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Biomedical subjects

A Pelosi

Publications and source records attributed to A Pelosi.

At least 19 recordsLinked to original sources
PubMed2005

The safety of antiepileptic drug withdrawal in patients with non-epileptic seizures.

BACKGROUND: To determine whether withdrawal of anticonvulsant drugs (AED) can be carried out safely in patients with non-epileptic seizures (NES). METHODS: Prospective evaluation of safety and outcome in 78 patients with NES who satisfied a standardised set of criteria for excluding the diagnosis of coexisting or underlying epilepsy. FINDINGS: The patients were taking from one to three AED. Sixty four patients were withdrawn as outpatients, 14 as inpatients. Five patients stopped their drugs abruptly, and two had AED restarted and had to be withdrawn again. Otherwise all patients adhered to withdrawal schedules. A new type of attack in addition to NES was seen in three patients (complex partial seizures in all three cases). NES frequency declined in the group as a whole over the period of the study (follow up 6-12 months) in all individuals except for eight patients in whom there was a transient increase. Fourteen patients reported new physical symptoms after withdrawal; however, no serious adverse events were reported. CONCLUSIONS: With appropriate diagnostic investigation and surveillance during follow up withdrawal of AED can be achieved safely in patients with NES.

Adult↗
PubMed2001

Testing for irritation with a multifactorial approach: comparison of eight non-invasive measuring techniques on five different irritation types.

BACKGROUND: Non-invasive bioengineering methods are widely used in the assessment of irritant skin reactions. OBJECTIVES: To assess the ability of eight non-invasive measurement techniques to distinguish changes in skin conditions over time, these changes being induced by five different irritants. METHODS: The following techniques were compared in a multivariate analysis: laser-Doppler perfusion imaging (LDI), laser-Doppler flowmetry (LDF), transepidermal water loss (TEWL), visual scoring (VS), colorimetric measurements (Chromameter CR 200 a* and L* scales), Mexameter Hb scale (Mexa Hb) and capacitance (Corneometer CM 820). Irritants tested were sodium lauryl sulphate 2% (SLS), tape stripping (TS), tretinoin 0.05% (TRET), ultraviolet (UV) exposure to 30 W m(-2) UVB/95 W m(-2) UVA, and dithranol 0.5% (DIT). Measurements were performed at baseline and after 24, 48 and 72 h. The study was conducted on the upper back of 11 healthy volunteers of both sexes aged 27-51 years. RESULTS: For DIT it was possible to discriminate over time with CR 200 a* and L*, VS, LDI, LDF and Mexa Hb. In SLS discrimination over time was seen with TEWL and LDF. Discrimination in TS was demonstrated for TEWL, VS, CR 200 a*, CM 820, LDF, LDI and Mexa Hb. In TRET discrimination ability was seen for LDI, LDF, Mexa Hb and VS. For UV it was possible to discriminate using VS, TEWL, LDF, LDI and Mexa Hb. CONCLUSIONS: Different irritation patterns need different measurement modalities in order to give optimal discrimination over time.

Adult↗
PubMed2001

Human stratum corneum penetration by nickel. In vivo study of depth distribution after occlusive application of the metal as powder.

Sequential tape stripping was implemented on three healthy volunteers to examine the surface distribution of nickel through human stratum corneum in vivo following occlusive application of the metal as powder on the volar forearm. Exposure sites were stripped 20 times at intervals from 5 min to 96 h post-dosing and the strips analyzed for metal content by Inductively Coupled Plasma-Mass Spectroscopy with a detection limit for nickel of 0.5 ppb. The gradients of nickel distribution profiles increased proportionally with occlusion time, but after the 10th strip to the 20th strip continued at constant levels. Total nickel removed with 20 stratum corneum strips to the level of the glistening layer after maximum occlusion of 96 h was 41.6 micrograms/cm2 (+/- 12.2; average n = 3). In order to normalize the nickel depth distribution profiles, stratum corneum removed by stripping of untreated skin after occlusion was determined by weighing. Following application of nickel dust over 24 h, analysis of the 20th strip still indicated nickel present at 1.42 micrograms/cm2 (+/- 0.68; average n = 3). These data indicate that, in contact with skin, nickel metal is oxidized to form soluble, stratum corneum-diffusible compounds which may penetrate the intact stratum corneum, presumably by the intercellular route, and have the potential to elicit allergic reactions.

Adult↗
PubMed2001

Differences in corneocyte surface area in pre- and post-menopausal women. Assessment with the noninvasive videomicroscopic imaging of corneocytes method (VIC) under basal conditions.

The differences between pre- and postmenopausal women and men on corneocyte surface area were investigated by a noninvasive exfoliation method. Surface corneocytes were collected with a modified detergent scrub technique. Separated corneocytes were analyzed by videomicroscopy and image analyses (NIH Image 1.59). Additionally transepidermal water loss (TEWL) and stratum corneum hydration, water-holding capacity and moisture accumulation velocity were measured. 21 postmenopausal females without hormonal substitution (age 50.6 years), 33 premenopausal women (age 41.0 years) and 25 men matched for age (age 44.0 years) were included in this study. The smallest corneocyte surface area was seen in premenopausal women (368.0 pixels). For postmenopausal women and the male control population almost equal values could be detected (postmenopausal women 401.1 pixels; men 401.8 pixels). Significant differences were calculated with the ANOVA test (p = 0.0050) and post-hoc analyses (Dunn test); premenopausal vs. postmenopausal women (p < 0.05) and premenopausal women vs. men (p < 0.05), but not postmenopausal women vs. men (p > 0.05). No statistically significant differences could be detected for TEWL, stratum corneum hydration parameters. No correlation could be found between the corneocyte surface area and barrier or hydration parameters. The detected differences support the hypothesis that sexual hormones have an impact on corneocyte surface area, because sex hormone levels are higher in premenopausal women than in non-hormone-substituted postmenopausal women or men.

Adult↗
PubMed2000

Strontium nitrate suppresses chemically-induced sensory irritation in humans.

Skin care products are complex formulations that may cause sensory irritation symptoms, characterized by stinging, burning, and itching. Substances capable of counteracting sensory irritation are of great practical interest. Strontium salts have been demonstrated to inhibit sensory irritation and inflammation when applied topically. In this double-blind study, we evaluated the efficacy of strontium nitrate in reducing chemically-induced skin sensory irritation in 8 subjects. In a random order, 20% strontium nitrate in 70% glycolic acid (pH=0.6) (mixture) was applied to the volar aspect of the forearm and a positive control (70% glycolic acid, pH=0.6) to the contralateral forearm. The irritation sensation was evaluated each min for the first 20 min after topical application using a scale from 0-4. The duration of the irritation sensation in min was also recorded. Strontium nitrate mixed with glycolic acid, in comparison with glycolic acid alone, markedly (p<0.01) shortened the duration of the irritation sensation from 24.4+/-4.1 (mean+/-SEM) min to 8.9+/-3.7 (mean+/-SEM) min, and significantly (p<0.05) reduced the mean magnitude of the irritation sensation at all time points (overall). The study demonstrated that strontium nitrate potently suppresses the sensation of chemically-induced irritation.

Adult↗
PubMed2000

Strontium nitrate decreased histamine-induced itch magnitude and duration in man.

BACKGROUND: Previous studies have demonstrated that strontium salts have a potent and broad ability to suppress sensory irritation. OBJECTIVE: To ascertain the possible antipruritic effects of topical strontium salts, we conducted a double-blind randomized study to evaluate the effect of 20% strontium nitrate on itch magnitude (intensity) and duration. METHODS: In 8 human subjects, strontium nitrate was applied to the volar forearm and vehicle control to the contralateral volar forearm for 30 min; both substances were reapplied for an additional 5 min. Itch was then experimentally induced by intradermal injection of histamine. Itch magnitude was rated each minute for the first 20 min using a visual analogue scale (VAS). Itch duration in minutes was also recorded. RESULTS: Strontium nitrate, in comparison to its vehicle control, significantly shortened itch duration from 28.1+/-5.4 min (mean +/- SEM) to 18.5+/-4.2 min (p<0.01) and reduced itch magnitude at time points 12-20 min and overall (p<0.05). CONCLUSION: Strontium nitrate may act as a topical antipruritic agent in reducing histamine-mediated itch.

Adult↗
PubMed1998

Thirteen-year follow-up of deliberate self-harm, using linked data.

BACKGROUND: We describe a national cohort of individuals surviving an episode of deliberate self-harm (DSH). Subsequent admissions for DSH and mortality over the following 13 years were studied. METHOD: In 1981, 8304 individuals were discharged from Scottish general hospitals with a diagnosis of attempted suicide (E950-959). They were followed-up to the end of 1994 using the Scottish Linked Data Set. Mortality was compared to the Scottish population using person-years analysis. RESULTS: 2624 people (31.6%) were readmitted with further episodes of DSH. The median number of readmissions was 1, range 1-137. The observed:expected ratio for all-cause mortality was 2.26 (95% CI 2.13-2.26). One hundred and sixty-eight people (2%) died from suicide, and 46 (0.6%) from undetermined causes. The observed:expected ratio for suicide plus undetermined deaths was 12.17 (95% CI 10.64-13.91). Accidental deaths in men and homicide deaths in men and women were elevated. The pattern of deaths from other causes suggested that alcohol misuse was a contributory factor. CONCLUSIONS: People admitted to general hospitals in Scotland after attempted suicide are at high risk of readmission for further episodes of DSH. Long-term follow-up of such large cohorts is impractical, but services should review the scope for intervention in alcohol misuse following DSH.

Adolescent↗
PubMed1996

Psychosocial risk factors for chronic fatigue and chronic fatigue syndrome following presumed viral illness: a case-control study.

This study investigated psychosocial morbidity, coping styles and health locus of control in 64 cases with and without chronic fatigue identified from a cohort of primary care patients recruited 6 months previously with a presumed, clinically diagnosed viral illness. A significant association between chronic fatigue and psychosocial morbidity, somatic symptoms and escape-avoidance coping styles was shown. Chronic fatigue cases were significantly more likely to have a past psychiatric history and a current psychiatric diagnosis based on a standardized clinical interview. Twenty-three of the cases fulfilled criteria for chronic fatigue syndrome (CFS). Such cases were significantly more fatigued than those not fulfilling criteria, but had little excess psychiatric disorder. A principal components analysis provided some evidence for chronic fatigue being separable from general psychosocial morbidity but not from the tendency to have other somatic complaints. Past psychiatric history and psychological distress at the time of the viral illness were risk factors for psychiatric 'caseness' 6 months later, while presence of fatigue, psychologising attributional style and sick certification were significant risk factors for CFS. These findings extend a previous questionnaire study of predictors of chronic 'post-viral' fatigue.

Adaptation, Psychological↗
PubMed1996

Bullous scabies.

Explore the source record for details and available documents.

Aged↗
PubMed1994

Predictors of chronic "postviral" fatigue.

We set out to determine the relation between a general practitioner (GP) diagnosis of viral illness and development of chronic fatigue 6 months later. 618 subjects who attended GPs clinics in London, south, and southwest England and who received a diagnosis of viral illness were followed prospectively and fatigue was assessed by questionnaire after 6 months. At presentation, GPs recorded fatigue in 62.6% of subjects, usually since the onset of symptoms. 502 (81.2%) subjects completed the 6-month questionnaire, of whom 88 (17.5%) met criteria for chronic fatigue and 65 (12.9%) had no reported fatigue before the viral illness. Compared with a similar group of non-postviral GP attenders, the risk ratio for chronic fatigue in the present cohort was 1.45 (95% CI 1.14-2.04). Infective symptoms did not predict fatigue 6 months later. Psychiatric morbidity, belief in vulnerability to viruses, and attributional style at initial presentation were all associated with self-designated postviral fatigue. Logistic regression showed that somatic attributional style, less definite diagnosis by the GP, and sick certification were the only significant predictors of chronic fatigue after viral infection when other factors were controlled for. Chronic severe fatigue 6 months after GP-diagnosed viral illness is related to symptom-attributional style and doctor behaviour, rather than to features of the viral illness. Some subjects with apparent postviral fatigue had complained of tiredness before their presentation with a viral illness.

Adult↗
PubMed1994

[Epidemiologic study of chronic fatigue in primary care (general practice)].

The results of a cross sectional study of fatigue in two large samples of patients attending primary care physicians are reported. The level of complaint of fatigue was higher in the prospective sample, which consisted of patients who had been diagnosed as suffering from a viral infection six months earlier. Duration and frequency of experience of fatigue correlated with severity in both samples. Severity, duration and frequency were continuously distributed in these populations. Attribution of fatigue in these two samples was mixed: social stresses, current physical illness and psychological problems all being offered as explanations. 11% of the cross sectional sample and 17% of the prospective sample met study operational criteria for a possible chronic fatigue state. These patients were assessed in greater detail. The majority had a diagnosable psychiatric disorder, predominantly depression. Physical illnesses were not adequate to explain these fatigue states. These studies in primary care do not support a clinical entity of a "chronic fatigue syndrome". Some patients in primary care settings have complaints of fatigue that are both disabling and long lasting, but they do not form a distinct group although the majority are likely however to be suffering from a concurrent psychiatric disorder. In contrast to similar patients with chronic fatigue syndromes attending hospital clinics, primary care patients with complaints of fatigue are much more varied in their ideas of causation with considerable less evidence of disease conviction.

Adult↗
PubMed1990

Tired, weak, or in need of rest: fatigue among general practice attenders.

OBJECTIVES: To determine the prevalence and associations of symptoms of fatigue. DESIGN: Questionnaire survey. SETTING: London general practice. PARTICIPANTS: 611 General practice attenders. MAIN OUTCOME MEASURES: Scores on a fatigue questionnaire and reasons given for fatigue. RESULTS: 10.2% Of men (17/167) and 10.6% of women (47/444) had substantial fatigue for one month or more. Age, occupation, and marital status exerted minor effects. Subjects attributed fatigue equally to physical and non-physical causes. Physical ill health, including viral infection, was associated with more severe fatigue. Women rather than men blamed family responsibilities for their fatigue. The profile of persistent fatigue did not differ from that of short duration. Only one person met criteria for the chronic fatigue syndrome. CONCLUSIONS: Fatigue is a common complaint among general practice attenders and can be severe. Patients may attribute this to physical, psychological, and social stress.

Adult↗