Proactive treatment of atopic dermatitis in adults with 0.1% tacrolimus ointment.

BACKGROUND: Long-term treatment for atopic dermatitis (AD) using low dose, intermittent, topical anti-inflammatory agents may control acute disease and prevent relapses. This 12-month, European, multicentre, randomized study investigated whether the proactive use of 0.1% tacrolimus ointment applied twice weekly can keep AD in remission and reduce the incidence of disease exacerbations (DE). METHODS: During the initial open-label period, 257 adults with AD applied 0.1% tacrolimus ointment twice daily (b.i.d.) for up to 6 weeks to affected areas. When an Investigator Global Assessment (IGA) score of < or =2 was achieved, the patient entered the disease control period (DCP) and was randomized to either proactive tacrolimus (n = 116) or vehicle ointment (n = 108) twice weekly for 12 months. Exacerbations were treated with 0.1% tacrolimus ointment b.i.d. until an IGA < or =2 was regained, then randomized treatment was restarted. The primary endpoint was the number of DEs during the DCP that required a substantial therapeutic intervention. RESULTS: Proactive tacrolimus 0.1% ointment application significantly reduced the number of DEs requiring substantial therapeutic intervention (median difference 2; P < 0.001; Wilcoxon rank sum test), the percentage of DE treatment days (median difference: 15.2%; P < 0.001; Wilcoxon rank sum test) and increased the time to first DE (median 142 vs 15 days; P < 0.001; stratified log-rank test). The adverse event profile was similar for the two treatment approaches. CONCLUSION: A 12-month, twice weekly proactive tacrolimus ointment application was an effective treatment in most study patients which prevented, delayed and reduced the occurrence of AD exacerbations.

Chromium exposure study in chemical based industry.

176 chromium-exposed and 30 control subjects were selected for this study. Blood samples (3 ml) were collected for the estimation of chromium. The data on chromium concentration indicated a significant higher level of chromium in the blood of the exposed workers as compared to the control. There was no significant correlation between the mean blood and environmental chromium level. This study suggests that exposure to chromium may have some effect on the health of workers, even though the dose response relationship could not be established between blood chromium and environmental chromium levels. This study suggests that exposure to chromium may have some effect on the health of workers, even though the dose response relationship could not be established between blood chromium and environmental chromium levels. Study also indicates that the environmental levels to Cr are well below the permissible levels at all the sites of the industry at the time of survey even though the blood Cr levels were observed high in 14.8% of workers and some of them were having Cr related morbidity. Therefore, preventive and engineering control measures are suggested to minimize the chromium exposure in the chromium based industry located in Gorwa industrial estate at Baroda, Gujarat. About three months period was taken to complete this study.