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1.
Auris Nasus Larynx ; 47(4): 559-564, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32586739

RESUMO

OBJECTIVE: to detect, analyze and discuss the different ear nose throat (ENT) manifestations those were reported in COVID19 positive patients in the reviewed and published literatures. METHODS: We performed a search in the PubMed databases, Web of Science, LILACS, MEDLINE, SciELO, and Cochrane Library using the keywords; COVID-19, Novel coronavirus, corona, 2019-nCoV, SARS-CoV-2, ENT, ear, nose, throat, otorhinolaryngology, ORL, pharynx, ORL, smell, larynx, different ENT related symptoms. We reviewed published and peer reviewed studies that reported the ENT manifestations in COVID-19 laboratory-confirmed positive patients. RESULTS: within the included 1773 COVID-19 laboratory-confirmed positive patients, the most common ENT manifestations of COVID-19 were sore throat (11.3%) and headache (10.7%). While the other reported ENT manifestations were pharyngeal erythema (5.3%), nasal congestion (4.1%), runny nose or rhinorrhea (2.1%), upper respiratory tract infection (URTI) (1.9%), and tonsil enlargement (1.3%). CONCLUSION: ENT manifestations for COVID-19 are not common as fever and cough. But, a universal questionnaire using well-defined COVID-19 manifestations is needed to make the COVID-19 data precisely defined, complete and homogenous.


Assuntos
Infecções por Coronavirus/fisiopatologia , Transtornos do Olfato/fisiopatologia , Faringite/fisiopatologia , Pneumonia Viral/fisiopatologia , Tonsila Faríngea , Betacoronavirus , Tosse/fisiopatologia , Diarreia/fisiopatologia , Dispneia/fisiopatologia , Eritema/fisiopatologia , Fadiga/fisiopatologia , Febre/fisiopatologia , Cefaleia/fisiopatologia , Humanos , Mialgia/fisiopatologia , Obstrução Nasal/fisiopatologia , Otorrinolaringopatias/fisiopatologia , Tonsila Palatina , Pandemias , Infecções Respiratórias/fisiopatologia
3.
BMC Infect Dis ; 19(1): 317, 2019 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-30975101

RESUMO

BACKGROUND: Necrotising fasciitis is a rapidly progressing soft-tissue infection with a low incidence that carries a relevant risk of morbidity and mortality. Although necrotising fasciitis is often fatal in adults, its case fatality rate seems to be lower in children. A highly variable clinical presentation makes the diagnosis challenging, which often results in misdiagnosis and time-delay to therapy. METHODS: We conducted a protocol-based systematic review to identify specific features of necrotising fasciitis in children aged one month to 17 years. We searched 'PubMed', 'Web of Science' and 'SCOPUS' for relevant literature. Primary outcomes were incidence and case fatality rates in population-based studies, and skin symptoms on presentation. We also assessed signs of systemic illness, causative organisms, predisposing factors, and reconstructive procedures as secondary outcomes. RESULTS: We included five studies reporting incidence and case fatality rates, two case-control studies, and 298 cases from 195 reports. Incidence rates varied between 0.022 and 0.843 per 100,000 children per year with a case-fatality rate ranging from 0% to 14.3%. The most frequent skin symptoms were erythema (58.7%; 175/298) and swelling (48%; 143/298), whereas all other symptoms occurred in less than 50% of cases. The majority of cases had fever (76.7%; 188/245), but other signs of systemic illness were present in less than half of the cohort. Group-A streptococci accounted for 44.8% (132/298) followed by Gram-negative rods in 29.8% (88/295), while polymicrobial infections occurred in 17.3% (51/295). Extremities were affected in 45.6% (136/298), of which 73.5% (100/136) occurred in the lower extremities. Skin grafts were necessary in 51.6% (84/162) of the pooled cases, while flaps were seldom used (10.5%; 17/162). The vast majority of included reports originate from developed countries. CONCLUSIONS: Clinical suspicion remains the key to diagnose necrotising fasciitis. A combination of swelling, pain, erythema, and a systemic inflammatory response syndrome might indicate necrotising fasciitis. Incidence and case-fatality rates in children are much smaller than in adults, although there seems to be a relevant risk of morbidity indicated by the high percentage of skin grafts. Systematic multi-institutional research efforts are necessary to improve early diagnosis on necrotising fasciits.


Assuntos
Fasciite Necrosante/epidemiologia , Adolescente , Estudos de Casos e Controles , Criança , Pré-Escolar , Diagnóstico Precoce , Edema/fisiopatologia , Eritema/fisiopatologia , Fasciite Necrosante/diagnóstico , Fasciite Necrosante/mortalidade , Fasciite Necrosante/fisiopatologia , Humanos , Lactente , Streptococcus pyogenes
4.
Microvasc Res ; 124: 54-60, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30877017

RESUMO

BACKGROUND: Methyl nicotinate (MN) induces a local cutaneous erythema in the skin and may be used as a local provocation in the assessment of microcirculation and skin viability. The aims were to measure the effects of increasing doses of MN, to find the concentration that yields the most reproducible effect from day to day and between sites, and to study the variation between skin sites. METHODS: Microvascular responses to topically applied MN at different concentrations were measured in 12 subjects on separate days and on contralateral sides, using laser speckle contrast imaging (LSCI). MN effects were measured in four different body sites. RESULTS: At 20 mmol/L, the response to MN was most reproducible day-to-day and site-to-site, and resulted in a plateau response between 5 and 20 min after application. The skin region of the lower back had a lower perfusion value compared to the epigastric region (p = 0.007). When responses were compared to nearby, unprovoked areas, a significantly larger increase in perfusion was seen in the forearm, compared to all other anatomical sites (p < 0.03). CONCLUSION: A concentration of 20 mmol/L MN generated the most reproducible microvascular response in the skin. The response varies between different body sites.


Assuntos
Eritema/induzido quimicamente , Eritema/fisiopatologia , Microcirculação/efeitos dos fármacos , Ácidos Nicotínicos/administração & dosagem , Ácidos Nicotínicos/efeitos adversos , Pele/irrigação sanguínea , Administração Cutânea , Adulto , Relação Dose-Resposta a Droga , Feminino , Humanos , Masculino , Fluxo Sanguíneo Regional/efeitos dos fármacos , Fatores de Tempo , Adulto Jovem
5.
Skin Res Technol ; 25(4): 553-563, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30770590

RESUMO

BACKGROUND: For early detection of initial skin changes in occupational screenings, only few objective assessment systems are available. OBJECTIVES: With the aim of assessing an objective measurement method for hand eczema, we trialed the application of the tissue viability imaging (TiVi) system, quantifying erythema non-invasively by polarized light spectroscopy. MATERIALS AND METHODS: In a field study with 625 employees of a semiconductor production company, 411 were exposed to prolonged wearing of occlusive gloves in the clean room. TiVi system and Hand Eczema Score for Occupational Screenings (HEROS), a quantitative skin score for the hands, were used, supplemented by a standardized personal interview. RESULTS: TiVi values of 65 up to 246 for each hand (palm or back), for each participant summed to overall 289 up to 848 (median 389), were measured. Higher TiVi values were noted for men, smokers, and with increasing age. Correlation between TiVi and HEROS was only weak. Several factors like skin pigmentation, thickness of the skin, or tattoos seem to influence TiVi results. CONCLUSIONS: The practical relevance of one-time measurements with the TiVi system in occupational screenings seems to be limited. Specifically, the TiVi system cannot replace dermatological examinations at the workplace. Notwithstanding, the application for other scientific purposes might be useful.


Assuntos
Mãos/irrigação sanguínea , Programas de Rastreamento/métodos , Pele/diagnóstico por imagem , Sobrevivência de Tecidos/fisiologia , Adolescente , Adulto , Estudos Transversais , Dermatite Ocupacional/diagnóstico por imagem , Dermatite Ocupacional/fisiopatologia , Diagnóstico Precoce , Eczema/diagnóstico por imagem , Eczema/fisiopatologia , Eritema/diagnóstico por imagem , Eritema/fisiopatologia , Feminino , Luvas Protetoras/efeitos adversos , Mãos/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Semicondutores/efeitos adversos , Pele/fisiopatologia , Análise Espectral/métodos , Adulto Jovem
6.
Dermatol Surg ; 45(9): 1155-1162, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-30730346

RESUMO

BACKGROUND: Botulinum toxin (BTX) has been used cosmetically with good clinical efficacy and tolerable safety. OBJECTIVE: This randomized, double-blind, split-face clinical study aimed to investigate the efficacy and safety of intradermal BTX in patients with rosacea. MATERIALS AND METHODS: Twenty-four participants were enrolled and randomly given intradermal injections of BTX and normal saline in both cheeks. Clinician Erythema Assessment (CEA) score, Global Aesthetic Improvement Scale (GAIS) score, skin hydration, transepidermal water loss (TEWL), melanin content, erythema index, elasticity, and sebum secretions were evaluated at baseline and 2, 4, 8, and 12 weeks. RESULTS: On the BTX-treated side, the CEA score significantly decreased and the GAIS score significantly increased. The erythema index decreased at Weeks 4 and 8. Skin elasticity was improved at Weeks 2 and 4 and skin hydration, at Weeks 2, 4, and 8. However, TEWL and sebum secretion did not show significant differences. CONCLUSION: Intradermal BTX injections reduced erythema and rejuvenated the skin effectively and safely in patients with rosacea.


Assuntos
Toxinas Botulínicas Tipo A/administração & dosagem , Eritema/tratamento farmacológico , Eritema/fisiopatologia , Dermatoses Faciais/tratamento farmacológico , Dermatoses Faciais/fisiopatologia , Fármacos Neuromusculares/administração & dosagem , Rosácea/tratamento farmacológico , Rosácea/fisiopatologia , Adulto , Toxinas Botulínicas Tipo A/efeitos adversos , Método Duplo-Cego , Elasticidade , Estética , Feminino , Humanos , Injeções Intradérmicas , Masculino , Pessoa de Meia-Idade , Fármacos Neuromusculares/efeitos adversos , Projetos Piloto , Rejuvenescimento , Sebo/metabolismo , Pele/fisiopatologia
7.
Int J Dermatol ; 58(5): 616-621, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30746680

RESUMO

BACKGROUND: There is little research available that describes the natural progression of split-thickness skin graft (STSG) donor site wounds after re-epithelialization. The purpose of this study was to evaluate the longitudinal clinical progress of transepidermal water loss (TEWL), color, and sensory elements in STSG donor sites in East Asians. METHODS: Eighteen patients participated in this study. The TEWL, color, pressure threshold, and static two-point discrimination were evaluated from the center and upper lateral corner of the wounds and adjacent normal skin preoperatively and at 1, 2, 7, and 12 months postoperatively. RESULTS: The age was negatively correlated with preoperative values of TEWL (r = -0.49, P = 0.039). The elevated TEWL level from the STSG donor sites did not return to normal until 12 months after surgery. In the measurement of skin color, the elevated L* value normalized after 12 months following surgery, while the elevated a* and b* values persisted. In the sensory testing, there were no significant changes during the observation period except at 2 months postoperatively, representing a significant increase of pressure threshold in the periphery. CONCLUSIONS: In East Asians, elevated skin lightness level in STSG donor sites returned to normal at 12 months postoperatively, while the elevated TEWL and skin redness levels were improved but were not normalized at 12 months after surgery.


Assuntos
Pigmentação da Pele/fisiologia , Transplante de Pele , Pele/inervação , Sítio Doador de Transplante/fisiopatologia , Perda Insensível de Água/fisiologia , Cicatrização/fisiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Eritema/etiologia , Eritema/fisiopatologia , Extremo Oriente , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estado de Hidratação do Organismo/fisiologia , Reepitelização/fisiologia , Pele/fisiopatologia , Transplante de Pele/efeitos adversos , Coxa da Perna , Água , Adulto Jovem
8.
Skin Res Technol ; 25(2): 204-210, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30357919

RESUMO

BACKGROUND/AIMS: How to select a suitable method in whitening products evaluation is still under discussion. Here, we compared two different artificial pigmentation models and explored an ideal UV dosage for skin whitening products evaluation model establishment. METHODS: Thirty five healthy volunteers with type IV human skin were recruited and the skin minimal erythema dose (MEDs) and minimal persistent pigment dose (MPPDs) were measured. All volunteers were simultaneously exposed to six increasing doses of radiations from different ultraviolet sources on lower back bilateral flattening area: 95% UVA/5% UVB with the radiating doses of 0.75, 0.94, 1.17, 1.46, 1.83, 2.29 MEDs was used on the left side; meanwhile 99% UVA/1% UVB with radiating doses of 6.0, 7.5, 9.4, 11.7, 14.6, 18.3 MPPDs were used on the right side. Observations and pigmentation measurements were carried out before and after UV radiation for 24 weeks. RESULT: 1.83 MED and 2.29 MED induced medium depth pigmentation by 95% UVA/5% UVB irradiation. 1.83 MED dose causing minimal photo-damage on skin was selected as the most suitable dose. With 99% UVA/1% UVB irradiation, 9.4 MPPD and 11.7 MPPD induced medium depth pigmentation. 9.4 MPPD dose causing minimal photo-damage on skin was selected. CONCLUSION: These findings potentiate advanced understanding of UV model establishment and selection for skin whitening products evaluation as related to dermatopharmacology and dermatotoxicology.


Assuntos
Preparações Clareadoras de Pele/uso terapêutico , Pigmentação da Pele/efeitos da radiação , Pele/efeitos da radiação , Raios Ultravioleta/efeitos adversos , Adulto , Relação Dose-Resposta à Radiação , Eritema/diagnóstico , Eritema/fisiopatologia , Humanos , Pessoa de Meia-Idade , Transtornos da Pigmentação/patologia , Transtornos da Pigmentação/terapia , Doses de Radiação , Pele/patologia , Higiene da Pele/métodos , Pigmentação da Pele/fisiologia
9.
Rev. med. (Säo Paulo) ; 98(3)maio-jun. 2019. ilus
Artigo em Português | LILACS | ID: biblio-1009758

RESUMO

A síndrome de Morbihan é uma doença rara, de fisiopatologia pouco conhecida, tipicamente caracterizada por edema e eritema facial, de aparecimento lento, simétrico, afetando terço superior da face. Este relato de caso se trata de um paciente com caso atípico de Síndrome de Morbihan, com acometimento assimétrico de face. Foram ressaltados aspectos clínicos e histopatológicos para diagnóstico dessa rara patologia, possíveis diagnósticos diferenciais e opções de tratamento. Também foi buscado difundir formas menos típicas desta doença.


Morbihan syndrome is a rare condition and its pathogenesis is not fully known. This entityh is characterized by facial edema and facial erythema, with a slow, symmetrical appearance, affecting the upper portion of the face. This case report is about a patient with an atypical case of Morbihan syndrome, with asymmetric facial involvement. Clinical and histopathological aspects were highlighted aiming the diagnosis of this rare pathology, as well as possible differential diagnoses and treatment options. It has also been aimed to call attention to less typical forms of this disease.


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Rosácea/diagnóstico , Edema/fisiopatologia , Eritema/fisiopatologia , Face/fisiopatologia , Dermatologia
11.
J Pak Med Assoc ; 68(6): 959-962, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30323370

RESUMO

Mixed connective tissue disease (MCTD) is a rare disease and presents with varied overlapping symptoms of different connective tissue disorders. Many patients evolve into other connective tissue disorders with the passage of time. The case series included 20 patients with the diagnosis of MCTD, registered at the Rheumatology Clinic of Jinnah Postgraduate Medical Centre (JPMC), Karachi, from June 2010 to May 2015. Of these, 16 (80.0%) were female and 4 (20.0%) patients were male. The mean age was 30.5±8.9 years and the mean duration of illness was 4.5±2 years. Commonest presenting symptom was arthralgia in 17 (85%) patients. All the patients had positive ANA and anti-RNP antibodies. Over the disease course of 6 years, 2 (10%) patients evolved into Systemic lupus erythematosus (SLE); One each (5%) into Sjogren's syndrome, Scleroderma and Rheumatoid arthritis.


Assuntos
Doença Mista do Tecido Conjuntivo/fisiopatologia , Adulto , Artralgia/etiologia , Artralgia/fisiopatologia , Autoanticorpos/imunologia , Eritema/etiologia , Eritema/fisiopatologia , Dermatoses Faciais/etiologia , Dermatoses Faciais/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doença Mista do Tecido Conjuntivo/complicações , Doença Mista do Tecido Conjuntivo/imunologia , Úlceras Orais/etiologia , Úlceras Orais/fisiopatologia , Paquistão , Transtornos de Fotossensibilidade/etiologia , Transtornos de Fotossensibilidade/fisiopatologia , Doença de Raynaud/etiologia , Doença de Raynaud/fisiopatologia , Ribonucleoproteína Nuclear Pequena U1/imunologia , Sinovite/etiologia , Sinovite/fisiopatologia , Adulto Jovem
13.
Am Fam Physician ; 98(5): 283-291, 2018 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-30216021

RESUMO

Annular lesions can present in a variety of diseases. Knowledge of the physical appearance and history of presentation of these skin findings can help in the diagnosis. A pruritic, annular, erythematous patch that grows centrifugally should prompt evaluation for tinea corporis. Tinea corporis may be diagnosed through potassium hydroxide examination of scrapings. Recognizing erythema migrans is important in making the diagnosis of Lyme disease so that antibiotics can be initiated promptly. Plaque psoriasis generally presents with sharply demarcated, erythematous silver plaques. Erythema multiforme, which is due to a hypersensitivity reaction, presents with annular, raised lesions with central clearing. Lichen planus characteristically appears as planar, purple, polygonal, pruritic papules and plaques. Nummular eczema presents as a rash composed of coin-shaped papulovesicular erythematous lesions. Treatment is aimed at reducing skin dryness. Pityriasis rosea presents with multiple erythematous lesions with raised, scaly borders, and is generally self-limited. Urticaria results from the release of histamines and appears as well-circumscribed, erythematous lesions with raised borders and blanched centers. Annular lesions occur less commonly in persons with fixed drug eruptions, leprosy, immunoglobulin A vasculitis, secondary syphilis, sarcoidosis, subacute cutaneous lupus erythematosus, and granuloma annulare.


Assuntos
Eritema , Administração dos Cuidados ao Paciente/métodos , Dermatopatias Genéticas , Dermatopatias/diagnóstico , Diagnóstico Diferencial , Eritema/diagnóstico , Eritema/etiologia , Eritema/fisiopatologia , Eritema/terapia , Humanos , Dermatopatias Genéticas/diagnóstico , Dermatopatias Genéticas/etiologia , Dermatopatias Genéticas/fisiopatologia , Dermatopatias Genéticas/terapia
14.
Int J Cosmet Sci ; 40(5): 488-493, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30155940

RESUMO

OBJECTIVE: To understand the drivers of body skin discomfort and to validate a new index to assess its severity. This index should be sensitive enough to capture changes in response to treatment. METHODS: Previous consumer studies suggested seven potential main dimensions behind skin discomfort. Four of them refer to self-declarations (stinging, itching, warming and tightening), whereas three can be assessed by a dermatologist (skin dryness, redness and desquamation). Intensity and frequency or extent of these items were measured using 0-9 ordinal scales. To generate the data for validation of a new index based on the 7 items, a group of 49 subjects complaining of skin discomfort was followed up for 5 weeks: 1-week without product application to check reproducibility, followed by 4 weeks of treatment to evaluate sensitivity to change. Items not significantly reported at baseline or with changes because of treatment not sufficiently correlated with the overall change measured by the index were discarded. A control group of 49 subjects presenting no discomfort at all was also included to check the capacity of our index to discriminate both groups. The final index (Body Skin Discomfort Index, BSDI) was normalized to facilitate the clinical interpretation of the results. RESULTS: After discarding warming and skin redness, the BSDI is finally a five-dimension score calculated as follows: (TI + TF + SI + SF + ItI + ItF + DI + DE + DqI + DqE) 9 9/90 where T, S, It, D and Dq refer to tightness, stinging, itching, dryness, desquamation respectively, and I, F or E refers to intensity, frequency or extent. The final BSDI score displayed a good capacity to discriminate people with skin discomfort from people with 'normal skin', a good reproducibility (intraclass coefficient correlation ICC = 0.85) and a good sensitivity to detect change because of treatment (Difference vs. Baseline of 2.63 on a 0-9 scale). CONCLUSION: The developed index, BSDI, is a reliable way to address the measurement issue of the multidimensional skin discomfort syndrome. It thus should simplify the evaluation of cosmetic products effect and helps to compare products dedicated to body cleansing.


Assuntos
Dermatopatias/fisiopatologia , Adulto , Estudos de Casos e Controles , Cosméticos , Eritema/fisiopatologia , Feminino , Humanos , Ictiose/fisiopatologia , Masculino , Pessoa de Meia-Idade , Prurido/fisiopatologia , Índice de Gravidade de Doença , Temperatura Cutânea , Inquéritos e Questionários , Adulto Jovem
16.
Photodermatol Photoimmunol Photomed ; 34(6): 400-404, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29953669

RESUMO

BACKGROUND: Ethnicity, skin phototype and colour influenced minimal erythema dose (MED). Sun exposure has been postulated to increase MED. We determined immediate pigment darkening dose to UVA (IPDDA), MED and minimal melanogenic dose (MMD) for UVB and UVA, and investigated factors affecting these doses. METHODS: Skin phototype was determined using Fitzpatrick phototype quiz, DSMII ColorMeter measured skin colours, sun exposure quantified using an index (SEI) and phototest performed with MEDlight-Multitester. RESULTS: A total of 167 healthy volunteers participated. There were 110 (66%) females and 56 (34%) males; 124 (74.7%) were Malay, 27 (16.3%) Chinese and 14 (8.4%) Indians. One hundred and nine (65.7%) skin phototype IV, 30 (18.1%) phototype III and 27 (16.3%) phototype V. IPDDA ranges from 6 ± 1.5-5.7 ± 1.4 J/cm2 . MED-UVB were 96.9 ± 17.6, 124 ± 29.3 and 118.6 ± 27.4 mJ/cm2 for phototype III, IV and V, respectively. All MED-UVA were outside the tested dose range of 3.6-11 J/cm2 . MMD-UVB were 106 ± 18.2, 134 ± 25.6 and 136 ± 31.1 mJ/cm2 while MMD-UVA were 4.1 ± 4.1, 4.9 ± 3.8 and 5.7 ± 3.7 J/cm2 respectively for phototypes III, IV and V. MED-UVB, MMD-UVB and MMD-UVA did not depend on skin phototype. Facultative skin whiteness (L*), erythema (E) and melanin content (M) correlated significantly with MED-UVB while constitutive skin colours were significant for L*, yellowness (b*), E and M. Sun exposure did not significantly correlate with MED-UVB and MMDs, however, an inverse relationship with MED-UVB was demonstrated. CONCLUSION: Minimal erythema doses in our cohort were slightly different from other regional countries. Constitutive and facultative skin whiteness, erythema and melanin content correlated with MED. There was no association between skin phototype and sun exposure with MED or MMD.


Assuntos
Eritema , Pigmentação da Pele/efeitos da radiação , Pele , Raios Ultravioleta/efeitos adversos , Adulto , Eritema/etiologia , Eritema/patologia , Eritema/fisiopatologia , Feminino , Humanos , Masculino , Pele/patologia , Pele/fisiopatologia
17.
Comput Med Imaging Graph ; 66: 44-55, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29524784

RESUMO

Psoriasis is a chronic skin disease which can be life-threatening. Accurate severity scoring helps dermatologists to decide on the treatment. In this paper, we present a semi-supervised computer-aided system for automatic erythema severity scoring in psoriasis images. Firstly, the unsupervised stage includes a novel image representation method. We construct a dictionary, which is then used in the sparse representation for local feature extraction. To acquire the final image representation vector, an aggregation method is exploited over the local features. Secondly, the supervised phase is where various multi-class machine learning (ML) classifiers are trained for erythema severity scoring. Finally, we compare the proposed system with two popular unsupervised feature extractor methods, namely: bag of visual words model (BoVWs) and AlexNet pretrained model. Root mean square error (RMSE) and F1 score are used as performance measures for the learned dictionaries and the trained ML models, respectively. A psoriasis image set consisting of 676 images, is used in this study. Experimental results demonstrate that the use of the proposed procedure can provide a setup where erythema scoring is accurate and consistent. Also, it is revealed that dictionaries with large number of atoms and small patch sizes yield the best representative erythema severity features. Further, random forest (RF) outperforms other classifiers with F1 score 0.71, followed by support vector machine (SVM) and boosting with 0.66 and 0.64 scores, respectively. Furthermore, the conducted comparative studies confirm the effectiveness of the proposed approach with improvement of 9% and 12% over BoVWs and AlexNet based features, respectively.


Assuntos
Eritema/diagnóstico por imagem , Eritema/fisiopatologia , Interpretação de Imagem Assistida por Computador/métodos , Psoríase/diagnóstico por imagem , Algoritmos , Humanos , Aprendizado de Máquina , Índice de Gravidade de Doença , Máquina de Vetores de Suporte
18.
Neuroscience ; 387: 4-12, 2018 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-29551562

RESUMO

Secondary mechanical hyperalgesia to punctate mechanical stimuli and light touch (allodynia) are prominent symptoms in neuropathic pain states. In a combined microneurographic and psychophysical study, we investigated the role of mechano-insensitive (silent) nociceptors regarding induction. Electrical thresholds of mechano-sensitive and silent nociceptors were assessed by microneurography with two closely spaced intracutaneous electrodes (i.c.) and a transcutaneous configuration (t.c.) in the foot dorsum. For t.c. stimulation there was a marked difference between silent (median, quartiles; 60, 50-70 mA, n = 63) and mechano-sensitive fibers (3, 2-5 mA, n = 107). In silent fibers, thresholds were lower for i.c. stimulation (16, 14-19 mA, n = 8), but higher in mechano-sensitive units (6, 5-6 mA, n = 13). Corresponding psychophysical tests showed no difference between the stimulation configuration for pain thresholds, but lower thresholds for the i.c. stimulation in axon reflex erythema (12 vs. 21 mA), punctate hyperalgesia (9 vs. 15 mA) and allodynia (15 vs. 18 mA). Punctate hyperalgesia was evoked at very low stimulation frequencies of 1/20 Hz (7/7 subjects), whereas the induction of an axon reflex flare required stimulation at 1/5 Hz. Electrical stimulation which is sufficient to excite mechano-insensitive C nociceptors can induce secondary mechanical hyperalgesia even at low frequencies supporting a role of such low-level input to clinical pain states. Thus, differential nociceptor class-specific input to the spinal cord adds to the complexity of modulatory mechanisms that determine nociceptive processing in the spinal cord.


Assuntos
Hiperalgesia/fisiopatologia , Nociceptores/fisiologia , Limiar da Dor/fisiologia , Pele/inervação , Adulto , Estimulação Elétrica , Eritema/complicações , Eritema/fisiopatologia , Feminino , Humanos , Hiperalgesia/complicações , Masculino , Psicofísica , Adulto Jovem
20.
J Perinatol ; 38(1): 64-70, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-29120456

RESUMO

OBJECTIVE: The objective of this study was to determine the skin barrier changes during postnatal month 1 among infants receiving routine mustard oil massage in the humid conditions of rural Nepal. STUDY DESIGN: This was an observational study among 500 live-born neonates receiving mustard oil massage. Skin integrity such as erythema, rash, dryness, skin pH, stratum corneum protein concentration and transepidermal water loss was measured on days 1, 3, 7, 14 and 28. RESULTS: Erythema and rash increased (worsened) during weeks 1 and 2, then decreased over weeks 3 and 4. Skin pH (6.1±0.5 to 5.0±0.6) and stratum corneum protein (16.6±7.9 to 13.5±5.9 µg cm-2) decreased. Transepidermal water loss increased from 33.2±23.5 to 43.0±24.5 g m-2 h-1 at day 28. Skin pH and stratum corneum protein were higher for early versus late premature infants. CONCLUSION: Premature and full-term skin condition was generally poor especially during the first 2 weeks, improving thereafter. Maturational changes were evident.


Assuntos
Epiderme/metabolismo , Eritema/fisiopatologia , Massagem/métodos , Mostardeira/efeitos adversos , Óleos Vegetais/efeitos adversos , Perda Insensível de Água/fisiologia , Administração Tópica , Emolientes/efeitos adversos , Feminino , Idade Gestacional , Humanos , Concentração de Íons de Hidrogênio , Recém-Nascido , Proteínas de Filamentos Intermediários/análise , Masculino , Nepal , Ensaios Clínicos Controlados Aleatórios como Assunto , População Rural
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