desquamation. The OHSI score ranged from 0 to 6. Only washing hands >20 times per day was positively associated with TEWL. A history of skin symptoms negatively correlated with self-esteem, and social and mental functioning, and positively with anxiety and depression. The results indicate the need for the continuation of efforts to establish effective primary preventive programmes for OSDs at national and EU levels. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. Targeted sequencing of clade-specific markers from skin microbiomes for forensic human identification.

    Science.gov (United States)

    Schmedes, Sarah E; Woerner, August E; Novroski, Nicole M M; Wendt, Frank R; King, Jonathan L; Stephens, Kathryn M; Budowle, Bruce

    2018-01-01

    The human skin microbiome is comprised of diverse communities of bacterial, eukaryotic, and viral taxa and contributes millions of additional genes to the repertoire of human genes, affecting human metabolism and immune response. Numerous genetic and environmental factors influence the microbiome composition and as such contribute to individual-specific microbial signatures which may be exploited for forensic applications. Previous studies have demonstrated the potential to associate skin microbial profiles collected from touched items to their individual owner, mainly using unsupervised methods from samples collected over short time intervals. Those studies utilize either targeted 16S rRNA or shotgun metagenomic sequencing to characterize skin microbiomes; however, these approaches have limited species and strain resolution and susceptibility to stochastic effects, respectively. Clade-specific markers from the skin microbiome, using supervised learning, can predict individual identity using skin microbiomes from their respective donors with high accuracy. In this study the hidSkinPlex is presented, a novel targeted sequencing method using skin microbiome markers developed for human identification. The hidSkinPlex (comprised of 286 bacterial (and phage) family-, genus-, species-, and subspecies-level markers), initially was evaluated on three bacterial control samples represented in the panel (i.e., Propionibacterium acnes, Propionibacterium granulosum, and Rothia dentocariosa) to assess the performance of the multiplex. The hidSkinPlex was further evaluated for prediction purposes. The hidSkinPlex markers were used to attribute skin microbiomes collected from eight individuals from three body sites (i.e., foot (Fb), hand (Hp) and manubrium (Mb)) to their host donor. Supervised learning, specifically regularized multinomial logistic regression and 1-nearest-neighbor classification were used to classify skin microbiomes to their hosts with up to 92% (Fb), 96% (Mb

  14. Effects of methylglyoxal bis(guanylhydrazone) on tumour and skin responses to hyperthermia in mice

    International Nuclear Information System (INIS)

    Miyakoshi, J.; Oda, W.; Inagaki, C.; Hiraoka, M.; Takahashi, M.; Abe, M.

    1984-01-01

    Effects of methylglyoxal bis(guanylhydrazone) (MGBG) on tumour and skin responses to hyperthermia (42degC) were examined in C3H mice. MGBG (50 mg/kg) was administered intraperitoneally to mice 4 hours before hyperthermic treatment. The tumour (FM3A) growth time was elongated by an amount dependent on the exposure time of treatment at 42degC (60, 90 and 120 min). Pre-treatment of mice with MGBG (50 mg/kg, i.p.) apparently further lengthened the tumour growth time after treatment at 42degC. No significant damage of foot skin was caused by 42degC hyperthermia. Pre-treatment with MGBG did not make the foot skin susceptible to the heating. From these findings, it can be considered that MGBG or related less-toxic compounds may have a clinical advantage for the mild (42degC) hyperthermic treatment in cancer therapy. (author)

  15. Effects of methylglyoxal bis(guanylhydrazone) on tumour and skin responses to hyperthermia in mice

    Energy Technology Data Exchange (ETDEWEB)

    Miyakoshi, J.; Oda, W.; Inagaki, C. (Kyoto Coll. of Pharmacy (Japan)); Hiraoka, M.; Takahashi, M.; Abe, M. (Kyoto Univ. (Japan). Faculty of Medicine)

    1984-09-01

    Effects of methylglyoxal bis(guanylhydrazone) (MGBG) on tumour and skin responses to hyperthermia (42degC) were examined in C3H mice. MGBG (50 mg/kg) was administered intraperitoneally to mice 4 hours before hyperthermic treatment. The tumour (FM3A) growth time was elongated by an amount dependent on the exposure time of treatment at 42degC (60, 90 and 120 min). Pre-treatment of mice with MGBG (50 mg/kg, i.p.) apparently further lengthened the tumour growth time after treatment at 42degC. No significant damage of foot skin was caused by 42degC hyperthermia. Pre-treatment with MGBG did not make the foot skin susceptible to the heating. From these findings, it can be considered that MGBG or related less-toxic compounds may have a clinical advantage for the mild (42degC) hyperthermic treatment in cancer therapy.

  16. The acute effects of lower limb intermittent negative pressure on foot macro- and microcirculation in patients with peripheral arterial disease.

    Directory of Open Access Journals (Sweden)

    Øyvind Heiberg Sundby

    Full Text Available Intermittent negative pressure (INP applied to the lower leg and foot increases foot perfusion in healthy volunteers. The aim of the present study was to describe the effects of INP to the lower leg and foot on foot macro- and microcirculation in patients with lower extremity peripheral arterial disease (PAD.In this experimental study, we analyzed foot circulation during INP in 20 patients [median (range: 75 (63-84yrs] with PAD. One leg was placed inside an air-tight vacuum chamber connected to an INP-generator. During application of INP (alternating 10s of -40mmHg/7s of atmospheric pressure, we continuously recorded blood flow velocity in a distal foot artery (ultrasound Doppler, skin blood flow on the pulp of the first toes (laser Doppler, heart rate (ECG, and systemic blood pressure (Finometer. After a 5-min baseline sequence (no pressure, a 10-min INP sequence was applied, followed by 5-min post-INP (no pressure. To compare and quantify blood flow fluctuations between sequences, we calculated cumulative up-and-down fluctuations in arterial blood flow velocity per minute.Onset of INP induced an increase in arterial flow velocity and skin blood flow. Peak blood flow velocity was reached 3s after the onset of negative pressure, and increased 46% [(95% CI 36-57, P<0.001] above baseline. Peak skin blood flow was reached 2s after the onset of negative pressure, and increased 89% (95% CI 48-130, P<0.001 above baseline. Cumulative fluctuations per minute were significantly higher during INP-sequences compared to baseline [21 (95% CI 12-30cm/s/min to 41 (95% CI 32-51cm/s/min, P<0.001]. Mean INP blood flow velocity increased significantly ~12% above mean baseline blood flow velocity [(6.7 (95% CI 5.2-8.3cm/s to 7.5 (95% CI 5.9-9.1cm/s, P = 0.03].INP increases foot macro- and microcirculatory flow pulsatility in patients with PAD. Additionally, application of INP resulted in increased mean arterial blood flow velocity.

  17. Anterior wrist and medial malleolus: the optimal sites for tissue selection in electric death through hand-to-foot circuit pathway.

    Science.gov (United States)

    Xu, Guangtao; Su, Ruibing; Lv, Junyao; Lai, Xiaoping; Li, Xianxian; Wu, Jiayan; Hu, Bo; Xu, Long; Shen, Ruilin; Gu, Jiang; Yu, Xiaojun

    2017-03-01

    Specific morphological changes may be absent in some cases of electrocution shocked by the voltage of 220 V or lower. In this study, we attempted to demonstrate that the anterior wrist and medial malleolus were the optimal sites with promising and significant changes in electric death through the hand-to-foot circuit pathway. We established an electric shock rat model and observed histopathologic changes in the anterior wrist and medial malleolus. The results showed that the current intensities in the left anterior wrist and right medial malleolus were remarkably higher than those in the other sites, and the nuclei long/short (L/S) axis ratios of the arterial endotheliocyte and the skeletal muscle cell in these two areas were significantly higher than those in other parts of the body. These findings suggested that the anterior wrist and/or medial malleolus soft tissues as the narrowest parts of the limbs could be used as promising and useful sites for the assessment of electrical shock death, especially in forensic pathologic evaluation.

  18. The reliability of the Adelaide in-shoe foot model.

    Science.gov (United States)

    Bishop, Chris; Hillier, Susan; Thewlis, Dominic

    2017-07-01

    Understanding the biomechanics of the foot is essential for many areas of research and clinical practice such as orthotic interventions and footwear development. Despite the widespread attention paid to the biomechanics of the foot during gait, what largely remains unknown is how the foot moves inside the shoe. This study investigated the reliability of the Adelaide In-Shoe Foot Model, which was designed to quantify in-shoe foot kinematics and kinetics during walking. Intra-rater reliability was assessed in 30 participants over five walking trials whilst wearing shoes during two data collection sessions, separated by one week. Sufficient reliability for use was interpreted as a coefficient of multiple correlation and intra-class correlation coefficient of >0.61. Inter-rater reliability was investigated separately in a second sample of 10 adults by two researchers with experience in applying markers for the purpose of motion analysis. The results indicated good consistency in waveform estimation for most kinematic and kinetic data, as well as good inter-and intra-rater reliability. The exception is the peak medial ground reaction force, the minimum abduction angle and the peak abduction/adduction external hindfoot joint moments which resulted in less than acceptable repeatability. Based on our results, the Adelaide in-shoe foot model can be used with confidence for 24 commonly measured biomechanical variables during shod walking. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Application of Multiscale Entropy in Assessing Plantar Skin Blood Flow Dynamics in Diabetics with Peripheral Neuropathy

    Directory of Open Access Journals (Sweden)

    Fuyuan Liao

    2018-02-01

    Full Text Available Diabetic foot ulcer (DFU is a common complication of diabetes mellitus, while tissue ischemia caused by impaired vasodilatory response to plantar pressure is thought to be a major factor of the development of DFUs, which has been assessed using various measures of skin blood flow (SBF in the time or frequency domain. These measures, however, are incapable of characterizing nonlinear dynamics of SBF, which is an indicator of pathologic alterations of microcirculation in the diabetic foot. This study recruited 18 type 2 diabetics with peripheral neuropathy and eight healthy controls. SBF at the first metatarsal head in response to locally applied pressure and heating was measured using laser Doppler flowmetry. A multiscale entropy algorithm was utilized to quantify the regularity degree of the SBF responses. The results showed that during reactive hyperemia and thermally induced biphasic response, the regularity degree of SBF in diabetics underwent only small changes compared to baseline and significantly differed from that in controls at multiple scales (p < 0.05. On the other hand, the transition of regularity degree of SBF in diabetics distinctively differed from that in controls (p < 0.05. These findings indicated that multiscale entropy could provide a more comprehensive assessment of impaired microvascular reactivity in the diabetic foot compared to other entropy measures based on only a single scale, which strengthens the use of plantar SBF dynamics to assess the risk for DFU.

  20. Split-dose recovery in epithelial and vascular-connective tissue of pig skin

    International Nuclear Information System (INIS)

    Peel, D.M.; Hopewell, J.W.; Simmonds, R.H.; Dodd, P.; Meistrich, M.L.

    1984-01-01

    In the first 16 weeks after irradiation, two distinct waves of reaction can be observed in pig skin; the first wave (3-9 weeks) represents the expression of damage to the epithelium while the second is indicative of primary damage to the dermis, mediated through vascular injury. Following β-irradiation with a strontium-90 applicator, a severe epithelial reaction was seen with little subsequent dermal effects. X-rays (250 kV) on the other hand, produced a minimal epithelial response at doses which led to the development of dermal necrosis after 10-16 weeks. Comparison of single doses with two equal doses separated by 24 h produced a D 2 -D 1 value of 7.0 Gy at the doses which produced moist desquamation in 50% of fields (ED 50 ) after strontium-90 irradiation. After X-irradiation comparison of ED 50 doses for the later dermal reaction suggested a D 2 -D 1 value of 4.5 Gy. Over this same dose range of X-rays the D 2 -D 1 value for the first wave epithelial reaction was 3.5 Gy. These values of D 2 -D 1 for epithelial and dermal reactions in pig skin were compared with published data and were examined in relation to the theoretical predictions of a linear quadratic model for tissue target cell survival. The results were broadly in keeping with the productions of such a model. (Auth.)

  1. Age patterns and transmission characteristics of hand, foot and mouth disease in China

    Directory of Open Access Journals (Sweden)

    Jijun Zhao

    2016-11-01

    Full Text Available Abstract Background Hand, foot and mouth disease (HFMD has circulated in China and caused yearly outbreak. To understand the transmission of the disease and to assess the spatial variation in cases reported, we examined age-specific transmission characteristics and reporting rates of HFMD for 31 provinces in mainland China. Methods We first analyzed incidence spatial patterns and age-specific incidence patterns using dataset from 2008 to 2012. Transmission characteristics were estimated based on catalytic model. Reporting rates were estimated using a simple mass action model from “Time Series Susceptible Infectious Recovered” (TSIR modeling. Results We found age-specific spatial incidence patterns: age-specific proportions of HFMD cases varied geographically in China; larger case percentage was among children of 3–5 years old in the northern part of China and was among children of 0–2 years old in the southern part of China. Our analysis results revealed that: 1 reporting rates and transmission characteristics including the average age at infection, the force of infection and the basic reproduction number varied geographically in China; 2 patterns of the age-specific force of infection for 30 provinces were similar to that of childhood infections in developed countries; the age group that had the highest infection risk was 3–5 years old in 30 provinces, and 10–14 years old in Tibet; 3 a large difference in HFMD transmission existed between northwest region and southeast region; 4 transmission characteristics determined incidence patterns: the higher the disease transmission in a province, the earlier the annual seasonality started and the more case percentage was among children 0–2 years old and less among 3–5 years old. Conclusion Because HFMD has higher transmission than most childhood infections reported, high effective vaccine coverage is needed to substantially reduce HFMD incidence. Control measures before the vaccine

  2. Comparison of blood volume pulse and skin conductance responses to mental and affective stimuli at different anatomical sites

    International Nuclear Information System (INIS)

    Kushki, Azadeh; Fairley, Jillian; Merja, Satyam; King, Gillian; Chau, Tom

    2011-01-01

    Measurements of blood volume pulse (BVP) and skin conductance are commonly used as indications of psychological arousal in affective computing and human–machine interfaces. To date, palmar surfaces remain the primary site for these measurements. Placement of sensors on palmar surfaces, however, is undesirable when recordings are fraught with motion and pressure artifacts. These artifacts are frequent when the human participant has involuntary movements as in hyperkinetic cerebral palsy. This motivates the use of alternative measurement sites. The present study examined the correlation between measurements of blood volume pulse and skin conductance obtained from three different sites on the body (fingers, toes and ear for BVP; fingers, toes and arch of the foot for skin conductance) in response to cognitive and affective stimuli. The results of this pilot study indicated significant inter-site correlation among signal features derived from different sites, with the exception of BVP amplitude, the number of electrodermal reactions and the slope of the electrodermal activity response. We attribute these differences in part to inter-site discrepancies in local skin conditions, such as skin temperature. Despite these differences, significant changes from baseline were present in the responses to the cognitive and affective stimuli at non-palmar sites, suggesting that these sites may provide viable signal measurements for use in affective computing and human–machine interface applications

  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

    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...... with a genetically impaired skin barrier, were associated with disability pension, suggesting that FLG mutations carriers with a history of atopic dermatitis and hand eczema could benefit from early attention with respect to choice of occupation....... a questionnaire about skin symptoms and hand eczema. Socioeconomic variables, including disability pension, and information on work in risk occupations were retrieved from national registries. The reasons for granting disability pension were unknown. Results: Disability pension was associated with hand eczema...

  4. Skin reaction and regeneration after single sodium lauryl sulfate exposure stratified by filaggrin genotype and atopic dermatitis phenotype.

    Science.gov (United States)

    Bandier, J; Carlsen, B C; Rasmussen, M A; Petersen, L J; Johansen, J D

    2015-06-01

    Filaggrin is key for the integrity of the stratum corneum. Mutations in the filaggrin gene (FLGnull) play a prominent role in atopic dermatitis (AD) pathogenesis. People with AD have increased susceptibility to irritants. However, little is known about the effect of filaggrin genotype and AD phenotype on irritant response and skin regeneration. To investigate the role of FLGnull and AD groups for skin reaction and recovery after sodium lauryl sulfate (SLS) irritation. This is a case-control study comprising 67 subjects, including healthy controls and patients with and without FLGnull and AD. Reactivity to different doses of SLS at 24, 48, 72 and 145 h after SLS application was measured by transepidermal water loss (TEWL) and laser Doppler flowmetry (LDF). Reactivity was assessed univariately and by pattern analysis. All patient groups showed a higher degree of skin-barrier disruption and inflammation than did controls in response to SLS. Assessing reactivity by the delta value of the area under the curve for both TEWL and LDF showed significant differences between healthy controls and those with the AD phenotype, irrespective of filaggrin mutation. The poorest regeneration was among those with the AD phenotype. The two AD phenotype groups were separated by multivariate technique, due to earlier inflammatory reactivity among subjects with FLGnullplus AD compared with the AD phenotype alone. Both skin reaction and regeneration were significantly different between the patient population and the healthy controls. Additionally, response severity and regeneration depended more on AD phenotype than on filaggrin genotype, whereas the response was more rapid among the FLGnullplus AD individuals. © 2015 British Association of Dermatologists.

  5. Predicting the incidence of hand, foot and mouth disease in Sichuan province, China using the ARIMA model.

    Science.gov (United States)

    Liu, L; Luan, R S; Yin, F; Zhu, X P; Lü, Q

    2016-01-01

    Hand, foot and mouth disease (HFMD) is an infectious disease caused by enteroviruses, which usually occurs in children aged ARIMA) model to forecast HFMD incidence in Sichuan province, China. HFMD infection data from January 2010 to June 2014 were used to fit the ARIMA model. The coefficient of determination (R 2), normalized Bayesian Information Criterion (BIC) and mean absolute percentage of error (MAPE) were used to evaluate the goodness-of-fit of the constructed models. The fitted ARIMA model was applied to forecast the incidence of HMFD from April to June 2014. The goodness-of-fit test generated the optimum general multiplicative seasonal ARIMA (1,0,1) × (0,1,0)12 model (R 2 = 0·692, MAPE = 15·982, BIC = 5·265), which also showed non-significant autocorrelations in the residuals of the model (P = 0·893). The forecast incidence values of the ARIMA (1,0,1) × (0,1,0)12 model from July to December 2014 were 4103-9987, which were proximate forecasts. The ARIMA model could be applied to forecast HMFD incidence trend and provide support for HMFD prevention and control. Further observations should be carried out continually into the time sequence, and the parameters of the models could be adjusted because HMFD incidence will not be absolutely stationary in the future.

  6. Foot Health

    Science.gov (United States)

    ... straight across and not too short Your foot health can be a clue to your overall health. For example, joint stiffness could mean arthritis. Tingling ... foot checks are an important part of your health care. If you have foot problems, be sure ...

  7. One-stop microvascular screening service: an effective model for the early detection of diabetic peripheral neuropathy and the high-risk foot.

    Science.gov (United States)

    Binns-Hall, O; Selvarajah, D; Sanger, D; Walker, J; Scott, A; Tesfaye, S

    2018-04-02

    To evaluate the feasibility of a one-stop microvascular screening service for the early diagnosis of diabetic distal symmetrical polyneuropathy, painful distal symmetrical polyneuropathy and the at-risk diabetic foot. People with diabetes attending retinal screening in hospital and community settings had their feet examined by a podiatrist. Assessment included: Toronto Clinical Neuropathy Score evaluation; a 10-g monofilament test; and two validated, objective and quick measures of neuropathy obtained using the point-of-care devices 'DPN-Check', a hand-held device that measures sural nerve conduction velocity and amplitude, and 'Sudoscan', a device that measures sudomotor function. The diagnostic utility of these devices was assessed against the Toronto Clinical Neuropathy Score as the 'gold standard'. A total of 236 consecutive people attending the retinal screening service, 18.9% of whom had never previously had their feet examined, were evaluated. The prevalence of distal symmetrical polyneuropathy, assessed using the Toronto Clinical Neuropathy Score, was 30.9%, and was underestimated by 10-g monofilament test (14.4%). The prevalence of distal symmetrical polyneuropathy using DPN-check was 51.5% (84.3% sensitivity, 68.3% specificity), 38.2% using Sudoscan foot electrochemical skin conductance (77.4% sensitivity, 68.3% specificity), and 61.9% using abnormality in either of the results (93.2% sensitivity, 52.8% specificity). The results of both devices correlated with Toronto Clinical Neuropathy Score (Peye, foot and renal screening is feasible, has a high uptake, reduces clinic visits, and identifies painful distal symmetrical polyneuropathy and the at-risk foot. Combined large- and small-nerve-fibre assessment using non-invasive, quantitative and quick point-of-care devices may be an effective model for the early diagnosis of distal symmetrical polyneuropathy. © 2018 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.

  8. Gerodermia osteodysplastica and wrinkly skin syndrome: are they the same?

    Science.gov (United States)

    Al-Gazali, L I; Sztriha, L; Skaff, F; Haas, D

    2001-07-01

    Gerodermia osteodysplastica (GO) is a connective tissue disorder characterized by premature aging, wrinkled, and lax skin with reduced elasticity which is more marked on the dorsum of the hands and feet associated with hyperextensible joints and osteoporosis. The wrinkly skin syndrome (WSS) is characterized by wrinkled skin over the dorsum of the hands, feet, and abdomen; hyperextensible joints, particularly of the hands; intrauterine growth retardation; postnatal failure to thrive; and mental and developmental delay. We report on five children from two consanguineous Arab families with features overlapping both GO and WSS. All five children had similar dysmorphic facial features consisting of broad and prominent forehead, hypotelorism with epicanthal folds, prominent bulbous nose, flat malar region, and large protruding ears. All had wrinkling of the skin more marked on the dorsum of the hands, feet, and abdomen; hyperextensibility of the joints, particularly of the hands; and aged appearance. Intrauterine growth retardation, subsequent failure to thrive, developmental delay, and variable degree of osteoporosis was also present in all of them. The older three children developed progressive prognathism. We suggest that GO and WSS could represent variable manifestation of the same disorder. Copyright 2001 Wiley-Liss, Inc.

  9. Adding Stiffness to the Foot Modulates Soleus Force-Velocity Behaviour during Human Walking

    Science.gov (United States)

    Takahashi, Kota Z.; Gross, Michael T.; van Werkhoven, Herman; Piazza, Stephen J.; Sawicki, Gregory S.

    2016-07-01

    Previous studies of human locomotion indicate that foot and ankle structures can interact in complex ways. The structure of the foot defines the input and output lever arms that influences the force-generating capacity of the ankle plantar flexors during push-off. At the same time, deformation of the foot may dissipate some of the mechanical energy generated by the plantar flexors during push-off. We investigated this foot-ankle interplay during walking by adding stiffness to the foot through shoes and insoles, and characterized the resulting changes in in vivo soleus muscle-tendon mechanics using ultrasonography. Added stiffness decreased energy dissipation at the foot (p < 0.001) and increased the gear ratio (i.e., ratio of ground reaction force and plantar flexor muscle lever arms) (p < 0.001). Added foot stiffness also altered soleus muscle behaviour, leading to greater peak force (p < 0.001) and reduced fascicle shortening speed (p < 0.001). Despite this shift in force-velocity behaviour, the whole-body metabolic cost during walking increased with added foot stiffness (p < 0.001). This increased metabolic cost is likely due to the added force demand on the plantar flexors, as walking on a more rigid foot/shoe surface compromises the plantar flexors’ mechanical advantage.

  10. Diagnostic value of polymerase chain reaction analysis of skin biopsies in purpura fulminans.

    Science.gov (United States)

    Beau, Caroline; Vlassova, Natalia; Sarlangue, Jean; Brissaud, Olivier; Léauté-Labrèze, Christine; Boralevi, Franck

    2013-01-01

    Even though prompt diagnosis and treatment of purpura fulminans (PF) is essential to reduce mortality, early administration of antibiotics may preclude identification of the causative agent by standard bacterial cultures and thus render definitive diagnosis impossible. Here we present a case of an infant with PF and negative bacterial cultures for whom polymerase chain reaction (PCR) analysis of a cutaneous biopsy specimen obtained 4 days after initiation of antibiotics identified the genomic sequence of Neisseria meningitidis genogroup C. When bacterial cultures fail to provide useful information, PCR of skin biopsy specimens can be a valuable diagnostic tool in PF. © 2013 Wiley Periodicals, Inc.

  11. Severe Toxic Skin Reaction Caused by a Common Anemone and Identification of the Culprit Organism.

    Science.gov (United States)

    Tezcan, Özgür Deniz; Gözer, Özgür

    2015-01-01

    In a marine envenomation, identification of the culprit organism can be difficult. In this case report, we present our method to identify snakelocks anemone (Anemonia viridis or formerly Anemonia sulcata) as the culprit of a severe toxic skin reaction. A. viridis is one of the most common anemones of the Mediterranean Sea and the North Atlantic Ocean. It lives at a depth of up to 10 m. It is a member of the phylum Cnidaria, which includes jellyfish, anemones, hydroids, and corals. They have toxic organelles called cnidocysts that have the capacity to inject venom with microscopic harpoon-like structures. The cnidocysts of A. viridis may cause toxic and allergic reactions, and although its venom is one of the most studied cnidarian venoms, detailed case reports are rare. © 2015 International Society of Travel Medicine.

  12. Characterization of skin friction coefficient, and relationship to stratum corneum hydration in a normal Chinese population.

    Science.gov (United States)

    Zhu, Y H; Song, S P; Luo, W; Elias, P M; Man, M Q

    2011-01-01

    Studies have demonstrated that some cutaneous biophysical properties vary with age, gender and body sites. However, the characteristics of the skin friction coefficient in different genders and age groups have not yet been well established. In the present study, we assess the skin friction coefficient in a larger Chinese population. A total of 633 subjects (300 males and 333 females) aged 0.15-79 years were enrolled. A Frictiometer FR 770 and Corneometer CM 825 (C&K MPA 5) were used to measure the skin friction coefficient and stratum corneum hydration, respectively, on the dorsal surface of the hand, the forehead and the canthus. In the females, the maximum skin friction coefficients on both the canthus and the dorsal hand skin were observed around the age of 40 years. In the males, the skin friction coefficient on the dorsal hand skin gradually increased from 0 to 40 years of age, and changed little afterward. Skin friction coefficients on some body sites were higher in females than in age-matched males in some age groups. On the canthus and the dorsal hand skin of females, a positive correlation was found between skin friction coefficient and stratum corneum hydration (p skin friction coefficient was positively correlated with stratum corneum hydration on the forehead and the dorsal hand skin (p skin friction coefficient varies with age, gender and body site, and positively correlates with stratum corneum hydration on some body sites. Copyright © 2010 S. Karger AG, Basel.

  13. A hand tracking algorithm with particle filter and improved GVF snake model

    Science.gov (United States)

    Sun, Yi-qi; Wu, Ai-guo; Dong, Na; Shao, Yi-zhe

    2017-07-01

    To solve the problem that the accurate information of hand cannot be obtained by particle filter, a hand tracking algorithm based on particle filter combined with skin-color adaptive gradient vector flow (GVF) snake model is proposed. Adaptive GVF and skin color adaptive external guidance force are introduced to the traditional GVF snake model, guiding the curve to quickly converge to the deep concave region of hand contour and obtaining the complex hand contour accurately. This algorithm realizes a real-time correction of the particle filter parameters, avoiding the particle drift phenomenon. Experimental results show that the proposed algorithm can reduce the root mean square error of the hand tracking by 53%, and improve the accuracy of hand tracking in the case of complex and moving background, even with a large range of occlusion.

  14. Leprosy

    Science.gov (United States)

    ... Seniors, WomenTags: ancient infections, blindness, chronic granulomatous disease, chronic infection, hand and foot deformities, hansen's disease, infections, leprosy, mycobacterium, rashes, skin lesions, testicle damage November 1, 2009 Copyright © American ...

  15. Effect of BCNU on mouse skin and spinal cord in single drug and radiation exposures

    International Nuclear Information System (INIS)

    Lelieveld, P.; Brown, J.M.; Goffinet, D.R.; Schoeppel, S.L.; Scoles, M.

    1979-01-01

    We set out to determine whether any interaction occurs between BCNU and radiation for the mouse skin and spinal cord. Single doses of BCNU of 10, 20, or 30 mg/kg were injected intraperitoneally as a function of time before or after irradiation of the foot or spinal cord of anesthesized C3H mice. Enhancement of the radiation skin reaction (dose enhancement factor = 1.3) was seen when BCNU (30 mg/kg) was given 1 day, 6 hr, and 2 hr prior to irradiation of the foot with 2,500 rad, and a larger DEF of 1.6 was observed when BCNU was given immediately before the radiation dose. However, with a different mouse strain (BALB/c) not anesthetized at the time of irradiation, no significant enhancement following a dose of 20 mg/kg BCNU was observed. Experiments are in progress to determine the cause of these differences. BCNU (10 mg/kg) was given 24 hr or immediately prior to various single doses of radiation to a 12 mm segment of the mouse spinal cord (T/sub 11-12/ to L/sub 1-2/), and the subsequent myelitis was scored monthly. The addition of BCNU to irradiation did not accelerate the development of myelitis, not the ultimate proportion of animals developing hind limb paralysis: the 50% myelitis dose at 10 months (MD/sub 50/10/sub mo/) values for irradiation alone, BCNU at the time of irradiation and 24 hr before were 3,722, 3,795 and 3,853 rad, respectively

  16. Foot reflexology in feet impairment of people with type 2 diabetes mellitus: randomized trial.

    Science.gov (United States)

    da Silva, Natália Chantal Magalhães; Chaves, Érika de Cássia Lopes; de Carvalho, Emilia Campos; Carvalho, Leonardo César; Iunes, Denise Hollanda

    2015-01-01

    to evaluate the effect of foot reflexology on feet impairment of people with type 2 diabetes mellitus. this is a randomized, controlled and blind clinical trial. The sample was comprised by people with type 2 diabetes mellitus who, after being randomized into Treated group (n = 21) and Control group (n = 24), received guidelines on foot self-care. To the Treated Group it was also provided 12 sessions of foot reflexology. The scores of impairment indicators related to skin and hair, blood circulation, tissue sensitivity and temperature were measured by means of the instrument for assessing tissue integrity of the feet of people with diabetes mellitus. Chi-square test, Fisher exact test, Mann-Whitney test and regression analyzes were applied to the data, considering a significance level of 5% (P value foot reflexology had a beneficial effect on feet impairment of people with type 2 diabetes mellitus, which makes it a viable therapy, deserving investment. This study was registered in the Brazilian Registry of Clinical Trials - RBR-8zk8sz.

  17. The effect of salmeterol and salbutamol on mediator release and skin responses in immediate and late phase allergic cutaneous reactions

    DEFF Research Database (Denmark)

    Petersen, Lars Jelstrup; Skov, P S

    1999-01-01

    on clinical and biochemical EAR and LPR in human skin. METHODS: Measurement of wheal and flare reactions to allergen, codeine, and histamine, and LPR (induration) to allergen. Assessment of histamine and prostaglandin D2 (PGD2) release by microdialysis technique in EAR, and measurement of mediators in LPR......, myeloperoxidase, or eosinophil cationic protein in LPR. CONCLUSIONS: Salmeterol and salbutamol inhibited allergen-induced skin responses, and reduced mediator release in EAR but not LPR. In general, the anti-inflammatory effects of salmeterol did not differ from those induced by salbutamol....

  18. Geriatric Foot Care: A Model Educational Program for Mid-Level Practitioners.

    Science.gov (United States)

    Suggs, Patricia K.; Krissak, Ruth; Caruso, Frank; Teasdall, Robert

    2002-01-01

    An educational program on geriatric foot care was completed by 59 nurse practitioners, 12 physicians' assistants, and 1 physician. The 3 1/2 day program included interactive sessions, observation, and hands-on patient care. Posttest results and 6-month follow-up showed significant knowledge increases and incorporation of learning into practice.…

  19. Late adverse reactions to intravascular iodinated contrast media

    International Nuclear Information System (INIS)

    Webb, Judith A.W.; Stacul, Fulvio; Thomsen, Henrik S.; Morcos, Sameh K.

    2003-01-01

    Late adverse reactions to intravascular iodinated contrast media are defined as reactions occurring 1 h to 1 week after contrast medium injection. They have received increasing interest over the past decade, but their prevalence remains uncertain and their pathophysiology is not fully understood. The Contrast Media Safety Committee of the European Society of Urogenital Radiology decided to review the literature and to issue guidelines. An extensive literature search was carried out and summarized in a report. Based on the available information, simple guidelines have been drawn up. The report and guidelines were discussed at the 8th European Symposium on Urogenital Radiology in Genoa. Late adverse reactions after intravascular iodinated contrast medium include symptoms such as nausea, vomiting, headache, itching, skin rash, musculoskeletal pain, and fever. A significant proportion of these reactions is unrelated to the contrast medium; however, allergy-like skin reactions are well-documented side effects of contrast media with an incidence of approximately 2%. Late reactions appear to be commoner after non-ionic dimers. The majority of late skin reactions after contrast medium exposure are probably T-cell-mediated allergic reactions. Patients at increased risk of late skin reactions are those with a history of previous contrast medium reaction and those on interleukin-2 treatment. Most skin reactions are self-limiting and resolve within a week. Management is symptomatic and similar to the management of other drug-induced skin reactions. (orig.)

  20. Diabetic Foot Risk Factors in Patients with Diabetes at the

    Directory of Open Access Journals (Sweden)

    R. Hosseini

    2008-10-01

    Full Text Available Background and Objectives Diabetic foot problems are one of the major causes of mortality and disability in diabetic patients. It is considered one of the costliest conditions for health care systems. This study is designed to identify diabetic foot risk factors in patients with diabetes mellitus at Kamkar Hospital diabetes clinic in Qom, Iran during 2006.MethodsThis study was performed on 140 diabetes mellitus patients at the Kamkar Hospital diabetic clinic. International working Group on the Diabetic Foot (IWGDF guidelines were used for physical exam of diabetic foot in these patients. The physical exam consisted of inspection of foot appearance for deformity, skin keratosis and ulcer, and neurological and arterial pulse exam of the lower extremities of these patients. Patients in this study were divided into four risk groups based on the IWGDF guidelines. ANOVA method was used for analysis and comparison of the results with P<0.05 considered as significant. ResultsMean age of the participants in this study was 52.4±11.2 years old from which 67.1% were female, 37.1% of patients were illiterate, and 10% were active smokers. Mean duration of diabetes in these patients was 8.9 years. Mean body mass index (BMI was 29.4± 4.4 and HbA1C was 9.3 ± 1.9. Percentages of the patients with retinopathy and nephropathy were 33.6% and 17.7% respectively. 95% of the patients did not know the correct way of nail clipping, 95.5% were wearing uncomfortable shoes, and 14.3% of patients had history of foot ulcer. None of the them had any education about foot care. Physical examination with monofilament, ankle reflex and vibration perception were defected in 28.6%, 52.5%, and 32.1% of patients respectively. 37.7% of patients had a decreased lower extremity pulse that was not felt by touch. Based on the IWGDF classifications, 70% of the patients were in the higher-risk group for diabetic foot ulcer. In the high risk group, age, duration of diabetes, illiteracy was

  1. Immediate Hypersensitivity Reactions Induced by Triamcinolone in a Patient with Atopic Dermatitis.

    Science.gov (United States)

    Son, Jee Hee; Park, Sook Young; Cho, Yong Se; Chung, Bo Young; Kim, Hye One; Park, Chun Wook

    2018-03-19

    Corticosteroids are potent anti-inflammatory and anti-allergic agents used in the treatment of various inflammatory diseases, including allergic disease. They are frequently considered the therapy-of-choice for many skin diseases. However, allergic reactions caused by corticosteroids have been reported. Among these, delayed reactions to topical steroids are more common, whereas immediate reactions to systemic steroids are rare. Herein, we report the case of a 32-year-old woman with triamcinolone-induced immediate hypersensitivity reaction, in which the patient had a positive prick test result with triamcinolone. She has had atopic dermatitis (AD) for three years. She had used systemic steroid, cyclosporine, and antihistamine with topical steroids for AD. In clinic, approximately 10 minutes after intralesional injection of triamcinolone, she complained of erythematous patches with slight elevation and itching on the face, trunk, and both hands. After intravenous injection of dexamethasone, her symptoms got worse. After treatment with epinephrine, all symptoms resolved within two hours. We performed an open test and skin prick test. She had a positive result only from the prick test with triamcinolone; all other steroids showed negative results from the open tests. Dermatologists should be aware of the possibility of anaphylaxis or other allergic hypersensitivity in response to corticosteroids. © 2018 The Korean Academy of Medical Sciences.

  2. The response of mouse skin to multiple small doses of radiation

    International Nuclear Information System (INIS)

    Denekamp, J.; Harris, S.R.

    1975-01-01

    The response of mouse skin has been tested by irradiating the foot of albino mice and scoring erythema and desquamation during the following month. Multiple small doses of 150, 250 and 350 rad have been given 'daily', and the test dose necessary to achieve a given reaction has been determined one day after the last small fraction. This test dose has been compared with the single dose necessary to produce the same reaction level in previously untreated mice, in order to determine the ratio of the slopes of the dose-response curve at low and high doses: Slope ratio = (single dose - test dose)/total fractionated priming dose. In three separate experiments the slope ratio decreased as the dose per fraction was reduced from 350 to 150 rad. This conflicts with the data of Dutreix et al, who found a constant slope ratio over this dose range. The present data are compared with those obtained by Denekamp using 4, 9 and 14 fractions of 300 rad and by Douglas et al, using the same experimental technique, over the dose range 45 to 200 rad/fraction. In addition, the results from multifraction experiments in which equal dose increments were administered until the requisite skin reaction was achieved are also analysed in terms of their slope ratio (Fowler et al. Douglas et al). When all these results are plotted it is impossible to be sure whether the slope ratio is decreasing over the range 300 to 45 rad per fraction, although it seems likely. Most of the values at low doses lie in the range 0.15 to 0.25, indicating that at low doses the radiation is only 15 to 25% as effective per rad in causing cell death as at higher doses. (author)

  3. Anatomical and functional properties of the foot and leg representation in areas 3b, 1 and 2 of primary somatosensory cortex in humans: A 7T fMRI study.

    Science.gov (United States)

    Akselrod, Michel; Martuzzi, Roberto; Serino, Andrea; van der Zwaag, Wietske; Gassert, Roger; Blanke, Olaf

    2017-10-01

    Primary somatosensory cortex (S1) processes somatosensory information and is composed of multiple subregions. In particular, tactile information from the skin is encoded in three subregions, namely Brodmann areas (BAs) 3b, 1 and 2, with each area representing a complete map of the contralateral body. Although, much is known about the somatotopic organization of the hand in human S1, less research has been carried out regarding the somatotopic maps of the foot and leg in S1. Moreover, a latero-medial S1 organization along the superior part of the postcentral gyrus has been reported when moving from hip to toes, yet to date there is no study investigating leg/foot maps within the different subregions of S1. Using ultra-high field MRI (7T), we mapped six cortical representations of the lower limb (hip to toes) at the single subject level and performed this analysis separately for BAs 3b, 1 and 2. Analyzing the BOLD responses associated with tactile stimulations of the mapped foot and leg regions on each side, we quantified the extent and the strength of activation to determine somatotopic organization. In addition, we investigated whether each mapped representation also responded to the stimulation of other body parts (i.e. response selectivity) and conducted dissimilarity analysis relating these anatomical and functional properties of S1 to the physical structure of the lower limbs. Our data reveal somatotopy for the leg, but not for the foot in all investigated BAs, with large inter-subject variability. We found only minor differences between the properties of the three investigated BAs, suggesting that S1 maps for the lower limbs differ from those described for the hand. We also describe greater extent/strength of S1 activation for the big toe representation (compared to the other mapped representations) within all BAs, suggesting a possible homology between the first digit of upper and lower extremity in humans, and report different patterns of selectivity in the

  4. Foot-controlled robotic-enabled endoscope holder for endoscopic sinus surgery: A cadaveric feasibility study.

    Science.gov (United States)

    Chan, Jason Y K; Leung, Iris; Navarro-Alarcon, David; Lin, Weiyang; Li, Peng; Lee, Dennis L Y; Liu, Yun-hui; Tong, Michael C F

    2016-03-01

    To evaluate the feasibility of a unique prototype foot-controlled robotic-enabled endoscope holder (FREE) in functional endoscopic sinus surgery. Cadaveric study. Using human cadavers, we investigated the feasibility, advantages, and disadvantages of the robotic endoscope holder in performing endoscopic sinus surgery with two hands in five cadaver heads, mimicking a single nostril three-handed technique. The FREE robot is relatively easy to use. Setup was quick, taking less than 3 minutes from docking the robot at the head of the bed to visualizing the middle meatus. The unit is also relatively small, takes up little space, and currently has four degrees of freedom. The learning curve for using the foot control was short. The use of both hands was not hindered by the presence of the endoscope in the nasal cavity. The tremor filtration also aided in the smooth movement of the endoscope, with minimal collisions. The FREE endoscope holder in an ex-vivo cadaver test corroborated the feasibility of the robotic prototype, which allows for a two-handed approach to surgery equal to a single nostril three-handed technique without the holder that may reduce operating time. Further studies will be needed to evaluate its safety profile and use in other areas of endoscopic surgery. NA. Laryngoscope, 126:566-569, 2016. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  5. The choice of sensitive skin layer responsible for aftereffects of daily irradiation of the skin

    International Nuclear Information System (INIS)

    Keirim-Markus, I.B.

    1992-01-01

    The choice of sensitive human skin layer manifesting in delayed period after daily irradiation of the human skin (stochastic and determined effects) was evaluated. It was established that delayed aftereffects of daily radiation of the skin manifested as epidem damages. This layer of papilla derma of 10-15 mg/cm 2 thick situated at the great part of body surface, 15 mg/cm 2 on dorsal side of hands and 40 mg/cm 2 on palms and pillows of the fingers. Sensitive layer of skin dosimeter for a control of daily irradiation of people must have the same geometry

  6. A Two-Stage Foot Repair in a 55-Year-Old Man with Poliomyelitis.

    Science.gov (United States)

    Pollack, Daniel

    2018-01-01

    A 55-year-old man with poliomyelitis presented with a plantarflexed foot and painful ulceration of the sub-first metatarsophalangeal joint present for many years. A two-stage procedure was performed to bring the foot to 90°, perpendicular to the leg, and resolve the ulceration. The first stage corrected only soft-tissue components. It involved using a hydrosurgery system to debride and prepare the ulcer, a unilobed rotational skin plasty to close the ulcer, and a tendo Achillis lengthening to decrease forefoot pressure. The second stage corrected the osseous deformity with a dorsiflexory wedge osteotomy of the first metatarsal. The ulceration has remained closed since the procedures, with complete resolution of pain.

  7. Elective penicillin skin testing in a pediatric outpatient setting.

    Science.gov (United States)

    Jost, Barbara Capes; Wedner, H James; Bloomberg, Gordon R

    2006-12-01

    Adverse reactions associated with penicillin-type antibiotics are common in pediatric practice, leading to the subsequent unnecessary use of alternative antibiotics. IgE-mediated penicillin allergy represents only a fraction of these adverse reactions. To examine (1) the trend of penicillin skin test reactivity during a recent 10-year interval, (2) the relative distribution of specific reagents related to a positive skin test result, and (3) skin test reactivity as a function of reaction history. Penicillin testing using 3 reagents--benzylpenicilloyl polylysine, penicillin G, and sodium penicilloate (penicillin A)--was conducted in a prospective study of 359 consecutive patients referred to an outpatient pediatric allergy clinic between January 1, 1993, and May 31, 2003. We also retrospectively reviewed penicillin skin test results for 562 children previously tested between January 1, 1979, and December 31, 1992. Between 1993 and 2003, the prevalence of penicillin skin test sensitivity markedly declined. Of all the positive skin test results between 1979 and 2002, either penicillin G or sodium penicilloate or both identified 34%, with sodium penicilloate alone responsible for 8.5%. The rate of positive skin test reactions was not significantly different between patients with vs without a history of suggestive IgE-mediated reactions. A marked decline in penicillin skin test sensitivity in the pediatric age group is identified. The minor determinant reagents penicillin G and sodium penicilloate are both necessary for determining potential penicillin allergy. Relating history alone to potential penicillin sensitivity is unreliable in predicting the presence or absence of a positive skin test result.

  8. Hand and goods judgment algorithm based on depth information

    Science.gov (United States)

    Li, Mingzhu; Zhang, Jinsong; Yan, Dan; Wang, Qin; Zhang, Ruiqi; Han, Jing

    2016-03-01

    A tablet computer with a depth camera and a color camera is loaded on a traditional shopping cart. The inside information of the shopping cart is obtained by two cameras. In the shopping cart monitoring field, it is very important for us to determine whether the customer with goods in or out of the shopping cart. This paper establishes a basic framework for judging empty hand, it includes the hand extraction process based on the depth information, process of skin color model building based on WPCA (Weighted Principal Component Analysis), an algorithm for judging handheld products based on motion and skin color information, statistical process. Through this framework, the first step can ensure the integrity of the hand information, and effectively avoids the influence of sleeve and other debris, the second step can accurately extract skin color and eliminate the similar color interference, light has little effect on its results, it has the advantages of fast computation speed and high efficiency, and the third step has the advantage of greatly reducing the noise interference and improving the accuracy.

  9. Modulation of motor cortex excitability by physical similarity with an observed hand action.

    Directory of Open Access Journals (Sweden)

    Marie-Christine Désy

    Full Text Available The passive observation of hand actions is associated with increased motor cortex excitability, presumably reflecting activity within the human mirror neuron system (MNS. Recent data show that in-group ethnic membership increases motor cortex excitability during observation of culturally relevant hand gestures, suggesting that physical similarity with an observed body part may modulate MNS responses. Here, we ask whether the MNS is preferentially activated by passive observation of hand actions that are similar or dissimilar to self in terms of sex and skin color. Transcranial magnetic stimulation-induced motor evoked potentials were recorded from the first dorsal interosseus muscle while participants viewed videos depicting index finger movements made by female or male participants with black or white skin color. Forty-eight participants equally distributed in terms of sex and skin color participated in the study. Results show an interaction between self-attributes and physical attributes of the observed hand in the right motor cortex of female participants, where corticospinal excitability is increased during observation of hand actions in a different skin color than that of the observer. Our data show that specific physical properties of an observed action modulate motor cortex excitability and we hypothesize that in-group/out-group membership and self-related processes underlie these effects.

  10. The clinical management of diabetic foot in the elderly and medico-legal implications.

    Science.gov (United States)

    Terranova, Claudio; Bruttocao, Andrea

    2013-10-01

    Diabetic foot is a complex and challenging pathological state, characterized by high complexity of management, morbidity and mortality. The elderly present peculiar problems which interfere on one hand with the patient's compliance and on the other with their diagnostic-therapeutic management. Difficult clinical management may result in medico-legal problems, with criminal and civil consequences. In this context, the authors present a review of the literature, analysing aspects concerning the diagnosis and treatment of diabetic foot in the elderly which may turn out to be a source of professional responsibility. Analysis of these aspects provides an opportunity to discuss elements important not only for clinicians and medical workers but also experts (judges, lawyers, medico-legal experts) who must evaluate hypotheses of professional responsibility concerning diabetic foot in the elderly.

  11. Exposures related to hand eczema

    DEFF Research Database (Denmark)

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

    2012-01-01

    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 bet...

  12. Improving adherence to hand hygiene practice: a multidisciplinary approach.

    OpenAIRE

    Pittet, D.

    2001-01-01

    Hand hygiene prevents cross-infection in hospitals, but health-care workers' adherence to guidelines is poor. Easy, timely access to both hand hygiene and skin protection is necessary for satisfactory hand hygiene behavior. Alcohol- based hand rubs may be better than traditional handwashing as they require less time, act faster, are less irritating, and contribute to sustained improvement in compliance associated with decreased infection rates. This article reviews barriers to appropriate han...

  13. Experimental and model-based analysis of differences in perception of cutaneous electrical stimulation across the sole of the foot.

    Science.gov (United States)

    Frahm, Ken Steffen; Mørch, Carsten Dahl; Grill, Warren M; Andersen, Ole Kæseler

    2013-09-01

    During electrocutaneous stimulations, variation in skin properties across locations can lead to differences in neural activation. However, little focus has been given to the effect of different skin thicknesses on neural activation. Electrical stimulation was applied to six sites across the sole of the foot. The intensities used were two and four times perception threshold. The subjects (n = 8) rated the perception quality and intensity using the McGill Pain Questionnaire and a visual analog scale (VAS). A finite element model was developed and combined with the activation function (AF) to estimate neural activation. Electrical stimulation was perceived as significantly less sharp at the heel compared to all other sites, except one site in the forefoot (logistic regression, p model showed that the AF was between 91 and 231 % higher at the five other sites than at the heel. The differences in perception across the sole of the foot indicated that the CNS received different inputs depending on the stimulus site. The lower AF at the heel indicated that the skin thicknesses could contribute to the perceived differences.

  14. Use of Preputial Skin as Cutaneous Graft after Nevus Excision

    Directory of Open Access Journals (Sweden)

    A. D'Alessio

    2010-01-01

    Full Text Available We report a four-year-old boy with a nevus covering all the plantar side of his second finger on the left foot. He was also affected by congenital phimosis. Surgical excision of the nevus was indicated, but the skin defect would have been too large to be directly closed. The foreskin was taken as a full-thickness skin graft to cover the cutaneous defect of the finger. The graft intake was favourable and provided a functional repair with good aesthetic characteristic.

  15. Individual skin care during radiation therapy

    International Nuclear Information System (INIS)

    Zimmermann, J.S.; Budach, W.; Doerr, W.

    1998-01-01

    Background: In many clinical settings, the irradiated patient feels additional discomfort by the inhibition of washing the treatment portals and interruption of his adapted skin care habits. Material and methods: An analysis of the scientific recommendations as well as an analysis of the skin dose to the irradiated portals has been performed. An individual scheme for skin care under radiation has been developed. Results: A substantial decrease of the skin dose is achieved in many modern radiation techniques. The consequent reduction of severe skin reactions allowed the use of water and mild soaps as has been approved within many radiotherapy departments. This has lead to an individualized concept for skin care under radiation treatment including the allowance of gentle washing. The skin marks may be saved by using highly tolerable adhesive plasters or small tattoo points, if they are not superfluous by using masks or single referee points instead of marks for the field borders. Conclusions: The individualized concept for skin care during radiation may offer improved life quality to the patient and may decrease the acute reactions of the skin at least in some cases. (orig.) [de

  16. Skin Problems: How to Protect Yourself from Job-Related Skin Problems

    Science.gov (United States)

    ... areas with chemicals. These include gasoline, kerosene, mineral spirits, and turpentine. After washing your hands, protect them with petroleum jelly, lotion, or cream. Know your workplace’s safety processes. For instance, what to do if your skin comes in contact ...

  17. 2D Hand Tracking Based on Flocking with Obstacle Avoidance

    Directory of Open Access Journals (Sweden)

    Zihong Chen

    2014-02-01

    Full Text Available Hand gesture-based interaction provides a natural and powerful means for human-computer interaction. It is also a good interface for human-robot interaction. However, most of the existing proposals are likely to fail when they meet some skin-coloured objects, especially the face region. In this paper, we present a novel hand tracking method which can track the features of the hand based on the obstacle avoidance flocking behaviour model to overcome skin-coloured distractions. It allows features to be split into two groups under severe distractions and merge later. The experiment results show that our method can track the hand in a cluttered background or when passing the face, while the Flocking of Features (FoF and the Mean Shift Embedded Particle Filter (MSEPF methods may fail. These results suggest that our method has better performance in comparison with the previous methods. It may therefore be helpful to promote the use of the hand gesture-based human-robot interaction method.

  18. 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...

  19. Seasonal modeling of hand, foot, and mouth disease as a function of meteorological variations in Chongqing, China

    Science.gov (United States)

    Wang, Pin; Zhao, Han; You, Fangxin; Zhou, Hailong; Goggins, William B.

    2017-08-01

    Hand, foot, and mouth disease (HFMD) is an enterovirus-induced infectious disease, mainly affecting children under 5 years old. Outbreaks of HFMD in recent years indicate the disease interacts with both the weather and season. This study aimed to investigate the seasonal association between HFMD and weather variation in Chongqing, China. Generalized additive models and distributed lag non-linear models based on a maximum lag of 14 days, with negative binomial distribution assumed to account for overdispersion, were constructed to model the association between reporting HFMD cases from 2009 to 2014 and daily mean temperature, relative humidity, total rainfall and sun duration, adjusting for trend, season, and day of the week. The year-round temperature and relative humidity, rainfall in summer, and sun duration in winter were all significantly associated with HFMD. An inverted-U relationship was found between mean temperature and HFMD above 19 °C in summer, with a maximum morbidity at 27 °C, while the risk increased linearly with the temperature in winter. A hockey-stick association was found for relative humidity in summer with increasing risks over 60%. Heavy rainfall, relative to no rain, was found to be associated with reduced HFMD risk in summer and 2 h of sunshine could decrease the risk by 21% in winter. The present study showed meteorological variables were differentially associated with HFMD incidence in two seasons. Short-term weather variation surveillance and forecasting could be employed as an early indicator for potential HFMD outbreaks.

  20. Clinical assessment of dynamic coefficient of friction effects in shoe-sole trituration of patients with drop foot.

    Science.gov (United States)

    Nima, Jamshidi; Firooz, Salami

    2012-06-01

    The aim of this study was examining the effect of human factors such as plantar friction, contact period time, and impulse on shoe-sole trituration of drop foot patients. Twenty-five patients with drop foot and twenty normal subjects were recruited in the study. The force plate and its related software's recorded human factor (coefficient of friction, ground reaction force, time of stance phase) as time dependent parameters. Dynamic coefficient of friction patterns were categorized based on their magnitude versus time when the longitudinal axis of the sole was plotted as the Y-axis and the transverse axis of the sole as X-axis during stance phase. The result of this research indicated that the average coefficient of friction among drop foot patients is 77.53 % (p value <0.05) lower than the normal subjects. Also the time of stance phase among drop foot patients is 7.56 % (p value <0.05) greater than normal subjects. There is no difference in the peaks, of vertical ground reaction force between normal and control group. The findings of this research revealed that the time of stance phase has a key role in shoe-sole trituration of patients with drop foot.

  1. UV-induced skin damage

    International Nuclear Information System (INIS)

    Ichihashi, M.; Ueda, M.; Budiyanto, A.; Bito, T.; Oka, M.; Fukunaga, M.; Tsuru, K.; Horikawa, T.

    2003-01-01

    Solar radiation induces acute and chronic reactions in human and animal skin. Chronic repeated exposures are the primary cause of benign and malignant skin tumors, including malignant melanoma. Among types of solar radiation, ultraviolet B (290-320 nm) radiation is highly mutagenic and carcinogenic in animal experiments compared to ultraviolet A (320-400 nm) radiation. Epidemiological studies suggest that solar UV radiation is responsible for skin tumor development via gene mutations and immunosuppression, and possibly for photoaging. In this review, recent understanding of DNA damage caused by direct UV radiation and by indirect stress via reactive oxygen species (ROS) and DNA repair mechanisms, particularly nucleotide excision repair of human cells, are discussed. In addition, mutations induced by solar UV radiation in p53, ras and patched genes of non-melanoma skin cancer cells, and the role of ROS as both a promoter in UV-carcinogenesis and an inducer of UV-apoptosis, are described based primarily on the findings reported during the last decade. Furthermore, the effect of UV on immunological reaction in the skin is discussed. Finally, possible prevention of UV-induced skin cancer by feeding or topical use of antioxidants, such as polyphenols, vitamin C, and vitamin E, is discussed

  2. Reliability of a Skin Diagnostic Device in Assessing Hydration and Erythema.

    Science.gov (United States)

    Huimin, Koh; Rowledge, Alexandra M; Borzdynski, Caroline J; Miller, Charne; Frescos, Nicoletta; McKenzie, Gayle; Perry, Elizabeth; McGuiness, William

    2017-10-01

    To examine the reliability of a skin diagnostic device, the SD202 (Courage+Khazaka GmBH, Cologne, Germany), in assessing hydration and erythema of periwound skin and pressure injury-prone areas. Intrarater reliabilities from 3 cross-sectional and prospective studies are reported. Patients attending an outpatient, nurse-led wound dressing clinic (n = 16), a podiatrist-led high-risk foot clinic (n = 17), and residents (n = 38) at a single residential aged-care facility. Skin hydration and erythema levels assessed using the SD202. High internal consistency was maintained for consecutive skin hydration and erythema measures at a single point on the venous leg ulcer periwound (α > .996 and α > .970 for hydration and erythema, respectively) and for the pressure-prone areas of the sacrum (α > .916), right (α > .994) and left (α > .967) ischium, right (α > .989) and left (α > .916) trochanter, right (α > .985) and left (α > .992) calcaneus, and right (α > .991) and left (α > .990) lateral malleolus. High consistency was also found for the measures obtained at 4 different locations around the periwound for the venous leg ulcer (α > .935 and α > .870 for hydration and erythema, respectively). In diabetic foot ulcer assessment, acceptable internal consistency of hydration measures around the periwound was observed (α > .634). Internal consistency of erythema measures was variable, ranging from low to high reliability, particularly among predebridement measures. Using the protocols outlined in this study, the SD202 demonstrates high reliability for assessing skin hydration and erythema levels. It is possible that the SD202 can be used in clinical practice as an appropriate tool for skin hydration and erythema assessment.

  3. Immediate effects of different treatments for the wrist joints of subdominant hands, using electromechanical reaction time.

    Science.gov (United States)

    Hu, Chunying; Huang, Qiuchen; Yu, Lili; Zhou, Yue; Gu, Rui; Cui, Yao; Ge, Meng; Xu, Yanfeng; Liu, Jianfeng

    2016-08-01

    [Purpose] The aim of this study was to examine the immediate effects of muscle strength training and neuromuscular joint facilitation distal resistance training on wrist joints by using electromechanical reaction time. [Subjects and Methods] The subjects were 12 healthy young people (24.2 ± 3.1 years, 169.7 ± 6.5 cm, 65.3 ± 12.6 kg). Two kinds of isotonic contraction techniques were applied on the wrist joint: the wrist joint extension muscle strength training and the wrist joint extension pattern of neuromuscular joint facilitation. The electromechanical reaction time, premotor time, and motor time of the left upper limb were measured before and after each intervention session of muscle strength training and neuromuscular joint facilitation. [Results] The neuromuscular joint facilitation group showed significant shortening of the electromechanical reaction time and motor time after the intervention. [Conclusion] These results suggest that the electromechanical reaction time and motor time of the wrist joint can be improved by neuromuscular joint facilitation together with proximal resistance training, which can be used as a new form of exercise for improving the functions of subdominant hand wrist joints.

  4. [The role of psychological factors and psychiatric disorders in skin diseases].

    Science.gov (United States)

    Kieć-Swierczyńska, Marta; Dudek, Bohdan; Krecisz, Beata; Swierczyńska-Machura, Dominika; Dudek, Wojciech; Garnczarek, Adrianna; Turczyn, Katarzyna

    2006-01-01

    In this paper, the relation between psychological factors and psychiatric disorders in patients with skin diseases is discussed. On the one hand psychological factors (stress, negative emotions) can influence the generation and aggravation of skin disorders (urticaria, atopic dermatitis, vitiligo), on the other hand psychological disorders can result in some skin diseases (psoriasis, atopic dermatitis). In the majority of cases the quality of life is poorly estimated by patients with skin problems. Psychodermatology is divided into three categories according to the relationship between skin diseases and mental disorders: 1) psychophysiologic disorders caused by skin diseases triggering different emotional states (stress), but not directly combined with mental disorders (psoriasis, eczema); 2) primary psychiatric disorders responsible for self-induced skin disorders (trichotillomania); and 3) secondary psychiatric disorders caused by disfiguring skin (ichthyosis, acne conglobata, vitiligo), which can lead to states of fear, depression or suicidal thoughts.

  5. Comparison of Standard Culture-Based Method to Culture-Independent Method for Evaluation of Hygiene Effects on the Hand Microbiome.

    Science.gov (United States)

    Zapka, C; Leff, J; Henley, J; Tittl, J; De Nardo, E; Butler, M; Griggs, R; Fierer, N; Edmonds-Wilson, S

    2017-03-28

    Hands play a critical role in the transmission of microbiota on one's own body, between individuals, and on environmental surfaces. Effectively measuring the composition of the hand microbiome is important to hand hygiene science, which has implications for human health. Hand hygiene products are evaluated using standard culture-based methods, but standard test methods for culture-independent microbiome characterization are lacking. We sampled the hands of 50 participants using swab-based and glove-based methods prior to and following four hand hygiene treatments (using a nonantimicrobial hand wash, alcohol-based hand sanitizer [ABHS], a 70% ethanol solution, or tap water). We compared results among culture plate counts, 16S rRNA gene sequencing of DNA extracted directly from hands, and sequencing of DNA extracted from culture plates. Glove-based sampling yielded higher numbers of unique operational taxonomic units (OTUs) but had less diversity in bacterial community composition than swab-based sampling. We detected treatment-induced changes in diversity only by using swab-based samples ( P hand hygiene industry methods and for future hand microbiome studies. On the basis of our results and previously published studies, we propose recommendations for best practices in hand microbiome research. IMPORTANCE The hand microbiome is a critical area of research for diverse fields, such as public health and forensics. The suitability of culture-independent methods for assessing effects of hygiene products on microbiota has not been demonstrated. This is the first controlled laboratory clinical hand study to have compared traditional hand hygiene test methods with newer culture-independent characterization methods typically used by skin microbiologists. This study resulted in recommendations for hand hygiene product testing, development of methods, and future hand skin microbiome research. It also demonstrated the importance of inclusion of skin physiological metadata in

  6. Finger tips detection for two handed gesture recognition

    Science.gov (United States)

    Bhuyan, M. K.; Kar, Mithun Kumar; Neog, Debanga Raj

    2011-10-01

    In this paper, a novel algorithm is proposed for fingertips detection in view of two-handed static hand pose recognition. In our method, finger tips of both hands are detected after detecting hand regions by skin color-based segmentation. At first, the face is removed in the image by using Haar classifier and subsequently, the regions corresponding to the gesturing hands are isolated by a region labeling technique. Next, the key geometric features characterizing gesturing hands are extracted for two hands. Finally, for all possible/allowable finger movements, a probabilistic model is developed for pose recognition. Proposed method can be employed in a variety of applications like sign language recognition and human-robot-interactions etc.

  7. Influence of misonidazole, anaesthesia, clamping of the leg and stress of the animal during treatment on the radiation-induced skin reaction of mouse feet

    International Nuclear Information System (INIS)

    Wondergem, J.; Haveman, J.; Schueren, E. van der

    1982-01-01

    The influence of anaesthesia and misonidazole on the 'acute' (average of the scores between day 10 and 30) and 'late' (average of the scores between day 100 and 120) skin reaction of the feet of mice was investigated under two different conditions. Firstly, the legs were kept untaped in the radiation field; secondly, the legs were fixed with surgical tape on the backscatter block. Irradiation was carried out by X-radiation at a dose of 35 Gy. Results showed that stress in unanaesthetized animals has a large influence on the radiation response of mouse skin. Adequate treatment conditions, tranquillizers or anaesthesia can compensate for this factor. Taping of the animals' legs, resulting in clamping, interferes with the assessment of these modalities. No influence of misonidazole on the skin reaction could be demonstrated in conditions where no artificial hypoxia was induced. The importance of taking experimental conditions into account is pointed out for the correct assessment of the effect of radiosensitizers and possibly other anticancer drugs. (U.K.)

  8. Foot reflexology in feet impairment of people with type 2 diabetes mellitus: randomized trial 1

    Science.gov (United States)

    da Silva, Natália Chantal Magalhães; Chaves, Érika de Cássia Lopes; de Carvalho, Emilia Campos; Carvalho, Leonardo César; Iunes, Denise Hollanda

    2015-01-01

    Abstract Objective: to evaluate the effect of foot reflexology on feet impairment of people with type 2 diabetes mellitus. Method: this is a randomized, controlled and blind clinical trial. The sample was comprised by people with type 2 diabetes mellitus who, after being randomized into Treated group (n = 21) and Control group (n = 24), received guidelines on foot self-care. To the Treated Group it was also provided 12 sessions of foot reflexology. The scores of impairment indicators related to skin and hair, blood circulation, tissue sensitivity and temperature were measured by means of the instrument for assessing tissue integrity of the feet of people with diabetes mellitus. Chi-square test, Fisher exact test, Mann-Whitney test and regression analyzes were applied to the data, considering a significance level of 5% (P value foot reflexology had a beneficial effect on feet impairment of people with type 2 diabetes mellitus, which makes it a viable therapy, deserving investment. This study was registered in the Brazilian Registry of Clinical Trials - RBR-8zk8sz. PMID:26444161

  9. Influence of slope steepness, foot position and turn phase on plantar pressure distribution during giant slalom alpine ski racing.

    Directory of Open Access Journals (Sweden)

    Thomas Falda-Buscaiot

    Full Text Available The purpose of this study was to investigate the evolution of ground reaction force during alpine skiing turns. Specifically, this study investigated how turn phases and slope steepness affected the whole foot normal GRF pattern while performing giant slalom turns in a race-like setting. Moreover, the outside foot was divided into different plantar regions to see whether those parameters affected the plantar pressure distribution. Eleven skiers performed one giant slalom course at race intensity. Runs were recorded synchronously using a video camera in the frontal plane and pressure insoles under both feet's plantar surface. Turns were divided according to kinematic criteria into four consecutive phases: initiation, steering1, steering2 and completion; both steering phases being separated by the gate passage. Component of the averaged Ground Reaction Force normal to the ski's surface([Formula: see text], /BW, and Pressure Time Integral relative to the entire foot surface (relPTI, % parameters were calculated for each turn phases based on plantar pressure data. Results indicated that [Formula: see text] under the total foot surface differed significantly depending on the slope (higher in steep sections vs. flat sections, and the turn phase (higher during steering2 vs. three other phases, although such modifications were observable only on the outside foot. Moreover, [Formula: see text] under the outside foot was significantly greater than under the inside foot.RelPTI under different foot regions of the outside foot revealed a global shift from forefoot loading during initiation phase, toward heel loading during steering2 phase, but this was dependent on the slope studied. These results suggest a differentiated role played by each foot in alpine skiing turns: the outside foot has an active role in the turning process, while the inside foot may only play a role in stability.

  10. Epidemiology of hand foot mouth disease in Northern Thailand in 2016: A prospective cohort study

    Directory of Open Access Journals (Sweden)

    Panupong Upala

    2017-06-01

    Full Text Available Objective: To determine the correlations between the meteorological data and the number of hand foot mouth disease (HFMD cases in 2016 in Northern Thailand, and to estimate the medical costs. Methods: A prospective cohort study was conducted. Data on numbers of HFMD cases were collected from 49 hospitals in three different provinces in Northern Thailand: 16 hospitals from Chiang Rai Province, 7 hospitals from Pha Yao Province, and 26 hospitals from Chiang Mai Province. A questionnaire had been developed and tested for validity and reliability before used. The specific form for collecting meteorological data was developed and used in the field. All information was recorded in the same data spread sheet before analysis. Chi-square and correlation tests were used for explaining the epidemiology of HFMD in the areas. An alpha error at 0.05 was used to determine the statistical significance level. Results: A total of 8 261 cases were analyzed in the study. 56.0% were males, 97.5% aged less than 6 years, 82.6% were out-patient department (OPD cases, 75.5% were reported in raining season, and 43.2% were from Chiang Mai Province. The number of HFMD cases had statistically significant correlations with temperature, air pressure, relative humidity, and rainfall amount. Averagely, 216 baht and 3 678 baht per case per visit had to be expended for medical cost in OPD and IPD cases, respectively. Most of the cases had been reported in the border areas: Thai-Myanmar, and Thai-Lao. Conclusions: Thailand health care system should provide a concrete schedule for taking care of HFMD patients during raining season, and should develop an effective preventive and control program for HFMD particularly among children less than 6 years.

  11. Reliability and minimal detectable difference in multisegment foot kinematics during shod walking and running.

    Science.gov (United States)

    Milner, Clare E; Brindle, Richard A

    2016-01-01

    There has been increased interest recently in measuring kinematics within the foot during gait. While several multisegment foot models have appeared in the literature, the Oxford foot model has been used frequently for both walking and running. Several studies have reported the reliability for the Oxford foot model, but most studies to date have reported reliability for barefoot walking. The purpose of this study was to determine between-day (intra-rater) and within-session (inter-trial) reliability of the modified Oxford foot model during shod walking and running and calculate minimum detectable difference for common variables of interest. Healthy adult male runners participated. Participants ran and walked in the gait laboratory for five trials of each. Three-dimensional gait analysis was conducted and foot and ankle joint angle time series data were calculated. Participants returned for a second gait analysis at least 5 days later. Intraclass correlation coefficients and minimum detectable difference were determined for walking and for running, to indicate both within-session and between-day reliability. Overall, relative variables were more reliable than absolute variables, and within-session reliability was greater than between-day reliability. Between-day intraclass correlation coefficients were comparable to those reported previously for adults walking barefoot. It is an extension in the use of the Oxford foot model to incorporate wearing a shoe while maintaining marker placement directly on the skin for each segment. These reliability data for walking and running will aid in the determination of meaningful differences in studies which use this model during shod gait. Copyright © 2015 Elsevier B.V. All rights reserved.

  12. Modelling of gecko foot for future robot application

    Science.gov (United States)

    Kamaruddin, A.; Ong, N. R.; Aziz, M. H. A.; Alcain, J. B.; Haimi, W. M. W. N.; Sauli, Z.

    2017-09-01

    Every gecko has an approximately million microscale hairs called setae which made it easy for them to cling from different surfaces at any orientation with the aid of Van der Waals force as the primary mechanism used to adhere to any contact surfaces. In this paper, a strain simulation using Comsol Multiphysic Software was conducted on a 3D MEMS model of an actuated gecko foot with the aim of achieving optimal sticking with various polymetric materials for future robots application. Based on the stress and strain analyses done on the seven different polymers, it was found that polysilicon had the best result which was nearest to 0%, indicating the strongest elasticity among the others. PDMS on the hand, failed in the simulation due to its bulk-like nature. Thus, PDMS was not suitable to be used for further study on gecko foot robot.

  13. Effects of ankle-foot orthoses on mediolateral foot-placement ability during post-stroke gait.

    Science.gov (United States)

    Zissimopoulos, Angelika; Fatone, Stefania; Gard, Steven

    2015-10-01

    Accurate and precise mediolateral foot placement is important for balance during gait, but is impaired post stroke. Mediolateral foot placement may be improved with ankle-foot orthosis use. The purpose of this study was to determine whether an ankle-foot orthosis improves mediolateral foot-placement ability during post-stroke ambulation. Crossover trial with randomized order of conditions tested. The accuracy and precision of mediolateral foot placement was quantified while subjects targeted four different randomized step widths. Subjects were tested with and without their regular non-rigid ankle-foot orthosis in two separate visits (order randomized). While ankle-foot orthosis use corrected foot and ankle alignment (i.e. significantly decreased mid-swing plantar flexion, p = 0.000), effects of ankle-foot orthosis use on hip hiking (p = 0.545), circumduction (p = 0.179), coronal plane hip range of motion (p = 0.06), and mediolateral foot-placement ability (p = 0.537) were not significant. While ankle-foot orthosis-mediated equinovarus correction of the affected foot and ankle was not associated with improved biomechanics of walking (i.e. proximal ipsilateral hip kinematics or mediolateral foot-placement ability), it may affect other aspects of balance that were not tested in this study (e.g. proprioception, cerebellar, vestibular, and cognitive mechanisms). Studies that investigate the effect of ankle-foot orthosis on gait can help advance stroke rehabilitation by documenting the specific gait benefits of ankle-foot orthosis use. In this study, we investigated the effect of ankle-foot orthosis use on mediolateral foot-placement ability, an aspect of gait important for maintaining balance. © The International Society for Prosthetics and Orthotics 2014.

  14. The World Health Organization's Clean Hands Save Lives

    DEFF Research Database (Denmark)

    Verwilghen, D.

    2018-01-01

    health and integrity as the first principle of good hand hygiene, using decontamination methods and products that are the least harmful to the skin is mandatory. This is why the currently accepted presurgical hand preparation methods do not involve aggressive brushing and disinfecting soaps anymore....... Rather, hands should be washed with a neutral pH friendly soap first before a hydroalcoholic solution is applied. Although the principles and benefits of proper hand hygiene have been recognised in the healthcare world, one of the major drawbacks remains the lack of compliance with established protocols...

  15. Madura foot: two case reports, review of the literature, and new developments with clinical correlation

    Energy Technology Data Exchange (ETDEWEB)

    White, Eric A. [University of Southern California, Department of Radiology, Los Angeles, CA (United States); Patel, Dakshesh B.; Forrester, Deborah M.; Gottsegen, Christopher J.; O' Rourke, Emily; Holtom, Paul; Charlton, Timothy; Matcuk, George R. [USC University Hospital, Los Angeles, CA (United States)

    2014-04-15

    ''Madura foot'' or pedal mycetoma is a rare destructive infection of the skin and subcutaneous tissues of the foot, progressing to involve muscle and bone. The infection can be caused by both bacteria and fungi. Infection typically follows traumatic implantation of bacteria or fungal spores, which are present in soil or on plant material. Clinically, this entity can be difficult to diagnose and can have an indolent and progressive course. Early diagnosis is important to prevent patient morbidity and mortality. We present two cases of pedal mycetoma, review the literature, review new developments in diagnosis, and discuss magnetic resonance imaging (MRI) features of this unusual entity. (orig.)

  16. Thermal comfort zone of the hands, feet and head in males and females.

    Science.gov (United States)

    Ciuha, Urša; Mekjavic, Igor B

    2017-10-01

    The present study compared the thermal comfort zones (TCZ) of the hands, feet and head in eight male and eight female participants, assessed with water-perfused segments (WPS). On separate occasions, and separated by a minimum of one day, participants were requested to regulate the temperature of three distal skin regions (hands, feet and head) within their TCZ. On each occasion they donned a specific water-perfused segment (WPS), either gloves, socks or hood for assessing the TCZ of the hands, feet and head, respectively. In the absence of regulation, the temperature of the water perfusing the WPS changed in a saw-tooth manner from 10 to 50°C; by depressing a switch and reversing the direction of the temperature at the limits of the TCZ, each participant defined the TCZ for each skin region investigated. The range of regulated temperatures (upper and lower limits of the TCZ) did not differ between studied skin regions or between genders. Participants however maintained higher head (35.7±0.4°C; p˂0.001) skin temperature (Tsk) compared to hands (34.5±0.8°C) and feet (33.8±1.1°C). When exposed to normothermic conditions, distal skin regions do not differ in ranges of temperatures, perceived as thermally comfortable. Copyright © 2017. Published by Elsevier Inc.

  17. Foot roll-over evaluation based on 3D dynamic foot scan.

    Science.gov (United States)

    Samson, William; Van Hamme, Angèle; Sanchez, Stéphane; Chèze, Laurence; Van Sint Jan, Serge; Feipel, Véronique

    2014-01-01

    Foot roll-over is commonly analyzed to evaluate gait pathologies. The current study utilized a dynamic foot scanner (DFS) to analyze foot roll-over. The right feet of ten healthy subjects were assessed during gait trials with a DFS system integrated into a walkway. A foot sole picture was computed by vertically projecting points from the 3D foot shape which were lower than a threshold height of 15 mm. A 'height' value of these projected points was determined; corresponding to the initial vertical coordinates prior to projection. Similar to pedobarographic analysis, the foot sole picture was segmented into anatomical regions of interest (ROIs) to process mean height (average of height data by ROI) and projected surface (area of the projected foot sole by ROI). Results showed that these variables evolved differently to plantar pressure data previously reported in the literature, mainly due to the specificity of each physical quantity (millimeters vs Pascals). Compared to plantar pressure data arising from surface contact by the foot, the current method takes into account the whole plantar aspect of the foot, including the parts that do not make contact with the support surface. The current approach using height data could contribute to a better understanding of specific aspects of foot motion during walking, such as plantar arch height and the windlass mechanism. Results of this study show the underlying method is reliable. Further investigation is required to validate the DFS measurements within a clinical context, prior to implementation into clinical practice. Copyright © 2013 Elsevier B.V. All rights reserved.

  18. Skin and Soft Tissue Infections (Patera Foot) in Immigrants, Spain

    Science.gov (United States)

    Ternavasio-de la Vega, Hugo-Guillermo; Ángel-Moreno, Alfonso; Hernández-Cabrera, Michele; Pisos-Álamo, Elena; Bolaños-Rivero, Margarita; Carranza-Rodriguez, Cristina; Calderín-Ortega, Antonio; Pérez-Arellano, José-Luis

    2009-01-01

    An unusual skin and soft tissue infection of the lower limbs has been observed in immigrants from sub-Saharan Africa who cross the Atlantic Ocean crowded on small fishing boats (pateras). Response to conventional treatment is usually poor. Extreme extrinsic factors (including new pathogens) may contribute to the etiology of the infection and its pathogenesis. PMID:19331742

  19. Contributions of foot muscles and plantar fascia morphology to foot posture.

    Science.gov (United States)

    Angin, Salih; Mickle, Karen J; Nester, Christopher J

    2018-03-01

    The plantar foot muscles and plantar fascia differ between different foot postures. However, how each individual plantar structure contribute to foot posture has not been explored. The purpose of this study was to investigate the associations between static foot posture and morphology of plantar foot muscles and plantar fascia and thus the contributions of these structures to static foot posture. A total of 111 participants were recruited, 43 were classified as having pes planus and 68 as having normal foot posture using Foot Posture Index assessment tool. Images from the flexor digitorum longus (FDL), flexor hallucis longus (FHL), peroneus longus and brevis (PER), flexor hallucis brevis (FHB), flexor digitorum brevis (FDB) and abductor hallucis (AbH) muscles, and the calcaneal (PF1), middle (PF2) and metatarsal (PF3) regions of the plantar fascia were obtained using a Venue 40 ultrasound system with a 5-13 MHz transducer. In order of decreasing contribution, PF3 > FHB > FHL > PER > FDB were all associated with FPI and able to explain 69% of the change in FPI scores. PF3 was the highest contributor explaining 52% of increases in FPI score. Decreased thickness was associated with increased FPI score. Smaller cross sectional area (CSA) in FHB and PER muscles explained 20% and 8% of increase in FPI score. Larger CSA of FDB and FHL muscles explained 4% and 14% increase in FPI score respectively. The medial plantar structures and the plantar fascia appear to be the major contributors to static foot posture. Elucidating the individual contribution of multiple muscles of the foot could provide insight about their role in the foot posture. Copyright © 2018. Published by Elsevier B.V.

  20. Applicability of the {sup 9}Be(d,n){sup 10}B reaction to AB-BNCT skin and deep tumor treatment

    Energy Technology Data Exchange (ETDEWEB)

    Capoulat, M.E., E-mail: capoulat@tandar.cnea.gov.ar [Gerencia de Investigacion y Aplicaciones, CNEA. Av. Gral. Paz 1499 (B1650KNA), San Martin, Buenos Aires (Argentina)] [Escuela de Ciencia y Tecnologia, Universidad Nacional de San Martin, M. de Irigoyen 3100 (1650), San Martin, Buenos Aires (Argentina)] [CONICET, Avenida Rivadavia 1917 (C1033AAJ), Buenos Aires (Argentina); Minsky, D.M.; Kreiner, A.J. [Gerencia de Investigacion y Aplicaciones, CNEA. Av. Gral. Paz 1499 (B1650KNA), San Martin, Buenos Aires (Argentina)] [Escuela de Ciencia y Tecnologia, Universidad Nacional de San Martin, M. de Irigoyen 3100 (1650), San Martin, Buenos Aires (Argentina)] [CONICET, Avenida Rivadavia 1917 (C1033AAJ), Buenos Aires (Argentina)

    2011-12-15

    In the range of low bombarding energies (less than about 1.5 MeV) the {sup 9}Be(d,n){sup 10}B reaction produces neutron spectra that can be moderated depending on the choice of the target thickness and the deuteron bombarding energy. In this work, a Monte Carlo simulation study to determine the capability of this reaction to deliver enough dose to efficiently control both skin and deep seated tumors has been performed by means of MCNP calculations using eight optimized {sup 9}Be targets.