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1.
J Appl Microbiol ; 131(4): 1564-1577, 2021 Oct.
Article in English | MEDLINE | ID: mdl-33825272

ABSTRACT

AIMS: Recent foodborne disease outbreaks have caused farmers to re-evaluate their practices. In particular, concern that soil amendments could introduce foodborne pathogens onto farms and promote their survival in soils has led farmers to reduce or eliminate the application of animal-based composts. However, organic amendments (such as composts and cover crops) could bolster food safety by increasing soil microbial diversity and activity, which can act as competitors or antagonists and reduce pathogen survival. METHODS AND RESULTS: Leveraging a study of a 27-year experiment comparing organic and conventional soil management, we evaluate the impacts of composted poultry litter and cover crops on soil chemistry, bacterial communities and survival of Salmonella enterica and Listeria monocytogenes. We found that bacterial community composition strongly affected pathogen survival in soils. Specifically, organic soils managed with cover crops and composts hosted more macronutrients and bacterial communities that were better able to suppress Salmonella and Listeria. For example, after incubating soils for 10 days at 20°C, soils without composts retained fourfold to fivefold more Salmonella compared to compost-amended soils. However, treatment effects dissipated as bacterial communities converged over the growing season. CONCLUSIONS: Our results suggest that composts and cover crops may be used to build healthy soils without increasing foodborne pathogen survival. SIGNIFICANCE AND IMPACT OF THE STUDY: Our work suggests that animal-based composts do not promote pathogen survival and may even promote bacterial communities that suppress pathogens. Critically, proper composting techniques are known to reduce pathogen populations in biological soil amendments of animal origin, which can reduce the risks of introducing pathogens to farm fields in soil amendments. Thus, animal-based composts and cover crops may be a safe alternative to conventional fertilizers, both because of the known benefits of composts for soil health and because it may be possible to apply amendments in such a way that food-safety risks are mitigated rather than exacerbated.


Subject(s)
Composting , Salmonella enterica , Animals , Fertilizers , Manure , Soil , Soil Microbiology
2.
Br J Dermatol ; 169(4): 734-59, 2013 Oct.
Article in English | MEDLINE | ID: mdl-23679682

ABSTRACT

The Children's Dermatology Life Quality Index (CDLQI) is a widely used questionnaire to measure the quality of life of children aged from 4 to 16 years. The purpose of this review is to summarize all published data regarding the clinical experience of the CDLQI and its psychometric properties as a single reference source for potential users. A literature search was carried out to identify all articles describing the use of the CDLQI from 1995 to November 2012. One hundred and six articles were identified, with four excluded. The CDLQI has been used in 28 countries in 102 clinical studies and is available in 44 languages, including six cultural adaptations; a cartoon version is available in 10 languages. It has been used in 14 skin conditions and used in the assessment of 11 topical drugs, nine systemic drugs, 13 therapeutic interventions and two epidemiological and other studies. There is evidence of high internal consistency, test-retest reliability, responsiveness to change, and significant correlation with other subjective and objective measures. Rasch analysis has not been carried out and more information is needed concerning minimal clinically important difference; these are areas requiring further study.


Subject(s)
Quality of Life , Severity of Illness Index , Skin Diseases/psychology , Administration, Oral , Child , Culture , Dermatologic Agents/administration & dosage , Global Health , Health Status Indicators , Humans , Psychometrics , Reproducibility of Results , Skin Diseases/therapy , Surveys and Questionnaires , Translations
3.
J Comp Neurol ; 521(15): 3464-77, 2013 Oct 15.
Article in English | MEDLINE | ID: mdl-23681972

ABSTRACT

Horizontal head rotation evokes significant responses from trochlear motoneurons of turtle that suggests they have a functional role in abduction of the eyes like that in frontal-eyed mammals. The finding is unexpected given that the turtle is generally considered lateral-eyed and assumed to have eye movements instead like that of lateral-eyed mammals, in which innervation of the superior oblique muscle by the trochlear nerve (nIV) produces intorsion, elevation, and adduction (not abduction). Using an isolated turtle head preparation with the brain removed, glass suction electrodes were used to stimulate nIV with trains of current pulses. Eyes were monitored via an infrared camera with the head placed in a gimble to quantify eye rotations and their directions. Stimulations of nIV evoked intorsion, elevation, and abduction. Dissection of the superior oblique muscle identified lines of action and a location of insertion on the eye, which supported kinematics evoked by nIV stimulation. Eye positions in alert behaving turtles with their head extended were compared with that when their heads were retracted in the carapace. When the head was retracted, there was a reduction in interpupillary distance and an increase in binocular overlap. Occlusion of peripheral fields by the carapace forces the turtle to a more frontal-eyed state, perhaps the reason for the action of abduction by the superior oblique muscle. These findings support why trochlear motoneurons in turtle respond in the same way as abducens motoneurons to horizontal rotations, an unusual characteristic of vestibulo-ocular physiology in comparison with other mammalian lateral-eyed species.


Subject(s)
Eye Movements/physiology , Ocular Physiological Phenomena , Trochlear Nerve/physiology , Turtles/physiology , Vision, Ocular/physiology , Analysis of Variance , Animals , Biomechanical Phenomena , Cranial Nerves/physiology , Data Interpretation, Statistical , Electric Stimulation , Eye/anatomy & histology , Head Movements/physiology , In Vitro Techniques , Oculomotor Muscles/anatomy & histology , Oculomotor Muscles/innervation , Oculomotor Muscles/physiology , Reflex, Vestibulo-Ocular/physiology
4.
Vis Neurosci ; 26(3): 309-18, 2009.
Article in English | MEDLINE | ID: mdl-19523265

ABSTRACT

The pond turtle (Trachemys scripta elegans) exhibits a notably sluggish pupillary light reflex (PLR), with pupil constriction developing over several minutes following light onset. In the present study, we examined the dynamics of the efferent branch of the reflex in vitro using preparations consisting of either the isolated head or the enucleated eye. Stimulation of the oculomotor nerve (nIII) using 100-Hz current trains resulted in a maximal pupil constriction of 17.4% compared to 27.1% observed in the intact animal in response to light. When current amplitude was systematically increased from 1 to 400 microA, mean response latency decreased from 64 to 45 ms, but this change was not statistically significant. Hill equations fitted to these responses indicated a current threshold of 3.8 microA. Stimulation using single pulses evoked a smaller constriction (3.8%) with response latencies and threshold similar to that obtained using train stimulation. The response evoked by postganglionic stimulation of the ciliary nerve using 100-Hz trains was largely indistinguishable from that of train stimulation of nIII. However, application of single-pulse stimulation postganglionically resulted in smaller pupil constriction at all current levels relative to that of nIII stimulation, suggesting that there is amplification of efferent drive at the ganglion. Time constants for constrictions ranged from 88 to 154 ms with relaxations occurring more slowly at 174-361 ms. These values for timing from in vitro are much faster than the time constant 1.66 min obtained for the light response in the intact animal. The rapid dynamics of pupil constriction observed here suggest that the slow PLR of the turtle observed in vivo is not due to limitations of the efferent pathway. Rather, the sluggish response probably results from photoreceptive mechanisms or central processing.


Subject(s)
Oculomotor Nerve/physiology , Reflex, Pupillary/physiology , Turtles/physiology , Animals , Ciliary Body/innervation , Efferent Pathways/physiology , Electric Stimulation/methods , Female , In Vitro Techniques , Male , Models, Biological , Nervous System Physiological Phenomena , Reaction Time
5.
Clin Exp Dermatol ; 32(1): 6-11, 2007 Jan.
Article in English | MEDLINE | ID: mdl-17004990

ABSTRACT

BACKGROUND: Allergic contact dermatitis (ACD) in childhood was considered rare until recently. However, reports are increasing, which may reflect an increased incidence and/or more frequent patch testing of children. It is also likely that allergen exposure in children has changed with time. AIMS: To determine the most common contact allergens and the rate of positive patch-test reactions among children with suspected contact allergy. METHODS: We carried out a retrospective case study of 114 children (66 girls and 48 boys) aged from 3 to 15 years (median 11.5) patch tested over a 3-year period. Indications for patch testing included uncontrolled or deteriorating atopic dermatitis, localized dermatitis or a history of reacting to a specific allergen. RESULTS: Of 110 children for whom we had notes, 83 (75%) had a history of atopy. Positive reactions that were of current, past or possible relevance were seen in 61 children (54%); in 58 (52%) of 111 tested with the standard series (SS) and in 6 (10%) of 60 tested with the medicament series. None of the children patch tested to the corticosteroid (n = 47), shoe (n = 15), fragrance (n = 12), cosmetic (n = 10) or rubber (n = 5) series had a positive reaction. However, 11 (10%) reacted to rubber allergens within the SS and one of five to their own shoes. The lowest rate of relevant positive reactions was among those with deteriorating atopic dermatitis (22%) and facial (33%) or perioral dermatitis (40%), and the highest rate amongst those with eyelid (86%) or hand (71%) dermatitis. Nickel was the most common allergen (20%) in line with previous reports (82% female), followed by rubber chemicals (10%), fragrance (7.2%), cobalt (5.4%) and lanolin (wool alcohol) (4.5%). CONCLUSIONS: The reported incidence of ACD among children, in particular nickel and rubber allergy, appears to be increasing, which may relate to changing fashions and hobbies. Contact allergy should be considered in all children with dermatitis, particularly with eyelid or hand dermatitis, and patch testing carried out more frequently.


Subject(s)
Dermatitis, Allergic Contact/epidemiology , Patch Tests , Adolescent , Age Distribution , Allergens/adverse effects , Child , Child, Preschool , Dermatitis, Allergic Contact/diagnosis , Female , Humans , Incidence , Male , Patch Tests/methods , Retrospective Studies
6.
Br J Dermatol ; 155(6): 1249-55, 2006 Dec.
Article in English | MEDLINE | ID: mdl-17107397

ABSTRACT

BACKGROUND: Atopic dermatitis (AD) accounts for 10-20% of referrals to secondary care dermatology, often requiring multiple visits and occupying much valuable time and resources. OBJECTIVES: We audited the usefulness (ease of use, reliability and sensitivity to change) of two simple and easy to use quality of life (QoL) measures, the Infants' Dermatitis Quality of Life Index (IDQOL) and Dermatitis Family Impact (DFI), for assessing the impact on QoL of AD in infants and their families in a routine clinical setting. We also examined the impact of an initial consultation with a dermatology team on AD severity and QoL impairment from the parent's perspective. METHODS: The parents of 203 infants (mean age 19.8 months) with AD attending paediatric dermatology clinics completed the DFI and IDQOL. The parents of 50 of these infants completed both questionnaires before first and second consultations. RESULTS: In the 203 children the mean of both the IDQOL and DFI scores was 8.47 (median 8 and 7 and SD 5.8 and 6.5, respectively). The IDQOL and DFI correlated well (r(s) = 0.776, P < 0.0001). The parent's assessment of the global severity of AD correlated well with the IDQOL score (r(s) = 0.636, P < 0.0001) but less well with the DFI (r(s) = 0.394, P < 0.001). The highest-scoring IDQOL items were itching and scratching, problems at bathtime and time taken to fall asleep. The highest-scoring DFI items were tiredness/exhaustion, sleep loss and emotional distress. In both measures these domains also correlated most strongly with eczema severity. After dermatology consultation the median global severity score, rated by 50 parents, fell from 2 (SD 0.83) to 1 (SD 0.8; 95% confidence interval, CI 0.5-1), the median IDQOL score fell from 8 (SD 5.92) to 5.5 (SD 5.92; 95% CI 2-5.5) and the median DFI score fell from 9 (SD 6.45) to 3 (SD 6.56; 95% CI 2-5.5). In 50 infants the median IDQOL scores for those infants with global AD severity scores of 1, 2 and 3 were 5 (SD 5.65), 8 (SD 4.27) and 14 (SD 5.67), respectively and improved by 10%, 38% and 64%, respectively while the median DFI scores improved by 54%, 56% and 79%, respectively. The most improved IDQOL items were the time taken to get to sleep and difficulty at mealtimes and the most improved DFI domains were tiredness/exhaustion and emotional distress in the parents. CONCLUSIONS: We have provided further important information on the effects of AD on infants and their families using the IDQOL and DFI QoL measures. We demonstrate the usefulness of these measures in routine clinical management of AD and show the beneficial effect for both infants and parents of the initial consultation by a dermatology team in a secondary care setting.


Subject(s)
Dermatitis, Atopic/psychology , Family/psychology , Health Status Indicators , Quality of Life , Child, Preschool , Dermatitis, Atopic/therapy , Female , Humans , Infant , Infant, Newborn , Male , Medical Audit , Referral and Consultation , Reproducibility of Results , Severity of Illness Index , Sickness Impact Profile , Surveys and Questionnaires
7.
Br J Dermatol ; 155(1): 145-51, 2006 Jul.
Article in English | MEDLINE | ID: mdl-16792766

ABSTRACT

BACKGROUND: Chronic disease can have physical and psychological effects which affect social functioning. These effects can be better understood from the perspective of parent and child by the use of health-related quality of life (HRQL) measures. Various HRQL measures are now available, of which generic health measures have been the most widely used. These permit comparison between different diseases and also the normal population. OBJECTIVES: To cross-validate a new generic HRQL proxy measure for children, the Children's Life Quality Index (CLQI), with an established speciality-specific dermatological questionnaire, the Children's Dermatology Life Quality Index (CDLQI), in a group of children with chronic skin diseases. The impairment of HRQL in the same group of children with skin disease was then compared with that associated with other common chronic childhood diseases using the CLQI. METHODS: The CDLQI was completed by 379 children aged 5-16 years with skin disease of more than 6 months' duration. Their parents (n=379) and parents of 161 children aged 5-16 years with other chronic diseases were also asked to complete a proxy measure, the CLQI. RESULTS: Using linear regression analysis, the CLQI and the CDLQI scores showed a strong linear association (rs=0.72, P<0.001) and on a Bland-Altman plot, reasonably good agreement (expressing scores out of 100, the 95% limits of agreement were from -25.5/100 to 26.7/100). In the child's opinion psoriasis and atopic dermatitis (AD) caused the greatest impairment (CDLQI scores of 30.6% and 30.5%), followed by urticaria (20%) and acne (18%). Using the generic CLQI (scored 0-36), from the parental perspective the highest score was for AD (33%), followed by urticaria (28%), psoriasis (27%) and alopecia (19%). Comparing this with children with other chronic diseases, those with cerebral palsy had the highest score (38%), followed in descending order by those with generalized AD (33%), renal disease (33%), cystic fibrosis (32%), urticaria (28%), asthma (28%) and psoriasis (27%). Diseases such as epilepsy (24%) and enuresis (24%) scored higher than diabetes (19%), localized eczema (19%), alopecia (19%) and acne (16%). CONCLUSIONS: Using the CLQI we have shown that HRQL impairment in children with chronic skin disease is at least equal to that experienced by children with many other chronic diseases of childhood, with AD and psoriasis having the greatest impact on HRQL among chronic skin disorders and only cerebral palsy scoring higher than AD. Cross-validation of the CLQI with the CDLQI in the group of children with skin disease demonstrates a strong linear association and good agreement between the two.


Subject(s)
Quality of Life , Skin Diseases/psychology , Activities of Daily Living , Adolescent , Child , Child, Preschool , Chronic Disease/psychology , Diet , Disabled Children , Female , Health Status , Humans , Life Style , Linear Models , Male , Sickness Impact Profile , Social Environment
8.
J Eur Acad Dermatol Venereol ; 20(1): 45-50, 2006 Jan.
Article in English | MEDLINE | ID: mdl-16405607

ABSTRACT

BACKGROUND: Acne vulgaris is known to adversely affect all aspects of quality of life. However, although acne is thought to occur in the majority of adolescents, there are few data currently available on the impact of acne in this age group. OBJECTIVES: Measurement of the impairment of health-related quality of life (HRQoL) in teenage Scottish schoolchildren in a comparative study using two HRQoL questionnaires. A secondary objective was to collect data on the use and perceived efficacy of medical and over-the-counter (OTC) preparations. STUDY DESIGN: An anonymous cross-sectional survey of 200 adolescent (15-18 years) Dundee schoolchildren was conducted by means of two self-reported questionnaires: the Children's Dermatology Life Quality Index (CDLQI) and the Cardiff Acne Disability Index (CADI). Data on demographics and therapeutic modalities and their perceived efficacy were also collected. ANALYSIS: Statistical analysis was performed using the package Stata 7.0. RESULTS: Self-reported acne was present in 83% of teenagers (147/178), with similar sex distribution (54% male, 46% female). The overall mean CDLQI score (max. 30) was low 1.7 {6% impairment} (CI -1 to 0), range 0-19. Nine pupils scored between 5 and 9 {17-30% impairment} suggesting moderate HRQoL impairment and three scored > 10 {> 33% impairment} indicating severe impairment. The overall mean CADI score (max. 15) of 1.9 {13% impairment}, CI 0 to 1 (range 0-15) was also low, but 12 pupils scored between 5 and 9 {33-60% impairment}, one scoring 10 + {> 67% impairment} and one scoring the maximum, 15 {100% impairment}. There was no significant difference in mean scores between the sexes in either questionnaire (P = 0.5). There was good correlation between the results from the two questionnaires (Spearman's rho = 0.62). Three-quarters (75%) had used OTC products, of which only a third (33%) felt they helped 'a lot'. Fifteen per cent were receiving prescribed treatment from their doctors of which 66% found it helpful. CONCLUSIONS: Self-reported acne occurred in 83% (147/178) of the Scottish teenagers involved in this study, which confirms previous reports of a high prevalence of acne in teenagers. Cross-validation of the CLDQI and CADI demonstrated good correlation and both scales were easy to administer and identified 11% (16/147) of teenagers who perceive their lives to be significantly affected by their acne (8% moderately to severely, 3% severely). It is important to identify and treat such teenagers early to reduce the future socio-economic burden of their acne.


Subject(s)
Acne Vulgaris/psychology , Quality of Life , Sickness Impact Profile , Acne Vulgaris/epidemiology , Adolescent , Cross-Sectional Studies , Disability Evaluation , Disabled Children/statistics & numerical data , Female , Humans , Male , Scotland/epidemiology , Statistics, Nonparametric
10.
Clin Exp Dermatol ; 29(4): 348-53, 2004 Jul.
Article in English | MEDLINE | ID: mdl-15245526

ABSTRACT

Wet wrap therapy (WWT) is a well-established treatment for severe atopic dermatitis (AD). However little evidence exists to justify widespread use in the community for less severe eczema. We compared the efficacy of WWT with a standard regime of hydrocortisone, to control moderate AD in children. We carried out a single-observer, randomized, controlled pilot study in 19 children under 5 years of age, with AD of 30% or more body surface area, using only 1% hydrocortisone (HC) prior to the study. Group one applied HC once in the morning for 2 weeks, with wet wraps twice daily for week 1, but only at night for week 2. Group two applied HC twice daily without wet wraps. Both applied emollient twice daily and as necessary. The primary outcome measure was the Six Area, Six Sign Atopic Dermatitis (SASSAD) severity score, and the secondary outcome measures were the Infants Dermatology Quality of Life Index (IDQOL), the Dermatitis Family Impact (DFI) score and the weight of topical steroids and emollients used. Over the 2-week active therapy period the mean fall in SASSAD was 8 [95% confidence interval (CI), -18 to +2; P = 0.11] more in the non-WWT group, the median change in the IDQOL was 2 for Group one and 7 for Group two (95% CI for difference, -10 to +3; P = 0.24) and the median change in DFI score was 2 for Group one and 5 for Group two (95% CI for difference, -14 to +2; P = 0.42). This small study has shown that conventional therapy with HC and emollients alone is as effective as WWT for infants with moderately severe, widespread AD, and provides weak evidence to suggest that it may be more effective. We would not advocate routine use of WWT for moderate eczema without further evaluation.


Subject(s)
Bandages , Dermatitis, Atopic/therapy , Anti-Inflammatory Agents/therapeutic use , Child, Preschool , Combined Modality Therapy , Dermatitis, Atopic/drug therapy , Dermatitis, Atopic/pathology , Drug Administration Schedule , Emollients/administration & dosage , Female , Humans , Hydrocortisone/therapeutic use , Infant , Male , Pilot Projects , Quality of Life , Severity of Illness Index , Treatment Outcome
11.
Avian Dis ; 48(1): 196-201, 2004.
Article in English | MEDLINE | ID: mdl-15077815

ABSTRACT

A clinical study was conducted on commercial layers housed in biological isolation units, within which exogenous stress factors potentially affecting bird performance were minimized. This set-up was devised in order to assess how a pre-lay inoculation of S6 strain Mycoplasma gallisepticum affects the leukocytic properties of laying chickens. Previous studies have demonstrated relative decreases in lymphocyte and relative increases in heterophil percentages in birds infected with other strains of Mycoplasma gallisepticum. However, current results showed that the differential percentages of lymphocytes were decreased, whereas those of heterophils were increased, in both sham-inoculated control birds and birds inoculated with S6 Mycoplasma gallisepticum between 19 and 26 wk of age. This study clearly shows that a pre-lay inoculation of S6 Mycoplasma gallisepticum alone had no apparent effect on the leukocyte profile of commercial layers housed in biological isolation units.


Subject(s)
Chickens/immunology , Chickens/microbiology , Leukocytes/immunology , Mycoplasma gallisepticum/pathogenicity , Animals , Female , Mycoplasma Infections/immunology , Mycoplasma Infections/physiopathology , Mycoplasma Infections/veterinary , Oviposition , Poultry Diseases/immunology , Poultry Diseases/physiopathology , Virulence
12.
Poult Sci ; 82(9): 1397-402, 2003 Sep.
Article in English | MEDLINE | ID: mdl-12967252

ABSTRACT

In two trials, the effects of an F-strain Mycoplasma gallisepticum (FMG) inoculation at 12 wk of age on the blood characteristics of commercial Single Combed White Leghorn laying hens were investigated throughout lay. Variables measured in both trials were whole blood hematocrit, plasma protein (PP), and serum cholesterol, triglycerides (ST), and calcium. In both trials, hematocrit at 20 wk of age was significantly increased in birds inoculated with FMG. In trial 1, ST and PP were significantly increased at 22 wk of age by FMG, while ST and PP were significantly decreased in FMG-inoculated birds at wk 54 and 52, respectively. When combined with the establishment of an FMG infection, the initial weeks of egg production become particularly stressful to the bird. Increases in these independent blood parameters between 8 and 10 wk postchallenge are suggestive of compensatory responses in these birds to an FMG challenge. Postpeak decreases in both ST (54 wk) and PP (52 wk) in FMG-infected birds may be the result of a more chronic effect of FMG on lipid and protein synthesis in the liver. These data are the first to suggest that alterations in egg production in response to FMG-infection in commercial layers, as noted in a previous report, may be associated with changes in hematocrit. However, because ST and PP were not affected by FMG in both trials, the responses of these blood parameters to FMG-infection may be inconsistent among flocks.


Subject(s)
Chickens/microbiology , Chickens/physiology , Mycoplasma Infections/veterinary , Mycoplasma/pathogenicity , Animals , Blood Proteins/analysis , Calcium/blood , Cholesterol/blood , Female , Hematocrit/veterinary , Hematologic Tests/veterinary , Liver/microbiology , Liver/physiology , Mycoplasma Infections/complications , Ovum , Poultry Diseases/microbiology , Triglycerides/blood
13.
Clin Exp Dermatol ; 28(5): 549-53, 2003 Sep.
Article in English | MEDLINE | ID: mdl-12950351

ABSTRACT

Poor adherence with therapy is a major cause of treatment failure in atopic dermatitis. Reasons given are multifactorial, and include fear of real or imaginary side-effects, under-prescribing, failure to renew prescriptions on time, lack of time, and child refusal of therapy. Most important, however, is lack of knowledge about treatment, in particular the use of topical corticosteroid (TCS) therapy. We conducted a questionnaire-based study to determine the level of use and knowledge of commonly prescribed TCS preparations amongst parents or carers of 100 children attending paediatric outpatient clinics. Weakly potent TCSs were the most commonly used (86%), but poorly understood. Only 35 (41%) who had used hydrocortisone were aware that it was weakly potent, and 44% graded it as moderately potent. Of 65 who had used the moderately potent TCS clobetasone butyrate 0.05% (Eumovate); Glaxo Wellcome, Uxbridge, UK), 19 (29%) graded it as potent and eight (12%) as weak. Of 50 who had used betamethasone valerate 0.1% (Betnovate); Glaxo Wellcome, Uxbridge, UK), 42% did not grade it as potent. Understanding of TCS/antimicrobial combinations was generally worse. The hydrocortisone 1%/fusidic acid 2% combination (Fucidin H(R); Leo, Risborough, Bucks, UK) was graded as moderate or strong by 88% of the 74 who had used it. Over half (53%) of the 34 using the combination of clobetasone butyrate 0.05%/nystatin 100000 i.u./g tetracycline 3% (Trimovate); Glaxo Wellcome, Uxbridge, UK) assumed that it was a potent TCS. Forty-nine had used Fucibet (betamethasone valerate 0.1%, fusidic acid 2%; Leo, Risborough, Bucks, UK) but 34.5% did not grade it as potent. There was poor knowledge of the strengths of some of the most commonly used TCSs, and all steroid/antimicrobial combinations were perceived as being of greater potency than the constituent steroid alone. Fusidic acid was thought to be a steroid by almost half (46.9%) of the respondents. The packaging of the different products by some pharmaceutical companies is remarkably similar and labelling contains information on the compound and percentage rather than potency of the TCS. This may be a source of confusion. We recommend that manufacturers clearly label TCS products by potency as mild, moderate, potent or very potent and that packaging is sufficiently different for each strength of TCS or emollient to avoid confusion. In order to achieve optimal topical treatment for atopic dermatitis, patients and their carers must receive adequate information and training in how and when to use topical therapies in conjunction with written care plans.


Subject(s)
Adrenal Cortex Hormones/administration & dosage , Dermatitis, Atopic/drug therapy , Health Knowledge, Attitudes, Practice , Parents/psychology , Administration, Topical , Child , Dermatitis, Atopic/psychology , Drug Combinations , Humans , Ointments , Surveys and Questionnaires
14.
Hum Mol Genet ; 12(11): 1241-52, 2003 Jun 01.
Article in English | MEDLINE | ID: mdl-12761039

ABSTRACT

Germline mutations of the fumarate hydratase (FH, fumarase) gene are found in the recessive FH deficiency syndrome and in dominantly inherited susceptibility to multiple cutaneous and uterine leiomyomatosis (MCUL). We have previously reported a number of germline FH mutations from MCUL patients. In this study, we report additional FH mutations in MCUL and FH deficiency patients. Mutations can readily be found in about 75% of MCUL cases and most cases of FH deficiency. Some of the more common FH mutations are probably derived from founding individuals. Protein-truncating FH mutations are functionally null alleles. Disease-associated missense FH changes map to highly conserved residues, mostly in or around the enzyme's active site or activation site; we predict that these mutations severely compromise enzyme function. The mutation spectra in FH deficiency and MCUL are similar, although in the latter mutations tend to occur earlier in the gene and, perhaps, are more likely to result in a truncated or absent protein. We have found that not all mutation-carrier parents of FH deficiency children have a strong predisposition to leiomyomata. We have confirmed that renal carcinoma is sometimes part of MCUL, as part of the variant hereditary leiomyomatosis and renal cancer (HLRCC) syndrome, and have shown that these cancers may have either type II papillary or collecting duct morphology. We have found no association between the type or site of FH mutation and any aspect of the MCUL phenotype. Biochemical assay for reduced FH functional activity in the germline of MCUL patients can indicate carriers of FH mutations with high sensitivity and specificity, and can detect reduced FH activity in some patients without detectable FH mutations. We conclude that MCUL is probably a genetically homogeneous tumour predisposition syndrome, primarily resulting from absent or severely reduced fumarase activity, with currently unknown functional consequences for the smooth muscle or kidney cell.


Subject(s)
Fumarate Hydratase/genetics , Kidney Neoplasms/genetics , Leiomyomatosis/genetics , Mutation , Skin Neoplasms/genetics , Uterine Neoplasms/genetics , Amino Acid Metabolism, Inborn Errors/genetics , Amino Acid Sequence , Enzyme Stability , Female , Fumarate Hydratase/chemistry , Fumarate Hydratase/deficiency , Fumarate Hydratase/metabolism , Genetic Predisposition to Disease , Germ-Line Mutation , Humans , Kidney Neoplasms/secondary , Leiomyomatosis/pathology , Molecular Sequence Data , Protein Conformation , RNA Stability , RNA, Messenger/metabolism , Sequence Homology, Amino Acid , Skin Neoplasms/pathology , Uterine Neoplasms/pathology
15.
Avian Dis ; 47(1): 96-100, 2003.
Article in English | MEDLINE | ID: mdl-12713163

ABSTRACT

Mycoplasma gallisepticum (MG), a reproductive/respiratory pathogen in poultry, has been implicated in suboptimum egg production and decreased hatchability. Commercial layer hens raised in a controlled environment were inoculated with the S6 strain of MG at 20 wk of age. The S6 inoculation had no effect on bird weight, egg production, digestive tract weight and length, or histopathologic lesion scores, although significant differences were noted in the lengths and weights of various portions of the reproductive tract. This study shows that S6MG inoculation does not detrimentally affect layer hen performance when in the absence of environmental stressors customary to a caged layer facility.


Subject(s)
Digestive System/microbiology , Digestive System/physiopathology , Mycoplasma Infections/physiopathology , Mycoplasma Infections/veterinary , Mycoplasma/physiology , Oviposition/physiology , Poultry Diseases/microbiology , Poultry Diseases/physiopathology , Aging , Animals , Chickens/microbiology , Female , Mycoplasma/classification , Mycoplasma Infections/microbiology , Mycoplasma Infections/pathology , Organ Size , Ovary/microbiology , Ovary/pathology , Oviducts/microbiology , Oviducts/pathology , Poultry Diseases/pathology , Uterus/microbiology , Uterus/pathology , Vagina/microbiology , Vagina/pathology
16.
Br J Dermatol ; 148(2): 285-90, 2003 Feb.
Article in English | MEDLINE | ID: mdl-12588381

ABSTRACT

BACKGROUND: In 1995 the Children's Dermatology Life Quality Index (CDLQI) was developed as a tool to allow quality of life assessment of children with skin conditions. This initial questionnaire was in a written format. OBJECTIVES: Using the same validated questions, a full-colour cartoon version has been developed. The aim of this study was to validate this against the initial written questionnaire in a three-part study. METHODS: The first part of the study piloted the use of both versions in an outpatient setting. One hundred and one children completed both versions of the CDLQI in a random order. A further 66 children completed the cartoon CDLQI in outpatients, and subsequently completed the cartoon version on the same day at home, which was returned by post. The scores were compared. In the second part, in more controlled conditions to eliminate parental and investigator bias, 107 children with current dermatological problems were administered both versions of the CDLQI in a random order. The scores were analysed, and time to complete each version, and the child and parental preferences, were recorded. The third part assessed compliance by asking 546 children recently reviewed in dermatology clinics to return a single completed postal CDLQI. Half of the children were given the text, and half the cartoon version. RESULTS: The median age of participating children was 11 years. There was no significant difference in scores between the two versions in both parts 1 and 2, but the cartoon version was completed faster (median 90 s) than the written version (median 120 s) (P < 0.0001). Both children and their parents significantly preferred the cartoon version and found it easier to use. Forty-six per cent of the postal CDLQI questionnaires were returned; there was no difference in compliance between the two versions. CONCLUSIONS: The cartoon CDLQI is equivalent to the previously validated written CDLQI version, but is faster and easier for children to use, and is preferred by both children and parents.


Subject(s)
Quality of Life , Skin Diseases , Surveys and Questionnaires , Adolescent , Child , Child, Preschool , Female , Humans , Male , Medical Illustration , Parents/psychology , Patient Satisfaction , Sickness Impact Profile , Time Factors
17.
Avian Dis ; 46(3): 593-7, 2002.
Article in English | MEDLINE | ID: mdl-12243522

ABSTRACT

Mycoplasma gallisepticum (MG) is a reproductive/respiratory disease in poultry implicated in suboptimum egg production and decreased hatchability. Commercial layer hens raised in a controlled environment were inoculated with the S6 strain of MG at 10 wk of age. Egg production and selected egg and egg quality parameters were quantitated over the entire lay cycle for inoculated and control birds. The S6 inoculation had no effect on bird weight, egg production, associated egg quality parameters, or histopathologic lesion scores. This study shows that in the absence of environmental stressors a prelay S6 MG inoculation does not produce detrimental effects on layer hen performance.


Subject(s)
Chickens , Eggs/standards , Mycoplasma Infections/veterinary , Oviposition , Poultry Diseases/physiopathology , Animals , Egg Shell/physiology , Eggs/microbiology , Female , Mycoplasma/pathogenicity , Mycoplasma Infections/pathology , Mycoplasma Infections/physiopathology , Oviposition/physiology , Poultry Diseases/pathology , Random Allocation
18.
Poult Sci ; 81(12): 1884-91, 2002 Dec.
Article in English | MEDLINE | ID: mdl-12512582

ABSTRACT

Experimental inoculation with the F-strain of Mycoplasma gallisepticum (FMG) between 8 and 18 wk of age is known to affect reproductive performance in commercial layers. Therefore, two trials were conducted to determine if changes in digestive and reproductive organ characteristics also occur in commercial laying hens infected with FMG at 12 wk of age. In Trial 1, liver weight, liver lipid and moisture contents, ovary weight, ovarian follicular hierarchy, and the weights, lengths, and histologies of the infundibulum, magnum, isthmus, uterus, and vagina were determined. In Trial 2, fatty liver hemorrhagic syndrome (FLHS) incidence and the weights, lengths, and histologies of the duodenum, jejunum, and ileum were determined in addition to the parameters examined in Trial 1. In both trials, the average number of mature (diameter > or = 12 mm) ovarian follicles was lower in FMG-inoculated hens in comparison to controls. Also, magnum/oviduct (cm/cm) length was reduced in treated birds. In Trial 2, isthmus/BW and isthmus/oviduct (g/ g) weight were decreased at 46 wk of age, and vagina/ BW and vagina/oviduct (g/g) weight were decreased at both 20 and 36 wk of age due to FMG treatment. In Trial 2, FMG treatment resulted in a 50% increase in the number of FLHS birds. Furthermore, treatment caused a decrease at 20 wk of age and an increase at 44 wk of age in liver moisture content. However, the intestinal characteristics examined were not affected by FMG inoculation. Altered liver, ovarian, and reproductive organ characteristics were associated with FMG infection in commercial layers. More specifically, FMG inoculation at 12 wk resulted in a higher incidence of FLHS, ovarian follicular regression, and decreased isthmal and vaginal proportions of the reproductive tract. These data clearly demonstrate that alterations in performance and egg characteristics of layers inoculated with FMG at 12 wk of age are related to mutual functional disturbances in the liver, ovary, and oviduct without concomitant intestinal changes.


Subject(s)
Aging , Chickens , Mycoplasma Infections/veterinary , Poultry Diseases/microbiology , Animals , Female , Genitalia, Female/pathology , Intestines/pathology , Lipids/analysis , Liver/chemistry , Liver/pathology , Mycoplasma Infections/physiopathology , Organ Size , Ovarian Follicle/pathology , Ovary/pathology , Oviducts/pathology , Poultry Diseases/pathology , Poultry Diseases/physiopathology , Vagina/pathology
19.
Br J Dermatol ; 144(1): 104-10, 2001 Jan.
Article in English | MEDLINE | ID: mdl-11167690

ABSTRACT

BACKGROUND: The impact on quality of life (QOL) caused by atopic dermatitis (AD) has been quantified in children and adults using established QOL measures. However, these are not suitable for use in infants under the age of 4 years, when AD usually develops. OBJECTIVES: To validate a new parent-generated QOL questionnaire, the Infants' Dermatitis QOL Index (IDQOL), which measures the impact of AD on the infant, and to provide further validation of the Family Dermatitis Index (FDI), which measures the impact of a child's dermatitis on the family. METHODS: Parents of 102 predominately caucasian infants under 4 years with AD (34 postal and 68 outpatients) were asked to complete the IDQOL and the FDI on two separate occasions to test for repeat validity. The Infants' Behavioural Check List (BCL) was also given to the study group and to parents of 22 normal control infants. Post-treatment IDQOL and FDI questionnaires were obtained from 25 of the study group. RESULTS: The return rate for initial questionnaires was 87.3% (61 boys, 28 girls) and for retest 70.6%. The mean score for IDQOL was 7.89 and for FDI 8.87. Spearman rank correlation between the IDQOL and FDI was high (r = 0.87). Correlations of IDQOL and FDI with clinical severity assessment by parents were lower (r = 0.58 for IDQOL and r = 0.5 for FDI). Test-retest data for IDQOL and FDI confirmed repeatability, there being negligible differences between the pairs using the method of Bland and Altman. The three highest scoring questions for IDQOL referred to itching and scratching, mood change and sleep disturbance. For the FDI they were parental sleep disturbance, tiredness and exhaustion, and emotional distress. Post-treatment questionnaires from 25 patients indicated sensitivity to clinical change with both IDQOL and FDI. Parameters of behaviour measured using the BCL in 82 study infants and 22 controls showed greater problems with frequent night-time wakening (43% vs. 4.5%) and miserable mood changes (24.4% vs. 9%) in the study infants. CONCLUSIONS: Initial validation of the IDQOL and further validation of the FDI show good test-retest repeatability and apparent sensitivity to change with treatment. The effect on health-related QOL as measured by these methods is poorly correlated with clinical severity, confirming that QOL measures should be used in conjunction with clinical measures for global assessments of disease impact. This work requires further validation but suggests that QOL measures may be useful as outcome measures in clinical practice and research. Their simple construction allows quick and easy use, which is particularly valuable in large-scale and postal studies.


Subject(s)
Dermatitis, Atopic/psychology , Health Status Indicators , Quality of Life , Child, Preschool , Dermatitis, Atopic/therapy , Family Health , Female , Humans , Infant , Infant Behavior , Male , Reproducibility of Results , Severity of Illness Index , Surveys and Questionnaires , Treatment Outcome
20.
J Neurophysiol ; 84(3): 1505-18, 2000 Sep.
Article in English | MEDLINE | ID: mdl-10980023

ABSTRACT

Oscillatory activity in excess of several hundred hertz has been observed in somatosensory evoked potentials (SEP) recorded in both humans and animals and is attracting increasing interest regarding its role in brain function. Currently, however, little is known about the cellular events underlying these oscillations. The present study employed simultaneous in-vivo intracellular and epipial field-potential recording to investigate the cellular correlates of fast oscillations in rat somatosensory cortex evoked by vibrissa stimulation. Two distinct types of fast oscillations were observed, here termed "fast oscillations" (FO) (200-400 Hz) and "very fast oscillations" (VFO) (400-600 Hz). FO coincided with the earliest slow-wave components of the SEP whereas VFO typically were later and of smaller amplitude. Regular spiking (RS) cells exhibited vibrissa-evoked responses associated with one or both types of fast oscillations and consisted of combinations of spike and/or subthreshold events that, when superimposed across trials, clustered at latencies separated by successive cycles of FO or VFO activity, or a combination of both. Fast spiking (FS) cells responded to vibrissae stimulation with bursts of action potentials that closely approximated the periodicity of the surface VFO. No cells were encountered that produced action potential bursts related to FO activity in an analogous fashion. We propose that fast oscillations define preferred latencies for action potential generation in cortical RS cells, with VFO generated by inhibitory interneurons and FO reflecting both sequential and recurrent activity of stations in the cortical lamina.


Subject(s)
Biological Clocks/physiology , Intracellular Fluid/physiology , Reaction Time/physiology , Somatosensory Cortex/physiology , Action Potentials/physiology , Animals , Excitatory Postsynaptic Potentials/physiology , Male , Oscillometry , Periodicity , Physical Stimulation , Rats , Rats, Sprague-Dawley , Somatosensory Cortex/cytology , Vibrissae/innervation , Vibrissae/physiology
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