Therapeutic Use of Stories for Children with Atopic Eczema and Other Chronic Skin Conditions

Children with chronic skin diseases often experience significant psychological difficulties, yet pediatric dermatologists rarely have psychology professionals on hand to help address them. This article presents personalized stories as a technique for integrating psychologically developed interventions into day‐to‐day clinical practice with a view to improving treatment outcomes.     

Synovial Sarcoma: Laryngopharynx a Challenge

Synovial sarcoma is a rare malignant tumor. It derives from a mesenchymal precursor stem cell that is unrelated to mature synovial tissue. Synovial sarcoma classically affects lower limbs between the ages of 15 and 40 years and the proportion of male-to-female patients is 3:2. It is very rare in the head and neck region especially in laryngopharynx. Till date, only six cases of synovial sarcoma involving laryngopharynx have been reported in the English literature. Painless mass, hoarseness, upper respiratory distress, and dysphagia characterize the original complaints in laryngopharyngeal synovial sarcoma. Because head and neck synovial sarcoma in clinical practice is so uncommon, early diagnosis is difficult and the treatment protocol is unclear. Therefore, every case report should include complete information on presentation and management. Also, long-term prognostic indices need to be evaluated. We hereby report a case of large laryngopharyngeal synovial sarcoma confirmed by histopathology and immunohistochemistry with review of literature.     

Within-individual stability of obesity-related biomarkers among women.

OBJECTIVE: Novel biomarkers including proinflammatory cytokines and adipokines are being explored as potential mediators of cancer and other obesity-related conditions. Prospective studies linking biomarker levels with disease outcomes often measure biomarkers at a single time point and assume that the within-individual variation in levels is small compared with the interindividual variation. However, this assumption is seldom tested. METHODS: This study examined the within-individual stability over time of plasma adiponectin, resistin, leptin, plasma activator inhibitor type 1, hepatocyte growth factor, tumor necrosis factor alpha, interleukin 6, and insulin among healthy young women. RESULTS: The study included 17 women (9 Black non-Hispanic, 2 Black Hispanic, 2 White Hispanic, and 4 other race/ethnicity) with mean age of 32.3 years, mean body mass index of 31.2 kg/m2, and 76% prevalence of smoking. Analysis of intraclass correlation (ICC) suggested high to moderate correlation over repeated samples taken over 3 years in levels of resistin (ICC = 0.95), hepatocyte growth factor (0.91), plasma activator inhibitor type 1 (0.84), adiponectin (0.73), insulin (0.62), and leptin (0.58). ICCs were weaker for levels of proinflammatory cytokines, tumor necrosis factor alpha (0.39), and interleukin 6 (0.47). CONCLUSION: In this population of minority young females with a high prevalence of overweight and smoking, several obesity-related endocrine markers were stable over a period of 3 years. This supports the feasibility of longitudinal studies relating these biomarkers to the future occurrence of cancer and other health consequences of obesity.     

<Emphasis Type="Italic">"They think we're OK and we know we're not"</Emphasis>. A qualitative study of asylum seekers' access,knowledge and views to health care in the UK

Background  

The provision of healthcare for asylum seekers is a global issue. Providing appropriate and culturally sensitive services requires us to understand the barriers facing asylum seekers and the facilitators that help them access health care. Here, we report on two linked studies exploring these issues, along with the health care needs and beliefs of asylum seekers living in the UK.     

Rapid decrease in tuberculin skin test reactivity at preschool age after newborn vaccination

A study of tuberculin sensitivity was performed in 353 children aged 4-6 years, all vaccinated at birth with British BCG vaccine. Significant waning of tuberculin reactions with increasing age was found (p < 0.05). In the age group < 4.5 years, the mean tuberculin reaction was 6.6 mm, in the age group 4.5-5.5 years 5.2 mm and in the age group of > 5.5 years 3.5 mm. The number of children with positive reactions (> or = 5 mm) was 165 (40%) and those with strong reactions (> or = 10 mm) 49 (14%). None of the latter children had active tuberculosis during a follow-up period of 12 months. Eighty-three (24%) of the children had no reaction. The children who had been revaccinated with the MPR vaccine against measles, rubella and parotitis (n = 31) had significantly larger tuberculin reactions than the non-revaccinated children. Atopic dermatitis or infections during the preceding six months did not have any significant influence on reaction sizes. Our results demonstrate that the variation in size of tuberculin reactions after BCG vaccination at birth is large. We conclude that tuberculin sensitivity wanes rapidly by the age of 4.0-6.3 years.     

Feeding during acute diarrhea as a risk factor for persistent diarrhea

Dietary intake during diarrhea in children less than three years of age was estimated from information recorded on illustrated dietary forms used by children's caretakers during the first week of illness in a prospective community-based study of diarrheal diseases in Lima, Peru. The frequency of consumption and the amount consumed of food groups and selected commonly consumed foods were analyzed by the final duration of the diarrheal episode. Cereals were less frequently consumed during the acute phase of diarrheal episodes that ultimately became persistent (>14 days'duration), apparently shortening the duration of the episode by one day (median duration of four days in children not consuming vs three days in children consuming cereals during diarrhea, p <0.02 Kaplan-Meier logrank test). Only roots and tubers (mainly potatoes) were consumed in greater quantity during episodes that became persistent. There was no evidence that consumption of breast milk or non-maternal milk was associated with an alteration in diarrheal duration. This study provides further evidence of the beneficial effects of continuing feeding during diarrhea using foods available at the home level, especially cereals, which are commonly used in the diet of young children.     

Role of Moraxella (Branhamella) catarrhalis as a respiratory pathogen in children

During a 12-month surveillance period in 1981-1982, Moraxella catarrhalis was detected in cultures from nasopharyngeal aspirates from 76 (17%) of 449 children hospitalized with middle or lower respiratory tract infection. Seroconversion to M. catarrhalis was positive in 4(5%) of the 76 patients with M. catarrhalis present in nasopharyngeal aspirates and in 4(1%) of 373 patients with a negative finding. Although children with respiratory tract infections were often colonized by the organism, this was rarely the infective agent of the middle or lower airways. Four of 8 patients with seroconversion to M. catarrhalis exhibited a concomitant RSV infection. The carriage of this species was more closely associated with parainfluenza virus infections. Serological responses to M. catarrhalis were not associated with acute otitis media, and were also rare in children with pneumonia. It is concluded that bronchopulmonary infections caused by M. catarrhalis are rare in children, and that M. catarrhalis aetiology need not be considered in the selection of antibiotics in cases of community-acquired pneumonia or other infections of the middle or lower respiratory tract affecting primarily healthy children.