Background
The use of photographs to diagnose and monitor skin diseases is gaining ground.
Objectives
To investigate the validity and reliability of photographic assessments of atopic dermatitis (AD) ...severity.
Methods
AD severity was evaluated in the clinic by two assessors using the Eczema Area and Severity Index (EASI), SCOring Atopic Dermatitis (SCORAD), and Investigator's Global Assessment (IGA). Participants photographed the lesions with their own smartphone and completed a questionnaire about the extent of eczema the same day from home. The photographs were assessed twice with an 8 weeks interval by five dermatologists experienced in photographic evaluations. Intraclass correlation coefficients (ICC) with 95% confidence interval (CI) were applied.
Results
Seventy‐nine participants were enrolled. The ICC between clinical EASI and photographic EASI was 0.88 (95% CI 0.81–0.93), and 0.86 (0.70–0.93) between clinical SCORAD and photographic SCORAD.
Perfect agreement between clinical IGA and photograph IGA was observed for 62%, with the difference between the two never deviating with more than 1 score.
The inter‐rater ICC for photographic EASI and photographic SCORAD, respectively, was 0.90 (0.85–0.94), and 0.96 (0.91–0.98). The intra‐rater agreements between the first and second assessments varied from 0.95 to 0.98 for photographic EASI, and from 0.86 to 0.94 for photographic SCORAD.
Conclusion
There was high agreement between mild to moderate AD severity assessed clinically and based on smartphone photographs. Further, the photographic assessments can be reproduced with high reliability.
Infants with bronchopulmonary dysplasia (BPD) are at high risk of developing cardiovascular sequelae in the form of pulmonary hypertension (PH) which significantly increases morbidity and mortality. ...The aim of this study was to evaluate the incidence of BPD, to identify characteristics associated with BPD and to identify characteristics associated with PH in infants with BPD.
A retrospective study was performed. Data were obtained from a regional neonatal database and by reviewing medical records of infants admitted during the 2002-2010 period. A total of 400 infants with a birth weight (BW) < 1,500 g were identified. Eight were excluded and 74 infants met the criteria for BPD. A total of 17 infants with BPD had PH.
We found that the incidence of BPD at the Neonatal Department at Hvidovre Hospital between January 2002 and December 2010 was 18%. Infants with BPD differed significantly from infants without BPD with regard to the following characteristics: Infants with BPD more frequently had a lower gestational age and BW, intubation at birth, mechanical ventilation within 24 hours of birth, a lower Apgar score at one minute and five minutes. The incidence of PH was 23% among infants with BPD. Furthermore, we found a significantly larger frequency of intubation at birth, postnatal infection, longer duration of continuous positive airway pressure treatment and use of oxygen therapy among infants with PH and BPD than among the remaining infants.
The incidence of BPD was 18%. Low gestational age was found to be the most important factor associated with development of BPD. Among BPD infants, postnatal infection was significantly associated with PH. Further prospective studies including routine echocardiography are needed to evaluate risk factors for PH.
not relevant.
not relevant.
Background: Airway responsiveness and inflammation are associated with the clinical manifestations of asthma and the response to pharmacological therapy. Objective: To investigate if airway ...responsiveness and inflammatory characteristics are related to asthma exacerbations during pregnancy. Materials and methods: In women with asthma who were prescribed controller medication and monitored closely during pregnancy, the risk of exacerbations was analyzed in relation to postpartum measures of fractional exhaled nitric oxide (F.sub.ENO), skin prick test reactivity, static and dynamic lung volumes, diffusing capacity for carbon monoxide, bronchial responsiveness to inhaled mannitol, and inflammatory characteristics in induced sputum. Obtained data were analyzed in relation to exacerbation status during pregnancy. The PD.sub.15 is defined as the cumulative administered dose causing a 15% decline in forced expiratory volume in the first second (FEV.sub.1). Results: Fifty women (mean age + or - standard deviation of 32+ or -5 years) were enrolled over an 11-month period and examined on average 4 months postpartum. During pregnancy, 13 women had a total of 16 exacerbations (8 mild and 8 severe). Women with asthma exacerbation during pregnancy had more pronounced airway responsiveness to inhaled mannitol (geometric mean PD 82 vs 171 mg, p=0.04) and were less likely to be atopic (62% vs 86%, respectively; p=0.04) than the non-exacerbators. No statistically significant difference was found between the 2 groups of women with regard to type of airway inflammation in sputum and fractional exhaled nitric oxide (F.sub.ENO). Conclusion: More pronounced airway hyperresponsiveness together with nonatopic status appears to characterize women at high risk of exacerbation of asthma during pregnancy. Keywords: asthma, inflammation, pregnancy
Remote monitoring was used to assess and manage skin diseases.
To investigate to what extent smartphone photographs along with a self-reported body region (BR) score can be used to evaluate psoriasis ...severity.
Psoriasis severity was assessed in the clinic using the psoriasis area and severity index and the physician’s global assessment. On the same day, the patients took a photograph of a representative lesion from 4 BR (head/neck, upper limbs, trunk, and lower limbs) and completed a questionnaire about BR score. The photographs were rated by 5 dermatologists. Intraclass correlation coefficients with 95% CIs were calculated.
Overall, 32 were included, of which 6% had almost clear, 69% had mild, and 25% had moderate psoriasis. Perfect agreement between the self-reported and the doctors’ BR score was observed for 59%, and near-perfect agreement (deviation of maximum 1 score) was 92%. The intraclass correlation coefficient between clinical and photographic psoriasis area and severity index was 0.78 (95% CI, 0.55-0.90), and for physician’s global assessment, perfect agreement was 53%.
The agreement between psoriasis severity assessed clinically and by photographs was good in a study setting. This gives the opportunity to remotely assess psoriasis severity by combining photographs with self-reported BR scores.
Background
Digital imaging of dermatological patients is a novel approach to remote assessment and has recently become more relevant since telehealth and remote decentralized clinical trials are ...gaining ground.
Objective
We aimed to investigate whether photographs taken by a smartphone are of adequate quality to allow severity assessments to be made and to explore the usefulness of an established atopic dermatitis severity assessment instrument on photograph evaluation.
Methods
During scheduled visits in a previously published study, the investigating doctor evaluated the severity of atopic dermatitis using the Scoring AD (SCORAD) index and took photographs of the most representative lesions (target lesions) with both a smartphone and a digital single-lens reflex camera (DSLR). The photographs were then assessed by 5 dermatologists using the intensity items of the SCORAD (iSCORAD), which consists of erythema, oedema/papulation, excoriations, lichenification, oozing/crusts, and dryness (scale 0-3, maximum score 18). The mean iSCORAD of the photographs was calculated and compared with in-person assessments using Pearson correlation and Bland-Altman plots. Intraclass correlation coefficients were used for interrater reliability.
Results
A total of 942 photographs from 95 patients were assessed. The iSCORAD based on smartphone photographs correlated strongly with the evaluations performed in person (iSCORAD: r=0.78, P<.001; objective SCORAD: r=0.81, P<.001; and total SCORAD: r=0.78, P<.001). For iSCORAD specifically, a Bland-Altman plot showed a difference in mean score of 1.31 for in-person and remote iSCORAD. In addition, the interrater agreement between the 5 rating dermatologists was 0.93 (95% CI 0.911-0.939). A total of 170 lesions were photographed, and the difference in mean scores was 1.32, 1.13, and 1.43 between in-person and remote evaluations based on photographs taken by a DSLR camera, a smartphone without flash, and a smartphone with flash, respectively.
Conclusions
In terms of quality, remote atopic dermatitis severity assessments based on photographs are comparable to in-person assessments, and smartphone photos can be used to assess atopic dermatitis severity to a similar degree as photographs from a DSLR camera. Further, the variation in how the dermatologists in this study rated the iSCORAD based on the photographs was very low.
Background: Remote monitoring was used to assess and manage skin diseases. Objective: To investigate to what extent smartphone photographs along with a self-reported body region (BR) score can be ...used to evaluate psoriasis severity. Methods: Psoriasis severity was assessed in the clinic using the psoriasis area and severity index and the physician’s global assessment. On the same day, the patients took a photograph of a representative lesion from 4 BR (head/neck, upper limbs, trunk, and lower limbs) and completed a questionnaire about BR score. The photographs were rated by 5 dermatologists. Intraclass correlation coefficients with 95% CIs were calculated. Results: Overall, 32 were included, of which 6% had almost clear, 69% had mild, and 25% had moderate psoriasis. Perfect agreement between the self-reported and the doctors’ BR score was observed for 59%, and near-perfect agreement (deviation of maximum 1 score) was 92%. The intraclass correlation coefficient between clinical and photographic psoriasis area and severity index was 0.78 (95% CI, 0.55-0.90), and for physician’s global assessment, perfect agreement was 53%. Conclusions: The agreement between psoriasis severity assessed clinically and by photographs was good in a study setting. This gives the opportunity to remotely assess psoriasis severity by combining photographs with self-reported BR scores.
Asthma has been linked with prolonged time to pregnancy compared to healthy controls, also asthma has been linked to a higher need for fertility treatment. However, knowledge of the possible ...association between allergy and need for fertility treatment is limited. Our aim was to explore a possible difference in having had fertility treatment in women with asthma and live births in those with perennial allergy (animals, fungi and dust mites) compared to no allergy/seasonal allergy. The primary outcome of interest was fertility treatment.
Women enrolled in the Management of Asthma during Pregnancy (MAP) program at Hvidovre Hospital, DK, were included in the present analysis provided they fulfilled the following criteria: 1) diagnosed with asthma and current anti-asthma therapy and 2) first visit to the respiratory outpatient clinic within the first 18 weeks of pregnancy. Participants were divided into two groups: asthma with perennial allergy (cases) and asthma with seasonal/no allergy (controls). Logistic regression analysis was applied, and findings expressed as odds ratios (OR).
Among women with asthma and perennial allergy (n=544 cases), 13.8% (n=75) had fertility treatment, compared to only 10.1% (n=39) among women with asthma and seasonal/no allergy (n=388, controls) (OR 1.43, 95% CI 0.95-2.16, p=0.087). This association remained statistically insignificant after adjusting for confounders, including BMI (OR 1.19, 95% CI 0.77-1.84, p=0.433). In women ≥35 years of age, 28% (n=44) and 20% (n=19), respectively, among cases and controls had fertility treatment (OR 1.60, 95% CI 0.87-2.94, p=0.132), and likewise, statistically insignificant after adjusting for confounders (OR 1.41, 95% CI 0.74-2.69, p<0.293).
In women with asthma and live births, our study revealed a trend towards an association between perennial allergy and a higher need for fertility treatment compared to seasonal/no allergy.
Psoriasis is a chronic T-cell-mediated inflammatory and proliferative skin disease. Chronic obstructive pulmonary disease (COPD) is an inflammatory disease of the airways. COPD has been studied as a ...comorbidity of psoriasis, but the association needs further study, hence the objective of this study.
A systematic review was performed using the database PubMed and 155 records were found including the ones found through references. Seven records were found eligible for this study including six observational studies and one experimental study with a total of 229,075 participants. The odds ratio of COPD in patients with psoriasis and healthy subjects was analysed using a random effects model.
The pooled data showed a significant association (OR=1.77, 95% CI 1.32; 2.39) between psoriasis and COPD with high inter-study heterogeneity (I
=96%). Sub-analyses of the different types of studies (cohort study: OR=2.53 2.43; 2.63, case-control study: OR=1.6 0.03; 100.96 and cross-sectional study: OR=1.57 0.58; 4.22) and smoking status (OR=1.7 0.69; 4.14) were also performed to further examine the association.
There is a significant association between psoriasis and COPD, but the underlying mechanism and how smoking status affects the results remain unclear and need further study. Physicians should be aware of the risk and its seriousness to provide better and more targeted treatment.
Allometry of Urtica urens in Polluted and Unpolluted Habitats Elkarmi, Ali (Hashemite University, Zarqa, Jordan), E-mail: karmi@hu.edu.jo; Eideh, Rajaa Abu (Hashemite University, Zarqa, Jordan)
Journal of plant biology = Singmul Hakhoe chi,
02/2006, Letnik:
49, Številka:
1
Journal Article
Recenzirano
The allometry of Urtica urens (small nettle), an important medicinal plant in many countries, growing in an area near pollution sources and an area away from pollution sources was determined. The ...allometric coefficients were determined for nonlinear relationships between plant height, stem width, root length, petiole length, leaf dry weight, petiole dry weight, leaf length, leaf width, leaf area and specific leaf area. The slopes of the linear equations were determined for the above parameters. The results showed that there is a difference in the allometry of different parts of U. urens growing in these two areas.
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