Nickel allergy as risk factor for hand eczema: a population-based study.

BACKGROUND: In population-based studies using self-reported nickel allergy, a hand eczema prevalence of 30-43% has been reported in individuals with nickel allergy. In a previous Swedish study, 958 schoolgirls were patch tested for nickel. In a questionnaire follow up 20 years later no association was found between nickel allergy and hand eczema. OBJECTIVES: To investigate further the relation between nickel allergy and hand eczema. METHODS: Three hundred and sixty-nine women, still living in the same geographical area, now aged 30-40 years, were patch tested and clinically investigated regarding hand eczema. RESULTS: Patch testing showed 30.1% nickel-positive individuals. The adjusted prevalence proportion ratio (PPR) for hand eczema after age 15 years in relation to nickel patch test results was 1.03 (95% confidence interval, CI 0.71-1.50). A history of childhood eczema was reported by 35.9%, and the PPR for hand eczema in relation to childhood eczema was 3.68 (95% CI 2.45-5.54). When analysing the relation separately in women with and without a history of childhood eczema a statistical interaction was found. The hand eczema risk was doubled in nickel-positive women without a history of childhood eczema, with a PPR of 2.23 (95% CI 1.10-4.49) for hand eczema after age 15 years. CONCLUSIONS: A doubled risk for hand eczema was found in nickel-positive women without a history of childhood eczema. When analysing all participants, there was no statistically significant difference between nickel-positive and nickel-negative women regarding occurrence of hand eczema. The most important risk factor for hand eczema was childhood eczema. The risk for hand eczema in nickel-positive women may previously have been overestimated.

Threshold response of benthic macrofauna integrity to metal contamination in West Greenland.

Sediment metal chemistry and benthic infauna surveys have been conducted over 33 years following a BACI protocol in relation to submarine tailings deposition (STD) from a lead-zinc mine in a western Greenland fjord system. We found clear predictable changes of benthic fauna composition in response to STD both temporally and spatially. Faunal re-colonization 15 years after mine closure, was slow and the impacted areas were still dominated by opportunistic species, although the most opportunistic ones (e.g. Capitella species) had decreased in importance. Concentration-response relations between sediment lead and faunal indices of benthic community integrity (e.g. the AMBI and DKI indices) indicated a threshold of ca. 200mg/kg, above which deterioration of faunal communities occurred. Above this threshold, diversity decreased dramatically and dominance of sensitive and indifferent species was substituted by tolerant or opportunistic species. Disposal of metal contaminated tailings may have long lasting effects on the biological system.

Acupuncture to reduce nausea during chemotherapy treatment of rheumatic diseases.

OBJECTIVE: To study if acupuncture, combined with ondansetron treatment, reduces nausea and vomiting associated with cyclophosphamide infusion in patients with rheumatic diseases. METHODS: Thirty-nine patients were treated with acupuncture at point PC 6 and/or in the ear to decrease nausea and vomiting. The patients reported the severity of nausea and number of bouts of vomiting at the start of chemotherapy and after 4, 8, 24, 48 and 72 h. RESULTS: Compared with ondansetron treatment alone, the combined acupuncture-ondansetron treatment significantly decreased both the severity of nausea and the number of bouts of vomiting 24 and 48 h after the subjects had received acupuncture at the first treatment session (nausea: P < 0.0001; vomiting: P < 0.0035). Nearly the same results were seen 48 and 72 h after the subjects had had their last treatment of acupuncture (nausea P < 0.0080). Similar results were found after 24 to 48 h, when a comparison was made between two sessions close in time (nausea: P < 0.0001 after 24 h, P < 0.0003 after 48 h; vomiting: P < 0.0007). CONCLUSIONS: Our results clearly indicate that combined treatment with acupuncture and ondansetron reduces the severity and the duration of chemotherapy-induced nausea as well as the number of bouts of vomiting as compared with ondansetron therapy alone, in patients with rheumatic diseases.

A functional index in myositis.

OBJECTIVE: To evaluate the interrater reliability and the construct validity of a specially constructed functional index and to assess functional status in 23 patients with myositis; and to describe the occurrence, intensity, and distribution of pain in these patients. METHODS: The functional test scored muscle endurance in extremities, neck, and trunk, grip strength, peak expiratory flow, turning in bed, and transferring from lying in bed to sitting. The scores of the different functions were added to create a functional index. The patients' subjective gradings of disability and pain intensity were indicated on a category scale. Blood samples for analyses of muscle enzyme levels were obtained in connection with the functional tests. RESULTS: The interrater reliability of the functional index was high. Grip strength and muscle endurance in shoulder abduction and flexion, hip flexion, and a step test and heel and toe lifting were significantly reduced compared to controls. Peak expiratory flow was lowered in 4 patients. The functional index did not correlate significantly with the laboratory tests, but there was significant correlation between the weakness of the lower extremities and the subjective grading of disability. All patients but one had experienced severe pain during the course of the disease. CONCLUSION: The described functional index has high interrater reliability, but its construct validity and sensitivity as a monitor of response to medication and training need further confirmation.