Topical corticosteroid phobia in atopic dermatitis: International feasibility study of the TOPICOP score.

BACKGROUND: Adherence to topical corticosteroids (TCS) is essential for the effective treatment of atopic dermatitis but can be limited by concerns about their use. This study examined the feasibility of applying the validated TOPICOP score for assessing TCS phobia across different countries. METHODS: This was a prospective multicentre feasibility study conducted in 21 hospitals in 17 countries. Patients >3 months of age with atopic dermatitis or their parents or legal representatives completed a validated translation of the TOPICOP questionnaire in the country's native language. Respondents also completed questionnaires collecting opinions about the feasibility and acceptability of the TOPICOP questionnaire. RESULTS: A total of 1564 participants in 15 countries were included in the analysis. 81% of respondents considered the questions clear or very clear, and 79% reported that it took less than 5 minutes to complete. Each of the individual items in the TOPICOP questionnaire was considered to be not at all difficult to answer by 49% to 74% of participants. The mean global TOPICOP score was 44.7%±20.5. Mean TOPICOP subscores were 37.0±22.8% for knowledge and beliefs, 54.7±27.8% for fears and 50.1±29.1% for behaviours. Global scores and subscores differed between countries, although the subscores did not always vary in parallel, suggesting different levels of TCS phobia and different drivers for each country. CONCLUSIONS: The TOPICOP score can be feasibly applied across countries and may therefore be useful for obtaining qualitative and quantitative data from international studies and for adapting patient education and treatment.

[Complex treatment of chronic periodontitis with balneopeloid therapy].

Complex investigation and treatment has been realized on 127 patients aged from 27 to 45 years with chronic generalized periodontitis. Patients were divided into two groups. In the fist group (68 patients) complex treatment included course of balneopeloid therapy with irrigation of high mineralized natural water (sanatorium "Tumentransgas" chink №1-95, Ugorsk) followed by application of sapropel mud (the Pake lake). The second group (59 patients) received only conventional periodontal treatment. Positive effect of balneopeloid therapy was identified, which was reflected in stabilizations of pathological process in the periodontal tissues in 78% of patients, as well as changes in physical and chemical properties of the oral gluid. Also the number of periodontopahogenic germs of gingival pockets was decreased.

[Differentiated physiotherapy of lumbar pain].

The results of the present study confirm the efficacy of combined differential treatment of pain sensation in the lower back with the use of the up-to-date physiotherapeutic methods. The choice of a concrete method depended on the mechanism of development of the vertebral syndrome (compression, disfixation, disgenia or aseptic inflammation). The treatment resulted in the improvement of major integral characteristics of the pathological process, marked reduction in the duration of therapy, and significant prolongation of the remission period.

[Protective effect of Lactobacillus acidophilus on development of infection, caused by Klebsiella pneumoniae]. / Protektivnoe deistvie Lactobacillus acidophilus pri razvitii infektsii, vyzvannoi Klebsiella pneumoniae.

The mechanisms of protective action of Lactobacillus have been studied during development of the generalized infection induced by Klebsiella pneumoniae in CBA mice after weaning. The mice were infected intragastrically during the first day after weaning (1 x 10(9) bacterias per mice). Suspensions of Lactobacillus were introduced before and after infection during 10 days (1 x 10(6) bacterias per mice). It has been shown that introduction of Lactobacillus substantially decreased the level of the gut contamination by Klebsiella, prevented generalization of infection and death of animals. Significant higher levels of IgA in the blood serum, IgA and IgM in the gut content, percentage of splenocytes, expressing surface IgM and IgG were observed on the 7th day as compared with those in animals without Lactobacillus. Significantly lower percentage of splenocytes, expressing CD4 antigen was also observed. On the 11th day after infection the mice receiving lactobacillus have shown a tendency to an increase of IgA in the gut content, significantly lower concentrations of IgM in the gut content and a higher level of IgA to the blood serum as compared with the control. Other characteristics were comparable to those of the control group. A conclusion is made that introduction of Lactobacillus prevents development of the Klebsiella infection and protects the immune system from excessive antigenic action.

[Effect of Klebsiella Pneumoniae bacterial colonization of the gastrointestinal tract on the immune processes in mice after weaning]. / Vliianie kolonizatsii zheludochno-kishechnogo trakta bakteriiami semeistva Klebsiella Pneumoniae na immunnye protsessy u myshei- ot"ëmyshei.

The influence of intestinal colonization by the Klebsiella pneumonia strain 50/59 on the characteristics of local and humoral immunity has been studied on CBA mice after weaning. Bacteria have been introduced intragastrally in doses of 1 x 10(6) bacteria per mice. Observations have been performed in dynamics during 11 days. They have shown that intestinal colonization induces significant elevation of the concentration of IgA in serum, intestinal content and percentage of splenocytes, expressing receptors of IgA, IgM, CD4 on the 7th day. On the 11th day a significant decrease in these parameters was observed. A conclusion is made that intestinal colonization is not indifferent for the whole organism and induces complex influences on its immune system.

[Deformities of the dental arch and alveolar process in children related to the removal of the lower temporary molars]. / Deformatsii zubnogo riada i al'veoliarnogo otrostka u detei, sviazannye s udaleniem nizhnikh vremennykh moliarov.

A total of 279 children aged 3 to 12 years were investigated. In 59 dentition defects were detected. These were located largely (39 patients) on a lower jaw. Dentoalveolar extension was found in 28 patients aged 5 to 8 years. Dentoalveolar extension was characterized as was the position and state of dental rudiments. Of 59 children put on a regular check-up list, in 28 preventive dentures were installed to avoid secondary deformation and dentomaxillary anomalies formation.

[Sanitary and helminthic characteristics of soil]. / Sanitarno-gelmintologicheskaia kharakteristika pochvy.

Soil of 20% of economic districts of Russian Federation is slightly polluted by helminths (10 eggs per kg of soil), 64% is moderately polluted (11-100 eggs per kg), 16% much polluted (more 100 eggs per kg). Soil of agricultural fields is polluted 2-3 times more because of use of sewage and their sediments. Recommendations on protection of soil from pollution by helminths are given.

[The effect of low-energy laser radiation in the infrared spectrum on bronchial patency in children with bronchial asthma]. / Vliianie nizkoénergeticheskogo lazernogo izlucheniia infrakrasnogo diapazona na sostoianie bronkhial'noi prokhodimosti u dete, bol'nykh bronkhial'noi astmoi.

Pulsed and continuous-wave low-energy infrared laser radiations were compared for effects on bronchial patency in 139 children with bronchial asthma aged 4-15 years. The pulsed regimen improved patency of the main bronchi in atopic asthma attacks and after them, while continuous-wave regimen improved patency of the peripheral bronchi in bacterial asthma in attack-free period.

[Effects of dysbacteriosis and impairment of immunity formation in the early neonatal period on morbidity of children during the 1st year of life and ways of its reduction]. / Vliianie disbakterioza i narusheniia stanovleniia immuniteta v rannem neonatal'nom periode na zabolevaemost' detei pervogo goda zhizni i puti ee snizheniia.

The catamnesis of 124 infants has been studied in the course of 12 months by means of questionnaires. Dysbacteriosis that occur in the early neonatal period produce an unfavourable effect on the immunity establishment and increase the disease incidence among the neonates. Moreover, dysbacteriosis may later result in the impairment of the formation of tolerance to food antigens supplied to the gastrointestinal tract. The carriership of Staphylococcus aureus in the fauces occurring in the presence of the decreased characteristics of local defence and phagocytic system of the newborn favours an increase of the disease incidence in the babies as well as the formation of the chronic foci of infection in the future. Prevention of dysbacteriosis of the early neonatal period by means of the use of biopreparations, particularly of pure cultures of Lactobacillus acidophilus does not only reduce the disease incidence in children of the first year of life but also improves on the whole their health status.

[The current concepts of the influence of lactobacilli on the immune system of the human body]. / Suchasni uiavlennia pro vplyv laktobakterii na imunnu systemu orhanizmu liudyny.

The review summarizes experimental and clinical data about the influence of Lactobacillus on the immune system. A conclusion is made that the effect of Lactobacillus is a multifactor process. After entering the intestinal tract live microorganisms or biologically active substances produced by them may activate specific and nonspecific systems of microorganism protection. Experimental and clinical data about the action of Lactobacillus as adjuvants to the humoral immune response are presented. The mechanisms of anticancerogenic action of Lactobacillus and their cell wall components are analyzed in detail. The prospects for the use of Lactobacillus as probiotics in medicine are considered. The conclusion about positive value of the multifactor action of these microorganisms on the human immune system is made, since no negative effects are evoked by the discussed mechanisms of specific effect of Lactobacillus. This opens wide possibilities for the development of application schemes of probiotics from lactobacillus for the stimulation of several functions of the immune system, creation a new forms of antitumor drugs and combination of them with oral vaccines for improving their immunogenicity.

[Tuberculin sensitivity in infants and preschool children]. / Tuberkulinovaia chuvstvitel'nost' u detei rannego i doshkol'nogo vozrasta.

Marked fluctuations in sensitivity to tuberculin related to the time of nonspecific vaccinations were found in children aged 1 to 7 years vaccinated with BCG within the first week of life in annual Mantoux test (2 tuberculin units). At the age of 3 and 7 years vaccinations raise sensitivity to tuberculin causing a rise in positive reactions to tuberculin. This indicates changes in postvaccination allergy to BCG.

[Prevention of dysbacteriosis in the early neonatal period using a pure culture of acidophilic bacteria]. / Profilaktika disbakteriozov rannego neonatal'nogo perioda s pomoshch'iu chistoi kul'tury atsidofil'nykh palochek.

In order to prevent dysbacterioses occurring in the early neonatal period, 60 neonates classified with the risk group were administered, when they were still at the puerperal room, pure cultures of specially selected strains of Lactobacillus acidophilus possessing marked anti-Klebsiella activity and antagonistic activity against Staphylococcus aureus. The cultures were instilled into the mouth and nasal passages. Forty neonates administered bifidum-bacterin and 54 neonates not given biopreparations were used as control. Application of the pure culture of Lactobacillus acidophilus noticeably raised the efficacy of the preventive measures. Over 60 percent of the neonates were discharged from the maternity home with a normally formed intestinal microflora, 60 percent had normal microflora in the fauces, 80 percent in the nose, and 70 percent of the neonates demonstrated normal skin microflora. The carriage of opportunistic microorganisms in the fauces and nose of the neonates had decreased substantially by the time of the discharge from the maternity home, while the incidence of pyo-inflammatory diseases had also reduced among them.

Immunomodulatory and clinical effects of Viscum album (Iscador M and Iscador P) in children with recurrent respiratory infections as a result of the Chernobyl nuclear accident.

Ninety-two children 5 to 14 years of age living in areas exposed to the radioactive fallout from Chernobyl with recurrent respiratory infections (RRIs) were treated after randomization with either Viscum album praeparatum mali or pini (Iscador M or P). The dosage was two subcutaneous injections a week for 5 weeks with individual doses of 0.001 mg to 1.0 mg. Both Viscum album preparations were effective in significantly reducing clinical symptoms. One year after a single treatment course, the frequency of RRI relapses decreased by 78% and 73%, respectively. Immunomodulatory effects were assessed by investigation of lymphocyte subsets, natural killer (NK) cell activity, phagocytic and oxidative activity of polymorphonuclear leukocytes, and antiviral activity of serum before and 1 week after treatment. Viscum album therapy resulted in normalization of initial immune indices either below or above the normal ranges. High levels of antiviral activity before treatment were significantly decreased by Viscum album mali. Viscum album treatment should be studied further in children with RRI.