Occupational Exposure of Employees in a Multispecialty Hospital to Factors Causing Contact Dermatitis-A Questionnaire Study.

Background and Objectives: Allergic contact dermatitis (ACD) is a serious health and socio-economic problem. Accurate and reliable assessment of exposure to ACD factors in the work environment would increase quality of life and work of employees. The aim of this study was to assess the level of exposure of workers of a multidisciplinary hospital to the factors causing ACD. Material and Methods: The proprietary OSDES-16 questionnaire was used. The effectiveness of the OSDES-16 was confirmed statistically. The study included 230 employees of the medical center in Polanica Zdrój, divided into groups. Results: The differences in the overall assessment of exposure between the individual groups in the OSDES-16 scale were statistically insignificant (p > 0.05). There was no significant correlation between the current workplace and the level of exposure to ACD (p > 0.05). The level of exposure to ACD in the group of employees with work experience in the current position for more than 10 years was significantly higher than those working less than 6 years (p < 0.05). Conclusions: Nurses, midwives and paramedics are the occupational group most exposed to the development of contact allergy related to exposure to factors present in the work environment. The seniority of more than 10 years in the current position was linked with a higher level of occupational exposure.

The novel questionnaire assessing occupational exposure to the risk factors of contact allergy among health professionals.

Introduction: Skin diseases account for about 7% of all occupational diseases in Europe. Allergic contact dermatitis (ACD) is one of the most common occupational skin diseases. Therefore, it constitutes the major health and economic problem. Increasing the detectability of ACD would significantly improve the quality of life of patients and their work efficiency. Aim: To design a questionnaire facilitating the diagnosis of ACD in work environment of healthcare providers. Material and methods: The initial questionnaire consisted of 53 questions related to ACD and exposure to various occupational hazards. On its basis, a scale of exposure to occupational skin diseases (OSDES-49) was created. The reliability of the scale was measured using the internal consistency test of the scale. It was assumed that individual items of the scale would be correlated with the total score if the Kleine and Nunnally criteria were met. Results: The Kleine and Nunnally criteria were met by 16 out of 49 items on the scale. OSDES-49 results were strongly correlated with the assessment using a questionnaire consisting of only 16 items (OSDES-16). Spearman's rank correlation coefficient was rho = 0.850 and p < 0.001. Conclusions: Results of the study showed that in any further screening tests, the OSDES-16 scale is reliable. The use of OSDES-16 reduces the time of initial diagnostics and simplifies it.

The protective effect of low-dose minocycline on brain microvascular ultrastructure in a rodent model of subarachnoid hemorrhage.

The multifaceted nature of subarachnoid hemorrhage (SAH) pathogenesis is poorly understood. To date, no pharmacological agent has been found to be efficacious for the prevention of brain injury when used for acute SAH intervention. This study was undertaken to evaluate the beneficial effects of low-dose neuroprotective agent minocycline on brain microvascular ultrastructures that have not been studied in detail. We studied SAH brain injury using an in vivo prechiasmatic subarachnoid hemorrhage rodent model. We analyzed the qualitative and quantitative ultrastructural morphology of capillaries and surrounding neuropil in the rodent brains with SAH and/or minocycline administration. Here, we report that low-dose minocycline (1 mg/kg) displayed protective effects on capillaries and surrounding cells from significant SAH-induced changes. Ultrastructural morphology analysis revealed also that minocycline stopped endothelial cells from abnormal production of vacuoles and vesicles that compromise blood-brain barrier (BBB) transcellular transport. The reported ultrastructural abnormalities as well as neuroprotective effects of minocycline during SAH were not directly mediated by inhibition of MMP-2, MMP-9, or EMMPRIN. However, SAH brain tissue treated with minocycline was protected from development of other morphological features associated with oxidative stress and the presence of immune cells in the perivascular space. These data advance the knowledge on the effect of SAH on brain tissue ultrastructure in an SAH rodent model and the neuroprotective effect of minocycline when administered in low doses.

Dynamic Reconstruction of the Lower Lip With Free Functioning Gracilis Muscle Transfer.

ABSTRACT: The restoration of large full-thickness lip defects still remains a formidable challenge for the reconstructive surgeons. Traumatic injuries, infections and tumors (primarily squamous cell carcinoma) are the most common source of the lip defects. Lower lips are more important in providing oral competence, unfortunately throughout the life-time they are significantly more exposed to ultraviolet radiation and thus are the most common site for the lip cancers (89%). This type of defect requires a complex reconstruction of an adequate sphincter function, defined vermilion, proper oral lining and sufficient mouth opening. To maintain the oral competence, it is of paramount importance to restore the function of orbicularis oris, which principally composes the body of the lip. Currently, the dynamic reconstructions are gaining considerable interest. They enables not only improvement of appearance but also a restoration of function and preservation of health-related quality of life. The use of the free gracilis muscle transfer to reconstruct the lower lip and its dynamic character in contrast to other, static reconstructions can provide the sufficient movement of the lower lip, which does not depend on function of other mimic muscles as it becomes an independent motor unit with its own neurotization. In our opinion the free functioning gracilis muscle flap, due to its anatomic and functional features as well as low-rate donor-site morbidity is the worth considering option for a lower lip reconstruction.

Limitations and limits and of vascularized composite allotransplantations: can we reach the holy grail?

PURPOSE OF REVIEW: In recent times, vascularized composite allotransplantation (VCA) have been gaining more attention and applications. Currently, VCA are at the highest level of the reconstruction pyramid, and thus the effects expected after them are intended to outweigh what the 'classical' reconstructive surgery can offer us, including even the most advanced microsurgical techniques. RECENT FINDINGS: Over 40 patients have received a partial or full-face transplant. Others have received penis, uterus, larynx, abdominal wall, and lower extremity transplants. Each type of VCA has its own problems and limitations. However, resolving the limits defined by immunosuppression and improved donor selection would revolutionize all of them. SUMMARY: Defining the limits and limitations of given procedures will not only allow for better preparation of transplant teams but will also help in determining the direction of future research.