Hauterkrankungen des Säuglings

Viele Hauterkrankungen des Kindesalters zeigen in der Symptomatik Ähnlichkeiten zu denen im Erwachsenenalter - dennoch gibt es Charakteristika, die typisch für das Säuglingsalter sind. Die Säuglingshaut ist vermehrt verletzlich, da die dermoepidermale Verzahnung noch nicht voll ausgebildet ist. Harmlose transitorische Veränderungen sind die neonatale Talgdrüsenhyperplasie, Milien, die transiente neonatale pustulöse Melanose, Miliaria rubra und cristallina und die Akne neonatorum. Die Aplasia cutis congenita, vaskuläre Anomalien und kongenitale melanozytäre Naevi zählen zu den häufigeren angeborenen Fehlbildungen der Haut. Eine Erythrodermie im Säuglingsalter ist potenziell bedrohlich. Mögliche Auslöser sind Infektionen (Staphylokokken, Candida), kongenitale Ichthyosen, Immundefizienzen, Stoffwechselerkrankungen und Dermatosen wie atopische Dermatitis, seborrhoische Dermatitis oder Arzneimittelreaktionen. Die differenzialdiagnostische Palette zu Blasen- und Bläschenbildung im Kindesalter reicht von Infektionen bis hin zu Epidermolysis bullosa, Incontinentia pigmenti, Mastozytose und Langerhanszellhistiozytose. Bei den Säuglingsekzemen steht klar die atopische Dermatitis im Vordergrund, daneben seborrhoisches Ekzem, Kontaktekzem oder eine Zinkmangeldermatitis. Nicht selten imitiert eine Skabiesinfestation beim Säugling das Bild einer akuten atopischen Dermatitis. Die Skabies kann auflichtmikroskopisch sehr gut diagnostiziert werden und in der Regel ist kein Direktpräparat notwendig. Besonders gute Aufklärung und Therapieplanung ist beim Einsatz von topischen Kortikoiden im Kindesalter notwendig, um die Compliance bei den Eltern zu fördern sowie das Rebound-Phänomen und mögliche Hautatrophie zu vermeiden. Topische Calcineurininhibitoren haben nach ca. 12 Jahren breiter Anwendung bei Kindern kein erhöhtes onkogenes Risiko gezeigt und sind insbesondere für die Anwendung im Gesicht und im Windelbereich als Alternative zu Kortikosteroiden ideal

Time perception and impulsivity: A proposed relationship in addictive disorders

International audienceAddictive disorders are characterized by impulsive behavior that leads to difficulties in preventing certain behaviors despite negative consequences. This symptom predisposes to a vulnerability in developing addictive disorders and is also aggravated by the addiction process itself. As such, understanding the underlying mechanisms of impulsivity is a challenge for understanding the pathophysiology of addiction. One common link between impulsivity and addiction is that both involve actions and decisions that are realized faster than they should be in time. Impulsive traits increase the tendency to choose immediate gratification instead of delayed gratification even when preferred. This observation suggests a relationship between impulsivity and time processing. To better understand this relationship, we reviewed the literature that describes the relationship between time processing and impulsivity in addictive disorders in humans. Despite a lack of literature concerning this question in alcohol, cannabis and gambling disorders, we highlight that addictive behaviors are a good model for understanding the pathophysiology of impulsivity, and could help us to better understand the relationship between time perception and impulsivity

Chronic treatment with a melatonin agonist in old hamsters facilitates resynchronization of the circadian clock after abrupt shifts in the light-dark circle

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A melatonin agonist facilitates circadian resynchronization in old hamsters after abrupt shifts in the light-dark cycle

Age-related changes in the mammalian circadian system may be associated with a decline in circulating melatonin levels. Using 'jet lag' paradigms involving abrupt shifts in the light-dark cycle, we showed that a melatonin agonist, S-20098, accelerated by ~25% resynchronization of the circadian activity rhythm in old hamsters to the new light-dark cycle. It suggests the usefulness of melatonin-related compounds to treat circadian disorders associated with aging. Copyright (C) 2000 Elsevier Science B.V.SCOPUS: sh.jinfo:eu-repo/semantics/publishe

Hormonal and behavioral effects of prenatal stress: focus on sleep and circadian rhythms

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High corticosterone levels in prenatally stressed rats predict persistent paradoxical sleep alterations.

Prenatal stress predisposes rats to long-lasting disturbances that persist throughout adulthood (e.g. high anxiety, dysfunction of the hypothalamo-pituitary-adrenal axis, and abnormal circadian timing). These disturbances parallel to a large extent those found in depressed patients, in which hypercortisolemia and sleep alterations may be related to stress-inducing events. We studied sleep-wake parameters in control and prenatally stressed adult rats (3-4 months old) and examined possible relationships with their corticosterone levels (determined at 2 months of age). Under baseline conditions, prenatally stressed rats showed increased amounts of paradoxical sleep, positively correlated to plasma corticosterone levels. Other changes include increased sleep fragmentation, total light slow-wave sleep time, and a slight decrease in the percentage of deep slow-wave sleep relative to total sleep time. During recovery sleep from acute restraint stress, all sleep changes persisted and were correlated with stress-induced corticosterone secretion. High corticosterone levels under baseline conditions as well as an acute stress challenge may thus predict long-term sleep-wake alterations in rats. Taken together with other behavioral and hormonal abnormalities in prenatally stressed animals, the pronounced changes in sleep-wake parameters that are similar to those found in depressed patients suggest that prenatal stress may be a useful animal model of depression.Journal ArticleResearch Support, Non-U.S. Gov'tSCOPUS: ar.jinfo:eu-repo/semantics/publishe

Stress and salivary cortisol in emergency medical dispatchers: A randomized shifts control trial.

Stress at work is a public health concern. Phone operators in emergency medical dispatch centers are particularly at risk. We aimed to demonstrate that the most stressful time for emergency medical dispatchers is the shift when they receive emergency incoming calls, with cortisol as a biomarker of stress. For each emergency medical dispatcher, we measured outcomes over a control day and during three types of shift: Incoming emergency call, Dispatch and Re-assessment. The pattern of shifts was randomized. Saliva was sampled every 15 minutes for 2 hours, i.e. 6 consecutive times, starting 15 minutes after the first life-and-death incoming emergency call between 2 and 5 pm during three types of shift. We measured saliva cortisol every 2 hours over a control day, from 7am to 9pm. Perceived stress was assessed by a visual analog scale. We recruited 22 phone operators aged 36.4+/-10.8 years old (14 women and 8 men). Cortisol values were higher during the Incoming emergency call shift than during the Dispatch (p = .04) and Re-assessment (p = .04) shifts. The increase in cortisol levels was greater in men than in women (p = .009). There were no differences between control values and those of the three shifts. The kinetics of cortisol increased with greater perceived stress overall (p < .001) and for each type of shift (Incoming emergency call, p = .02; Dispatch p = .03; Re-assessment: p < .001). The kinetics of cortisol in response to incoming emergency calls was greater when the call was an absolute emergency (p = .03), and also tended to further increase when a subsequent absolute incoming emergency call was received (p = 0.07). In conclusion, the incoming emergency call shift carries particular risk for dispatchers, who have greater perceived stress and a greater increase in cortisol levels