Current Issue : October - December Volume : 2013 Issue Number : 4 Articles : 6 Articles
Background: This study aimed to estimate the association between eczema in early childhood and the onset of\r\nasthma and rhinitis later in life in children.\r\nMethods: A total of 3,124 children aged 1ââ?¬â??2 years were included in the Dampness in Building and Health (DBH)\r\nstudy in the year 2000, and followed up 5 years later by a parental questionnaire based on an International Study\r\nof Asthma and Allergies in Childhood protocol. The association between eczema in early childhood and the\r\nincidence of asthma and rhinitis later in life was estimated by univariable and multivariable logistic regression\r\nmodelling.\r\nResults: The prevalence of eczema in children aged 1ââ?¬â??2 years was 17.6% at baseline. Children with eczema\r\nhad a 3-fold increased odds of developing asthma (adjusted odds ratio [aOR], 3.07; 95% confidence interval (CI)\r\n1.79ââ?¬â??5.27), and a nearly 3-fold increased odds of developing rhinitis (aOR, 2.63; 1.85ââ?¬â??3.73) at follow-up compared\r\nwith children without eczema, adjusted for age, sex, parental allergic disease, parental smoking, length of\r\nbreastfeeding, site of living, polyvinylchloride flooring material, and concomitant allergic disease. When eczema was\r\ndivided into subgroups, moderate to severe eczema (aOR, 3.56; 1.62ââ?¬â??7.83 and aOR, 3.87; 2.37ââ?¬â??6.33, respectively),\r\nearly onset of eczema (aOR, 3.44; 1.94ââ?¬â??6.09 and aOR, 4.05; 2.82ââ?¬â??5.81; respectively), and persistence of eczema (aOR,\r\n5.16; 2.62ââ?¬â??10.18 and aOR, 4.00; 2.53ââ?¬â??6.22, respectively) further increased the odds of developing asthma and rhinitis.\r\nFurther independent risk factors increasing the odds of developing asthma were a parental history of allergic\r\ndisease (aOR, 1.83; 1.29ââ?¬â??2.60) and a period of breast feeding shorter than 6 months (aOR, 1.57; 1.03ââ?¬â??2.39). The\r\nincidence of rhinitis was increased for parental history of allergic disease (aOR, 2.00; 1.59ââ?¬â??2.51) and polyvinylchloride\r\nflooring (aOR, 1.60; 1.02ââ?¬â??2.51).\r\nConclusion: Eczema in infancy is associated with development of asthma and rhinitis during the following 5-year\r\nperiod, and eczema is one of the strongest risk factors. Early identification is valuable for prediction of the atopic\r\nmarch....
Background: Primary keratinocytes derived from epidermis, oral mucosa, and urothelium are used in construction\r\nof cell based wound healing devices and in regenerative medicine. This study presents in vitro technology that\r\nrapidly expands keratinocytes in culture by growing monolayers under large volumes of serum-free, essential fatty\r\nacid free, low calcium medium that is replaced every 24 hrs.\r\nMethods: Primary cell cultures were produced from epidermal skin, oral mucosa and ureter by trypsinization of\r\ntissue. Cells were grown using Epilife medium with growth factors under high medium volumes. Once densely\r\nconfluent, the keratinocyte monolayer produced cells in suspension in the overlying medium that can be harvested\r\nevery 24 hrs. over a 7ââ?¬â??10 day period. The cell suspension (approximately 8 X 105 cells/ml) is poured into a new flask\r\nto form another confluent monolayer over 2ââ?¬â??4 days. This new culture, in turn produced additional cell suspensions\r\nthat when serially passed expand the cell strain over 2ââ?¬â??3 months, without the use of enzymes to split the cultures.\r\nThe cell suspension, called epithelial Pop Up Keratinocytes (ePUKs) were analyzed for culture expansion, cell size\r\nand glucose utilization, attachment to carrier beads, micro-spheroid formation, induction of keratinocyte\r\ndifferentiation, and characterized by immunohistochemistry.\r\nResults: The ePUKs expanded greatly in culture, attached to carrier beads, did not form micro-spheroids, used\r\napproximately 50% of medium glucose over 24 hrs., contained a greater portion of smaller diameter cells\r\n(8ââ?¬â??10 microns), reverted to classical appearing cultures when returned to routine feeding schedules (48 hrs. and\r\n15 ml/T-75 flask) and can be differentiated by either adding 1.2 mM medium calcium, or essential fatty acids. The\r\nePUK cells are identified as cycling (Ki67 expressing) basal cells (p63, K14 expressing).\r\nConclusions: Using this primary culture technique, large quantities of epithelial cells can be generated without the\r\nuse of the enzyme trypsin to split the cultures. The cells are small in diameter and have basal cell progenitor/ââ?¬Âstemââ?¬Â\r\n(P/SC) cell characteristics induced by daily feeding with larger than normal medium volumes. The ePUK epithelial\r\ncells have the potential to be used in regenerative medicine and for basic studies of epithelia P/SC phenotype....
Minor postoperative bleeding is the most common complication of cutaneous surgery. Because of the commonality of this\r\ncomplication, hemostasis is an important concept to address when considering dermatologic procedures. Patients that have a\r\nbleeding diathesis, an inherited/acquired coagulopathy, or who are on anticoagulant/antiplatelet medications pose a greater risk for\r\nbleeding complications during the postoperative period. Knowledge of these conditions preoperatively is of the utmost importance,\r\nallowing for proper preparation and prevention. Also, it is important to be aware of the various hemostatic modalities available,\r\nincluding electrocoagulation, which is among the most effective and widely used techniques. Prompt recognition of hematoma\r\nformation and knowledge of postoperative wound care can prevent further complications such as wound dehiscence, infection, or\r\nskin-graft necrosis, minimizing poor outcomes....
Patientsââ?¬â?¢ knowledge about psoriasis and its treatment has been randomly studied previously. The aim of the study is to investigate\r\npatientsââ?¬â?¢ knowledge about psoriasis in relation to undergoing patient education in the context of climate therapy (CT).Thepsoriasis\r\nknowledge questionnaire (PKQ) was used in a follow-up preââ?¬â??post study design ofNorwegian patients with psoriasis at the age of 20\r\nyears and older undergoing CT at Gran Canaria (Spain). Patients completed the PKQ and provided selected demographic, clinical\r\nand health information before (T1), immediately after (T2), and 3 months after (T3) CT. Disease severity was assessed using the\r\npsoriasis area and severity index (PASI). 254 psoriasis patients were included (74%). The PKQ score improved significantly fromT1\r\nto T2 and T3 (?? < 0.001 for both comparisons). Although patientââ?¬â?¢s knowledge improved, further research should use gold standard\r\ndesigns (experiments) to study the effects of educational interventions in different contexts....
Background: A previous study indicated that a single application of 4% dimeticone liquid gel was effective in\r\ntreating head louse infestation. This study was designed to confirm this in comparison with two applications of 1%\r\npermethrin.\r\nMethods: We have performed a single centre parallel group, randomised, controlled, open label, community based\r\ntrial, with domiciliary visits, in Cambridgeshire, UK. Treatments were allocated through sealed instructions derived\r\nfrom a computer generated list. We enrolled 90 children and adults with confirmed head louse infestation analysed\r\nby intention to treat (80 per-protocol after 4 drop outs and 6 non-compliant). The comparison was between 4%\r\ndimeticone liquid gel applied once for 15 minutes and 1% permethrin creme rinse applied for 10 minutes, repeated\r\nafter 7 days as per manufacturer�s directions. Evaluated by elimination of louse infestation after completion of\r\ntreatment application regimen.\r\nResults: Intention to treat comparison of a single dimeticone liquid gel treatment with two of permethrin gave\r\nsuccess for 30/43 (69.8%) of the dimeticone liquid gel group and 7/47 (14.9%) of the permethrin creme rinse group\r\n(OR 13.19, 95% CI 4.69 to 37.07) (p < 0.001). Per protocol results were similar with 27/35 (77.1%) success for\r\ndimeticone versus 7/45 (15.6%) for permethrin. Analyses by household gave essentially similar outcomes.\r\nConclusions: The study showed one 15 minute application of 4% dimeticone liquid gel was superior to two\r\napplications of 1% permethrin creme rinse (p < 0.001). The low efficacy of permethrin suggests it should be\r\nwithdrawn....
Background: Sebaceous glands are components of the skin essential for its normal lubrication by the production\r\nof sebum. This contributes to skin health and more importantly is crucial for the skin barrier function. A mechanistic\r\nunderstanding of sebaceous gland cells growth and differentiation has lagged behind that for keratinocytes, partly\r\nbecause of a lack of an in vitro model that can be used for experimental manipulation.\r\nMethods: We have developed an in vitro culture model to isolate and grow primary human sebocytes without\r\ntransformation that display functional characteristics of sebocytes. We used this novel method to probe the effect\r\nof Transforming Growth Factor �Ÿ (TGF�Ÿ) signaling on sebocyte differentiation, by examining the expression of\r\ngenes involved in lipogenesis upon treatment with TGF�Ÿ1. We also repressed TGF�Ÿ signaling through knockdown\r\nof the TGF�Ÿ Receptor II to address if the effect of TGF�Ÿ activation is mediated via canonical Smad signal\r\ntransduction.\r\nResults: We find that activation of the TGF�Ÿ signaling pathway is necessary and sufficient for maintaining\r\nsebocytes in an undifferentiated state. The presence of TGF�Ÿ ligand triggered decreased expression in genes\r\nrequired for the production of characteristics sebaceous lipids and for sebocyte differentiation such as FADS2 and\r\nPPAR?, thereby decreasing lipid accumulation through the TGF�Ÿ RII-Smad2 dependent pathway.\r\nConclusion: TGF�Ÿ signaling plays an essential role in sebaceous gland regulation by maintaining sebocytes in an\r\nundifferentiated state. This data was generated using a novel method for human sebocyte culture, which is likely to\r\nprove generally useful in investigations of sebaceous gland growth and differentiation. These findings open a new\r\nparadigm in human skin biology with important implications for skin therapies....
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