Different Approaches to Atopic Dermatitis by Allergists, Dermatologists, and Pediatricians

Objectives. Atopic dermatitis (AD) is the most prevalent chronic inflammatory skin disease, with a vast drug arsenal and guidelines available for its management and diagnosis and different medical specialties engaged in providing care. This study aimed to outline the therapeutic and diagnostic approaches to the AD of allergists, dermatologists, and pediatricians and verify whether they are compliant with the guidelines. Methods. A cross-sectional study using an electronic questionnaire administered through the SurveyMonkey® platform was disclosed by participating medical societies to their medical associates. Results. Of the 1,473 participating physicians, the use of moisturizers as part of AD treatment was observed among pediatricians (91.9%), dermatologists (97.5%), and allergists (100%; p = 0.07 ). The preference for the use of new emollients was lower among pediatricians (57%) than dermatologists (75.9%) and allergists (71.4%; p < 0.001 ). The prevalence of wet-wrap therapy was lower among dermatologists (16.3%) than allergists (51%; p < 0.001 ). The recommendation of proactive treatment with topical corticosteroids was more frequently reported by allergists (65.3%) than pediatricians (43.3%) and dermatologists (40.8%; p < 0.001 ), and the same trend was observed in relation to proactive treatment using calcineurin inhibitors. The use of oral anti-histamines to control pruritus was mainly considered by pediatricians (69.2%) and dermatologists (59.2% p < 0.001 ). Clinical experience with systemic immunomodulating agents was greater among allergists (77.5%) and dermatologists (60.8%; p < 0.001 ), with cyclosporine being the most cited systemic immunomodulating agent. Environmental control of aeroallergens was recommended by pediatricians (89.8%), dermatologists (86.9%), and allergists (100%; p = 0.01 ). Conclusion. There were differences in the therapeutic and diagnostic approaches to AD used by allergists, dermatologists, and pediatricians and those recommended by the guidelines, especially regarding the use of wet-wrap therapy, proactive treatment with topical corticosteroids or calcineurin inhibitors, prescription of anti-histamines, recommendation of phototherapy, and control of aeroallergens.

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Multidisciplinary team decision is rare and decreasing in percutaneous vascular interventions despite positive impact on in-hospital outcomes

VASA ◽

10.1024/0301-1526/a000771 ◽

2019 ◽

Vol 48 (3) ◽

pp. 262-269 ◽

Cited By ~ 3

Author(s):

Christian-Alexander Behrendt ◽

Tilo Kölbel ◽

Thea Schwaneberg ◽

Holger Diener ◽

Ralf Hohnhold ◽

...

Keyword(s):

Multidisciplinary Team ◽

Positive Impact ◽

Cross Sectional Study ◽

Invasive Treatment ◽

Cross Sectional ◽

Hospital Outcomes ◽

Vascular Intervention ◽

Medical Specialties ◽

Team Decision ◽

The Impact

Abstract. Background: Worldwide prevalence of peripheral artery disease (PAD) is increasing and peripheral vascular intervention (PVI) has become the primary invasive treatment. There is evidence that multidisciplinary team decision-making (MTD) has an impact on in-hospital outcomes. This study aims to depict practice patterns and time changes regarding MTD of different medical specialties. Methods: This is a retrospective cross-sectional study design. 20,748 invasive, percutaneous PVI of PAD conducted in the metropolitan area of Hamburg (Germany) were consecutively collected between January 2004 and December 2014. Results: MTD prior to PVI was associated with lower odds of early unsuccessful termination of the procedures (Odds Ratio 0.662, p < 0.001). The proportion of MTD decreased over the study period (30.9 % until 2009 vs. 16.6 % from 2010, p < 0.001) while rates of critical limb-threatening ischemia (34.5 % vs. 42.1 %), patients´ age (70 vs. 72 years), PVI below-the-knee (BTK) (13.2 % vs. 22.4 %), and rates of severe TASC C/D lesions BTK (43.2 % vs. 54.2 %) increased (all p < 0.001). Utilization of MTD was different between medical specialties with lowest frequency in procedures performed by internists when compared to other medical specialties (7.1 % vs. 25.7 %, p < 0.001). Conclusions: MTD prior to PVI is associated with technical success of the procedure. Nonetheless, rates of MTD prior to PVI are decreasing during the study period. Future studies should address the impact of multidisciplinary vascular teams on long-term outcomes.

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ROLE OF PHARMACIST INTERVENTION ON COPD PATIENTS OF SELECTED AREAS IN CHITRADURGA: A KAP STUDY

Journal of Biomedical and Pharmaceutical Research ◽

10.32553/jbpr.v8i2.586 ◽

2019 ◽

Vol 8 (2) ◽

Author(s):

Melvin K Mathews ◽

Abubaker Siddiq ◽

Bharathi D R

Keyword(s):

Illness Perceptions ◽

Pharmacist Intervention ◽

Cross Sectional Study ◽

Chronic Obstructive ◽

Cross Sectional ◽

Obstructive Pulmonary Disease ◽

Copd Patients ◽

Post Test ◽

Knowledge Practice ◽

And Control

Background: Chronic obstructive pulmonary disease (COPD) is preventable and treatable disease state characterized by air flow limitation that is not fully reversible. Severity of the symptoms is increased during exacerbations. Objectives: The purpose of the study is to assess and improve the knowledge regarding COPD among study subjects. Materials and Methods: A Cross-sectional interventional study was carried out among the peoples in selected areas of the Chitradurga city for a period of six months. Result: A total 207 subjects enrolled in the study in that 155 male and 52 females. In our study mean score of post test was more (5.87±1.68) when compare to pre-test (2.63±1.46) which show significant increase in their knowledge after educating them (p=0.000). A total of 207 subjects were enrolled into the study. SPSS Software was used to calculate the statistical estimation. Paired t-test was used to detect the association status of different variables. Conclusion: The relatively good level of COPD awareness needs to be maintained to facilitate future prevention and control of the disease. This study had identified that negative illness perceptions should be targeted, so that they will not avoid patients from seeking for COPD treatment and adhere to it. Key words: Cross sectional study, Knowledge, practice, COPD.

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Cut off value of plasma 25-hydroxyvitamin D concentration for predicting metabolic syndrome

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2019.6_7.10 ◽

2019 ◽

pp. 68-73

Author(s):

Trong Nghia Nguyen ◽

Thi Nhan Nguyen ◽

Thi Dua Dao

Keyword(s):

Metabolic Syndrome ◽

Medical Center ◽

Cross Sectional Study ◽

Control Group ◽

Cross Sectional ◽

Hydroxyvitamin D ◽

The Metabolic Syndrome ◽

25 Hydroxyvitamin D ◽

Key Words Metabolic Syndrome ◽

And Control

Background: The metabolic syndrome is a constellation of cardiometabolic risk factors that tend to cluster together in affected individuals more often than predicted by chance. The presence of the metabolic syndrome substantially increases the risk of developing type 2 diabetes and cardiovascular disease, and is associated with a range of adverse clinical outcomes, many of which are closely associated with aging. Current estimates suggest that approximately 20 - 25% of the world’s population is affected by the metabolic syndrome. The prevalence of the metabolic syndrome rises with age and more than 45% of people aged over 60 years have the metabolic syndrome. Recent studies show that low vitamin D status is very common in the world and this is a risk factor of metabolic syndrome. Objective: (1) Plasma 25-hydroxyvitamin D concentration in subjects with metabolic syndrome. (2) Cut off value of plasma 25-hydroxyvitamin D concentration for predicting metabolic syndrome. Material and method: A cross-sectional study with control group on 318 adult subjects for health examinations at International Medical Center at Hue Central Hospital, including 139 subjects with metabolic syndrome and control group of 179 healthy subjects. Metabolic syndrome was defined according to the IDF, NHLBI, AHA, WHF, IAS, IASO (2009). Plasma hydroxyvitamin D concentration was measured using chemiluminescent microparticle immunoassay. Reciever operating characteristic (ROC) curve were generated to assess sensitivity and specificity for different cut off value of 25-hydroxyvitamin D concentration for predicting metabolic syndrome. Results: Plasma 25-hydroxyvitamin D concentration in subjects with metabolic syndrome was 26.4 ng/ml, incidence of plasma 25-hydroxyvitamin D deficiency (59.7%) was significantly higher than in control group (23.5%) (p < 0.001). The optimal cut off point for 25-OH-D concentration for predictor of metabolic syndrome as 26.4 ng/ml (AUC=0.657, sensitivity=53.4%, specificity=71.6%). Conclusion: In 139 subjects with metabolic syndrome, the plasma 25-hydroxyvitamin D concentration was 26.4 ng/ml and the incidence of 25-hydroxyvitamin D deficiency in the metabolic syndrome group was 59.7%. The optimal cut off point for plasma 25-hydroxyvitamin D concentration for predictor of metabolic syndrome as 26.4 ng/ml. Key words: Metabolic syndrome, 25-hydroxyvitamin D

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The effect of type of water supply on water quality in a developing community in South Africa

Water Science & Technology ◽

10.2166/wst.1997.0706 ◽

1997 ◽

Vol 35 (11-12) ◽

pp. 35-40 ◽

Cited By ~ 6

Author(s):

B. Genthe ◽

N. Strauss ◽

J. Seager ◽

C. Vundule ◽

F. Maforah ◽

...

Keyword(s):

Water Quality ◽

Water Supply ◽

Cross Sectional Study ◽

Cross Sectional ◽

E Coli ◽

Guideline Values ◽

Developing Communities ◽

Quality Guideline ◽

And Control ◽

The Relationship

Efforts to provide water to developing communities in South Africa have resulted in various types of water supplies being used. This study examined the relationship between the type of water supply and the quality of water used. Source (communal taps, private outdoor and indoor taps) and point-of-use water samples were examined for heterotrophic plate counts (HPC), total and faecal coliforms, E. coli, and coliphages. Ten percent of samples were also analysed for enteric viruses, Giardia and Cryptosporidium. Approximately 320 households were included in a case-control study. In addition, a cross-sectional study was conducted. Both studies examined the relationship between different types of water facilities and diarrhoea among pre-school children. The source water was of good microbial quality, but water quality was found to have deteriorated significantly after handling and storage in both case and control households, exceeding drinking water quality guideline values by 1-6 orders of magnitude. Coliphage counts were low for all water samples tested. Enteric viruses and Cryptosporidium oocysts were not detected. Giardia cysts were detected on one occasion in case and control in-house samples. Comparisons of whether in-house water, after handling and storage, complied with water quality guideline values demonstrated households using communal taps to have significantly poorer quality than households using private outdoor or indoor taps for HPC and E. coli (χ2 = 14.9, P = 0.001; χ2 = 6.6, P = 0.04 respectively). A similar trend (although not statistically significant) was observed for the other microbial indicators. The cross-sectional study demonstrated an apparent decrease in health risk associated with private outdoor taps in comparison to communal taps. This study suggests that a private outdoor tap is the minimum level of water supply in order to ensure the supply of safe water to developing communities.

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Cow’s milk exposure and atopic dermatitis after six months of age

Paediatrica Indonesiana ◽

10.14238/pi56.6.2016.325-9 ◽

2017 ◽

Vol 56 (6) ◽

pp. 325

Author(s):

Surya Jayanti Kadek ◽

Dewi Kumara Wati Ketut ◽

Karyana Putu Gede

Keyword(s):

Atopic Dermatitis ◽

Maternal Diet ◽

Multiple Logistic Regression Analysis ◽

Cross Sectional Study ◽

Cow’S Milk ◽

Milk Formula ◽

Sectional Study ◽

Cross Sectional ◽

Cow's Milk ◽

Study Population

Background About 60% of individuals with atopic dermatitis (AD) develop their first manifestation during infancy. Cow’s milk (CM) exposure is considered to be a risk factor for AD.Objective To evaluate for an association between cow’s milk exposure and atopic dermatitis in infants > 6 months of age. Methods This cross-sectional study consisted of subjects from a previous study and new subjects recruited in order to meet the minimum required number of subjects. Our study population comprised 120 infants, born between 1 February and 30 November, 2012 in Sanglah Hospital, Denpasar. Subjects were divided into CM and non-CM groups and analyzed for their risk of AD. Subjects were included to CM group if they were fed with cow’s milk/formula and included to non-CM group if they were breastfeed exclusively in the first six months of life. Other possible risk factors were assessed by multivariate analysis. Results One hundred twenty subjects were enrolled and analyzed (59 in the CM and 61 in the non-CM groups). The prevalence of AD was 30%. Multiple logistic regression analysis revealed a significant association between CM exposure and AD, with odds ratio (OR) 2.37 (95%CI 1.036 to 5.420; P=0.04). In addition, maternal diet including eggs and/or cow’s milk during the breastfeeding period was significantly associated with AD in infants (OR 3.18; 95%CI 1.073 to 9.427; P=0.04).Conclusion Cow’s milk exposure is significantly associated with atopic dermatitis in infants > six months of age.

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Infection control practices and challenges in Pakistan during the COVID-19 pandemic: a multicentre cross-sectional study

Journal of Infection Prevention ◽

10.1177/17571774211012761 ◽

2021 ◽

pp. 175717742110127

Author(s):

Salma Abbas ◽

Faisal Sultan

Keyword(s):

Personal Protective Equipment ◽

Prevention And Control ◽

Infection Prevention ◽

Hospital Staff ◽

Cross Sectional Study ◽

Infection Prevention And Control ◽

Protective Equipment ◽

Cross Sectional ◽

Healthcare Facilities ◽

And Control

Background: Patient and staff safety at healthcare facilities during outbreaks hinges on a prompt infection prevention and control response. Physicians leading these programmes have encountered numerous obstacles during the pandemic. Aim/objective: The aim of this study was to evaluate infection prevention and control practices and explore the challenges in Pakistan during the coronavirus disease 2019 pandemic. Methods: We conducted a cross-sectional study and administered a survey to physicians leading infection prevention and control programmes at 18 hospitals in Pakistan. Results: All participants implemented universal masking, limited the intake of patients and designated separate triage areas, wards and intensive care units for coronavirus disease 2019 patients at their hospitals. Eleven (61%) physicians reported personal protective equipment shortages. Staff at three (17%) hospitals worked without the appropriate personal protective equipment due to limited supplies. All participants felt overworked and 17 (94%) reported stress. Physicians identified the lack of negative pressure rooms, fear and anxiety among hospital staff, rapidly evolving guidelines, personal protective equipment shortages and opposition from hospital staff regarding the choice of recommended personal protective equipment as major challenges during the pandemic. Discussion: The results of this study highlight the challenges faced by physicians leading infection prevention and control programmes in Pakistan. It is essential to support infection prevention and control personnel and bridge the identified gaps to ensure patient and staff safety at healthcare facilities.

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Mask-wearing and control of SARS-CoV-2 transmission in the USA: a cross-sectional study

The Lancet Digital Health ◽

10.1016/s2589-7500(20)30293-4 ◽

2021 ◽

Vol 3 (3) ◽

pp. e148-e157 ◽

Cited By ~ 4

Author(s):

Benjamin Rader ◽

Laura F White ◽

Michael R Burns ◽

Jack Chen ◽

Joseph Brilliant ◽

...

Keyword(s):

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

The Usa ◽

And Control

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Perception of the health surveillance users on the health electronic surveillance network (HESN), Saudi Arabia, 2016

Journal of Egyptian Public Health Association ◽

10.1186/s42506-021-00074-1 ◽

2021 ◽

Vol 96 (1) ◽

Author(s):

Zayid K. Almayahi ◽

Fahad Alswaidi ◽

Abdullah Alzahrani

Keyword(s):

User Satisfaction ◽

Cross Sectional Study ◽

General Level ◽

Electronic Surveillance ◽

Surveillance Network ◽

Design Data ◽

Cross Sectional ◽

Level Of Satisfaction ◽

Composite Scores ◽

And Control

Abstract Background The established aim of the Saudi Health Electronic Surveillance Network (HESN) is to support the prevention and control of different health events, and to facilitate the delivery of other public health programs. This study aims to evaluate the perceptions of active HESN users regarding its general performance through five major components: practicability, design, data and communication, technical support, and general impression. Methods A cross-sectional study was conducted in 2016 using a sample of active HESN users. Out of 1535 active users, 700 were randomly selected. A predesigned electronic questionnaire was sent to each participant via email which was completed by 485 participants. Different composite scores were calculated and compared to the sociodemographic and other technical variables. Results The mean age of the participants was 36.92 ± 9.12 (24–65 years), and 57.8% of the sample were male. Riyadh and the KSA’s eastern province represented the highest two regions of participation, at (18.4%) and (14.2%) participants, respectively. About 70.8% were generally satisfied with HESN, while 86.6%% believed that it is better than the traditional paper-work system. Participants who used to work more frequently expressed more level of satisfaction compared to those with minimal use per week or month (P ≤ 0.001). Internet speed displayed a significant association with the general level of satisfaction with HESN (P < 0.001). Additionally, users who accessed HESN with the Google Chrome browser displayed higher levels of satisfaction when compared to users who relied on other browsers (P = 0.003). Conclusion Presently, the level of user satisfaction with HESN is reasonable. However, to achieve optimal outcomes for HESN usage, improvements should be considered.

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Relation between Feed Particle Size Distribution and Plumage Condition in Laying Hens on Commercial Farms

Animals ◽

10.3390/ani11030773 ◽

2021 ◽

Vol 11 (3) ◽

pp. 773

Author(s):

Ruben Schreiter ◽

Klaus Damme ◽

Markus Freick

Keyword(s):

Damage Control ◽

Geometric Mean ◽

Cross Sectional Study ◽

Cross Sectional ◽

Nutrient Analysis ◽

Indirect Measure ◽

Model Animal ◽

Commercial Farms ◽

And Control ◽

Feed Samples

In this cross-sectional study, 103 complete feed samples from laying hen herds affected by plumage damage as an indirect measure for severe feather pecking (affected herds; AH, n = 37) and control herds without plumage damage (control herd; CH, n = 66) of commercial German farms were examined by dry sieve and nutrient analysis. AH showed higher percentages of particles >2.50 mm (mean ± SD, CH: 11.0 ± 8.5%, AH: 24.9 ± 14.3%) and 2.00–2.50 mm (CH: 11.2 ± 5.3%, AH: 15.7 ± 5.7%), but lower proportions of fractions 1.01–1.60 mm (CH: 22.9 ± 4.9%, AH: 17.8 ± 5.7%), 0.51–1.00 mm (CH: 25.5 ± 8.2%, AH: 16.0 ± 6.8%) and ≤0.50 mm (CH: 15.4 ± 5.0%, AH: 11.0 ± 4.8%) (p < 0.001). Diets of AH had a higher geometric mean diameter (GMD) compared to CH (AH: 1470.8 ± 343.9 μm; CH: 1113.3 ± 225.7 μm) (p < 0.001). Contents of crude ash (CH: 130.3 ± 18.8 g/kg, AH: 115.9 ± 24.3 g/kg), lysine (CH: 8.2 ± 1.0 g/kg, AH: 7.7 ± 1.2 g/kg), methionine (CH: 3.4 ± 0.5 g/kg, AH: 3.2 ± 0.6 g/kg) and sodium (CH: 1.7 ± 0.4 g/kg, AH: 1.3 ± 0.4 g/kg) were lower in AH (p ≤ 0.041). In a logistic regression model, animal age (p = 0.041) and GMD (p < 0.001) were significant factors on the occurrence of plumage damage.

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