Age, sex, and disease status as determinants of skin hydration and transepidermal water loss among children with and without eczema.

PURPOSE: Skin hydration (SH) and transepidermal water loss (TEWL) are important skin biophysical parameters for assessment of childhood eczema. This study investigated whether age, sex, and disease status influence these parameters. METHODS: Skin hydration and TEWL were measured by Delfin MoistureMeterSC and Delfin Vapometer SWL5, respectively, among children aged ≤18 years with and without eczema. Disease status was evaluated using Scoring Atopic Dermatitis (SCORAD) and Nottingham Eczema Severity Score (NESS) clinical tools. RESULTS: Clinical scores and objective measurements were reviewed for 132 patients with eczema and 120 patients without eczema. In both sexes, SH was significantly higher among children aged ≤2 years with and without eczema than among children aged >2 years with and without eczema. Among children aged >2 years, SH was higher among girls with and without eczema than among boys with and without eczema. Regardless of age or sex, SH was lower among children with eczema than among children without eczema. Age-, sex-, and disease-related differences were not observed for TEWL. Skin hydration was negatively correlated with objective SCORAD (r=-0.418, P<0.001), overall SCORAD (r=-0.385, P<0.001), oedema/papulation (r=-0.243, P=0.041), lichenification (r=-0.363, P=0.002), dryness (r=-0.415, P<0.001), and intensity (r=-0.266, P=0.025). Transepidermal water loss was positively correlated with objective SCORAD (r=0.209, P=0.018), overall SCORAD (r=0.215, P=0.015), and lichenification (r=0.240, P=0.043). Skin hydration was negatively correlated with TEWL among children without eczema (r=-0.401, P<0.001), but not among children with eczema. CONCLUSION: Skin hydration can be used to distinguish clinical differences in eczema based on age, sex, and disease status.

Utility of the Pediatric Allergic Disease Quality of Life Questionnaire for childhood eczema.

BACKGROUND: Childhood atopic dermatitis (AD) is a chronic inflammatory disease associated with pruritus and sleep loss. It is important to evaluate quality-of-life (QoL) impairment objectively in atopic diseases in children. OBJECTIVES: To investigate the utility of the Pediatric Allergic Disease Quality of Life Questionnaire (PADQLQ) in children with eczema. METHODS: PADQLQ, Patient-Oriented Eczema Measure (POEM, a short-term subjective symptom score), Nottingham Eczema Severity Score (NESS, a long-term subjective symptom score) and Children's Dermatology Life Quality Index (CDLQI, a short-term subjective symptom score) were compared and correlations evaluated. RESULTS: PADQLQ, POEM, NESS and CDLQI correlated well with each other (n = 132 sets; Spearman correlations: rho = 0·48-0·70, P < 0·001). A Bland-Altman plot showed a reasonably good agreement between CDLQI and PADQLQ. PADQLQ showed that symptoms of asthma, allergic conjunctivitis and allergic rhinitis were present in 20-30%, 45-71% and 58-67% of children with AD, respectively. Nevertheless, there was no association of eczema symptomatology by POEM or NESS with the severity of other allergic diseases. CONCLUSIONS: PADQLQ correlates well with AD-specific severity and QoL scores and reflects all allergic symptoms that holistically influence QoL in children with AD. PADQLQ is hence a composite severity score in terms of clinical symptomatology and QoL impairment for AD.

Assessment of adherence to eczema treatment in Hong Kong children.

Introduction: Eczema is the most common childhood skin problem in Hong Kong. Treatment adherence is crucial in symptom management and the effectiveness of eczema management. The Problematic Experiences of Therapy Scale (PETS) is used to assess adherence to treatment among children with eczema. Objective: This study examined the psychometric properties of the translated Chinese version of PETS (C-PETS) among parents and caregivers of children with eczema. Methods: PETS was translated into Chinese and data obtained from a convenience sample of 147 Chinese participants from a regional hospital in Hong Kong. Results: The internal consistency of C-PETS with a Cronbach's α of 0.93 and good test-retest reliability with weighted Kappa ranging from 0.74 to 0.89 were obtained. Significant positive correlations were found among the C-PETS, Children's Dermatology Life Quality Index (r = 0.25, p = .002), and Severity Grading of Atopic Dermatitis scores (r = 0.38, p = .001). A significant negative correlation was found between C-PETS and Chinese adaptation of Generic Self-Efficacy scale (r = -0.40, p = .001). Confirmatory factor analysis showed that the data supported the structural validity of C-PETS. Conclusion: This study indicates that C-PETS is a reliable and valid measure to evaluate treatment adherence for Chinese parents and caregivers of children with eczema.

Biotyping of Campylobacter pylori.

Ninety-one biochemical tests were done on each of 50 strains of Campylobacter pylori isolated from the gastric mucosa of patients with gastritis and peptic ulcers in Singapore. The API ZYM system distinguished three biotypes of C. pylori. The organism was found to be biochemically different from C. jejuni and C. coli. We propose a biochemical identification kit that would be of use in identifying and differentiating biotypes of C. pylori, and would distinguish them from C. jejuni and C. coli.

Incision depth vs. incision number in the rupture strength of pig eyes following radial keratotomy.

The effects of incision depth and the number of incisions on globe rupture were studied in porcine enucleated eye model. In one group, radial keratotomy was performed using a diamond blade set at 100%, 75%, and 50% of corneal thickness. In another set of eyes, 16, 8, and 4 incisions were made with the diamond knife set at 100% of corneal thickness. The eyes were then subjected to blunt trauma. The mean energy of globe rupture for incisions at 100%, 75%, and 50% of corneal thickness was 3.0, 4.2, and 4.6 joules respectively. In contrast, mean energy of globe rupture for 16, 8, and 4 incisions at 100% corneal thickness was 2.8, 2.9, and 3.0 joules, respectively. This study suggests that incision depth in radial keratotomy reduces the strength of the cornea more than incision number.

Attitudes of physical therapists in Wisconsin toward disabled persons.

This article contains descriptive statistics on attitudes toward disabled persons of a population of physical therapist. The instrument used to measure attitudes was the Attitudes Toward Disabled Persons Scale-Form A. The population for this study was the 553 physical therapists listed in the 1976-77 Directory of the Wisconsin Chapter of the American Physical Therapy Association, and living in Wisconsin. From this population, a sample of 125 (22.5%) completed and returned the form. A table of normative data in the form of percentiles was developed, along with a table of descriptive statistics that include the median, the quartile deviation, and measures of skewness and kurtosis.

Comparison of culture and histology for the identification of Helicobacter pylori in endoscopic biopsies.

The aim of the study was to compare culture with microscopic examination of haematoxylin and eosin stained tissue sections in the identification of Helicobacter pylori in gastric antral mucosa. Duplicate gastric antral biopsies from 89 patients were cultured and examined histologically for H pylori. H pylori was cultured in 46 cases (51%) and identified histologically in 63 (71%). Results from the two tests concurred in 63 cases (71%). The presence of H pylori was strongly correlated with histological gastritis. Microscopic examination of haematoxylin and eosin stained tissue sections is therefore a reliable and convenient method of identifying H pylori.

Keratoconjunctivitis sicca in female patients infected with human immunodeficiency virus.

We recently reported keratoconjunctivitis sicca (KCS) occurring as a single entity in approximately 20% of male patients testing positive for human immunodeficiency virus (HIV). In a subsequent study of HIV-positive females (n = 59; age range: 23 to 42 years), ten were found to have clinical signs and symptoms of KCS. The Schirmer test without anesthetic was performed on these patients, as well as on ten HIV negative females in the same age range. Reported as mean +/- 1 standard deviation, the result of the Schirmer test was 5.6 +/- 4.1 mm of wetting in the HIV-positive group, and 15.6 +/- 7.8 mm of wetting in the control group. The mean tear osmolarity test value of the HIV-positive patients was 318.8 +/- 9.5 mOsm/L, with 18 of the 20 suspect eyes testing positive for KCS. The tear osmolarity value among the female control patients was 304.1 +/- 5.9 mOsm/L, with one of the 20 eyes testing positive for KCS. We conclude from the data that KCS occurs at a significantly greater rate in HIV positive females than in the general population.

Computed tomography of pressure sores, pelvic abscess, and osteomyelitis in patients with spinal cord injury.

Nine patients with spinal cord injury (SCI) and large pressure ulcers and other possible complications, were evaluated by computed tomography (CT), conventional radiography, tomography, bone scanning, gallium scanning, and sonography. CT revealed the depth, extent, and relationship of the ulcer-bed to the underlying structures in all 9 patients. CT also positively identified unsuspected intra- and extra-pelvic abscess and pelvic osteomyelitis in 4 patients each. Other modalities identified only 2 of these complications. We believe CT is the modality of choice for evaluation of these complications in SCI patients, because of its superior ability in evaluation of pressure sores and detection of pathologic changes in soft tissue and bone in the pelvic region.