Adverse effects of topical corticosteroids in paediatric eczema: Australasian consensus statement.

Atopic eczema is a chronic inflammatory disease affecting about 30% of Australian and New Zealand children. Severe eczema costs over AUD 6000/year per child in direct medical, hospital and treatment costs as well as time off work for caregivers and untold distress for the family unit. In addition, it has a negative impact on a child's sleep, education, development and self-esteem. The treatment of atopic eczema is complex and multifaceted but a core component of therapy is to manage the inflammation with topical corticosteroids (TCS). Despite this, TCS are often underutilised by many parents due to corticosteroid phobia and unfounded concerns about their adverse effects. This has led to extended and unnecessary exacerbations of eczema for children. Contrary to popular perceptions, (TCS) use in paediatric eczema does not cause atrophy, hypopigmentation, hypertrichosis, osteoporosis, purpura or telangiectasia when used appropriately as per guidelines. In rare cases, prolonged and excessive use of potent TCS has contributed to striae, short-term hypothalamic-pituitary-adrenal axis alteration and ophthalmological disease. TCS use can also exacerbate periorificial rosacea. TCS are very effective treatments for eczema. When they are used to treat active eczema and stopped once the active inflammation has resolved, adverse effects are minimal. TCS should be the cornerstone treatment of atopic eczema in children.

Analysis of salazinic, norstictic, and usnic acids in Xanthoparmelia chlorochroa by ultra-performance liquid chromatography/tandem mass spectrometry.

The lichen species Xanthoparmelia chlorochroa is toxic when consumed by domestic sheep, cattle, and Rocky Mountain elk. Clinical signs exhibited by poisoned animals include red urine, ataxia, and muscular weakness that rapidly progresses to recumbency. Elk are unable to recover once becoming recumbent; however, most affected cattle can recover if offered suitable feed shortly following the onset of signs. At present, the pathogenesis and specific toxin(s) are unknown. As part of an effort to elucidate the proximate toxin, a method using ultra-performance LC coupled to MS/MS with negative-ion electrospray ionization has been developed to compare salazinic, norstictic, and usnic acid concentrations in X. chlorochroa collected from locales associated with lichen poisonings. Compounds were extracted from lichen samples with acetone and sonication. The stationary phase was a Waters Acquity UPLCTM BEH Ca18 (50 x 2.1 mm; 1.7 microm particle size) column. The mobile phase consisted of an acetonitrile-water gradient. The precision of the method was confirmed by an SD below 0.4% (n=9) for triplicate samples. LOD values were 200, 100, and 50 ng/mL for salazinic, norstictic, and usnic acids, respectively.

Experimental reproduction of tumbleweed shield lichen (Xanthoparmelia chlorochroa) poisoning in a domestic sheep model.

Xanthoparmelia chlorochroa, commonly called tumbleweed lichen, is found throughout the Rocky Mountain region. This particular species of lichen was incriminated in the poisoning of cattle and sheep in Wyoming during the 1930s. More than 70 years elapsed before another case was reported. There is virtually no information in the veterinary literature regarding toxicity of this lichen. This report describes X. chlorochroa poisoning in domestic sheep fed lichen collected from different locales and at different times of the year. Affected animals voided red urine and displayed incoordination. A transient spike in serum creatine kinase activity occurred in all ewes during the course of the feeding trial. Histologically, necrosis of a few individual appendicular skeletal myocytes was observed in 1 ewe, but grossly discernible myonecrosis was absent. The severity of clinical signs varied depending on the location and/or time of year the lichen was collected, indicating that toxicity of the lichen may be influenced by environmental conditions. Results demonstrate that domestic sheep are a useful model for further investigation of X. chlorochroa intoxication. The current study should act as a starting point for elucidating the pathogenesis of X. chlorochroa poisoning and aid in the development of a diagnostic assay to confirm lichen poisoning.

Liver metal concentrations in Greater Sage-grouse (Centrocercus urophasianus).

Greater Sage-grouse (Centrocercus urophasianus) are a species of concern due to shrinking populations associated with habitat fragmentation and loss. Baseline health parameters for this species are limited or lacking, especially with regard to tissue metal concentrations. To obtain a range of tissue metal concentrations, livers were collected from 71 Greater Sage-grouse from Wyoming and Montana. Mean +/- SE metal concentrations (mg/kg wet weight) in liver were determined for vanadium (V) (0.12 +/- 0.01), chromium (Cr) (0.50 +/- 0.02), manganese (Mn) (2.68 +/- 0.11), iron (Fe) (1,019 +/- 103), nickel (Ni) (0.40 +/- 0.04), cobalt (Co) (0.08 +/- 0.02), copper (Cu) (6.43 +/- 0.40), mercury (Hg) (0.30 +/- 0.09), selenium (Se) (1.45 +/- 0.64), zinc (Zn) (59.2 +/- 4.70), molybdenum (Mo) (0.93 +/- 0.07), cadmium (Cd) (1.44 +/- 0.14), barium (Ba) (0.20 +/- 0.03), and lead (Pb) (0.17 +/- 0.03). In addition to providing baseline data, metal concentrations were compared between sex, age (juvenile/adult), and West Nile virus (WNv) groups (positive/negative). Adult birds had higher concentrations of Ni and Cd compared to juveniles. In addition, Zn and Cu concentrations were significantly elevated in WNv-positive birds.