Αναζήτηση αυτού του ιστολογίου

Πέμπτη 28 Δεκεμβρίου 2017

Infant Health and Future Childhood Adversity

Abstract

Objective To investigate the extent to which disabling infant health conditions are associated with adverse childhood experiences at age 5. Methods We conducted a secondary analysis of data from the Fragile Families and Child Wellbeing Study, a national urban birth cohort. We estimated logistic regression models of associations between the presence of a disabling infant health condition and the child's ACE exposures at age 5, controlling for factors that preceded the child's birth, including the mother's sociodemographic characteristics, physical health, mental illness, and substance abuse and the parents' criminal justice system involvement and domestic violence or sexual abuse. ACEs included 4 categories of child maltreatment (physical, sexual, psychological abuse, neglect) and 5 categories of household dysfunction (father absence, substance use, mental illness, caregiver treated violently, incarceration). Results 3.3% of the children were characterized as having a disabling health condition that was likely present at birth. Logistic regression estimates indicate that having a disabling infant health condition was associated with 83% higher odds of the child experiencing 2 or more ACEs (AOR 1.83, CI 1.14–2.94) and 73% higher odds of the child experiencing 3 or more ACEs (AOR 1.73, CI 1.07–2.77) at age 5. Conclusions for Practice The finding of strong links between disabling infant health conditions and ACEs at age 5 suggests that child health and ACEs play intertwining and mutually reinforcing roles during the early lifecourse and highlights the critical importance of investing in systems that simultaneously promote optimal child development and address childhood adversity.



Spontaneous pulmonary adenosquamous carcinoma in a free-living black capuchin monkey (Sapajus nigritus)

Abstract

Pulmonary neoplasia is rare among wild New World primates. We report the gross, microscopical, and immunohistochemical features of a primary multicentric pulmonary adenosquamous carcinoma in a free-living black capuchin monkey (Sapajus nigritus). Herein, the spectrum of pulmonary neoplasms in non-human primates is widened and briefly reviewed.



Hepatocellular carcinoma in a free-living marmoset (Callithrix sp.) with concomitant biliary trematodiasis

Abstract

Hepatocellular carcinoma (HCC) is rare in New World primates. We report the gross, microscopical, and immunocytochemical features of a spontaneous HCC in a free-living marmoset (Callithrix sp.). Hepatitis B and C virus and aflatoxin immunohistochemistry were negative; however, concomitant intra- and extrahepatic biliary trematodiasis could have played a role.



Neck rejuvenation by direct anterior medial cervicoplasty: the modified zigzag-plasty according to Tschopp

Abstract

Background

Conventional cervicofacial rhytidectomy has become the standard treatment of skin excess of the ageing neck. However, some patients want to avoid an extensive surgical procedure, especially if the anterior neck is the predominant problem zone.

Objective

To report on the efficacy and safety of a zigzag-shaped skin excision combined with platysma plication.

Methods & Materials

We present a retrospective case review series of 6 female patients. Skin excess was marked preoperatively using the skin pinching technique, then transferred into a zigzag-shaped area and finally excised using the method according to Tschopp, which is described. Patients were followed up for at least one year.

Results

All patients (age: 55 to 82 yrs., median: 65 yrs.) were very satisfied with the results. On an overall patient satisfaction scale of 1 to 10 (1 being the best), the scars were graded on average 1,85 (median: 2) 1 year after surgery. No scar hypertrophy, functional impairment, nerve damage or other serious complications were observed.

Conclusion

In selected patients, the direct anterior zigzag-shaped excision poses an effective, safe and easy surgical option for both skin and fat excess and platysma banding. The technique is easily reproducible, with low morbidity and high patient satisfaction.

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Role of T-helper 17 cells and T regulatory cells in alopecia areata: Comparison of lesion and serum cytokine between controls and patients

Abstract

Background

Alopecia areata (AA) is an organ-specific autoimmune disease with T-cell-mediated attack of hair follicle autoantigens. As T-helper 17 (Th17) cells and T regulatory (Treg) cells are crucially involved in the pathogenesis, the role of Th17 and Treg cytokines has not been studied yet.

Objective

To determine whether AA is associated with alterations in lesional and serum Th17 and Treg cytokines, and studied whether they were associated with clinical type.

Methods

Scalp skin samples from 45 patients and 8 normal controls were obtained for PCR specific for IFN-γ, TNF-α, TGF-β, IL-1, IL-2, IL-4, IL-10, IL-12A, IL-13, IL-17, IL-22 and IL-23. Serum cytokines were measured from 55 patients and 15 normal controls using ELISA.

Results

Lesional IL-17 and IL-22 were significantly increased in patients group. Moreover, positive correlations were shown between lesional IL-17, IL-22 and disease severity. Serum IL-1, IL-17, TNF-α, and TGF-β were significantly increased, and positive correlation was shown between serum IL-17 and disease severity.

Conclusion

These results showed significantly high Th17 cytokines in both lesion and serum in AA patients, which may highlight a functional role of these cytokines in the pathogenesis of AA.

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Design, development and optimization of a transungual duple nail lacquer for onychomycosis therapy

Abstract

Onychomycosis is a degenerative fungal infection inflicting toes and finger nails which is caused by both dermatophytes and non-dermatophytes such as Trichophyton rubrum and Candida spp. respectively. The infection apparently causes nail mutilation making nails stiff, skinny, flawed, and dyschromic. Owing to the anatomical presentation of the disease, a topical application is warranted which asserts positive attributes like ease of preparation, improved adherence, negligible drug interactions, low systemic adverse effects and voluntary removal.

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Letter on ‘European dermatology forum S1-guideline on the diagnosis and treatment of sclerosing diseases of the skin, Part 2: Scleromyxedema, scleredema and nephrogenic systemic fibrosis’

Abstract

We read with interest the guidelines recently published on sclerosing diseases of the skin (Part 2: Scleromyxedema, scleredema and nephrogenic systemic fibrosis)[1, 2]. However, we are concerned that the guideline recommendations proposed for prevention of nephrogenic systemic fibrosis (NSF) are potentially dangerous. Although we recognise the challenges in constructing comprehensive guidelines, we are concerned that this may be because the guidelines have not involved a multidisciplinary team.

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A novel scale for measurement of acquired dermal macular hyperpigmentation (ADHM) severity

Abstract

Acquired dermal macular hyperpigmentation (ADMH) is a hypernym which includes lichen planus pigmentosus (LPP), Riehl's melanosis (RM), pigmented contact dermatitis (PCD) and erythema dyschromicum perstans (EDP). There is considerable overlap between the clinical and histopathological features of these conditions. Despite affecting a large number of patients, there is no validated quantitative scale for LPP/EDP/RM/PCD/ADMH.

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A Pathway-Based Association Analysis Identified FMNL1-MAP3K14 as Susceptibility Genes for Leprosy

Abstract

The nuclear transcription factor-κB (NF-κB) plays a pivotal role in controlling both innate and adaptive immunity and regulates the expressions of many immunological mediators. Abundant evidences have showed that the importance of NF-κB pathway in the host immune responses against Mycobacterium leprae in the development of leprosy. However, no particular association study between leprosy and NF-κB pathway related gene polymorphisms was reported. Here, we performed a large scale and two-stage candidate association study to investigate the association between 94 NF-κB pathway related genes and leprosy. Our results showed that rs58744688 was significantly associated with leprosy (P=7.57×10-7, OR=1.12) by combining the previous genome wide association datasets and four independent validation sample series, consisting of a total of 4631 leprosy cases and 6413 healthy controls. This founding implicated that MAP3K14 and FMNL1 were susceptibility genes for leprosy, which suggested the involvement of macrophage targeting and NF-κB pathway in the development of leprosy.

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Characterization of the facial microbiome in twins discordant for rosacea

Abstract

Previously, we determined that genetic and environmental factors contributed equally towards rosacea in twins. To assess an environmental factor, we characterized the malar cheek bacterial microbiome from twins discordant for rosacea. We found no significant difference in facial microbiome alpha and beta diversity between related twins discordant for rosacea. However, the relative percentage abundance of Gordonia and Geobacillus, low abundant genera, was positively and negatively associated with rosacea severity, respectively. Our data demonstrate a significant correlation between facial microbiome and severity of rosacea in genetically matched twins and importantly that overall microbiome composition is largely unchanged.

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Making Sense of Self Talk

Abstract

People talk not only to others but also to themselves. The self talk we engage in may be overt or covert, and is associated with a variety of higher mental functions, including reasoning, problem solving, planning and plan execution, attention, and motivation. When talking to herself, a speaker takes devices from her mother tongue, originally designed for interpersonal communication, and employs them to communicate with herself. But what could it even mean to communicate with oneself? To answer that question, we need a theory of communication that explains how the same linguistic devices may be used to communicate with others and oneself. On the received view, which defines communication as information exchange, self talk appears to be an anomaly, for it is hard to see the point of exchanging information with oneself. However, if communication is analysed as a way of negotiating commitments between speaker and hearer, then communication may be useful even when speaker and hearer coincide. Thus a commitment-based approach allows us to make sense of self talk as well as social talk.



Improving the UNC Passive Aerosol Sampler Model Based on Comparison with Commonly Used Aerosol Sampling Methods

Abstract
Objectives
In an occupational environment, passive sampling could be an alternative to active sampling with pumps for sampling of dust. One passive sampler is the University of North Carolina passive aerosol sampler (UNC sampler). It is often analysed by microscopic imaging. Promising results have been shown for particles above 2.5 µm, but indicate large underestimations for PM2.5. The aim of this study was to evaluate, and possibly improve, the UNC sampler for stationary sampling in a working environment.
Methods
Sampling was carried out at 8-h intervals during 24 h in four locations in an open pit mine with UNC samplers, respirable cyclones, PM10 and PM2.5 impactors, and an aerodynamic particle sizer (APS). The wind was minimal. For quantification, two modifications of the UNC sampler analysis model, UNC sampler with hybrid model and UNC sampler with area factor, were compared with the original one, UNC sampler with mesh factor derived from wind tunnel experiments. The effect of increased resolution for the microscopic imaging was examined.
Results
Use of the area factor and a higher resolution eliminated the underestimation for PM10 and PM2.5. The model with area factor had the overall lowest deviation versus the impactor and the cyclone. The intraclass correlation (ICC) showed that the UNC sampler had a higher precision and better ability to distinguish between different exposure levels compared to the cyclone (ICC: 0.51 versus 0.24), but lower precision compared to the impactor (PM10: 0.79 versus 0.99; PM2.5: 0.30 versus 0.45). The particle size distributions as calculated from the different UNC sampler analysis models were visually compared with the distributions determined by APS. The distributions were obviously different when the UNC sampler with mesh factor was used but came to a reasonable agreement when the area factor was used.
Conclusions
High resolution combined with a factor based on area only, results in no underestimation of small particles compared to impactors and cyclones and a better agreement with the APS's particle size distributions. The UNC sampler had lower precision than the impactors, but higher than the respirable cyclone. The UNC sampler with area factor could be used for PM2.5, PM10 and respirable fraction measurements in this working environment without wind.

Reflectance confocal microscopy for the diagnosis of tinea nigra



A 3-variable prognostic score (3-PS) for overall survival prediction in metastatic castration-resistant prostate cancer treated with 223 Radium-dichloride

Abstract

Objective

In mCRPC patients treated with 223Ra, a major issue is the validation of reliable prognostic and predictive biomarkers to maximize clinical benefit and minimize toxicities and costs. Bearing in mind how changes in tALP did not meet statistical requirements as surrogate marker for survival, aim of this single-center retrospective study was to characterize the prognostic and predictive role of baseline clinical variables associated with overall survival in patients receiving 223Ra treatment.

Methods

92 consecutive CRPC patients with symptomatic bone metastases receiving 223Ra treatment were included. Available baseline clinical data relevant to the survival analysis were retrospectively collected. The primary end-point of the study was overall survival, which was established from the first 223Ra administration until date of death from any cause.

Results

Median follow-up time from the first 223Ra administration was 6 months (range 1–31 months). The univariate analysis evaluating the prognostic value of all baseline clinical variables showed that patients' weight, BMI, ECOG PS, Hb and tALP values were independently associated with OS. On multivariable analysis only baseline Hb value and ECOG PS remained significantly correlated with OS. To determine reliable baseline predictive factors for survival in patients receiving 223Ra treatment, we produced a predictive score. We tried all possible variable combinations, and found that the best score was obtained by combining baseline ECOG PS with Hb < 12 g/dl and PSA ≥ 20 ng/ml. This resulted in a score ranging from 0 to 4, with AUC 78.4% (p < 0.001).

Conclusions

We propose a multidimensional clinical evaluation to select those mCRPC subjects suitable to receive the maximum benefit from 223Ra treatment.



Nickel and cobalt release from earrings and piercing jewellery – analytical results of a German survey in 2014

Summary

Background

Nickel and cobalt are important metal allergens, and more knowledge on the levels of exposure to these from everyday contacts is needed.

Objectives

To report the results of a repeat routine surveillance scheme in the Federal Republic of Germany on the release of nickel and cobalt.

Methods

Fifteen laboratories assessed earrings and piercing jewellery items from 12 of the states in 2014, complying with EN 1811:2011 + AC:2012 and using atomic absorption spectrometry, inductively coupled plasma mass spectrometry and inductively coupled plasma optical emission spectrometry for quantification. Kaplan–Meier analysis for left-censored data was employed to account for measurements below the limit of quantification.

Results

Nickel release exceeded 0.35 µg/cm2 per week in 26 of 160 piercing posts (16.2%), and 0.88 µg/cm2 per week in 2.0–5.9% of other parts, that is, the current respective 'pass' thresholds, with no change from the previous 2008 survey. The level of cobalt release was lower than that of nickel release, and also significantly lower than in the previous survey.

Conclusions

The finding of the highest level of nickel release from piercing posts, with their deliberately lower threshold of acceptability, is worrying, as is the largely unchanged overall level of nickel release. A regulation on cobalt release is currently lacking; risk assessment and management based on dose-elicitation data are needed.



Issue Information



Clinical Snippets



Preeclampsia and Hypertension During Pregnancy in Areas with Relatively Low Levels of Traffic Air Pollution

Abstract

Objectives Air pollution exposure may contribute to the development of preeclampsia and hypertension during pregnancy. However, the evidence for such a relation is still limited. We investigated the associations between exposure for moderate to low levels of air pollution during pregnancy and preeclampsia and gestational hypertension in selected urban and county areas of Norway. Methods This study used a sub-group of 17,533 women in the Norwegian Mother and Child Cohort Study. Air pollution levels at residential addresses were estimated using land use regression models and back-extrapolated to the period of each pregnancy. Information on preeclampsia and gestational hypertension were obtained from the Medical Birth Registry of Norway and information on lifestyle factors was collected from questionnaires completed by the women during pregnancy. Results Moderate mean levels of NO2 (13.6 ± 6.9 µg/m3) at residential address during pregnancy were not associated with preeclampsia and pregnancy hypertension. We found no statistically significant associations per 10 µg/m3 change in NO2 exposure and preeclampsia (adjusted OR 0.89, 95% CI 0.74, 1.08) or hypertension during pregnancy (adjusted OR 0.91, 95% CI 0.78, 1.06). Conclusions for Practice In this large Norwegian pregnancy cohort, we found no statistically significant associations for moderate to low levels of pregnancy NO2 exposure and preeclampsia or hypertension during pregnancy.



Factors Associated with Vaccination Status of Children Aged 12–48 Months in India, 2012–2013

Abstract

Objectives India has more unvaccinated children than any other country despite provision of free vaccines through the government's Universal Immunization Program. In this study, we calculated the proportion of children aged 12–48 months who were fully vaccinated, under-vaccinated, or who had not received any vaccines. Childhood, household, and sociocultural factors associated with under-vaccination and non-vaccination were evaluated. Methods Using data from India's 4th District-level Health and Facility Survey, 2012–2013 (DLHS-4) and the 2012–2013 Annual Health Survey (AHS), we calculated the proportion of children who were non-vaccinated, under-vaccinated, or fully vaccinated with 1 dose of Bacillus Calmette–Guérin, 3 doses of oral polio vaccine, 3 doses of diphtheria–pertussis–tetanus, and 1 dose of measles-containing vaccine. The odds of full vaccination compared to non-vaccination and under-vaccination relative to various factors was assessed using a multivariable, multinomial logistic regression which accounted for survey design. Results Of 1,929,580 children aged 12–48 months, 59% were fully vaccinated, 34% were under-vaccinated, and 7% were non-vaccinated. Compared to children born in government institutions, children delivered in non-institutional settings with a skilled birth attendant present had higher odds of non-vaccination (OR 1.66) and those without a skilled attendant present had still greater odds of non-vaccination (OR 2.39) and under-vaccination (OR 1.11). Conclusions for Practice India's vaccination rates among children aged 12–48 months remains unacceptably low. The Indian government should encourage institutional delivery or birthing with a skilled attendant to ensure women receive adequate health education through antenatal care that includes the importance of childhood vaccination.



Ring a ring o'roses, a patient with Kaposi's? Pazopanib, pazopanib, it might go away. Mediterranean (classic) Kaposi sarcoma responds to the tyrosine kinase inhibitor pazopanib after multiple lines of standard therapy