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PubMed1987

The determination of trace metals in sweat by anodic stripping voltammetry.

Sweating was induced on the forearm of subjects by pilocarpine iontophoresis, and the sweat collected on a small membrane filter. Zinc, cadmium, lead and copper were then determined in the filter by anodic stripping voltammetry (ASV) using one of two alternative techniques: leaching the filter with a supporting electrolyte (0.1 M NaNO3/0.002 M HNO3), followed by ASV of the leachate; or, direct ASV analysis of the trace metals in the membrane filter using a novel thin-layer cell. Average values found for zinc, cadmium, lead and copper in sweat from males were (micrograms 1-1): 720, less than 3, 15 and 80, respectively. Copper in sweat from females was lower (23 micrograms l-1) than for males, although use of oral contraceptives appeared to increase copper concentration.

Electrochemistry↗
PubMed2006

A survey of newborn screening for cystic fibrosis in Europe.

BACKGROUND: Cystic fibrosis (CF) is a recessively inherited condition caused by mutation of the CFTR gene. Newborn infants with CF have raised levels of immuno-reactive trypsinogen (IRT) in their serum. Measurement of IRT in the first week of life has enabled CF to be incorporated into existing newborn screening (NBS) blood spot protocols. However, IRT is not a specific test for CF and NBS therefore requires a further tier of tests to avoid unnecessary referral for diagnostic testing. Following identification of the CFTR gene, DNA analysis for common CF-associated mutations has been increasingly used as a second tier test. The aim of this study was to survey the current practice of CF NBS programmes in Europe. METHOD: A questionnaire was sent to 26 regional and national CF NBS programmes in Europe. RESULTS: All programmes responded. The programmes varied in number of infants screened and in the protocols employed, ranging from sweat testing all infants with a raised first IRT to protocols with up to four tiers of testing. Three different assays for IRT were used; in the majority (24) this was a commercially available kit (Delfia). A number of programmes employed a second IRT measurement in the 4th week of life (as the IRT is more specific at this point). Nineteen programmes used DNA analysis for common CFTR mutations on samples with a raised first IRT. Three programmes used a second IRT measurement on infants with just one recognised mutation to reduce the number of infants referred for sweat testing. Referral to clinical services was prompt and diagnosis was confirmed by sweat testing, even in infants with two recognised mutations in most programmes. Subsequent clinical pathways were less uniform. Multivariate analysis demonstrated a relationship between the age of diagnosis and the timing of the first IRT. More sweat tests were undertaken if the first IRT was earlier and the diagnosis was later. CONCLUSIONS: Annually these programmes screen approximately 1,600,000 newborns for CF and over 400 affected infants are recognised. The findings of this survey will guide the development of European evidence based guidelines and may help new regions or nations in the development and implementation of NBS for cystic fibrosis.

Cystic Fibrosis↗
PubMed1999

Effects of treadmill exercise on sweating in three breeds of goats.

OBJECTIVE: To compare the sweating responses of three breeds of goats to exercise at 30 degrees C. DESIGN: Factorial experiment with two goats of each of three breeds exercised for 60 min at 3 km/h and 30 degrees C on 6 days. PROCEDURE: Two mature females of the Anglo-Nubian, Saanen and Toggenburg breeds were used. Rectal temperature, respiration rate and sweating rate at three sites were recorded every 20 min during six replicates of exercise at 48 h intervals on a treadmill. RESULTS: Respiration rate varied with time and breed (P < 0.01) and increased from 20 +/- 2 breaths/min to 135, 195 and 260/min after 60 min exercise in Anglo-Nubian, Saanen and Tottenburg goats, respectively. Bread differences in rectal temperature were small but significant (P < 0.001), and mean values increased from 38.9 degrees C before exercise to 39.7 degrees C after 1 h exercise. The breed x sites interaction for sweating was significant (P < 0.01). On the rump breed differences in sweating rate were not significant. On the loin, Toggenburg goats started to sweat most rapidly and reached maximal values of 80.2 +/- 10.6 g/m2/h after 20 min and then decreased to 70.0 +/- 4.3 g/m2/h at 60 min. Sweating rate on the ear was highest in Toggenburg goats, followed by those of Saanen and Anglo-Nubian goats (P < 0.05), but the differences were small (7 g/m2/h); peak values of 67.3 to 76.1 g/m2/h were recorded after 20 min. CONCLUSION: Respiration and sweating rates increased significantly during exercise in all three breeds of goats, but breed differences were marked only for respiration rate. The goats sweated more on the rump than on the loin on ear, with peak values after 40 min of exercise.

Analysis of Variance↗
PubMedDate not supplied

Treatment of palmar hyperhidrosis using needlescopic T2 sympathetic block by clipping: analysis of 102 cases.

Endoscopic thoracic sympathicotomy, or sympathectomy by a 2-mm scope, is an effective method for treating palmar hyperhidrosis. However, postoperative compensatory sweating may be troublesome in some patients. We report needlescopic T2 sympathetic block by clipping, which may provide reverse operation for patients encountering compensatory sweating. Between January 1998 and January 2002, a total of 102 patients with palmar hyperhidrosis underwent video-assisted thoracoscopic sympathetic blocking of the T2 ganglion. There were 47 males and 55 females (mean age, 24.1 years; range, 9-50 years). All patients were placed in a semi-sitting position under single-lumen intubated anesthesia. We performed T2 sympathetic block by clipping at the second and third intercostal spaces using a 2-mm, 0 degrees thoracoscope. Among these 102 patients, all bilateral T2 sympathetic blockings were achieved. The operation was usually accomplished within 30 minutes (range, 16-40 minutes). All patients were discharged within 4 hours after the operation. There were no surgical complications or surgical mortality cases. The mean postoperative follow-up period was 37.1 months (range, 16-64 months). Improvement of palmar hyperhidrosis can be obtained in all patients. Eighty-six patients (84%) have developed compensatory sweating of the trunk and lower limbs. Two patients had a reverse operation and had improvement of compensatory sweating at 2 and 13 days after removal of endo clips. Needlescopic T2 sympathetic block by clipping is a safe and effective method for treating palmar hyperhidrosis; compensatory sweating may be improved after reverse operation removal of endo clip.

Adolescent↗
PubMed2005

Autonomic features in cluster headache. Exploratory factor analysis.

The objective is to identify the pathogenesis of each autonomic manifestation in cluster headache (CH). Through a deductive statistics method (factor analysis) we analysed the type of autonomic symptoms reported by 157 CH patients. Three principal components were identified in the analysis: parasympathetic activation (lacrimation, conjunctival injection and rhinorrhoea), sympathetic defect (miosis and ptosis) and parasympathetic mediated effect (nasal congestion, eyelid oedema and forehead sweating). This work suggests that there are three different mechanisms underlying autonomic manifestations in CH.

Adult↗
PubMed2002

Effects of modafinil on heat thermoregulatory responses in humans at rest.

The effects of modafinil on heat thermoregulatory responses were studied in 10 male subjects submitted to a sweating test after taking 200 mg of modafinil or placebo. Sweating tests were performed in a hot climatic chamber (45 degrees C, relative humidity <15%, wind speed = 0.8 m x s(-1), duration 1.5 h). Body temperatures (rectal (Tre) and 10 skin temperatures (Tsk)), sweat rate, and metabolic heat production (M) were studied as well as heart rate (HR). Results showed that modafinil induced at the end of the sweating test higher body temperatures increases (0.50 +/- 0.04 versus 0.24 +/- 0.05 degrees C (P < 0.01) for deltaTre and 3.64 +/- 0.16 versus 3.32 +/- 0.16 degrees C (P < 0.05) for deltaTsk (mean skin temperature)) and a decrease in sweating rate throughout the heat exposure (P < 0.05) without change in M, leading to a higher body heat storage (P < 0.05). AHR was also increased, especially at the end of the sweating test (17.95 +/- 1.49 versus 12.52 +/- 1.24 beats/min (P < 0.01)). In conclusion, modafinil induced a slight hyperthermic effect during passive dry heat exposure related to a lower sweat rate, probably by its action on the central nervous system, and this could impair heat tolerance.

Adult↗
PubMedDate not supplied

A missed cystic fibrosis diagnosis in childhood.

We describe a suggestive case of cystic fibrosis (CF) with a CF transmembrane conductance regulator (CFTR) mutation compatible with survival in which the diagnosis was missed in childhood. A 46-year-old man presented to our pediatric hospital with infertility and chronic cough, which had been present since 7 years of age. History was notable for high transaminase levels, hepatic steatosis sinusitis, chronic bronchitis, and duodenal inflammation. A sweat test was performed in duplicate and revealed a near-abnormal chloride level for adult age (77 mEq/L; normal value < 72 mEq/L). Significant findings of chronic bronchitis and bronchiectasis were found on x-ray film. A culture of sputum was positive for Pseudomonas aeruginosa. Spirometry showed a severe airflow limitation (FEV, 40%, and FVC, 61% of the predicted). CFTR mutation analysis showed the presence of homozygous 3849+10kbct mutation. Among CFTR mutations, 3849+ 10kbC>T has been reported frequently in adult patients with normal sweat tests and may cause a late diagnosis of CF. We conclude that because the diagnosis of CF might be missed during childhood, the diagnosis of CF in adults should be considered by practitioners, in subjects with chronic respiratory, gastrointestinal, and hepatic complaints.

Cystic Fibrosis↗
PubMed2001

Clinical, immunologic, and pathologic correlates of bone marrow involvement in 291 patients with acquired immunodeficiency syndrome-related lymphoma.

Bone marrow involvement is reported in approximately 25% of patients with newly diagnosed acquired immunodeficiency syndrome-related lymphoma (ARL). Studied were 291 patients with ARL, diagnosed and treated at one medical center between 1984 and 1998. Clinical, immunologic, and pathologic characteristics of patients with bone marrow involvement were compared with those of patients without marrow involvement. Bone marrow involvement was present in 55 patients (19%). Small noncleaved lymphoma was diagnosed in 38% of the entire group and was the most common pathologic subtype in patients with bone marrow involvement (55% versus 34%; P =.008). Analysis of complete blood counts revealed a median hemoglobin level of 10.6 g/dL in both marrow-positive and marrow-negative groups. In contrast, a platelet count lower than 100 000/microL was more common in patients with bone marrow involvement (27% versus 11%; P =.02). Patients with marrow involvement were more likely to have leptomeningeal (cerebrospinal fluid [CSF]) lymphoma than patients whose marrows were uninvolved (24% versus 7%; P <.001) and were also more likely to have high lactate dehydrogenase (LDH) (P =.002), bone involvement (P <.001), and/or systemic B symptoms including fever, night sweats, and/or weight loss (P =.05). Median survival did not differ between marrow-positive and marrow-negative groups. On multivariate analysis, factors associated with decreased survival of marrow-positive patients included greater than 50% involvement (P =.002), systemic B symptoms (P =.008), and high-grade histologic type (P =.035). Marrow involvement in ARL correlates with small noncleaved pathology, thrombocytopenia lower than 100 000 mm(3), high LDH, and lymphomatous involvement of the CSF. Survival is statistically shorter in patients with greater than 50% marrow involvement, high-grade pathology, and/or systemic B symptoms.

Adult↗
PubMed1999

Hyperhidrosis and sympathetic skin response in chronic alcoholic patients.

Palmoplantar hyperhidrosis is frequently observed in patients with a clinical history of chronic abnormal alcoholic intake. It can be related to peripheral or central mechanisms such as abnormal spontaneous activity in peripheral damaged fibres; receptor hypersensitivity; compensatory incremented activity in segmentary anhidrosis; or impairment of central sweat control. With the aim of quantifying this phenomenon and of identifying its possible origin, sympathetic skin response (SSR) analysis was performed in 20 chronic alcoholic patients with clinical diffuse acral hyperhidrosis, compared with 30 normal subjects and 2 patients affected by primary palmoplantar hyperhidrosis (PPH). SSRs were recorded by disc electrodes place on the hands and feet, simultaneously. At the hand level two recording sites were selected: palm-dorsum proximally and ventral-dorsal tip of the third finger distally. Attention was paid to the number of SSR after a single endogenous or exogenous stimulus. The alcoholic patients were divided into two groups, with and without mild polyneuropathy. Both patient groups showed synchronous SSR at recording sites, with the same pattern and the normal delay between upper and lower arms. In the control group one response was generally related to a single stimulus; if more responses were elicited an evident adaptation was shown; in the two groups of patients an increase of the waves was observed in all the recording sites without any adaptation. The SSR profile described in alcoholic patients was observed also in PPH. The pattern of SSR waves in alcoholic patients seems to suggest a possible central origin of this type of hyperhidrosis.

Adolescent↗
PubMedDate not supplied

Prospective evaluation of the efficacy of dermal botulinium toxin for primary axillary hyperhidrosis.

BACKGROUND: Primary axillary hyperhidrosis (PAH) is an embarassing, socially disabling condition, most commonly seen in young people. Previous treatments for this condition have included sympathectomy or axillary skin excision. Recently botulinum toxin has been used to provide effective, non-invasive treatment for this condition. AIMS: To investigate the effect of botulinum toxin injection in patients with PAH on sweat production and psychological wellbeing. METHODS: Ten patients were assessed before treatment with botulinum toxin injection using gravimetric analysis and a psychometric questionnaire. Patients were reassessed at intervals of one, four and twelve weeks following treatment. RESULTS: Injection with botulinum toxin resulted in significant improvement in patients physical symptoms and psychological wellbeing. However, improvement was short-lived with recurrence of symptoms at three months. CONCLUSION: Botulinum toxin injection provides very effective short-term relief of PAH. While its limitations should be recognised and explained when consenting patients for treatment, this does not necessarily diminish its value in the treatment of PAH.

Axilla↗
PubMed2003

The impact of cystic fibrosis on neonatal intestinal obstruction: the need for prenatal/neonatal screening.

To determine the incidence of cystic fibrosis (CF) in neonates with intestinal obstruction (NIO) secondary to meconium ileus (MI), jejunoileal atresia (JA), meconium plug syndrome (MPS), volvulus (V), and meconium peritonitis (MP) and analyze the correlation of ultrasonographic (US) signs with CF in NIO with a prenatal diagnosis of intestinal anomaly, a prospective analysis of different types of NIO from 1990 to 1998 was undertaken. Immunoreactive trypsin measurement, genetic studies, and sweat tests were performed to confirm or rule out CF. Cases with prenatal diagnosis were analyzed for gestational age, dilated bowel, ascites, hyperechoic bowel, and calcifications. Of 80 neonates, 19 (24%) had CF: 2/33 (6%) JA, 6/14 (43%) MPS, 1/14 (7.1%) MP, 10/10 (100%) MI, and 0/9 V. Thirty (37.5%) had a prenatal diagnosis of an intestinal anomaly. The overall incidence of CF in NIO with a prenatal diagnosis of intestinal anomaly was 4/30 (13%), or 333 times the estimated risk of CF in the general population. A hyperechoic pattern with dilated bowel was associated with higher specificity for CF: 3/3 cases (100%), followed by hyperechoic bowel with ascites: 3/4 cases (75%). All babies with any type of NIO should thus be screened for CF. Prenatal screening for CF should be indicated in all pregnancies with US patterns of specific intestinal disorders.

Cystic Fibrosis↗
PubMed2005

Public response to chest pain in Jordan.

BACKGROUND: Chest pain is one of the main and most frequent manifestations of myocardial infarction (MI). Increased level of public awareness on the optimal response to chest pain due to MI attacks is crucial for minimizing its complications and mortality rate. AIMS: The first aim of this investigation was to assess the level of public awareness on their response to acute chest pain. The second aim was to obtain information about self-reported risk factors for coronary heart disease and acute myocardial infarction. SETTINGS AND DESIGN: This survey was conducted in various regions of Jordan during the period of July-September 2004. A total of 4194 adults (out of 4500), 2086 males (49.7%) and 2108 females (50.3%) resident in Jordan were included in the sample. The response rate was 92.3%. METHODS: Each individual of the sample who agreed voluntarily to participate in the investigation was asked to report in a questionnaire his/her possible risk factors for MI. Moreover, each person of the sample was asked "What do you do when you suffer from a severe and crushing chest pain that persists for longer than 15 min and radiates to jaws, neck or left shoulder, with sweating and paleness of the face?" The person was asked to choose one option out of 11. STATISTICAL ANALYSIS: The frequency and percentage were determined for each investigated parameter. RESULTS AND CONCLUSION: The highest percentage of respondents had good response by selecting the option "I go to a doctor" while the lowest percentage of respondents showed poor response by choosing the option "I use an antacid". The remainder of responses was distributed among other options. Excellent awareness was reported by 47% of the sample. Differences in the type of responses were detected when the results were analyzed according to gender, type of job, level of education and ethnicity. Approximately half of the interviewed individuals of the sample had 2-4 clustering risk factors for developing acute MI attacks. Individuals in more than half of the sample had family history of hypertension and diabetes mellitus. It is concluded that although the type of response to chest pain in Jordan is good-excellent, more improvement is recommended since the risk to MI is relatively high. Community education campaigns may participate in increasing public health education on the optimal response to chest pain of myocardial origin.

Acute Disease↗
PubMed2002

Self-reported organic and nonorganic sleep problems in schoolchildren aged 11 to 15 years in Vienna.

PURPOSE: To estimate the prevalence of self-reported sleep problems, to examine associations among demographic characteristics, familial factors, and sleep problems, and to investigate the association between the symptoms of obstructive sleep apnea (OSA) and nonorganic sleep disorders. METHODS: An anonymous questionnaire with 22 questions was designed. 332 schoolchildren (aged 11-15 years, mean age 12 years and 9 months; median, 12 years; 56% female, 44% male) from two high schools in Vienna were investigated with regard to self-reported symptoms characteristic for obstructive sleep apnea and for parasomnia/insomnia. Data were analyzed by definition of three groups (problem, occasional problem, and nonproblem sleepers, and by calculation of an insomnia/parasomnia sum score). Statistical analysis included nonparametric tests (Mann Whitney-U and Kruskal), Pearson correlation test, and multiple regression analysis. RESULTS: Twelve percent reported at least one sleep problem every night, 76% reported occasional sleep problems, and 12% had no sleep problems. Girls were affected more frequently than boys (p <.01). Children with sleep problems suffered more often from concentration difficulties (p <.05), daytime fatigue (p <.001), and daytime naps (p <.05). Children who snored had nightmares (10% vs. 2%, p <.01), night terrors (4% vs. 1.5%, p <.001), sleepwalking (1.4% vs. 1%, p <.05), and nocturnal awakening (16% vs. 5%, p <.01) more frequently. On multiple regression analysis, 23% of the variability of a defined parasomnia/insomnia sum score had the characteristic OSA symptoms of nocturnal sweating, dryness of the mouth, snoring, hyperactivity, and daytime fatigue. CONCLUSION: 12% of schoolchildren aged 11-15 years reported sleep problems almost every night. The children suffer from daytime fatigue, naps, and concentration difficulties. Nearly one-fourth of the symptoms of parasomnia/insomnia were associated with characteristic signs of OSA, suggesting the importance of a routine clinical investigation in children with so-called nonorganic sleep disorders.

Adolescent↗
PubMed1980

Prenatal diagnosis of harlequin ichthyosis.

We report the successful prenatal diagnosis of ichthyosis in the fetus of a woman whose previous liveborn child was affected with "harlequin ichthyosis". The fetal diagnosis was established through analysis of ultrasonographically guided fetoscopic skin biopsies. These biopsies showed premature hyperkeratosis, most marked around hair follicles and sweat ducts, and forming plugs of hyperkeratotic debris. These observations were in distinct contrast to those in control fetuses, whose epidermis consists of squamous epithelium only a few cells in depth with minimal keratinization.

Adult↗
PubMed2006

Report of a Korean patient with cystic fibrosis, carrying Q98R and Q220X mutations in the CFTR gene.

Although cystic fibrosis (CF) is one of the most frequently seen autosomal-recessive disorders in Caucasians, it is extremely rare in the Korean population. Recently, a 15-yr-old Korean boy was admitted to our hospital complaining of coughing, sputum, and exertional dyspnea. Chest radiographs and computed tomographic chest and paranasal sinus scans revealed diffuse bronchiectasis and pansinusitis. Pulmonary function tests revealed severe obstructive impairment. The average sweat chloride concentrations on both of the patients' forearms were 63.0 mM/L (reference limit: < 40 mM/L). Upon mutation analysis, two different mutations (Q98R and Q220X) were identified in the cystic fibrosis transmembrane conductance regulator gene, both of which had been previously detected in CF patients, one from France and the other from England. As CF is quite rare in Korea, the diagnosis of CF in this patient might be delayed. Therefore, we recommend that a diagnosis of CF should be suspected in patients exhibiting unexplained chronic respiratory symptoms.

Adolescent↗
PubMed1993

[Presence and localization of proteins immunologically related to membrane skeletal proteins in human skin].

Recent biochemical studies have shown that spectrin, protein 4.1, and actin form a skeletal protein network that underlines the inner surface of the erythrocyte membrane. The skeleton is a flexible structure that appears to be important in maintaining the shape and mechanical properties of the erythrocyte. Recent studies indicate that immunoanalogues of erythrocyte membrane skeletal proteins and ankyrin (protein 2.1) have been found in a wide variety of non-erythroid tissues. In the present study, in order to examine if human skin contains membrane skeletal proteins, immunochemical analysis was utilized using antibodies against anti-spectrin, anti-beta-fodrin (non-erythroid spectrin), anti-protein 4.1 and anti-ankyrin antibodies. Immunoblot analysis of human epidermis with anti-spectrin and anti-beta-fodrin antibodies revealed that human epidermis contains 240 kDa and 235 kDa spectrin-like proteins, which might be identical to brain fodrin. Human epidermis also contains 4.1-like proteins of 80 kDa and 78 kDa that cross react with anti-protein 4.1 antibodies, and contains ankyrin-like proteins of 210 kDa that cross react with anti-ankyrin antibodies. Analysis with immunofluorescence microscopy revealed that these antibodies reacted along the plasma membranes of human epidermal keratinocytes, eccrine sweat gland cells and sweat ductal cells. These results suggest that a membrane skeletal protein lattice might exist in these cells. Cultured human epidermal keratinocyte in the low Ca2+ medium (0.15 mM) showed that immunoreactive form of protein 4.1 and actin were present diffusely in the cytoplasm. When the cells were cultured with standardized Ca2+ medium (1.85 mM), protein 4.1 and actin were observed linearly along the cell margin and in the cytoplasm. Similar patterns of distribution were observed when anti-beta-fodrin antibody was used. Movement of membrane skeletal proteins from cytosol to the membrane suggest that these proteins or membrane skeletal lattice might play an important role in the formation of intercellular junctions.

Calcium↗