Overview on vitamin D and sunbed use

Vitamin D seems to be associated with a protective effect in a vast range of diseases, including cardiovascular, autoimmune and oncologic conditions. Since ultraviolet (UV) B light is the most important prerequisite for the cutaneous synthesis of vitamin D, sunbeds are able to increase serum vitamin D levels, although only transiently in most cases. In this scenario, the artificial tanning industry relentlessly tries to promote the use of sunbeds as a ‘safe’ therapeutic measure to achieve an adequate serum vitamin D status. The World Health Organization classified UV‐emitting tanning devices, as well as the whole UV spectrum, as group‐1 carcinogens, as they significantly increase the risk of melanoma and non‐melanoma skin cancer. In case of vitamin D deficiency or insufficiency, the current risk‐benefit ratio is therefore in favour of vitamin D supplementation instead of sunbed use. Artificial tanning devices should never be considered as an option to achieve an appropriate vitamin D status. Their supposedly beneficial effects, vastly publicised by the artificial tanning industry, are not worth the carcinogenic risk associated with sunbed use.     

Possible induction of malignant melanoma by sunbed use

Malignant melanoma of the female genitalia is rare. A patient who regularly used a sunbed developed a malignant melanoma after 4 years. The possible aetiological role of sunbeds in the development of such a malignancy is discussed.     

Melanoma attributable to sunbed use and tan seeking behaviours: an Italian survey

Melanoma is the most deadly form of skin cancer and its incidence is increasing worldwide. In 2009, the International Agency for Research on Cancer classified the entire UV spectrum as carcinogenic. In many countries, including Italy, the use of tanning equipment by minors and individuals with high risk phenotypes has been banned. This study assessed tan-seeking behaviour in a Mediterranean population with a relatively high melanoma incidence, where a considerable time is spent tanning outdoors. Subjects spending the most time in the sun were typically young single men, who use significantly less sunscreen and sunglasses. The overall prevalence of sunbed usewas 22% in youth (≤35 years old) and18%of them used sunbeds throughout the year. Sunbed use in youth was greater for phenotypes at risk. In Italy, 3.8% of melanoma cases are attributable to sunbed use, more in women (4.2% vs 3.1%, for women and men respectively) and much more in the young (17%). Of 8013 new melanoma cases in 2008 in Italy, 293 were attributable to sunbed use, with a high proportion of these in women (168) and 1045 were attributable to sun exposure. Among youth, 172 cases were attributable to sunbed use and 140 exclusively to sunbed use. This analysis reveals that a large number of cancers each year in Italy could be avoided by changing cultural attitudes to tanning. Sun avoidance and protection is generally inadequate in adults, especially young men. These results have important implications for the primary prevention of melanoma.     

Rubber: new allergens and preventive measures

Natural rubber latex (NRL) and rubber accelerators are well-known causes of occupational skin diseases. The latest epidemiological data on rubber allergy show that rubber additives are still among the allergens most strongly associated with occupational contact dermatitis, however, a decrease in NRL allergy has been confirmed. A review of recent publications on rubber allergens based on the Pubmed database is presented. New glove manufacturing processes have been developed, such as low-protein natural rubber gloves, vulcanisation accelerator-free gloves, or specific-purpose gloves containing antimicrobial agents or moisturisers. Several websites provide information on allergens found in gloves and/or glove choice according to occupation.     

Legislative and preventive measures related to contact dermatitis

Legislation can be a useful tool in the prevention of contact dermatitis. This is particularly true for dermatitis due to exposure to the many contact allergens that are chemical substances in products. A brief review is given of the most important European legislation--the EU Nickel Directive, the Cosmetics Directive, the Hazardous Substances Directive and the Hazardous Preparations Directive--and of some national regulations and standardization projects. It is concluded that it is essential that experts on contact dermatitis support, with their expert knowledge, national and European authorities.     

尖锐湿疣反复发作的危险因素探索

目的：研究尖锐湿疣（CA）患者复发存在的危险因素,同时探讨合理的预防措施。方法：回顾分析我院自2010年5月至2012年10月以来,于我科治疗的276例CA患者临床资料,统计一般情况与个人行为,以及皮损情况和复发情况,对CA复发存在的危险因素进行归纳总结,并依据治疗方式将患者分为两组,对比临床效果。结果：嗜酒（95％CI值为1.319～2.004,OR值为1.658）、熬夜（95％CI值为1.715～21.658,OR值为6.336）、皮损出现于肛周（95％CI值为0.608～1.049,OR值为0.752）、患者皮损的HPV型别呈16型（95％CI值为1.031～2.524,OR值为1.428）、患者皮损的HPV型呈复合型（95％CI值为2.058～6.082,OR值为3.539）,均为CA复发最主要的促进因素。经治疗后,患者疣体经激光烧灼,均结痂脱落,达到临床治愈,并且创面能够自行恢复,未出现瘢痕,A 组患者再次复发率同 B 组相比较,差异显著（P＜0.05）。结论：影响CA复发的危险因素较多,患者应用激光、干扰素与斯奇康联合治疗,能够有效降低复发率,应予推广。     

Who,why, where: an overview of determinants of sunbed use in Europe

Although exposure to indoor tanning has been established as a clear risk factor for skin cancer, sunbeds are still commonly used in Europe. Understanding the determinants of sunbed use in Europe is key to plan educational interventions, behavioural strategies and legislative measures, which should be tailored to subgroups with different risk profiles. Evidences show that the typical sunbed users in Europe are young‐adult women, with intermediate skin type, a current employment and a medium/high socio‐economic status. Typical users display sun‐seeking behaviours and other risky behaviours such as smoking. Indoor tanning seems more common in northern than southern Europe. However, sunbed use remains common in fair‐skinned individuals and among adolescents/pre‐adolescents. Commonly reported reasons for sunbed use in Europe include aesthetic motives (i.e. looking attractive), the pursue of a prevacation tan, the influence of peers/parents engaging in the same habit, and the treatment of health conditions. The most commonly reported places to get an artificial tan in Europe are tanning studios and beauty salons. However, sunbeds are also available in sport venues, such as swimming pools and gyms, hotels and private houses. All these factors should be taken into account when planning educational, behavioural and legislative interventions to reduce the popularity of artificial tanning in Europe.     

Long-term use of psoralens and ultraviolet A for psoriasis: evidence for efficacy and cost savings

A 7.3-year prospective study of 1,380 patients with psoriasis who were treated with oral methoxsalen (8-methoxypsoralen) and ultraviolet A photochemotherapy (PUVA) revealed that patients who continued on PUVA therapy used inpatient hospital treatment less than one fourth as often as those who had discontinued treatment. Patients who continued to use PUVA therapy also had less extensive psoriasis than did other patients in this cohort who discontinued PUVA therapy. These findings demonstrate that PUVA is an effective outpatient therapy for severe psoriasis. The potential toxicity of PUVA treatment, which was the primary reason that one third of the study patients were concerned about their prolonged or continued treatment, must be balanced against the therapy's apparent effectiveness and relatively low cost.     

7221例梅毒流行病学分析及防治对策的初步探讨

目的:分析泉州地区梅毒流行的特征,为今后防治工作提供科学依据.方法:用全国性病计算机管理系统软件汇总分析泉州市1991年～2002年的性病疫情年度报表.结果:1991年～1994年为散发,从1995年至2002年开始出现流行态势;病期以早期(一、二期)梅毒为主,占74.58%;患者的文化程度以中学及以下为多,占94%;职业分布以无业、农民、饮服业、工人、个体为多;性别比例为男女之比为1∶1;年龄主要集中于20～39岁;已婚占47.42%;传染方式66%为非婚性接触.结论:本地区梅毒发病率已形成流行态势,同全国流行趋势一致.因此,应加强性病防治知识的宣传教育,提倡安全性行为,加强对高危人群的监测,规范梅毒的诊治等综合措施,以便能有效地控制梅毒的流行.     

女青年人工流产后妇科感染性疾病的影响因素分析与预防措施探讨

目的：调查分析女青年人工流产后妇科感染性疾病的影响因素,并对其预防措施进行针对性的探讨.方法：选取2012年1月至2012年12月在我院自愿进行人工流产术的516例25岁以下女青年为观察对象,采用自拟调查问卷进行调查,对调查问卷中所列的各种影响因素进行统计分析.结果：调查显示,516例调查对象中患妇科感染性疾病者284例,发病率为55.04%.各相关因素中,初次性行为年龄≤18岁（OR值=0.696,P=0.017）、是否采用避孕措施（OR值=1.358,P=0.001）、外阴清洁间隔时间（OR值=0.375,P=0.002）、妇科感染性疾病史（OR值=1.358,P=0.001）、月经期是否有过性行为（OR值=1.314,P=0.006）是主要的影响因素.结论：女青年人工流产后妇科感染性疾病的发病率相当高.针对以上主要影响因素给予生殖健康教育,应有助于降低这一人群妇科感染性疾病的发生率.     

A quantitative estimate of melanoma mortality from ultraviolet A sunbed use in the U.K

BACKGROUND: Concern has been expressed for many years in the medical and regulatory literature about the adverse health effects, especially melanoma, from the use of sunbeds for cosmetic tanning. OBJECTIVES: To estimate the mortality from melanoma as a result of the use of sunbeds for cosmetic tanning in the U.K. METHODS: A model using a Monte Carlo random sampling technique was developed to estimate human ultraviolet exposure to both sunlight and sunbeds, and these data were used to predict the contribution of sunbeds to melanoma mortality in the U.K. RESULTS: The mortality from melanoma due to sunbed use each year in the U.K. is estimated to be about 100 deaths. CONCLUSIONS: Sunbed use could be regarded as a relatively minor self-imposed detriment to public health compared with other voluntary 'pleasurable' activities associated with significant mortality, such as smoking and drinking alcohol. While cosmetic tanning using sunbeds should be discouraged, prohibition is not warranted especially as exposure to the sun, which cannot be regulated, remains the major contributory factor to the risk of melanoma.     

常山县妊娠期女性生殖系统感染的危险因素分析及预防对策

目的:探究常山县妊娠期女性生殖系统感染的危险因素以及预防对策。方法:选取2012年1月至2014年1月期间我院接收治疗的100例生殖系统感染的妊娠期女性患者,以及同期无生殖系统感染的健康孕妇100例。对研究对象的临床资料进行统计,测定其血清蛋白和血红蛋白水平以及体重指数。采集患者阴道分泌物标本做细菌培养,观察患者生殖系统感染的病原菌分布情况。结果:文化程度较低、有分娩史、流产史、年龄≥35岁、以往有生殖系统感染、合并妊娠期糖尿病和贫血均为妊娠期生殖系统感染的高危因素。经过logistic回归分析得出,年龄≥35岁、以往有生殖系统感染史、流产史、分娩史、文化程度在高中以下、贫血和合并妊娠期糖尿病是患者妊娠期生殖系统感染的独立危险因素,具有统计学意义(p0.05)。100例生殖系统感染患者在细菌培养中,排除培养基污染情况,一共分离出89株病原菌,其中大肠埃希菌占67.42%,数量最多,肺炎链球菌占2.25%数量最少,其余分别为6.74%的肺炎克雷伯菌,6.74%的粪肠球菌,4.49%的变形菌属和3.37%的屎肠球菌。结论:妊娠期生殖系统感染的因素是复杂多变的,因此在治疗发生生殖系统感染孕妇时应当顾及到胎儿的安全,并对孕妇进行相关的健康教育。     

Atopic dermatitis and the indoor climate. The effect from preventive measures

Nine patients with atopic dermatitis (AD) were clinically evaluated before and after moving to new houses with improved air exchange, low relative humidity and optimal temperature control. During a 2-year period three clinical and subjective assessments were performed each month of disease activity, and compared with changes in suspended and respirable dust particles, room temperature, air exchange rate, concentration of house-dust mites in bedrooms, and the concentration of organic solvents in the indoor air. Ten matched patients with AD, who did not move, served as a control group. The skin condition of patients moved improved significantly after moving. The indoor climate was improved on: 1) air exchange rate, 2) relative humidity, and 3) room temperature, but the amounts of house dust mites, respirable air particles and organic solvents were unchanged. The clinical and subjective improvement in AD could not be correlated to any single indoor environmental factor. The present investigation supports the current concept, that AD may be a multifactorial disease, and that the indoor climate may be a contributing factor affecting the eczema.