Pruritus after cardiopulmonary bypass.
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Aged↗
Biomedical subjects
R Marks
Publications and source records attributed to R Marks.
Influence of morbid obesity and non-insulin-dependent diabetes mellitus on high-density lipoprotein composition and subpopulation distribution.
The chemical composition, subpopulation distribution and peak hydrated density of high-density lipoprotein (HDL) were examined in 18 morbidly obese women with either normal glucose tolerance or with non-insulin-dependent diabetes mellitus (NIDDM), and in 15 age-matched lean control subjects. Similar measurements were made in the morbidly obese subjects after gastric bypass surgery for weight loss. In the diabetic group, HDL was relatively protein-enriched and cholesterol- and cholesterol ester-poor compared with the lean controls. The same trend was seen in the nondiabetic group, although the cholesterol ester difference was not significant. In both cases, both electrophoretic and density gradient analysis showed that plasma HDL contained more of the HDL3 and less of the HDL2 subfractions than that for the lean controls. Following surgery in the diabetic group, the protein percentage of HDL decreased, and that of cholesterol ester increased; for the nondiabetic group, the protein decreased and phospholipid increased. In the diabetic group, a shift of the electrophoretic HDL subpopulation distribution toward more HDL2 accompanied these changes. Average hydrated peak density of HDL shifted from the HDL3 to the HDL2 range for the diabetic group following surgery; for the nondiabetic group the peak density also decreased but still remained within the HDL3 range. In all cases, the differences seen were more pronounced among the diabetic patients. These changes in the properties of HDL after gastric bypass surgery may favorably influence the risk for coronary heart disease usually associated with diabetes.
Adult↗
Melanoma prevention: behavioral and nonbehavioral factors in sunburn among an Australian urban population.
BACKGROUND: To determine the independent contribution of behavioral factors to the occurrence of sunburn, sun protection behavior was assessed over 13 successive summer weekends in a total of 1,655 adults in Melbourne, Australia. METHODS: Telephone survey respondents provided detailed accounts of activities engaged in, time spent outside, and hat, clothing, and sunscreen coverage in the 4 hr around the solar midday on both weekend days, as well as skin type, sociodemographic descriptors, and degree of sunburn experienced. Independent measures of atmospheric temperature and ambient ultraviolet radiation (UVR) were added to individual records. RESULTS: The (mostly recreational) weekend sunburn in this urban sample was strongly associated with UVR, as expected. Temperature at 3 PM, sensitive skin type, youthfulness, and being male were also independently associated with sunburn. After all other predictors were controlled for, the body exposure index (which took into account time outside and hat, clothing, and sunscreen coverage) made a strong independent contribution to the explanation of sunburn (P < 0.001). CONCLUSION: It was concluded that behavior change strategies to prevent malignant melanoma of the skin are warranted.
Adolescent↗
Stratum corneum changes in patients with senile pruritus.
BACKGROUND: Generalized pruritus in the elderly is a common and distressing problem; often there is no evidence of skin disease other than xerosis. OBJECTIVE: The aim of the study was to determine whether any abnormality could be detected in the structure and function of the skin of patients with generalized pruritus. METHODS: The skin of 13 elderly patients with generalized pruritus, without skin disease or any underlying cause, was contrasted with that of age- and sex-matched normal control subjects. RESULTS: The patients had clinically drier skin (mean visual analogue scale score 2.9 [standard deviation +/- 2.2], controls 0.52 [+/- 0.59], p = 0.002). The severity of the pruritus was related to the degree of xerosis (r = 0.66). The patients had decreased skin surface conductance (10.7 mumho [+/- 3.4], controls 16 mumho [+/- 5.3], p = 0.017), and increased intracorneal cohesion (240.5 g [+/- 88], controls 162.7 g [+/- 39.8], p = 0.001). The patients also had statistically significantly diminished parameters of skin surface contour. CONCLUSION: The findings of increased intracorneal cohesion and altered skin surface contour parameters suggest that elderly patients with generalized pruritus may have an acquired abnormality of keratinization.
Aged↗
Quantification of microvascular changes in the skin in patients with psoriasis.
It has been suggested that there is a widespread abnormality of the capillaries in the skin of patients with psoriasis. This study was carried out to obtain more evidence on this point. Lesions of 20 patients with typical psoriasis, and uninvolved skin 3 cm from these lesions, were biopsied and compared with biopsies from 10 normal healthy control subjects. The dermal microvasculature was quantified in all these biopsies with regard to endothelial and luminal volume relative to the volume of dermal components of skin using stereological point counting methods utilizing the Delesse principle. The values for endothelial volume in specimens taken from the centre of the lesions did not differ significantly from those taken from the margins (33.6 x 10(-3) and 35.8 x 10(-3), respectively). The same was true for the luminal volume from the two sites (9.1 x 10(-3) and 10.0 x 10(-3), respectively). There was a highly significant difference, however, between the value for endothelial volume in biopsies from psoriatic patients compared to controls (P less than 0.001) and specimens from uninvolved psoriatic skin also showed a highly significant difference (P less than 0.001) from involved areas. There was no significant difference between uninvolved areas in psoriasis patients and control specimens. Significant differences were also found between values for control subjects and those for both involved and uninvolved psoriatic skin for luminal volume (P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
Unilateral bullous pemphigoid in a hemiplegic patient.
A 78-year-old man with a long-standing left-sided hemiplegia presented with bullous pemphigoid which affected his paralysed side only. Although the rash was unilateral, direct immunofluorescence demonstrated IgG antibody at the dermo-epidermal junction on both sides of the body. Indirect immunofluorescence was also positive. A suction-blister test showed increased skin fragility on the affected side.
Aged↗
Fixed drug eruption to mefenamic acid: a report of three cases.
Mefenamic acid (Ponstan) is widely used in the treatment of dysmenorrhoea, menorrhagia, and musculoskeletal pain. Although only 17 cases of fixed drug eruption provoked by mefenamic acid have been reported in the world literature, in a 7-day period a further three patients with fixed drug eruption due to mefenamic acid presented to the dermatology out-patient clinic of the University Hospital of Wales, Cardiff. The lesions of all the patients became inflamed within a few hours of taking the drug, but two of the three patients failed to appreciate the association. There have been no further episodes of inflammation since the patients avoided mefenamic acid.
Adult↗
Stereological studies of desmosomes in ichthyosis vulgaris.
Standardized stereological methods were performed on biopsies from three subjects with normal skin and from three patients with autosomal dominant and three with autosomal recessive sex-linked ichthyosis to determine the relative numbers and dimensions of desmosomes. The results showed an increase in the persistence of desmosomes in the stratum corneum in both ichthyotic groups. This suggests a pathogenetic role for desmosomes in the abnormal desquamation of the two types of ichthyosis vulgaris.
Adolescent↗
The measurement of photodamage.
The use of non-invasive and invasive techniques for the assessment of human photodamaged skin is reviewed. Physical changes during photodamage and its treatment are best scored using a visual analogue scale rather than a short, non-equal interval scale. Epidermal thickness can be measured by histometric methods but dermal thickness can be measured non-invasively using pulsed A-scan and B-scan ultrasound techniques. These approaches are not effective in detecting any changes due to photodamage. Mechanical properties of the dermis can be determined using either a static or a dynamic test mode. The authors have used extensometry to provide a measure of the laxity of skin. Replicas of the crow's foot areas have been taken before and after tretinoin treatment, and the replicas have been inspected by optical profilometry. Reductions of blood flow in photodamaged skin have been established using laser Doppler measurements, the effect being reversed by topical tretinoin. Invasive biochemical techniques have the disadvantage that they generally require large amounts of tissue. Cytochemical techniques, however, have shown increased glucose-6-phosphate dehydrogenase activity in the granular cell layer of patients with non-melanoma skin cancer, premalignant epidermal lesions, sun-damaged epidermis and artificially irradiated skin. This technique may provide an important model for the study of photodamage. It is concluded that there is no single method available to quantify the degenerative changes associated with photodamage and the effects of tretinoin.
Adult↗
An evaluation of the irritancy potential of povidone iodine solutions: comparison of subjective and objective assessment techniques.
A double-blind study has been carried out in 12 normal volunteer subjects in order to determine the relative irritancy of povidone-iodine solutions. Aqueous solutions of 10% povidone-iodine (PI), standardized 10% povidone-iodine (SPI) and reformulated standardized 10% povidone-iodine (RSPI) were applied to the backs and occluded using aluminium chambers. At 1, 2, 3, 4, 5, 6, and 8 hours, chambers were removed and the degree of cutaneous irritancy assessed. As well as subjective assessment of erythema, objective measurement of skin colour was performed using an erythema meter. In addition, laser Doppler blood-flow measurements have been carried out. The results show a rapid increase in cutaneous irritancy as evidenced by an increase in visual scores of erythema, increased erythema meter readings and increased cutaneous blood-flow. The increase was greatest for SPI treated sites for all three methods. Statistically these differences were significant at P < 0.05. Thus in this controlled study it has been possible to discriminate between the similar formulations in terms of their cutaneous irritancy.
Adult↗
Public knowledge about characteristics of moles and melanomas.
In a study aiming to determine public knowledge about moles and melanomas 590 residents of Victoria aged 14 and over were interviewed in a face-to-face household survey. The majority believed that moles were primarily raised lesions. Recognition of the term melanoma was high (91 per cent), but many held misconceptions about key characteristics. Many thought an early melanoma was raised (20 per cent) or could be raised (42 per cent), compared with only 10 per cent who thought it was flat. Fifty per cent of respondents thought being ugly was a common characteristic. In response to photographs of skin lesions, a late melanoma, seborrhoeic keratosis and a squamous cell carcinoma were most likely to be identified as needing to be seen by a doctor, while a normal raised mole and two early melanomas were least likely. The data suggest that a large proportion of the community have misconceptions about the early signs of melanoma. Education programs are needed to inform the public that most early melanomas are flat. Strategies which might confuse this message, such as likening melanoma to moles, should be avoided.
Adolescent↗
Effects of cetirizine, loratadine and terfenadine on histamine weal and flare reactions.
This randomised double-blind, placebo-controlled, cross-over study compared the effects of single oral doses of terfenadine 120 mg, cetirizine 10 mg, and loratadine 10 mg on experimentally induced weal and flare reactions. The areas of weal and flare induced by intracutaneous injections of histamine were measured using planimetry, weal thickness by A-scan pulsed ultrasound and erythema index by a device which measures the relative reflectance of red and green light. All three antihistamines suppressed the weal and flare area and weal thickness 3, 6, 12 and 24 h after dosing. At the usual currently recommended doses terfenadine and cetririzine were most effective after 6 h and were more potent than loratadine for the first 6 h of the study.
Administration, Oral↗
Derivation of a dysplasia index for epidermal neoplasia.
Measurements have been performed on histological sections of normal, paralesional and affected skin of patients with solar keratoses in an attempt at quantification of the degree of dysplasia. Features of dysplasia, including the epidermal thickness, the nuclear fraction and nuclear size distribution and shape, have been individually derived and incorporated into a formula designed to reflect the degree of dysplastic change within the epidermis. Application of this 'index of dysplasia' has been shown to differentiate lesional epidermis from that of the surrounding and normal non-sun-exposed skin. In addition, this index correlated well with independent dermatopathologists' assessments of the degree of dysplasia.
Cell Nucleus↗
Failure of a binaural comprehension deficit to select responders to earplug use in schizophrenia.
Previous studies have suggested that on the Auditory Comprehension Test, a significant proportion of schizophrenics demonstrate a binaural comprehension deficit. To test whether wearing an earplug in their more poorly performing ear would be beneficial, we studied 34 in-patient schizophrenics and noted a binaural deficit in 12 (35%). Of these, eight patients subsequently wore an earplug in each ear for at least one week. We found no effect of the earplug on psychopathology.
Adult↗
Trends in tans and skin protection in Australian fashion magazines, 1982 through 1991.
We rated 3971 photographs of models from midsummer editions of six Australian fashion magazines from 1982-1983 to 1990-1991 for tan on a 9-point scale, for the presence of hats, for sun-protective clothing, and for shade setting. With the exception of the 1990-1991 sample, there was an increasing proportion of light tans over the years. Men were more likely to be deeply tanned than were women. The proportion of models wearing hats followed an increasing linear trend across the five periods. Three quarters of the outdoor photographs were taken in unshaded settings. In unshaded settings, 17% of the women and 5% of the men wore hats.
Australia↗
Name the spot. National Skin Cancer Awareness Week 23 to 29 November.
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Australia↗
British Association of University Teachers of Dermatology (BAUTOD)
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Academic Medical Centers↗
Double-blind, controlled, crossover study of cyclosporin in adults with severe refractory atopic dermatitis.
A few patients remain severely affected by atopic dermatitis into adult life despite treatment with systemic steroids, azathioprine, and photochemotherapy. 33 patients took part in a double-blind, placebo-controlled, crossover study to assess the efficacy and safety of cyclosporin (5 mg/kg per day) in adults with severe refractory atopic dermatitis. Treatments were given for eight weeks each with one group (n = 16) receiving placebo followed by cyclosporin and another (n = 17) receiving cyclosporin and then placebo. Disease activity, extent of disease, sleep and itch, topical steroid use, and adverse events were assessed every two weeks. Both extent and activity of dermatitis were significantly improved (p less than 0.001) as were subjective measures of disease. 20 patients receiving cyclosporin reported adverse events compared with 8 taking placebo, although no patient required withdrawal from the study. Cyclosporin therapy led to an increase in the mean serum urea, creatinine, and bilirubin concentrations, although only the rise in bilirubin was significant (p = 0.001). Our results confirm that cyclosporin is a safe and effective short-term treatment for severe, refractory atopic dermatitis.
Adolescent↗