Evaluation of antimicrobial textiles for atopic dermatitis.

BACKGROUND: Functional textiles have been proposed as safe adjunct treatment for atopic dermatitis (AD). Some data have been published regarding their antimicrobial properties and their clinical efficacy. OBJECTIVE: This study examined the physical and functional properties of 11 commercially available functional textiles, including their antimicrobial activity in vitro, as a function of multiple laundering cycles. METHODS: All materials were weighed and examined under scanning electron microscopy (SEM) before and after laundering for fibre morphology and silver coating. Bioburden of newly purchased textiles was assessed by measuring bacterial colony forming units (CFU). Deliverable antimicrobial efficacy was evaluated in vitro for each specimen, before and after 30, 70, 100, 150 and 200 laundering cycles. RESULTS: Textile weight showed high variability. Damaged silver coating of variable degree was observed under SEM in most materials after laundering. Products made of silk showed smoother and tighter fibre morphology compared to cotton. The bacterial load of unwashed material ranged from <1 CFU to 35 CFU per 50 × 50 mm specimen. Most silver-containing products lost their antimicrobial activity rapidly after laundering. Silk and cotton retrieved products had no deliverable antimicrobial effect even in their original state. CONCLUSION: Elastic, lightweight textiles with smooth fibres are comfortable for daily use. Functional textiles rapidly losing their deliverable antimicrobial activity in vitro are not advisable for AD patients. Recommendations for functional textiles should be based on a combination of in vitro analysis of products in their original state and after laundering, together with real-life data obtained from controlled clinical trials.

Robust perfusion deficits in cognitively impaired patients with secondary-progressive multiple sclerosis.

BACKGROUND AND PURPOSE: Cognitive impairment is a common, disabling symptom of MS. We investigated the impact of cerebral perfusion and brain and lesion volumetry on cognitive performance in 45 patients with SPMS by using MR imaging. MATERIALS AND METHODS: Cognition was assessed by using a standard battery, the Minimal Assessment of Cognitive Function in Multiple Sclerosis. qCBF and qCBV maps were analyzed by using SPM and PLS. SPM was also used to conduct the GM, WM, and WML volumetric analyses. RESULTS: Both SPM and PLS demonstrated significantly reduced qCBV in the superior medial frontal cortex of impaired patients. PLS also revealed significantly lower qCBV in the bilateral thalami and caudate nuclei of impaired patients and identified a pattern of significantly attenuated qCBF similar to that of qCBV. Performance on the Symbol Digit Modalities Test, which assesses information-processing speed, correlated most strongly overall with cerebral perfusion. Focal (ie, voxelwise) analyses of GM, WM, and WML volume revealed no significant differences between patients with and without cognitive impairment, though global GM volume was significantly decreased and global WML volume was significantly increased in impaired patients. CONCLUSIONS: These results suggest that cognitively impaired patients with SPMS exhibit robust perfusion deficits in cortical and subcortical GM and impaired processing speed.

Decreased frontal lobe gray matter perfusion in cognitively impaired patients with secondary-progressive multiple sclerosis detected by the bookend technique.

BACKGROUND AND PURPOSE: There is increasing evidence implicating microvascular impairment in MS pathogenesis. Perfusion imaging offers a unique opportunity to investigate the functional impact of GM pathology. We sought to quantify differences in MR imaging-based bookend-derived cerebral perfusion between cognitively impaired and nonimpaired patients with SPMS. MATERIALS AND METHODS: Patients were prospectively recruited and assessed using MR imaging and the standard cognitive battery called the Minimal Assessment of Cognitive Function in MS. Patients exhibiting impairment on ≥ 2 individual tests were classified as cognitively impaired. Healthy controls were prospectively recruited and assessed using MR imaging to validate bookend assumptions. Structural and perfusion scans were coregistered and partitioned into anatomic brain regions and tissue compartments. Clinical and radiologic characteristics were compared between patients with and without impairment to identify potential confounders. A Bonferroni adjusted P value threshold (P < .005) was used for lobar and sublobar level analyses to correct for multiple comparisons. RESULTS: Thirty-seven patients with SPMS (age 56 ± 9 years; 23 women, 14 men) and 10 age- and sex-matched healthy controls were recruited. Bookend assumptions were found to be valid in MS. GM and WM qCBV were all globally reduced in impaired patients. After adjusting for potential confounders while examining sublobar level perfusion, only GM qCBV was significantly different between cognitive groups, and this hypoperfusion localized to the bilateral medial superior frontal regions and left inferior, middle, and superior frontal regions (P < .005) of impaired patients compared with nonimpaired patients. GM qCBV accounted for 22.5% of the model variance compared with a model including only confounders (P = .0007). CONCLUSIONS: Bookend-derived GM qCBV was significantly reduced in cognitively impaired patients with SPMS in functionally relevant brain regions.

Habit training as treatment of encopresis secondary to chronic constipation.

Fifty-eight encopretic children were placed on a habit training regimen consisting of initial disimpaction followed by attempts to defecate after a specific meal, and use of enemas contingent on failure to defecate for 2 successive days. All patients had gross incontinence of long duration. After an average of less than four visits in 5 months, 83% had an excellent outcome, 60% were completely continent, and 23% had only staining. Patients not achieving continence averaged a 90% decrease in frequency of incontinence. The mean frequency of incontinent episodes decreased from 13.2 to 0.52 per week, while appropriate bowel movements increased from 3.8 to 5.9 per week. At follow-up (average of 3 years), 61% of 43 patients contacted had excellent outcomes, 51% were continent, and 10% had only staining. Patients still incontinent at follow-up averaged 89% fewer episodes than they had prior to treatment. These findings show habit training to be a rapidly effective and long-lasting treatment for encopresis secondary to chronic constipation.