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1.
Medicine (Baltimore) ; 98(45): e17914, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31702670

RESUMO

There are very few reports of eczema and other prosthetic-related allergic skin complications following arthroplasty. We aimed to assess the risk of eczema after joint replacement.We performed a retrospective population-based cohort study in 2024 joint replacement patients using the Longitudinal Health Insurance Database. For comparison, 8096 controls were selected, with 4 control subjects for each joint replacement patient matched for age, sex, and index year, to assess eczema risk. We examined 14-year cumulative eczema incidence associated with age, sex, immunity, disease history, and joint replacement location.Eczema rates in the joint replacement patients were 38% higher than in the control group (57.90 vs 41.84 per 1000 person-years, respectively). Compared with the control group, joint replacement patients showed a 1.35-fold increased risk of eczema according to the multivariable Cox model (95% Confidence interval [CI] = 1.23-1.49). Knee replacement patients had higher eczema risk compared with the control group (Hazard ratio [HR] = 1.45, 95% CI = 1.33-1.70). Stratified by study period, the joint replacement cohort had a higher eczema risk after the 3-month follow-up.Our study revealed that joint arthroplasty increased risk of eczema in this 14-year follow-up study, and this was not related to personal atopic history or gender.


Assuntos
Artroplastia de Substituição/efeitos adversos , Eczema/epidemiologia , Prótese Articular/efeitos adversos , Idoso , Artroplastia de Substituição/estatística & dados numéricos , Estudos de Casos e Controles , Comorbidade , Dermatite Alérgica de Contato/epidemiologia , Eczema/etiologia , Feminino , Humanos , Incidência , Estudos Longitudinais , Masculino , Metais/efeitos adversos , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Fatores de Risco
2.
Environ Int ; 125: 252-260, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30731375

RESUMO

We studied indoor sources of indoor particulate matter (PM), outdoor air pollution and antibiotic use in relation to asthma, rhinitis and eczema among pre-school children and investigated synergistic effects between PM and antibiotics use. Children (3-6y) from randomly selected day care centres in seven cities across China were included (n = 39,782). Data on ambient temperature and air pollution were collected from local monitoring stations. Data on indoor PM sources (ETS, burning of incense or mosquito coils and biomass for cooking), antibiotics use and health (doctor diagnosed asthma and rhinitis, lifetime eczema, current wheeze and current rhinitis) were assessed by a parental questionnaire. Associations were calculated by multilevel logistic regression. Asthma diagnosis was associated with outdoor temperature, NO2 and burning mosquito coils. Rhinitis diagnosis was associated with NO2, ETS, gas cooking and burning biomass for cooking. Lifetime eczema was associated with temperature, PM10, NO2, ETS, biomass cooking and burning mosquito coils. Burning incense was associated with current wheeze and current rhinitis. Children using antibiotics had more asthma, wheeze, rhinitis, and eczema. Excluding children with respiratory infections did not change associations with antibiotics use. Antibiotics use enhanced the effects of ETS and PM10 (a synergistic effect). In conclusion, a warmer climate, outdoor NO2 and PM10, ETS, gas cooking and burning biomass, incense and mosquito coils can increase the risk of asthma, wheeze, rhinitis and eczema among pre-school children in China. Antibiotics use is a risk factor for childhood asthma, wheeze, rhinitis and eczema and ETS and outdoor PM10 can enhance the effect.


Assuntos
Poluentes Atmosféricos/análise , Poluição do Ar em Ambientes Fechados/análise , Asma/etiologia , Eczema/etiologia , Material Particulado/análise , Rinite/etiologia , Poluição por Fumaça de Tabaco/efeitos adversos , Poluentes Atmosféricos/toxicidade , Poluição do Ar em Ambientes Fechados/efeitos adversos , Antibacterianos/efeitos adversos , Criança , Pré-Escolar , China , Cidades , Clima , Culinária , Sinergismo Farmacológico , Feminino , Humanos , Modelos Logísticos , Masculino , Material Particulado/efeitos adversos , Sons Respiratórios/etiologia , Fatores de Risco , Inquéritos e Questionários
4.
Int Arch Occup Environ Health ; 92(4): 587-598, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30627853

RESUMO

PURPOSE: In the past 60 years, the prevalences of asthma and allergy among children have increased around the world. Neither genetic nor outdoor environmental factors can explain this increase. METHODS: We performed a cross-sectional study of 7366 children in Tianjin, China, on associations of home environment and lifestyles with asthma and allergy. RESULTS: The prevalences of diagnosed asthma, rhinitis and eczema among 0- to 8-year-old children in the Tianjin area were 4%, 9% and 39%. Home environment and lifestyle, together with infections, were strong risk factors. For asthma and allergy, the population attributable fraction (PAF) due to modern floors and wall coverings (i.e., laminated wooden floors and painted walls compared to tile floors and lime-coated walls) was 22%. Window condensation in winter and air conditioner use in summer, both of which are proxies for less ventilation, accounted for 7-17% of rhinitis and eczema. Cesarean delivery accounted for 10% of eczema symptoms. We developed a modern life index from appropriate home characteristics and lifestyle and food consumption habits and found it to have a clear dose-response relationship with asthma and allergy in Tianjin children. CONCLUSIONS: The results indicate that a "modern" home environment together with a modern lifestyle is associated with increased prevalences of asthma and allergies among children. Appropriate indoor environmental interventions and education of children's caregivers are important in the management of childhood asthma and allergy.


Assuntos
Asma/epidemiologia , Habitação , Hipersensibilidade/epidemiologia , Estilo de Vida , Asma/etiologia , Cesárea/efeitos adversos , Criança , Pré-Escolar , China/epidemiologia , Estudos Transversais , Eczema/epidemiologia , Eczema/etiologia , Exposição Ambiental/efeitos adversos , Feminino , Humanos , Hipersensibilidade/etiologia , Lactente , Recém-Nascido , Decoração de Interiores e Mobiliário , Masculino , Rinite Alérgica/epidemiologia , Rinite Alérgica/etiologia , Ventilação
5.
J Pediatr ; 204: 263-269, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30270158

RESUMO

OBJECTIVES: To describe the prevalence and the relationship between asthma, eczema, food allergy, and rhinitis in children after liver transplantation. STUDY DESIGN: Children who were liver transplant recipients were investigated to assess whether the high prevalence of food allergies was accompanied by eczema, rhinitis, and asthma. Furthermore, we included 56 children with chronic liver disease to explore the risk of allergy, eczema, and asthma in this group. RESULTS: After liver transplantation, children had higher prevalence of allergic reactions to food as compared with children with chronic liver disease (P < .001). Current asthma (P = .04) and eczema (P < .02) were observed more frequently in transplanted children as compared with children with chronic liver disease. For transplanted children who had ever received tacrolimus the relative risk (RR) of asthma was 1.7 (95% CI, 1.2-2.4; P = .02) as compared with children with chronic liver disease. Transplanted children with asthma had higher rates of sensitization to food allergens than those without asthma (RR, 3.6; 95% CI, 1.3-10.3; P = .01). The most frequent food allergens associated with asthma in transplanted children were milk (RR for asthma, 3.9; 95% CI, 1.6-9.4; P < .01), eggs (RR, 2.9; 95% CI, 1.2-7.0; P = .03), and peanuts (RR, 3.7; 95% CI, 1.6-8.3; P < .01). Food allergies occurred earlier than asthma, at 1.5 years after transplantation (IQR, 0.5-3.0 years) vs 2.5 years after transplantation (IQR, 1.0-4.5 years; P < .05). Food allergies were also associated with eczema, but not with sensitization to aero-allergens or rhinitis. CONCLUSIONS: The high risk of food allergies in children who were liver transplant recipients was associated with eczema and asthma, but not rhinitis. The most frequent food allergens associated with asthma were milk, eggs, and peanuts.


Assuntos
Asma/epidemiologia , Eczema/epidemiologia , Doença Hepática Terminal/complicações , Hipersensibilidade Alimentar/epidemiologia , Transplante de Fígado/efeitos adversos , Asma/etiologia , Criança , Pré-Escolar , Estudos Transversais , Eczema/etiologia , Doença Hepática Terminal/cirurgia , Feminino , Hipersensibilidade Alimentar/etiologia , Humanos , Imunossupressores/efeitos adversos , Lactente , Masculino , Prevalência , Testes de Função Respiratória/métodos , Rinite/epidemiologia , Rinite/etiologia , Fatores de Risco
6.
Pediatr Allergy Immunol ; 30(1): 36-46, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30338578

RESUMO

BACKGROUND: The prevalence of asthma and allergy is increasing in US children. In utero exposure to chemicals used in personal care products and plastics may contribute to increase in these diseases. METHODS: We quantified urinary concentrations of eight phthalate metabolites and bisphenol A in mothers twice during pregnancy in 1999-2000 in Salinas, California. We assessed probable asthma, aeroallergies, eczema, and spirometry in their children at age 7, and measured T helper 1 and T helper 2 cells in blood at ages 2, 5, and 7 (N = 392). We employed Bayesian model averaging to select confounders from additional biomarkers measured in this population and controlled for them in logistic and linear regressions. RESULTS: Monocarboxyisooctyl phthalate was associated with increased odds for probable asthma (odds ratio: 1.54, 95% CI: 1.12, 2.12), and with lower forced expiratory volume in one second (ß: -0.09 L, 95% CI: -0.15, -0.03) and forced expiratory flow from 25% to 75% of forced vital capacity (ß: -7.06 L/s, 95% CI: -11.04, -2.90). Several other associations were attenuated in final models that controlled for additional biomarkers. CONCLUSION: Monocarboxyisooctyl phthalate was associated with lower respiratory health after controlling for related chemical exposure, which suggests that confounding by multiple chemical exposures should be considered in future research.


Assuntos
Asma/epidemiologia , Compostos Benzidrílicos/urina , Eczema/epidemiologia , Fenóis/urina , Ácidos Ftálicos/urina , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Adolescente , Adulto , Asma/etiologia , Teorema de Bayes , Compostos Benzidrílicos/efeitos adversos , Biomarcadores/urina , California , Criança , Pré-Escolar , Eczema/etiologia , Exposição Ambiental/efeitos adversos , Poluentes Ambientais/efeitos adversos , Feminino , Humanos , Fenóis/efeitos adversos , Ácidos Ftálicos/efeitos adversos , Gravidez , Prevalência , Espirometria/métodos , Linfócitos T Auxiliares-Indutores , Adulto Jovem
7.
Zhonghua Shao Shang Za Zhi ; 34(12): 881-886, 2018 Dec 20.
Artigo em Chinês | MEDLINE | ID: mdl-30585052

RESUMO

Objective: To investigate the clinical effects of combined utilization of narrow-spectrum medium-wave ultraviolet, red light, and low power He-Ne laser on treatment of post-burn eczema. Methods: From July 2014 to July 2017, 80 patients with post-burn eczema who met the study inclusion criteria were treated in our burn rehabilitation center, and their clinical data were analyzed retrospectively. Patients were divided into ultraviolet treatment group, red light treatment group, laser treatment group, and combination treatment group according to the utilized treatment methods, with 20 cases in each group. Patients in ultraviolet treatment group were treated with narrow-spectrum medium-wave ultraviolet once every other day for 10 minutes each time. Patients in red light treatment group and laser treatment group were treated with red-light and low power He-Ne laser respectively once a day for 10 minutes each time. Patients in combination treatment group were treated with combination of the above three methods without sequence or interval time, and the treatment time and interval time were the same as the previously described. All patients were treated for four weeks since the time of admission. The itching degree, surface area of the affected body, degree of keratosis, and degree of cracking of target tissue were evaluated using Eczema Area and Severity Index (EASI) scoring method after each treatment. Eczema improvement rate was calculated according to the total score of EASI to determine the curative effect. The therapeutic effective time was recorded. The therapeutic effective rate was calculated according to the total scores of EASI before treatment for the first time and 4 weeks after treatment. Besides, the adverse reactions of patients were also observed and recorded. Data were analyzed by Chi-square test, Kruskal-Wallis rank sum test, Wilcoxon signed rank sum test, one-way analysis of variance, Least Significant Difference-t test, and Bonferroni correction. Results: Therapeutic effective times of eczema of patients in ultraviolet treatment group, red light treatment group, and laser treatment group were similar, respectively (13.7±1.3), (16.4±1.6), and (15.1±1.7) d (t=0.32, 0.58, 0.74, P>0.05). The therapeutic effective time of combination treatment group was (6.3±0.9) d, significantly shorter than that of ultraviolet treatment group, red light treatment group, or laser treatment group (t=5.62, 4.72, 4.61, P<0.05 or P<0.01). Compared with those before treatment for the first time, eczema itching degree, surface area of affected body, degree of keratosis, degree of cracking, and total score of EASI of patients in ultraviolet treatment group, red light treatment group, laser treatment group, and combination treatment group showed obvious improvement in 4 weeks after treatment (Z=5.372, 4.392, 4.284, 3.998, 4.092, 3.904, 4.042, 4.216, 3.684, 3.890, 5.081, 4.794, 4.094, 3.493, 3.995, 5.084, 4.903, 4.384, 3.995, 4.063, P<0.05 or P<0.01). Each item score and total score of EASI of eczema of patients in the first three groups were close (P>0.05), while each item score and total score of EASI of eczema of patients in combination treatment group was significantly better than those of ultraviolet treatment group, red light treatment group, and laser treatment group (H=2.482, 2.491, 3.583, 3.462, 6.025, 2.492, 3.693, 3.085, 3.482, 6.042, 5.831, 5.831, 4.893, 4.092, 6.931, P<0.05). Therapeutic effective rates of eczema of patients in ultraviolet treatment group, red light treatment group, and laser treatment group were close, respectively 60%, 60%, and 55% (χ(2)=1.46, 1.63, 0.97, P>0.05). The therapeutic effective rate of eczema of patients in combination treatment group was 90%, significantly higher than that of ultraviolet treatment group, red light treatment group, or laser treatment group (χ(2)=3.43, 4.15, 2.97, P<0.05 or P<0.01). There were no serious adverse reactions appeared in patients of all the four groups after treatment. Three patients in ultraviolet treatment group had local skin erythema, which was alleviated after symptomatic treatment. Conclusions: Combination of narrow-spectrum medium-wave ultraviolet, red light, and low power He-Ne laser in treating post-burn eczema is superior to single therapy in terms of clinical effective time and efficacy, which has no obvious adverse reaction and is worthy of promotion.


Assuntos
Queimaduras/complicações , Eczema/radioterapia , Lasers de Gás/uso terapêutico , Unidades de Queimados , Queimaduras/terapia , Eczema/etiologia , Eczema/terapia , Humanos , Estudos Retrospectivos , Resultado do Tratamento
8.
Complement Ther Med ; 41: 90-98, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30477869

RESUMO

OBJECTIVES: To assess the feasibility of a definitive trial investigating the effects of acupuncture on atopic dermatitis symptoms including itching. DESIGN: A randomized, sham-controlled preliminary trial with three arms with a 4-week intervention period and a 4-week follow-up. INTERVENTIONS: Thirty participants were allocated to three arms (the verum acupuncture group 1 [VA1, 3 times weekly for 4 weeks], the verum acupuncture group 2 [VA2, twice weekly for 4 weeks], and the sham acupuncture group [SA, twice weekly for 4 weeks]) at a 1:1:1 ratio. MAIN OUTCOME MEASURES: We determined the visual analogue scale (VAS) for itching and insomnia, SCORing Atopic Dermatitis (SCORAD), Eczema Area and Severity Index (EASI), Patient Oriented Eczema Measure (POEM), and Dermatology Life Quality Index (DLQI) scores over the course of the study. Baseline index score (BIS) comparison according to general symptom was performed. RESULTS: The SCORAD, VAS (Pruritus), VAS (Insomnia), POEM, DLQI, and EASI were significantly improved in the VA groups. Significant BIS mean differences were observed most predominantly in epigastric tenderness and dyspepsia. There was no significant difference between VA1 and VA2 groups in all the main evaluation indices. CONCLUSIONS: For the following research, the authors suggest SCORAD (Total) as primary outcome and SCORAD (objective), VAS (Itch), VAS (insomnia), EASI, POEM, and DLQI as secondary outcomes. Thirty six participants should be conducted a 4-week acupuncture period (twice weekly) and a 4-week follow-up. It is necessary to compare the differences of general symptoms according to presence of epigastric tenderness or dyspepsia at the screening level.


Assuntos
Terapia por Acupuntura , Dermatite Atópica , Eczema/terapia , Prurido/terapia , Índice de Gravidade de Doença , Adolescente , Adulto , Dermatite Atópica/complicações , Dermatite Atópica/terapia , Eczema/etiologia , Feminino , Humanos , Masculino , Prurido/etiologia , Escala Visual Analógica , Adulto Jovem
9.
J Drugs Dermatol ; 17(10): 1032-1036, 2018 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-30365582

RESUMO

BACKGROUND: Epidemiologic studies of patients who present to dermatology clinics are necessary to identify the needs of patients. OBJECTIVE: To quantify and compare diagnoses according to race, ethnicity, and socioeconomic status (SES) at 6 general dermatology clinics from January 2013 to December 2016. METHODS: A retrospective cohort of new patients was established using an electronic medical record database. Primary diagnoses and diagnostic codes were recorded. Geocoding was utilized to obtain SES. RESULTS: There were 65969 new patient visits. Racial and ethnic demographics were obtained with the overall top 3 conditions being eczema or dermatitis, benign skin neoplasm, and adnexal disease. In blacks, however, follicular disorders were the third most common condition seen. The most frequently encountered diagnoses at the clinics with the highest and lowest SES were benign skin neoplasm and eczema or dermatitis, respectively. LIMITATIONS: Only primary diagnoses were included in analysis. Determining one's race is increasingly difficult. CONCLUSION: Follicular disorders occurred with an increased frequency in blacks. When examining SES, eczema or dermatitis was the most frequently encountered primary diagnosis at the clinic with the lowest SES, with benign skin neoplasm seen with the highest frequency at the clinic with the highest SES. J Drugs Dermatol. 2018;17(10):1032-1036.


Assuntos
Dermatopatias/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Estudos de Coortes , Eczema/epidemiologia , Eczema/etnologia , Eczema/etiologia , Grupos Étnicos , Feminino , Humanos , Lactente , Masculino , Registros Médicos , Michigan/epidemiologia , Pessoa de Meia-Idade , Visita a Consultório Médico/estatística & dados numéricos , Estudos Retrospectivos , Dermatopatias/etnologia , Dermatopatias/etiologia , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/etnologia , Neoplasias Cutâneas/etiologia , Fatores Socioeconômicos , Adulto Jovem
10.
Environ Int ; 121(Pt 1): 538-549, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30293015

RESUMO

BACKGROUND: Personal care product chemicals may be contributing to risk for asthma and other atopic illnesses. The existing literature is conflicting, and many studies do not control for multiple chemical exposures. METHODS: We quantified concentrations of three phthalate metabolites, three parabens, and four other phenols in urine collected twice during pregnancy from 392 women. We measured T helper 1 (Th1) and T helper 2 (Th2) cells in their children's blood at ages two, five, and seven, and assessed probable asthma, aeroallergies, eczema, and lung function at age seven. We conducted linear and logistic regressions, controlling for additional biomarkers measured in this population as selected by Bayesian Model Averaging. RESULTS: The majority of comparisons showed null associations. Mono-n-butyl phthalate (MnBP) was associated with higher Th2% (RR: 10.40, 95% CI: 3.37, 17.92), and methyl paraben was associated with lower Th1% (RR: -3.35, 95% CI: -6.58, -0.02) and Th2% at borderline significance (RR: -4.45, 95% CI: -8.77, 0.08). Monoethyl phthalate was associated with lower forced expiratory flow from 25 to 75% of forced vital capacity (FEF25-75%) (RR: -3.22 L/s, 95% CI: -6.02, -0.34). Propyl paraben (OR: 0.86, 95% CI: 0.74, 0.99) was associated with decreased odds of probable asthma. CONCLUSIONS: While some biomarkers, particularly those from low molecular weight phthalates, were associated with an atopic cytokine profile and poorer lung function, no biomarkers were associated with a corresponding increase in atopic disease.


Assuntos
Asma/etiologia , Eczema/etiologia , Exposição Materna , Parabenos/toxicidade , Fenóis/urina , Ácidos Ftálicos/urina , Efeitos Tardios da Exposição Pré-Natal , Adolescente , Adulto , Asma/epidemiologia , Teorema de Bayes , Biomarcadores/urina , Criança , Estudos de Coortes , Cosméticos/efeitos adversos , Cosméticos/química , Eczema/epidemiologia , Exposição Ambiental , Feminino , Humanos , Hipersensibilidade , Estudos Longitudinais , Masculino , Parabenos/análise , Fenóis/toxicidade , Ácidos Ftálicos/efeitos adversos , Gravidez , Adulto Jovem
11.
Clin Exp Allergy ; 48(12): 1688-1697, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30311981

RESUMO

BACKGROUND: Cigarette smoke contains compounds similar to coal tar, an ancient remedy of eczema. Some studies have reported protective effects of maternal gestational smoking on offspring eczema; however, others have shown no or increased risks. Similarly, studies linking breastfeeding duration and eczema have demonstrated contradictory findings. No study has yet investigated combined effects of these two factors on eczema. OBJECTIVE: Since tobacco compounds can pass to offspring via breast milk, we investigated their combined effects on eczema development from childhood to adolescence. METHODS: We obtained information regarding gestational smoking, exclusive breastfeeding duration, and eczema at ages 1-or-2, 4, 10, and 18 years from the Isle of Wight (IOW) birth cohort, UK. Using generalized estimating equations, we assessed the interaction of gestational smoking and residual exclusive breastfeeding duration (Resid-BF-duration, obtained by regressing the latter on maternal smoking) on eczema over time adjusting for confounders. For the three transition periods of 1-or-2 to 4 years, 4-10, and 10-18 years, we estimated risks of persistent, incident, and remitting eczema associated with the interaction using repeated measurements. RESULTS: If the mother smoked during gestation, longer Resid-BF-duration was associated with a lower risk of eczema, compared to if she did not smoke. The risk ratios (95% CI) if the mother smoked during gestation and exclusively breastfed for at least 3, 9, 15, 21 weeks are 0.7 (0.6, 1.7), 0.6 (0. 4, 0.9), 0.5 (0.3, 0.8), and 0.4 (0.2, 0. 8), respectively. Additionally, in all three transition periods, the risk of persistent eczema was lower with longer Resid-BF-duration if the mother smoked during gestation. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest a protective effect of gestational smoking combined with longer duration of exclusive breastfeeding on early-onset persistent eczema. Future studies should examine underlying biological mechanisms. Prolonged breastfeeding should be encouraged even if the mother smoked during gestation.


Assuntos
Aleitamento Materno , Eczema/epidemiologia , Eczema/etiologia , Exposição Materna , Efeitos Tardios da Exposição Pré-Natal , Fumar , Adolescente , Fatores Etários , Biomarcadores , Criança , Pré-Escolar , Feminino , Predisposição Genética para Doença , Humanos , Lactente , Masculino , Gravidez , Vigilância em Saúde Pública , Medição de Risco , Fumar/efeitos adversos
12.
Ann Agric Environ Med ; 25(3): 428-432, 2018 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-30260196

RESUMO

INTRODUCTION: A growing number of epidemiological studies suggest that paracetamol, which is commonly used in children, may be a risk factor for asthma, allergic rhinitis, and atopic eczema. OBJECTIVE: The aim of this study was to determine and characterize the correlation between paracetamol use and asthma, allergic rhinitis, and atopic eczema symptoms in the Polish population. MATERIAL AND METHODS: The study is part of the ECAP project involving the use of the ISAAC and ECRHS questionnaires. Completed questionnaires of 18,617 subjects, including 10,011 (53.8%) females, were analyzed. Children aged 6-7 (n=4,510), adolescents aged 13-14 (n=4,721), and adults aged 20-44 (n=9,386) constituted 24.2%, 25.4%, and 50.4% of respondents, respectively. Study subjects lived in 8 major urban centres and one rural area. The frequency of paracetamol use during the previous 12 months and symptoms of asthma, allergic rhinitis, and atopic eczema during that period were analyzed. RESULTS: The use of paracetamol was associated with a significant dose-dependent increase in the risk of asthma symptoms in all evaluated age groups. This was demonstrated via odds ratios (OR) for developing asthma symptoms, including wheezing or whistling in the chest in 6-7-year-olds and exercise-induced shortness of breath in 13-14-year-olds and adults, depending on the frequency of paracetamol use in the previous 12 months, compared to no paracetamol intake during that period. CONCLUSIONS: The use of paracetamol in the last 12 months was associated with a significant dose-dependent increase in the risk of rhinitis and skin allergy symptoms, as demonstrated by the odds ratio. Therefore, frequent paracetamol use may be a risk factor for symptoms of asthma, rhinitis, and skin allergy in the Polish population.


Assuntos
Acetaminofen/efeitos adversos , Analgésicos não Entorpecentes/efeitos adversos , Asma/etiologia , Eczema/etiologia , Rinite/etiologia , Acetaminofen/administração & dosagem , Adolescente , Adulto , Analgésicos não Entorpecentes/administração & dosagem , Asma/epidemiologia , Criança , Eczema/epidemiologia , Feminino , Humanos , Masculino , Polônia/epidemiologia , Rinite/epidemiologia , Inquéritos e Questionários , Adulto Jovem
13.
Clin Dermatol ; 36(5): 616-630, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30217274

RESUMO

Atopic dermatitis (AD) is a complex and heterogeneous disorder with a profound symptom burden and harmful impact on multiple domains of quality of life (QOL). Many different patient-reported outcome (PRO) measures exist to assess clinical manifestations and QOL impairment in AD, but none comprehensively assess all aspects of the disease. This review addresses the PRO and QOL measures currently used in AD and their properties, strengths, weaknesses, and feasibility for assessing AD in randomized controlled trials and clinical practice. Currently, the patient-oriented eczema measure (POEM) has emerged as a preferred PRO for AD clinical manifestations, though no single instrument has developed as a preferred QOL measure. Validated PRO and QOL measures should be incorporated in all clinical trials of AD and in clinical practice where feasible.


Assuntos
Dermatite Atópica/complicações , Medidas de Resultados Relatados pelo Paciente , Prurido/etiologia , Qualidade de Vida , Eczema/etiologia , Humanos , Avaliação de Sintomas
14.
Clin Dermatol ; 36(5): 662-667, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30217280

RESUMO

Patient education programs are beneficial in the treatment of chronic diseases. In Germany, France, and other countries worldwide, educating children, adolescents, and adults plus the parents of children with atopic dermatitis (AD) leads to better coping with the skin disease, as well as to a reduction in the severity of the skin symptoms and signs. The results in Europe led to the idea to also establish an eczema school in the United States. In the style of the German eczema school, an eczema school was founded in 2014 at Temple University, Philadelphia, PA. Since then, a team consisting of a dermatologist, psychologist, nutritionist, and nurse practitioner has offered an eczema school to interested patients with AD and their families three times a year. This patient education program consists of three weekly 2-hour sessions, which address proper skin care, the itch-scratch cycle, healthy nutrition, and the role of stress in AD. The current review summarizes the first experiences with the education program in the United States.


Assuntos
Dermatite Atópica/terapia , Eczema/terapia , Educação de Pacientes como Assunto/métodos , Higiene da Pele , Corticosteroides/uso terapêutico , Dermatite Atópica/etiologia , Eczema/etiologia , Humanos , Educação de Pacientes como Assunto/organização & administração , Prurido/fisiopatologia , Prurido/terapia , Estresse Psicológico/complicações , Estresse Psicológico/prevenção & controle , Estados Unidos
15.
Allergy Asthma Proc ; 39(4): 311-315, 2018 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-30111442

RESUMO

BACKGROUND: The disrupted skin barrier in eczema has been associated with an increased risk of immunoglobulin E (IgE) sensitization in childhood. However, it is unclear whether eczema, independent of atopy, is a risk factor for the development of allergic sensitization in adulthood. OBJECTIVE: To determine if skin barrier dysfunction, independent of atopy, is a risk factor for incident sensitization in adult workers at a mouse production and research facility. METHODS: New employees at The Jackson Laboratory enrolled in a cohort study and underwent skin-prick testing (SPT) at baseline and every 6 months to mouse and to a panel of aeroallergens (net wheal ≥3 mm indicated a positive SPT result). Mouse allergen exposure was measured every 6 months by using personal air monitors. Physician-diagnosed eczema was defined as self-reported physician-diagnosed eczema. Cox proportional hazard modeling was used to examine the association between baseline physician-diagnosed eczema and incident mouse skin test sensitization and adjusted for potential confounders. RESULTS: The participants (N = 394) were followed up for a median of 24 months. Fifty-four percent were women, 89% were white, and 64% handled mice. At baseline, 7% of the participants reported physician-diagnosed eczema and 9% reported current asthma; 61% had at least one positive skin test result. At 30 months, 36% of those with eczema versus 14% of those without eczema had developed a positive mouse skin test result (p = 0.02, log-rank test). After adjusting for age, race, sex, smoking status (current, former, never), current asthma, hay fever, the number of positive SPT results at baseline, and mouse allergen exposure, physician-diagnosed eczema was an independent risk factor for incident mouse SPT sensitization (hazard ratio 5.6 [95% confidence interval, 2.1-15.2]; p = 0.001). CONCLUSION: Among adult workers at a mouse production and research facility, physician-diagnosed eczema was a risk factor for incident mouse sensitization, independent of atopy, which indicated that a defect in skin barrier alone may increase the risk of skin sensitization, not just in childhood, but throughout life.


Assuntos
Alérgenos/imunologia , Técnicos em Manejo de Animais , Eczema/epidemiologia , Eczema/etiologia , Imunoglobulina E/imunologia , Exposição Ocupacional/efeitos adversos , Adulto , Animais , Eczema/diagnóstico , Feminino , Humanos , Imunoglobulina E/sangue , Estimativa de Kaplan-Meier , Masculino , Camundongos , Modelos de Riscos Proporcionais , Testes Cutâneos , Adulto Jovem
16.
Allergy ; 73(11): 2182-2191, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30085352

RESUMO

BACKGROUND: Prospective studies of antenatal and infant vitamin D exposure and atopic disease from extensively characterised, disease-specific, maternal-infant cohorts with gold standard analysis of vitamin D status and clinically validated atopic outcomes are lacking. This study aimed to investigate associations between intrauterine vitamin D status and atopic outcomes in an extensively characterised, disease-specific, maternal-infant cohort. METHODS: Circulating 25-hydroxyvitamin D (25(OH)D) was measured in maternal sera at 15 weeks of gestation (n = 1537) and umbilical cord blood (n = 1050) using a CDC-accredited LC-MS/MS platform, and the association with clinically validated atopic disease outcomes (eczema, food allergy, asthma, allergic rhinitis) at 2 and 5 years was explored using multivariable logistic regression. RESULTS: Persistent eczema in the first 2 years of life was present in 5% of infants. Food allergy at 2 years was confirmed in 4%. The prevalence of aeroallergen sensitisation at 2 years was 8%. Asthma at 5 years was reported in 15% and allergic rhinitis in 5% of 5-year-olds. There were no significant differences in the distributions of maternal 25(OH)D at 15 weeks of gestation (mean [SD] 58.4 [26.2] and 58.5 [26.1] nmol/L) and cord 25(OH)D concentrations (mean [SD] 35.2 [17.8] and 35.4 [18.3] nmol/L) between children with and without atopic disease. Neither maternal (aOR [95% CI]: 1.02 [0.97, 1.08], P = 0.450) nor cord 25(OH)D (aOR [95% CI]: 1.00 [0.91, 1.09], P = 0.991) were significant predictors of atopic disease outcomes in fully adjusted models. CONCLUSION: These data in a disease-specific cohort with prospectively collected, validated atopic outcomes do not support an association between antenatal exposure to vitamin D and atopic disease outcomes in childhood.


Assuntos
Asma/etiologia , Eczema/etiologia , Hipersensibilidade Alimentar/etiologia , Exposição Materna , Efeitos Tardios da Exposição Pré-Natal , Rinite Alérgica/etiologia , Vitamina D/efeitos adversos , Asma/epidemiologia , Pré-Escolar , Estudos de Coortes , Eczema/epidemiologia , Feminino , Hipersensibilidade Alimentar/epidemiologia , Humanos , Hipersensibilidade Imediata/epidemiologia , Hipersensibilidade Imediata/etiologia , Masculino , Exposição Materna/efeitos adversos , Gravidez , Rinite Alérgica/epidemiologia , Vitamina D/administração & dosagem
17.
Diabetes Technol Ther ; 20(8): 566-570, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-30044134

RESUMO

Use of insulin pump and glucose sensor in children with diabetes has been shown to cause skin problems such as eczema, wounds, and itching. The mechanisms for development of skin problems are unknown as well as the influence on the everyday life of the patient. The aim of this study was through focus groups to get more perspective on perception of skin problems as well as the patients' view on causes of skin problems. The two focus groups gave new insight into the consequences of skin problems to both patient and parents in terms of itching, concentration, self-esteem, guilt, etc. The focus group gave as well new perspectives on causes of skin problems, and especially three concepts must be further investigated: material (plastic, patch and vacuum effect), time, and skin characteristics.


Assuntos
Automonitorização da Glicemia/efeitos adversos , Eczema/etiologia , Sistemas de Infusão de Insulina/efeitos adversos , Prurido/etiologia , Adolescente , Criança , Pré-Escolar , Diabetes Mellitus Tipo 1/tratamento farmacológico , Feminino , Grupos Focais , Humanos , Hipoglicemiantes/uso terapêutico , Insulina/uso terapêutico , Masculino
19.
Ann Work Expo Health ; 62(9): 1077-1086, 2018 11 12.
Artigo em Inglês | MEDLINE | ID: mdl-30016387

RESUMO

Objectives: To examine the associations of inhalable grain dust exposure with respiratory health outcomes, rhinitis, and eczema reported by workers from rice, wheat, and maize storage facilities. Methods: A cross-sectional study of 136 workers (73 operators and 63 administrative staff and other workers) from eight Costa Rican grain storage facilities was conducted in 2014-2015. Full-shift personal inhalable dust samples from all workers were collected. Study participants were administered a short version of the European Community Respiratory Health Survey questionnaire to identify symptoms of asthma, chronic bronchitis, rhinitis, and eczema. Associations between grain dust exposure and health outcomes were assessed using multivariable logistic and negative binomial regression models adjusted for age, smoking history, grain type, and presence of pets or farm animals in the home. Results: The median inhalable grain dust concentration was 2.0 (25th to 75th percentile: 0.3-7.0) mg m-3. Higher concentrations of inhalable dust were associated with increased odds of (i) asthma symptoms or medication use [adjusted Odds ratio (ORa) per 10-fold increase in dust concentration 2.7; 95% confidence interval (CI): 1.3-6.7]; (ii) a score of at least two out of five symptoms suggestive of asthma (ORa 1.2; 95% CI: 1.0-1.3); and (iii) eczema (ORa 3.6; 95% CI: 1.7-9.6). No associations of inhalable grain dust exposure with chronic bronchitis and rhinitis were observed. Conclusions: High exposure to inhalable dust in Costa Rican grain storage facilities was associated to asthma symptoms and eczema in workers.


Assuntos
Poluentes Ocupacionais do Ar/efeitos adversos , Asma , Poeira/análise , Eczema , Grão Comestível/efeitos adversos , Exposição por Inalação , Exposição Ocupacional , Rinite , Adulto , Asma/epidemiologia , Asma/etiologia , Costa Rica/epidemiologia , Estudos Transversais , Eczema/epidemiologia , Eczema/etiologia , Humanos , Exposição por Inalação/efeitos adversos , Exposição por Inalação/análise , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Exposição Ocupacional/efeitos adversos , Exposição Ocupacional/análise , Razão de Chances , Rinite/epidemiologia , Rinite/etiologia , Fumar/efeitos adversos
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