Photopneumatic therapy for the treatment of keratosis pilaris.

BACKGROUND: Current treatment options for keratosis pilaris (KP) are limited and are often found to be unsatisfactory to patients. OBJECTIVE: Pilot study to determine if photopneumatic therapy (PPx) can improve the erythema and skin texture in KP. METHODS: Ten patients with KP were treated with one session of PPx on the upper arm and then evaluated one month later for treatment efficacy. RESULTS: Average investigator-assessed improvement was 27% in erythema and 56% in skin texture roughness. Average patient self-reported improvement was 52% in erythema and 53% in skin texture. The mean satisfaction score was 6.3 on a scale of 1 to 10 (median 7.5) and 8 out of 10 participants reported they would choose to receive PPx for their KP again in the future. LIMITATIONS: Small number of patients, short follow-up period, and lack of blinding of the examiner and the patients making recall bias possible. CONCLUSIONS: One treatment of PPx improved both the erythema and redness associated with KP over at least a one month period.

Impact of a health literacy intervention on pediatric emergency department use.

OBJECTIVE: The aim of this study was to measure the impact of a simple parent health literacy intervention on emergency department and primary care clinic usage patterns. METHODS: Study participants consisted of parents who brought their children to the Harbor-UCLA Medical Center pediatric emergency department for nonurgent complaints. Study participants filled out questionnaires regarding their management of children's mild health complaints and where respondents first seek help when their children become sick. After completing the questionnaires, participants were educated about how to use the health aid book What to Do When Your Child Gets Sick and provided a free copy. After 6 months, telephone follow-up interviews were conducted to assess whether the health literacy intervention had influenced the participants' management of their children's mild health complaints and their health care resource usage patterns. RESULTS: One hundred thirteen parents were enrolled in the preintervention phase, and 61 were successfully interviewed at 6 months by telephone. Before and after comparisons demonstrated a 13% reduction in the percentage of respondents who stated they would go to the emergency department first if their child became sick. In addition, 30% fewer respondents reported actual visits to the emergency department in the previous 6 months. Regarding specific low-acuity scenarios, significantly fewer participants would take their child to the emergency department for a low-grade fever with a temperature of 99.5 degrees F and for vomiting for 1 day. There was no significant change in the proportion of parents who would take their child to the emergency department for earache or cough. CONCLUSIONS: Health literacy interventions may reduce nonurgent emergency department visits and help mitigate emergency department overcrowding and the rising costs of health care.

Successful treatment of severe refractory atopic dermatitis with efalizumab.

Despite multiple therapeutic modalities, treatment of atopic dermatitis with its chronic, relapsing nature remains a challenge. Chronic use of standard therapies is associated with variable efficacy and potential side effects. Targeted therapeutic approaches using biologic agents may prove to be a novel alternative. We present a case of severe recalcitrant atopic dermatitis successfully treated with efalizumab.

Characterization of a lactose permease mutant that binds IIAGlc in the absence of ligand.

Enzyme IIA(Glc) of the Escherichia coli phosphoenolpyruvate:glucose phosphotransferase system plays a direct role in regulating inducible transport systems. Dephosphorylated IIA(Glc) binds directly to lactose permease in a reaction that requires binding of a galactosidic substrate. A double-Cys mutation (Ile129 --> Cys/Lys131 --> Cys) was introduced into helix IV of the permease near the IIA(Glc) binding site in cytoplasmic loop IV/V and in the vicinity of the galactoside binding site at the interface of helices IV, V, and VIII. The mutant no longer requires galactoside for IIA(Glc) binding as demonstrated by both a [(125)I]IIA(Glc) binding assay and a newly developed fluorescence anisotropy assay. Further characterization of the mutant shows that it binds substrate with high affinity, but is almost completely defective in all modes of translocation across the cytoplasmic membrane. The data are consistent with the interpretation that the double mutant is locked in an inward-facing conformation.