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Biomedical subjects

L Nall

Publications and source records attributed to L Nall.

33 records · Page 2Linked to original sources

Nail psoriasis.

Psoriatic nail involvement is common and accompanies skin lesions on the body surface. The occurrence of nail psoriasis has been reported in up to 50 percent of patients, including children, adults, and the elderly. The characteristics of psoriatic nails are pitting, discoloration, onycholysis, subungual hyperkeratosis, as well as crumbling and grooving of nails and splinter hemorrhages. There is no consistently effective treatment for psoriatic nail involvement; nails are difficult to treat and respond slowly to therapy. Corticosteroids, 5-fluorouracil, systemic agents such as photochemotherapy, oral retinoids, and methotrexate, and nail avulsion are among the therapeutic approaches utilized. We offer suggested measures whereby patients may benefit in the prevention and control of their nail psoriasis.

Humans↗

Natural history and treatment of scalp psoriasis.

The scalp is a common site of involvement at onset and throughout the course of psoriasis. Worldwide census studies report that approximately half of the psoriasis population are afflicted with psoriasis of the scalp. We describe the frequency, clinical aspects, and treatment of scalp psoriasis in childhood, adulthood, and in the geriatric age groups. Measures of prevention and control are reviewed.

Adolescent↗

Tinea versicolor: epidemiologic, clinical, and therapeutic aspects.

Age of the patient, climate, season, and local environmental factors influence the onset and course of tinea versicolor (pityriasis versicolor). A number of effective topical therapies are available. In addition, a single dose of 400 mg of oral ketoconazole eliminates the disease and can be used prophylactically in some cases to prevent recurrence.

Adult↗

The action and safety of ketoconazole: a brief literature review.

A great number of human diseases can be attributed in some way to the effects of fungi, and consequently have long been recognized as important to the dermatologist and mycologist. However, not in all spheres of medicine are fungi significant in the diagnosis and treatment of disease. Fungi are biochemically similar to the host since they are eukaryotic. Thus, it is difficult to synthesize agents that will destroy the pathogenic organism and not harm the patient. Ketoconazole, an imidazole, was the first broad-spectrum, oral antifungal drug to be used in clinical medicine. Selected publications on the pharmacology, comparative efficacy in treatment, toxicity and safety of ketoconazole are briefly reviewed. In addition, new areas of research being undertaken for the azole derivatives are surveyed.

Chemical Phenomena↗

Development of creative language devices in signed and oral production.

The development of linguistic and cognitive flexibility was examined by evaluating nonliteral language use by 20 deaf and 20 hearing children aged 7;11 to 15;0 years. Each subject was videotaped telling stories on two experimenter-supplied themes. Deaf subjects' stories were translated and transcripts for both samples were scored for gesture, pantomime, linguistic modifications, and inventions as well as novel and frozen trope. Results indicated deaf children produced just as much figurative language in sign language as their matched hearing age-mates did in English. Deaf subjects exceeded their hearing peers in other types of creative productions. They also evidenced a "literal period" in language development, comparable to hearing children but delayed approximately 4 years. Findings are discussed in terms of their implications for understanding both language and cognitive flexibilities of deaf children.

Adolescent↗

Infantile psoriasis: a follow-up study.

The appearance of psoriasis in infancy has been questioned by many dermatologists and pediatricians, although childhood psoriasis is a well-recognized entity. To elicit further information on this matter, a follow-up group of nine children who had been diagnosed initially as having infantile psoriasis was reexamined 6 to 13 years later to determine the course of the disease over time. Seven of the nine children had recurrent psoriatic lesions and two remained completely clear after the resolution of the initial eruption. The majority did not have a severe disease course; on the contrary, progression of the illness was mild for most of them. Familial aggregation was noted in almost all of the children. In fact, over the intervening years the number of relatives with psoriasis significantly increased. Most patients were not aware of the role of such factors as infections, injury, and stress in precipitating psoriasis. Participation in a self-help workshop is recommended as a way for both parents and children to learn to cope with the clinical and psychologic aspects of the illness.

Age Factors↗

Metaphoric competence in cognitive and language development.

Consideration of the age-related changes in children's language and cognitive development suggests qualitative changes in their creative language use. Many, if not most, researchers in the area have argued that some metaphoric competence emerges far earlier than would be expected on the basis of explanation or interpretation tasks alone. These same researchers, however, appear largely to have neglected consideration of the cognitive prerequisites for such abilities and differences between what is nonliteral for the adult and nonliteral for the child. If figurative language is defined as involving intentional violation of conceptual boundaries in order to highlight some correspondence, one must be sure that children credited with that competence have (1) the metacognitive and metalinguistic abilities to understand at least some of the implications of such language (Lakoff & Johnson, 1980; Nelson, 1974; Nelson & Nelson, 1978), (2) a conceptual organization that entails the purportedly violated conceptual boundaries (Lange, 1978), and (3) some notion of metaphoric tension as well as ground. Having stacked the definitional cards, we doubt that many investigators would assert that 2-year-old children at nonverbal symbolic play are doing anything that is literally metaphorical in our terms. But neither will we deny that one can observe creative components in the verbal and nonverbal play of the young child that are precursors of later nonliteral language skills (see McCune-Nicolich, 1981, for discussion). We simply do not see these creative abilities as specific to language in any way that justifies calling them metaphoric competence. Rather, the child's abilities to deal flexibly with the world, to "play" with possible alternative organizations of it, and to see similarity in diversity represent the bases of subsequent cognitive as well as language development. Far from being an exceptional aspect of development, apparently nonliteral language should be considered a fundamental tool in the young child's construction of both internal and external worlds (McCune-Nicolich, 1981; Vygotsky, 1978). If one is willing to accept that children's conceptual organization might not match that of adults, then what is appropriately called nonliteral language in the young child must be reexamined. We find it strange that researchers acknowledge differences, for example, in children's notions of animacy, and yet assume that errors of animacy attribution are figurative constructions indicative of an ability to supercede a level of analysis the child does not have.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗

Psoriasis: a disease of the total skin.

Psoriasis is a disease of the total skin, which becomes clinically evident when a psoriatic lesion appears following an injury to the symptomless skin of a psoriasis patient. Although not all biopsy specimens of the symptomless skin show pathologic findings, the evolution of a psoriatic plaque can be envisioned as developing from the nonvisible phases of residual psoriasis, prepsoriasis, and latent psoriasis into a visible state where macules evolve into papules and papules coalesce to form plaques.

Biopsy↗

An appraisal of measures to prevent and control psoriasis.

Prevention in a broad sense refers to limiting the progress of disease at any stage of its course; control refers to reduction in frequency and/or severity of a disease in a population. Measures to prevent and control psoriasis require a knowledge on behalf of both the physician and the patient to recognize genetic and environmental components in the onset and course of the disease. Triggering factors include streptococcal throat infection, injury, drugs, low humidity, and emotional stress. From a study of 102 severely affected psoriasis patients, the "Three-P Concept" for the management of psoriasis has evolved encompassing: (1) prevention of injury, (2) persistence in avoiding overtreatment, and (3) pauses or rest periods in the course of treatment with sedation, emolliation, and humidification. Educating psoriasis patients about their disease and encouraging them to take responsibility for self-care will lessen the morbidity.

Adult↗

Psoriasis. A review of recent advances in treatment.

Current concepts in the treatment of psoriasis are reviewed, including: traditional modalities of dithranol (anthralin), tar, and corticosteroids alone or in combination with other agents; phototherapy and photochemotherapy; experimental studies with the aromatic retinoid etretinate and related analogues; dialysis; and the potential use of hyperthermia. Prudent administration of agents that are known to have serious side effects should be the concern of all clinicians. Many regimens that have beneficial short term results may have the potential for long term sequelae that may not only affect the patient but the offspring as well. Two of the most promising innovative concepts in the therapeutic armamentarium for psoriasis are psoriasis 'day care centres', and prevention and self-care. With the ever-increasing costs of medical care throughout the world, ways and means of reducing costs should be initiated by the clinician when considering a treatment programme. The clinician has the responsibility of determining whether the severity of the disease warrants ambulatory outpatient regimens or hospitalisation. If the patient would benefit from daily attention, then the psoriasis day care centre approach provides an appropriate clinical setting. However, in addition to administering appropriate medication, it is incumbent upon the clinician to educate patients regarding their disease and the triggering factors to prevent exacerbations. 'Disability prevention' means extending the services of clinicians and others to deal systematically with 2 areas involved in disease development; one is recognising the genetic component of psoriasis; the other, environmental triggering factors, e.g. infection, trauma to the skin, low humidity, and stress. Until recently, dermatology has focused on diseases and repairing the damage they cause. Now, the significance of genetic and environmental influences in multifactorial diseases like psoriasis has been realised, as has the importance of educating psoriasis patients to understand their disease and to encourage them to take responsibility for self-care so that the morbidity will be lessened.

Administration, Topical↗