Cutaneous Effects of Smoking

2004 ◽  
Vol 8 (6) ◽  
pp. 415-423 ◽  
Author(s):  
Anatoli Freiman ◽  
Garrett Bird ◽  
Andrei I. Metelitsa ◽  
Benjamin Barankin ◽  
Gilles J. Lauzon
Keyword(s):  
Cigarette Smoking ◽  
English Language ◽  
Developed Countries ◽  
Skin Lesions ◽  
Health Concern ◽  
Protective Effects ◽  
Level Of Evidence ◽  
Cutaneous Manifestations ◽  
Medline Search ◽  
Mesh Terms

Background: Cigarette smoking is the single biggest preventable cause of death and disability in developed countries and is a significant public health concern. While known to be strongly associated with a number of cardiovascular and pulmonary diseases and cancers, smoking also leads to a variety of cutaneous manifestations. Objective: This article reviews the effects of cigarette smoking on the skin and its appendages. Methods: A literature review was based on a MEDLINE search (1966–2004) for English-language articles using the MeSH terms cutaneous, dermatology, tobacco, skin, and smoking. An additional search was subsequently undertaken for articles related to smoking and associated mucocutanous diseases, with the focus on pathogenesis and epidemiologic data. Articles presenting the highest level of evidence and latest reports were preferentially selected. Results: Smoking is strongly associated with numerous dermatologic conditions including poor wound healing, wrinkling and premature skin aging, squamous cell carcinoma, psoriasis, hidradenitis suppurativa, hair loss, oral cancers, and other oral conditions. In addition, it has an impact on the skin lesions observed in diabetes, lupus, and AIDS. The evidence linking smoking and melanoma, eczema, and acne is inconclusive. Anecdotal data exist on the possible protective effects of smoking in oral/genital aphthosis of Behçet's disease, herpes labialis, pyoderma gangrenosum, acral melanoma, and Kaposi's sarcoma in AIDS patients. Conclusions: An appreciation of the adverse cutaneous consequences of smoking is important. Dermatologists can play an integral role in promoting smoking cessation by providing expert opinion and educating the public on the deleterious effects of smoking on the skin.

Ranitidine Bismuth Citrate in the Treatment of Helicobacter Pylori Infection and Duodenal Ulcer

1998 ◽  
Vol 32 (6) ◽  
pp. 672-679 ◽  
Author(s):  
Thomas G Vondracek
Keyword(s):  
Duodenal Ulcer ◽  
Helicobacter Pylori ◽  
Adverse Effects ◽  
Ulcer Healing ◽  
English Language ◽  
Protective Effects ◽  
Double Blind ◽  
Medline Search ◽  
Bismuth Citrate ◽  
Duodenal Ulcer Healing

OBJECTIVE: To review the clinical pharmacology of ranitidine bismuth citrate in the treatment of Helicobacter pylori (HP) Infection and Duodenal Ulcer. DATA SOURCES: A MEDLINE search of the English-language literature from 1992 to January 1997 was conducted using the key terms Tritec, ranitidine, and bismuth. References of articles pertaining to treatment of duodenal ulcer or HP were extensively searched for relevant sources. DATA EXTRACTION: All articles pertaining to ranitidine bismuth citrate were considered for inclusion, with emphasis placed on randomized, double-blind trials. Priority was placed on data pertaining to regimens that are currently approved by the Food and Drug Administration for the treatment of duodenal ulcer in conjunction with HP. DATA SYNTHESIS: Each tablet of ranitidine bismuth citrate 400 mg contains 162 mg of ranitidine base, 128 mg of trivalent bismuth, and 110 mg of citrate. It uses the acid-suppressive actions of ranitidine and the antimicrobial and mucosal protective effects of bismuth to eradicate HP. Ranitidine bismuth citrate in conjunction with clarithromycin represents one of four treatment regimens currently approved in the US for duodenal ulcer associated with HP infection. In four double-blind, randomized trials, this agent has achieved HP eradication rates of 73–94% and duodenal ulcer healing rates of 73–89%. It is given twice daily for 28 days, and is associated with very low rates of adverse effects. CONCLUSIONS: Relative to some therapeutic alternatives, ranitidine bismuth citrate plus clarithromycin may be simpler to take and have less adverse effects, but may be more expensive. Compared with omeprazole plus clarithromycin, it is less expensive, may have lower ulcer healing rates, but may be more effective in eradicating HP. The role of ranitidine bismuth citrate will continue to evolve as more patients are treated, and other regimens continue to be tested for duodenal ulcer healing and HP eradication.

scholarly journals Intensive Care Management Following Endovascular Clot Retrieval for Acute Stroke: A Systematic Review of the Literature

2019 ◽  
Vol 03 (02) ◽  
pp. 105-112
Author(s):  
Alice Ma ◽  
Gerard Moynihan ◽  
Lachlan H. Donaldson
Keyword(s):  
Critical Care ◽  
Practice Guidelines ◽  
Care Management ◽  
English Language ◽  
Human Subjects ◽  
Cochrane Central Register ◽  
Inclusion Criteria ◽  
Level Of Evidence ◽  
Medline Search ◽  
Number Of Patients

AbstractThere has been an increase in the number of patients requiring ICU care following endovascular clot retrieval (ECR) for acute ischemic stroke (AIS). The authors’ objective was to systematically assess the evidence surrounding postprocedural care of ECR patients in critical care areas. A systematic literature review was conducted examining the critical care management of adult patients following ECR. The preliminary search results were sorted manually by two authors and conflicts were settled by consensus with a third reviewer. References of key papers were also reviewed for studies meeting the inclusion criteria. In addition, the authors sought to identify all relevant practice guidelines from major neurological and critical care societies. Study quality was assessed using the Newcastle Ottawa Quality Assessment Scale for cohort studies. Medline, Embase, Cochrane Central Register of Controlled Trials databases, Web of Science, and bibliographies of retrieved articles were searched. Studies were limited to human subjects and English language. Studies specific to the post ECR population were limited. In the initial Medline search, 3,882 papers were returned. A total of 16 studies met the inclusion criteria. There were also 10 practice guidelines from relevant scientific bodies. The level of evidence for postprocedural care was found to be variable and mostly based on expert opinion and data extrapolated from general stroke and postthrombolysis patients. There is limited evidence guiding the postprocedural care of ECR patients. Given the increase in both the availability and application of ECR, trials looking specifically at how best to care for this patient population are needed.

scholarly journals Stereotactic radiosurgery for trigeminal neuralgia: a systematic review

2019 ◽  
Vol 130 (3) ◽  
pp. 733-757 ◽  
Author(s):  
Constantin Tuleasca ◽  
Jean Régis ◽  
Arjun Sahgal ◽  
Antonio De Salles ◽  
Motohiro Hayashi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Trigeminal Neuralgia ◽  
Stereotactic Radiosurgery ◽  
English Language ◽  
Recurrence Rates ◽  
Level Of Evidence ◽  
Root Entry Zone ◽  
Mesh Terms ◽  
Consensus Statements ◽  
Scale Scores

OBJECTIVESThe aims of this systematic review are to provide an objective summary of the published literature specific to the treatment of classical trigeminal neuralgia with stereotactic radiosurgery (RS) and to develop consensus guideline recommendations for the use of RS, as endorsed by the International Society of Stereotactic Radiosurgery (ISRS).METHODSThe authors performed a systematic review of the English-language literature from 1951 up to December 2015 using the Embase, PubMed, and MEDLINE databases. The following MeSH terms were used in a title and abstract screening: “radiosurgery” AND “trigeminal.” Of the 585 initial results obtained, the authors performed a full text screening of 185 studies and ultimately found 65 eligible studies. Guideline recommendations were based on level of evidence and level of consensus, the latter predefined as at least 85% agreement among the ISRS guideline committee members.RESULTSThe results for 65 studies (6461 patients) are reported: 45 Gamma Knife RS (GKS) studies (5687 patients [88%]), 11 linear accelerator (LINAC) RS studies (511 patients [8%]), and 9 CyberKnife RS (CKR) studies (263 patients [4%]). With the exception of one prospective study, all studies were retrospective.The mean maximal doses were 71.1–90.1 Gy (prescribed at the 100% isodose line) for GKS, 83.3 Gy for LINAC, and 64.3–80.5 Gy for CKR (the latter two prescribed at the 80% or 90% isodose lines, respectively). The ranges of maximal doses were as follows: 60–97 Gy for GKS, 50–90 Gy for LINAC, and 66–90 Gy for CKR.Actuarial initial freedom from pain (FFP) without medication ranged from 28.6% to 100% (mean 53.1%, median 52.1%) for GKS, from 17.3% to 76% (mean 49.3%, median 43.2%) for LINAC, and from 40% to 72% (mean 56.3%, median 58%) for CKR. Specific to hypesthesia, the crude rates (all Barrow Neurological Institute Pain Intensity Scale scores included) ranged from 0% to 68.8% (mean 21.7%, median 19%) for GKS, from 11.4% to 49.7% (mean 27.6%, median 28.5%) for LINAC, and from 11.8% to 51.2% (mean 29.1%, median 18.7%) for CKR. Other complications included dysesthesias, paresthesias, dry eye, deafferentation pain, and keratitis. Hypesthesia and paresthesia occurred as complications only when the anterior retrogasserian portion of the trigeminal nerve was targeted, whereas the other listed complications occurred when the root entry zone was targeted. Recurrence rates ranged from 0% to 52.2% (mean 24.6%, median 23%) for GKS, from 19% to 63% (mean 32.2%, median 29%) for LINAC, and from 15.8% to 33% (mean 25.8%, median 27.2%) for CKR. Two GKS series reported 30% and 45.3% of patients who were pain free without medication at 10 years.CONCLUSIONSThe literature is limited in its level of evidence, with only one comparative randomized trial (1 vs 2 isocenters) reported to date. At present, one can conclude that RS is a safe and effective therapy for drug-resistant trigeminal neuralgia. A number of consensus statements have been made and endorsed by the ISRS.

Understanding Allergic Reactions to Local Anesthetics

1996 ◽  
Vol 30 (7-8) ◽  
pp. 851-857 ◽  
Author(s):  
Steven T Eggleston ◽  
Lori W Lush
Keyword(s):  
Local Anesthetic ◽  
Local Anesthetics ◽  
English Language ◽  
Case Reports ◽  
Skin Testing ◽  
Drug Hypersensitivity ◽  
Alternative Therapies ◽  
Allergic Reactions ◽  
Medline Search ◽  
Mesh Terms

OBJECTIVE: To review the pharmacology and mechanisms by which local anesthetics cause allergic reactions. Recommendations concerning appropriate use of local anesthetics and alternative therapies in patients with documented local anesthetic allergies are given. DATA SOURCE: A MEDLINE search of the English-language literature identified pertinent clinical studies, case reports, and reviews. The periods of review were Med1, 1990-present; and Med2, 1985-1989, using the MeSH terms drug hypersensitivity and anesthetics. References from the selected studies, case reports, and reviews were reviewed. STUDY SELECTION: Controlled and uncontrolled prospective studies and case reports pertaining to local anesthetic allergies were reviewed. The selection focused on information pertaining to the etiology and diagnosis of allergic reactions to local anesthetics and alternative therapies for patients with local anesthetic allergies. DATA SYNTHESIS: Local anesthetics are classified as either ester or amide compounds. Esters are associated with a higher incidence of allergic reactions, due to a p-aminobenzoic acid (PABA) metabolite. Amide agents do not undergo such metabolism. However, preservative compounds (methylparaben) used in the preparation of amide-type agents are metabolized to PABA. Patients who are allergic to ester local anesthetics should be treated with a preservative-free amide local anesthetic. If the patient is not allergic to ester local anesthetics, these agents may be used in amide-sensitive patients. In the rare instance that hypersensitivity to both ester and amide local anesthetics occurs, or if skin testing cannot be performed, then alternative therapies including diphenhydramine, opioids, general analgesia, or hypnosis can be used. CONCLUSIONS: A true immunologic reaction to a local anesthetic is rare. Intradermal skin testing of local anesthetic compounds, methylparaben, and metabisulfite should be performed in patients when a thorough history does not rule out a possible allergic reaction to local anesthetics and future local anesthesia is necessary. Skin testing enables the clinician to identify autonomic responses to minor surgical procedures and toxic reactions to anesthetics so that patients are not incorrectly labeled as “caine” allergic. Diphenhydramine can be used as an alternative to ester and amide local anesthetics in minor procedures of short duration.

scholarly journals Cutaneous manifestations and COVID-19 infection in children and teenagers: an integrative review

2020 ◽  
Vol 10 (3) ◽  
Author(s):  
Alessandra Oliveira ◽  
Kamilla Pádua ◽  
Maria Carolina Alves ◽  
Karine Cardoso ◽  
Alexia Oliveira
Keyword(s):  
Children And Adolescents ◽  
English Language ◽  
Skin Lesions ◽  
Integrative Review ◽  
Childhood And Adolescence ◽  
Cutaneous Manifestations ◽  
Pediatric Age Group ◽  
Analysis And Synthesis ◽  
Skin Abnormalities ◽  
Coronavirus Infection

The study aims to analyse the cutaneous manifestations described in the literature so far, in children and adolescents, related to COVID-19. An integrative review was carried out using the descriptors and combinations in the English language: skin abnormalities, coronavirus infection, child, and adolescent. The inclusion criteria were articles that related skin manifestations in children and adolescents with COVID-19. The analysis and synthesis of the data obtained in a descriptive manner, characterizing the cutaneous manifestations analyzed. The study ended with 5 articles and it was observed that patients in the pediatric age group with COVID-19 may present diverse skin lesions as a single manifestation or accompanied by mild symptoms, and that these may be similar to those of other diseases common in childhood and adolescence.

Contributory Factors for Obesity in Elderly: Review of the Literature

2019 ◽  
Vol 15 (3) ◽  
Author(s):  
Nur Raihan Ismail ◽  
Noor Aman Hamid
Keyword(s):  
English Language ◽  
The Elderly ◽  
Dietary Factors ◽  
Health Concern ◽  
Cross Sectional ◽  
Contributory Factors ◽  
The Past ◽  
Prevalence Of Obesity ◽  
Program Intervention ◽  
Future Education

Introduction: The prevalence of obesity has been rising, adding to morbidity and mortality. As the proportion of elderly aged 60 years and above grows, so too the prevalence of obesity among this population. Obesity in the elderly is a rapidly growing public health concern as it contributes to significant changes in the health of older people. Objective: This review aims to assess the contributory factors for obesity in the elderly over the past decade. Methods: A literature search was conducted. The search was restricted to articles written in the English language published from 2008 to 2018. Qualitative studies were excluded. Results: A total of 19 full articles were retrieved, of which 18 cross-sectional and one cohort were included. The contributory factors were divided into three components: (a) socio demographic characteristics, (b) medical history and dietary factors and (c) environmental factors. Conclusions: This review informs an emerging knowledge regarding contributory factors for obesity and has implications for future education and program intervention in fighting obesity in the elderly.

Traditional Herbal Medicines, Newer Herbs and Other Novel Approaches Integrated in Herbal Medicine for Atopic Dermatitis-A Narrative Review

2020 ◽  
Vol 15 (3) ◽  
pp. 194-208
Author(s):  
Pravin Kumar ◽  
Dinesh Kumar Sharma ◽  
Mahendra Singh Ashawat
Keyword(s):  
Atopic Dermatitis ◽  
Herbal Medicines ◽  
Developed Countries ◽  
Skin Lesions ◽  
Scientific Data ◽  
Herbal Drugs ◽  
Biological Drugs ◽  
Alternative Treatment Option

Atopic Dermatitis (AD) is a prolonged reverting skin ailment with characteristically distributed skin lesions. In the previous decades, researchers had shown a marked interest in AD due to its increased prevalence in developed countries. Although different strategies including biological and immune modulators are available for the treatment of AD, each has certain limitations. The researchers had shown considerable interest in the management of AD with herbal medicines. The establishment of herbal drugs for AD might eliminate local as well as systemic adverse effects associated with long term use of corticosteroids and also higher cost of therapy with biological drugs. The present review discusses the traditional East Asian herbal medicines and scientific data related to newer herbal extracts or compositions for the treatment of AD. In vivo animal models and in vitro cell cultures, investigated with herbal medicines to establish a possible role in AD treatment, have also been discussed in the paper. The paper also highlights the role of certain new approaches, i.e. pharmacopuncture, a combination of allopathic and herbal medicines; and novel carriers (liposomes, cubosomes) for herbal drugs on atopic skin. In conclusion, herbal medicines can be a better and safe, complementary and alternative treatment option for AD.

Scabies: A Neglected Global Disease

2020 ◽  
Vol 16 (1) ◽  
pp. 33-42 ◽  
Author(s):  
Alexander K.C. Leung ◽  
Joseph M. Lam ◽  
Kin F. Leong
Keyword(s):  
English Language ◽  
Clinical Manifestations ◽  
Skin Lesions ◽  
Sarcoptes Scabiei ◽  
Clinical Findings ◽  
Effective Control ◽  
Search Term ◽  
Skin Contact ◽  
Intense Pruritus ◽  
Meta Analyses

Background: Scabies is a skin disease caused by an obligate human parasite mite Sarcoptes scabiei var. hominis. Children under the age of two and elderly individuals are at the greatest risk. Knowledge of this condition is important for an early diagnosis to be made and treatment to be initiated. Objective: The review aimed to familiarize physicians with the clinical manifestations, diagnosis, evaluation, and management of scabies. Methods: A search was conducted using Pubmed with the built-in "Clinical Queries" tool. The search term "Scabies" was used. The categories of "epidemiology", "diagnosis", "therapy", "prevention" and "prognosis" had a limited scope for primary clinical studies. Meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews were included. Only papers published in the English language were included. A descriptive, narrative synthesis was provided of the retrieved articles. Results: Worldwide, scabies affects 200 to 300 million individuals annually. The average prevalence is estimated to be 5 to 10% in children of developing countries. Transmission usually occurs after close prolonged skin-to-skin contact. Classic scabies is characterized by an erythematous papular eruption, serpiginous burrows, and intense pruritus. Sites of predilection include the webs of the fingers, volar wrists, lateral aspects of fingers, extensor surfaces of elbows and knees, waist, navel, abdomen, buttocks, groins, and, genitals. A clinical diagnosis of classic scabies can be made on the basis of the history and clinical findings. Other clinical variants include crusted scabies, nodular scabies, and bullous scabies. Finding the mite, ova, or fecal pellets on microscopic examination of scrapings taken from skin lesions confirms the diagnosis of scabies infestation. For eradication of scabies mites, the drugs of choice are topical permethrin and oral ivermectin. Conclusion: Scabies is a highly contagious parasitic cutaneous disease that is stigmatising and debilitating. Increased awareness, accurate diagnosis, and prompt treatment are essential for the effective control of scabies and for the prevention of the spread of the disease.

scholarly journals Emerging cellular and molecular mechanisms underlying anticancer indications of chrysin

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Marjan Talebi ◽  
Mohsen Talebi ◽  
Tahereh Farkhondeh ◽  
Jesus Simal-Gandara ◽  
Dalia M. Kopustinskiene ◽  
...  
Keyword(s):  
Blood Cells ◽  
Molecular Mechanisms ◽  
Web Of Science ◽  
Experimental Studies ◽  
Protective Effects ◽  
Pharmacological Activities ◽  
Current Review ◽  
Mesh Terms ◽  
Online Databases ◽  
Anti Cancer

AbstractChrysin has been shown to exert several beneficial pharmacological activities. Chrysin has anti-cancer, anti-viral, anti-diabetic, neuroprotective, cardioprotective, hepatoprotective, and renoprotective as well as gastrointestinal, respiratory, reproductive, ocular, and skin protective effects through modulating signaling pathway involved in apoptosis, oxidative stress, and inflammation. In the current review, we discussed the emerging cellular and molecular mechanisms underlying therapeutic indications of chrysin in various cancers. Online databases comprising Scopus, PubMed, Embase, ProQuest, Science Direct, Web of Science, and the search engine Google Scholar were searched for available and eligible research articles. The search was conducted by using MeSH terms and keywords in title, abstract, and keywords. In conclusion, experimental studies indicated that chrysin could ameliorate cancers of the breast, gastrointestinal tract, liver and hepatocytes, bladder, male and female reproductive systems, choroid, respiratory tract, thyroid, skin, eye, brain, blood cells, leukemia, osteoblast, and lymph. However, more studies are needed to enhance the bioavailability of chrysin and evaluate this agent in clinical trial studies. Graphic abstract

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