Very Common (very + common)

Distribution by Scientific Domains
Distribution within Medical Sciences


Selected Abstracts


Suppression of background gradients in (B0 gradient-based) NMR diffusion experiments

CONCEPTS IN MAGNETIC RESONANCE, Issue 5 2007
Gang Zheng
Abstract Artifacts arising from background gradients are very common in NMR diffusion (i.e., PGSE) experiments involving B0 gradients because of the unavoidable magnetic susceptibility differences and B0 inhomogeneity within and around the sample. This article presents the general methodology to develop PGSE sequences with background gradient suppression. Most of the available methods which can be used for the suppression of the effects of background gradients are discussed. And two newly developed methods are presented in detail: frequency analysis of spin-dephasing, which assumes the artifacts due to background gradients come from the resonance between the spin-dephasing caused by applied gradients and background gradients, and asymmetric bipolar stimulated-echo-based PGSE, which can suppress the effects of nonconstant background gradients. © 2007 Wiley Periodicals, Inc.Concepts Magn Reson Part A 30A: 261,277, 2007. [source]


Towards a framework and a benchmark for testing tools for multi-threaded programs

CONCURRENCY AND COMPUTATION: PRACTICE & EXPERIENCE, Issue 3 2007
Yaniv Eytani
Abstract Multi-threaded code is becoming very common, both on the server side, and very recently for personal computers as well. Consequently, looking for intermittent bugs is a problem that is receiving more and more attention. As there is no silver bullet, research focuses on a variety of partial solutions. We outline a road map for combining the research within the different disciplines of testing multi-threaded programs and for evaluating the quality of this research. We have three main goals. First, to create a benchmark that can be used to evaluate different solutions. Second, to create a framework with open application programming interfaces that enables the combination of techniques in the multi-threading domain. Third, to create a focus for the research in this area around which a community of people who try to solve similar problems with different techniques can congregate. We have started creating such a benchmark and describe the lessons learned in the process. The framework will enable technology developers, for example, developers of race detection algorithms, to concentrate on their components and use other ready made components (e.g. an instrumentor) to create a testing solution. Copyright © 2006 John Wiley & Sons, Ltd. [source]


FS13.5 Occupational contact dermatitis: printer worker's viewpoints

CONTACT DERMATITIS, Issue 3 2004
Terry Brown
Introduction:, Occupational contact dermatitis (OCD) is very common in the printing industry due to contact with chemicals, paper, and wet work. It can be avoided by adequate protective measures, but the effectiveness of intervention depends heavily on the employer's and employee's awareness of this health risk. Objectives:, The study aimed to collect information on the knowledge, attitudes and beliefs of print workers about the risk of OCD and methods of prevention. Methods:, A series of focus groups were held with print workers, health and safety officers and managers to discuss their awareness of dermal risk factors, risk behaviour at work, attitudes to health and safety and options on possible preventive measures. A number of companies were also visited to observe, overtly and covertly, the normal work practices. Results:, OCD was not perceived to be either a major problem or a health and safety priority. There was general agreement about the processes and work practices that could cause skin problems. However, work practices varied considerably and did not always reflect this awareness. There was general concern about the type and availability of personal protective equipment, especially gloves and after-work skin cream. The provision of an occupational health service was generally felt to be inadequate, and no company had a policy in place that specifically addressed skin care. Conclusions:, These findings highlight the urgency to intensify health and safety education on skin care within the printing industry. Recommendations were developed for the evaluation of a series of risk reduction strategies. [source]


Dental gold alloys and contact allergy

CONTACT DERMATITIS, Issue 2 2002
Halvor Möller
Contact allergy to gold as demonstrated by patch testing is very common among patients with eczematous disease and seems to be even more frequent among patients with complaints from the oral cavity. There is a positive correlation between gold allergy and the presence of dental gold. Gold allergy is often found in patients with non-specific stomatitides as well as in those with lichenoid reactions or with only subjective symptoms from the oral cavity. The therapeutic effect of substituting other dental materials for gold alloys is conspicuous in casuistic reports but less impressive in larger patient materials. The amount of dental gold is correlated qualitatively and quantitatively to the blood level of gold and the effects if any of circulating blood gold are unknown. There is clearly a need for prospective studies in the field and gold sodium thiosulfate is considered an important item in the dental series for patch testing. [source]


Retrospective clinical study of 90 avulsed permanent teeth in 58 children

DENTAL TRAUMATOLOGY, Issue 6 2008
Vasileios Tzigkounakis
We analyzed the documentations of a sample of patients containing 57 children who had a total of 90 avulsed teeth and were treated in Dentistry Department of Medical Faculty in Pilsen, Czech Republic, in the years between 1995 and 2005. We discovered that most frequently the children experience dental avulsion in the age between 8 and 11 years old, the most affected teeth are the upper central incisors and the most frequent causes are sports and games which are very common in these ages, in various environments, like schools, sport fields and home. The majority of the children were transferred to the Dentistry Department either quite long after the avulsion incident and without the avulsed teeth, or with the avulsed teeth which were carried in an inappropriate transport medium, indicating that there is insufficient knowledge of adult people, especially the ones who are in daily contact with children, on how to provide first aid in cases of dental avulsion. [source]


Evaluation of the knowledge of the treatment of avulsions in elementary school teachers in Rio de Janeiro, Brazil

DENTAL TRAUMATOLOGY, Issue 2 2003
Luciana Fernandes Pacheco
Abstract ,,,Avulsions are very common in a school setting. Teachers are often requested to help in such emergency situations. A survey consisting of seven simple questions regarding dental avulsion was answered by 60 teachers from five different elementary schools in Rio de Janeiro, Brazil, in order to evaluate their knowledge on the subject and establish a guideline to be followed when an accident of this type happens. A lack of technical information was observed among the teachers; most of them answered intuitively rather than on an informative basis. This study showed the need of a more effective communication between dental professionals and school teachers in order to better handle dental emergencies. [source]


Follicular Unit Transplantation: The Option of Beard Construction in Eunuchoid Men

DERMATOLOGIC SURGERY, Issue 9 2002
Kayihan, ahinoglu MD
background. Psychosocial problems are very common in eunuchoids and may be related to the impact of underlying disorders on the physical appearance which makes them unable to overcome the sense of inferiority of childhood. A beardless patient treated with follicular unit transplantation (FUT) is reported here. objective. Such patients desire to get rid of a boyish appearance and want to achieve a masculine appearance. One of the easiest methods to achieve this goal is FUT. methods. By using an 18-gauge needle, the recipient bed was prepared under local anesthesia after premedication, and 1200 one- or two-hair micrografts were transplanted to the perioral (goatee) and its extensions to the sideburns. results. After completion of the procedure to the planned area, we achieved restoration of a masculine appearance which made the patient seem quite satisfied. conclusion. The process of beard reconstruction is time consuming and tedious, but highly effective. [source]


Postgraduate education for doctors in smoking cessation

DRUG AND ALCOHOL REVIEW, Issue 5 2009
NICHOLAS A. ZWAR
Abstract Introduction and Aims. Smoking cessation advice from doctors helps improve quit rates but the opportunity to provide this advice is often missed. Postgraduate education is one strategy to improve the amount and quality of cessation support provided. This paper describes a sample of postgraduate education programs for doctors in smoking cessation and suggests future directions to improve reach and quality. Design and Methods. Survey of key informants identified through tobacco control listserves supplemented by a review of the published literature on education programs since 2000. Programs and publications from Europe were not included as these are covered in another paper in this Special Issue. Results. Responses were received from only 21 key informants from eight countries. Two further training programs were identified from the literature review. The following components were present in the majority of programs: 5 As (Ask, Advise, Assess, Assist and Arrange) approach (72%), stage of change (64%), motivational interviewing (72%), pharmacotherapies (84%). Reference to clinical practice guidelines was very common (84%). The most common model of delivery of training was face to face. Lack of interest from doctors and lack of funding were identified as the main barriers to uptake and sustainability of training programs. Discussion and Conclusions. Identifying programs proved difficult and only a limited number were identified by the methods used. There was a high level of consistency in program content and a strong link to clinical practice guidelines. Key informants identified limited reach into the medical profession as an important issue. New approaches are needed to expand the availability and uptake of postgraduate education in smoking cessation.[Zwar NA, Richmond RL, Davidson D, Hasan I. Postgraduate education for doctors in smoking cessation. Drug Alcohol Rev 2009;28:466,473] [source]


Heat or Cold Packs for Neck and Back Strain: A Randomized Controlled Trial of Efficacy

ACADEMIC EMERGENCY MEDICINE, Issue 5 2010
Gregory Garra DO
Abstract Objectives:, Acute back and neck strains are very common. In addition to administering analgesics, these strains are often treated with either heat or cold packs. The objective of this study was to compare the analgesic efficacy of heat and cold in relieving pain from back and neck strains. The authors hypothesized that pain relief would not differ between hot and cold packs. Methods:, This was a randomized, controlled trial conducted at a university-based emergency department (ED) with an annual census of 90,000 visits. ED patients >18 years old with acute back or neck strains were eligible for inclusion. All patients received 400 mg of ibuprofen orally and then were randomized to 30 minutes of heating pad or cold pack applied to the strained area. Outcomes of interest were pain severity before and after pack application on a validated 100-mm visual analog scale (VAS) from 0 (no pain) to 100 (worst pain), percentage of patients requiring rescue analgesia, subjective report of pain relief on a verbal rating scale (VRS), and future desire for similar packs. Outcomes were compared with t-tests and chi-square tests. A sample of 60 patients had 80% power to detect a 15-mm difference in pain scores. Results:, Sixty patients were randomized to heat (n = 31) or cold (n = 29) therapy. Mean (±standard deviation [SD]) age was 37.8 (±14.7) years, 51.6% were female, and 66.7% were white. Groups were similar in baseline patient and pain characteristics. There were no differences between the heat and cold groups in the severity of pain before (75 mm [95% CI = 66 to 83] vs. 72 mm [95% CI = 65 to 78]; p = 0.56) or after (66 mm [95% CI = 57 to 75] vs. 64 mm [95% CI = 56 to 73]; p = 0.75) therapy. Pain was rated better or much better in 16/31 (51.6%) and 18/29 (62.1%) patients in the heat and cold groups, respectively (p = 0.27). There were no between-group differences in the desire for and administration of additional analgesia. Twenty-five of 31 (80.6%) patients in the heat group and 22 of 29 (75.9%) patients in the cold group would use the same therapy if injured in the future (p = 0.65). Conclusions:, The addition of a 30-minute topical application of a heating pad or cold pack to ibuprofen therapy for the treatment of acute neck or back strain results in a mild yet similar improvement in the pain severity. However, it is possible that pain relief is mainly the result of ibuprofen therapy. Choice of heat or cold therapy should be based on patient and practitioner preferences and availability. ACADEMIC EMERGENCY MEDICINE 2010; 17:484,489 © 2010 by the Society for Academic Emergency Medicine [source]


Rapid detection and identification of counterfeit of adulterated products of synthetic phosphodiesterase type-5 inhibitors with an atmospheric solids analysis probe

DRUG TESTING AND ANALYSIS, Issue 2 2010
Marian Twohig
Abstract The market success of the three approved synthetic phosphodiesterase type-5 (PDE-5) inhibitors for the treatment of erectile dysfunction has led to an explosion in counterfeit versions of these drugs. In parallel a large market has developed for herbal products claimed to be natural alternatives to these synthetic drugs. The herbal products are heavily advertised on the internet and are freely available to purchase without prescription. Furthermore, adulteration of these supposed natural medicines is a very common and serious phenomenon. Recent reports have shown that the adulteration has extended to the analogues of the three approved synthetic PDE-5 inhibitors. An Atmospheric Solids Analysis Probe (ASAP) was used for the direct analysis of the counterfeit pharmaceuticals and herbal products. Using the ASAP combined with time-of-flight mass spectrometry (TOF MS) it was possible to detect fraudulent counterfeit tablets. The physical appearance of the pills resembled the pills from the original manufacturer but contained the wrong active pharmaceutical ingredient (API). Detecting adulteration for five herbal supplements marketed as natural alternatives to PDE-5 inhibitors was also possible using the ASAP. Three types of adulteration were found in the five samples: adulteration with tadalafil or sildenafil, mixed adulteration (tadalafil and sildenafil), and adulteration with analogues of these drugs. Copyright © 2010 John Wiley & Sons, Ltd. [source]


Dendrogeomorphic reconstruction of past debris-flow activity using injured broad-leaved trees

EARTH SURFACE PROCESSES AND LANDFORMS, Issue 4 2010
Estelle Arbellay
Abstract Tree-ring records from conifers have been regularly used over the last few decades to date debris-flow events. The reconstruction of past debris-flow activity was, in contrast, only very rarely based on growth anomalies in broad-leaved trees. Consequently, this study aimed at dating the occurrence of former debris flows from growth series of broad-leaved trees and at determining their suitability for dendrogeomorphic research. Results were obtained from gray alder (Alnus incana (L.) Moench), silver birch and pubescent birch (Betula pendula Roth and Betula pubescens Ehrh.), aspen (Populus tremula L.), white poplar, black poplar and gray poplar (Populus alba L., Populus nigra L. and Populus x canescens (Ait.) Sm.), goat willow (Salix caprea L.) and black elder (Sambucus nigra L.) injured by debris-flow activity at Illgraben (Valais, Swiss Alps). Tree-ring analysis of 104 increment cores, 118 wedges and 93 cross-sections from 154 injured broad-leaved trees allowed the reconstruction of 14 debris-flow events between AD 1965 and 2007. These events were compared with archival records on debris-flow activity at Illgraben. It appears that debris flows are very common at Illgraben, but only very rarely left the channel over the period AD 1965,2007. Furthermore, analysis of the spatial distribution of disturbed trees contributed to the identification of six patterns of debris-flow routing and led to the determination of preferential breakout locations of events. The results of this study demonstrate the high potential of broad-leaved trees for dendrogeomorphic research and for the assessment of the travel distance and lateral spread of debris-flow surges. Copyright © 2010 John Wiley & Sons, Ltd. [source]


Controlling factors of gullying in the Maracujá Catchment, southeastern Brazil

EARTH SURFACE PROCESSES AND LANDFORMS, Issue 11 2005
L. de A. P. Bacellar
Abstract Hundreds of gullies (,voçorocas') of huge dimensions (up to 400,500 m long, 150 m wide and 50 m deep) are very common in the small Maracujá Catchment in southeastern Brazil. These erosional features, which occur with an uneven intensity throughout the area, started due to bad soil management practices at the beginning of European settlement, at the end of the 17th century, and nowadays are still evolving, but at a slower rate. As surface soils are usually very resistant to erosion, the outcrop of the more erodible basement saprolites seems to be an essential condition for their beginning. An analysis of well known erosion controlling factors was performed, aiming to explain the beginning and evolution of these gullies and to understand the reasons for their spatial distribution. Data shows that geology and, mainly, geomorphology are the main controlling factors, since gullies tend to be concentrated in basement rock areas with lower relief (domain 2) of Maracujá Catchment, mainly at the fringes of broad and flat interfluves. At the detailed scale (1:10 000), gullies are more common in amphitheatre-like headwater hollows that frequently represent upper Quaternary gullies (paleogullies), which demonstrate the recurrence of channel erosion. So, gullies occur in areas of thicker saprolites (domain 2), in places with a natural concentration of surface and underground water (hollows). Saprolites of the preserved, non-eroded hollows are usually pressurized (confined aquifer) due to a thick seal of Quaternary clay layer, in a similar configuration to the ones found in hollows of mass movement (mudflow) sites in southeastern Brazil. Therefore, the erosion of the resistant soils by human activities, such as road cuts and trenches (,valos'), or their mobilization by mudflow movements, seem to be likely mechanisms of gullying initiation. Afterwards, gullies evolve by a combination of surface and underground processes, such as wash and tunnel erosion and falls and slumps of gully walls. Copyright © 2005 John Wiley & Sons, Ltd. [source]


Patterns of commonness and rarity in central European birds: reliability of the core-satellite hypothesis within a large scale

ECOGRAPHY, Issue 4 2002
David Storch
The frequency distribution of species' area of occupancy is often bimodal, most species being either very rare or very common in terms of number of occupied sites. This pattern has been attributed to the nonlinearity associated with metapopulation dynamics of the species, but there are also other explanations comprising sampling artifact and frequency distribution of suitable habitats. We tested whether the bimodal frequency distribution of occupied squares in central European birds could be derived solely from the frequency distribution of species population sizes (i.e. the sampling artifact hypothesis) or from the spatial distribution of their preferred habitats. Both models predict high proportion of very common species, i.e. the right side of frequency distribution. Bimodality itself is well predicted by models based on random placement of individuals according to their abundances but neither model predicts the observed prevalence of rare species. Even the combined models that assume random placement of individuals within the squares with suitable habitat do not predict such a high proportion of rare species. The observed distribution is more aggregated, rare species occupying a smaller portion of suitable habitat than predicted on the basis of their abundance. The pattern is consistent with metapopulation processes involving local population extinctions. The involvement of these processes is supported by two further observations. First, species rarity is associated with significant population trend and/or location on the edge of their ranges within central Europe, both situations presumably associated with metapopulation processes. Second, suitable habitats seem to be either saturated or almost unoccupied, which is consistent with the predictions of the metapopulation model based on nonlinear dynamics of extinction and colonization. Although the habitat suitability is an important determinant of species distribution, the rarity of many species of birds within this scale of observation seems to be affected by other factors, including local population extinctions associated with fragmentation of species' habitats. [source]


Holly leaf-miners on two continents: what makes an outbreak species?

ECOLOGICAL ENTOMOLOGY, Issue 2 2001
Sabine Eber
Summary 1. Some herbivore species periodically undergo damaging, high-density outbreak phases followed by less damaging low-density phases. Others maintain steady, low to moderate density levels that do little damage to their hosts. 2. Two closely related holly leaf-miner species were compared that share many ecological traits and have very similar life cycles, but only one of which exhibits outbreaks. Phytomyza ilicicola in the eastern U.S.A. varied widely in mortality and infestation levels, reaching local densities of over 10 mines per leaf. In contrast, Phytomyza ilicis in the U.K. showed low infestation and high mortality at all sites. Using data from the literature and from field studies, the factors responsible for these contrasting dynamics were sought. 3. Phytomyza ilicicola oviposits into the leaf lamina, and experiences weak larval competition only at high densities. Phytomyza ilicis oviposits into the leaf midrib, which leads to high mortality of young larvae before mine formation. Multiply mined leaves were therefore very common in P. ilicicola but rare in P. ilicis. 4. Differences in the parasitoid complexes of the two systems accounted for further differences in survival to adulthood. The main (larval) parasitoid, which was found to impose high, density-dependent mortality on P. ilicis, is missing on P. ilicicola. It is replaced by an egg,pupal parasitoid, which varies in its impact at differe,t sites. Multiple emergence of adults from multiply mined leaves is therefore widespread in P. ilicicola but does not occur in P. ilicis. 5. The differences in oviposition behaviour and in the parasitoid complexes are likely to allow P. ilicicola to outbreak when habitat conditions are favourable, while P. ilicis is always tightly regulated. [source]


Study of Electrochemical Processes with Coupled Homogeneous Chemical Reaction in Differential Pulse Voltammetry at Spherical Electrodes and Microhemispheres

ELECTROANALYSIS, Issue 16 2010
Eduardo Laborda
Abstract Homogeneous chemical reactions coupled to oxidation-reduction processes at electrode surfaces are very common in electrochemistry. In this paper we cope with the application of Differential Pulse Voltammetry at spherical electrodes and microhemispheres for the study of this kind of systems. Analytical expressions are deduced from which the influence of the different experimental variables is examined. Several diagnostic criteria for elucidation of the reaction mechanism from DPV peak parameters are given, as well as working curves for extraction of the kinetic rate constants of the chemical reaction. [source]


Post mortem survey of dental disorders in 349 donkeys from an aged population (2005,2006).

EQUINE VETERINARY JOURNAL, Issue 3 2008
Part 1: Prevalence of specific dental disorders
Summary Reasons for performing study: Donkey dental disorders are being recognised with increased frequency worldwide and have important welfare implications; however, no detailed investigations of dental disorders in donkeys appear to have been published. Objectives: To determine the prevalence of specified dental disorders in donkeys by performing a prospective post mortem study on donkeys that were subjected to euthanasia or died for other reasons at the Donkey Sanctuary, UK. Methods: Post mortem examinations were performed on 349 donkeys over an 18 month period, 2005,2006. The presence and extent of specified dental disorders were recorded and these data analysed to determine their prevalence and common locations. 45Results: A high prevalence (93%) of disorders was noted in the population with a median age of 31 years. In particular, cheek teeth diastemata (85% prevalence) were very common, often associated with advanced periodontal disease. Other disorders observed included missing teeth (in 55.6% of donkeys), displaced teeth (43%), worn teeth (34%), local overgrowths (15%), focal sharp overgrowths (3%) and dental-related soft tissue injuries (8%). Conclusions and potential relevance: Aged donkeys have a high prevalence of significant dental disease, especially cheek teeth diastemata. These findings highlight the importance of routine dental examinations and prophylactic dental treatments to improve the dental health and welfare of donkeys. [source]


High prevalence of restless legs syndrome in multiple sclerosis

EUROPEAN JOURNAL OF NEUROLOGY, Issue 5 2007
M. Manconi
Despite the fact that multiple sclerosis (MS) patients often include leg restlessness as a sensory symptom, MS is not mentioned amongst symptomatic restless legs syndrome (RLS) forms. The aim of this study was to estimate RLS prevalence in a large population of MS patients, comparing clinical and MRI findings between patients with and without RLS. Each of the 156 MS patients (100 females, 56 males, mean age 40.7 ± 10.4) enrolled in a prospective study underwent a medical history interview, a neurological examination with the assessment of the Expanded Disability Status Scale (EDSS), and a structured questionnaire to verify the presence and features of RLS. Conventional brain,spinal MRIs of 99 subjects were also evaluated and compared between patients with and without RLS. Fifty-one subjects (32.7%) (mean age 43.8 ± 12.8) met the criteria for RLS. In a few patients (8.5%), the RLS preceded clinical MS onset, whilst in the remaining cases the RLS was followed by or was simultaneous with clinical MS onset. Comparing the RLS group with the group without RLS, no significant differences were found in MS duration, gender, and referred sleep habits. The primary progressive MS course was more represented in the RLS group, which also showed a higher EDSS score. RLS is a very common finding in MS patients and should be considered amongst the symptomatic RLS forms. RLS is also associated with higher disability. [source]


EFFECTIVE POPULATION SIZES AND TEMPORAL STABILITY OF GENETIC STRUCTURE IN RANA PIPIENS, THE NORTHERN LEOPARD FROG

EVOLUTION, Issue 11 2004
Eric A. Hoffman
Abstract Although studies of population genetic structure are very common, whether genetic structure is stable over time has been assessed for very few taxa. The question of stability over time is particularly interesting for frogs because it is not clear to what extent frogs exist in dynamic metapopulations with frequent extinction and recolonization, or in stable patches at equilibrium between drift and gene flow. In this study we collected tissue samples from the same five populations of leopard frogs, Rana pipens, over a 22,30 year time interval (11,15 generations). Genetic structure among the populations was very stable, suggesting that these population were not undergoing frequent extinction and colonization. We also estimated the effective size of each population from the change in allele frequencies over time. There exist few estimates of effective size for frog populations, but the data available suggest that ranid frogs may have much larger ratios of effective size (Ne) to census size (Nc) that toads (bufonidae). Our results indicate that R. pipiens populations have effective sizes on the order of hundreds to at most a few thousand frogs, and Nee/Nc ratios in the range of 0.1,1.0. These estimates of Ne/Nc are consistent with those estimated for other Rana species. Finally, we compared the results of three temporal methods for estimating Ne. Moment and pseudolikelihood methods that assume a closed population gave the most similar point estimates, although the moment estimates were consistently two to four times larger. Wang and Whitlock's new method that jointly estimates Ne and the rate of immigration into a population (m) gave much smaller estimates of Ne and implausibly large estimates of m. This method requires knowing allele frequencies in the source of immigrants, but was thought to be insensitive to inexact estimates. In our case the method may have failed because we did not know the true source of immigrants for each population. The method may be more sensitive to choice of source frequencies than was previously appreciated, and so should be used with caution if the most likely source of immigrants cannot be identified clearly. [source]


Welche Bedeutung hat die sexuelle Reproduktion für den Erfolg der Art Calamagrostis epigejos (L.) Roth?

FEDDES REPERTORIUM, Issue 3-4 2003
A. Grüttner Dr.
Als Quellen der Variabilität im Potential der sexuellen Reproduktion fanden sich Unterschiede in der Keimungsgeschwindigkeit (entspelzte Karyopsen keimten rascher und synchroner), bei den Keimraten und vor allem bei der Zahl keimfähiger Diasporen pro Rispe. Von den anderen abweichend zeigten kleine isolierte Bestände geringere Keimraten und brachten , wohl bedingt durch Selbstinkompatibilität , kaum keimfähige Diasporen hervor. Bei gezielter Suche fanden sich Keimlinge auf offenen, zumindest leicht tonhaltigen Rohböden. Das Wachstum der Keimlinge stagnierte und keiner von über 6000 überlebte bis zum nächsten Jahr. Da Bewässerung die Entwicklung auf dem selben Substrat sehr förderte, war offenbar Wassermangel für das geringe Wachstum ausschlaggebend. Die erfolgreiche generative Etablierung ist also auf den Zufall günstiger Witterungsphasen oder Standorte angewiesen. Auch im Frühjahr waren noch keimfähige Diasporen in aufrechten Rispen nachweisbar, sodass sich der Diasporenfall mehr oder weniger über das gesamte Jahr erstreckt. Im Zusammenspiel mit dem Fehlen von Dormanz ermöglicht das die Nutzung nicht vorhersagbarer günstiger Witterungsphasen. Bei einem Kulturversuch kamen einzelne Individuen auch mit schwierigen Substraten gut zurecht, auf denen die Mehrzahl kümmerte. Danach ergibt sich die standörtliche Breite der Art C.,epigejos als Summe sehr unterschiedlicher Reaktionsnormen der Individuen. Die angeführten Befunde unterstreichen insgesamt die Bedeutung der sexuellen Reproduktion und der genetischen Diversität für den Erfolg der Art. Is sexual reproduction important to the success of Calamagrostis epigejos (L.) Roth? Calamagrostis epigejos is very common in Central Europe and occupies an extraordinary wide range of habitats. As up to now nearly no reports exist on spontaneous seedling emergence, we aimed to investigate several aspects of sexual reproduction, thereby refering to contrasting habitat types. Components in the variability of the potential of sexual reproduction were differences in germination speed and rates and, above all, number of germinable seeds per panicle. Unlike the others, small isolated stands produced very low numbers of germinable seeds, probably caused by selfincompatibility. Our search for seedlings was successful at several sites , all distinguished by raw soil, a certain clay content, and little cover of vegetation and plant litter. The seedlings grew very slowly and none of more than 6000 survived the first year. Additional water enabling much better growth indicates the necessity of favorable weather or favorable habitats (with constant water supply) for successful seedling establishment. Seed dispersal nearly all around the year, combined with the lack of dormancy, allows to make use of the unpredictable opportunities of suitable weather periods. A growth experiment on different substrates demonstrated: the more extreme the conditions, the more differentiated the amount of biomass achieved by each of 20 genets. Some genets grew well even on substrates where most others stagnated. This outcome suggests the wide range of habitats covered by C. epigejos to be the result of the genetic diversity, which in turn is maintained by sexual reproduction and avoidance of inbreeding. [source]


Kaposiform hemangioendothelioma arising in the ethmoid sinus of an 8-year-old girl with severe epistaxis

HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 8 2006
Manfred T. Birchler MD
Abstract Background. Epistaxis is very common during childhood. It occurs primarily in boys and is usually self-limiting. Trauma and nose picking are among the most common causes. In general, epistaxis can be easily treated with anterior nasal packing or electrocoagulation. Methods. We report a case of an 8-year-old girl with severe unilateral epistaxis. Results. The bleeding originated from a kaposiform hemangioendothelioma arising in the left nasal cavity and ethmoid sinus. The feeding vessels originating from the maxillary artery were first embolized. The tumor was then surgically removed through a combined external ethmoidectomy and endonasal approach. The postoperative course was uneventful. MRI at 6 months after surgery showed no tumor recurrence. Conclusions. We report a previously undescribed cause of epistaxis in children, namely, a kaposiform hemangioendothelioma. To our knowledge, this is the first such case in the English-language literature. The differential diagnosis of severe unilateral nasal bleeding among the pediatric population should include the possibility of a kaposiform hemangioendothelioma. © 2006 Wiley Periodicals, Inc. Head Neck, 2006 [source]


Oral contrast-enhanced sonography for the diagnosis and grading of postsurgical recurrence of Crohn's disease

INFLAMMATORY BOWEL DISEASES, Issue 9 2008
Fabiana Castiglione MD
Abstract Background: Postsurgical recurrence (PSR) is very common in patients with Crohn's disease (CD) and previous surgery. Endoscopy is crucial for the diagnosis of PSR, also showing high prognostic value. Bowel sonography (BS) with or without oral contrast enhancement (OCBS) is accurate for CD diagnosis but its role in PSR detection and grading is poorly investigated. The aim was to evaluate the diagnostic accuracy of BS and OCBS for PSR compared to the endoscopical Rutgeerts's grading system. Methods: We prospectively performed endoscopy, BS, and OCBS in 40 CD patients with previous bowel resection to provide evidence of possible PSR. Endoscopy, BS, and OCBS were executed 1 year after surgery, with PSR diagnosis and grading made in accordance with Rutgeerts. BS and OCBS were considered suggestive for PSR in the presence of bowel wall thickness (BWT) >3 mm. OCBS was performed after ingestion of 750 mL of polyethylene glycol (PEG). Also, a receiver operating characteristic (ROC) curve was constructed in order to define the best cutoff of BWT to discriminate mild from severe PSR (grade 0,2 versus 3,4 of Rutgeerts) for both BS and OCBS. Results: In all, 22 out of the 40 CD showed an endoscopic evidence of PSR (55%). A severe PSR was present in 14 patients (64%). Sensitivity, specificity, and positive and negative predictive values were 77%, 94%, 93%, and 80% for BS, and 82%, 94%, 93%, and 84% for OCBS. On the ROC curve a BWT >5 mm showed sensitivity, specificity, and positive and negative predictive values of 93%, 96%, 88%, and 97% for the diagnosis of severe PSR at BS, while a BWT >4 mm was the best cutoff differentiating the mild from the severe CD recurrence for OCBS, with a sensitivity, specificity, and positive and negative predictive values of 86%, 96%, 97%, and 79%, respectively. Conclusions: Both BS and OCBS show good sensitivity and high specificity for the diagnosis of PSR in CD, with a BWT >5 mm for BS and BWT >4 mm for OCBS strongly indicative of severe endoscopic PSR. Accordingly, these techniques could replace endoscopy for the diagnosis and grading of PSR in many cases. (Inflamm Bowel Dis 2008) [source]


Prevalence and cognitive impact of cerebrovascular findings in Alzheimer's disease: a retrospective, naturalistic study

INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 2 2009
N. Tabet
Summary Aims:, Cerebrovascular disease (CVD) is a major risk factor for cognitive decline associated with progression to Alzheimer's disease (AD) and dementia. The objective of this study was to retrospectively assess the prevalence of CVD and its cognitive impact in patients with AD in everyday clinical practice. Methods:, Medical notes were retrospectively reviewed for all individuals who presented at East Sussex Memory Clinic (2004,2008) for investigation of cognitive impairment and had brain magnetic resonance imaging (MRI) as part of their clinical work-up. Global cognitive status was assessed with Mini-Mental State Examination (MMSE) and Cambridge Cognitive Examination. The extent of cerebrovascular abnormalities was qualitatively evaluated with MRI. Results:, Notes were reviewed for 232 patients (109 males, 123 females), mean age 76 years (range 62,93), who underwent MRI. Of these, 167 (72%) patients were diagnosed with AD. CVD was present in 89% of AD patients and 47% of patients had moderate to severe cerebrovascular abnormalities. The majority of patients (57%) had MMSE scores in the 21,26 range, indicative of mild AD. There was a trend towards worse cognitive status in patients with more severe CVD, which did not reach significance. Hachinski Ischaemic score indicated these patients did not have vascular dementia (VaD) (mean ± standard deviation 1.1 ± 1.3). Conclusion:, These findings, based on qualitative MRI, indicate that cerebrovascular pathology is a very common associated feature in patients with mild to moderate AD, without VaD. Although the study suggests that CVD does not contribute to cognitive decline, and is not associated with the development of VaD, a non-significant trend was observed towards worsening cognitive status with increasing severity of CVD. The finding of this trend suggests a need for additional research, especially a prospective quantitative method of assessing CVD, to improve our understanding of how CVD contributes to cognitive impairment in AD. [source]


Anaemia in heart failure: a common interaction with renal insufficiency called the cardio-renal anaemia syndrome

INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 2 2008
A. Palazzuoli
Summary Background:, Although many studies have found a high prevalence of anaemia in patients with congestive heart failure (CHF), few have carefully examined the relationship between the CHF and the prevalence of anaemia and chronic renal insufficiency (CRI). Patients with advanced renal failure, significant anaemia, diffuse atherosclerosis, respiratory disease and more elderly patients have been systematically excluded from the great majority of the randomised clinical trials. Discussion:, Both anaemia and renal insufficiency are very common associated diseases associated with increased mortality, morbidity and rate of hospitalisation in CHF patients. Impaired renal function is associated with adverse outcomes because it represents a marker of coexistent disease and more diffuse atherosclerosis. In patients with CHF, progressive renal dysfunction leads to a decrease in erythropoietin (EPO) levels with reduced erythrocyte production from bone marrow. This may explain the common association between CHF, anaemia and CRI in clinical practice. The normalisation of haemoglobin concentration by EPO in patients with CHF and CRI results in improved exercise capacity by increasing oxygen delivery and improving cardiac function. Conclusion:, In this review, we describe the mechanisms linking anaemic status, CRI and CHF, the prognostic relevance of each disease, treatment implications, and potential benefit of EPO administration. [source]


Characteristics of skin aging in Korean men and women

INTERNATIONAL JOURNAL OF COSMETIC SCIENCE, Issue 1 2005
J. H. Chung
Introduction Korea is located between Japan and Mainland China. The people of these three countries have similar appearances and it is difficult to differentiate between them. Although the population of Asia is more than half of the total population of the Earth, the inherent characteristics of Asian skin have not been well investigated. Commercial markets for cosmetics and drugs for photoaged skin are rapidly expanding in many Asian countries. Therefore, many investigators in the field of dermatology and cosmetology have become interested in brown Asian skin. Clinical characteristics of skin aging and photoaging in Asians Skin aging can be divided into two basic processes: intrinsic aging and photoaging [1]. Intrinsic aging is characterized by smooth, dry, pale, and finely wrinkled skin, whereas photoaging, which indicates premature skin aging in chronically photodamaged skin, is characterized by severe wrinkling and irregular pigmentation. The pattern of wrinkling in Asians seems to differ from that in Caucasians. Asians have coarser, thicker and deep wrinkles, particularly in the forehead, perioral and Crow's foot areas. In contrast, Caucasians usually have relatively fine cheek and Crow's foot wrinkles. The reasons for these differences are not known and need further investigation. There are racial, ethnic and genetic differences, and differences of skin structure and function, between the brown skin of Asians and the white skin of Caucasians. As Asian skin is more pigmented, acute and chronic cutaneous responses to UV irradiation differ from those in white skin. Many people believe, based on clinical impressions, that the main process of photoaging in Asians involves pigmentary changes, rather than wrinkling. However, no study has been performed to confirm this belief. Risk factors for skin wrinkles and their relative risks in Korean skin [2] Various factors such as age, sun-exposure, and smoking are known to be important risk factors for wrinkles. However, the relative risks of each factor on wrinkles in the brown skin of Asians have not been investigated, and they could differ from those in Caucasians. An evaluation system for skin wrinkling is necessary for Asian skin [3]. Thus, we developed an eight-point photographic scale for assessing wrinkles in both Korean genders [2]. This scale can probably be applied to the populations of other Asian countries, at least to the Japanese and Chinese. The pattern of wrinkles in both genders appears to be similar. Age Age is an important risk factor for wrinkling in Asians, as in Caucasians. Korean subjects in their 60s showed a 12-fold increased risk of wrinkling, while subjects in their 70s have a 56-fold increased risk compared with young age group. UV light It is well known that the UV component in sunlight can cause and accelerate photoaging. The pigmented skin of Asian may better protect skin from acute and chronic UV damage. However, we found a strong association between sun-exposure and the development of wrinkling in Koreans. It was found that sun exposure of more than 5 h per day was associated with a 4.8-fold increased risk in wrinkling versus less than 2 h of sun-exposure in Koreans. Estrogen deficiency Korean females have more wrinkles than men, after controlling for age, sun exposure, and smoking, it was found that they have a 3.6-fold increased risk of developing wrinkles than their male counterparts [2]. It has also been reported, that the relative risk for wrinkling in women is higher than in men as for in white Caucasians [4]. The reason why women show more wrinkles remains to be determined. It is possible that a reduction in skin collagen because of estrogen deficiency in postmenopausal woman may aggravate wrinkling severity. Korean women with more than 10 years since menopause showed a 3.9-fold higher risk of wrinkling than the women 5 years of beyond menopause [5]. We demonstrated that women with a history of HRT have a significantly lower risk, more specifically, one fifth of the risk of facial wrinkling relative to those who had no history of HRT. Interestingly, we found that wrinkle severity significantly increased with an increasing number of full term pregnancies. The relative risk for severe wrinkling is increased by approximately 1.8-fold per full term pregnancy. Smoking It is known that smoking causes skin wrinkling in Caucasians, and that it plays no role in Blacks [6, 7]. Koreans with have a smoking history of more than 30 pack years showed a more than 2.8-fold increased risk of wrinkles [2]. The relative risks of wrinkles associated with a 30,50 pack-years history of smoking were 2.8- and 5.5-fold, respectively. Dyspigmentation in Asian skin To follow pigmentary changes, six photographic standards for both genders were developed for Korean skin, to produce a 6-point scale [2, 8]. Hyperpigmented spots, mostly lentigines, were prominent among women, while seborrheic keratosis tended to be more prominent in men. Seborrheic keratosis in Korean men Seborrheic keratoses (SKs) are benign cutaneous tumors. They have diverse clinical and histopathological appearances and are very common in the elderly (over 50 years old). The etiology of SKs is not well understood, although patients with a great number of lesionsshow a familial trait with an autosomal dominant pattern, and human papilloma virus has been suggested as possible cause because of verrucous appearance of the lesions. Exposure to sunlight has been suggested to be a risk factor for SKs. However, there is still some debate in terms of the role of sunlight. Recently, we have investigated the clinical characteristics of SKs and relationship between SKs and sunlight exposure in Korean males [9]. The prevalence of SKs in Koreans increases with age; it rose from 78.9% at 40 years, to 93.9% at 50 years and 98.7% in those over 60 years. Exposed areas, i.e. the face, neck and dorsum of the hands, demonstrate a significant increase in the prevalence of SKs by decade, whereas partly exposed areas, although SKs tended to increase in prevalence with age, this trend was not significant. When the estimated body surface area (BSA) is taken into account, the number of SKs on both the face and dorsum of the hands (0.51 ± 0.08 per 1% BSA) was over-represented compared with the trunk. SKs were also concentrated on the neck (0.38 ± 0.07 per 1% BSA) and in the V-area (0.47 ± 0.09 per 1% BSA). Outer forearms also showed 3-fold more SKs per unit area than neighboring arms and inner forearms, which are classified as partly exposed area (0.09 ± 0.02, 0.03 ± 0.01, respectively). The total area covered by SKs on exposed area also became significantly larger with aging than on intermittently exposed areas. These results indicate that exposure to sunlight might be related to SK growth. Our results indicated that excessive sun exposure is an independent risk factor of SKs. After controlling for age, smoking, and skin type, subjects with a sun exposure history of more than 6 hours per day showed a 2.28-fold increased risk of having severe SKs (n , 6) compared with those exposed for less that 3 h per day. These findings indicated that sun-exposure may play an important role in SK development. In summary, SKs are very common in Korean males and represent one of the major pigmentary problems. SKs concentrate on exposed skin, especially on the face and dorsum of the hands. Both age and lifetime cumulative sunlight exposure are important contributing factors and may work in a synergistic manner. Conclusion Many people tend to believe that wrinkles are not a prominent feature of Asian photoaged skin, and that dyspigmentation is a major manifestation in Asian skin. Contrary to this impression, wrinkling is also a major problem in the photoaged skin of Asians, and Korean people showing severe pigmentary changes usually tend to have severe wrinkles. In conclusion, the wrinkling patterns and pigmentary changes of photoaged skin in East Asians differ from those of Caucasians, and the relative risks of aggravating factors may be different from those of Caucasian skin. References 1.,Gilchrest, B.A. Skin aging and photoaging: an overview. J. Am. Acad. Dermatol. 21, 610,613 (1989). 2.,Chung, J.H. et al. Cutaneous photodamage in Koreans: influence of sex, sun exposure, smoking, and skin color. Arch. Dermatol. 137, 1043,1051 (2001). 3.,Griffiths, C.E. et al. A photonumeric scale for the assessment of cutaneous photodamage. Arch. Dermatol. 128, 347,351 (1992). 4.,Ernster, V.L. et al. Facial wrinkling in men and women, by smoking status. Am. J. Public Health. 85, 78,82 (1995). 5.,Youn, C.S. et al. Effect of pregnancy and menopause on facial wrinkling in women. Acta Derm. Venereol. 83, 419,424 (2003). 6.,Kadunce, D.P. et al. Cigarette smoking: risk factor for premature facial wrinkling. Ann. Intern. Med. 114, 840,844 (1991). 7.,Allen, H.B., Johnson, B.L. and Diamond, S.M. Smoker's wrinkles? JAMA. 225, 1067,1069 (1973). 8.,Chung, J.H. Photoaging in Asians. Photodermatol. Photoimmunol. Photomed. 19, 109,121 (2003). 9.,Kwon, O.S. et al. Seborrheic keratosis in the Korean males: causative role of sunlight. Photodermatol. Photoimmunol. Photomed. 19, 73,80 (2003). [source]


Peau sèche-rêche et "Hydratation".

INTERNATIONAL JOURNAL OF COSMETIC SCIENCE, Issue 4 2004
Concept de la capture de l'eau organisée comme de la glace
Synopsis About sixty years ago Frank and Evans showed, by entropy measurements, that when a "non-polar molecule dissolves in water it modifies the water structure in the direction of greater ,cristallinity', the water builds a microscopic iceberg around it" Now, we propose the "concept of ice-like-water capture": a lowering of organized ice-like water promotes aggregation (loss of solubility) of the filaggrin/keratin1/keratin10 associations through their hydrophobic patches. The capture of ice-like water may be performed by the glucoceramides-rich bilayers in stratum granulosum. Probably, the same process aggregates the proteins of corneocytes envelope as well as corneodesmosomes proteins. According to the "concept of ice-like-water capture", to regulate the keratinization, it is not total water that must be added to the stratum corneum, but ice-like water that must be removed from stratum granulosum. Both petrolatum (lipophilic ingredient) and glycerol (hydrophilic ingredient) would capture the ice-like water, most probably after combination with the lipid bilayers of stratum corneum. Moisturizing cream, when organized in secondary droplets is likely to perform the same action. Measurements by near-infrared reflectance spectroscopy of the skin show that petrolatum; glycerol and/or moisturizing cream enhance the quantity of bulk water (1890,1897 nm band). As the ice-like water is the complement of bulk water, the enhanced bulk water let presume an ice-like water lessening. Some desynchronization (late or forward) of the keratinization/differentiation which confer the somatosensory problems associated with "dry and flaky skin" may be linked to an excess or lack of ice-like. For instance, the winter xerosis, very common by chilling weather, could be explained by an increase of ice-like water driven by the fall of the temperature. Résumé En s'appuyant: 1°-sur d'anciens travaux de thermodynamique montrant, d'une part que les molécules d'eau autour des zones apolaires en solution dans l'eau s'organise selon une structure d'eau-comme-de-la-glace, d'autre part qu'en l'absence de cette eau-comme-de-la-glace les molécules de protéines s'agrègent par leurs zones hydrophobes; 2°-sur des travaux récents utilisant la spectroscopie de l'infrarouge proche; technique qui permet de mesurer la quantité d'eau-en-vrac, forme que prend l'eau-comme-de-la-glace après sa fusion lors de l"établissement de liaisons/interactions hydrophobes; nous proposons le "concept de la capture de l"eau-comme-de-la-glace" selon lequel : 1° la différenciation des kératinocytes, qui se traduit à la fois par l'agrégation des trios filaggrine/K1/K10 (ainsi que notamment la formation de l'enveloppe des cornéocytes et des cornéodesmosomes) est promue par une baisse de la teneur en eau organisée dans le stratum granulosum. La captation de l'eau-comme-de-la-glace pourrait être assurée in situ par la structure lipidique riche en glucocéramides dont l'apparition dans le stratum granulosum est contemporaine du début de la baisse de la teneur en eau; 2° contrairement à la "tradition", la peau sèche-rêche n'est pas améliorée par une augmentation de l'hydratation du stratum corneum mais par la capture d'eau-comme-de-la-glace dans le stratum granulosum. 3° le glycérol, la Vaseline et les crèmes "hydratantes" peuvent concourir à cette capture d'eau-comme-de-la-glace, vraisemblablement après s"être combinés aux bicouches céramidiques du stratum corneum, et ainsi agir depuis ce stratum sur le stratum granulosum. 4°-la baisse hivernale de la température provoque une baisse de la quantité d'eau organisée et confère une aggravation de la peau sèche-rêche. 5°-une désynchronisation de la synthèse ou une modification de la structure et/ou de la composition des bicouches glucocéramidiques du stratum granulosum pourraient être à l'origine de certains types de peau sèche-rêche. [source]


Super giant basal cell carcinoma of the abdominal wall: still possible in the 21st century

INTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 7 2010
Eelco De Bree MD
Basal cell carcinoma (BCC) is very common and usually encountered when it is small in size. Giant BCC (i.e. greater than 5 cm in diameter) is quite rare and comprises 0.5 percent of all BCC. Extremely rarely, tumors larger than 20 cm have been reported. Herein, a case with an enormous, vegetating BCC of the abdominal wall, 30 x 20 cm in size, is described. This report demonstrates that such a case can still be observed in the civilized world of the 21st century, which remains profoundly astonishing. A literature survey was performed and revealed only 7 cases with such super giant BCC (i.e. larger than 20 cm in diameter). Generally, this tumor attains these enormous proportions due to neglect on the patient's part, and is usually located at sites covered by clothes. Treatment is mainly surgical and generally curative, resulting also in an improved quality of life. Tumor size of more than 10 cm in diameter is associated with increased risk for metastatic disease, severe morbidity and consequently impaired prognosis. [source]


Acne vulgaris in Nigerian adolescents , prevalence, severity, beliefs, perceptions, and practices

INTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 5 2009
Husain Yahya MSc
Background, Community-based studies of acne vulgaris conducted in many parts of the world show that it is very common in adolescents but little is known from Africa. Methods, In a cross-sectional study, 539 randomly selected students aged 11,19 years in a secondary school in Kaduna, Nigeria were administered a questionnaire to assess self-report of acne, its severity and impact; beliefs and perceptions of causes, and treatments used. 418 students were later examined to detect and grade acne severity. Results, 274 (50.8%) were male while 265 (49.2%) were female. Mean age for respondents was 16 years. 320 students (59.4%) self-reported acne. Of 418 students examined, 379 had acne giving a prevalence of 90.7%. There was no significant gender difference in prevalence at all ages of adolescence. Prevalence of acne increased with age (76.7% at age 10,13 years; 88.2% at age 14,16 years; 97.1% at age 17,19 years). 353 of 379 (93.1%) had mild acne while 26 of 379 (6.9%) had moderate acne. The severity of acne was similar in boys and girls. 47.7% of students reported feeling "very sad/unhappy" about their acne although in more than 70% of those who self-reported, this did not interfere with relationship with family, friends or school work. Diet was the commonest factor believed to cause acne. Cleansing agents were the most commonly used treatments. Conclusions, Acne vulgaris is very common in Nigerian adolescents, although it is mild acne in most. [source]


Current epidemiology of atopic dermatitis in south-eastern Nigeria

INTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 10 2004
Edith N. Nnoruka MB
Background, Atopic dermatitis (AD) is a common pruritic, eczematous skin disorder that runs a chronic and relapsing course. In Nigeria, it is currently on the increase, particularly amongst infants, and has created cost burdens for families. It occurs in association with a personal or family history of asthma, allergic rhinitis and conjunctivitis. Major and minor criteria exist as guidelines for arriving at a diagnosis of AD, and surveys from Western countries have shown that these features, in particular the minor features, vary with ethnicity and genetic background and can be used to aid diagnosis. African dermatologists have also voiced concern that the much used Hanifin criteria for diagnosis of AD may need some adaptation for use in Africa. Objective, To document the features and disease outcomes of AD seen amongst dermatology hospital patients in Enugu, south-eastern Nigeria, with a view to reflecting current features amongst Nigerian Blacks. Methods, A prospective study of AD patients seen over a 2-year period at a tertiary referral dermatology clinic (University of Nigeria Teaching Hospital, Enugu, Nigeria) was carried out. A total of 1019 patients aged between 4 weeks and 57 years were included in the study. Results, The prevalence of AD was 8.5%, which is much higher than the prevalence of AD reported in various parts of Nigeria 15 years ago. AD occurred before the age of 10 years in 523 (51.3%) patients, whilst 250 (24.5%) had onset after 21 years. The earliest age of onset in infants was in the first 6 weeks of life, and this was found in 129 patients (12.7%). Education and occupation of household heads were the most significant (P < 0.001) factors associated with seeking proper health care for the child's AD. Four hundred and forty-one (43.3%) patients presented with subacute atopic eczema and 326 (32%) patients with severe impeteginized eczema. Four hundred and twenty-five patients (41.7%) had at least one first-degree family member with AD (16.7%), allergic rhinitis (10.3%), asthma (14.6%) and allergic conjunctivitis (2.1%), while 55 (13.3%) of controls had a positive family history (P < 0.01) of allergy. A personal history of AD only, without concomitant respiratory allergies, was seen in 486 (47.7%) patients. The face was affected in 431 (42.3%) patients. Inverse distribution of a flexural rash was observed over the extensor aspect of the joints: the elbow in 502 patients (49.3%), the wrist joint in 183 patients (17.9%) and the knee joints in 354 patients (34.7). The commonly observed minor features included xerosis in 719 patients (71%), papular lichenoid lesions in 547 patients (54.1%), infraorbital folds in 498 patients (49.2%), palmar hyper linearity in 524 patients (51.8%) and raised peripheral blood eosinophils in 519 patients (51%), particularly for those with severe AD. Fissured heels, forehead lichenification, orbital darkening, nail pitting, sand paper-like skin lesions on the elbows/knees/lateral malleolli, knuckle dermatitis of the hands, palmar erythema and pitted keratolysis occurred more uncommonly as minor features. Infective complications were very common and included bacterial infections (folliculitis, impetiginized dermatitis and pyodermas) in 425 (41.7%) patients, fungal infections in 377 (37%) patients, parasitic infections (scabies) in 90 (8.8%) patients and viral infection (herpes simplex and molluscum contagiosum) in 29 (2.9%) patients. Thirteen of these atopics were also HIV positive. Aggravating factors most commonly reported included heat intolerance, excessive sweating, humidity, grass intolerance, thick woollen clothing and drug reactions. Only three patients had food intolerance. Three hundred and ten patients (30.4%) recalled their AD being worse in the hot humid periods and 383 (37.6%) could not recall any periods of relief or remission. Conclusions, The prevalence of AD amongst south-eastern Nigerian Blacks is on the increase, as in other areas, although it is still lower here than in other parts of the world. Many conventional minor features were found, but some occurred less frequently than in other countries, which may be attributed to ethnicity. Further studies will be required to confirm the ethnic differences in these features of AD amongst Nigerians and other Africans, to clarify the features of AD that are peculiar to Africans. [source]


Neuropsychiatric symptoms of dementia: cross-sectional analysis from a prospective, longitudinal Belgian study

INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 11 2005
Sebastiaan Engelborghs
Abstract Objective Given the rather limited knowledge on profiles of neuropsychiatric symptoms (behavioural and psychological signs and symptoms of dementia, BPSD) in several degenerative dementias, we designed a prospective study of which we here present the baseline data. Methods Diagnosed according to strictly applied clinical diagnostic criteria, patients with probable Alzheimer's disease (AD) (n,=,205), frontotemporal dementia (FTD) (n,=,29), mixed dementia (MXD) (n,=,39) and dementia with Lewy bodies (DLB) (n,=,23) were included. All patients underwent a neuropsychological examination and behavioural assessment by means of a battery of scales (Middelheim Frontality Score (MFS), Behave-AD, Cohen-Mansfield Agitation Inventory, Cornell Scale for Depression in Dementia). Results In AD and MXD, activity disturbances and aggressiveness occurred in more than 80% of the patients. With a prevalence of 70%, apathy was very common whereas delusions and hallucinations were rare in FTD patients. Frequently used behavioural assessment scales like the Behave-AD systematically underestimated BPSD in FTD whereas the MFS displayed high sensitivity for frontal lobe symptoms. Hallucinations discriminated DLB patients from other dementias. A high prevalence of disinhibition (65%) in DLB pointed to frontal lobe involvement. Conclusions Behavioural assessment may help differentiating between different forms of dementia, further stressing the need for the development of new and more sensitive behavioural assessment scales. By means of the MFS, frontal lobe involvement was frequently observed in DLB. As 70% of FTD patients displayed apathy, prevalence was about two times higher compared to the other disease groups, meanwhile indicating that apathy is frequently observed in dementia, irrespective of its etiology. Copyright © 2005 John Wiley & Sons, Ltd. [source]


Role of behavioural disturbance in the loss of autonomy for activities of daily living in Alzheimer patients

INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 11 2003
L. Lechowski
Abstract Background Cognitive impairment is associated with functional impairment in patients with Alzheimer's disease (AD). Behavioural disturbance is very common in these patients. Nevertheless, there has been very little research into the relations between behavioural disturbance and functional status in AD. The purpose of this study is to investigate the relationship between behavioural disturbance and functional status after taking account of cognitive impairment. Material and methods 579 patients were prospectively evaluated at 16 French hospitals, all referents for AD, and were diagnosed with possible or probable AD. These patients were assessed with NeuroPsychiatric Inventory (NPI), cognitive subscales of the Alzheimer's Disease Assessment Scale (ADAS-cog), Clinical Dementia Rating scale (CDR) and Instrumental Activities of Daily Living scale (IADL). Results The number of men with available data for IADL total score was too small to make any analysis. ,Group A' gathered 256 women for whom the relation between autonomy for Activities of Daily Living (ADL) and the other variables were determined. ,Group B', pooled 85 women for whom relations found were verified. Linear regression was used for the analysis. With age, cognitive impairment allows us to explain best (38%) the loss of autonomy for ADL. Conclusion The role of behavioural disturbances in the loss of autonomy for ADL was not determinant in our study, whereas cognitive impairment and age were better able to determine the loss of autonomy for ADL. Further study is needed to explain the decline of functional status in AD patients. Copyright © 2003 John Wiley & Sons, Ltd. [source]