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1.
Actas Dermosifiliogr ; 115(7): 712-721, 2024.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-38556197

RESUMO

After the meeting held by the Spanish Contact Dermatitis and Skin Allergy Research Group (GEIDAC) back in October 2021, changes were suggested to the Spanish standard series patch testing. Hydroxyethyl methacrylate (2% pet.), textile dye mixt (6.6% pet.), linalool hydroperoxide (1% pet.), and limonene hydroperoxide (0.3% pet.) were, then, added to the series that agreed upon in 2016. Ethyldiamine and phenoxyethanol were excluded. Methyldibromoglutaronitrile, the mixture of sesquiterpene lactones, and hydroxyisohexyl 3-cyclohexene (Lyral) were alo added to the extended Spanish series of 2022.


Assuntos
Dermatite Alérgica de Contato , Testes do Emplastro , Humanos , Espanha , Dermatite Alérgica de Contato/diagnóstico , Dermatite Alérgica de Contato/etiologia , Alérgenos/efeitos adversos
2.
Actas Dermosifiliogr ; 113(3): 236-243, 2022 Mar.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-35526918

RESUMO

BACKGROUND: Hand eczema is common in patients with atopic dermatitis (AD), but few studies have described the characteristics of these patients in large, representative populations from different geographic regions and occupational settings. OBJECTIVE: To describe the epidemiological, clinical, and allergy profile of patients with hand eczema who underwent patch testing and compare patients with and without AD. METHODS: Analysis of data from the Spanish Contact Dermatitis Registry, a multicenter registry of patients who undergo patch testing in Spain. RESULTS: We included 1466 patients with hand eczema who were patch tested between January 2018 and June 2020. Those with AD were younger and had had symptoms for longer before testing. They were also more likely to have been exposed to occupational triggers (38% vs 53% for patients without AD). The only profession for which significant differences were found was hairdressing. The most common allergens were nickel sulfate, methylchloroisothiazolinone/methylisothiazolinone, cobalt chloride, potassium dichromate, fragrance mixes I and II, and formaldehyde. The most common diagnoses were allergic contact dermatitis (24% vs 31% in patients with and without AD, P=.0224) and irritant contact dermatitis (18% and 35% respectively, P<.001). CONCLUSIONS: AD is common in patients with predominant hand eczema who undergo patch testing. Patients with hand eczema and AD have different clinical and epidemiological characteristics to hand eczema patients in general and their final diagnosis following patch testing is also different.


Assuntos
Dermatite Alérgica de Contato , Dermatite Atópica , Eczema , Dermatoses da Mão , Alérgenos , Dermatite Alérgica de Contato/diagnóstico , Dermatite Alérgica de Contato/epidemiologia , Dermatite Alérgica de Contato/etiologia , Dermatite Atópica/diagnóstico , Dermatite Atópica/epidemiologia , Eczema/diagnóstico , Eczema/epidemiologia , Dermatoses da Mão/diagnóstico , Dermatoses da Mão/epidemiologia , Dermatoses da Mão/etiologia , Humanos , Testes do Emplastro , Sistema de Registros , Estudos Retrospectivos
3.
Clin Exp Dermatol ; 47(1): 180-182, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34363648

RESUMO

Lymphangioma is a known, but rare manifestation of Noonan syndrome. We present the case of disseminated and circumscribed cutaneous lymphangiomas in the context of Noonan syndrome. Oral rapamycin is a promising treatment in these extensive and morbidity-causing cases.


Assuntos
Antibióticos Antineoplásicos/uso terapêutico , Linfangioma/complicações , Linfangioma/tratamento farmacológico , Síndrome de Noonan/complicações , Sirolimo/uso terapêutico , Neoplasias Cutâneas/complicações , Neoplasias Cutâneas/tratamento farmacológico , Administração Oral , Adolescente , Humanos , Linfangioma/patologia , Masculino , Pênis/patologia , Escroto/patologia , Neoplasias Cutâneas/patologia , Resultado do Tratamento
4.
Actas dermo-sifiliogr. (Ed. impr.) ; 112(9): 798-805, oct. 2021. tab
Artigo em Espanhol | IBECS | ID: ibc-213472

RESUMO

Antecedentes y objetivo La actualización de las series estándar de pruebas epicutáneas debe basarse en datos objetivos de frecuencia de sensibilización de los alérgenos que componen cada batería. La última renovación de la batería estándar española se realizó en 2016 y de la europea en 2019, quedando pendiente valorar la inclusión de alérgenos emergentes. Material y método Desarrollamos un estudio observacional, prospectivo y multicéntrico de los pacientes consecutivos del registro del Grupo Español de Investigación en Dermatitis y Alergia Cutánea sometidos a pruebas epicutáneas con hidroperóxido de linalool, hidroperóxido de limoneno, 2-hidroxi-etil-metacrilato, benzisotiazolinona, octilisotiazolinona, mezcla textil, metabisulfito sódico, propóleo, bronopol, mezcla de compuestas II, diazolidinil urea, imidazolidinil urea, decil glucósido y lauril glucósido, durante los años 2019 y 2020. Resultados Se analizó una muestra de 4.654 pacientes estudiados con diazolidinil urea, imidazolidinil urea y bronopol, y de 1.890 pacientes con el resto de los alérgenos. El índice MOAHLFA fue: M 30%, O 18%, A 15%, H 29%, L 6,5%, F 23%, A 68%. Siete alérgenos mostraron una frecuencia de sensibilización mayor del 1%: hidroperóxido de linalool, 2-hidroxi-etil-metacrilato, benzisotiazolinona, hidroperóxido de limoneno, mezcla textil, metabisulfito sódico y propóleo. Tres alérgenos mostraron una frecuencia de relevancia presente superior al 1%: hidroperóxido de linalool, 2-hidroxi-etil-metacrilato e hidroperóxido de limoneno; para benzisotiazolinona y mezcla textil, esta frecuencia fue de entre el 0,9 y el 1%. Conclusiones Nuestros resultados indican que debería valorarse la inclusión de siete nuevos alérgenos en la batería estándar española. Estos resultados podrían contribuir a la próxima actualización de la batería basal europea (AU)


Background Standard patch test series must be updated using objective data on allergen sensitization. The Spanish standard series was last updated in 2016 and the European series in 2019, and the inclusion of several emerging allergens needs to be evaluated. Material and methods We conducted a prospective, observational, multicenter study of consecutive patients from the registry of the Spanish Contact Dermatitis and Skin Allergy Research Group (GEIDAC) who were patch tested in 2019 and 2020 with linalool hydroperoxide, limonene hydroperoxide, 2-hydroxyethyl-methacrylate, benzisothiazolinone, octylisothiazolinone, textile dye mix (TDM), sodium metabisulfite, propolis, bronopol, Compositae mix II, diazolidinyl urea, imidazolidinyl urea, decyl glucoside, and lauryl glucoside. Results We analyzed data for 4654 patients tested with diazolidinyl urea, imidazolidinyl urea, and bronopol, and 1890 tested with the other allergens. The values for the MOAHLFA index components were 30% for male, 18% for occupational dermatitis, 15% for atopic dermatitis, 29% for hand, 6.5% for leg, 23% for face, and 68% for age > 40 years. Sensitization rates above 1% were observed for 7 allergens: linalool hydroperoxide, 2-hydroxyethyl-methacrylate, benzisothiazolinone, limonene hydroperoxide, TDM, sodium metabisulfite, and propolis. Three allergens had a current relevance rate of over 1%: linalool hydroperoxide, 2-hydroxyethyl-methacrylat, and limonene hydroperoxide. Benzisothiazolinone and TDM had a relevance rate of between 0.9% and 1%. Conclusions Our results indicate that 7 new allergens should be considered when extending the Spanish standard patch test series. The data from our series could be helpful for guiding the next extension of the European baseline series (AU)


Assuntos
Humanos , Masculino , Feminino , Dermatite de Contato/etiologia , Dermatite de Contato/diagnóstico , Alérgenos/classificação , Registros , Dermatite de Contato/epidemiologia , Estudos Prospectivos , Testes do Emplastro , Espanha/epidemiologia
6.
Actas dermo-sifiliogr. (Ed. impr.) ; 111(1): 47-52, ene.-feb. 2020. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-191484

RESUMO

OBJETIVOS: El objetivo del trabajo es mostrar la tendencia de la sensibilización de contacto entre los años 2004 y 2014 tras la regulación de su concentración en cosméticos en el año 2009 e investigar los factores de riesgo de la alergia de contacto a la parafenilendiamina. MATERIAL Y MÉTODOS: El diseño del estudio fue observacional retrospectivo e incluyó a pacientes con sospecha de alergia de contacto parcheados con la serie estándar del Grupo Español de Investigación en Dermatitis de Contacto y Alergia Cutánea durante los años 2004 a 2014, en 8 hospitales terciarios españoles. En las pruebas epicutáneas estaba incluida la parafenilendiamina al 1% en vaselina o 0,073 mg/cm2 en el TRUE-test(R). El estudio estadístico se realizó siguiendo las recomendaciones internacionales del análisis de los datos en alergia de contacto. RESULTADOS: Un total de 386 (4,1%) pacientes de los 9.341 incluidos fueron positivos a la parafenilendiamina, cuya tendencia empezó a decrecer en los primeros años (2004-2007) y a partir de ahí se mantuvo en torno al 4%. Los factores de riesgo para el desarrollo de una alergia de contacto a la parafenilendiamina fueron el sexo, la edad por encima de los 40 años, la polisensibilización y la profesión, entre las que destacan los trabajadores de la peluquería, los trabajadores de la goma y el plástico CONCLUSIONES: La alergia de contacto a la parafenilendiamina sigue siendo elevada en pacientes con eccema de contacto. Los factores de riesgo que predisponen a la alergia de contacto a la PPD coinciden con los que han sido publicados previamente


OBJECTIVES: To analyze trends in the prevalence of contact sensitization to p-phenylenediamine between 2004 and 2014, taking into consideration that the concentration of this product in cosmetics was regulated in 2009. To explore risk factors for contact allergy to p-phenylenediamine. MATERIAL AND METHODS: Retrospective observational study of patients suspected of having contact dermatitis from allergy to p-phenylenediamine during the years between 2004 and 2015 in 8 tertiary level hospitals. The patients underwent patch testing (TRUE-test) with the standard series of the Spanish Research Group on Contact Dermatitis and Skin Allergies. This series included p-phenylenediamine 1%. We followed international recommendations for the statistical analysis of data related to contact allergies. RESULTS: Three hundred eighty-six out of 9341 patients (4.1%) had positive reactions to p-phenylenediamine. The prevalence tended to decrease in the early years (2004-2007) and then leveled off at around 4%. Risk factors for developing contact dermatitis from p-phenylenediamine were sex, age over 40 years, multiple sensitivities, and profession, notably workers in hair salons and those who handle rubber and plastics. CONCLUSIONS: The prevalence of p-phenylenediamine allergy remains high among patients with contact eczema. Risk factors for p-phenylenediamine contact allergy are consistent with previous reports


Assuntos
Humanos , Masculino , Feminino , Adulto , Cosméticos/efeitos adversos , Doenças Profissionais/epidemiologia , Dermatite Alérgica de Contato/etiologia , Fenilenodiaminas , Corantes/efeitos adversos , Espanha/epidemiologia , Fatores de Risco , Estudos Retrospectivos , Testes Cutâneos/instrumentação , Modelos Logísticos
7.
Actas Dermosifiliogr (Engl Ed) ; 111(1): 47-52, 2020 Jan 02.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31627850

RESUMO

OBJECTIVES: To analyze trends in the prevalence of contact sensitization to p-phenylenediamine between 2004 and 2014, taking into consideration that the concentration of this product in cosmetics was regulated in 2009. To explore risk factors for contact allergy to p-phenylenediamine. MATERIAL AND METHODS: Retrospective observational study of patients suspected of having contact dermatitis from allergy to p-phenylenediamine during the years between 2004 and 2015 in 8 tertiary level hospitals. The patients underwent patch testing (TRUE-test) with the standard series of the Spanish Research Group on Contact Dermatitis and Skin Allergies. This series included p-phenylenediamine 1%. We followed international recommendations for the statistical analysis of data related to contact allergies. RESULTS: Three hundred eighty-six out of 9341 patients (4.1%) had positive reactions to p-phenylenediamine. The prevalence tended to decrease in the early years (2004-2007) and then leveled off at around 4%. Risk factors for developing contact dermatitis from p-phenylenediamine were sex, age over 40 years, multiple sensitivities, and profession, notably workers in hair salons and those who handle rubber and plastics. CONCLUSIONS: The prevalence of p-phenylenediamine allergy remains high among patients with contact eczema. Risk factors for p-phenylenediamine contact allergy are consistent with previous reports.


Assuntos
Corantes/efeitos adversos , Dermatite Alérgica de Contato/epidemiologia , Dermatite Alérgica de Contato/etiologia , Fenilenodiaminas/efeitos adversos , Adulto , Feminino , Humanos , Masculino , Prevalência , Estudos Retrospectivos , Fatores de Risco , Espanha/epidemiologia
8.
Mol Metab ; 9: 28-42, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29428596

RESUMO

OBJECTIVE: The peroxisome proliferator-activated receptor-γ coactivator-1α1 (PGC-1α1) regulates genes involved in energy metabolism. Increasing adipose tissue energy expenditure through PGC-1α1 activation is potentially beneficial for systemic metabolism. Pharmacological PGC-1α1 activators could be valuable tools in the fight against obesity and metabolic disease. Finding such compounds has been challenging partly because PGC-1α1 is a transcriptional coactivator with no known ligand-binding properties. While, PGC-1α1 activation is regulated by several mechanisms, protein stabilization is a crucial limiting step due to its short half-life under unstimulated conditions. METHODS: We designed a cell-based high-throughput screening system to identify PGC-1α1 protein stabilizers. Positive hits were tested for their ability to induce endogenous PGC-1α1 protein accumulation and activate target gene expression in brown adipocytes. Select compounds were analyzed for their effects on global gene expression and cellular respiration in adipocytes. RESULTS: Among 7,040 compounds screened, we highlight four small molecules with high activity as measured by: PGC-1α1 protein accumulation, target gene expression, and uncoupled mitochondrial respiration in brown adipocytes. CONCLUSIONS: We identify compounds that induce PGC-1α1 protein accumulation and show that this increases uncoupled respiration in brown adipocytes. This screening platform establishes the foundation for a new class of therapeutics with potential use in obesity and associated disorders.


Assuntos
Adipócitos Marrons/efeitos dos fármacos , Fármacos Antiobesidade/farmacologia , Coativador 1-alfa do Receptor gama Ativado por Proliferador de Peroxissomo/metabolismo , Bibliotecas de Moléculas Pequenas/farmacologia , Desacopladores/farmacologia , Proteína Desacopladora 1/metabolismo , Adipócitos Marrons/metabolismo , Animais , Fármacos Antiobesidade/química , Respiração Celular , Células HEK293 , Humanos , Camundongos , Mitocôndrias/efeitos dos fármacos , Mitocôndrias/metabolismo , Estabilidade Proteica , Bibliotecas de Moléculas Pequenas/química , Desacopladores/química , Proteína Desacopladora 1/genética
9.
Rev. chil. reumatol ; 34(1): 16-26, 2018. tab
Artigo em Espanhol | LILACS | ID: biblio-1254082

RESUMO

La hipertensión de la arteria pulmonar (HAP) es una grave complicación que pue-den presentar los pacientes con enfermedades autoinmunes del tejido conectivo de prevalencia variable según cada país. Habitualmente su diagnóstico es tardío lo que influye negativamente en su pronóstico y respuesta terapéutica. En el pre-sente trabajo se ha iniciado una revisión en conjunto entre la Unidad de Hemodi-namia y de Reumatología del Hospital San Juan de Dios, con el propósito de tener una caracterización de los pacientes con HAP y enfermedades autoinmunes del tejido conectivo y poder así elaborar planes de manejo de acuerdo a las caracte-rísticas clínicas de estos pacientes e intentar obtener un diagnostico precoz, para mejorar la sobrevida de los portadores de estas enfermedades.


High blood pressure in the pulmonary artery (HAP) is a serious complication that may occur in patients with autoimmune diseases of the connective tissue of vari-able prevalence according to each country. Diagnosis is usually late which affects negatively their prognosis and therapeutic response. In the present work has been initiated a review in conjunction between the unit of Hemodynamic and Rheumatology of the Hospital San Juan de Dios, with the purpose of having a characterization of patients with PAH and autoimmune diseases of the connective tissue and can thus develop management plans according to the clinical features of these patients and try to get an early diagnosis, to improve the survival of the carriers of these diseases.


Assuntos
Humanos , Masculino , Feminino , Doenças Autoimunes/complicações , Doenças do Tecido Conjuntivo/complicações , Hipertensão Arterial Pulmonar/epidemiologia , Chile/epidemiologia , Epidemiologia Descritiva , Doenças Pulmonares Intersticiais/etiologia , Diagnóstico Precoce , Hipertensão Arterial Pulmonar/diagnóstico , Hipertensão Arterial Pulmonar/mortalidade
10.
Actas dermo-sifiliogr. (Ed. impr.) ; 108(9): 852-858, nov. 2017. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-168143

RESUMO

Introducción y objetivos: La dosis de inicio en la fototerapia UVB de banda estrecha (UVBBE) viene determinada por el fototipo o por la determinación de la dosis eritematógena mínima (DEM). El cálculo de la DEM identifica pacientes con fotosensibilidad no sospechada. El objetivo de nuestro estudio es conocer la influencia que puedan tener en una DEM disminuida los fármacos fotosensibilizantes concomitantes, el diagnóstico, la asociación con acitretina en pacientes con psoriasis y evidenciar si la DEM alterada provoca más reacciones adversas y más graves. Material y métodos: Se trata de un estudio observacional de una cohorte retrospectiva desde el período comprendido entre el 1 de febrero de 2009 al 31 de marzo de 2015. La determinación de la DEM se categorizó en DEM normal o patológica. Resultados: Trescientos dos pacientes con distintas dermatosis inician UVBBE en función de la DEM. No se han encontrado diferencias entre el grupo con DEM patológica respecto al normal, ni en el número de fármacos consumidos (p = 0,071), ni en el potencial fotosensibilizante (p = 0,806). El análisis multivariante ajustado por edad, sexo y fototipo reveló que la psoriasis es un factor protector de DEM patológica (OR = 0,31 [IC 95%: 0,16-0,58]). No se encontró riesgo significativo de eritema ni prurito en los pacientes con DEM alterada OR = 1,68 (IC 95%: 0,91-3,29) y OR = 2,04 (IC 95%: 0,99-4,22), respectivamente. Conclusiones: La psoriasis protege de tener una DEM patológica. Si bien el eritema y el prurito fueron más frecuentes en los pacientes con DEM patológica, las diferencias no fueron estadísticamente significativas (AU)


Introduction and objectives: The starting dose for narrowband UV-B phototherapy is determined by a patient's skin phototype or minimal erythema dose (MED). Calculation of MED identifies patients with unsuspected photosensitivity. The aim of this study was to investigate the influence of factors such as concomitant use of photosensitizing agents, diagnosis, and combination with acitretin in patients with psoriasis on the frequency and severity of adverse effects in patients with a low MED to narrowband UV-B phototherapy. Material and methods: We undertook a retrospective observational cohort study between February 1, 2009 and March 31, 2015. MED values were classified as normal or low. Results: In total, 302 patients with different skin conditions started narrowband UV-B phototherapy at a dose determined by their MED. No differences were found between patients with a low MED and those with a normal MED for number of drugs taken (P = .071) or use of photosensitizing agents (P = 0.806). Following adjustment for age, sex, and phototype, the multivariate analysis showed that psoriasis exerted a protective effect against a low MED (OR = 0.31 [95% CI, 0.16-0.58]). No significant risk of erythema or pruritus was detected in patients with a low MED (OR = 1.68; 95% CI, 0.91-3.29 and OR = 2.04; 95% CI, 0.99-4.22, respectively). Conclusions: Psoriasis protects against a low MED. Although erythema and pruritus were more common in patients with a low MED, the differences were not significant (AU)


Assuntos
Humanos , Eritema/prevenção & controle , Terapia Ultravioleta/métodos , Dermatopatias/terapia , Fototerapia/métodos , Doses de Radiação , Transtornos de Fotossensibilidade/diagnóstico , Raios Ultravioleta/efeitos adversos , Psoríase/terapia
12.
Actas Dermosifiliogr ; 108(9): 852-858, 2017 Nov.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-28687116

RESUMO

INTRODUCTION AND OBJECTIVES: The starting dose for narrowband UV-B phototherapy is determined by a patient's skin phototype or minimal erythema dose (MED). Calculation of MED identifies patients with unsuspected photosensitivity. The aim of this study was to investigate the influence of factors such as concomitant use of photosensitizing agents, diagnosis, and combination with acitretin in patients with psoriasis on the frequency and severity of adverse effects in patients with a low MED to narrowband UV-B phototherapy. MATERIAL AND METHODS: We undertook a retrospective observational cohort study between February 1, 2009 and March 31, 2015. MED values were classified as normal or low. RESULTS: In total, 302 patients with different skin conditions started narrowband UV-B phototherapy at a dose determined by their MED. No differences were found between patients with a low MED and those with a normal MED for number of drugs taken (P=.071) or use of photosensitizing agents (P=0.806). Following adjustment for age, sex, and phototype, the multivariate analysis showed that psoriasis exerted a protective effect against a low MED (OR=0.31 [95% CI, 0.16-0.58]). No significant risk of erythema or pruritus was detected in patients with a low MED (OR=1.68; 95% CI, 0.91-3.29 and OR=2.04; 95% CI, 0.99-4.22, respectively). CONCLUSIONS: Psoriasis protects against a low MED. Although erythema and pruritus were more common in patients with a low MED, the differences were not significant.


Assuntos
Eritema/etiologia , Dermatopatias/radioterapia , Terapia Ultravioleta/efeitos adversos , Adulto , Idoso , Relação Dose-Resposta à Radiação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prurido/etiologia , Psoríase/radioterapia , Estudos Retrospectivos , Estações do Ano , Pigmentação da Pele
15.
Actas dermo-sifiliogr. (Ed. impr.) ; 104(6): 488-496, jul. 2013. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-114108

RESUMO

Antecedentes: El tratamiento tópico es fundamental en el manejo de la psoriasis y la adherencia al mismo contribuye a su eficacia en el tratamiento prolongado. Objetivos: Establecer un consenso sobre la adherencia al tratamiento tópico en la psoriasis y recomendaciones para mejorarla, así como evaluar las características de los diferentes vehículos. Método: Se elaboró un cuestionario sobre adherencia al tratamiento tópico de la psoriasis que se sometió a Consenso Delphi por un panel de expertos, al igual que un cuestionario sobre las características de los principales vehículos utilizados, que también fue sometido a consenso por los miembros del Grupo de Psoriasis de la Academia Española de Dermatología y Venereología. Resultados: Se alcanzó consenso en que: a) la adherencia al tratamiento tópico aumenta su eficacia en la psoriasis; b) para aumentar la adherencia es necesario mejorar la comunicación con el personal sanitario, proporcionar instrucciones escritas, simplificar el tratamiento, con preparados de aplicación cómoda, preferiblemente diaria, y agradables; y c) la satisfacción con el tratamiento aumenta la adherencia y tiende a mejorar la calidad de vida relacionada con la salud de los pacientes. La pomada fue el vehículo peor valorado, mientras que los mejor considerados fueron las espumas y las soluciones. Las cremas y el gel lipofílico tuvieron valoraciones superiores a la pomada en diversos parámetros. Conclusión: Para aumentar la adherencia al tratamiento tópico y la eficacia del mismo en la psoriasis hay que proporcionar más información, simplificar el tratamiento y prescribir preparados cómodos de aplicar y que aseguren la satisfacción del paciente (AU)


Background: Topical therapy is key to the successful management of psoriasis, and patient adherence to treatment contributes to its effectiveness in the long-term. Objectives: To establish consensus on adherence to topical treatment in psoriasis, draw up recommendations on how adherence could be improved, and evaluate the properties of the main vehicles used. Method: We designed a questionnaire on adherence to topical treatments in psoriasis and another on the properties of the main vehicles used; the 2 questionnaires were evaluated using the Delphi method by a panel of experts and members of the Psoriasis Group of the Spanish Academy of Dermatology and Venereology, respectively. Results: Consensus was reached on the following statements: a) treatment adherence increases the effectiveness of topical treatments in psoriasis; b) to improve adherence, it is necessary to improve communication between patients and health care staff, provide written instructions, and simplify treatment with easy-to-use, pleasant products that are preferably applied only once a day; c) treatment satisfaction increases adherence and tends to improve the health related quality of life of the patient. Ointment was rated the worst vehicle, while foams and solutions were rated the best. Creams and lipophilic gels were considered to be better than ointment in several respects. Conclusion: To improve adherence to topical regimens in psoriasis and the effectiveness of such therapy, we need to give patients more information, simplify treatment regimens, and prescribe easy-to-use products that will ensure satisfaction (AU)


Assuntos
Humanos , Masculino , Feminino , Satisfação do Paciente/legislação & jurisprudência , Psoríase/epidemiologia , Psoríase/prevenção & controle , Sociedades Médicas/organização & administração , Sociedades Médicas/normas , Sociedades Médicas/tendências , Sociedades Médicas , Inquéritos e Questionários
16.
Actas Dermosifiliogr ; 104(6): 488-96, 2013.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-23395400

RESUMO

BACKGROUND: Topical therapy is key to the successful management of psoriasis, and patient adherence to treatment contributes to its effectiveness in the long-term. OBJECTIVES: To establish consensus on adherence to topical treatment in psoriasis, draw up recommendations on how adherence could be improved, and evaluate the properties of the main vehicles used. METHOD: We designed a questionnaire on adherence to topical treatments in psoriasis and another on the properties of the main vehicles used; the 2 questionnaires were evaluated using the Delphi method by a panel of experts and members of the Psoriasis Group of the Spanish Academy of Dermatology and Venereology, respectively. RESULTS: Consensus was reached on the following statements: a) treatment adherence increases the effectiveness of topical treatments in psoriasis; b) to improve adherence, it is necessary to improve communication between patients and health care staff, provide written instructions, and simplify treatment with easy-to-use, pleasant products that are preferably applied only once a day; c) treatment satisfaction increases adherence and tends to improve the health-related quality of life of the patient. Ointment was rated the worst vehicle, while foams and solutions were rated the best. Creams and lipophilic gels were considered to be better than ointment in several respects. CONCLUSION: To improve adherence to topical regimens in psoriasis and the effectiveness of such therapy, we need to give patients more information, simplify treatment regimens, and prescribe easy-to-use products that will ensure satisfaction.


Assuntos
Adesão à Medicação/estatística & dados numéricos , Satisfação do Paciente , Psoríase/tratamento farmacológico , Administração Tópica , Técnica Delphi , Humanos , Veículos Farmacêuticos , Sensação/efeitos dos fármacos , Inquéritos e Questionários
17.
J Nanosci Nanotechnol ; 12(8): 6828-34, 2012 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-22962830

RESUMO

Nanostructured silica based xerogels and aerogels are prepared by sol-gel technology, using methyltrimethoxysilane as precursor. The influence of the drying method and conditions on the microstructure of the obtained materials is investigated, since the drying stage has a critical influence on their porosity. Two types of drying methods were used: atmospheric pressure drying (evaporative), to produce xerogels, and supercritical fluids drying, to obtain aerogels. Although the supercritical fluids drying technique is more expensive and hazardous than the atmospheric pressure drying, it is well known that aerogels are less dense than the xerogels due to less pore shrinkage. However, the ideal situation would be to use atmospheric pressure drying in conditions that minimize the pore collapse. Therefore, in this work, different temperature cycles for atmospheric pressure drying and two heating rates for the supercritical fluids drying are tested to study the gels' shrinkage by analyzing the density and porosity properties of the final materials. The best materials obtained are aerogels dried with the lower heating rate (approximately 80 degrees C/h), since they exhibit very low bulk density (approximately 50 kg/m3), high porosity (95%)-mainly micro and mesopores, high surface area (approximately 500 m2/g), moderate flexibility and a remarkable hydrophobic character (>140 degrees). It was proved that the temperature cycles of atmospheric pressure drying can be tuned to obtain xerogels with properties comparable to those of aerogels, having a bulk density only approximately15 kg/m3 higher. All the synthesized materials fulfill the requirements for application as insulators in Space environments.

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