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Biomedical subjects

William D James

Publications and source records attributed to William D James.

At least 19 recordsLinked to original sources
PubMed2007

Growth inhibition of Trichophyton species by Pseudomonas aeruginosa.

OBJECTIVE: To assess the ability of Pseudomonas aeruginosa to inhibit the growth of Trichophyton mentagrophytes (TM) and Trichophyton rubrum (TR). DESIGN: Pseudomonas aeruginosa, Escherichia coli, or Staphylococcus epidermidis were grown in co-culture with either TM or TR. SETTING: An academic medical center. MAIN OUTCOME MEASURES: The total fungal units and hyphal-spore ratio were measured at days 1, 5, 10, and 15. RESULTS: There was a 73% and 46% reduction of total fungal units and a final hyphal-spore ratio of 0.16 and 0.04, respectively, when TM and TR were co-cultured with P aeruginosa. The number of fungal units increased when TM and TR were cultured with E coli (28% and 42%, respectively), S epidermidis (13% and 18%, respectively), and control media (44% and 62%, respectively), and the hyphal-spore ratio increased to above 30 in the presence of S epidermidis, E coli, and control media. CONCLUSION: Pseudomonas aeruginosa exhibits growth inhibitory properties against TM and TR.

Coculture Techniques↗
PubMed2006

Ultraviolet recall reaction after total body irradiation, etoposide, and methotrexate therapy.

Ultraviolet (UV) reactivation reactions are rare and can occur in areas of prior sunburn or UV light therapy after the administration of chemotherapy, antibiotics, and other medications. Reactions may occur within days, as described after methotrexate therapy, or may appear months later, as described with ampicillin. Such reactions have been variably termed "UV recall," "sunburn recall," "photo recall," and "photodermatitis reactivation," making classification difficult. We report a UV reactivation reaction in a patient with acute lymphocytic leukemia treated with total body irradiation, etoposide, and methotrexate. We propose the terms "UV recall" and "UV enhancement" be used in future reports to classify UV reactivation reactions in a scheme analogous to the terminology for cutaneous reactions after radiotherapy.

Antimetabolites, Antineoplastic↗
PubMed2006

An experiment using neutron activation analysis and a rare earth element to mark cotton plants and two insects that feed on them.

Studies on insect dispersal and other behaviors can benefit from using markers that will not alter flight and fitness. Rare earth elements, such as samarium (Sm), have been used as ingested markers of some insects and detected using neutron activation analysis (NAA). In this study, samarium nitrate hexahydrate was mixed into artificial diet for boll weevils, Anthonomus grandis grandis Boheman (Coleoptera: Curculionidae), at different dosages and in water used to irrigate cotton, Gossypium hirsutum L. Samarium was detected in adult boll weevils fed on the samarium-labeled diet, but not after 5 or 10 days of being switched to non-labeled diet, even if the insects were given labeled diet for as long as 7 consecutive days. Introduced in irrigation water, 1% samarium (m/m) was detectable in cotton squares and leaf tissue. However, boll weevil adults fed samarium-labeled squares did not retain detectable levels of samarium, nor did boll weevil adults reared to adulthood from samarium-labeled squares. Fourth instar beet armyworms, Spodoptera exigua (Hübner) (Noctuidae: Lepidoptera), fed on samarium-labeled cotton leaves obtained enough samarium for NAA detection, but adult moths reared from them did not have detectable amounts of samarium. Although samarium can be useful as a marker when insects are presented with a continuous pulse of the label, elements that are assimilated by the insect would be more useful if a continuous infusion of the marker cannot be provided.

Animals↗
PubMed2006

Dermatologic toxicity of chemotherapeutic agents.

Due to its high metabolic rate, skin represents one of the major target organs of chemotherapy-associated toxicity. Reactions range from common, nonspecific exanthematous eruptions to rare but distinctive cutaneous lesions that may not become apparent until a drug transitions from clinical trials to widespread oncologic use. The challenge of the physician is to recognize reaction patterns that reflect a drug reaction, identify a likely causative drug, and determine whether the reaction is a dose-limiting toxicity. This review will focus on the cutaneous side effects of the newer classes of chemotherapy drugs, including targeted monoclonal antibody therapy and small molecule inhibitors.

Animals↗
PubMed2006

The utility of the TRUE test in a private practice setting.

BACKGROUND: Studies suggest that the Thin-Layer Rapid-Use Epicutaneous Test (TRUE Test) may be inadequate to completely diagnose a significant number of patients with allergic contact dermatitis (ACD). OBJECTIVE: To study the usefulness of the TRUE Test as a triage tool in a private practice setting. METHODS: A retrospective chart review of patients who were patch-tested with the TRUE Test between July 1, 2000, and June 30, 2004, in four private dermatology practices was conducted. RESULTS: Of the 183 patients evaluated, 50.8% had at least one positive reaction, 31.7% had a diagnosis of ACD, and 24.0% were suspected to have ACD from other allergens. Of the patients with positive reactions, 62.4% were determined to have reactions that were of present relevance. CONCLUSIONS: The TRUE Test allows patients with dermatitis to be triaged systematically in a private practice setting. It is important to supplement patch testing with the patients' personal products, especially in cases of facial or periorbital dermatitis, and to be aware of potential false negatives, particularly with fragrance and rubber additives.

Adolescent↗
PubMed2005

Soak and smear: a standard technique revisited.

BACKGROUND: Atopic dermatitis, nummular eczema, chronic hand dermatitis, palmar plantar psoriasis, and xerotic eczema are common inflammatory skin conditions. They may be refractory to conventional topical and even systemic treatment. Little evidence is available that demonstrates the benefits of aggressive topical treatment of patients with these disorders. OBJECTIVE: To describe a simple, inexpensive, effective topical treatment with an accompanying patient educational sheet. DESIGN: A retrospective study of 28 patients referred to a tertiary care center for refractory chronic pruritic eruptions. Intervention with a plain water 20-minute soak followed by smearing of mid-strength to high-strength corticosteroid ointment led to clearing or dramatic improvement. RESULTS: Objective and symptomatic improvement was obtained from aggressive topical treatment. It was well accepted in this group of referral patients. CONCLUSIONS: Hydration for 20 minutes before bedtime followed by ointment application to wet skin and alteration of cleansing habits is an effective method for caring for several common skin conditions. Prospective studies are needed to further validate these findings.

Administration, Cutaneous↗
PubMed2005

Patients' attitudes toward resident participation in dermatology outpatient clinics.

The attitudes of patients toward resident participation in a university-based dermatology outpatient clinic were evaluated. Of 206 patients asked to participate, 191 patients completed the self-administered questionnaire (92.7%). The overwhelming majority of patients (99.5%) were satisfied (81.8% "very satisfied" and 17.7% "satisfied") with the resident's participation in their care. Many more patients expressed a willingness to allow residents to take histories (93.6%), perform physical examinations (87.2%), and counsel on preventive measures (74.5%), than to allow surgical excisions of skin cancers (19.7%), perform skin biopsies (43.6%), or prescribe medications (44.7%). Of respondents to the questionnaire, 83.2% self-reported an understanding of the difference between "resident" and "attending" physicians. However, only 31.3% (95% confidence interval 24.5-38.1) were able to broadly categorize the amount of training completed by dermatology residents. Dermatology resident participation in outpatient clinics is essential to quality dermatologic education. Consistent with the results of prior studies in other medical disciplines, our study demonstrated an overwhelming patient satisfaction with the participation of dermatology residents in their care.

Clinical Competence↗
PubMed2005

Subcutaneous fat in normal and diseased states: 1. Introduction.

In recent years, our understanding of adipose tissue physiology and function has undergone an enormous transformation. Once considered a passive storage receptacle with a fixed number of cells and limited purpose, adipose tissue is now recognized as a complicated organ with important endocrine and metabolic functions. It is now known that both increased and decreased adipose tissue mass, as seen in obesity, anorexia, and lipodystrophy, have profound effects on multiple body systems, including immune, reproductive, and hematopoietic. The study of adipose tissue, therefore, is important not only for those who treat obesity, lipoatrophy, and their associated metabolic and endocrine derangements, but also for those dermatologists who specialize in the medical and surgical treatment of disorders within the body's largest adipose tissue subdivision, the subcutaneous fat. This introductory article is the first in a series about adipose tissue in normal and diseased states.

Adipocytes↗
PubMed2005

Subcutaneous fat in normal and diseased states: 2. Anatomy and physiology of white and brown adipose tissue.

White and brown adipose tissues, both present to some degree in all mammals, represent counter actors in energy metabolism. One of the primary functions of white adipocytes is to store excess energy as lipid, which is then mobilized to other tissues in response to metabolic needs that arise in times of food shortage. White adipocyte physiology can be grouped into 3 main categories with potentially overlapping mechanisms: lipid metabolism, glucose metabolism, and endocrine functions. Brown adipocytes, on the other hand, use accumulated lipid from food primarily as a source for chemical energy that can then be released from the cell in the form of heat. Recently, new discoveries about the significance of brown fat have sparked interest in this organ as a potential tool in the fight against obesity in adult humans. A basic overview of the anatomy and physiology of adipose tissue, with particular emphasis on the differences between white and brown fat, is presented.

Adipocytes↗
PubMed2005

Antimicrobial peptides: effectors of innate immunity in the skin.

The ability of the cutaneous barrier to help defend the body against pathogens relies on both acquired and innate immune responses. Recently, a large body of research has suggested that a critical component of the innate immune response in the skin is 3 antimicrobial peptides: the cathelicidins, defensins, and dermcidins. These 3 classes of peptides have been shown to act as antimicrobials by directly inhibiting pathogen growth as well as potentiating other branches of the innate, humoral, and cell-mediated immune system. Here, we review the antimicrobial peptides with an emphasis on their role in the cutaneous immune response. We present an overview of defensin, cathelicidin, and dermcidin physiology, elucidating their various functions. In addition, we delve into the role of these peptides in specific dermatologic conditions including wound healing, atopy, and microbial infection. Finally, we discuss the future of antimicrobial peptide research including therapeutic options.

Antimicrobial Cationic Peptides↗
PubMed2005

Topical tacrolimus: a review of its uses in dermatology.

Tacrolimus is one of the newer immunosuppressants that act by inhibiting T-cell activation and cytokine release. It is approved for the treatment of atopic dermatitis, and its safety and efficacy have been extensively studied in large-scale randomized controlled trials and open-label studies worldwide involving over 12,000 patients and up to 3 years of follow-up. Since its introduction, anecdotal reports and case series have found topical tacrolimus also to be effective and well tolerated in patients with a variety of other skin disorders, including other types of eczema, papulosquamous disorders, disorders of cornification, rosacea, other inflammatory skin conditions, vesiculobullous diseases, vitiligo, connective-tissue diseases, graft-versus-host disease, and follicular disorders. This paper reviews the currently available evidence on the use of topical tacrolimus for these conditions, as well as its safety profile and cost-effectiveness. Tacrolimus does appear to offer a safe and efficacious alternative that minimizes the need for topical glucocorticoids and does not cause skin atrophy. However, the risk of systemic absorption is increased with generalized disruption of the skin barrier. Further large-scale studies are needed to clarify the efficacy of topical tacrolimus in a variety of conditions for which anecdotal reports of success exist, especially in regard to different racial groups and in comparison to (as well as in combination with) other existing therapies. Long-term safety data should continue to be monitored and reported.

Administration, Cutaneous↗
PubMed2004

Comparison of skin biopsy triage decisions in 49 patients with pigmented lesions and skin neoplasms: store-and-forward teledermatology vs face-to-face dermatology.

OBJECTIVE: To determine the relative efficacy of store-and-forward teledermatology vs face-to-face dermatology consultations in triage decisions about the need for a biopsy of neoplastic skin changes. DESIGN: Prospective study of consecutive patients judged by an internist to require dermatologic consultation for a skin growth. SETTING: Private primary care and dermatology practices and an academic dermatology practice. PATIENTS: Patients requiring dermatology consultation for evaluation of skin growths. Patients were seen by a single primary care physician between July 10, 1998, and August 4, 2000. INTERVENTION: Digital photographs of skin growths were obtained by the primary care physician and evaluated by a teledermatologist. The patient was then seen face-to-face by a dermatologist. A biopsy was performed if either dermatologist favored biopsy. MAIN OUTCOME MEASURES: Decisions to perform a biopsy. Agreement between the dermatologists was assessed. RESULTS: Of the 49 patients with evaluable photographs, the face-to-face dermatologist and teledermatologist recommended a biopsy for the same 26 patients, yielding a sensitivity of the teledermatologist of 1.00 (95% confidence interval [CI], 0.87-1.00) and a specificity of 1.00 (95% CI, 0.85-1.00). The agreement between the dermatologists (kappa) was 1.00 (95% CI, 0.72-1.00). CONCLUSION: Store-and-forward teledermatology may provide an accurate and cost-effective method of determining whether skin growths in patients presenting to primary care physicians should undergo biopsy.

Biopsy↗