Intestinal dysbiosis is thought to be an important cause of disease progression and the gastrointestinal symptoms experienced in patients with inflammatory bowel disease (IBD). Inflammation appears ...to be a major contributor in perpetuating a dysregulated gut microbiota. Although current drug therapies can significantly induce and maintain disease remission, there is no cure for these diseases. Nevertheless, ongoing human studies investigating dietary fibre interventions may potentially prove to exert beneficial outcomes for IBD. Postulated mechanisms include direct interactions with the gut mucosa through immunomodulation, or indirectly through the microbiome. Component species of the microbiome may degrade dietary-fibre polysaccharides and ferment the products to form short-chain fatty acids such as butyrate. Prebiotic dietary fibres may also act more directly by altering the composition of the microbiome. Longer term benefits in reducing the risk of more aggressive disease or colorectal cancer may require other dietary fibre sources such as wheat bran or psyllium. By critically examining clinical trials that have used dietary fibre supplements or dietary patterns containing specific types or amounts of dietary fibres, it may be possible to assess whether varying the intake of specific dietary fibres may offer an efficient treatment for IBD patients.
IntroductionCurrent evidence indicates an alarming increase in topical steroid (TS) misuse in India. Data regarding the magnitude and characteristics of this problem in rural India, where 68% of the ...population resides, are insufficient. This study analyses the magnitude, causes, characteristics and consequences of TS misuse in rural India. It also examines the association between TS misuse and patients’ perception of skin disease.MethodsA mixed-method observational study was conducted among the attendees of the dermatology outpatient department in a rural North Indian hospital. Those with a history of TS misuse were analysed for behaviour patterns and outcome.ResultsOut of 723 patients, 213 (29.2%) misused TS. Clobetasol propionate (58.2%) was most commonly misused. Seventy brands of inappropriate fixed drug combination steroid creams were recovered from the patients. Pharmacists and local healers together contributed to 78% of the sources for steroid misuse. Almost 58% of participants perceived their skin conditions to be allergic reactions to food, when in fact 70.1% were tinea, 10% scabies and 9% acne. Eighty per cent of the respondents having tinea had tinea incognito and 97% had extensive lesions. Eighty-five per cent of the participants with scabies had atypical lesions and 80% with acne had steroid rosacea or aggravation of acne. The median expenditure incurred in purchasing these potentially harmful steroid creams was Rs 1000 (US$14.1, equivalent to 3 days’ wages of a labourer).ConclusionSteroid misuse is a problem of epidemic proportion in rural India. This practice is changing the profile of many common and infective skin conditions, which portends diagnostic dilemmas and therapeutic challenges for clinicians. Misconceptions about skin disease drive the public to seek ‘quick fixes’ from non-allopathic providers who have unrestricted access to potent steroids. There is an urgent need to tighten regulatory controls over the manufacturing, sale and prescription of irrational TS combinations.
Melasma is a common disorder of hyperpigmentation that presents a therapeutic challenge for clinical dermatologists. The pathogenesis is complex, but previous studies have demonstrated vascular ...proliferation is a key factor in the development of the classic hyperpigmented patches. Studies have revealed reduction of erythema by oral tranexamic acid; however, there has been no direct comparison to placebo. This 24‐week randomised placebo‐controlled trial demonstrates oral tranexamic acid may improve erythema in melasma. This mechanism of action may be the reason for the success of tranexamic acid in complex and difficult to treat melasma.
The newly revised Australian Infant Feeding Guidelines recommends that all infants, including those at high risk of allergy, be introduced foods traditionally considered allergenic (such as peanut ...butter, dairy, wheat and egg) within the first year of life. High‐risk infants are those with early onset eczema (<3‐months old) or with moderate to severe eczema not responding to treatment (<6‐months old). Eczema can also represent a symptom of allergy presentation and the recommended introduction of some foods in this group may lead to allergic reactions at home. Although there have been no reported deaths from gradual food introduction to infants at home and cohort studies have only reported mild to moderate reactions, there is anecdotal evidence that more severe reactions can occur rarely. Allergic reactions, even if they are not life‐threatening, can be a terrifying experience for parents. Dermatologists play an important role when dealing with high‐risk infants in promoting the message of early allergenic food introduction yet also instigating appropriate allergy testing when necessary. This short review aims to provide an update to Australasian dermatologists on the newly revised Australian Infant Feeding Guidelines and provide a food allergy screening pathway for high‐risk infants prior to commencement of allergenic foods.
Think UV, not heat Wong, Celestine C; Liu, Wenyuan; Gies, Peter ...
Australasian journal of dermatology,
November 2015, Letnik:
56, Številka:
4
Journal Article
Recenzirano
Background
Australia has the highest incidence of skin cancer in the world, a preventable disease caused primarily by exposure to ultraviolet radiation (UVR) in sunlight. Health promotion strategies ...play a significant role in sun protection.
Objectives
To assess the understanding of a population sample as to the time of year that the sun was ‘at its most burning’ in Melbourne, Australia.
Methods
A cross‐sectional study was performed using questionnaires completed at corporate skin checks, conducted on 668 participants during 2011 to 2013.
Results
Only a minority (n = 82, 12%) gave the correct theoretical answer; the summer solstice or 21–22 December, while another 38% (n = 254) correctly named December and January as the times when the UVR is actually highest. In all, 18% (n = 122) said February was the month when the temperature is hottest and 170 (25%) either mentioned the period May–August when UVR is negligible in Melbourne or had no idea, including saying ‘all year round’. There was no significant difference in this knowledge between different age groups.
Conclusion
One‐quarter of participants did not understand that sunburn was related to high levels of UVR, which occur in summer. Almost one‐fifth associated the heat of February with the highest UVR. Understanding these concepts is important for Australians residing in cooler parts of southern Australia, as UVR levels may be high and yet the temperature may be relatively cool. There needs to be more emphasis on UVR in sun awareness campaigns to prompt sun‐protective behaviour.
Background
Allergic contact dermatitis (ACD) caused by chromium in cement is a significant occupational hazard. However, legislation in Europe over the past two decades to reduce the concentration of ...chromium in cement to <2 ppm through the addition of ferrous sulphate to cement, has seen a significant decrease in the incidence of chromium allergy. No such legislation exists in Australia.
Methods
A retrospective analysis of results from the Patchcams database of patients attending the Occupational Dermatology Clinic at the Skin & Cancer Foundation, Melbourne, who were patch tested for chromium between 1 January 1993 to 31 December 2013, was conducted.
Results
Our review revealed that there has not been any significant change in the number of cases of ACD to chromium attributed to sensitisation through cement. Based on our data, we estimate that a minimum of 24 cases of chromium occupational ACD (OACD) from cement is found in Australia yearly, causing considerable morbidity, often associated with an inability to work, costly workers' compensation claims and sometimes the development of the disabling condition, persistent post‐occupational dermatitis.
Conclusion
These findings highlight the need for high‐level discussions about adopting European legislation in Australia in order to reduce the likelihood of developing chromium OACD from cement.
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