Determination of acetochlor and its metabolites in urine using liquid chromatography-tandem mass spectrometry / 中华劳动卫生职业病杂志

Objective: A method for the determination of acetochlor and its metabolites in urine by liquid chromatography-tandem mass spectrometry (LC-MS/MS) was established. Methods: After cleaned-up by a HLB extraction cartridges, the urine was eluted with 1% acetic acid acetonitrile solution. The target compounds were separated by ACQUITY UPLC®HSS T3 Column (2.1 mm×100 mm×1.8 μm) by using 1% formic acid solution and acetonitrile as mobile phase with gradient elution program, and analyzed in positive electrospray ionization mode by liquid chromatography tandem mass spectrometry. Results: All the target compounds showed good linear relationships in the range of 1-50 μg/L, and the correlation coefficients (r) were higher than 0.997. The recoveries rates at three different spiked levels for all target compounds in blank matrices were 107.6%-129.1%, and the relative standard deviations (RSD) were 1.5%-9.9% (n=6) . The limits of detection and quantitation of the method were 0.04-0.11 μg/L and 0.15-0.42 μg/L, respectively, and target substances were detected in all urine samples from occupational exposure workers to acetochlor. Conclusion: This method is suitable for rapid screening and analysis of acetochlor and metabolites in urine with the advantages of accuracy, rapidity, simplicity, high sensitivity and good specificity.

Novel and potent inhibitors targeting DHODH are broad-spectrum antivirals against RNA viruses including newly-emerged coronavirus SARS-CoV-2

Emerging and re-emerging RNA viruses occasionally cause epidemics and pandemics worldwide, such as the on-going outbreak of the novel coronavirus SARS-CoV-2. Herein, we identified two potent inhibitors of human DHODH, S312 and S416, with favorable drug-likeness and pharmacokinetic profiles, which all showed broad-spectrum antiviral effects against various RNA viruses, including influenza A virus, Zika virus, Ebola virus, and particularly against SARS-CoV-2. Notably, S416 is reported to be the most potent inhibitor so far with an EC of 17 nmol/L and an SI value of 10,505.88 in infected cells. Our results are the first to validate that DHODH is an attractive host target through high antiviral efficacy in vivo and low virus replication in DHODH knock-out cells. This work demonstrates that both S312/S416 and old drugs (Leflunomide/Teriflunomide) with dual actions of antiviral and immuno-regulation may have clinical potentials to cure SARS-CoV-2 or other RNA viruses circulating worldwide, no matter such viruses are mutated or not.

Novel and potent inhibitors targeting DHODH are broad-spectrum antivirals against RNA viruses including newly-emerged coronavirus SARS-CoV-2

Emerging and re-emerging RNA viruses occasionally cause epidemics and pandemics worldwide, such as the on-going outbreak of the novel coronavirus SARS-CoV-2. Herein, we identified two potent inhibitors of human DHODH, S312 and S416, with favorable drug-likeness and pharmacokinetic profiles, which all showed broad-spectrum antiviral effects against various RNA viruses, including influenza A virus, Zika virus, Ebola virus, and particularly against SARS-CoV-2. Notably, S416 is reported to be the most potent inhibitor so far with an EC of 17 nmol/L and an SI value of 10,505.88 in infected cells. Our results are the first to validate that DHODH is an attractive host target through high antiviral efficacy in vivo and low virus replication in DHODH knock-out cells. This work demonstrates that both S312/S416 and old drugs (Leflunomide/Teriflunomide) with dual actions of antiviral and immuno-regulation may have clinical potentials to cure SARS-CoV-2 or other RNA viruses circulating worldwide, no matter such viruses are mutated or not.

Novel and potent inhibitors targeting DHODH are broad-spectrum antivirals against RNA viruses including newly-emerged coronavirus SARS-CoV-2

Emerging and re-emerging RNA viruses occasionally cause epidemics and pandemics worldwide, such as the on-going outbreak of the novel coronavirus SARS-CoV-2. Herein, we identified two potent inhibitors of human DHODH, S312 and S416, with favorable drug-likeness and pharmacokinetic profiles, which all showed broad-spectrum antiviral effects against various RNA viruses, including influenza A virus, Zika virus, Ebola virus, and particularly against SARS-CoV-2. Notably, S416 is reported to be the most potent inhibitor so far with an EC of 17 nmol/L and an SI value of 10,505.88 in infected cells. Our results are the first to validate that DHODH is an attractive host target through high antiviral efficacy in vivo and low virus replication in DHODH knock-out cells. This work demonstrates that both S312/S416 and old drugs (Leflunomide/Teriflunomide) with dual actions of antiviral and immuno-regulation may have clinical potentials to cure SARS-CoV-2 or other RNA viruses circulating worldwide, no matter such viruses are mutated or not.

Sangue oculto nas fezes: uma comparação entre os métodos químico e imunoquímico / Fecal occult blood: a comparison of chemical and immunochemical tests

ABSTRACT BACKGROUND: Colorectal bleeding is a warning sign that may be identified by fecal occult blood testing. A positive fecal occult blood test result requires a subsequent colonoscopy, a costly and invasive examination. Therefore, the use of diagnostic tests with optimal sensitivity and specificity is warranted. In this study, we evaluated four different fecal occult blood tests in 176 patients undergoing colonoscopy and compared their results. OBJECTIVE: To assess the sensitivity, specificity and predictive values of chemical and immunochemical fecal occult blood tests in patients undergoing colonoscopy and to evaluate the degree of concordance between the tests and colonoscopy. METHODS: Patients with indications for colonoscopy also underwent fecal occult blood testing by chemical (toluidine test) and immunochemical methods, employing three commercially available kits. Based on the endoscopic findings, the colonoscopy was rated as positive or negative for colorectal bleeding. The degree of concordance between the fecal occult blood tests and the colonoscopy was evaluated by the kappa index. RESULTS: Forty-four (25%) colonoscopies were categorized as positive for colorectal bleeding. The toluidine test presented lower concordance than the immunochemical tests, which showed moderate concordance with the colonoscopy. The toluidine test had the least sensitivity, specificity, and positive and negative predictive values. CONCLUSION: The immunochemical fecal occult blood tests showed greater sensitivity, specificity and predictive values in detecting colorectal bleeding. The immunochemical tests had superior indexes of agreement with colonoscopy compared to the toluidine test.

RESUMO CONTEXTO: O sangramento colorretal é considerado um sinal de alarme e não deve ser ignorado. O resultado positivo de um teste de pesquisa de sangue oculto nas fezes (PSOF) requer investigação complementar com colonoscopia, exame invasivo e de alto custo. Justifica-se, portanto, a aplicação de um teste diagnóstico mais sensível e específico. No presente estudo, foram avaliados quatro diferentes testes de PSOF em 176 pacientes submetidos à colonoscopia e seus resultados foram comparados. OBJETIVO: Avaliar a sensibilidade, a especificidade e os valores de predição dos testes químico e imunoquímico de PSOF em pacientes submetidos à colonoscopia e avaliar o grau de concordância entre os testes de PSOF e a colonoscopia. MÉTODOS: Pacientes com indicação de realizar colonoscopia foram submetidos também à PSOF pelo método químico (o-toluidina) e pelo método imunoquímico, empregando três kits comerciais disponíveis no mercado. Fundamentado nos achados endoscópicos, a colonoscopia foi categorizada em positiva ou negativa, de acordo com a possível fonte de sangramento colorretal. O grau de concordância entre os testes de PSOF foi avaliado pelo índice kappa. RESULTADOS: Quarenta e quatro (25%) colonoscopias foram categorizadas como positivas quanto à fonte de sangramento colorretal. O teste da o-toluidina mostrou menor concordância que os testes imunoquímicos, os quais apresentaram moderada concordância com a colonoscopia. O teste da o-toluidina revelou menor sensibilidade, especificidade, valor preditivo positivo e valor preditivo negativo. CONCLUSÃO: Os testes imunoquímicos revelaram maior sensibilidade, especificidade e valores de predição na detecção de sangramento colorretal. Os testes imunoquímicos apresentaram melhores índices de concordância com a colonoscopia, quando comparados ao teste da o-toluidina.

Efficacy and Safety of Teriflunomide in Chinese Patients with Relapsing Forms of Multiple Sclerosis: A Subgroup Analysis of the Phase 3 TOWER Study / 中华医学杂志(英文版)

Background@#Disease-modifying therapy is the standard treatment for patients with multiple sclerosis (MS) in remission. The primary objective of the current analysis was to assess the efficacy and safety of two teriflunomide doses (7 mg and 14 mg) in the subgroup of Chinese patients with relapsing MS included in the TOWER study.@*Methods@#TOWER was a multicenter, multinational, randomized, double-blind, parallel-group (three groups), placebo-controlled study. This subgroup analysis includes 148 Chinese patients randomized to receive either teriflunomide 7 mg (n = 51), teriflunomide 14 mg (n = 43), or placebo (n = 54).@*Results@#Of the 148 patients in the intent-to-treat population, adjusted annualized relapse rates were 0.63 (95% confidence interval [CI]: 0.44, 0.92) in the placebo group, 0.48 (95% CI: 0.33, 0.70) in the teriflunomide 7 mg group, and 0.18 (95% CI: 0.09, 0.36) in the teriflunomide 14 mg group; this corresponded to a significant relative risk reduction in the teriflunomide 14 mg group versus placebo (-71.2%, P = 0.0012). Teriflunomide 14 mg also tended to reduce 12-week confirmed disability worsening by 68.1% compared with placebo (hazard ratio: 0.319, P = 0.1194). There were no differences across all treatment groups in the proportion of patients with treatment-emergent adverse events (TEAEs; 72.2% in the placebo group, 74.5% in the teriflunomide 7 mg group, and 69.8% in the teriflunomide 14 mg group); corresponding proportions for serious adverse events were 11.1%, 3.9%, and 11.6%, respectively. The most frequently reported TEAEs with teriflunomide versus placebo were neutropenia, increased alanine aminotransferase, and hair thinning.@*Conclusions@#Teriflunomide was as effective and safe in the Chinese subpopulation as it was in the overall population of patients in the TOWER trial. Teriflunomide has the potential to meet unmet medical needs for MS patients in China.@*Trial Registration@#ClinicalTrials.gov, NCT00751881; https://clinicaltrials.gov/ct2/show/NCT00751881?term=NCT00751881&rank=1.

The role of mast cells in vascularized recurrent pterygium / O papel dos mastócitos no pterígio recidivado vascularizado

Objective: To determine and compare the mast cell count in primary and recurrent vascularized pterygium, and in normal bulbar conjunctiva. Methods: The study included 22 patients with primary pterygium (PP group) and 28 patients with vascularized recurrent pterygium (VRP group) that underwent excision via the limbal conjunctival autograft technique. Normal conjunctiva samples were collected from the superotemporal bulbar conjunctival region, just temporal to the site from which the autograft conjunctival tissue was harvested. The total number of mast cells in the pterygium (primary and recurrent) and control tissue samples was calculated microscopically using 1% toluidine blue stain under 400× magnification. Results: The mean mast cell count in primary and vascularized recurrent pterygium tissue was 7.45 ± 2.06 mm–2 and 16.11 ± 4.33 mm–2, respectively, and the difference was significant (independent samples t-test, P<0.001). The mean mast cell count in pterygium tissue was significantly higher than that in normal conjunctiva tissue in both groups (Student's t-test, P<0.001). Conclusion: An increase in the number of mast cells might play a role in the pathogenesis of recurrent pterygium. Determination of a mast cell count cut-off value could be of diagnostic significance for recurrent pterygium. .

Objetivo: Determinar e comparar o número de mastócitos em pterígio primário e recidivado vascularizado, assim como em conjuntiva bulbar normal. Métodos: O estudo incluiu 22 pacientes com pterígio primário (grupo PP) e 28 pacientes com pterígio recidivado vascularizado (grupo VRP), submetidos à exérese por meio da técnica de transplante de conjuntiva autólogo de limbo. Amostras de conjuntivas normais foram coletadas da região bulbar superotemporal, próximas do local a partir do qual o tecido autólogo de conjuntiva foi colhido. O número total de mastócitos em amostras de tecido dos pterígios (primários e recidivados) assim como dos controles foi calculado microscopicamente utilizando azul de toluidina a 1% sob magnificação de 400×. Resultados: O número de mastócitos médio no tecido pterígio primário e recidivado vascularizado foi de 7,45 ± 2,06 mm-2 e 16,11 ± 4,33 mm-2, respectivamente, e a diferença foi significativa (amostras independentes t-test, P<0,001). A contagem média de mastócitos no tecido pterígio foi significativamente mais elevada do que no tecido conjuntivo normal em ambos os grupos (teste t de Student, P<0,001). Conclusão: Um aumento no número de mastócitos pode desempenhar um papel na patogênese do pterígio recidivado. A determinação de um valor de corte na contagem de mastócitos pode ser importante para o diagnóstico de pterígio recidivado. .

Comparison of three larval bioassays to evaluate susceptibility of Rhipicephalus (Boophilus) microplus to amitraz / Comparação de três bioensaios larvais para avaliar a suscetibilidade de Rhipicephalus (Boophilus) microplus ao amitraz

Field samples of Rhipicephalus (Boophilus) microplus from the state of Rio Grande do Sul, Brazil, were assessed using the following methods: larval packet test (LPT), larval immersion test (LIT) and syringe immersion test (SIT). The following parameters were determined for each population and for the Mozo susceptible reference strain: lethal concentration for 50% (LC50) with its 95% confidence interval (95% CI), regression line slope and resistance ratio (RR). Using the LPT, only one population was susceptible to amitraz, presenting a RR of 1.9. Using the same technique, the other populations presented RRs of between 92.9 and 3445.8 and were considered resistant. The LC50 of the Mozo strain calculated using the LPT, LIT and SIT was 2.9, 27.3, and 52.7 µg/mL, respectively. In general, a good fit to the probit statistical model was only achieved using the LPT. The results obtained in this study impair recommendations for using the LIT and SIT to diagnose amitraz resistance in R. (B.) microplus populations. Additional studies are required to improve the sensitivity of these tests in relation to the LPT.

Amostras de Rhipicephalus (Boophilus) microplus coletadas à campo no Rio Grande do Sul, Brasil, foram analisadas pelos seguintes métodos: teste do pacote de larvas (TPL), teste de imersão de larvas (TIL) e teste de imersão em seringas (TIS). Os seguintes parâmetros foram determinados para cada população e para a amostra referência suscetível Mozo: concentração letal para 50% (CL50) e seu intervalo de confiança de 95% (IC95%), inclinação da reta de regressão e os fatores de resistência (FR). Pelo TPL, apenas uma população foi sensível ao amitraz, com FR de 1,9. Utilizando a mesma técnica, as outras amostras apresentaram FR entre 92,9 e 3445,8 sendo consideradas resistentes. As CL50 da cepa Mozo calculadas por meio do TPL, TIL e TIS foram 2,9, 27,3 e 52,7 µg/mL, respectivamente. De forma geral, a adequação ao modelo estatístico de probitos só foi alcançada com o uso do TPL. Os resultados obtidos no presente estudo limitam a recomendação de uso do TIL e TIS para diagnóstico de resistência ao amitraz em populações de R. (B.) microplus. Estudos adicionais são necessários para aprimorar a sensibilidade destes testes em relação ao LPT.

Comparison between 25% benzyl benzoate, 5% permethrin and 10% crotamiton in the treatment of scabies in Gaza

To compare the efficacy of three different modalities treatments for scabies. This prospective study was carried out at Dermatology clinic at Jordanian Military Field Hospital, Gaza, Palestine from August 2012 to October 2012. A total number of 120 patients were included in the study. Scabies was diagnosed by clinical examination with three of the following criteria: burrows identification, presence of excoriated papules at the classical sites and nocturnal itching and was confirmed by direct light microscopic examination. Patients were divided into three groups 40 patients in each. The first group received 5% Permethrin cream, the second group received 25% benzyl benzoate and the third group received 10% crotamiton lotion. To assess cure rate we followed all patients up to one and two weeks after completing their treatment. Absence of itching along with no new lesions appearing and disappearing of the old lesions was considered a cure. The group who received 5% permethrin cream showed the highest cure rate, while those who received 10% crotamiton lotion showed the lowest cure rate. Permethrin cream rinse was the best treatment for scabies

Comparison of 1% permethrin, trimethoprim-sulfamethoxazole and crotamiton in the treatment of pediculosis capitis

To compare the efficacy of three different treatments for pediculosis capitis. This prospective study was carried out at Jordanian Military Field Hospital, Gaza from August 2012 to October 2012. A total of 60 patients were included in this study. Pediculosis capitis was diagnosed by direct examination of scalp and hair and was confirmed by direct light microscopic examination. Patients were divided into three equal groups: The first group received 1% permethrin cream, the second group received only oral Trimethoprim-sulfamethoxazole and the third group received crotamiton lotion. To assess cure rate we followed these patients up to two and four weeks after completing their treatment. Absence of adults' lice and nits was considered a cure. The group which received 1% permethrin cream showed the highest cure rate, while those who received oral Trimethoprim-sulfamethoxazole showed the lowest cure rate. 1 % permethrin cream rinse was the best treatment to head lice and oral TM-SMX therapy did not give desirable results

Chemotherapeutic drugs for common parasitic diseases in Korea

Incidence of parasitic diseases in Korea has been changing recently. The incidence of some parasitic diseases such as toxocariasis and cryptosporidiosis has increased, while that of soil-transmitted helminthic diseases has drastically decreased. Malaria reemerged in 1993 but has decreased in the 2010s. Here, common parasitic diseases that can be encountered in the clinical field are introduced, along with therapeutic agents such as anthelmintics, anti-malarial drugs, and anti-protozoan drugs to help general physicians select the appropriate medicine for parasitic diseases. Currently, soil-transmitted helminths are not a public health problem. On the other hand, the egg positive rate of Clonorchis sinensis has not decreased rapidly due to the habit of eating raw fresh water fishes in endemic areas; however, due to low worm density, it is difficult to detect infected persons only by clinical symptoms. Toxocariasis and ocular acanthamoebiasis can be detected more frequently due to appropriate diagnostic tools and physicians' concern. Cases of intestinal trematodiases, intestinal protozoasis, and vaginal trichomoniasis have decreased year by year. Since enterobiasis, pediculosis, and scabies are contact-borne diseases, local transmission and resurgence are always possible. Only a few antiparasitic agents can be prescribed in the clinics: albendazole, praziquantel, metronidazole, chloroquine, primaquine, and crotamiton. It may be helpful to general physicians to be reminded of the indications, prescription methods, and side effects described briefly for each drug that can be prescribed for parasitic diseases. Further information can be gathered from the Korea Pharmaceutical Information Service (http://www.kpis.or.kr/). For accurate diagnosis and prescription, a parasitologist may be consulted.

Resistance to cypermethrin and amitraz in Rhipicephalus (Boophilus) microplus on the Santa Catarina Plateau, Brazil / Situação da resistência do Rhipicephalus (Boophilus) microplus à cipermetrina e amitraz no Planalto Catarinense, Brasil

With the objective of evaluating Rhipicephalus (Boophilus) microplus resistance to cipermetrina and amitraz, were collected engorged tick females from cattle on 20 farms on the Santa Catarina Plateau, in southern Brazil, between January of 2004 and May of 2006. Were also received 20 groups of engorged R. (B.) microplus females, collected by cattle farmers requesting acaricidal efficacy (AE) testing. Were performed in vitro tests, which consisted of immersing engorged females in cypermethrin (0.015%) and in amitraz (0.025%). An AE >95% was considered indicative of effectiveness. Of the 20 collected groups, 18 (90%) showed cypermethrin resistance and 1 (5%) showed amitraz resistance. Of the 20 received groups, 19 (95%) showed cypermethrin resistance and 2 (10%) showed amitraz resistance. The AE of cypermethrin was found to be >95%, 85-94%, and 55-64%, respectively, in 4 (57.1%), 2 (28.6%), and 1 (14.3%) of 7 reference groups, collected in the 1997-2001 period. The AE of amitraz was >95% in all of those groups. Among the groups of specimens received for analysis in that period, the AE of amitraz was >95% in 6 (85.71%) and 75-84% in 1 (14.28%). R. (B.) microplus resistance to acaricides is increasing on the Santa Catarina Plateau.

Com os objetivos de avaliar a resistência do Rhipicephalus (Boophilus) microplus à cipermetrina e ao amitraz no Planalto Catarinense, no período de janeiro de 2004 a maio de 2006, foram coletadas teleóginas em bovinos de 20 propriedades onde os produtores autorizaram a coleta (amostras por conveniência) e recebidas teleóginas de mais 20 propriedades com objetivo de diagnóstico de eficácia. Os testes in vitro foram realizados por imersão de teleóginas em cipermetrina (0,015%) e amitraz (0,025%). Considerando a eficácia igual ou superior a 95%, das 20 propriedades amostradas, 18 (90%) apresentaram resistência à cipermetrina e uma (5%) ao amitraz. Das 20 propriedades com teleóginas para diagnóstico, 19 (95%) apresentaram resistência à cipermetrina e duas (10%) ao amitraz. No período de agosto de 1997 a dezembro de 2001, das sete amostras coletadas, em quatro (57,1%) a eficácia da cipermetrina foi >95%, em duas (28,6%) entre 85% e 94% e em uma, (14,3%) entre 55% e 64%. A eficácia do amitraz foi >95%, em teleóginas de todas as propriedades. Nas amostras para diagnóstico, seis (85,71%) apresentaram eficácia para o amitraz >95% e uma (14,28%) entre 75% e 84%. A resistência desse ixodídeo aos carrapaticidas testados é crescente no Planalto Catarinense.

A Case of Amitraz Poisoning Initially Misdiagnosed as Acute Organophosphate Insecticide Poisoning

Amitraz is acaricidal and insecticidal pesticide used worldwide to control ticks and mites in plants and animals. Amitraz poisoning is characterized by clinical toxidrome such as central nervous system, respiratory depression, bradycardia, hypotension, hypothermia, and hyperglycemia. Toxic mechanism of amitraz is mainly alpha2-agonistic function and poisonings may occur by any route. Such clinical symptoms and signs of acute amitraz poisoning were possible to be thought as a toxidrome of acute organophosphate poisoning. We reported a 68-year-old woman that initially was misdiagnosed as acute organophosphate poisoning on the ground of symptoms and signs of mental change, respiratory depression, bradycardia, and hypotension. However, the serum level of pseudocholinesterase level at emergency room admission was within normal level and a vacant bottle of amitraz pesticide was founded around the yard of the patient. The patient was totally recovered from acute amitraz poisoning 2 days later after mechanical ventilation and conservative cares including atropine injection.

Occupational Cancer Update / 대한산업의학회지

This article reviews newly available knowledge regarding occupational cancer based on an assessment of International Agency for Research on Cancer (IARC) Monograph program from 2006 to 2010. The IARC reviewed the agents to evaluate the carcinogenicity in humans according to their priority. During the last five years, the IARC has reviewed many kinds of agents, including all of the Group 1 carcinogenic agents. Agents belonging to groups other than Group 1 were also reviewed. A few agents, such as shiftwork and firefighting, were reviewed for the first time after introducing the IARC Monograph Program. Most of the reassessed Group 1 agents were reaffirmed, showing that there was sufficient evidence to prove their carcinogenicity to human beings. However, some carcinogens were correlated to the new cancer site, since it was deemed that sufficient evidence was present. For example, larynx and ovary cancer deemed to have sufficient evidence of carciongenicity relating to asbestos exposure, joining lung cancer and mesothelioma. Some agents, such as benzo(a)pyrene, ortho-toluidine, 1,3-butadiene, and others belonging to Group 2A were upgraded to Group 1 based on newly identified epidemiologic findings, along with sufficient animal and mechanistic evidence. Benzo(a)pyrene and benzidine-based dyes were classified as human carcinogens based on sufficient animal and pervasive mechanistic evidence. This new data shows that not only chemical agents but also working conditions, such as stress and shiftwork were found to apply to human carcinogenicity. The IARC listed these agents in order to prioritize their review regarding their carcinogenicity to humans. There is a great need to study these newly emerging agents suspected to relate human carcinogenicity, and deem they are worthy of notice.

Unilateral Demodicidosis in a Patient with Seborrheic Dermatitis / 대한의진균학회지

Demodex mites are considered part of the normal skin flora. Typically, Demodex is harmless and causes no clinical symptoms. We present a 43-year-old woman with pruritic erythematous plaque and papulopustular eruptions on the right cheek. The patient was treated seborrheic dermatitis in face from several years ago. However, the lesion was aggravated after continuous topical steroid usage for several months at a local clinic. Histological examinations revealed Demodex mites in the follicular ostia with perivascular and perifollicular lymphohistiocytic inflammation. Treatment was initiated with metronidazole at a dose of 250 mg three times per day and then crotamiton ointment once daily. The lesion showed marked improvement after six weeks of treatment with mild residual erythema. The findings presented here indicate that Demodex infestation should be considered in the differential diagnosis of unilateral follicular eruptions of the face.

Reemerging skin disease caused by arthropods I: scabies

Scabies is one of the most common world-wide arthropod-born diseases in both humans and animals caused by the "itch" mite Sarcoptes scabiei. The incidence of scabies has shown a tendency to increase for the last several years in Korea. The previous peak incidence in Korea was between the early 1970s and early 1980s. A substantial part of the cyclic resurgence of scabies has been considered the result of inexperience and indifference of medical doctors toward the disease. The recent resurgence is presumed to be derived from not only indifference of the doctors but also an increase in elderly patients admitted to nursing homes and eldercare hospitals. Scraping using mineral oil for scabies patients is a very simple and effective method for definite diagnosis. A new diagnostic method using a dermoscope is also effective, especially for very young patients. Lindane and crotamiton are two available antiscabietic preparations in Korea. Crotamiton is less effective, while infants and pregnant women should not use lindane. In conclusion, medical personnel should be alert coping with the resurgence of scabies, and it is strongly suggested that other antiscabietic drugs such as permethrin, ivermectin, etc. should be made available for resistant patients in the near future in the Republic of Korea.

Crusted Scabies Misdiagnosed as a Cutaneous Side Reaction due to Allopurinol in a Patient with Acquired Perforating Dermatosis / 대한피부과학회지

Crusted (Norwegian) scabies is a clinical variant of human infestation with Sarcoptes scabiei, and is characterized by extensive, heavily crusted skin lesions. It usually affects immunocompromised patients. The diagnosis is commonly missed, and can lead to mismanagement. Here we report a case of crusted scabies misdiagnosed as a cutaneous side reaction due to allopurinol in a 48 year old male patient with acquired perforating dermatosis who had been treated with allopurinol for about 20 weeks. The lesion showed pruritic, excessive hyperkeratotic scaly crusts and fissures on the hands, and on pelvic, genital and inguinal areas. His skin lesions disappeared after treatment with 10% crotamiton cream for 2 weeks.

Análise in vitro da eficácia do amitraz sobre populações de Rhipicephalus (Boophilus) microplus (Canestrini, 1887) da região sul do Rio Grande do Sul / In vitro analysis of amitraz efficacy against Rhipicephalus (Boophilus) microplus (Canestrini, 1887) populations of southern region of Rio Grande do Sul state

Formulações comerciais à base de amitraz são muito utilizadas como acaricidas na Região Sul do Rio Grande do Sul, contudo sem maiores estudos da sua eficácia nessa região. O presente estudo objetivou estimar a frequência de populações de R. (B.) microplus resistente ao amitraz na Região Sul do Rio Grande do Sul, e comparar a eficácia de cinco produtos comerciais à base desse princípio ativo. Os resultados demonstraram que, em 23% das populações estudadas, o amitraz teve uma eficácia inferior a 69%. Em 29% dessas amostras de carrapatos, o grau de eficácia foi igual a zero, sugerindo a presença de altos níveis de resistência ao amitraz. Além disso, o produto comercial mais utilizado na região demonstra o menor índice de eficácia. Esses resultados alertam sobre a possibilidade da dispersão de populações de carrapatos resistentes, o que justifica a necessidade de direcionar pesquisas visando a novas alternativas e produtos para o controle desse parasito.

Commercial formulation of the amitraz is the most used acaricide in the southern region of Rio Grande do Sul State, however scientific data about the efficacy of these products in this region are sparse. The aim of the present study was to evaluate the frequency of R. (B.) microplus populations resistant to amitraz acaricides in the Southern region of Rio Grande do Sul State. So, the efficacies of five commercial products containing amitraz were compared. Results showed that the efficacy of amitraz acaricides was lower than 69% in 23% of studied populations. Nearly 29% of the tick samples showed an acaricide efficacy equal to zero, suggesting the presence of a high level of resistance to amitraz. Moreover, the most used commercial product in the region showed the lowest efficacy index. These results alert about the possible spreading of resistant on tick populations and justify research directed toward the search for alternative products to control this parasite.

Intraocular Pressure and Central Corneal Thickness in Premature Infants

PURPOSE: To evaluate of the range and relationship between intraocular pressure (IOP), and central corneal thickness (CCT) in premature infants. METHODS: To investigate the correlation of IOP and CCT with gestational age and body weight, 58 premature infants 37 weeks-old or younger were examined. Under topical anesthesia, IOP was measured with Tono-Pen(R) XL (Medtronic Solan, Jacksonville, FL) and the CCT with pachymeter (SP-2000, TOMEY(R), Japan). The fundus was examined in infants with a risk of retinopathy of prematurity (ROP). RESULTS: Average gestational age of the subjects was 33 weeks and 6 days and body weight was 1506+/-520 grams (mean+/-standard deviation). Forty-five subjects had oxygen therapy, and 10 patients were found to have any one of the stages of ROP. Average IOP was 15.14+/-4.64 mmHg in the right eye and 15.29+/-3.70 mmHg in the left eye. CCT was 594.72+/-74.87 micrometer in the right eye and 599.78+/-74.17 micrometer in the left eye. No statistically significant correlation was found between IOP or CCT and gestational age or body weight. CONCLUSIONS: Gestational age and body weight did not appear to affect IOP or CCT in the gestational age between 26 and 37 weeks. The maturing eye in the neonate is known for fast development in the first year after birth. There are, however, few reports in the literature regarding the changes in dimensions of ocular structures in the premature neonate. These normative values may aid ophthalmologists in assessing IOP and CCT in premature infants.

Intraocular Pressure and Central Corneal Thickness in Premature Infants

PURPOSE: To evaluate of the range and relationship between intraocular pressure (IOP), and central corneal thickness (CCT) in premature infants. METHODS: To investigate the correlation of IOP and CCT with gestational age and body weight, 58 premature infants 37 weeks-old or younger were examined. Under topical anesthesia, IOP was measured with Tono-Pen(R) XL (Medtronic Solan, Jacksonville, FL) and the CCT with pachymeter (SP-2000, TOMEY(R), Japan). The fundus was examined in infants with a risk of retinopathy of prematurity (ROP). RESULTS: Average gestational age of the subjects was 33 weeks and 6 days and body weight was 1506+/-520 grams (mean+/-standard deviation). Forty-five subjects had oxygen therapy, and 10 patients were found to have any one of the stages of ROP. Average IOP was 15.14+/-4.64 mmHg in the right eye and 15.29+/-3.70 mmHg in the left eye. CCT was 594.72+/-74.87 micrometer in the right eye and 599.78+/-74.17 micrometer in the left eye. No statistically significant correlation was found between IOP or CCT and gestational age or body weight. CONCLUSIONS: Gestational age and body weight did not appear to affect IOP or CCT in the gestational age between 26 and 37 weeks. The maturing eye in the neonate is known for fast development in the first year after birth. There are, however, few reports in the literature regarding the changes in dimensions of ocular structures in the premature neonate. These normative values may aid ophthalmologists in assessing IOP and CCT in premature infants.