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1.
Nutr J ; 16(1): 44, 2017 Jul 13.
Article in English | MEDLINE | ID: mdl-28705254

ABSTRACT

BACKGROUND: Severe acute malnutrition (SAM) has been associated with low polyunsaturated fatty acid (PUFA) status. However, investigations regarding PUFA status and correlates in children with moderate acute malnutrition (MAM) from low-income countries are scarce. The aim of this study was to describe whole-blood PUFA levels in children with moderate acute malnutrition (MAM) and to identify correlates of PUFAs. METHODS: We conducted a cross-sectional study using baseline data from a prospective nutritional intervention trial among 1609 children with MAM aged 6-23 months in Burkina Faso,West Africa. Whole-blood PUFAs were measured by gas chromatography and expressed as percent of total whole-blood fatty acids (FA%). Potential correlates of PUFAs including infection, inflammation, hemoglobin, anthropometry (difference between children diagnosed as having MAM based on low mid-upper-arm-circumference (MUAC) only, low MUAC and weight-for-height z-score (WHZ), or low WHZ only) and diet were assessed by linear regression adjusted for age and sex. RESULTS: Children with MAM had low concentrations of whole-blood PUFAs, particularly n-3 PUFAs. Moreover, children diagnosed with MAM based only on low MUAC had 0.32 (95% confidence interval (CI), 0.14; 0.50) and 0.40 (95% CI, 0.16; 0.63) FA% lower arachidonic acid (AA) than those recruited based on both low WHZ as well as low MUAC and those recruited with low WHZ only, respectively. Infection and inflammation were associated with low levels of all long-chain (LC)-PUFAs, while hemoglobin was positively associated with whole-blood LC-PUFAs. CONCLUSION: While PUFA deficiency was not a general problem, overall whole-blood PUFA concentrations, especially of n-3 PUFAs, were low. Infection, inflammation, hemoglobin, anthropometry and diet were correlates of PUFAs concentrations in children with MAM. TRIAL REGISTRATION: The trial is registered at http://www.isrctn.com ( ISRCTN42569496 ).


Subject(s)
Fatty Acids, Unsaturated/blood , Malnutrition/drug therapy , Malnutrition/epidemiology , Anthropometry , Burkina Faso/epidemiology , C-Reactive Protein/metabolism , Child , Cross-Sectional Studies , Diet , Fatty Acids, Unsaturated/administration & dosage , Fatty Acids, Unsaturated/deficiency , Female , Hemoglobins/metabolism , Humans , Infant , Male , Morbidity , Nutrition Assessment , Orosomucoid/metabolism , Socioeconomic Factors
2.
J Eur Acad Dermatol Venereol ; 29(12): 2463-9, 2015 Dec.
Article in English | MEDLINE | ID: mdl-26471106

ABSTRACT

BACKGROUND: Severe acute malnutrition is a life-threatening condition. It can be associated with severe skin changes, first properly described by Williams in 1933. The aetiology of these skin changes is still unknown and their character has never been systematically described in dermatological terms. The skin changes have been shown to be a predictor of mortality in hospital care. Systematic investigations on the character of the skin changes that have effect on prognosis, are needed to investigate which of the skin changes that are relevant to improve treatment. OBJECTIVES: Our main objective was to identify the skin changes characteristic of children with severe acute malnutrition and to develop a clinical score that describes the morphology and severity in dermatological terms. We also investigated if any of the different skin changes were connected to prognosis. MATERIALS AND METHODS: At Mulago Hospital, Mwanamugimu (Department of Paediatrics and Child Health), Uganda, 120 children were included over a period of six months and observed when treated for severe acute malnutrition. Skin changes were registered through clinical examination and photo documentation and associated to prognosis using Cox and logistic regression analysis. RESULTS: Skin manifestations were characterized by five objective skin signs: telogenic effluvium, pigmentary changes (hyper- and hypo-pigmentation), ichthyosiform skin changes, lichenoid skin changes and bullae-erosion-desquamation. The skin changes could be registered in a systematic manner using our simple clinical score. Lichenoid skin changes were a significant predictor of death and allowed improved accuracy of prediction of mortality. CONCLUSIONS: The clinical score is simple and practical. A standardized way to register and score the skin changes, will allow a more unified way of reporting results in future studies. The standardization of observations, obtained through the proposed scoring system, will enable comparison of study results in the future.


Subject(s)
Child Nutrition Disorders/complications , Severe Acute Malnutrition/complications , Severity of Illness Index , Skin Diseases/etiology , Blister/etiology , Child Nutrition Disorders/pathology , Child, Preschool , Female , Hair Diseases/etiology , Humans , Hyperpigmentation/etiology , Hypopigmentation/etiology , Ichthyosis/etiology , Infant , Lichenoid Eruptions/etiology , Logistic Models , Male , Prognosis , Severe Acute Malnutrition/pathology , Skin Diseases/pathology
3.
J Eur Acad Dermatol Venereol ; 28(8): 995-1001, 2014 Aug.
Article in English | MEDLINE | ID: mdl-24661336

ABSTRACT

Children with oedematous malnutrition, known as kwashiorkor, may develop a characteristic skin lesion, named 'Dermatosis of Kwashiorkor' (DoK). Only a few studies have been concerned with this condition, and the reason for the development of DoK remains unexplained. This study review the existing studies concerning DoK, including its clinical manifestations, histopathology, suggested pathophysiology, current treatment and prognosis for children of the age of 6 months to 5 years. Standardized clinical studies are needed to further understand the implications of DoK. Such studies would suffer from the lack of consistency concerning the terminology and scoring of the lesions in DoK. We therefore stress the need for a standardized scoring of the degree of DoK. This would facilitate valid and comparable studies and the development of better treatment for this vulnerable group of patients.


Subject(s)
Kwashiorkor/complications , Skin Diseases/complications , Child , Humans , Kwashiorkor/diet therapy , Prognosis , Skin Diseases/diet therapy , Skin Diseases/therapy
4.
Nervenarzt ; 76(6): 724-32, 2005 Jun.
Article in German | MEDLINE | ID: mdl-15580469

ABSTRACT

We present laboratory data from 22 patients suspected of having neurosyphilis. In two cases the suspicion could not be confirmed, and in 20 cases neurosyphilis was detected. The sera from 17 patients were also assayed for Borrelia-specific antibodies. Suspicious immunoglobulin G antibody indices were detected in nine cases and a suspicious immunoglobulin M antibody index in one. In six of these, stored CSF/serum pairs were available to specify the antibodies by immunoblotting. This allowed for the identification of one patient apparently infected by both Borrelia spp. and Treponema pallidum. In all cases of newly suspected neurosyphilis, we recommend considering neuroborreliosis at the same time.


Subject(s)
Immunoglobulin G/blood , Lyme Neuroborreliosis/blood , Lyme Neuroborreliosis/diagnosis , Neurosyphilis/blood , Neurosyphilis/diagnosis , Adult , Aged , Diagnosis, Differential , Female , Humans , Male , Middle Aged , Retrospective Studies
6.
Hautarzt ; 53(11): 730-4, 2002 Nov.
Article in German | MEDLINE | ID: mdl-12402135

ABSTRACT

A 19 year old man with severe acne conglobata and ulcerated pyoderma gangraenosum-like skin lesions on the face was first treated with isotretinoin (Roaccutan((R))), then immunosuppressively with prednisolone, diaminodiphenylsulfone (Dapson-Fatol((R))) and mycophenolate mofetil (Cellcept((R))). Under a daily maintenance dose of immunosuppressive treatment with 2.5 mg prednisolone and 1 g mycophenolate mofetil, weakness, muscle and joint aches appeared. Due to proteinuria, haematuria and an elevated antineutrophil cytoplasmic antibody (cANCA) and the histological detection of a leukocytoclastic vasculitis, the diagnosis of cANCA positive vasculitis of the skin and kidneys was established. Therapy with cyclophosphamide (Endoxan((R))) along with prednisolone was effective. An exact classification of this disease process was not possible.


Subject(s)
Acne Vulgaris/immunology , Antibodies, Antineutrophil Cytoplasmic/immunology , Facial Dermatoses/immunology , Kidney/blood supply , Pyoderma Gangrenosum/immunology , Vasculitis/immunology , Acne Vulgaris/drug therapy , Acne Vulgaris/pathology , Adult , Cyclophosphamide/therapeutic use , Diagnosis, Differential , Drug Therapy, Combination , Endothelium, Vascular/immunology , Endothelium, Vascular/pathology , Facial Dermatoses/drug therapy , Facial Dermatoses/pathology , Humans , Immunosuppressive Agents/administration & dosage , Immunosuppressive Agents/therapeutic use , Isotretinoin/adverse effects , Isotretinoin/therapeutic use , Male , Neutrophils/immunology , Neutrophils/pathology , Prednisolone/therapeutic use , Pyoderma Gangrenosum/drug therapy , Pyoderma Gangrenosum/pathology , Vasculitis/drug therapy , Vasculitis/pathology
7.
Hautarzt ; 53(6): 403-8, 2002 Jun.
Article in German | MEDLINE | ID: mdl-12132297

ABSTRACT

The rarely occurring multiple lentigines (LEOPARD) syndrome represents a complex of skin, heart, skeleton and other malformations and is described in a 36-year-old male and his 9-year-old daughter. With the occurrence of multiple lentigines, the diagnostic search for further malformations should always be undertaken. Its differential diagnosis and its pathogenetic and clinical aspects are discussed in this paper.


Subject(s)
Neurofibromatosis 1/diagnosis , Skin Neoplasms/diagnosis , Adult , Child , Chromosome Aberrations , Diagnosis, Differential , Female , Genes, Dominant , Humans , Male , Neurofibromatosis 1/genetics , Neurofibromatosis 1/pathology , Patient Care Team , Phenotype , Skin/pathology , Skin Neoplasms/genetics , Skin Neoplasms/pathology
8.
J Eur Acad Dermatol Venereol ; 15(4): 340-2, 2001 Jul.
Article in English | MEDLINE | ID: mdl-11730048

ABSTRACT

Papular-purpuric gloves and socks syndrome (PPGSS) occurs mainly in young adults, but it should also be considered in the differential diagnosis of childhood exanthems. The case presented here is the youngest patient hitherto reported with PPGSS and supports the concept of a viral genesis.


Subject(s)
Erythema Infectiosum/diagnosis , Hand Dermatoses/diagnosis , Parvovirus B19, Human , Child, Preschool , Erythema Infectiosum/pathology , Foot Dermatoses/diagnosis , Foot Dermatoses/pathology , Foot Dermatoses/virology , Hand Dermatoses/pathology , Hand Dermatoses/virology , Humans
12.
J Eur Acad Dermatol Venereol ; 14(5): 382-8, 2000 Sep.
Article in English | MEDLINE | ID: mdl-11305380

ABSTRACT

OBJECTIVE: To evaluate the efficacy, safety and side-effects of methotrexate (MTX) in psoriasis. DESIGN: A 26-year retrospective study. SETTING: Department of Dermatology, Leipzig University, Leipzig, Germany. PATIENTS: One hundred and fifty-seven patients with extensive plaque psoriasis, erythrodermic, pustular and arthropathic forms, were treated with low-dose methotrexate (15-20 mg maximum weekly dosage [Weinstein schedule]), the majority for long-term periods. The mean cumulative dose was 3394 mg, the mean duration 237 weeks. RESULTS: The effect of MTX treatment was good in 76%, moderate in 18% and poor in 6% of subjects; 61% experienced side-effects, most frequently due to liver function abnormalities, bone marrow suppression, nausea, gastric complaints and hair loss. In 20% of cases the subjects were forced to discontinue therapy; 9% refused therapy due to physical and psychological discomfort, 2% wanted to become pregnant, 16% were lost to follow-up, 6% died from multimorbidity and old age. Three subjects (2%) developed cancer of the lung, breast or cervix uteri, possibly in relation to long-term MTX treatment. Altogether there were no deaths or life-threatening side-effects attributable to MTX treatment, and no cases of progressive liver cirrhosis apart from two extensive skin necroses due to overdosage (misunderstanding, suicidal attempt) that were treated successfully with citrovorum factor. CONCLUSION: Low-dose MTX (<15-20 mg/week) is an effective therapy for extensive and severe forms of psoriasis if patients are selected carefully and monitored regularly, particularly with respect to liver and bone marrow toxicity. This helps to reduce severe side-effects even during long-term treatment. Drug interactions must be avoided. MTX therapy according to the guidelines is relatively safe and still has a place in the systemic treatment of psoriasis with 40 years of experience and an acceptable safety record.


Subject(s)
Immunosuppressive Agents/therapeutic use , Methotrexate/therapeutic use , Psoriasis/drug therapy , Drug Administration Schedule , Drug Interactions , Female , Follow-Up Studies , Humans , Immunosuppressive Agents/administration & dosage , Immunosuppressive Agents/adverse effects , Male , Methotrexate/administration & dosage , Methotrexate/adverse effects , Middle Aged , Retrospective Studies , Time Factors
15.
Acta Derm Venereol ; 73(5): 365-9, 1993 Oct.
Article in English | MEDLINE | ID: mdl-7904404

ABSTRACT

The induction of type IV hypersensitivity to contact allergens in guinea pigs has been studied by using allogenic peritoneal exudate cells (> 90% macrophages), which had been incubated primarily in vitro with dinitrochlorobenzene, formaldehyde, potassium dichromate, nickel II sulphate or para-aminobenzoic acid. In these guinea pig sensitization experiments Freund's complete adjuvant was used. In all haptens investigated the sensitization rates of the presented method were parallel to the known contact allergenicity in humans and, apart from the potassium dichromate results, comparable with those of the guinea pig maximization test. Because of its alternative immunization procedure, in which only few or no allergen molecules escape the effective presentation pathway, the authors conclude that this method could be developed into a predictive test assay for the evaluation of the contact allergenicity of water-soluble substances.


Subject(s)
Allergens/adverse effects , Ascitic Fluid/cytology , Dermatitis, Allergic Contact/immunology , Haptens/immunology , Macrophages/immunology , Animals , Dermatitis, Allergic Contact/diagnosis , Female , Freund's Adjuvant/pharmacology , Guinea Pigs , Immunization , Male , Patch Tests
19.
Dermatol Monatsschr ; 176(8): 475-81, 1990.
Article in German | MEDLINE | ID: mdl-2227060

ABSTRACT

We investigated the inhibition of granulocyte phagocytosis by 8-MOP and monochromatic or polychromatic UV light. After application of 8-MOP and UV there was an additional inactivation compared with UV alone, as expected from studies on other cell species. This additional inhibition of phagocytosis was found to be increasing with 8-MOP level. The action spectra of granulocyte inactivation by 8-MOP and UV involves the investigated UVB range (until 300 nm). A marked inactivation of granulocytes was seen after erythemogenic fluences only. Therefore we assume that inactivation of granulocytes by direct UV action does not play an essential role in UV therapy in vivo.


Subject(s)
Methoxsalen/pharmacology , Neutrophils/immunology , Phagocytosis/radiation effects , Ultraviolet Rays , Cells, Cultured , Dose-Response Relationship, Radiation , Humans , Phagocytosis/drug effects
20.
Biofizika ; 34(6): 1001-3, 1989.
Article in Russian | MEDLINE | ID: mdl-2631954

ABSTRACT

The effect of UV-irradiation on three functions of human isolated granulocytes (viability, phagocyte activity and capacity to reduce nitrotetrazolium blue) was investigated. The phagocytosis appeared to be the most sensitive function. The number of phagocytic cells was decreased under UV-doses as low as 0.63 kJ.m-2. Cell lethality was increased under UV-doses 4.32 kJ.m-2 and higher. The capacity to reduce nitrotetrazolium blue was uneffected even at the dose as high as 10.17 kJ.m-2.


Subject(s)
Granulocytes/immunology , Phagocytosis/radiation effects , Ultraviolet Rays , Granulocytes/radiation effects , Humans , In Vitro Techniques , Nitroblue Tetrazolium
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