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Biomedical subjects

G B Jemec

Publications and source records attributed to G B Jemec.

At least 19 recordsLinked to original sources
PubMed2001

Impact factors of dermatological journals for 1991 - 2000.

BACKGROUND: The impact factors of scientific journals are interesting but not unproblematic. It is speculated that the number of journals in which citations can be made correlates with the impact factors in any given speciality. METHODS: Using the Journal Citation Report (JCR) for 1997, a bibliometric analysis was made to assess the correlation between the number of journals available in different fields of clinical medicine and the top impact factor. A detailed study was made of dermatological journals listed in the JCR 1991-2000, to assess the relevance of this general survey. RESULTS: Using the 1997 JCR definitions of speciality journals, a significant linear correlation was found between the number of journals in a given field and the top impact factor of that field (rs = 0.612, p < 0.05). Studying the trend for dermatological journals 1991 to 2000 a similar pattern was found. Significant correlations were also found between total number of journals and mean impact factor (rs = 0.793, p = 0.006), between the total number of journals and the top impact factor (rs = 0.759, p = 0.011) and between the mean and the top impact factor (rs = 0.827, p = 0.003). CONCLUSIONS: The observations suggest that the number of journals available predict the top impact factor. For dermatology journals the top and the mean impact factor are predicted. This is in good agreement with theoretical expectations as more journals make more print-space available for more papers containing citations. It is suggested that new journals in dermatology should be encouraged, as this will most likely increase the impact factor of dermatological journals generally.

Bibliometrics↗
PubMed2001

Measurement of the mechanical properties of skin with ballistometer and suction cup.

BACKGROUND: There is no consensus on the methodology for describing the mechanical properties of human skin in vivo. Current descriptions are generally method dependent. METHOD: The mechanical properties of palmar skin of the hypothenar as well as dorsal and ventral forearm skin were studied in 17 healthy volunteers. Two methods were used: ballistometry [Dia-stron Torsional Ballistometer (Diastron Ltd., Andover, UK)] and suction cup [The Dermaflex machine (Cortex Technology, Hadsund, Denmark)]. RESULTS: A moderate degree of correlation was found between the methods (rs=0.315-0.540), while internal correlation between different measures obtained with one method was higher (rs=0.375-0.967). The suction cup method parameters (distensibility and elasticity) correlated significantly with the ballistometry parameters (indentation, alpha, area and coefficient of restitution), while the hysteresis did not correlate to ballistometry parameters. The coefficient of variation of both methods (CV=0.02-0.35) was within the range obtained with other non-invasive methods, e.g., TEWL. Regional differences were identified with both methods, while only the suction cup method identified age-related changes. CONCLUSIONS: The results suggest that while both methods may be useful, they describe related but not identical aspects of skin mechanics. The differences in measuring principle suggest that the suction cup method predominantly measures elasticity, while the ballistometer predominantly appears to measure stiffness. Hysteresis may be a unique measure of skin viscosity. Additional studies, however, are needed to specify the clinical significance of the various measures of skin mechanics.

Biomechanical Phenomena↗
PubMed2001

Morbidity in patients with hidradenitis suppurativa.

BACKGROUND: Although skin diseases are often immediately visible to both patients and society, the morbidity they cause is only poorly defined. It has been suggested that quality-of-life measures may be a relevant surrogate measure of skin disease. Hidradenitis suppurativa (HS) leads to painful eruptions and malodorous discharge and is assumed to cause a significant degree of morbidity. The resulting impairment of life quality has not previously been quantitatively assessed, although such an assessment may form a pertinent measure of disease severity in HS. OBJECTIVES: To measure the impairment of life quality in patients with HS. METHODS: In total, 160 patients suffering from HS were approached. The following data were gathered: quality-of-life data (Dermatology Life Quality Index, DLQI questionnaire), basic demographic data, age at onset of the condition and the average number of painful lesions per month. RESULTS: One hundred and fourteen patients participated in the study. The mean +/- SD age of the patients was 40.9 +/- 11.7 years, the mean +/- SD age at onset 21.8 +/- 9.9 years and the mean +/- SD duration of the disease 18.8 +/- 11.4 years. Patients had a mean +/- SD DLQI score of 8.9 +/- 8.3 points. The highest mean score out of the 10 DLQI questions was recorded for question 1, which measures the level of pain, soreness, stinging or itching (mean 1.55 points, median 2 points). Patients experienced a mean of 5.1 lesions per month. CONCLUSIONS: HS causes a high degree of morbidity, with the highest scores obtained for the level of pain caused by the disease. The mean DLQI score for HS was higher than for previously studied skin diseases, and correlated with disease intensity as expressed by lesions per month. This suggests that the DLQI may be a relevant outcome measure in future therapeutic trials in HS.

Adult↗
PubMed2001

Anxiety level and severity of skin condition predicts outcome of psychotherapy in atopic dermatitis patients.

BACKGROUND: Atopic dermatitis (AD) is a skin disease associated with an increased anxiety level. Psychotherapy studies of AD patients report improvement in anxiety level and skin condition after psychotherapy. METHODS: This psychotherapy study investigated 32 adult AD patients with mild to severe AD. Sixteen participants received 6 months of brief dynamic psychotherapy, while 16 were controls. The participants were compared using Spielberger's State-Trait Anxiety Index (STAI) and Severity Scoring of Atopic Dermatitis Index (SCORAD) pre- and post-therapy, and at follow-up after 12 months. RESULTS: Initially, no outcome differences were found between the two groups; however, a post hoc multiple regression analysis indicated that AD patients with a higher intake level of trait anxiety (TA) showed greater improvement after psychotherapy, in terms of anxiety level and skin condition, than did AD patients with a low intake level of TA. Atopic dermatitis patients with a higher anxiety level, in the no-treatment group, were more likely to discontinue the program. CONCLUSIONS: The results suggest that AD patients with a higher anxiety level are more likely to improve their psychologic and dermatologic condition after psychotherapy, but are more vulnerable to nonadherence when no adequate psychologic treatment is offered. The results underscore the importance of proper psychologic assessment and treatment in addition to dermatologic treatment.

Adult↗
PubMed2001

Skin irritation and exposure to diisocyanates in orthopedic nurses working with soft casts.

BACKGROUND: Diisocyanates are widely used in industry, for example at hospitals as a constituent of Scotch Cast soft casts (3M, Glostrup, Denmark). They are a cause of occupational asthma and have been described as causing cutaneous problems both as irritants and as sensitizers. OBJECTIVE: The sensitizing potential of diisocyanates has previously only sporadically been described, predominantly in case reports. Therefore, we conducted this study to investigate eventual work-related skin sensitization to diisocyanates in a regularly exposed population. METHODS: The nursing staff of an orthopaedic outpatient clinic, consisting of 10 persons, were interviewed and subjected to patch testing using 5 types of diisocyanates and the TRUE Test (ECDRG Standard Series) to elucidate possible other type IV allergies with similar symptoms. Patch test results were evaluated according to the guidelines of the International Contact Dermatitis Group. RESULTS: We found no relationship between exposure time and severity of symptoms. Symptoms were mild, consisting of redness, itching, or both, lasting about 30 minutes. There was no suggestion that they result in any chronic skin problems. One nurse presented a doubtful reaction towards diaminophenylmethane (MDA) and isophorene diisocyanate (IPDI). Nine persons had no reactions to the 5 diisocyanates used in the patch test. Positive reactions were seen to nickel (4/10), thiomersal (2/10), and perfume mix (1/10). CONCLUSION: Our observations suggest that diisocyanates are primarily irritants rather than sensitizers in the professional setting studied. The skin symptoms of irritation were all mild and temporary.

Adult↗
PubMed2001

Vasculitis occurring during leflunomide therapy.

Leflunomide has recently been introduced for systemic treatment of rheumatoid arthritis. It has both immunosuppressive effects and anti-inflammatory properties. We report a patient treated with leflunomide who developed vasculitis as an adverse side effect. As far as we are aware, this is the first published report of vasculitis associated with leflunomide therapy.

Arthritis, Rheumatoid↗
PubMed2001

Crohn's disease presenting as a breast abscess: a case report.

A case of cutaneous Crohn's disease (CD) involving the areola-nipple region of both breasts in a 45-year-old woman is reported. The lesion had initially been diagnosed and treated as a simple abscess. Histopathological examination, however, showed granulomatous inflammation with eosinophils suggesting extraintestinal CD. The patient also had a minor area of cutaneous CD localized at the umbilicus and severe anogenital lesions. Twenty-six years previously the woman had undergone a course of sulphasalazine treatment together with steroid enema for chronic inflammatory colitis, but the colitis had been inactive for 25 years. Treatment with sulphasalazine, metronidazole, prednisolone and azothioprine had only minor effect on the skin lesions. CD is a systemic disorder and the most prominent manifestations may be extraintestinal.

Abscess↗
PubMed2000

[Treatment of acne].

Acne vulgaris is one of the world's most common diseases, and although most patients only experience mild disease there is often demand for therapy. Therapy can be initiated due to objective changes, risk of scarring and self-perceived need of treatment in the patient. The development of isotretinoin has made it possible to control even the most severe degrees of acne. The substance however has a documented potential for teratogenicity which limits its general use. There are however a number of other effective treatments available in clinical practice. Treatment may be topical or systemic, but in most cases the patients will benefit from a combination therapy aimed at different pathogenic steps in the development of acne. Standard treatments and combinations may be suggested based on the primary effects of different drugs.

Acne Vulgaris↗
PubMed2000

[Acne neonatorum/acne infantum].

Acne is generally considered to be a disease of adolescence. However 20% of newborns have acne neonatorum, which may to be overlooked because it is usually mild and transient. Acne can also be seen in infants and children, where the skin lesions are normally more severe. We describe a case of a ten-month-old boy with severe acne without other underlying diseases. Treatment with systemic erythromycin and local application with isotretinoin gel was moderately successful, but the eruption cleared when treated with isotretinoin 0.5 mg/kg.

Acne Vulgaris↗
PubMed2000

[Evidence-based ambulatory dermatological treatment].

The evidence base for routine therapeutic decisions in dermatological out-patients was studied in a random sample of the case-notes from 115 out-patients. The evidence base of therapy prescribed when the diagnosis was ascertained was studied in literature searches in MEDLINE and EMBASE. Evidence was structured into primary evidence consisting of randomised controlled trials, and secondary evidence consisting of follow-up studies or applying trial results from clinical analogies, e.g. atopic and seborrheic dermatitis treatment. Randomised controlled trials could be found describing 38% (95% confidence interval: 30-47) of all treatments. Secondary evidence was found for 33% (24-41), while no evidence was found for 23% (16-31) of the given treatments. Approximately 75% of dermatological out-patient therapy is founded on scientific evidence spanning from randomised controlled trials to logical deduction about a given disease from an analogous clinical situation. The proportion of evidence based medicine in dermatological therapy therefore appears comparable to that of other fields of medicine.

Adolescent↗
PubMed2000

Treatment of perforating collagenosis of diabetes and renal failure with allopurinol.

We present a case of widespread reactive perforating collagenosis in a 63-year-old woman undergoing haemodialysis after diabetic nephropathy, who was treated successfully with allopurinol. The patient responded well and rapidly to a dose of 100 mg allopurinol daily. It is suggested that more patients with reactive perforating collagenosis may benefit from allopurinol therapy.

Allopurinol↗
PubMed2000

Ultrasound in dermatology. Part I. High frequency ultrasound.

This paper addresses the basic terminology of modern ultrasound equipment for the examination of the skin, the technical limitations of currently available equipment and the normal skin structure. Different applications for dermatosonography are discussed, and the paper summarises current knowledge about common sources of variation in the ultrasound image of the skin, such as skin tumours and selected skin diseases.

Skin↗
PubMed1999

Hydration of human nails investigated by NIR-FT-Raman spectroscopy.

The human nail, although it is usually stable against outer influences, becomes soft and flexible after soaking in water. Frequent washing increases brittleness of nails. Hydration of nails is thought to be the most important factor influencing the physical properties of nails and possibly acts through changes in keratin structure. Here NIR-FT-Raman has been used to examine molecular structural changes of intact moisten nails. Raman spectra were obtained both in vitro from nail samples and in vivo before and after soaking in water. The water uptake of normal nail samples during the first 15 min was reflected in the increasing intensity ratio of the nu(OH)/nu(CH(2)) bands. A saturating effect appeared soon after 10 min which is explained by a defined water holding capacity. R(nu) representation of the low frequency range of the Raman spectra showed that mainly bound water is found both in dry and in wet nails. This implies water-protein interaction. Protein backbone vibration at 932 cm(-1) indicating alpha-helical proteins increased in intensity in the wet nails. The nu(S-S) which is sensitive to changes in conformation of proteins showed a 4% higher intensity. Additional protein-water interactions could lead to a slight change of the dihedral angle of the C-S-S-C bonds and to geometric changes in coiling behavior of the alpha-helical protein. Suggesting a separation between matrix proteins and fiber proteins giving them a greater freedom of flexibility. The in vivo spectra detected from the distal part of the nail resembled spectra in vitro. Raman spectra of the proximal part of the nail showed that it was fully saturated with water. The proximal part of the nail did not show changes in water content and protein structure during nail moisturizing in the Raman spectra. Our results suggest that the softening of the nail following hydration may be due to changed matrix protein molecular structure induced by water.

Humans↗
PubMed1999

Plasticising effect of water and glycerin on human skin in vivo.

Application of water and glycerin is known to influence skin mechanics. The kinetics of these processes are of great interest. A study was performed to show the immediate changes in skin-mechanics. A Dermaflex machine (R) was used to study 23 healthy volunteers. Water or glycerin was applied to the flexorside of the forearm, and readings were made after 3, 6, 9, 12 and 15 min. Regional untreated skin served as baseline. In agreement with earlier studies both substances influenced hysteresis. Water caused a significant increase in hysteresis after 12 and 15 min of hydration (P<0.01). Glycerin caused significantly increased hysteresis after 3 min (P<0.05) and the effect continued to the end of the observation period. No significant differences were seen in the distensibility. The onset of action is rapid for both substances, and the effects are therefore supposed to take place in the outermost layers of epidermis. The effect of glycerin on the hysteresis is more rapid in onset than that of water. Comparing the permeability coefficients, the effect on the mechanical properties of the skin does not appear to be determined by the permeability coefficients as water has a higher permeability coefficient but induces smaller changes than glycerin. Water alone does not appear to be the optimal plasticiser of human skin and other substances soluble in both water and lipids may have an even greater influence on skin mechanics in vivo.

Adult↗