Association of biomass fuel use with the risk of vision impairment among Chinese older adults: a cohort study.

Cooking with biomass fuels has been reported to have adverse effects on health. This study aims to explore the association between cooking with biomass fuels and vision impairment among Chinese older adults aged 65 years and above. This cohort study drew on data from the 2011/2012 wave and the 2014 follow-up wave of the Chinese Longitudinal Healthy Longevity Survey. Participants' visual function was examined through a vision screening test. Exposure to indoor biomass fuels was self-reported. Cox proportional hazards models were applied to explore the relationship between biomass fuel use and vision impairment. Additionally, we compared the risk of vision impairment between participants who switched cooking fuel types and those who did not. Subgroup and interaction analyses were conducted to explore the potential effect modifiers. A total of 4711 participants were included in this study. During the follow-up, 1053 (22.35%) participants developed vision impairment. Cooking with biomass fuels increased the risk of vision impairment by 40% (hazard ratio [HR]: 1.40, 95% confidence interval [CI]: 1.21-1.61). Participants who switched from clean fuels to biomass fuels had a greater risk of vision impairment than persistent clean fuel users (HR: 1.44, 95% CI: 1.03-2.00). Greater effect estimates were found in participants who lived in eastern and central China and urban residents. Cooking with biomass fuels resulted in a greater risk of vision impairment among Chinese older adults. This risk also existed in those who changed their cooking fuels from clean fuels to biomass fuels. Further studies with an objective assessment of biomass fuel combustion are required to confirm our findings.

Prickly pear spine keratoconjunctivitis.

OBJECTIVES: To study the ocular and extra-ocular features, clinical presentation, and treatment of prickly pear glochids. MATERIALS AND METHODS: This retrospective study included 23 eyes of 21 patients with ocular prickly pear spines who were seen between August and October 2011 in the outpatient ophthalmic clinic at Prince Rashid Bin Al Hassan military hospital in Jordan. Medical records of patients including age, gender, history of exposure to prickly pear plants, and ocular examination were reviewed. All glochids were localized and removed with forceps under topical anesthesia with the patient at the slit lamp. Patients were followed up after one week. RESULTS: The mean age of patients was 37.1 years with a male to female ratio of 1.6: 1. Involvement of the right eye was seen in 61.9% patients, left eye in 28.6% patients, and bilateral involvement in 9.5% patients. Glochids were most commonly found in the upper subtarsal conjunctival space (47.6%) followed by inferior palpebral conjunctiva in 23.8% eyes. The most common complaint was eye irritation in 95.2% patients. Pain was a complaint in 57.1% patients. Superior corneal epithelial erosions or ulcer were found in 33.3% patients, inferior corneal epithelial erosions in 19.1% patients, and diffuse epithelial erosions in 9.5% patients. Glochids were found in other parts of the body in 38.1% patients. CONCLUSION: Although prickly pear glochid ocular surface injury is not uncommon in the region during summer, it should be considered in patient with eye pain during that period. Farmers who are in close contact with prickly pears should use protective eyeglasses and gloves.

Evaluation and management of 2 ferocactus spines in the orbit.

A 49-year-old woman, who had fallen face first in a cactus 1 week earlier, presented with a small, mobile, noninflamed subcutaneous nodule at the rim of her right lateral orbit with no other functional deficits. A CT scan was obtained, which revealed a 4-cm intraorbital tubular-shaped foreign body resembling a large cactus spine. A second preoperative CT scan, obtained for an intraoperative guidance system, demonstrated a second cactus spine, which was initially not seen on the first CT scan. Both spines were removed surgically without complication. The authors discuss factors that can cause diagnosis delay, review the radiographic features of cactus spines, and discuss the often times benign clinical course of retained cactus spine foreign bodies. To the authors' knowledge, this is the first case report of cactus spines in the orbit. Health-care professionals should have a low threshold for imaging in cases of traumatic injuries involving cactus spines.

A role for nociceptive, myelinated nerve fibers in itch sensation.

Despite its clinical importance, the underlying neural mechanisms of itch sensation are poorly understood. In many diseases, pruritus is not effectively treated with antihistamines, indicating the involvement of nonhistaminergic mechanisms. To investigate the role of small myelinated afferents in nonhistaminergic itch, we tested, in psychophysical studies in humans, the effect of a differential nerve block on itch produced by intradermal insertion of spicules from the pods of a cowhage plant (Mucuna pruriens). Electrophysiological experiments in anesthetized monkey were used to investigate the responsiveness of cutaneous, nociceptive, myelinated afferents to different chemical stimuli (cowhage spicules, histamine, capsaicin). Our results provide several lines of evidence for an important role of myelinated fibers in cowhage-induced itch: (1) a selective conduction block in myelinated fibers substantially reduces itch in a subgroup of subjects with A-fiber-dominated itch, (2) the time course of itch sensation differs between subjects with A-fiber- versus C-fiber-dominated itch, (3) cowhage activates a subpopulation of myelinated and unmyelinated afferents in monkey, (4) the time course of the response to cowhage is different in myelinated and unmyelinated fibers, (5) the time of peak itch sensation for subjects with A-fiber-dominated itch matches the time for peak response in myelinated fibers, and (6) the time for peak itch sensation for subjects with C-fiber-dominated itch matches the time for the peak response in unmyelinated fibers. These findings demonstrate that activity in nociceptive, myelinated afferents contributes to cowhage-induced sensations, and that nonhistaminergic itch is mediated through activity in both unmyelinated and myelinated afferents.

Possible mechanism of betel-quid-extract-induced expression of matrix metalloproteinase-2.

BACKGROUND/PURPOSE: Betel quid extract (BQE) has been demonstrated to induce matrix metalloproteinase (MMP)-2 expression. This study aimed to establish the possible mechanism involved in this event. METHODS: Western blotting, reverse-transcription polymerase chain reaction, and gelatin zymography were used to study the expression level of MMP-2. LY294002, PD98059, U0126, N-acetyl-L-cysteine, SB203580, SP600125, and Bay 11-7082 were used to pretreat OECM-1 cells before BQE treatment and MMP-2 detection. RESULTS: OECM-1 cells were subjected to short-term (10 minutes) or long-term (24 hours) BQE treatment (designated as SBT and LBT, respectively), and we found that both treatments increased MMP-2 protein and extracellular signal-regulated kinase (ERK) phosphorylation levels in a concentration- and time-dependent manner. LBT also increased MMP-2 mRNA level. LBT-induced MMP-2 secretion was not inhibited by PD98059 (up to 50 µM) when ERK was effectively blocked, but was attenuated by LY294002 (0-10 µM) in a concentration-dependent manner. This LBT effect was inhibited strongly by SB203580 (10 µM), SP600125 (10 µM), and Bay 11-7082 (10 µM) and mildly by N-acetyl-L-cysteine (5 mM), but not by U0126 (10 µM). CONCLUSION: Both SBT and LBT upregulate MMP-2 expression, and LBT-induced MMP-2 expression might be mediated by phosphoinositide 3-kinase, p38 mitogen-activated protein kinase, c-Jun N-terminal kinase, and nuclear factor-κB, and to a lesser extent, by reactive oxygen species, rather than by ERK.

Similar itch and nociceptive sensations evoked by punctate cutaneous application of capsaicin, histamine and cowhage.

Itch evoked by cowhage or histamine is reduced or blocked by capsaicin desensitization, suggesting that pruriceptive neurons are capsaicin-sensitive. Topical capsaicin can evoke both nociceptive sensations and itch, whereas intradermal injection of capsaicin evokes only burning pain. To dissociate the pruritic and nociceptive sensory effects caused by the chemical activation of sensory neurons, chemicals were applied in a punctiform manner to the skin of the forearm using individual, heat-inactivated cowhage spicules treated with various concentrations of capsaicin (1-200 mg/ml) or histamine (0.01-100 mg/ml). Perceived intensities of itch, pricking/stinging and burning were obtained every 30 s using the general version of the Labeled Magnitude Scale and compared with ratings evoked by individual native cowhage spicules. Similar to cowhage, capsaicin and histamine spicules reliably evoked sensations of itch in a dose-dependent manner which were most often accompanied by pricking/stinging and to a lesser extent burning. Spicules containing 200 mg/ml capsaicin or 10 mg/ml histamine yielded peak magnitudes and durations of sensations comparable to those elicited by cowhage. Each type of spicule also produced comparable areas of dysesthesias (enhanced mechanically evoked itch or pain) and/or skin reactions (wheal and/or flare) in surrounding skin, though inconsistently. The incidence of flare was greater in response to histamine than to capsaicin or cowhage. These results suggest the possibility that capsaicin, histamine and cowhage activate common peripheral or central neural mechanisms that mediate pruritic sensations and associated dysesthesias.

The sacred lotus (Nelumbo nucifera) - phytochemical and therapeutic profile.

OBJECTIVES: Nelumbo nucifera Gaertn. (Nymphaeaceae), also known as sacred lotus, is a well known medicinal plant. This article reviews the traditional uses, phytochemistry and therapeutic reports on different parts of N. nucifera viz. the seeds, rhizomes, leaves and flowers. This review also describes various compounds isolated from different parts of this plant and the therapeutic benefits derived from those phytoconstituents. KEY FINDINGS: There are several therapeutic benefits of this plant for which different parts are used. The extracts of rhizomes, seeds, flowers and leaves have been reported to have varied therapeutic potential. Several bioactive compounds have been derived from these plant parts belonging to different chemical groups, including alkaloids, flavonoids, glycosides, triterpenoid, vitamins etc., which all have their own therapeutic impact. Thus, the pharmacological effects and various active ingredients of different parts of N. nucifera are well understood. SUMMARY: In this review we explore the current pharmaceutical, phytochemical and pharmacological knowledge about this well known plant species as well as several emerging aspects for research on N. nucifera.

Calotropis procera -induced keratitis.

Calotropis procera produces copious amounts of latex, which has been shown to possess several pharmacological properities. Its local application produces intense inflammatory response. In the 10 cases of Calotropis procera -induced keratitis reported here, the clinical picture showed corneal edema with striate keratopathy without any evidence of intraocular inflammation. The inflammation was reversed by the local application of steroid drops.

Upregulation of matrix metalloproteinase-1 (MMP-1) expression in oral carcinomas of betel quid (BQ) users: roles of BQ ingredients in the acceleration of tumour cell motility through MMP-1.

Matrix metalloproteinases (MMPs) are commonly expressed in carcinomas including oral squamous cell carcinomas (OSCCs). On the other hand, some evidences suggested that ingredients of betel quid (BQ) inhibit the activity and/or expression of some MMPs thought to be the pathogenesis of oral submucous fibrosis. This study was to analyse whether MMP-1 expression is inhibited in OSCC specimens from BQ users and in cell lines survived from the challenge of BQ ingredients. We found that MMP-1 mRNA was expressed in all the tested 27 OSCC. Levels of MMP-1 mRNA and protein were significantly elevated in the tested five OSCC specimens than in their adjacent tissues (P<0.001 and 0.05, respectively). Esophageal carcinoma (CE81T/VGH) and OSCC (OECM-1) cell lines survived from the cytotoxic BQ extract (BQE) and arecoline selection process were found to express higher MMP-1 mRNA and protein levels, or to exhibit a significant acceleration of two-dimensional (2D) motility than their non-selected parental cells. The enhanced motility was further demonstrated to be specifically and significantly inhibited by the MMP-1 neutralizing antibody and/or by the transfection of an MMP-1 specific antisense oligodeoxynucleotide. These results suggest that in some carcinomas of the upper aerodigestive tract, BQ usage may upregulate MMP-1 expression in the survived tumour cells, and increase their mobility in an MMP-1-dependent manner.

Polymorphisms of COX-2 -765G>C and p53 codon 72 and risks of oral squamous cell carcinoma in a Taiwan population.

The association between polymorphisms of COX-2 -765G>C and p53 codon 72, and oral squamous cell carcinoma (OSCC) remains unclear. We investigated the associations between COX-2 and p53 polymorphisms, oral precancerous lesions (OPL), and OSCC. Demographic data and substance use (smoking, drinking, and betel quid chewing) data were collected from 297 patients with OSCC, 70 with oral leukoplakia (OL), 39 with oral submucosal fibrosis (OSF), and 280 healthy controls. COX-2 and p53 polymorphisms were determined by PCR-RFLP methods. A significantly higher proportion of OSCC and OPL patients were male, and frequent habitual users of the three substances. No association was found between p53 and COX-2 polymorphisms, ethnicity, and gender. Polymorphisms of p53 were not associated with OSCC development and malignant potential of OPL, OSF, and OL. The frequency of COX-2 -765G/G genotype was significantly higher in healthy controls (chi(2)=93.83, p<0.0001). After adjusting for possible confounding factors, COX-2 -765C allele vs. -765G/G genotype (OR=0.22, 95%CI=0.12-0.39) was a protective factor against OSCC development, but was a risk factor for malignant potential of OSF (OR=3.20, 95%CI=1.32-8.94) and OL (OR=6.73, 95%CI=2.84-19.87). We suggest that COX-2 -765G>C polymorphisms play a different role in OSCC development than in malignant potential of OSF and OL. However, p53 codon 72 polymorphisms show no such correlation.

Phytophotodermatitis due to Ficus carica.

The genus Ficus belongs to the Moraceae (the mulberry family). Figs can cause irritant or phototoxic reactions. Phytophotodermatitis is a common cutaneous phototoxic reaction. Contact with plant-derived phototoxic substances (furocoumarins or psoralens) followed by sunlight exposure produces the clinical lesions. Here, we present a case of phytophotodermatitis after contact with fig fruits and leaves. The vesicular dermatitis was primarily located in areas of vitiligo.

Composição florística dos afloramentos rochosos do Morro do Forno, Altinópolis, São Paulo / Floristic composition of the rock outcrops of the Morro do Forno, Altinópolis-SP

Áreas de afloramentos rochosos em topos de morros abrigam uma vegetação bastante peculiar. Muitas das espécies que ocorrem nessas áreas apresentam uma série de características que permitem sua sobrevivência num ambiente com solo pobre e arenoso, com alta insolação e grande oscilação de temperatura entre o dia e a noite. Essas características particulares despertaram o interesse no estudo da flora das áreas de afloramentos rochosos do Morro do Forno (Altinópolis-SP). A flora apresenta um total de 157 espécies distribuídas em 48 famílias. Fabaceae (14 spp.), Asteraceae (12 spp.), Poaceae (12 spp.), Rubiaceae (11 spp.), Malpighiaceae (9 spp.) e Melastomataceae (8 spp.) são as famílias com o maior número de espécies. O estrato herbáceo-arbustivo caracteriza a área (61 por cento), seguido pelo arbóreo (19 por cento), sendo de menor representatividade as lianas (11 por cento) e os subarbustos (9 por cento). Muitas das espécies que ocorrem na área estão presentes em outros afloramentos rochosos brasileiros como, por exemplo, nos campos rupestres da Serra do Cipó e Serra da Canastra em Minas Gerais e nos cerrados rupestres da Chapada dos Guimarães no Mato Grosso.

Rock outcrops on the plateaus of hills have peculiar vegetation. The major part of the species occurring on these areas have various features that allow their survival under adverse environmental conditions as poor and sandy soil with intense solar radiation and great temperature ranging from day and night. These particular characteristics aroused the interest in the study of the flora on rock outcrops of Morro do Forno (Altinópolis-SP). A list of 157 species of 48 families was recorded. Fabaceae (14 spp.), Asteraceae (12 spp.), Poaceae (12 spp.), Rubiaceae (11 spp.), Malpighiaceae (9 spp.) and Melastomataceae (8 spp.) are the families with more number of species. The herbaceous-shruby stratum characterizes the area (61 percent), followed by arboreous (19 percent); lianas (11 percent) and subshruby (9 percent) are less representative. Many of the species occurring on the area are present another Brazilian rocky outcrops as, for example, the "campos rupestres" of the Minas Gerais state (Serra do Cipó and Serra da Canastra) and the "cerrados rupestres" of the Mato Grosso state (Chapada dos Guimarães).

Corneal injury by wild taro.

We report a case of crystalline keratopathy caused by Alocasia macrorrhiza. The diagnosis was made based on the observation of needle-like crystals in the corneal stroma following injury to that eye. The condition resolved in 3 months with the disappearance of the crystals confirmed by follow-up confocal microscopy.

Toxicity study of the volatile constituents of Myoga utilizing acute dermal irritation assays and the Guinea-pig Maximization test.

Myoga is a fragrant plant which is the special product of Japan and is cultivated throughout Japan. According to our earlier investigation (unpublished data) of myoga cultivators in Japan, 8 of 35 cultivators experienced contact dermatitis in the harvest season. The purpose of this study was to assess the allergenicity of myoga and its major volatile components. The volatile components of myoga were analyzed by gas chromatograph (GC). They included a-pinene, beta-pinene and R-(+)-limonene. We performed a toxicity study of each of the major fragrant components of myoga using acute dermal irritation assays and the Guinea-Pig Maximization test (GPMT) in order to probe the mechanism of allergic contact dermatitis. In acute dermal irritation assays, alpha-pinene, beta-pinene and limonene showed positive responses at concentrations of 4%; limonene oxide at 20% and myoga showed a positive response at concentrations of 100%. From the results of the GPMT, according to Kligman scores, limonene oxide was identified as an extreme skin sensitizer and myoga as a mild skin sensitizer. The results of the present study show that R-(+)-limonene is the most important allergen amongst the chemical components of myoga, and we consider it to be the reason why myoga cultivators experience allergic contact dermatitis.

Allergic contact dermatitis to plants in a Spanish dermatology department: a 7-year review.

To investigate the incidence of allergic contact dermatitis (ACD) to plants in our area, we reviewed the records of the patients that were studied in the Allergic Contact Unity of our hospital in the last 7 years (2248 patients). We found 69 cases of positive patch tests to plant allergens, representing 3% of all the patients in that period. Diallyl disulfide was the most frequent allergen (47 cases), involving mainly middle-aged housewives with chronic hand eczema. Positive tests to sesquiterpene lactone mix (SL mix) were found in 11 patients, mostly middle-aged rural workmen with an airborne clinical pattern. Other allergens detected were lichens, primin, tulipalin A and wood. These results show a high incidence of ACD to diallyl disulfide that, in our opinion, should be tested in all housewives or cooks with chronic hand eczema. The predominance of the classical airborne pattern of allergy to SL in our study may be because the airborne way of allergen exposure in our area, with a high percentage of rural population, is the most frequent, and it makes it important to remember this possibility in the differential diagnosis of photosensitivity.