Unpleasantness and physiological responses in using sanitary napkins

This study investigated the physiological and psychological effects of sanitary napkins (SN) on women in hemorrhage treatment during the menstrual phase. Mesh and non-woven napkins were employed, and the effects were studied during the follicular and menstrual phases; mesh SN presented a higher textural surface-roughness. In both phases, the increases in systolic and diastolic blood pressure were significantly dependent on the application intervals. The low-frequency component of systolic blood pressure variability significantly increased, while the salivary secretion rate decreased with the use of mesh SN during the follicular phase compared with non-woven SN. In addition, the heart rate during the menstrual phase significantly increased in subjects after the replacement of mesh SN compared with non-woven SN. In cases of wearing the unpleasant mesh SN, electroencephalography (EEG) manifested bilateral enhancements in beta and alpha2 waves in the frontal areas increased arousal level during both phases. From the above findings, napkin use increased physiological loading and wearing napkins with higher textural surface-roughness tended to increase activities of the autonomic nervous system and brain arousal level.     

Vulvar syringoma,report of a case and review of the literature

Syringomas are common intraepidermal sweat gland tumors most often found in women around the time of adolescence. Frequent sites of involvement include the lower eyelids and malar areas, however vulvar involvement is relatively rare. These lesions often present as small, multiple, skin-colored-to-yellowish papules and are often associated with increased vulvar discomfort and itching. We present a case of a 29-year old female who presented to her gynecologist complaining of vulvar itching and burning. A small condylomatous-type wart observed on her vulva was biopsied and found to be a syringoma. Because of their clinical presentation and associated symptoms, vulvar syringomas should be considered in the differential diagnosis of any multicentric papular lesion of the vulva, vulvar pain syndrome, and pruritis vulvae.     

面部糖皮质激素依赖性皮炎伴难辨认癣1例

报道面部糖皮质激素依赖性皮炎伴难辨认癣1例.患者男,40岁,面部弥漫红斑、脱屑、丘疹,伴瘙痒、灼热症状,反复发作7a.曾在外院被诊断为脂溢性皮炎、湿疹、接触性皮炎,给予多种糖皮质激素药膏外用.取面部皮屑做真菌直接镜检为阳性,经鉴定为红色毛癣菌.诊断为面部激素依赖性皮炎、难辨认癣.给予伊曲康唑100 mg/次,2次/d,口服;第1周给予曲安奈德益康唑乳膏2次/d外用;第2周给予舍他康唑2次/d外用.2周后患者皮损明显好转,停用口服药物,给予他克莫司1次/d外用.4周后,患者皮损达临床治愈.     

Role of candida albicans infection in napkin rashes

Skin scrapings, mouth swabs, and faecal specimens from children with eruptions in the napkin area and from a series of normal infants were examined for the presence of Candida albicans.This was found in 41% of all napkin eruptions but in only one of the 68 normal infants. While C. albicans is a common secondary invader of all types of napkin eruption, primary Candida infection of the skin in the napkin area is probably uncommon.No evidence was found that generalized psoriasiform or eczematous eruptions occurring in association with napkin rashes are due to an allergic response to the fungus. C. albicans is more likely to be present in a napkin rash if the organism has been found in the alimentary tract.     

Geographical distribution of cercarial dermatitis in Norway

Bird schistosomes can cause a disease called cercarial dermatitis, or swimmer's itch, in humans. The disease occurs when people have direct contact with fresh water or sea water containing the free-swimming cercariae of the flukes. The symptoms are well known, and include intense itching, maculae, papulae, urticariae and, in some cases, local oedema with enlarged lymph nodes and fever. In this study, we present the geographical distribution of freshwater cercarial dermatitis in Norway. The study is based on random reports obtained from both individuals and physicians treating patients with itching skin rash after freshwater bathing. The first case of cercarial dermatitis in Norway was reported in 1980 and was traced to a lake near Trondheim in the central part of Norway. In the following years, an increasing number of cases were reported, especially in southern Norway. However, case reports are distributed almost all over the country, even from lakes in northern Norway. As far as we know, these are the northernmost case reports in Europe. So far, only one fluke species (Trichobilharzia franki) from a single infected snail (Radix auricularia) has been identified in Norway. However, unidentified schistosomatid ocellate cercariae have been found on several occasions in snails collected from six lakes where swimmer's itch is frequently reported. Future studies should be performed to identify the fluke species, as well as the most important snail and bird hosts, in Norwegian lakes.     

Heavy metals in contact dermatitis: A review

Contact dermatitis is an inflammatory skin reaction caused by direct contact with chemical substances in the environment and can either be irritant or allergic in nature. The clinical symptoms of contact dermatitis, include local skin rash, itching, redness, swelling, and lesions. Nowadays, 15–20% of people have some degree of contact dermatitis, which can be more or less severe. Immune responses in allergic contact dermatitis (ACD) are due to the effects of cytokines and allergen-specific CD4⁺ and CD8⁺ T cells on the skin. Acids and alkalis such as drain cleaners, plants such as poinsettias, hair colors, and nail polish remover, are all prominent causes of irritant contact dermatitis (ICDs). Heavy metals are metallic elements with a high atomic weight that are hazardous in low quantities and are known to cause dermatitis after systemic or local exposure. Nickel (Ni), chromium (Cr), lead (Pb), and copper (Cu) are among the most common heavy metals used in various industries. Metal allergies may cause ACD and also systemic contact dermatitis (SCD). Contact dermatitis is detected by laboratory tests such as patch testing, lymphocyte stimulation test (LST), and evaluation of cytokine production by primary cultures of peripheral blood mononuclear cells. This article presents an update on the epidemiological and clinical characteristics of ACD and SCD caused by three heavy metals (Cr, Cu, and Pb). Ni is not discussed due to recent coverage. Furthermore, the effects of contact sensitivity to some other heavy metals, such as gold (Au), cobalt (Co), palladium (Pd), and mercury (Hg) are discussed.     

Contact dermatitis to Biobrane

Contact dermatitis to Biobrane has not been reported previously. We report a patient who developed a bullous skin reaction directly related to a second exposure to Biobrane. The second exposure occurred 18 days after initial use of Biobrane, and the bullous reaction developed within 48 hours of repeat exposure. Sensitivity was confirmed by patch testing. Clinicians should be aware of the possibility of contact dermatitis to Biobrane.     

Algerian ivy dermatitis; a California disease

A hitherto unrecognized cause of contact dermatitis in California is the widely cultivated plant known as Algerian ivy. This plant, which grows in California (and its close relative, English ivy) causes a dermatitis which is similar to although milder than that caused by poison oak. Dermatitis from this cause occurs most frequently when persons who have become sensitive to it by previous contact trim the plant back in the spring after its seasonal spurt of growth. For persons whose occupations require repeated contact with the plant, dermatitis from this cause is an occupational hazard. Dermatitis from this plant is easily diagnosed by means of a simple patch test. In a series of 12 cases the only effective treatment was with corticosteroid agents.     

ALGERIAN IVY DERMATITIS—A California Disease

A hitherto unrecognized cause of contact dermatitis in California is the widely cultivated plant known as Algerian ivy. This plant, which grows in California (and its close relative, English ivy) causes a dermatitis which is similar to although milder than that caused by poison oak. Dermatitis from this cause occurs most frequently when persons who have become sensitive to it by previous contact trim the plant back in the spring after its seasonal spurt of growth. For persons whose occupations require repeated contact with the plant, dermatitis from this cause is an occupational hazard. Dermatitis from this plant is easily diagnosed by means of a simple patch test.In a series of 12 cases the only effective treatment was with corticosteroid agents.     

Expression of vascular endothelial growth factors VEGF- C and D, VEGFR-3, and comparison of lymphatic vessels density labeled with D2-40 antibodies as a prognostic factors in vulvar intraepithelial neoplasia (VIN) and invasive vulvar cancer

OBJECTIVE: The aim of this study was to compare the immunohistochemical expression of vascular endothelial growth factors VEGF-C and D, as well as the expression of VEGFR-3 in VIN and vulvar invasive cancer and to compare the density of lymphatic marker D2-40 antibody in both groups, and to compare them with different clinicopathologic features. Materials & Methods: The study was performed using tissue material and clinical data from 100 women diagnosed with VIN and 100 women diagnosed with invasive vulvar cancer. Results: No significant differences were found in the expression of VEGF-C and -D or VEGFR-3 between those patients with VIN and those with invasive vulvar cancers. Weak expression of VEGF-C was confirmed only in two cases of the analyzed series; in all cases, expression of VEGF-D and VEGFR-3 was observed. The strongest expression of VEGF-D and VEGFR-3 was observed in the group of invasive cancers. The highest density of lymphatic vessels per 2 mm was observed in VIN. In the cancer group, small lymphatic vessels with a narrow oval lumen were observed. Moreover, in two cases of vulvar cancer, the presence of intratumoral lymphatic vessels was observed. Conclusions: These results suggest that lymphangiogenesis begins at the preinvasive stage of vulvar carcinogenesis and suggests the important role of VEGF-C, VEGF-D, VEGFR-3 and LV (D2-40) as prognostic factors in the process of carcinogenesis in the vulvar area.     

Factors associated with health effects from occupational exposure to pesticide residues among greengrocers in fresh market,Bangkok, Thailand

Greengrocers are occupationally exposed to pesticide residues (PRs) on vegetables via dermal contact, especially organophosphates (OPs). The study's aim was to explore health effects from exposure to PRs. Eighty five vegetable vendors at a large fresh market in Bangkok were tested blood cholinesterase activity by the Test-mate ChE Kit (Model 400). The average acetylcholinesterase (AChE) and plasma cholinesterase (PChE) levels were 3.33 ± 0.66 U/ml and 2.06 ± 0.46 U/ml, respectively. The subjective symptoms were skin rash/itching, fatigue/tiredness, eye irritation/blurred vision, headache, and excessive sweating. Multiple linear regression analysis showed a positively significant association between scores of practices regarding exposure to PRs and AChE levels, and a negatively significant relationship between OP residues on hands and PChE levels (p-value < 0.05). Binary logistic regression analysis revealed that either AChE or PChE was significantly associated with eye symptoms and neuromuscular symptoms (p-value < 0.05). A statistically significant association between low score of dermal practice and having skin symptoms was found. Exposure to PRs by hand contact and consumption with poor hygiene habits can pose health problems among greengrocers. The findings emphasized that good personal hygiene practices such as wearing gloves and washing hands can prevent and reduce the health effects from exposure to PRs.     

Contact Hypersensitivity to Oxazolone Provokes Vulvar Mechanical Hyperalgesia in Mice

The interplay among pain, allergy and dysregulated inflammation promises to yield significant conceptual advances in immunology and chronic pain. Hapten-mediated contact hypersensitivity reactions are used to model skin allergies in rodents but have not been utilized to study associated changes in pain perception in the affected skin. Here we characterized changes in mechanical hyperalgesia in oxazolone-sensitized female mice challenged with single and repeated labiar skin exposure to oxazolone. Female mice were sensitized with topical oxazolone on their flanks and challenged 1-3 times on the labia. We then measured mechanical sensitivity of the vulvar region with an electronic pressure meter and evaluated expression of inflammatory genes, leukocyte influx and levels of innervation in the labiar tissue. Oxazolone-sensitized mice developed vulvar mechanical hyperalgesia after a single labiar oxazolone challenge. Hyperalgesia lasted up to 24 hours along with local influx of neutrophils, upregulation of inflammatory cytokine gene expression, and increased density of cutaneous labiar nerve fibers. Three daily oxazolone challenges produced vulvar mechanical hyperalgesic responses and increases in nerve density that were detectable up to 5 days post-challenge even after overt inflammation resolved. This persistent vulvar hyperalgesia is resonant with vulvodynia, an understudied chronic pain condition that is remarkably prevalent in 18-60 year-old women. An elevated risk for vulvodynia has been associated with a history of environmental allergies. Our pre-clinical model can be readily adapted to regimens of chronic exposures and long-term assessment of vulvar pain with and without concurrent inflammation to improve our understanding of mechanisms underlying subsets of vulvodynia and to develop new therapeutics for this condition.     

Risk factors for secondary infertility among women in Karachi, Pakistan

Background

Secondary infertility in developing countries is mostly attributable to blockage of the fallopian tubes due to adhesions caused by reproductive tract infections. There is a dearth of information on the prevalence and causes of secondary infertility from Pakistan. This paper presents results on factors associated with secondary infertility among married women in Karachi, Pakistan.

Methods

A matched case-control study was conducted. Cases were women aged 15–35 years with history of at least one previous conception and currently seeking treatment for secondary infertility. Controls were women residing in the neighborhood of cases with at least one live birth and not taking treatment for secondary infertility. The age of controls was matched by ±5 years to that of cases. Data was collected from June to August 2003. Conditional logistic regression was used to determine crude and adjusted odds ratios (OR) with corresponding 95% confidence intervals (CI) for factors associated with secondary infertility.

Results

The final multivariate logistic regression model revealed that after adjusting for age, cases were more likely to be the housewives (AOR = 2.6, 95% CI:1.5–4.4), had used inappropriate material to absorb blood during menstruation (AOR = 9.0, 95% CI: 5.0–16.4), and at their last delivery, had a birth attendant who did not wash hands with soap and water (AOR = 3.0, 95% CI: 1.4–5.7). Moreover, women with secondary infertility were more likely to report current or past history of having STI symptoms (AOR = 3.6, 95% CI: 2.4–5.6) and use of intra-vaginal indigenous medicines during their last post-partum period (AOR = 3.1, 95% CI: 1.6–5.7).

Conclusion

We recommend health education and awareness messages for safe practices during menstruation, delivery, and the postpartum period for women in general. Additionally, sanitary napkins should be made available at an affordable cost, and safe delivery kits should contain educational/pictorial brochures for appropriate hand washing skills.     

Helicobacter pylori infection: further evidence for the role of feco-oral transmission

BACKGROUND: Helicobacter pylori infection is recognized as a major cause of chronic digestive diseases with a major public health impact, yet the knowledge of transmission pathways is limited. We studied the transmission in employees taking care of institutionalized persons with mental disabilities with a documented high prevalence of H. pylori. MATERIALS AND METHODS: Six hundred and seventy-one health-care workers were screened for H. pylori serology. For each employee, information was collected on age, sex, father's and mother's education level, number of household members and number of children sleeping in the same bedroom during childhood, as well as lifestyle factors such as smoking and tropical journeys and occupational exposure data such as type of contact with inhabitants (changing napkins with stools, washing inhabitants, feeding inhabitants, personal contact) and seniority in the institution. RESULTS: Seroprevalence for H. pylori increased significantly with age. In univariate analysis, risk factors for H. pylori positivity were (age-adjusted): father's education, mean length of employment, smoking, contact with fecal materials of inhabitants, washing and feeding of inhabitants. Controlling for confounders, in multiple logistic regression analysis, only fecal contact remained as a significant risk factor for H. pylori infection. CONCLUSIONS: In health-care workers caring for a population with a high prevalence of H. pylori infection, there is an association with fecal transmission. This, however, does not rule out the possibility of other ways of transmission.     

Biofeedback treatment of atopic dermatitis: controlled case studies of eight cases.

To investigate the feasibility of a behaviorally oriented intervention program with atopic dermatitis, 12 patients were exposed to a fixed sequence of treatment phases including a no-treatment baseline phase, a phase incorporating nonspecific treatment factors, and a phase involving frontal electromyographic (EMG) feedback and relaxation instructions. Photographic analyses of involved skin areas revealed significant remission of dermatological problems across the entire program, although significant changes could not be attributable to any specific phase. Ratings of itching level decreased within but not across treatment sessions, and variable correlations across subjects were found between frontal EMG and itching level. MMPI results from the dermatitis subjects were within normal limits. Overall, the results provided mixed support for the hypothesis that atopic dermatitis may be amenable to intervention through behaviorally oriented treatment procedures.     

Augmentation mammaplasty and breast cancer: a 5-year update of the Los Angeles study.

We have previously reported on the risk of breast cancer in women during the first few years following cosmetic augmentation mammaplasty and are now presenting results after longer exposure. Long-term carcinogenicity of breast implants in humans has not been assessed previously. We conducted a retrospective cohort study of 3112 patients with a median of 10.6 years of postimplant experience (range 0.1 to 31.7 years). Patients were enrolled from surgeons' records, and cancer outcomes were monitored by the population-based cancer registry serving Los Angeles County. Because of confidentiality concerns, there was no direct patient contact. Twenty-one breast cancers were observed among the implant patients as compared with 31.7 expected, based on Los Angeles County incidence rates [standardized incidence ratio (SIR) = 66 percent, 95 percent confidence limits (CL): 41 percent, 101 percent]. For all other malignancies combined, 45 were observed and 50.0 were expected (SIR = 90 percent, CL: 66 percent, 120 percent). Although the numbers of cases were very small, increased frequencies of lung and vulvar cancers were observed. Based on the evidence to date, we conclude that there is no increase in breast cancer incidence following augmentation mammaplasty.     

Maternal use of selective serotonin re-uptake inhibitors in early pregnancy and infant congenital malformations

BACKGROUND: Maternal use of selective serotonin re-uptake inhibitors (SSRIs) has recently been associated with an increased risk for certain malformations. METHODS: Using the Swedish Medical Birth Register, we identified women who had reported the use of SSRIs in early pregnancy and studied their infants, born between July 1, 1995 and the end of 2004. Congenital malformations were identified from that register, from the Register of Congenital Malformations, and from the Hospital Discharge Register. The effect of drug exposure was studied after adjustment for a number of identified maternal characteristics that could act as confounders. RESULTS: We identified 6,481 women who reported the use of SSRIs in early pregnancy and their 6,555 infants. There was no general increase in malformation risk. An increased risk for cystic kidneys was seen, but this was based on only nine malformed infants, and the pathology varied between these cases. An in-depth study of cardiovascular defects identified an association between such defects and notably ventricular and atrial septum defects and maternal use of paroxetine but not other SSRIs. No support for a postulated association between SSRI use and infant craniostenosis or omphalocele was found. CONCLUSIONS: Use of SSRIs in early pregnancy does not seem to be a major risk factor for infant malformations. The association between paroxetine use and infant cardiovascular defects may be a result of multiple testing, but is supported by other studies.     

Immune-mediated interface dermatitis in a rhesus macaque

BACKGROUND: Autoimmune dermatitis, specifically interface dermatitis, is rarely reported in nonhuman primates. RESULTS AND CONCLUSIONS: This report describes a case of idiopathic immune-mediated dermatitis clinically manifesting as palmoplantar hyperkeratosis in a rhesus macaque, successfully controlled with the use of long-term oral corticosteroid therapy.     

A novel acoustic evaluation system of scratching in mouse dermatitis: rapid and specific detection of invisibly rapid scratch in an atopic dermatitis model mouse

Scratching is an essential and a skin specific behavior induced by itching, which is a common symptom of atopic dermatitis (AD) and other types of dermatitis. Itching sensation and scratching are closely associated and thus scratching times are currently used for evaluating itching in animal models. However, objective measuring systems of scratching to assess the grade of dermatitis and the effectiveness of anti-pruritic drugs in animal dermatitis models are lacking. To investigate a quantitative evaluation system for itching, we have developed a novel acoustic scratching counting system and compared its accuracy with time-consuming slow-motion video recording system. We have also objectively evaluated the efficacy of an antihistamine using this novel system. Scratching behavior of an AD model mouse (K14 driven IL-18 transgenic mouse) was recorded visually and acoustically. Specific scratching sound produced by mice was recorded and counted using a software we have developed, and the results obtained using our acoustic system were not statistically different from data obtained using slow motion video system. Surprisingly, mice scratched more than 10 times/second, which was invisibly rapid motion and revealed inaccuracy of conventional hand counting system. Results were identical to that of measured by 10 times time costing slow-motion video analysis. The antihistamine is clearly effective for suppression of scratching as demonstrated using this objective and accurate method. This novel motion analysis system will open a window for physiological and pathological analysis for animal models and development of anti-pruritic drugs.