Politics may color interpretations of facts, and thus perceptions of risk. We find that a higher share of Trump voters in a county is associated with lower perceptions of risk during the COVID-19 ...pandemic. Controlling for COVID-19 case counts and deaths, as Trump's vote share rises in the local area, individuals search less for information on the virus and its potential economic impacts, and engage in fewer visits to non-essential businesses. Our results suggest that politics and the media may play an important role in determining the formation of risk perceptions, and may therefore affect both economic and health-related reactions to unanticipated health crises.
Summary
A 65‐year‐old pluripathological woman attended our hospital with a cutaneous eruption of sudden appearance after vancomycin treatment. She presented targetoid lesions affecting approximately ...25–30% of her body surface, large erosions with mucosal lesions and positive Nikolsky sign. Under the initial clinical suspicion of toxic epidermal necrolysis (TEN), and considering the recent literature of successful use of etanercept in these cases, she was treated with a single dose of this antitumour necrosis factor (anti‐TNF) agent. Subsequently, the exanthema progression stopped and resolution of the lesions happened in a few days. Later on, histopathology revealed a subepidermal blister with dense neutrophilic infiltrate and linear deposits of immunoglobulin A (IgA) on the dermoepidermal junction, allowing us to establish the diagnosis of drug‐induced linear IgA dermatosis mimicking TEN. Linear IgA dermatosis can have severe clinical manifestations, even mimicking TEN, and can have high mortality, especially in drug‐induced cases. We have not found any other report of linear IgA dermatosis treated with etanercept in the English literature. Anti‐TNF medications could represent useful therapeutic alternatives in this dermatosis.
What's already known about this topic?
Linear IgA dermatosis is an autoimmune bullous dermatosis that can have multiple clinical presentations including a severe one that mimics toxic epidermal necrolysis.
Drug‐induced cases are frequently more serious.
Apart from drug suspension no medication has been proven to modify its natural course.
What does this study add?
We could not find any previous report of linear IgA dermatosis treated with etanercept.
We report a more rapid than expected improvement of this disease, which we believe was due to this therapy.
This could point to a more important role of tumour necrosis factor (TNF)‐α in this dermatosis.
Anti‐TNF agents could represent alternative therapies.
The objective of this study was to analyse the sun exposure habits of elite aquatics athletes, together with their sunburn history and skin examination habits, taking into account differences by sex ...and between sports. A cross-sectional health survey was conducted at world championship events during which elite surfers, windsurfers and Olympic sailors from 30 different countries were invited to participate. The athletes were asked to complete a self-administered questionnaire focused on sun protection habits, sun exposure and sports practices. The survey was completed by 240 athletes, 171 men (71.3%) and 69 women (28.8%), with a mean age of 22 years (SD 5.86) and skin phototypes I (6.3%), II (3.3%), III (22.0%), IV (32.5%), V (9.2%) and VI (1.7%). There were significant differences between male and female athletes in skin self-examination (
p
< 0.001) and in the use of sunglasses (
p
< 0.001). In sunburn history during the last season, there were significant differences (
p
< 0.001) among the three sports analysed, in both sexes. The mean rate of sunburn during the previous season was 76.7%, and 27.5% of participants reported having experienced three or more sunburns that lasted at least 1 day. This type of athlete is at high risk of sunburn and hence of future skin cancer. However, there is a general lack of awareness of this risk. This study highlights the need to inform such athletes and to raise awareness of the dangers, through educational interventions on the importance of protecting against sunburn in order to reduce the future incidence of skin cancer.
Objectives. To assess inflammatory serum markers including serum proinflammatory cytokines, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) according to the clinical inflammatory ...activity of patients with hidradenitis suppurativa (HS). Patients and Methods. Seventy-four patients with HS were studied based on the Hidradenitis Suppurativa-Physician Global Assessment (HS-PGA) score and Hurley staging system. Proinflammatory cytokines were measured using a multiplex cytokine assay. Twenty-two healthy volunteers were recruited. Results. Serum interleukin- (IL-) 6, IL-23, soluble tumour necrosis factor alpha (TNF-α) receptor I (sTNF-RI), CRP, and ESR were different in the patients with HS compared with those in the healthy controls (P<0.05). The levels of IL-1β, IL-6, IL-8, IL-10, IL-12p70, IL-17A, sTNF-RII, CRP, and ESR were significantly elevated according to inflammatory activity based on HS-PGA scores (r>0.25, P<0.05). The levels of IL-6 (r=0.53, P<0.001), CRP (r=0.54, P<0.001), and ESR (r=0.60, P<0.001) were especially well correlated with clinical inflammatory activity based on HS-PGA scores. The levels of IL-6, IL-8, sTNF-RI, sTNF-RII, CRP, and ESR were significantly elevated according to Hurley staging system. Conclusions. Serum proinflammatory cytokines, CRP, and ESR are increased in relation to the clinical inflammatory activity of patients with HS compared with healthy controls. Serum IL-6, CRP, and ESR are effective biomarkers for evaluating the severity of HS.
Nephropathia epidemica (NE), an emerging rodent-borne viral disease, has become the most important cause of infectious acute renal failure in Belgium, with sharp increases in incidence occurring for ...more than a decade. Bank voles are the rodent reservoir of the responsible hantavirus and are known to display cyclic population peaks. We tried to relate these peaks to the cyclic NE outbreaks observed since 1993. Our hypothesis was that the ecological causal connection was the staple food source for voles, being seeds of deciduous broad-leaf trees, commonly called "mast". We also examined whether past temperature and precipitation preceding "mast years" were statistically linked to these NE outbreaks.
Since 1993, each NE peak is immediately preceded by a mast year, resulting in significantly higher NE case numbers during these peaks (Spearman R = -0.82; P = 0.034). NE peaks are significantly related to warmer autumns the year before (R = 0.51; P < 0.001), hotter summers two years before (R = 0.32; P < 0.001), but also to colder (R = -0.25; P < 0.01) and more moist summers (R = 0.39; P < 0.001) three years before. Summer correlations were even more pronounced, when only July was singled out as the most representative summer month.
NE peaks in year 0 are induced by abundant mast formation in year-1, facilitating bank vole survival during winter, thus putting the local human population at risk from the spring onwards of year 0. This bank vole survival is further promoted by higher autumn temperatures in year-1, whereas mast formation itself is primed by higher summer temperatures in year-2. Both summer and autumn temperatures have been rising to significantly higher levels during recent years, explaining the virtually continuous epidemic state since 2005 of a zoonosis, considered rare until recently. Moreover, in 2007 a NE peak and an abundant mast formation occurred for the first time within the same year, thus forecasting yet another record NE incidence for 2008. We therefore predict that with the anticipated climate changes due to global warming, NE might become a highly endemic disease in Belgium and surrounding countries.
Purpose To identify and quantify the main concepts included in published studies focusing on individuals with schizophrenia using the International Classification of Functioning, Disability and ...Health (ICF). Methods Searches (limited to those published from 2008 to 2012) were performed in MEDLINE, PsycINFO and CINAHL. Included studies described participants with schizophrenia, were original articles and included only subjects who were at least 18 years of age at study entry. All concepts underlying the measures and the text of the articles were extracted, and they were linked to ICF categories using standardized rules. Results From the 3584 abstracts retrieved, 348 were randomly selected, and of these, 206 studies met the inclusion criteria. A total of 17,141 concepts were extracted, 84.8% of which could be linked to 491 ICF categories: 222 (45.21%) of the categories referred to Body Functions, 29 (5.91%) to Body Structures, 186 (37.88%) to Activities and Participation and 54 (11%) to Environmental Factors. Seventy second-level categories were reported in at least 5% of all studies: 30 of these categories referred to Body Functions, 2 to Body Structures, 34 to Activities and Participation and 4 to Environmental Factors. Conclusion The study has allowed us to identify and quantify the main concepts included in studies focusing on people with schizophrenia using the ICF. The majority of the concepts refer to Body Functions and Activities and Participation, rather than to Body Structures and Environmental Factors.
Schizophrenia is a chronic mental illness associated with several functional impairments. The International Classification of Functioning, Disability and Health (ICF) Core Sets for schizophrenia are ...shortlists of ICF categories that are relevant for describing the functioning and disability of people suffering from schizophrenia. The aims of this study were to explore the content validity of these Core Sets from the perspective of psychiatrists and to identify — from this perspective and using the ICF framework – the most common problems of patients with schizophrenia. In a three-round survey using the Delphi technique, psychiatrists experienced in schizophrenia treatment were asked about the problems they commonly encounter in these patients. A total of 352 psychiatrists from 63 countries representing all six WHO regions responded to the first-round questionnaire, and 303 completed all three rounds (86% response rate). From the first-round responses, 7133 concepts were extracted and linked to 387 ICF categories and 35 personal factors. Of these, consensus (≥75% agreement) was reached for 91 ICF categories and 31 personal factors. Eighty-seven of the 97 ICF categories that form the Comprehensive ICF Core Set for schizophrenia were represented in this list. Only four of the categories for which consensus was reached do not feature in the Comprehensive Core Set. From the perspective of psychiatrists the content validity of the ICF Core Sets for schizophrenia was largely supported. This suggests that these Core Sets offer an effective framework for describing functioning and disability in individuals with schizophrenia.
•Validity of the ICF-CS for schizophrenia from the perspective of psychiatrists was confirmed.•The ICF-CS for schizophrenia could be a highly useful tool in clinical psychiatry.•The ICF-CS may facilitate communication and coordination among health professionals.
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