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1.
Int J Dermatol ; 61(1): 33-38, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34212363

RESUMO

Celiac disease is a multifactorial, inflammatory disorder initiated and sustained by the ingestion of gluten. Occurring across a broad population, the intestinal and extraintestinal manifestations of celiac disease are variable in severity and may be nonspecific in presentation. Given that environmental, genetic, and immune factors involved in the pathogenesis of celiac disease that the digestive tract and skin share many characteristics, and with a prevalence of 0.5-1% in most populations, it is reasonable to consider varying presentations of skin conditions that are linked with celiac disease. The association between celiac disease and skin conditions has been discussed earlier, but new studies have emerged suggesting cutaneous involvement in addition to dermatitis herpetiformis. We review the current literature identifying the relationship and potential mechanisms between celiac disease and various skin conditions.


Assuntos
Doença Celíaca , Dermatopatias , Doença Celíaca/complicações , Doença Celíaca/epidemiologia , Glutens/efeitos adversos , Humanos , Pele , Dermatopatias/epidemiologia , Dermatopatias/etiologia
2.
Dermatol Clin ; 40(1): 83-93, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34799038

RESUMO

Many dermatologic conditions common in the pediatric population may have unique presentations in skin of color or occur with greater incidence. This may be due to ethnic origin, socioeconomic factors, or other influences. Awareness of the potential variations in skin of color may enhance prompt diagnosis, appropriate treatment, and/or reassurance as indicated.


Assuntos
Dermatologia , Dermatopatias , Criança , Humanos , Pele , Dermatopatias/epidemiologia , Pigmentação da Pele
3.
Cells ; 10(12)2021 12 16.
Artigo em Inglês | MEDLINE | ID: mdl-34944067

RESUMO

Aryl Hydrocarbon Receptor (AhR) is an evolutionary transcription factor which acts as a crucial sensor of different exogenous and endogenous molecules Recent data indicate that AhR is implicated in several physiological processes such as cell physiology, host defense, proliferation and differentiation of immune cells, and detoxification. Moreover, AhR involvement has been reported in the development and maintenance of several pathological conditions. In recent years, an increasing number of studies have accumulated highlighting the regulatory role of AhR in the physiology of the skin. However, there is evidence of both beneficial and harmful effects of AHR signaling. At present, most of the evidence concerns inflammatory skin diseases, in particular atopic dermatitis, psoriasis, acne, and hidradenitis suppurativa. This review exam-ines the role of AhR in skin homeostasis and the therapeutic implication of its pharmacological modulation in these cutaneous inflammatory diseases.


Assuntos
Fatores de Transcrição Hélice-Alça-Hélice Básicos/genética , Inflamação/genética , Psoríase/genética , Receptores de Hidrocarboneto Arílico/genética , Dermatopatias/genética , Diferenciação Celular/genética , Doença Crônica/epidemiologia , Dermatite Atópica , Regulação da Expressão Gênica/genética , Humanos , Inflamação/epidemiologia , Inflamação/patologia , Queratinócitos/metabolismo , Queratinócitos/patologia , Estresse Oxidativo/genética , Psoríase/epidemiologia , Psoríase/patologia , Pele/metabolismo , Pele/patologia , Dermatopatias/epidemiologia , Dermatopatias/patologia
4.
J Assoc Physicians India ; 69(11): 11-12, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34781609

RESUMO

BACKGROUND: Dermatological disorders are common in patients being treated in intensive care units (ICU). However, they are often neglected in context of a critically ill patient. Very few studies focusing on these dermatoses have been undertaken. OBJECTIVES: To determine the prevalence and spectrum of dermatological disorders in patients being treated in medical ICU of a tertiary care centre. METHODS: This was a descriptive study conducted over a period of one year. All the patients admitted in the medical ICU were examined for the presence of any preexisting or newly developed dermatological disorder. Dermatological disorders were initially classified into infective and non-infective disorders. Patients with dermatological findings were classified into two groups: those who survived and those who died; which were compared with each other with respect to age and sex distribution, length of ICU stay and dermatological findings. RESULTS: Out of 776 cases admitted in ICU during the study period, dermatological disorders were observed in 164 (21.13%) cases. Life-threatening dermatological disorders were seen in 3.05% cases. Twenty nine (17.68%) patients with dermatological findings died. Amongst these cases, infectious dermatological disorders were significantly less common; while no significant difference was noticed in context of reactive dermatological disorders. CONCLUSION: Dermatological disorders in ICU are common and have a wide spectrum. They often need treatment and may be indicative of underlying potentially fatal systemic illness. Besides, a subset of cutaneous lesions may develop in response to various medical interventions, immunosuppression and immobility. Knowledge of such dermatoses is thus, essential, both for the intensivist and dermatologist.


Assuntos
Dermatopatias , Cuidados Críticos , Estado Terminal , Hospitalização , Humanos , Unidades de Terapia Intensiva , Tempo de Internação , Dermatopatias/epidemiologia , Centros de Atenção Terciária
5.
Psychiatr Danub ; 33(Suppl 4): 613-621, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34718289

RESUMO

BACKGROUND: Most dermatovenereological diseases are not life-threatening but nevertheless are highly prevalent disorders. Psychosocial aspects of skin diseases and physical symptoms strongly influence patient's quality of life (QoL) which results in the development of different coping mechanisms in patient's behaviour. Development of psychiatric comorbidity in patients with skin diseases is well known. On the other hand, little is known about psychological comorbidity associated with dermatovenereological diseases. Aims of this study were to investigate QoL and psychological burden among dermatovenereological patients. SUBJECTS AND METHODS: Two hundred and ninety patients suffering from different dermatological and venereological diseases participated in the study, divided into three study groups: itchy/painful dermatoses, non-itchy/non-painful dermatoses and venereological diseases. Participants completed standardized psychological questionnaires: Dermatology Specific Quality of Life (DSQL), Beck Depression Inventory (BDI) and State and Trait Anxiety Inventory (STAI). Intensity of the disease and localisation of the lesions were also assessed. RESULTS: Physical aspect of QoL was mostly influenced by itchy/painful dermatoses but psychological aspect and everyday activities and choices were mostly affected by patients with non-itchy/non-painful dermatoses and venereological diseases. 4.1% of participants had serious depressive symptoms, 11.5% had high and very high anxiety symptoms as state and 15.6% as trait. However, participants with severe skin conditions were more depressed, while participants with always and sometimes exposed lesions were more anxious. CONCLUSION: It is essential to recognise subgroups of dermatovenereological patients whose treatment approach should be interdisciplinary. Further studies are needed to detect psychosocial needs of patients with venereological diseases.


Assuntos
Qualidade de Vida , Dermatopatias , Adaptação Psicológica , Ansiedade/epidemiologia , Humanos , Dermatopatias/epidemiologia , Inquéritos e Questionários
6.
Ann Glob Health ; 87(1): 92, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34621627

RESUMO

Background: Amongst established growing industries worldwide, the construction industry contributes about 7.5% of the world labor force and 16.4% of global occupational diseases and accidents. A variety of activities are practiced in construction work, such as masonry, painting, welding, carpentry, plastering, concrete and cement mixing. These may eventually lead to exposures that can subject the workers to risks of developing occupational skin diseases. Most studies done on the construction industry in Tanzania have focused on effects such as injuries, respiratory problems and ergonomics; very little research has been done on skin diseases. Objectives: The study aimed at assessing the prevalence of occupational skin diseases, associated factors and preventive measures among building construction workers in Dar es Salaam, Tanzania. Methods: Construction sites and participants were selected using simple random sampling. The Nordic Occupational Skin Questionnaire (NOSQ) was adapted and used for assessing the development of skin diseases among constructions workers. Analysis of categorical variables, associated factors and skin preventive measures was done using Chi-square tests. Bivariate and multivariate logistic regression analyses were performed to determine odds ratio and adjusted odds ratio for factors indicating an influence on the occurrence of skin diseases. Findings: The study consisted of 420 building construction workers from different sites with a mean age of 32.7 years. The participants were masons, assistant masons and carpenters. The mean work duration was 6 years. Occupational Skin diseases were prevalent in 228 (54%) workers. Carpenters had a higher prevalence of skin diseases 12(67%), followed by assistant masons 43 (64%). Timely provision of safety trainings and of PPE utility, training and guidance lowered the occurrence of skin diseases. Conclusion: A high number of construction workers experienced skin diseases, especially those who have worked for more than 4 years. Workers who received safety training before the work shift had lesser prevalence of skin diseases compared to those who did not. Receiving proper information on PPE usage and proper wearing of gloves had a protective effect.


Assuntos
Indústria da Construção , Doenças Profissionais , Dermatopatias , Adulto , Humanos , Doenças Profissionais/epidemiologia , Doenças Profissionais/prevenção & controle , Dermatopatias/epidemiologia , Dermatopatias/prevenção & controle , Tanzânia/epidemiologia , Local de Trabalho
7.
J Cosmet Dermatol ; 20(11): 3630-3641, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34605159

RESUMO

BACKGROUND: Worldwide 10-20% of the population is tattooed. However, tattoo complications can occur, such as allergic tattoo reactions, infections, and manifestations of autoimmune dermatoses. Despite the growing popularity of tattoos and changes in tattoo ink composition over the last decades, little is known about these complications, its clinical aspects, pathomechanism, and relative occurrence. OBJECTIVE: The aim of this article is to describe the types and clinical aspects of dermatological tattoo complications, its relative occurrence and underlying conditions. METHODS: We performed a retrospective cohort study enrolling all patients with tattoo complications from the Tattoo Clinic. Tattoo complications were categorized into infections, inflammatory tattoo reactions, neoplasms, or miscellaneous reactions and correlated to clinical data. RESULTS: Of the total of 326 patients, 301 patients were included with 308 complications. The majority of the complications were chronic: 91.9%. Allergic red tattoo reactions and chronic inflammatory black tattoo reactions (CIBTR) accounted for 50.2% and 18.2%, respectively, of all tattoo complications. Of these CIBTR reactions, extracutaneous involvement was found in 21.4%, including tattoo-associated uveitis (7.1%) and systemic sarcoidosis (14.2%). Of all black tattoo reactions, systemic sarcoidosis was found in 7.8%. CONCLUSION: Tattoos can cause a wide range in complications that may start years after getting the tattoo. The most frequent tattoo reactions are allergic red tattoo reactions and chronic inflammatory black tattoo reactions, making these the most relevant for the dermatologist. CIBTR have a high percentage of multi-organ involvement, and therefore, screening for sarcoidosis, including ocular involvement, is advised.


Assuntos
Sarcoidose , Dermatopatias , Tatuagem , Humanos , Tinta , Estudos Retrospectivos , Dermatopatias/epidemiologia , Dermatopatias/etiologia , Tatuagem/efeitos adversos
8.
J Dtsch Dermatol Ges ; 19 Suppl 5: 25-53, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34662491

RESUMO

BACKGROUND: In Germany, skin diseases are mainly treated in the 115 dermatological hospitals. METHODS: Health care and health economic analysis of dermatological inpatient care and prediction of future care needs based on primary and secondary data. RESULTS: Outpatient and inpatient care for dermatologic treatment indications is predominantly provided by dermatology specialists. Inpatient treatment was provided for 833,491 cases in 2018, corresponding to 4.21 % of all inpatient cases (19,808,687). Most common treatment cases were: epithelial skin cancer (total 87,386, of which dermatology clinics 52,608), followed by melanoma (23,917/17,774), psoriasis (19,291/13,352), erysipelas (73,337/11,260), other dermatitis (12,671/10,842), atopic dermatitis (AD) (11,421/9,734), and herpes zoster (26,249/9,652). With an average length of stay of 5.69 days, dermatology hospitals were in the bottom third. The proportion of inpatient indications cared for in dermatology hospitals was highest for prurigo (95.2 %), pemphigus (94.9 %), parapsoriasis (94.6 %), pemphigoid (90.3 %), eczema other than AD (85.6 %), and AD (85.2 %). While the total number of inpatient treatment cases in Germany has increased by an average of 17.5 % between 2000 and 2018, this is the case for 26.6 % of skin diseases and over 150 % for individual ones. The projection of current to future inpatient care suggests a continued high demand for inpatient care by dermatology hospitals. CONCLUSION: Inpatient dermatological care will continue to be an indispensable component of qualified, socially necessary care in Germany.


Assuntos
Dermatologia , Prurigo , Dermatopatias , Atenção à Saúde , Alemanha/epidemiologia , Humanos , Pacientes Internados , Dermatopatias/epidemiologia , Dermatopatias/terapia
9.
Br J Nurs ; 30(16): S22-S30, 2021 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-34514829

RESUMO

BACKGROUND: Peristomal skin complications (PSCs) impair life for people with an ostomy. Visual signs of PSCs include discolouration, but sensation symptoms like pain, itching, and burning are equally important and underreported. AIM: To provide improved understanding of PSC prevalence and associated challenges in the communities of ostomy patients and ostomy care nurses. METHODS: The Ostomy Life Study 2019 encompassed a patient survey (completed by 5187 people with an ostomy) and a nurse survey (completed by 328 ostomy care nurses). FINDINGS: In total, 88% of patients experienced PSCs and 75% experienced PSC symptoms in the absence of discolouration. Eighty per cent of nurses considered ostomy-related issues to be the main reason for PSCs, and a correlation between PSC severity and number of nurse consultations was demonstrated. CONCLUSION: This study revealed a remarkably high PSC incidence in the absence of discolouration and highlighted direct consequences of having compromised skin and the health-economic consequences.


Assuntos
Estomia , Dermatopatias , Estomas Cirúrgicos , Humanos , Prevalência , Higiene da Pele , Dermatopatias/epidemiologia , Dermatopatias/etiologia , Estomas Cirúrgicos/efeitos adversos
10.
Rev Med Liege ; 76(9): 651-656, 2021 Sep.
Artigo em Francês | MEDLINE | ID: mdl-34477334

RESUMO

Köbner's phenomenon and its related phenomena are dermatological curiosities that are still partially misunderstood. The Köbner phenomenon is by far the best known and the most studied. It is characterized as the appearance of an inflammatory or infectious dermatosis in an area of healthy skin after skin trauma. The dermatoses most frequently concerned are psoriasis, lichen planus and vitiligo. The inverse Köbner phenomenon and the Renbök phenomenon are two very similar phenomena. The first represents the disappearance of a skin lesion after skin trauma. The second is characterized by a skin trauma that is more specifically induced by another dermatosis. Finally, the Wolf's isotopic phenomenon corresponds to the appearance of a new dermatosis on an area of the skin that was previously the site of another healed dermatosis.


Assuntos
Dermatologia , Psoríase , Dermatopatias , Humanos , Dermatopatias/epidemiologia , Dermatopatias/etiologia
11.
Bol Med Hosp Infant Mex ; 78(5): 450-456, 2021.
Artigo em Espanhol | MEDLINE | ID: mdl-34571515

RESUMO

This paper analyzed the beginning of medical care of children with skin diseases at the Hospital Infantil de Mexico Federico Gomez, an institution has been of great importance for the development of pediatrics and its subspecialties, one of them pediatric dermatology. The analysis is based on articles about skin disorders of childhood published in the Boletín Medico del Hospital Infantil de Mexico, an important source for the study of medicine in Mexico.


Assuntos
Hospitais , Dermatopatias , Criança , Humanos , Institucionalização , México , Dermatopatias/epidemiologia , Dermatopatias/terapia
12.
Dermatol Clin ; 39(4): 575-585, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34556247

RESUMO

During the COVID-19 pandemic, rapid, real-world evidence is essential for the development of knowledge and subsequent public health response. In dermatology, provider-facing and patient-facing registries focused on COVID-19 have been important sources of research and new information aimed at guiding optimal patient care. The 7 dermatology registries included in this update now include more than 8000 case reports sourced from physicians and patients from countries all over the world.


Assuntos
COVID-19/epidemiologia , Sistema de Registros/estatística & dados numéricos , Dermatopatias/epidemiologia , Suscetibilidade a Doenças , Humanos , Prevalência , Fatores de Risco
13.
Dermatol Clin ; 39(4): 587-597, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34556248

RESUMO

The impact of the COVID-19 pandemic on dermatology practice cannot be overstated. At its peak, the pandemic resulted in the temporary closure of ambulatory sites as resources were reallocated towards pandemic response efforts. Many outpatient clinics have since reopened and are beginning to experience a semblance of pre-pandemic routine, albeit with restrictions in place. We provide an overview of how COVID-19 has affected dermatology practice globally beginning with the rise of teledermatology. A summary of expert recommendations that shape the "new normal" in various domains of dermatology practice, namely, dermatology consultation, procedural dermatology, and phototherapy, is also provided.


Assuntos
Instituições de Assistência Ambulatorial/tendências , Dermatologia/normas , Atenção Primária à Saúde/tendências , Dermatopatias/terapia , Telemedicina/tendências , COVID-19/epidemiologia , Dermatologia/tendências , Acesso aos Serviços de Saúde/tendências , Humanos , Visita a Consultório Médico/tendências , Dermatopatias/epidemiologia
14.
Atherosclerosis ; 333: 116-123, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34399983

RESUMO

BACKGROUND AND AIMS: Familial hypercholesterolaemia (FH) is associated with high cardiovascular risk and underdiagnosed. Cutaneous manifestations are traditionally used as a major criterion of FH. They are included in the Dutch Lipid Clinic Network or Simon Broome registry criteria. The objective of this study was to evaluate cutaneous manifestations in contemporary FH patients. METHODS: We prospectively analysed the clinical presentation of FH patients referred to a University lipid clinic and validated these data in the German FH registry CaRe High. RESULTS: Physical examination revealed that only 14.4% of the FH patients in the lipid clinic cohort (n = 223) showed cutaneous manifestations. An arcus cornealis was present in 0.9%, xanthomata in 1.8%, and xanthelasmata in 12.1%. Xanthelasmata are not part of the clinical scores, but represented 84.4% of all cutaneous manifestations. In 42.6% (n = 95) of the patients, genetic analysis was available. A causal FH mutation was detected in 50.5%. Among carriers, 66.7% had no cutaneous manifestation, 8.3% exhibited an arcus cornealis or xanthomata, and 25.0% had xanthelasmata. In the CaRe High FH registry, data on cutaneous manifestations were available in n = 1274 patients. 3.5% had xanthomata, 5.7% an arcus cornealis, and 7.7% at least one of both; xanthelasmata were present in 10.3%. CONCLUSIONS: Cutaneous manifestations are only present in a minority of contemporary patients with FH including the subgroup with monogenic FH mutations. Although rare, the cutaneous signs have value in terms of specificity. However, the clinical characteristics shared by the majority of FH patients may be better suited for screening purposes.


Assuntos
Hiperlipoproteinemia Tipo II , Dermatopatias , Xantomatose , LDL-Colesterol/genética , Testes Genéticos , Humanos , Hiperlipoproteinemia Tipo II/diagnóstico , Hiperlipoproteinemia Tipo II/epidemiologia , Hiperlipoproteinemia Tipo II/genética , Mutação , Dermatopatias/diagnóstico , Dermatopatias/epidemiologia , Dermatopatias/genética , Xantomatose/diagnóstico , Xantomatose/epidemiologia , Xantomatose/etiologia
15.
Vet Q ; 41(1): 242-249, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34403624

RESUMO

BACKGROUND: Masai Giraffes have declined dramatically in recent decades due to loss of habitat and illegal hunting. Hence, it is critically important that the epidemiology and etiology of so-called giraffe skin disease (GSD) is understood well. AIM: To assess the prevalence and histopathological characteristics of GSD in the Tarangire-Manyara Ecosystem (TME), northern Tanzania. METHODS: The study used road transects to gather field information on GSD. Eighty-four giraffes were sighted by systematic random sampling in the six study sites. Examination of giraffes involved body distribution of lesions, severity of the lesions and whether they were associated with age and sex of the affected giraffes. Five giraffes with GSD were immobilized for tissue collection and histopathological analysis. RESULTS: Prevalence among adults was 79%. Affected animals typically had 1-5 lesions which were mostly moderate and were predominantly observed on the forelegs. GSD positivity rate was higher among females versus males, whereas males had a higher rate of severe lesions and generally had more lesions than females. Calves showed no lesions. All tissue sections from five affected giraffes showed the presence of large quantities of fungal elements (hyphae and spores) that involved hair shafts and sub-cutaneous tissue after staining with Grocott Methenamine Silver as special fungal staining technique. CONCLUSIONS: Our findings suggest the involvement of fungal infection in GSD pathogenesis. CLINICAL RELEVANCE: We recommend further characterization of the lesions using modern molecular techniques and culture to identify primary and secondary or opportunistic etiologies, and the order in which the pathogens occur in the lesions.


Assuntos
Girafas , Micoses/veterinária , Dermatopatias/veterinária , Animais , Feminino , Fungos/isolamento & purificação , Masculino , Prevalência , Dermatopatias/epidemiologia , Dermatopatias/microbiologia , Dermatopatias/patologia , Tanzânia/epidemiologia
16.
Medicina (B Aires) ; 81(4): 546-554, 2021.
Artigo em Espanhol | MEDLINE | ID: mdl-34453795

RESUMO

Dermatological emergencies are a frequent reason for emergency departments consultation. In order to determine the prevalence of dermatological emergencies, to describe the kind of dermatological diseases that present as emergencies, to analyze the coincidence between the diagnoses received by the patients in those cases with a previous consultations for the same cutaneous manifestation, and to analyze the behavior according to the health system segment in which they were attended: public segment and private segment; a prospective, observational, analytical, cross-sectional and multi-center study was carried out. Two thousand eight hundred one patients were included. The prevalence of consultations for dermatological emergencies in adults was 15% in the same time period (public segment: 10.6 and private segment: 22.5%, p < 0.05). The consultation was due to an infectious disease in 35.5%, allergic in 29.6% and neoplastic in 8.6%; 0.7% of patients were hospitalized. In 31.7% of patients who had a previous consultation, a coincidence was found between the diagnoses made in 80.7% of those attended by a dermatologist, and 52.6% evaluated by non-dermatologist physician. The high prevalence of dermatological consultations and the existing differences in the probability of receiving an appropriate diagnosis according to the specialization of the intervening professional, show the importance of the presence of dermatology-trained physicians in the emergency area.


Assuntos
Dermatologia , Dermatopatias , Adulto , Argentina/epidemiologia , Estudos Transversais , Emergências , Humanos , Estudos Prospectivos , Dermatopatias/diagnóstico , Dermatopatias/epidemiologia
17.
Medicina (Kaunas) ; 57(8)2021 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-34440978

RESUMO

Background and Objectives: The COVID-19 pandemic has a considerable influence on public health, either directly or indirectly. We investigated outpatient skin disease diagnoses at the dermatology clinic to determine the effect of the COVID-19 pandemic on these patients. Materials and Methods: We conducted a retrospective study using the International Codes of Diseases data from the outpatient department of Dermatology clinic, Vajira hospital, Navamindradhiraj University, Bangkok, Thailand from January 2019 to June 2021. Results: A total of 20,915 patients with 34,116 skin diagnoses were included in the study. The average weekly dermatologic clinic visits remained unchanged between the years with and without COVID-19 pandemic. While the percentage of xerosis cutis, other skin infections (syphilis and parasitic infections), hair and nail disorders, pigmentary disorders, benign skin tumors and drug eruptions were significantly decreased during the COVID-19 pandemic years, the percentage of other dermatitis, fungal and viral skin infections, acne, psoriasis, urticaria, vesiculobullous and autoimmune diseases were increased. Conclusion: The COVID-19 pandemic had a minimal effect on the average weekly skin clinic visits, but the diagnosed skin diseases pattern was affected. Knowing the pattern of skin diseases may help aid hospitals to better prepare for future pandemics in securing appropriate medications and supplies and training the medical teams.


Assuntos
COVID-19 , Dermatologia , Dermatopatias , Humanos , Pandemias , Estudos Retrospectivos , SARS-CoV-2 , Dermatopatias/epidemiologia , Tailândia
18.
Acta Derm Venereol ; 101(9): adv00560, 2021 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-34427313

RESUMO

The globally increasing prevalence of chronic inflammatory skin diseases has substantial costs. Biologicals have become available as therapeutic options, but are encumbered with barriers to prescription. The aim of this study was to evaluate the barriers to prescription of biologicals in the treatment of chronic dermatological diseases. Dermatologists working in private practices in the German federal states of Bavaria and Lower Saxony participated in a cross-sectional study. Economic and legal aspects, including "high therapy costs", "low reimbursements", and "fear of regress claims", were identified as the most prevalent barriers. Significant differences between dermatologists from Bavaria and Lower Saxony were found only regarding the treatment of atopic dermatitis. This study demonstrates the prevalence of barriers to the prescription of biologicals in the treatment of chronic dermatological diseases. Overcoming these barriers could improve the usage of modern therapies and thereby expand patient-centred care for chronic skin diseases.


Assuntos
Produtos Biológicos , Dermatite Atópica , Dermatopatias , Produtos Biológicos/efeitos adversos , Estudos Transversais , Dermatite Atópica/diagnóstico , Dermatite Atópica/tratamento farmacológico , Dermatite Atópica/epidemiologia , Humanos , Prescrições , Dermatopatias/diagnóstico , Dermatopatias/tratamento farmacológico , Dermatopatias/epidemiologia
19.
Medicina (B.Aires) ; 81(4): 546-554, ago. 2021. graf
Artigo em Espanhol | LILACS | ID: biblio-1346505

RESUMO

Resumen Las urgencias dermatológicas constituyen un motivo de consulta frecuente en los departamentos de urgencias. Con el objetivo de determinar la prevalencia de las consultas por urgencias dermato lógicas, describir las mismas, analizar la coincidencia entre los diagnósticos recibidos por los pacientes, en los casos que realizaron dos consultas por el mismo cuadro, y analizar el comportamiento de las variables de acuerdo al subsector del sistema de salud en el cual fueron atendidos: subsector público, y subsector privado, se realizó un estudio prospectivo, observacional, analítico, de corte transversal y multicéntrico. Se incluyeron 2801 pacientes. La prevalencia de las consultas por urgencias dermatológicas en adultos fue de 15% en el mismo período horario (subsector público: 10.6% y subsector privado: 22.5%, p < 0.05). Motivó la consulta una enfermedad infecciosa en el 35.5%, alérgica en el 29.6% y neoplásica en el 8.6%. Se hospitalizó el 0.7% de los pacientes. El 31.7% de los pacientes había realizado consultas previas. En estos casos se encontró coincidencia entre los diagnósticos realizados en el 80.7% de los atendidos de forma precedente por un médico dermatólogo, y el 52.6% de los evaluados por médicos no dermatólogos. La alta prevalencia de las consultas por urgencias dermatológicas y las diferencias existentes en la probabilidad de recibir un diagnóstico apropiado de acuerdo con la especialización del profesional interviniente, muestran la importancia de la presencia de un médico con formación en dermatología en el área de urgencias.


Abstract Dermatological emergencies are a frequent reason for emergency departments consultation. In order to determine the prevalence of dermatological emergencies, to describe the kind of dermatological diseases that present as emergencies, to analyze the coincidence between the diagnoses received by the patients in those cases with a previous consultations for the same cutaneous manifestation, and to analyze the behavior according to the health system segment in which they were attended: public segment and private segment; a prospective, ob servational, analytical, cross-sectional and multi-center study was carried out. Two thousand eight hundred one patients were included. The prevalence of consultations for dermatological emergencies in adults was 15% in the same time period (public segment: 10.6 and private segment: 22.5%, p < 0.05). The consultation was due to an infectious disease in 35.5%, allergic in 29.6% and neoplastic in 8.6%; 0.7% of patients were hospitalized. In 31.7% of patients who had a previous consultation, a coincidence was found between the diagnoses made in 80.7% of those attended by a dermatologist, and 52.6% evaluated by non-dermatologist physician. The high prevalence of dermatological consultations and the existing differences in the probability of receiving an appropri ate diagnosis according to the specialization of the intervening professional, show the importance of the presence of dermatology-trained physicians in the emergency area.


Assuntos
Humanos , Adulto , Dermatopatias/diagnóstico , Dermatopatias/epidemiologia , Dermatologia , Argentina/epidemiologia , Estudos Transversais , Estudos Prospectivos , Emergências
20.
Nutrients ; 13(6)2021 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-34203033

RESUMO

The Kaliningrad region is known for its specific climate, which can negatively affect the adaptive potential of the body. This manifests in an increased incidence of respiratory diseases and skin conditions. To prevent high morbidity, a plant protein product was included in the diet of first-year university students. This study aimed to assess the effectiveness of this food intervention in preventing the most common diseases among Kaliningrad students. Two groups of university students took part in the food trial. In the control group, catabolic processes prevailed in nutrient metabolism. Disadaptation manifested itself in the metabolism of proteins, vitamins, minerals, hematopoiesis and humoral immunity. Inflammation was indicated by α1- and α2-globulins, a weak immune response, and IgM and IgG. High oxidative stress and low antioxidative ability of blood serum were observed. The plant-based protein product (FP) helped preserve testosterone level and prevent an increase in catabolic reactions. Moreover, it had a positive effect on both red blood cell hematopoiesis (a smaller increase in the average volume of erythrocytes, the same average concentration and content of hemoglobin, an increased relative red cell distribution width (RDW) and white blood cell hematopoiesis (a beneficial effect for the immune system: lymphocytes, the relative content of neutrophils, monocytes, basophils and eosinophils). The stimulation of humoral immunity was evidenced by beta- and gamma-globulins, an active immune response, the level of IgM and IgG, antioxidant protection, reduction of peroxides and an increase in antioxidant activity of blood serum. The 34-week observation showed a 1.7-fold decrease in the incidence of respiratory illnesses and a 5.7-fold decrease in skin and subcutaneous tissue diseases. Acute respiratory infections were reduced 1.8-fold. There were no cases of community-acquired pneumonia in the treatment group, compared with 55.1‰ in the control group. The incidence of respiratory diseases was 3.3-10.6 times lower in the treatment group than in the control group in weeks 6-19. The findings testify to the prophylactic effect of functional food during social adaptation and acclimatization of students.


Assuntos
Alimento Funcional , Proteínas de Vegetais Comestíveis/administração & dosagem , Doenças Respiratórias/prevenção & controle , Dermatopatias/prevenção & controle , Contagem de Células Sanguíneas , Clima , Alimento Funcional/análise , Hematopoese , Humanos , Imunidade Humoral , Micronutrientes/análise , Minerais/sangue , Estresse Oxidativo , Doenças Respiratórias/epidemiologia , Federação Russa , Dermatopatias/epidemiologia , Testosterona/sangue , Vitaminas/sangue
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