Interpretability in atopic dermatitis:all about the anchor

Abstract Linked Article:  Vakharia et al. Br J Dermatol 2018; 178:925–930.</jats:p

Allergic contact dermatitis is a frequent disease in the dermatological practice : Patch Test is used to make the diagnosis of this disease

La dermatitis alérgica de contacto (DAC) es una enfermedad frecuente en la consulta dermatológica. Para su diagnóstico contamos con una herramienta muy útil como es el test del parche. Objetivos: Determinar características epidemiológicas de nuestra población y prevalencia de alérgenos en los pacientes atendidos en el Hospital LC Lagomaggiore de Mendoza a través del test del parche. Materiales y métodos: Estudio descriptivo observacional transversal. Se seleccionaron pacientes con antecedentes de eczema crónico evaluados en el Servicio de Dermatología desde marzo 2017 hasta junio 2017. Los mismos fueron estudiados mediante la aplicación de pruebas epicutáneas (test del parche) y utilizándose la batería estándar latinoamericana de alérgenos recomendada por el consenso de la Sociedad Argentina de Dermatología. LA-1000 Chemotechnique (Suecia). Resultados: Se estudiaron un total de 21 pacientes, 16 fueron mujeres (76%) y 5 varones (24%). Del total, 11 pacientes (52%) obtuvieron un resultado positivo al menos a un alérgeno. El níquel (21%, 7 pacientes) fue el alérgeno más frecuente. Las manos fueron el sitio con mayor afectación (18%, 16 pacientes). Conclusión: El test del parche es una prueba segura y una herramienta fundamental en el diagnóstico de la DAC. Permite hallar el o los alérgenos involucrados y así poder evitar la exposición a los mismos como parte fundamental de la terapéutica.Allergic contact dermatitis is a frequent disease in the dermatological practice. Patch test is used to make the diagnosis of this disease. Objectives: To determine the epidemiological characteristics and prevalence of allergens in patients of the Hospital LC Lagomaggiore´s in Mendoza. Materials and methods: Transversal observational descriptive study. Patients with a history of chronic eczema were evaluated at Dermatology Unit since March 2017 to June 2017. Patients were studied by applying epicutaneous tests (Patch test) and using the standard Latin American allergen battery recommended by the Argentinian Dermatology Society. Results: A total of 21 patients were studied, 16 were women (76%) and 5 men (24%). Of the total, 11 patients (52%) obtained a positive result at least to one allergen. Nickel (21%, 7 patients) was the most frequent allergen. The hands were the most affected site (18%, 16 patients). Conclusion: The patch test is a safe test and a fundamental tool in the diagnosis of allergic contact dermatitis. It allows to find the allergen involved and thus avoid its exposure as a fundamental part of the therapy.Fil: Cheseé, Clara. Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de DermatologíaFil: Abaca, María Celeste. Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de DermatologíaFil: Bassotti, Adriana. Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de DermatologíaFil: Parra, Viviana. Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de Dermatologí

Exploring cycling and sports in people with a lower limb amputation: prosthetic aspects

Many people begin cycling since childhood and later commute daily by cycling. Sometimes, cycling can become part of a social activity. Nevertheless, information on how many people cycle after a lower limb amputation, why or why not is limited. This thesis explored cycling participation of people with a lower limb amputation and factors predicting cycling, particularly toward the use of prostheses. After the amputation, the results of the reviews showed 4-48% of people cycled. Surveys showed 47% and 67% of people cycled in Thailand, and the Netherlands respectively for health benefits, recreation and transportation. Socioeconomic, personal, and environmental factors, including prostheses and bicycles, influenced cycling. For example, a prosthetic foot with more ankle motions increased cycling likelihood. Another example is people with a higher functional level were more likely to cycle than people who use a cane, crutch, walker or have comorbidities. Moreover, people with a higher perceived number of cycling facilitators were more likely to cycle.Thai recreational cyclists were more satisfied with the prosthesis than non-cyclists. Athletes with a lower limb amputation were satisfied with the prosthetic sports foot. The performance was the key factor determining the sports foot satisfaction. For those reasons, it is important for people with a lower limb amputation to get a prosthesis and training that match their desired activities participation. Involved professionals should evaluate how to increase the number of facilitators and reduce barriers in order to promote cycling for health benefits and social inclusion of all people in society

Contact Sensitivity in Patients with Atopic Dermatitis

Atopic dermatitis (AD) is a common chronic and relaps- ing, non-contagious inflammatory skin disorder, characterized by skin barrier impairment and baseline immune irregularities. The literature on the relationship between AD and cutaneous delayed- type hypersensitivity is inconclusive. There is an ongoing debate whether contact sensibility (CS) is found more or less often among patients with AD. Aim of the study was to evaluate the incidence of contact sensitivity (positive patch test reactions) in patients with and without AD. We patch tested a total of 2143 patients (563 men and 1580 women). There were 226 patients with history of AD; 61 (27%) men and 165 (73%) women. The patient group without AD consisted of 1917 patients, 502 (26%) male and 1415 (74%) female patients, who were referred to our Department with clinical suspicion of al- lergic contact dermatitis (ACD). A patch test was performed with the baseline series, and readings were performed on days D2, D3, and D7. Among patients with AD, 109 (48.2%) had a positive patch test reaction to at least one allergen, whereas 1094 (57.1%) patients with no history of AD had a positive patch test reaction. The most common positive allergens in patients with AD were nickel (II) sulfate (13.3%), thimerosal (12.4%), cobalt (II) chloride (11.5%), methylisothi- azolinone (MI) (8.4%), fragrance mix I (6.6%), potassium dichromate (5.3%), methyldibromo glutaronitrile (4.0%), and carba mix (4.0%). The results of our study agree with previous findings that there is no significant difference in prevalence of CS between the atopic and nonatopic populations

Gaining insight in factors associated with successful ageing: body composition, nutrition, and cognition

Frailty is defined as a geriatric condition characterized by an increased vulnerability to external stressors, leading to a loss of reserve capacity. This condition is characterized by a loss of muscle mass. Muscle ultrasound might play an important role in quantifying this loss, and therefore the validity and reliability of muscle ultrasound was investigated. Furthermore, this thesis aimed to identify methods for determining malnutrition and lastly we investigated the influence of nutrition and exercise on psychosocial frailty. This thesis shows that muscle ultrasound is a valid and reliable method for determining muscle size. Currently, muscle ultrasound cannot be used to diagnose sarcopenia and malnutrition because in both definitions it is not muscle size, but (whole body) muscle mass that is determined. Determining muscle size is important as it provides possibilities for starting targeted interventions. For example, in the event of loss of muscle mass in the lower limbs, exercise intervention may be indicated as part of the treatment. Another recommendation from this thesis is that normative data for muscle size should be determined, in order to be included in the criteria of sarcopenia and malnutrition. This dissertation also suggests that a healthy diet plays an important role in cognitive functioning and that protein intake contributes to the maintenance of muscle mass

Individuals with filaggrin-related eczema and asthma have increased long-term medication and hospital admission costs

Background Eczema and asthma are chronic diseases with onset usually before the age of 5 years. More than 50% of individuals with eczema will develop asthma and/or other allergic diseases. Several loss‐of‐function mutations in filaggrin (FLG) have been identified in patients with eczema. However, the association of FLG with healthcare use is unknown. Objectives To determine whether FLG mutations are associated with increased prescribing for eczema and asthma and whether increased prescribing is associated with increased healthcare costs. Methods A secondary analysis of BREATHE, a cross‐sectional study of gene–environment associations with asthma severity, was undertaken. BREATHE data was collected for 1100 participants with asthma, in Tayside and Fife, Scotland during the period 2003–2005. Through collaboration with the Health Informatics Centre in Dundee, BREATHE was linked to accident and emergency, community prescribing and Scottish morbidity records. The data linkage allowed longitudinal exploration of associations between genetic variation and prescribing. Results An association was found between FLG mutations and increased prescribing for mild and moderate eczema, asthma‐reliever medicine and asthma exacerbations. A strong association was found between FLG mutations and prescribing of emollients [incidence rate ratio (IRR) 2·19, 95% confidence interval (CI) 1·36–3·52], treatment for severe eczema (IRR 2·18, 95% CI 1·22–3·91) and a combination of a long‐acting β2‐agonist and corticosteroids (IRR 3·29, 95% CI 1·68–6·43). Conclusions The presence of FLG mutations in this cohort is associated with increased prescribing for eczema and asthma. Randomized controlled trials are required to determine if these individuals could benefit from management strategies to reduce morbidity and treatment costs

Verbindingen tussen agrarische ondernemers en burgers. Verkennend onderzoek naar verschillende typen verbindingen

Agrarische ondernemers en burgers zijn in de loop der jaren van elkaar verwijderd geraakt. Veel burgers komen nog maar weinig op het platteland, kennen geen boeren meer en het voedsel dat ze kopen komt niet meer van de boer om de hoek. Deze ontwikkelingen kunnen ertoe leiden dat het maatschappelijk draagvlak voor de land- en tuinbouw afneemt. Tegelijkertijd is er ook een andere trend waarneembaar; een trend waarin steeds meer ondernemers burgers bij hun bedrijf betrekken, ze uitnodigen op het bedrijf of producten en diensten aanbieden die de burger naar het bedrijf trekken. Ook veel burgers zijn actief op zoek naar een nieuwe relatie met de beheerder van het platteland en de producent van zijn voedsel. Daardoor ontstaan (nieuwe) verbindingen tussen boeren en burgers. Hierbij is niet alleen sprake van een economische relatie maar ook van een proces van opgaan in de maatschappij, van vermaatschappelijken. Onderwerp van dit onderzoek zijn de (nieuwe) verbindingen tussen agrarisch ondernemer en burger

Van picknickplek tot ecoduct Over mensenwensen voor natuur 17 april 2009

Onder de titel 'Van picknickplek tot ecoduct' discussieert het Consumentenplatform van het ministerie van LNV op 17 april over natuur. De nadruk ligt daarbij op de relatie tussen de wensen voor natuur (als burger of consument) en het natuurbeleid. In dat kader komt LNV met een achtergrondsdocument. Natuur is een bekend begrip bij de consument, maar het begrip wordt vaak zeer divers opgevat: van weiland tot Waddenzee, van koeien in de wei tot vissen in de vijver. Een ruime meerderheid van de consumenten (95%) verwacht dat er de komende 25 jaar wel iets gaat veranderen in de Nederlandse natuur. 36% verwacht dat de natuuroppervlakte gaat verdwijnen en nog eens 35% vermoedt dat er meer woningen en wegen worden gebouwd ten koste van natuu