Efficacy of a Hand Regimen in Skin Barrier Protection in Individuals With Occupational Irritant Contact Dermatitis.

BACKGROUND: Occupational irritant contact dermatitis (OICD) is a dif cult and hard to manage condition. It occurs more frequently in certain occupations where contact with harsh chemicals, use of alcohol-based disinfectants, and frequent hand washing heightens the risk. Treatment for OICD includes patient education in addition to physical, topical, and systemic therapies. OBJECTIVE: To review the pathogenesis and treatment options for OICD and evaluate the ef cacy of a selective skin-care regimen involv- ing a hand protectant cream alone as well as combined with a repair cream and speci c cleanser. MATERIALS AND METHODS: A single-center open study was performed comprising 42 healthy male and female adult volunteers prone to occupational irritant contact dermatitis due to frequent wet work or contact with detergents. Between day 0 and day 7, subjects applied a hand protectant cream as needed on both hands (at least twice daily). On days 7 to 14, subjects applied a hand protectant cream and cleanser as needed on both hands (at least twice daily) as well as a repair cream each evening. A diary log was given to each volunteer for application control and for a subjective evaluation of daily tolerability. RESULTS: In these subjects prone to occupational irritant contact dermatitis, the hand protectant cream applied during the initial 7-day period was effective in restoring the damaged skin barrier and improving the stratum corneum hydration. A regimen that combined the hand protectant and repair creams with a speci c cleanser during a further 7-day period allowed contin- ued improvement of skin hydration and additional clinical bene ts while respecting the skin barrier function. CONCLUSION: The results of this study support the use of a 3-step approach for patients who are at risk of repeated exposure to external irritants. J Drugs Dermatol. 2016;15(suppl 11):s81-85..

Stratum Corneum Abnormalities and Disease-Affected Skin: Strategies for Successful Outcomes in Inflammatory Acne.

Stratum corneum (SC) abnormalities are associated with disease-affected skin conditions such as inflammatory acne. Current topical acne treatment options including benzoyl peroxide and retinoids can worsen the barrier dysfunctions by increasing transepidermal water loss, depleting SC vitamin E levels, and relatively decreasing SC thickness. However, strategies exist to employ these treatments in a more effective manner and lessen barrier function disruption including use of less irritating vehicles or concomitant application of moisturizers. Patients also play a role in the outcome of their skin barrier function based on their compliance and administration technique. By increasing patient compliance and proper application of treatments, patient skin barrier function can improve. Additionally, future treatments are on the horizon that may customize acne therapy at a molecular level.

J Drugs Dermatol. 2016;15(10):1170-1173.

[What are the reasons for patient dropout in nursing home residents in an intervention study. An analysis of unit nonresponders in 12 German nursing homes]. / Welche Ausfallursachen liegen bei Pflegeheimbewohner(inne)n in einer Interventionsstudie vor? Eine Analyse der Unit-Nonresponder in zwölf deutschen Pflegeheimen.

BACKGROUND: Non-response bias is a major problem for the validity of survey answers. Analyses of reasons for non-response in surveys with nursing home residents (NHR) are scarce. AIM AND METHOD: The aim of this study was to develop reliable and valid categories which represent reasons for non-response in nursing homes using the "Prozessmodell induktiver Kategorienbildung" following Mayring (2010). Furthermore, characteristics of unit non-responder and responder were compared. RESULTS: Forming of categories of reasons for non-response was conducted with 522 NHR, longitudinally. Four major categories were identified (general refusal, health reasons, accessibility, excessive demand) and further 17 subcategories. Unit-non-responder and responder did not differ in age and sex; however follow-up non-responder showed differences in marital status, training qualification, and cognitive status. CONCLUSIONS: The presented scheme of categories can be used to assess reasons for non-response in nursing homes. Standardised assessment of reasons for non-response may contribute to higher response rates in this setting.

Synthesis and materials chemistry of bismuth tris-(di-i-propylcarbamate): deposition of photoactive Bi2O3 thin films.

The bismuth carbamate Bi(O2CNPr(i)2)3, a tetramer in the solid-state, has been synthesized and used to deposit mixtures of bismuth oxides by aerosol-assisted chemical vapor deposition (AACVD). The nature of the deposited oxide is a function of both temperature and run-time. Initially, δ-Bi2O3 is deposited, over which grows a thick layer of ß-Bi2O3 nanowires, the latter having an increasing degree of preferred orientation at higher deposition temperatures. The photocatalytic activity of a thin film of δ-Bi2O3 for the degradation of methylene blue dye was found to be similar to that of a commercial TiO2 film on glass, while the film overcoated with ß-Bi2O3 nanowires was less active. Exposure of Bi(O2CNPr(i)2)3 to controlled amounts of moist air affords the novel oxo-cluster Bi8(O)6(O2CNPr(i)2)12, whose structure has also been determined.

Review and assessment of global and domestic ultraviolet light protection programs.

Skin cancer is the most commonly diagnosed cancer in the United States. A number of UV protection programs have been developed and initiated both globally and domestically, and this article will review and assess the effectiveness of each of these programs. The programs reviewed in this article target grade school aged children, as this is a time when adult health behaviors are being formed. Among these programs, multiunit programs were more effective at changing behavior as they were given over a longer period of time with more frequent interventions and included various learning techniques.

Targeted therapy for cutaneous oncology: a review of novel treatment options for non-melanoma skin cancer: part I.

The field of cutaneous oncology is exploding with innovative treatment options, specifically in the field of targeted therapy. These advances offer new hope to select patients with high risk skin cancers. Here we provide a two part series reviewing targeted therapy for non-melanoma skin cancer. We begin our discussion with basal cell carcinoma, moving beyond the first-in-class hedgehog inhibitors and highlighting promising clinical trials.

Targeted therapy for cutaneous oncology: a review of novel treatment options for non-melanoma skin cancer: part II.

The field of cutaneous oncology is exploding with innovative treatment options, specifically in the field of targeted therapy. These advances offer new hope to select patients with high risk skin cancers. In part two of our series on targeted therapy for skin cancer, we focus our attention on squamous cell carcinoma. We begin with the epidermal growth factor receptor inhibitors and branch out into newer areas of active research.

Functional consequences of structural differences in stingray sensory systems. Part I: mechanosensory lateral line canals.

Short range hydrodynamic and electrosensory signals are important during final stages of prey capture in elasmobranchs (sharks, skates and rays), and may be particularly useful for dorso-ventrally flattened batoids with mouths hidden from their eyes. In stingrays, both the lateral line canal and electrosensory systems are highly modified and complex with significant differences on ventral surfaces that relate to feeding ecology. This study tests functional hypotheses based on quantified differences in sensory system morphology of three stingray species, Urobatis halleri, Myliobatis californica and Pteroplatytrygon violacea. Part I investigates the mechanosensory lateral line canal system whereas part II focuses on the electrosensory system. Stingray lateral line canals include both pored and non-pored sections and differ in branching complexity and distribution. A greater proportion of pored canals and high pore numbers were predicted to correspond to increased response to water flow. Behavioral experiments were performed to compare responses of stingrays to weak water jets mimicking signals produced by potential prey at velocities of 10-20 cm s(-1). Bat rays, M. californica, have the most complex and broadly distributed pored canal network and demonstrated both the highest response rate and greater response intensity to water jet signals. Results suggest that U. halleri and P. violacea may rely on additional sensory input, including tactile and visual cues, respectively, to initiate stronger feeding responses. These results suggest that stingray lateral line canal morphology can indicate detection capabilities through responsiveness to weak water jets.

Functional consequences of structural differences in stingray sensory systems. Part II: electrosensory system.

Elasmobranch fishes (sharks, skates and rays) possess highly sensitive electrosensory systems, which enable them to detect weak electric fields such as those produced by potential prey organisms. Different species have unique electrosensory pore numbers, densities and distributions. Functional differences in detection capabilities resulting from these structural differences are largely unknown. Stingrays and other batoid fishes have eyes positioned on the opposite side of the body from the mouth. Furthermore, they often feed on buried prey, which can be located non-visually using the electrosensory system. In the present study we test functional predictions based on structural differences in three stingray species (Urobatis halleri, Pteroplatytrygon violacea and Myliobatis californica) with differing electrosensory system morphology. We compare detection capabilities based upon behavioral responses to dipole electric signals (5.3-9.6 microA). Species with greater ventral pore numbers and densities were predicted to demonstrate enhanced electrosensory capabilities. Electric field intensities at orientation were similar among these species, although they differed in response type and orientation pathway. Minimum voltage gradients eliciting feeding responses were well below 1 nVcm(-1) for all species regardless of pore number and density.

Hairstylists' experience with chronic hair pulling.

This study examined 88 hairstylists' awareness, exposure, and perceptions about treatment for people with trichotillomania (TTM). We investigated the influence of hairstylists' obtained educational level, years of experience, and understanding of TTM in relation to their willingness to refer clients for mental health treatment. Results indicate that hairstylists notice hair loss and discussed this with their clients. Hairstylists generally reported a favorable opinion of psychotherapy and a willingness to refer clients to mental health professionals. No measured variables (e.g. experience, education, or awareness of TTM) predicted willingness to refer clients for treatment. Overall, the results from this study suggest that hairstylists may aid in the early identification of TTM symptoms, particularly for females because a greater proportion of clients seen by hairstylists are females and females more commonly present with symptoms of TTM.

Exploring attitudes of healthcare professionals towards ICT-based interventions for nursing home residents with dementia: a mixed-methods approach.

BACKGROUND: Information and Communication Technologies (ICTs) could be useful for delivering non-pharmacological therapies (NPTs) for dementia in nursing home settings. AIMS: To identify technology-related expectations and inhibitions of healthcare professionals associated with the intention to use ICT-based NPTs. DESIGN: Cross-sectional multi-method survey. METHODS: N = 205 healthcare professionals completed a quantitative survey on usage and attitudes towards ICTs. Additionally, N = 11 semi-structured interviews were conducted. RESULTS: Participants were classified as intenders to use ICTs (53%), non-intenders (14%) or ambivalent (32%). A MANCOVA revealed higher perceived usefulness for intenders compared to non-intenders and ambivalent healthcare professionals (V =.28, F(12, 292)= 3.94, p <.001). Qualitative interviews revealed generally high acceptance of ICTs in the workplace. Furthermore, benefits for residents emerged as a key requirement. CONCLUSION: Staff trainings should stress specific benefits for residents and healthcare professionals to facilitate successful implementation and acceptance of ICTs in nursing home settings.

Comprehensive Tuberculosis Testing for the Dermatologist.

Tuberculosis remains a noteworthy disease worldwide, rendering detection of latent tuberculosis of great importance. As healthcare workers, dermatologists should be aware of the available testing options and how they compare. In general, the tuberculin skin test has been around longer and, thus, there have been more studies performed on its sensitivity and specificity compared to interferon gamma release assays, which are newer to the market. The tuberculin skin test requires more office visits, takes longer to obtain results, is subject to healthcare worker bias, and can cause a booster phenomenon; whereas, interferon gamma release assays have a higher cost and less data available on their use in children under five years old. Both the tuberculin skin test and interferon gamma release assays fail to differentiate between recent and remote infections, have a low predictive value for active tuberculosis, and a lower sensitivity in people living with human immunodeficiency virus/acquired immunodeficiency syndrome.

HIV incidence appears constant in men who have sex with men despite widespread use of effective antiretroviral therapy.

OBJECTIVE: To estimate the trend in HIV incidence between 1995 and 2001 in men who have sex with men (MSM) attending sexually transmitted infection (STI) clinics in the UK. DESIGN: The Serological Testing Algorithm for Recent HIV Seroconversion (STARHS) was applied to serum specimens from MSM attending 15 STI clinics collaborating in an HIV unlinked anonymous prevalence serosurvey. METHODS: STARHS was performed on anti-HIV-1 positive specimens and HIV incidence rates determined. Specimens from MSM with previously diagnosed HIV or an AIDS defining condition were excluded. National data on uptake of antiretroviral therapy (ART), AIDS mortality and diagnoses of gonorrhoea in MSM were used to aid interpretation of the HIV incidence findings. RESULTS: Of 43,100 specimens collected from MSM 3565 were anti-HIV-1 positive. Of these, 1645 were eligible and available for STARHS testing, of which 317 were deemed to come from recently acquired infections. The overall estimated annual incidence ranged from 1.5% (1999) to 3.3% (1996). In 2001 it was 2.45%, with a 3.1% incidence in London and 1.0% elsewhere. No significant trends in HIV incidence were found. CONCLUSIONS: Despite the widespread use of ART there was no significant decline in HIV incidence. Individuals whose HIV infection has been diagnosed should be less infectious. However, over 20% of infections in MSM remain undiagnosed, many with acute STI, and this pool of unmanaged HIV infection may be an important driver of the ongoing epidemic. Initiatives to diagnose and treat a greater proportion of HIV infections may be the key to reducing HIV incidence in MSM.

Battling a diploma mill: the early fight to preserve the osteopathic principles of A.T. Still.

Andrew Taylor Still, MD, DO, founded the first school of osteopathy, the American School of Osteopathy (ASO), in 1892. Two graduates from the second class of the ASO, Elmer and Helen Barber, opened the "second school of osteopathy," the National School of Osteopathy (NSO), in 1895. The guiding principles of the NSO were vastly different than those of the ASO, and Still saw the Barbers as a threat to his founding osteopathic philosophy and their school as a "diploma mill." In the present article, the author uses primary historical documents to detail the battle between the ASO and the NSO and thus provides a snapshot of the early fight to gain respect within the medical community.

Periodontal pathogens and reactivation of latent HIV infection: a review of the literature.

PURPOSE: Infection by the human immunodeficiency virus (HIV) causes the host to have a compromised immune system due to the virus's ability to infect cells of the immune system, such as helper T-cells (specifically CD4+ T-cells), macrophages and dendritic cells. HIV remains latent within these cells, which function as memory cells and remains in the body for years. People who have a compromised immune system caused by HIV are more highly susceptible to other infections, including periodontal disease. Until recently, very little attention has been given to the potential interactions between chronic oral infections, such as periodontal disease and latent HIV reactivation/upregulation. This review focuses on the literature available between 2009 and 2011, evaluating the potential link between bacterial infections, including oral infections caused by periodontal pathogens, the reactivation of latent HIV leading to the potential failure of highly active antiretroviral therapy and acquired immunodeficiency syndrome (AIDS) progression. It has been hypothesized that infections by periodontal pathogens can stimulate reactivation of HIV-latently infected cells. Studies showed that soluble factors produced in response to periodontal pathogens by gingival cells could be indirect contributors to HIV-1 promoter activation. It was also found that the oral bacteria stimulated the HIV promoter activation in a dose-dependent and time-dependent manner. While these preliminary studies present a potential link between oral periodontal pathogens and HIV reactivation, additional clinical and epidemiological studies are needed to clarify the causal link and mechanisms of HIV latency reactivation associated with oral pathogens.

Linking sensory biology and fisheries bycatch reduction in elasmobranch fishes: a review with new directions for research.

Incidental capture, or bycatch, in fisheries represents a substantial threat to the sustainability of elasmobranch populations worldwide. Consequently, researchers are increasingly investigating elasmobranch bycatch reduction methods, including some focused on these species' sensory capabilities, particularly their electrosensory systems. To guide this research, we review current knowledge of elasmobranch sensory biology and feeding ecology with respect to fishing gear interactions and include examples of bycatch reduction methods used for elasmobranchs as well as other taxonomic groups. We discuss potential elasmobranch bycatch reduction strategies for various fishing gear types based on the morphological, physiological, and behavioural characteristics of species within this diverse group. In select examples, we indicate how an understanding of the physiology and sensory biology of vulnerable, bycatch-prone, non-target elasmobranch species can help in the identification of promising options for bycatch reduction. We encourage collaboration among researchers studying bycatch reduction across taxa to provide better understanding of the broad effects of bycatch reduction methods.