Phototherapy trends in dermatology 2015-2018.

BACKGROUND: Trends in phototherapy utilization including its main clinical indications were last characterized by Luersen et al. for the time period of 1997-2010. In this study, we update data on the use of phototherapy in the United States from 2015 to 2018. METHODS: We queried the National Ambulatory Medical Care Survey (NAMCS) data on the number of phototherapy visits as well as demographics and associated dermatoses. RESULTS: There were approximately 1.31 million outpatient phototherapy visits during the study period with a decreasing trend over time. Leading indications for phototherapy were dermatitis not otherwise specified (NOS), (25.7%) followed by atopic dermatitis (AD) (11.7%), and pruritus (9.7%). CONCLUSION: There is a downtrend in the use of phototherapy from 2015 to 2018. Psoriasis is no longer the main indication for phototherapy, which may be due to the advent of highly effective novel biologics.

Realistic Food-Based Approaches Alone May Not Ensure Dietary Adequacy for Women and Young Children in South-East Asia.

Objectives Micronutrient deficiencies, in southeast Asia (SE Asia), remain a public health challenge. We evaluated whether promoting the consumption of locally available nutritious foods, which is a low-risk micronutrient intervention, alone can ensure dietary adequacy, for women of reproductive age and 6-23 m old children. Methods Representative dietary data from Cambodia, Indonesia, Lao PDR, Thailand and Vietnam were analysed using linear programming analysis to identify nutrients that are likely low in personal food environments (problem nutrients), and to formulate food-based recommendations (FBRs) for three to six target populations per country. Results The number of problem nutrients ranged from zero for 12-23 m olds in Indonesia, Thailand and Vietnam to six for pregnant women in Cambodia. The FBRs selected for each target population, if adopted, would ensure a low percentage of the population was at risk of inadequate intakes for five to ten micronutrients, depending on the country and target population. Of the 11 micronutrients modelled, requirements for iron, calcium and folate were most difficult to meet (≥ 10 of the 24 target populations), using FBRs alone. The number of individual FBRs selected per set, for each target population, ranged from three to eight; and often included meat, fish or eggs, liver/organ meats, vegetables and fruits. Conclusions for practice Intervention strategies need to increase access to nutritious foods, including products fortified with micronutrients, in SE Asia, when aiming to ensure dietary adequacy for most individuals in the population.

Integrating a project monitoring system into a public health network: experiences from Alive & Thrive Vietnam.

Little information is available about how to build a monitoring system to measure the output of preventive nutrition interventions, such as counselling on infant and young child feeding. This paper describes the Alive & Thrive Vietnam (A&T) project experience in nesting a large-scale project monitoring system into the existing public health information system (e.g. using the system and resources), and in using monitoring data to strengthen service delivery in 15 provinces with A&T franchises. From January 2012 to April 2014, the 780 A&T franchises provided 1,700,000 counselling contacts (~3/4 by commune franchises). In commune franchises in April 2014, 80% of mothers who were pregnant or with children under two years old had been to the counselling service at least one time, and 87% of clients had been to the service earlier. Monitoring data are used to track the progress of the project, make decisions, provide background for a costing study and advocate for the integration of nutrition counselling indicators into the health information system nationwide. With careful attention to the needs of stakeholders at multiple levels, clear data quality assurance measures and strategic feedback mechanisms, it is feasible to monitor the scale-up of nutrition programmes through the existing routine health information system.

Serum levels of trace elements and iron-deficiency anemia in adult Vietnamese.

This study was aimed at assessing the serum levels of vitamin A, copper, zinc, selenium, and iron among adult Vietnamese with and without iron-deficiency anemia. Blood was collected from adult Vietnamese living in the midland of northern Vietnam. One hundred twenty-three subjects in the age range 20-60 yr were included in the study. Anemia, where the concentration of hemoglobin in whole blood is less than 120 g/L in females and 130 g/L in males, was found in 30% (37/123) of the study population. The levels of vitamin Aand selenium in the sera of anemic subjects (n = 37) were significantly lower than that in nonanemic group (n = 86). On the other hand, no significant differences were observed in the concentrations of copper and zinc between the two groups. This study was the first to show serum levels of trace elements in adult Vietnamese, providing useful baseline information for further studies.