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991.
992.
Madelaine Haddican Rita V. Linkner Giselle Singer Shelbi C. Jim Matthew Gagliotti Gary Goldenberg 《The Journal of clinical and aesthetic dermatology》2014,7(7):32-36
Background:
Staphylococcus aureus has been implicated in the pathogenesis of adult hand/foot dermatitis. Objective: The authors hypothesized that retapamulin 1% ointment and clobetasol propionate 0.05% foam would decrease disease severity in subjects with hand/foot dermatitis and provide a higher clearance of Staphylococcus aureus colonization, when compared to vehicle (placebo) ointment and clobetasol propionate 0.05% foam. Methods: Adult subjects with moderate to very severe hand/foot dermatitis had twice-daily topical application of clobetasol propionate 0.05% foam to hands/feet for 14 days and were randomized to apply either retapamulin 1% ointment or vehicle ointment twice daily to hands/feet and nares for five days. Results: Seventy-three percent of subjects in the retapamulin/clobetasol group were clear/almost clear at Day 15 compared to 47 percent of subjects in the vehicle/clobetasol group (p-value of 0.04). The percentage of subjects who had both negative skin and nares cultures and were clear/almost clear was also statistically significant in favor of the retapamulin/clobetasol group at Day 15 (p-value of 0.05). Limitations: Sample size, study population. Conclusion: At Day 15, retapamulin 1% ointment with clobetasol propionate 0.05% foam was more efficacious than vehicle ointment and clobetasol propionate 0.05% foam for disease improvement and Staphylococcus aureus clearance in adult subjects with hand/foot dermatitis.Hand/foot dermatitis (HFD) is a chronic disease with both genetic and environmental contributing risk factors.1 Several studies have implicated bacterial colonization, especially Staphylococcus aureus, as a pathogenic factor for eczematous lesions.2-4 Different mechanisms have been suggested to account for the increased S. aureus colonization. For example, the defective epidermal barrier in subjects with eczema allows S. aureus to invade these lesions and stimulate keratinocytes to release proinflammatory cytokines.5-9 In a recent study, which investigated the relationship between S. aureus and hand dermatitis, infection rates with S. aureus were found to be significantly higher in the disease cohort (48%) as compared to controls (8%). Furthermore, the presence of S. aureus correlated closely to disease severity.10 Another published clinical trial investigated the effect of treating S. aureus infection in children with generalized atopic dermatitis. The concomitant use of intranasal mupirocin and dilute bleach baths significantly decreased the severity of eczema in the treatment arm as compared to placebo. However, S. aureus carriage persisted in both skin and nares cultures.11 In a randomized, double-blind, placebo-controlled study of nasal carriers of S. aureus who applied retapamulin 1% ointment (Altabax®, Stiefel Laboratories) to both nostrils for five days, cultures carriage four weeks after treatment was negative for 86 percent of subjects.12 Thus, retapamulin 1% ointment offers the opportunity to effectively treat the presence of S. aureus in HFD. The primary purpose of this study was to investigate the use of retapamulin 1% ointment in combination with clobetasol propionate 0.05% foam for the treatment of HFD in adult subjects. 相似文献
993.
Philip H. Smith Gregory G. Homish Gary A. Giovino Lynn T. Kozlowski 《American journal of public health》2014,104(2):e127-e133
Objectives. We compared prevalence, severity, and specific symptom profiles for nicotine withdrawal across categories of mental illness. We also examined the influence of nicotine withdrawal on efforts to quit smoking among those with mental illness.Methods. We analyzed data from 2 sources: wave 1 of the National Epidemiologic Survey on Alcohol and Related Conditions, limiting the sample to current smokers (2001–2002; n = 9913); and a 2-wave cohort telephone survey of a national sample of adult smokers (2004–2006; n = 751).Results. Mental illness was associated with a substantially greater likelihood of nicotine withdrawal syndrome; approximately 44% of nicotine withdrawal syndrome diagnoses were attributable to mental illness. Symptom profiles were highly comparable between mental illness categories, although anxiety-related symptoms were better markers of withdrawal for those with an internalizing disorder. Smokers with mental illness were motivated to quit but were less likely to be successful in their quit attempts, and both dependence and withdrawal independently accounted for this lower likelihood of success.Conclusions. Nicotine withdrawal may be a particularly important target for intervention among those with mental illness who smoke cigarettes.Individuals with mental illness are more likely to smoke cigarettes, are more dependent on nicotine, and have greater difficulty quitting smoking1,2 than are those without mental illness. The prevalence of mental illness in the United States is approximately 28%; yet, smokers with mental illness consume 40%–50% of cigarettes.1,2 A self-medication hypothesis has largely driven the conceptualization of this issue3–8: smoking is initiated and maintained to reduce psychiatric symptoms, and these symptoms are exacerbated during abstinence. This notion, that smoking can be important for symptom self-management, has likely contributed to smoking disparities between those with and those without mental illness.3 There are effective means of treating smoking for those with mental illness9; however, nontreatment remains the norm.10 A growing body of researchers, clinicians, and policymakers has called for a paradigm shift in how we approach this issue.3,11–13 Smoking is becoming increasingly viewed as a preventable and treatable cause of diminished life quality among those with mental illness,3,12 rather than a necessary form of self-medication.A 2008 National Institute of Mental Health report noted that the focus on a self-medication hypothesis has come at the expense of research on other important facets of smoking, particularly nicotine withdrawal.3 Studies have found that cigarette smokers with mental illness may experience more severe nicotine withdrawal symptoms14,15; however, these studies were conducted among small samples with a limited range of diagnoses. Weinberger et al. conducted an investigation using data from a US nationally representative sample of cigarette smokers and found that those with mental illness were more likely to report nicotine withdrawal symptoms and life problems associated with their withdrawal.16 Weinberger et al. focused on a few particular diagnoses; thus, they did not investigate the overall extent to which nicotine withdrawal is an issue among those with mental illness or comparisons of nicotine withdrawal between mental illness diagnoses. Previous research on this topic has also been limited in that specific nicotine withdrawal symptom profiles have not been compared across mental illness diagnoses. This type of analysis will potentially highlight specific nicotine withdrawal symptom targets for intervention. Finally, it remains unclear whether nicotine withdrawal in itself is associated with lower likelihood of quit success among those with mental illness or whether nicotine withdrawal is simply an extension of greater nicotine dependence among those with mental illness.We conducted 2 studies of nicotine withdrawal, mental illness, and tobacco cessation. In the first, we compared the likelihood of being diagnosed with a nicotine withdrawal syndrome and the severity of nicotine withdrawal symptoms between smokers with and those without mental illness and across mental illness diagnoses. We then estimated the proportions of nicotine withdrawal syndrome in the population of smokers attributable to each mental illness category. We compared nicotine withdrawal symptom profiles between mental illness categories to better understand consistencies and differences in specific nicotine withdrawal symptoms.In the second study, we examined whether smokers with mental illness were more or less motivated to quit smoking and more or less likely to make quit attempts. Among smokers who made a quit attempt, we examined whether those with mental illness were more or less likely to successfully stop using tobacco and how nicotine withdrawal and dependence influenced cessation efforts. 相似文献
994.
Carol J. Burns J. Michael Wright Jennifer B. Pierson Thomas F. Bateson Igor Burstyn Daniel A. Goldstein James E. Klaunig Thomas J. Luben Gary Mihlan Leonard Ritter A. Robert Schnatter J. Morel Symons Kun Don Yi 《Environmental health perspectives》2014,122(11):1160-1165
Background: There is a recognized need to improve the application of epidemiologic data in human health risk assessment especially for understanding and characterizing risks from environmental and occupational exposures. Although there is uncertainty associated with the results of most epidemiologic studies, techniques exist to characterize uncertainty that can be applied to improve weight-of-evidence evaluations and risk characterization efforts.Methods: This report derives from a Health and Environmental Sciences Institute (HESI) workshop held in Research Triangle Park, North Carolina, to discuss the utility of using epidemiologic data in risk assessments, including the use of advanced analytic methods to address sources of uncertainty. Epidemiologists, toxicologists, and risk assessors from academia, government, and industry convened to discuss uncertainty, exposure assessment, and application of analytic methods to address these challenges.Synthesis: Several recommendations emerged to help improve the utility of epidemiologic data in risk assessment. For example, improved characterization of uncertainty is needed to allow risk assessors to quantitatively assess potential sources of bias. Data are needed to facilitate this quantitative analysis, and interdisciplinary approaches will help ensure that sufficient information is collected for a thorough uncertainty evaluation. Advanced analytic methods and tools such as directed acyclic graphs (DAGs) and Bayesian statistical techniques can provide important insights and support interpretation of epidemiologic data.Conclusions: The discussions and recommendations from this workshop demonstrate that there are practical steps that the scientific community can adopt to strengthen epidemiologic data for decision making.Citation: Burns CJ, Wright JM, Pierson JB, Bateson TF, Burstyn I, Goldstein DA, Klaunig JE, Luben TJ, Mihlan G, Ritter L, Schnatter AR, Symons JM, Yi KD. 2014. Evaluating uncertainty to strengthen epidemiologic data for use in human health risk assessments. Environ Health Perspect 122:1160–1165; http://dx.doi.org/10.1289/ehp.1308062 相似文献
995.
Win Brown Nel Druce Julia Bunting Scott Radloff Desmond Koroma Srishti Gupta Brian Siems Monica Kerrigan Dan Kress Gary L. Darmstadt 《Studies in family planning》2014,45(1):73-84
This report describes the purpose for developing a quantitative goal for the London Summit on Family Planning held in July 2012, the methodology behind its formulation, and the lessons learned in the process. The London Summit has evolved into the global initiative known as FP2020, and the goal has become “120 by 20,” or reaching 120 million additional users of modern contraceptive methods by 2020 in the world's poorest countries. The success of FP2020 will first be evaluated on the basis of quantitative verification to determine that the “120 by 20” goal was reached. More important, however, is the extent to which the goal today serves as a global rallying cry to mobilize resources and leadership around current family planning programs, with a focus on voluntary family planning and quality of care, and with an emphasis on meeting girls' and women's unmet needs and their right to practice contraception. We hope this article provides greater transparency and understanding of the FP2020 goal, and that the global goal spurs annual monitoring of progress toward national goals in the world's poorest countries. 相似文献
996.
997.
998.
Jian Yan Daniel O. Villarreal Trina Racine Jaemi S. Chu Jewell N. Walters Matthew P. Morrow Amir S. Khan Niranjan Y. Sardesai J. Joseph Kim Gary P. Kobinger David B. Weiner 《Vaccine》2014
Despite an intensive vaccine program influenza infections remain a major health problem, due to the viruses’ ability to change its envelope glycoprotein hemagglutinin (HA), through shift and drift, permitting influenza to escape protection induced by current vaccines or natural immunity. Recently a new variant, H7N9, has emerged in China causing global concern. First, there have been more than 130 laboratory-confirmed human infections resulting in an alarmingly high death rate (32.3%). Second, genetic changes found in H7N9 appear to be associated with enabling avian influenza viruses to spread more effectively in mammals, thus transmitting infections on a larger scale. Currently, no vaccines or drugs are effectively able to target H7N9. Here, we report the rapid development of a synthetic consensus DNA vaccine (pH7HA) to elicit potent protective immunity against the H7N9 viruses. We show that pH7HA induces broad antibody responses that bind to divergent HAs from multiple new members of the H7N9 family. These antibody responses result in high-titer HAI against H7N9. Simultaneously, this vaccine induces potent polyfunctional effector CD4 and CD8T cell memory responses. Animals vaccinated with pH7HA are completely protected from H7N9 virus infection and any morbidity associated with lethal challenge. This study establishes that this synthetic consensus DNA vaccine represents a new tool for targeting emerging infection, and more importantly, its design, testing and development into seed stock for vaccine production in a few days in the pandemic setting has significant implications for the rapid deployment of vaccines protecting against emerging infectious diseases. 相似文献
999.