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Systemic Causes (systemic + cause)
Selected AbstractsWillan's itch and other causes of pruritus in the elderlyINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 4 2005Jon R. Ward MD Itch in the elderly presents a diagnostic and therapeutic challenge. A thorough history, review of systems, and physical examination are critical to determining its cause. Examination of the skin may be misleading. There are frequently only secondary lesions, eczematous changes, lichenification, and excoriation, which may be misdiagnosed as a primary dermatitis. Xerosis may be the cause, but it is sometimes merely coincidental. If primary lesions are present, a skin biopsy can enable a diagnosis to be made. Systemic causes of itch, such as cholestasis, uremia, hyperthyroidism, medications, or lymphoma, must be considered. If the cause remains elusive, idiopathic itching of the elderly or so-called "senile pruritus" may be considered. However, we propose to discard the term "senile pruritus", which can be offensive and frightening. We propose to replace it with "Willan's itch". Robert Willan (1757,1812) is honored as one of the founders of modern dermatology thanks to his book, On Cutaneous Diseases, and its morphological approach to skin disease. He was probably the first to give a good clinical description of itching in the elderly. The diagnosis of Willan's itch should be reserved for generalized pruritus in the absence of xerosis or other recognizable cause. The pathophysiology of this form of pruritus is poorly understood, but it is likely that age-related changes of the skin, cutaneous nerves, and other parts of the nervous system play a role. Anecdotal and limited data suggest that gabapentin, cutaneous field stimulation, serotonin antagonists, and ultraviolet B phototherapy may attenuate itch in some of these patients. [source] Women and Money: Lessons from SenegalDEVELOPMENT AND CHANGE, Issue 3 2006Isabelle Guérin This article examines the complexity and diversity of women's informal financial practices using data from surveys conducted in Senegal. It suggests that these practices are at the centre of a constant dialectic between short-term and long-term horizons, between the requirements of daily survival and the demands of community solidarity, and between personal aspirations and collective constraints. These practices also clearly illustrate a desire among the women in Senegal to impose a form of financial self-discipline, and to create situations that will oblige them to earn income. The socio-economic diversity among these entrepreneurs is also underscored. Informal financial arrangements are both a product and producer of gender inequalities and inequalities among women, as reflected in the research. This has direct policy implications, especially for microfinance products. If they are to be effective, microfinance services must develop beyond a standard, one-size fits all model and become more innovative and adaptable to the diverse demands of women. They must be combined with complementary measures that challenge the systemic causes of inequality. Microfinance programmes should draw on informal financial arrangements while challenging their tendency to perpetuate inequality. [source] DPT vaccine-induced lipoatrophy: an observational studyINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 10 2007Kabir Sardana MD, MNAMS Introduction Diphtheria Pertussis Tetanus (DPT) vaccine is universally used in infants and children. It is generally safe and well tolerated. Local reactions such as erythema, induration, palpable nodules, and injection site abscess are well known. Injection site lipoatrophy has not been reported earlier. Patients and Methods Retrospective review of all cases presenting with lipoatrophy developing at injection site following DPT administration between 2000,2005 in 3 hospitals in New Delhi, India was performed. In each case, the patients were extensively evaluated for other possible causes of lipoatrophy. Results 8 infants (2 boys & 6 girls), age range 4,12 months, had presented with injection site lipoatrophy following DPT vaccination. The duration between the last injection and lipoatrophy ranged from 4 to 8 weeks. All had been administered the vaccine in the buttock instead of the thigh, as generally recommended in infants. Majority (6/8) developed lipoatrophy after the second dose. No systemic causes were found. Conclusion DPT vaccine may, in rare instances, lead to injection site lipoatrophy. Inadvertent administration into the subcutaneous fat of the buttock may have been causative. Other possible mechanisms are discussed. Paramedics and general practitioners need to be educated to administer intramuscular vaccines in the thigh in infants and young children. [source] Root Causes of Peacelessness and Approaches to Peace in AfricaPEACE & CHANGE, Issue 2 2000Yash Tandon Conflicts are endemic in society, but what is their specific nature in Africa, and why do they deteriorate into such intense violence as negates humanity itself? This article looks at the "mainstream" theorythat attempts to explain this, taking as example the UN secretary-general's recent report on the subject. The report is both partial and ideological; it seeks to hide the systemic causes of poverty and conflict in Africa. The role of the peace activist is to understand conflict in Africa from a holistic and systemic perspective. He or she must work at various levels to alleviateconflict and prevent its degeneration into violence, based on the dual strategy of partially de-linking Africa from the global system and developing tolerance towards interethnic and political differences. This approach requires a new kind of moral and political culture, and new structures of political decision-making and accountability that are locally accountable and diversified. [source] | ||||||||||