Home About us Contact
|
Home About us Contact | ||
|
|
||
Moderate Severity (moderate + severity)
Selected AbstractsHand eczema: causes, course, and prognosis ICONTACT DERMATITIS, Issue 6 2008Niels K. Veien Background:, Hand eczema is a common dermatosis. The course is often protracted. The prognosis is not well described. Objective:, To describe in detail a consecutive cohort of hand eczema patients with regard to aetiology and morphology as well as the dynamics of the hand eczema. Patients and Methods:, This prospective study included 522 consecutive patients (175 men and 347 women with hand eczema) seen in 1 year in a private practice of dermatology. 425 (81%) of the patients were patch tested in relation to the current study. Most of the remainder had been previously patch tested. Results:, 38% had mild dermatitis, 49% had dermatitis of moderate severity, and 11% had severe dermatitis. 23% had had dermatitis for more than 10 years. 33% had irritant contact dermatitis, 13% of the men and 20% of the women had allergic contact dermatitis, and 15% of the men and 16% of the women had atopic dermatitis. For 34% of the men and 29% of the women, the dermatitis was certainly or possibly occupational. There was no relationship to smoking. Conclusions:, The majority of this cohort of hand eczema patients had long-standing disease. Irritant contact dermatitis was the most common aetiological diagnosis. [source] The dimensionality of alcohol use disorders and alcohol consumption in a cross-national perspectiveADDICTION, Issue 2 2010Guilherme Borges ABSTRACT Aims To replicate the finding that there is a single dimension trait in alcohol use disorders and to test whether the usual 5+ drinks for men and 4+ drinks for women and other measures of alcohol consumption help to improve alcohol use disorder criteria in a series of diverse patients from emergency departments (EDs) in four countries. Design Cross-sectional surveys of patients aged 18 years and older that reflected consecutive arrival at the ED. The Composite International Diagnostic Interview Core was used to obtain a diagnosis of DSM-IV alcohol dependence and alcohol abuse; quantity and frequency of drinking and drunkenness as well as usual number of drinks consumed during the last year. Setting Participants were 5195 injured and non-injured patients attending seven EDs in four countries: Argentina, Mexico, Poland and the United States (between 1995,2001). Findings Using exploratory factor analyses alcohol use disorders can be described as a single, unidimensional continuum without any clear-cut distinction between the criteria for dependence and abuse in all sites. Results from item response theory analyses showed that the current DSM-IV criteria tap people in the middle,upper end of the alcohol use disorder continuum. Alcohol consumption (amount and frequency of use) can be used in all EDs with the current DSM-IV diagnostic criteria to help tap the middle,lower part of this continuum. Even though some specific diagnostic criteria and some alcohol consumption variables showed differential item function across sites, test response curves were invariant for ED sites and their inclusion would not impact the final (total) performance of the diagnostic system. Conclusions DSM-IV abuse and dependence form a unidimensional continuum in ED patients regardless of country of survey. Alcohol consumption variables, if added, would help to tap patients with more moderate severity. The DSM diagnostic system for alcohol use disorders showed invariance and performed extremely well in these samples. [source] Epidemiology of tomato yellow leaf curl begomovirus in the Fayium area, EgyptEPPO BULLETIN, Issue 2 2000A. E. Aboul-Ata Tomato yellow leaf curl begomovirus (TYLCV) severely invaded tomato plantations in Egypt (Lower and Middle Egypt) in 1989. This study aimed to discover the relationship between TYLCV and other epidemic-associated factors in the Fayium area. The rate of TYLCV infection was inspected visually for three successive years (1994/1996) in the Fayium area. During the same period, whiteflies were collected for virus detection using bait-plant and DNA hybridization techniques. DAS-ELISA was used to detect mixed virus infections in tomato plants. TYLCV infection was prevalent (60,68%) and severe (2.1,3.0) in the Fayium fields. Cucumber mosaic cucumovirus (CMV) was found in some fields (5,28%) with moderate severity (1.0,20). Potato Y potyvirus (PVY) and potato leaf roll polerovirus (PLRV) were found in few fields (5,19% and 5% respectively) at very low severity. There was a negative correlation between TYLCV occurrence and distance from the source of infection, and a positive correlation (98%) between TYLCV intensity and percentage of viruliferous whiteflies in 1994 and 1995. There was no positive correlation between TYLCV and the total population of whiteflies caught during the same period. Five percent of viruliferous whiteflies, as proved by cDNA hybridization, led to 46% TYLCV infection. The same percentage of whiteflies, as shown by bioassay, led to 68% TYLCV infection. Monitoring of viruliferous whiteflies could be used for early prediction of TYLCV infection. [source] Assessing burn severity and comparing soil water repellency, Hayman Fire, ColoradoHYDROLOGICAL PROCESSES, Issue 1 2006Sarah A. Lewis Abstract An important element of evaluating a large wildfire is to assess its effects on the soil in order to predict the potential watershed response. After the 55 000 ha Hayman Fire on the Colorado Front Range, 24 soil and vegetation variables were measured to determine the key variables that could be used for a rapid field assessment of burn severity. The percentage of exposed mineral soil and litter cover proved to be the best predictors of burn severity in this environment. Two burn severity classifications, one from a statistical classification tree and the other a Burned Area Emergency Response (BAER) burn severity map, were compared with measured ,ground truth' burn severity at 183 plots and were 56% and 69% accurate, respectively. This study also compared water repellency measurements made with the water drop penetration time (WDPT) test and a mini-disk infiltrometer (MDI) test. At the soil surface, the moderate and highly burned sites had the strongest water repellency, yet were not significantly different from each other. Areas burned at moderate severity had 1·5 times more plots that were strongly water repellent at the surface than the areas burned at high severity. However, the high severity plots most likely had a deeper water repellent layer that was not detected with our surface tests. The WDPT and MDI values had an overall correlation of r = ,0·64(p < 0·0001) and appeared to be compatible methods for assessing soil water repellency in the field. Both tests represent point measurements of a soil characteristic that has large spatial variability; hence, results from both tests reflect that variability, accounting for much of the remaining variance. The MDI is easier to use, takes about 1 min to assess a strongly water repellent soil and provides two indicators of water repellency: the time to start of infiltration and a relative infiltration rate. Copyright © 2005 John Wiley & Sons, Ltd. [source] Once-daily desloratadine improves the signs and symptoms of chronic idiopathic urticaria: a randomized, double-blind, placebo-controlled studyINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 1 2001Johannes Ring MD Background Chronic idiopathic urticaria (CIU) is the most common type of chronic urticaria, and pruritus is the most prominent symptom. Antihistamines are the first-line treatment for CIU. Sedation and anticholinergic adverse effects are often experienced with the first-generation antihistamines and there is a risk of cardiovascular adverse effects and drug interactions with some second-generation agents. Hence, new treatment options are needed. Desloratadine is a new, potent, nonsedating antihistamine that has an excellent cardiovascular safety profile. Methods This was a multicenter, randomized, double-blind, placebo-controlled study designed to determine the efficacy and safety of desloratadine in the treatment of moderate-to-severe CIU. A total of 190 patients, aged 12,79 years, with at least a 6-week history of CIU and who were currently experiencing a flare of at least moderate severity, were randomly assigned to therapy with desloratadine 5 mg or placebo once daily for 6 weeks. Twice daily, patients rated the severity of CIU symptoms (pruritus, number of hives, and size of largest hive), as well as the impact of CIU symptoms on sleep and daily activity. Patients and investigators jointly evaluated therapeutic response and overall condition. Safety evaluations included the incidence of treatment-emergent adverse events, discontinuations due to adverse events, and changes from baseline in vital signs, laboratory parameters, and ECG intervals. Results Desloratadine was superior to placebo in controlling pruritus and total symptoms after the first dose and maintained this superiority to the end of the study. Measures of sleep, daily activity, therapeutic response, and global CIU status were also significantly better with desloratadine after the first dose; these clinical benefits were also maintained throughout the 6-week study. No significant adverse events occured. Conclusions Desloratadine 5 mg daily is a safe and effective treatment for CIU with significant benefits within 24 h and maintained through the treatment period. [source] The safety of sublingual immunotherapy with one or multiple pollen allergens in childrenALLERGY, Issue 12 2008F. Agostinis Background:, Since the majority of allergic patients are polysensitized, it is often necessary to prescribe immunotherapy with multiple allergens. It is crucial to know if the administration of multiple allergens with sublingual immunotherapy (SLIT) increases the risk of side-effects in children. Methods:, Consecutive children with respiratory allergy because of pollens, receiving SLIT for multiple or single allergens were followed-up in a postmarketing survey. Inclusion criteria were those for prescribing SLIT according to guidelines. Parents recorded in a diary card the side-effects (eye symptoms, rhinitis/ear itching, asthma, oral itching/swelling, nausea, vomiting, abdominal pain, diarrhoea, urticaria, angioedema and anaphylaxis). The side-effects were graded as mild, moderate and severe. Results:, Four hundred and thirty-three children (285 male, age range 3,18 years) receiving SLIT were surveyed. Of them, 179 received a single extract, and 254 multiple allergens. The total number of doses given was 40 169 (17 143 with single allergen). Overall, 178 episodes were reported. Of them, 76 occurred with the single allergen (42.46% patients, 4.43/1000 doses) and 102 (40.3% patients, 4.42/1000 doses) with multiple allergens (P = NS). 165 episodes (92.5%) were mild and self-resolving and were equally distributed in the two groups. In 13 cases, the events were judged of moderate severity and medical advice was required. Three patients discontinued SLIT, despite the local side-effects being mild. No emergency treatment was required at all. Conclusion:, The use of multiple allergens for SLIT does not increase the rate of side-effects in children. [source] Colorectal carcinoma development in inducible nitric oxide synthase-deficient mice with dextran sulfate sodium-induced ulcerative colitisMOLECULAR CARCINOGENESIS, Issue 5 2007Darren N. Seril Abstract The overproduction of reactive oxygen and nitrogen species (RONS) may play an important role in ulcerative colitis (UC)-associated carcinogenesis. In order to study the role of nitric oxide (NO) in UC-associated colorectal carcinogenesis, the development of colorectal carcinoma was studied using the DSS-induced and iron-enhanced model of chronic UC in inducible nitric oxide synthase (iNOS)-deficient mice. Female wild-type C57BL/6 (iNOS+/+) and iNOS,/, mice were administered 1% DSS (w/v) through the drinking fluid for 15 DSS cycles and fed twofold iron-enriched diet. Colorectal inflammation and mucosal ulceration of moderate severity were observed in both iNOS+/+ and iNOS,/, mice. Similar tumor incidence and multiplicity in the colon were observed that 15 out of 23 (65.2%) iNOS+/+ mice developed colorectal tumors with a tumor multiplicity of 1.47,±,0.17 (mean,±,SE) after 15 DSS cycles, and 13 out of 19 (68.4%) iNOS,/, mice developed colorectal tumors with a tumor multiplicity of 2.08,±,0.21. Histopathologically, the tumors were confirmed to be well-differentiated adenocarcinomas. Nitrotyrosine, an indicator of peroxynitrite-caused protein modification, was detectable by immunohistochemistry in inflammatory cells and epithelial cells of the colon in iNOS+/+ and iNOS,/, mice, and no difference in staining intensity was observed between the two groups. Immunostaining for endothelial NOS (eNOS) was observed in lamina propria macrophages and colonic blood vessels, and eNOS protein levels were increased in the inflamed colon. These results show that there is no difference in UC-associated cancer development in iNOS+/+ and iNOS,/, mice, and suggest that in the absence of iNOS, other factors, such as eNOS, may play a role in nitrosative stress and UC-associated carcinogenesis in this model system. © 2006 Wiley-Liss, Inc. [source] Effective Bilirubin Reduction by Single-Pass Albumin Dialysis in Liver FailureARTIFICIAL ORGANS, Issue 8 2009Ussanee Boonsrirat Abstract Albumin dialysis is widely accepted as a liver-support technique for patients with liver failure. The Molecular Adsorbent Recirculating System, the widely accepted albumin dialysis technique, has limited use in developing countries because of its technical difficulties and high cost. Therefore, we assessed the efficacy of the more practical modality, the single-pass albumin dialysis (SPAD), in terms of bilirubin reduction, as a marker of albumin-bound toxins removal, as well as the patient outcomes. Twelve acute or acute-on-chronic patients with liver failure who had hyperbilirubinemia (total bilirubin > 20 mg/dL) were treated with SPAD by using 2% human serum albumin dialysate for 6 h. SPAD treatment significantly improved the levels of total bilirubin, conjugated bilirubin, urea, and creatinine (P < 0.001 for all parameters). The reduction ratios of these four parameters were 22.9 ± 3.8%, 20.9 ± 5%, 19.0 ± 4.1%, and 27.7 ± 3.2%, respectively. No significant difference was observed between serum ammonia before and after treatment. No significant changes in mean arterial pressures were noted during the maneuver, representing cardiovascular tolerability. No treatment-related complications were found. The 15-day in-hospital survival was 16.7%. However, a subgroup of the patients who had moderate severity showed 100% 15-day-survival rate (2 of 2 patients). In conclusion, SPAD is salutarily effective in reducing bilirubin in patients with liver failure. The procedure is safe and simply set up. [source] Treatment of vesico-ureteric reflux: a new algorithm based on parental preferenceBJU INTERNATIONAL, Issue 3 2003N. Capozza Authors from Rome evaluated parental preference for treatment in children with grade III VUR. Parents were provided with detailed information about the three treatment options: antibiotic treatment, open surgery, endoscopic treatment. Most parents chose endoscopic management; with this in mind, the authors proposed a new treatment algorithm for VUR. OBJECTIVE To assess parental preference (acknowledged in treatment guidelines as important when choosing therapy) about treatments for vesico-ureteric reflux (VUR, commonly associated with urinary tract infection and which can cause long-term renal damage if left untreated), as at present there is no definitive treatment for VUR of moderate severity (grade III). SUBJECTS AND METHODS The parents of 100 children with grade III reflux (38 boys and 62 girls, mean age 4 years, range 1,15) were provided with detailed information about the three treatment options available for treating VUR (antibiotic prophylaxis, open surgery and endoscopic treatment), including the mode of action, cure rate and possible complications, and the practical advantages and disadvantages. They were then presented with a questionnaire asking them to choose their preferred treatment. RESULTS Most parents preferred endoscopic treatment (80%), rather than antibiotic prophylaxis (5%) or open surgery (2%); 13% could not decide among the three options and endoscopic treatment was recommended. CONCLUSION Given the strong preference for endoscopic treatment we propose a new algorithm for treating VUR; endoscopic treatment would be considered as the first option for persistent VUR, except in severe cases where open surgery would still be recommended. [source] Serum antidiuretic hormone is elevated in relation to the increase in average total body transepidermal water loss in severe atopic dermatitisBRITISH JOURNAL OF DERMATOLOGY, Issue 2 2005T. Aoki Summary Background, While elevation of antidiuretic hormone (ADH) (arginine vasopressin) levels in the serum has been reported in severe atopic dermatitis (AD), the cause is as yet unexplained. On the other hand, transepidermal water loss (TEWL) is known to increase in the damaged skin due to AD. Objectives, As ADH increases as a result of dehydration of the body, this study examined whether the high ADH level in severe AD is a reaction to the increased water loss through the entire body skin surface area. Methods, Forty-eight patients of different ages and with various degrees of AD along with six age- and sex-matched control persons were the study subjects. Using a quick responsive evaporimeter, an average total body TEWL (ATEWL) value was obtained for each subject. Laboratory tests including ADH, serum lactate dehydrogenase (LDH) and peripheral blood eosinophil count (EOS) were also performed. Clinical severity grading was made globally. The relevancy of this grading was empirically demonstrated by its statistically significant relation to LDH and EOS which are commonly known as appropriate gauges for AD severity. Results, ATEWL was observed to be significantly greater in patients with AD of at least moderate severity than in normal controls, and ADH was significantly greater in patients with severe and very severe AD. Both ATEWL and ADH showed a significant relation to AD severity. Finally, a significant correlation was found between ADH and ATEWL. Conclusions, It is possible that elevated ADH is at least in part a reaction to increased ATEWL. [source] Efficacy and safety of 800 and 1200 mg eslicarbazepine acetate as adjunctive treatment in adults with refractory partial-onset seizuresACTA NEUROLOGICA SCANDINAVICA, Issue 5 2009A. Gil-Nagel Objectives ,,, To evaluate the efficacy and safety of eslicarbazepine acetate (ESL) as adjunctive therapy in adults with partial-onset seizures. Material and methods ,,, Double-blind, placebo-controlled, parallel-group, multicenter study consisting of an 8-week baseline period, after which patients were randomized to placebo (n = 87) or once-daily ESL 800 mg (n = 85) or 1200 mg (n = 80). Patients received half dose during 2 weeks preceding a 12-week maintenance period. Results ,,, Seizure frequency over the maintenance period was significantly (P < 0.05) lower than placebo in both ESL groups. Responder rate was 23% (placebo), 35% (800 mg), and 38% (1200 mg). Median relative reduction in seizure frequency was 17% (placebo), 38% (800 mg), and 42% (1200 mg). The most common adverse events (AEs) (>10%) were dizziness, somnolence, headache, and nausea. The majority of AEs were of mild or moderate severity. Conclusions ,,, Once-daily treatment with ESL 800 and 1200 mg was effective and generally well tolerated. [source] | ||||||||||