Assessment and comparison of likely density distributions in the cases of thickness measurement of skin tumours by ultrasound examination and histological analysis

Ultrasonic diagnostic methods are used to estimate the structural changes and to measure parameters of lesions of the human tissue. Nowadays, the special algorithms of medical data analysis are able to perform diagnosis and monitor the progress of treatment, efficiency of treatment methods, also to estimate the health status and to make prognosis of the diseases evolution. The aim of the presented research is to check the goodness of fit test for thicknesses of the skin tumours measured in two different ways (ultrasound examination and histological analysis) and to compare the compatibility of likely density of histological thicknesses distribution of the skin tumours and density of Normal distribution. As a result, the study has showed that thicknesses of the skin tumours measured by ultrasonic method are strongly similar to histological values, which means that the density of ultrasonic thicknesses distribution and density of Normal distribution are closely interconnected. Therefore, the obtained results show the sufficient level of reliability in the case of application of non-invasive ultrasonic thickness measurement comparing with reference invasive technique based on biopsy and histological thickness evaluation

Application of automatic statistical post-processing method for analysis of ultrasonic and digital dermatoscopy images

Ultrasonic and digital dermatoscopy diagnostic methods are used in order to estimate the changes of structure, as well as to non-invasively measure the changes of parameters of lesions of human tissue. These days, it is very actual to perform the quantitative analysis of medical data, which allows to achieve the reliable early-stage diagnosis of lesions and help to save more lives. The proposed automatic statistical post-processing method based on integration of ultrasonic and digital dermatoscopy measurements is intended to estimate the parameters of malignant tumours, measure spatial dimensions (e.g. thickness) and shape, and perform faster diagnostics by increasing the accuracy of tumours differentiation. It leads to optimization of time-consuming analysis procedures of medical images and could be used as a reliable decision support tool in the field of dermatology.Keywords: Ultrasound; digital dermatoscopy; melanoma; ROC analysis; thresholding; Gaussian smoothing; nonparametric statistic

Verification of new method for automatic thickness measurement of melanocytic skin tumours by high frequency ultrasound

Histological thickness of cutaneous melanoma (CM), known as the Breslow index (pT), represents the most important prognostic factor. The objective of this study is to evaluate the reliability of automatic algorithm based on B-scan image processing of 22 MHz ultrasound (US) for measuring the thickness of CM and melanocytic nevi (MN). The thickness of CM (n = 54) and MN (n = 91) has been measured manually (mT) and automatically (aT) using an algorithm based on B-scan image processing of 22 MHz US. All melanocytic skin tumours (MST) were surgically excised and their histological thicknesses (pT) according to Breslow were evaluated. The investigated parameters were expressed as medians with interquartile range (IQR) because of their asymmetric distribution, Spearman’s correlation coefficient was determined as well. An agreement between values of mT/aT and mT/pT was evaluated by using the Bland-Altman plots. We found a good agreement of aT and mT with the moderate bias of 0.08 mm and relatively small range (95 % CI –0.01 to 0.18) in CM, accordingly 0.03 mm (95 % CI 0.00 to 0.07 mm) regarding MN. The medians of mT/pT in cases of CM and MN were 0.96 mm (IQR: 0.65-1.52) / 0.97 (IQR: 0.66-1.62) and 0.51 mm (IQR: 0.37-0.67) / 0.69 mm (IQR: 0.46-1.01) respectively. The parameters of the thickness correlated better in CM (r = 0.86) than in MN (r = 0.64) cases. The difference between manual (mT) and automatic (aT) measurements while evaluating the thickness of MST was non-significant. Therefore, automatic algorithm based on B-scan image processing of 22 MHz US is a reliable tool for measuring the thickness of MST by less experienced operators

Validation of the Wound-QoL-17 and the Wound-QoL-14 in a European sample of 305 patients with chronic wounds

The Wound-QoL assesses the impact of chronic wounds on patients' health-related quality of life (HRQoL). A 17-item and a shortened 14-item version are available. The Wound-QoL-17 has been validated for multiple languages. For the Wound-QoL-14, psychometric properties beyond internal consistency were lacking. We aimed to validate both Wound-QoL versions for international samples representing a broad range of European countries, including countries for which validation data had yet been pending. Patients with chronic wounds of any aetiology or location were recruited in Austria, Lithuania, the Netherlands, Poland, Slovakia, Spain, Switzerland and Ukraine. Psychometric properties were determined for both Wound-QoL versions for the overall sample and, if feasible, country-wise. We included 305 patients (age 68.5 years; 52.8% males). Internal consistency was high in both Wound-QoL-17 (Cronbach's α: 0.820–0.933) and Wound-QoL-14 (0.779–0.925). Test–retest reliability was moderate to good (intraclass correlation coefficient: 0.618–0.808). For Wound-QoL-17 and Wound-QoL-14, convergent validity analyses showed highest correlations with global HRQoL rating (r = 0.765; r = 0.751) and DLQI total score (r = 0.684; r = 0.681). Regarding clinical data, correlations were largest with odour (r = −0.371; r = −0.388) and wound size (r = 0.381; r = 0.383). Country-wise results were similar. Both Wound-QoL versions are valid to assess HRQoL of patients with chronic wounds. Due to its psychometric properties and brevity, the Wound-QoL-14 might be preferrable in clinical practice where time is rare. The availability of various language versions allows for the use of this questionnaire in international studies and in clinical practice when foreign language patients are being treated.</p

How does a chronic wound change a patient's social life?:A European survey on social support and social participation

Chronic wounds can severely limit patient's social life. This cross-sectional study investigated quantitatively social support of patients with chronic wounds, its association with health-related quality of life as well as qualitatively changes in social participation of these patients. Overall, 263 patients from seven countries participated. The most frequent wound class was leg ulcer (49.2%). Results revealed generally high levels of social support (mean global score: 5.5) as measured with the Multidimensional Scale of Perceived Social Support. However, individuals differed considerably (range 1.0–7.0). All dimensions of social support differed by patients' family and living situations (p &lt; 0.001 to p = 0.040) and were positively correlated with generic health-related quality of life (r = 0.136–0.172). Having children, living with others and being in a relationship were significant predictors of having higher global social support. Patients reported great support from family members. Many participants reported no changes in relationships with friends. Wound care managers took an important role and provided additional emotional support. Patients reported a range of discontinued activities. Despite the high overall level of social support, inter-individual differences should be acknowledged. The importance of family carers should be acknowledged to be able to reduce caregiver burden and to ensure high-qualitative wound care.</p

How does a chronic wound change a patient's social life? A European survey on social support and social participation

Chronic wounds can severely limit patient's social life. This cross-sectional study investigated quantitatively social support of patients with chronic wounds, its association with health-related quality of life as well as qualitatively changes in social participation of these patients. Overall, 263 patients from seven countries participated. The most frequent wound class was leg ulcer (49.2%). Results revealed generally high levels of social support (mean global score: 5.5) as measured with the Multidimensional Scale of Perceived Social Support. However, individuals differed considerably (range 1.0–7.0). All dimensions of social support differed by patients' family and living situations (p &lt; 0.001 to p = 0.040) and were positively correlated with generic health-related quality of life (r = 0.136–0.172). Having children, living with others and being in a relationship were significant predictors of having higher global social support. Patients reported great support from family members. Many participants reported no changes in relationships with friends. Wound care managers took an important role and provided additional emotional support. Patients reported a range of discontinued activities. Despite the high overall level of social support, inter-individual differences should be acknowledged. The importance of family carers should be acknowledged to be able to reduce caregiver burden and to ensure high-qualitative wound care.</p

European patch test results with audit allergens as candidates for inclusion in the European Baseline Series, 2019/20:Joint results of the ESSCA(A) and the EBSB working groups of the ESCD, and the GEIDAC(C)

Background In 2019, a number of allergens (haptens), henceforth, "the audit allergens," were considered as potential additions to the European Baseline Series (EBS), namely, sodium metabisulfite, 2-bromo-2-nitropropane-1,3-diol, diazolidinyl urea, imidazolidinyl urea, Compositae mix II (2.5% or 5% pet), linalool hydroperoxides (lin-OOH), limonene hydroperoxides (lim-OOH), benzisothiazolinone (BIT), octylisothiazolinone (OIT), decyl glucoside, and lauryl glucoside; Evernia furfuracea (tree moss), was additionally tested by some departments as well. Objectives To collect further data on patch test reactivity and clinical relevance of the audit allergens in consecutive patients across Europe. Methods Patch test data covering the audit allergens in 2019 and 2020 were collected by those departments of the European Surveillance System on Contact Allergies testing these, as well as further collaborators from the EBS working group of the European Society of Contact Dermatitis (ESCD), and the Spanish Grupo Espanol de Investigacion en Dermatitis de Contacto y Alergia Cutanea. As patch test outcome, reactions between day (D) 3 and D5 were considered. Results Altogether n = 12 403 patients were tested with any of the audit allergen. Positive reactions were most common to lin-OOH 1% pet. (8.74% [95%CI: 8.14-9.37%]), followed by lin-OOH 0.5% pet., and lim-OOH 0.3% pet (5.41% [95% CI: 4.95-5.89%]). Beyond these terpene hydroperoxides, BIT 0.1% pet. was the second most common allergen with 4.72% (95% CI: 4.2-5.28%), followed by sodium metabisulfite 1% pet. (3.75% [95%CI: 3.32-4.23%]) and Compositae mix 5% pet. (2.31% [95% CI: 1.84-2.87%]). For some allergens, clinical relevance was frequently difficult to ascertain. Conclusions Despite many positive patch test reactions, it remains controversial whether lin- and lim-OOH should be tested routinely, while at least the two preservatives BIT and sodium metabisulfite appear suitable. The present results are a basis for further discussion and ultimately decision on their implementation into routine testing among the ESCD members

Formaldehyde 2% is not a useful means of detecting allergy to formaldehyde releasers- results of theESSCAnetwork, 2015-2018

BACKGROUND Studies suggest that patch testing with formaldehyde releasers (FRs) gives significant additional information to formaldehyde 1% aq. and should be considered for addition to the European baseline series (EBS). It is not known if this is also true for formaldehyde 2% aq. OBJECTIVES To determine the frequency of sensitization to formaldehyde 2% aq. and co-reactivity with FRs. To establish whether there is justification for including FRs in the EBS. MATERIALS AND METHODS A 4-year, multi-center retrospective analysis of patients with positive patch test reactions to formaldehyde 2% aq. and five FRs. RESULTS A maximum of 15 067 patients were tested to formaldehyde 2% aq. and at least one FR. The percentage of isolated reactions to FR, without co-reactivity to, formaldehyde 2% aq. for each FR were: 46.8% for quarternium-15 1% pet.; 67.4% imidazolidinyl urea 2% pet.; 64% diazolidinyl urea 2% pet.; 83.3% 1,3-dimethylol-5, 5-dimethyl hydantoin (DMDM) hydantoin 2% pet. and 96.3% 2-bromo-2-nitropropane-1,3-diol 0.5% pet. This demonstrates that co-reactivity varies between FRs and formaldehyde, from being virtually non-existent in 2-bromo-2-nitropropane-1,3-diol 0.5% pet. (Cohen's kappa: 0, 95% confidence interval [CI] -0.02 to 0.02)], to only weak concordance for quaternium-15 [Cohen's kappa: 0.22, 95%CI 0.16 to 0.28)], where Cohen's kappa value of 1 would indicate full concordance. CONCLUSIONS Formaldehyde 2% aq. is an inadequate screen for contact allergy to the formaldehyde releasers, which should be considered for inclusion in any series dependant on the frequency of reactions to and relevance of each individual allergen

Patch test results with the European baseline series, 2019/20-Joint European results of the ESSCA and the EBS working groups of the ESCD, and the GEIDAC

BACKGROUND Continual analyses of patch test results with the European baseline series (EBS) serve both contact allergy surveillance and auditing the value of included allergens. OBJECTIVES To present results of current EBS patch testing, obtained in 53 departments in 13 European countries during 2019 and 2020. METHODS Anonymised or pseudonymised individual data, and partly aggregated data on demographic/clinical characteristics and patch test rest results with the EBS were prospectively collected and centrally pooled and analysed. RESULTS In 2019 and 2020, 22581 patients were patch tested with the EBS. Sensitization to nickel remained most common (19.8 (19.2-20.4)% positivity (95% confidence interval)). Fragrance mix I and Myroxylon pereirae yielded very similar results with 6.80 (6.43-7.19)% and 6.62 (6.25-7.00)% positivity, respectively. Formaldehyde at 2% aq. yielded almost one percentage point more positive reactions than 1% concentration (2.49 (2.16-2.85)% vs. 1.59 (1.33-1.88)); methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) and MI alone up to around 5% positives. Among the new additions, propolis was most commonly positive (3.48 (3.16-3.82)%), followed by 2-hydroxyethyl methacrylate (2.32 (2.0-2.68)%). CONCLUSIONS Ongoing surveillance on the prevalence of contact sensitization contributes to an up-to-date baseline series containing the most frequent and/or relevant contact sensitizers for routine patch testing in Europe. This article is protected by copyright. All rights reserved