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2.
  • Darsow, U., et al. (author)
  • ETFAD/EADV eczema task force 2009 position paper on diagnosis and treatment of atopic dermatitis
  • 2010
  • In: Journal of the European Academy of Dermatology and Venereology. - : Wiley. - 1468-3083 .- 0926-9959. ; 24:3, s. 317-328
  • Research review (peer-reviewed)abstract
    • Background The diagnosis of atopic dermatitis (AD) is made using evaluated clinical criteria. Management of AD must consider the symptomatic variability of the disease. Methods EADV eczema task force developed its guideline for atopic dermatitis diagnosis and treatment based on literature review and repeated consenting group discussions. Results and Discussion Basic therapy relies on hydrating topical treatment and avoidance of specific and unspecific provocation factors. Anti-inflammatory treatment based on topical glucocorticosteroids and topical calcineurin antagonists is used for exacerbation management and more recently for proactive therapy in selected cases. Topical corticosteroids remain the mainstay of therapy, but the topical calcineurin inhibitors, tacrolimus and pimecrolimus are preferred in certain locations. Systemic anti-inflammatory treatment is an option for severe refractory cases. Microbial colonization and superinfection may induce disease exacerbation and can justify additional antimicrobial/antiseptic treatment. Systemic antihistamines (H1) can relieve pruritus, but do not have sufficient effect on eczema. Adjuvant therapy includes UV irradiation preferably of UVA1 wavelength or UVB 311 nm. Dietary recommendations should be specific and given only in diagnosed individual food allergy. Allergen-specific immunotherapy to aeroallergens may be useful in selected cases. Stress-induced exacerbations may make psychosomatic counselling recommendable. 'Eczema school' educational programmes have been proven to be helpful.
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  • Carlsson, C P, et al. (author)
  • Therapeutic and experimental therapeutic studies on acupuncture and itch: review of the literature.
  • 2010
  • In: Journal of the European Academy of Dermatology and Venereology. - : Wiley. - 1468-3083 .- 0926-9959. ; 24, s. 1013-1016
  • Journal article (peer-reviewed)abstract
    • Abstract Itch accompanies most inflammatory skin diseases but may occur as a solitary sensation in otherwise normal skin. Chronic itch often requires combined treatments but some cases remain therapy resistant. Complementary medicine is becoming increasingly popular among patients. Acupuncture is the oldest and most well-studied alternative option with evidence-based effect on pain. This article summarizes the rational for the use of acupuncture in treatment of itch and reviews therapeutic and experimental therapeutic studies on acupuncture and itch.
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  • Majewski, S., et al. (author)
  • The impact of a quadrivalent human papillomavirus (types 6, 11, 16, 18) virus-like particle vaccine in European women aged 16 to 24
  • 2009
  • In: Journal of the European Academy of Dermatology and Venereology. - : Wiley. - 1468-3083 .- 0926-9959. ; 23:10, s. 1147-1155
  • Journal article (peer-reviewed)abstract
    • Background Quadrivalent human papillomavirus (HPV types 6/11/16/18) L1 VLP vaccine is highly effective in preventing HPV 6/11/16/18-related cervical and external genital disease. Herein, we evaluated the impact of the quadrivalent HPV 6/11/16/18 L1 VLP vaccine on prevention of HPV-associated cervico-genital lesions in a broad population of sexually active European women. Methods Female subjects (N = 9265) aged 16-24 with four or fewer lifetime sexual partners were enrolled and randomized to quadrivalent HPV vaccine or placebo. Subjects underwent cervicovaginal sampling for HPV DNA detection. Papanicolaou testing and anti-HPV 6/11/16/18 serology testing was also performed. Results Vaccine efficacy against lesions representing immediate cervical cancer precursors (cervical intraepithelial neoplasia grade 2/3 or adenocarcinoma in situ) related to HPV 6/11/16/18 in the per-protocol population was 100.0%[95% confidence interval (95% CI), 89.8-100.0]. Efficacy against external genital lesions (vulvar or vaginal intraepithelial neoplasia, condyloma, vulvar or vaginal cancer) related to vaccine HPV types in the per-protocol European population was 99.0% (95% CI, 94.4-100.0). Conclusion These data demonstrate that quadrivalent HPV 6/11/16/18 vaccination programs in 16- to 24-year-old European women can be beneficial. NCT0009252, NCT00092534, NCT00092495.
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7.
  • Nilsson, H-J., et al. (author)
  • Profound inhibition of chronic itch induced by stimulation of thin cutaneous nerve fibres
  • 2004
  • In: Journal of the European Academy of Dermatology and Venereology. - : Elsevier. - 0926-9959 .- 1468-3083. ; 18:1, s. 37-43
  • Journal article (peer-reviewed)abstract
    • BACKGROUND: Despite the fact that severe itch is common in many dermatological diseases, the therapeutic arsenal against itching is limited. From neurophysiological experiments, using a new technique termed cutaneous field stimulation, it is known that acute itch can be effectively relieved by stimulation of cutaneous nociceptors. METHODS: We tested the effects of cutaneous field stimulation (25 min, 16 electrodes, 4 Hz per electrode, up to 0.8 mA) on chronic itch due to atopic dermatitis. Transcutaneous electrical nerve stimulation (100 Hz, up to 26 mA) was used for comparison. In 27 patients, itch was measured just prior to, during and at regular intervals up to 12 h after either type of treatment. RESULTS: Both treatments augmented the itch sensation during ongoing stimulation, presumably reflecting an altered sensory processing in the somatosensory pathways of chronic itch patients. However, after cessation of cutaneous field stimulation, but not transcutaneous electrical nerve stimulation, the itch sensation was significantly depressed for up to 7 h. The peak inhibitory effect (about 25% of control) was reached between 1 and 5 h poststimulation. Neither treatment had any significant effect on alloknesis, as measured before and 10 min after stimulation. CONCLUSION: It is concluded that cutaneous field stimulation strongly depresses chronic itch, and is a potentially useful symptomatic treatment of itch.
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8.
  • Nilsson, H-J, et al. (author)
  • Profound inhibition of chronic itch induced by stimulation of thin cutaneous nerve fibres.
  • 2004
  • In: Journal of the European Academy of Dermatology and Venereology. - : Wiley. - 1468-3083 .- 0926-9959. ; 18:1, s. 37-43
  • Journal article (peer-reviewed)abstract
    • Background Despite the fact that severe itch is common in many dermatological diseases, the therapeutic arsenal against itching is limited. From neurophysiological experiments, using a new technique termed cutaneous field stimulation, it is known that acute itch can be effectively relieved by stimulation of cutaneous nociceptors. Methods We tested the effects of cutaneous field stimulation (25 min, 16 electrodes, 4 Hz per electrode, up to 0.8 mA) on chronic itch due to atopic dermatitis. Transcutaneous electrical nerve stimulation (100 Hz, up to 26 mA) was used for comparison. In 27 patients, itch was measured just prior to, during and at regular intervals up to 12 h after either type of treatment. Results Both treatments augmented the itch sensation during ongoing stimulation, presumably reflecting an altered sensory processing in the somatosensory pathways of chronic itch patients. However, after cessation of cutaneous field stimulation, but not transcutaneous electrical nerve stimulation, the itch sensation was significantly depressed for up to 7 h. The peak inhibitory effect (about 25% of control) was reached between 1 and 5 h poststimulation. Neither treatment had any significant effect on alloknesis, as measured before and 10 min after stimulation. Conclusion It is concluded that cutaneous field stimulation strongly depresses chronic itch, and is a potentially useful symptomatic treatment of itch.
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  • Susitaival, P., et al. (author)
  • An outbreak of furniture related dermatitis ('sofa dermatitis') in Finland and the UK: history and clinical cases
  • 2010
  • In: Journal of the European Academy of Dermatology and Venereology. - : Wiley. - 1468-3083 .- 0926-9959. ; 24:4, s. 486-489
  • Journal article (peer-reviewed)abstract
    • In February 2007, an epidemic of severe dermatitis from Chinese recliner chairs and sofas started to unfold first in Finland and a few months later in the UK. Some patients reacted in patch tests (PTs) strongly to the material of their furniture, either leather or fabric. There have been hundreds of reports of chair or sofa dermatitis from Finland and the UK, with all cases linked to the same furniture factory in China. Clinical findings in both countries were very similar and unlike any known dermatosis. Many cases have been quite severe, resembling mycosis fungoides or septic infections, requiring hospitalization. Commercial PTs did not reveal the cause but a fungicide was strongly suspected, although such use was denied by the factory. The laboratory of Malmo University Dermatology Clinic has helped in the process by making thin layer chromatograms from sofa or chair materials and test substances of suspected chemicals. Finally, sachets marked with 'mouldproof agent' were found in varying numbers and distribution in the sofas. These contained dimethyl fumarate (DMF) which proved in skin tests to cause strong positive reactions with down to 0.01 dilution. Reports from other countries (Belgium, France, Ireland, Sweden and Spain) have since appeared, and the EU has banned the use of DMF in consumer products.
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  • Wallengren, Joanna (author)
  • Vasoactive peptides in the skin
  • 1998
  • In: Journal of the European Academy of Dermatology and Venereology. - : Wiley. - 1468-3083 .- 0926-9959. ; 11:S2, s. 73-73
  • Conference paper (peer-reviewed)abstract
    • The vascular effects of endogenous substances can be eas- ily studied in the skin. Early in this century vasoregulation was shown to be dependent on innervation. Peptidergic trans- mitters have been shown to coexist and cotransmit along with noradrenalin and acetylcholine, sometimes being responsi- ble for non-adrenergic-non-cholinergic responses. This review summarizes recent information on vasoregulatory effects of neuropeptides such as substance P (SP), neurokinin A (NU), calcitonin gene-related peptide (CGRP), vasoactive intestinal peptide (VIP), pituitary adenylate cyclase activating peptide (PACAP), neuropeptide Y (NF’Y) and somatostatin. All these peptides are vasodilators, and some of them seem to be in- volved in neurogenic inflammation. Some vasoactive peptides and other vasoactive molecules such as nitric oxide (NO) and histamine can originate both from nerves and cells and are crucially involved in vasoregulation. Other cell-derived peptides and molecules such as bradykinin, endothelins and prostaglandins may contribute to neurogenic inflammation. All the peptides and molecules described also exist in other organs such as the brain, heart, lung, pancreas and gastrointestinal tract. The effect of neuropeptides seems to vary from one organ or tissue to another - e.g., NPY e.g., is a potent vasoconstrictor in cardiac and cerebral vascular beds but acts as a vasodilator when it occurs in the skin. The presence of mast cells and inflammatory cells may create a special environment in the Skin
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  • Domeika, Marius, et al. (author)
  • Guidelines for the laboratory diagnosis of Chlamydia trachomatis infections in East European countries
  • 2009
  • In: Journal of the European Academy of Dermatology and Venereology. - : Wiley. - 0926-9959 .- 1468-3083. ; 23:12, s. 1353-1363
  • Research review (peer-reviewed)abstract
    • The present guidelines aim to provide comprehensive information regarding the laboratory diagnosis of infections caused by Chlamydia trachomatis in East European countries. These recommendations contain important information for laboratory staff working with sexually transmitted infections (STIs) and/or STI-related issues. Individual East European countries may be required to make minor national adjustments to these guidelines as a result of lack of accessibility to some reagents or equipment, or laws in a specific country.
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13.
  • Domeika, Marius, et al. (author)
  • Guidelines for the laboratory diagnosis of trichomoniasis in East European countries
  • 2010
  • In: Journal of the European Academy of Dermatology and Venereology. - : Wiley. - 0926-9959 .- 1468-3083. ; 24:10, s. 1125-1134
  • Research review (peer-reviewed)abstract
    • The laboratory diagnosis of sexually transmitted infections in many Eastern European countries remains suboptimal. The main objective of the present evidence-based guidelines is to provide comprehensive information regarding the laboratory diagnosis of infections caused by Trichomonas vaginalis in East European countries. In particular, the present guidelines recommend: (i) to encourage examination of the wet mounts of vaginal exudates, instead of stained smears, at all clinical settings; (ii) nucleic acid amplification tests (NAATs) or culture could be employed if no trichomonads are detected on microscopic examination of the wet preparation and there is a strong indication of infection and (iii) the use of NAATs is encouraged in screening, using non-invasive specimens, or high volume testing situations. In the absence of internationally recognized commercial NAAT systems, tests developed in-house should be validated using obtainable international standards and quality assured strictly. Individual East European countries may be required to make minor national adjustments to these guidelines as a result of lack of accessibility to some reagents or equipment, or laws in a specific country.
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  • Shipitsyna, Elena, et al. (author)
  • First evaluation of six nucleic acid amplification tests widely used in the diagnosis of Chlamydia trachomatis in Russia
  • 2009
  • In: Journal of the European Academy of Dermatology and Venereology. - : Wiley. - 0926-9959 .- 1468-3083. ; 23:3, s. 268-276
  • Journal article (peer-reviewed)abstract
    • Abstract Background In Russia, nationally developed nucleic acid amplification tests (NAATs), which have never been validated to international commercially available NAATs, are mainly used in the diagnosis of Chlamydia trachomatis infection. Objective To evaluate the performance characteristics of six NAATs widely used to diagnose C. trachomatis infection in Russia. Materials and methods In total, 446 consecutive symptomatic patients (319 females and 127 males) were included. Five polymerase chain reaction (PCR) assays and one real-time nucleic acid sequence-based amplification (NASBA) assay were evaluated on cervical and vaginal samples from females and on urethral and first voided urine samples from males. As reference methods, the Cobas Amplicor PCR, as the main 'gold standard' method, and LightMix 480HT PCR were used. Results The overall prevalence of C. trachomatis infection was 12.6%. The Russian NAATs and the reference methods displayed a high level of concordance (97.9% to 99.2%). In comparison with the reference methods, the sensitivities, specificities, positive predictive values and negative predictive values of the Russian tests in different specimens ranged from 86.1% to 100%, 99.1% to 100%, 92.3% to 100% and 98.2% to 100%, respectively. Conclusions According to the reference methods, C. trachomatis NAATs developed and used in Russia have relatively good performance characteristics for both invasive and non-invasive samples. However, larger studies that include symptomatic and asymptomatic patients as well as genital and extra-genital samples, and in comparison with other internationally well-recognized, validated, and ideally Food and Drug Administration-approved C. trachomatis NAATs performed strictly according to the manufacturer's instructions, need to be conducted. Conflicts of interest None declared.
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  • Sokolovskiy, E, et al. (author)
  • Guidelines for the laboratory diagnosis of syphilis in East European countries
  • 2009
  • In: Journal of the European Academy of Dermatology and Venereology. - : Wiley. - 0926-9959 .- 1468-3083. ; 23:6, s. 623-632
  • Journal article (peer-reviewed)abstract
    • The present guidelines aim to provide comprehensive and precise information regarding the laboratory diagnosis of the sexually transmitted infection (STI) syphilis in East European countries. These recommendations contain important information for laboratory staff working with STIs and/or STI-related issues. Individual East European countries may be required to make minor national adjustments to these guidelines as a result of lack of accessibility to some reagents or equipment, or laws in a specific country. None declared.
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  • Bein, D., et al. (author)
  • Evaluation of disease activity and damage in different subtypes of cutaneous lupus erythematosus using the CLASI
  • 2011
  • In: Journal of the European Academy of Dermatology and Venereology. - : Wiley. - 0926-9959 .- 1468-3083. ; 25:6, s. 652-659
  • Journal article (peer-reviewed)abstract
    • Background: The Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) is a scoring system for patients with cutaneous lupus erythematosus (CLE) to assess disease activity and damage. Objective: The aim of this study was to evaluate whether the CLASI is a useful instrument which reflects the different subtypes of CLE comparably well in each parameter. Methods: A total of 50 patients (42 female, 8 male) with different subtypes of CLE, including acute CLE (ACLE), subacute CLE (SCLE), chronic CLE (CCLE) and LE tumidus (LET), from the Departments of Dermatology, University of Dusseldorf, Germany, and Danderyd Hospital, Stockholm, Sweden, were evaluated using the CLASI at one time point. Results: The total CLASI activity score was significantly lower in patients with LET compared with ACLE (P < 0.05) and CCLE (P < 0.001), and the total CLASI damage score was significantly lower in patients with LET than with ACLE (P < 0.05), SCLE (P < 0.001) and CCLE (P < 0.001). The erythema score and the scale/hypertrophy score were significantly lower in LET than in ACLE (P < 0.05, both) and CCLE (P < 0.05 and P < 0.001, respectively). The dyspigmentation score was lowest in patients with LET, differing significantly from ACLE (P < 0.05), SCLE (P < 0.05) and CCLE (P < 0.001). The scarring/atrophy/panniculitis score was significantly higher in patients with CCLE in contrast to SCLE and LET (P < 0.05 and P < 0.001, respectively). Conclusion: These data characterize the CLASI as an overall useful instrument to analyse disease activity and damage in CLE. However, the CLASI does not give an accurate assessment of all disease subtypes; therefore, a revision of the CLASI with critical analysis of all parameters is recommended.
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22.
  • Berg, Mats, et al. (author)
  • Possible gender differences in the quality of life and choice of therapy in acne
  • 2011
  • In: Journal of the European Academy of Dermatology and Venereology. - : Wiley. - 0926-9959 .- 1468-3083. ; 25:8, s. 969-972
  • Journal article (peer-reviewed)abstract
    • Background Acne is a very common skin disease that has major impact on the patients' quality of life. Although the disease has been extensively studied we still need more knowledge of factors influencing the decisions for choice of therapy. Objective To evaluate the relationships between clinical severity, patients' self-reported quality of life, treatment choice and the outcome of therapy in a structured out-patient acne clinic. Methods In total 211 consecutive patients (143 females, 68 males) at a structured acne clinic were included. At the first visit a clinical assessment was conducted, therapy was initiated and the patients answered a quality-of-life questionnaire (Dermatology Life Quality Index, DLQI). A follow up was performed after six months, when patients once again answered the DLQI questionnaire and the clinical outcome was assessed by the physician. Results The quality of life was improved after treatment at a group level. At the first visit, the quality of life showed a gender difference (females scoring worse) but did not correlate to the clinical grading nor to the choice of therapy. At six months the DLQI correlated with clinical outcome. Patients with isotretinoin therapy showed a significantly greater improvement in quality of life. There was a tendency to gender difference in the choice of therapy, as in females 32% of the patients were treated with isotretinoin although they were clinically graded as moderate. The corresponding figure for males was 23%. A correlation was found between the initial clinical grading and gender, age and the choice of therapy. Conclusion DLQI can be used to evaluate treatment effects in acne. However, the self-reported quality of life will depend on several factors including age, gender, psychosocial factors and clinical severity.
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  • Berg, Mats, et al. (author)
  • Psoriasis and stress : A prospective study
  • 2008
  • In: Journal of the European Academy of Dermatology and Venereology. - : Wiley. - 0926-9959 .- 1468-3083. ; 22:6, s. 670-674
  • Journal article (peer-reviewed)abstract
    • Background Psoriasis is generally thought to be worsened by stress. This presumption has been supported primarily by retrospective studies using questionnaires. No controlled prospective study on this issue has been performed. Methods Nine women with moderate plaque psoriasis were enrolled in the study. They all believed that their psoriasis was worsened by stress. They filled in a daily diary with estimations of actual stress levels and grades of psoriasis. The study of each patient started when her skin disease was in a stable phase and was concluded when her psoriasis was worsened by at least 25% from the starting level. Psoriasis area severity index scores were recorded at the start, as soon as possible after exacerbation and 2 weeks later. Stress-related blood samples were taken at the same visits. The study was analysed as a nine-case study. Results No clear pattern was found between stress levels and worsening of psoriasis in our nine patients. One patient had elevated stress levels 13 days before exacerbation of psoriasis, but for at least seven patients, there were no identifiable time relationships between stress and psoriasis appearance. For two patients, there were clear elevations of stress levels after psoriasis outbreak. Conclusion This limited study does not support the assumption that stress is a worsening factor in psoriasis.
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  • Carlsen, K H, et al. (author)
  • Non-attendance rate in a Danish University Clinic of Dermatology
  • 2011
  • In: Journal of the European Academy of Dermatology and Venereology. - : Wiley-Blackwell. - 0926-9959 .- 1468-3083. ; 25:11, s. 1269-1274
  • Journal article (peer-reviewed)abstract
    • Aim To clarify the rate of non-attendance (NA) in an out-patient clinic. less thanbrgreater than less thanbrgreater thanMethods Attendance lists of 3592 patients were collected daily from 21 July-21 August and 21 October-21 November, 2009. NA patients were contacted to determine extenuations. To study NA in relation to diagnosis and age, a control group of patients who attended before or after a NA was established. Furthermore, two time periods from 8:00-11:30 AM and 11:30 AM-3:00 PM were compared. less thanbrgreater than less thanbrgreater thanResults In total, 13% NA gave no cancellation (54.2% females and 45.8% males). Divided into age groups, 496 patients 0-25 years old had appointments, but 87 (18.6%) showed NA. In the 26-65 years old, 2188 patients were planned, but 313 (14.1%) showed NA. Over 65 years old, 878 patients were planned, but 69 patients (7.9%) showed NA. NA was higher (P andlt; 0.05) in patients 0-25 years old in comparison with the other age groups. Diagnoses had no influence on the rate of NA (P andgt; 0.05), neither had seasons nor time of the day. The main explanations reported by the NA were: forgetfulness (34.3%), erroneous scheduling (27.7%) and various reasons (38.0%). However, 18.5% had shown NA before while 17.1% were NA first timers. less thanbrgreater than less thanbrgreater thanConclusion The NA rate 13% of 3592 patients was mostly patient-related. Erroneous scheduling was estimated to be 3.6%. NA was more frequent among young patients. NA rate is small in comparison with non-adherence to medicines, however, of major practical and economic consequence for the health system. SMS or e-mail notification and improved scheduling are potential actions to improve NA in the routine.
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  • Danielsson, Karin, et al. (author)
  • Increased levels of COX-2 in oral lichen planus supports an autoimmune cause of the disease
  • 2012
  • In: Journal of the European Academy of Dermatology and Venereology. - : Wiley-Blackwell. - 0926-9959 .- 1468-3083. ; 26:11, s. 1415-1419
  • Journal article (peer-reviewed)abstract
    • Background: Oral lichen planus (OLP) is a chronic inflammatory disease for which the pathogenesis is not fully understood. OLP has autoimmune features and auto immunity has been suggested as a potential cause, whereas WHO has classified OLP as a premalignant condition. Association between chronic inflammation and cancer is known and chronic inflammation is one of the characteristics of OLP. A protein connected to inflammation and suggested to be involved in cancer development is cyclooxygenase-2 (COX-2) which can be inhibited by microRNA-26b (miR-26b).Objective: The aim was to map levels of COX-2 and miR-26b in OLP lesions to see if there was any correlation between expression of COX-2 and its regulator miR-26b in OLP.Methods: In biopsies from 20 OLP patients and 20 age and gender-matched controls laser- micro dissection of epithelium was performed. Quantitative RT-PCR, immunohistochemistry and Western blot were used in the analysis.Results: Levels of COX-2 mRNA were significantly higher while levels of miR-26b were significantly lower in OLP lesions compared to controls. Using immunohistochemistry normal oral mucosa samples did not show any expression of COX-2 while OLP samples expressed the protein. No COX-2 protein was detectable with Western blot.Conclusion: Increased expression of COX-2 and decreased expression of miR-26b in OLP suggests both to play a role in OLP. COX-2 has been connected to both malignant development and autoimmunity but as malignant development of OLP is quite rare we suggest that the increased levels of COX-2 seen here support an autoimmune cause of the disease.
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  • Domeika, Marius, et al. (author)
  • Laboratory diagnostics for non-viral sexually transmitted infections in St. Petersburg, Russia : current situation and hallmarks for improvements
  • 2008
  • In: Journal of the European Academy of Dermatology and Venereology. - : Wiley. - 0926-9959 .- 1468-3083. ; 22:9, s. 1094-100
  • Journal article (peer-reviewed)abstract
    • BACKGROUND: The numbers and performance characteristics of laboratories providing sexually transmitted infection (STI) diagnostic services, as well as the rates of morbidity due to STIs in St. Petersburg, Russia, remain largely unknown. OBJECTIVE: The aim of the present study was to evaluate the range, quality and availability of diagnostic services for several non-viral STIs (Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum and Trichomonas vaginalis) in St. Petersburg during the period September 2005 to June 2006. METHODS: Survey data focusing on organization and performance characteristics of STI diagnostic services were assessed using questionnaires, telephone interviews and site visits. RESULTS: A total of 118 laboratories providing STI diagnostic services were identified. Of the surveyed laboratories, 54% (64 of 118) diagnosed syphilis, 81% (96 of 118) gonorrhoea, 80% (94 of 118) trichomoniasis and 49% (58 of 118) chlamydial infections. Although most of the laboratories could provide a presumptive diagnosis for syphilis, most of the N. gonorrhoeae and T. vaginalis testing of women did not adhere to international recommendations. Of the laboratories with the capacity to diagnose C. trachomatis infection, 69% still used serological testing (enzyme-linked immunosorbent assay) to detect antibodies to C. trachomatis. CONCLUSIONS: Overall, the diagnostic methods used to establish a laboratory diagnosis, the system of case reporting, the training of laboratory personnel and the level of interlaboratory communication clearly require improvement. This study represents the first step in a process of evaluation of the laboratory support for STI services and the establishment of an interlaboratory network in St. Petersburg.
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  • Domeika, Marius, et al. (author)
  • Mailed urine samples are not an effective screening approach for Chlamydia trachomatis case finding among young men
  • 2007
  • In: Journal of the European Academy of Dermatology and Venereology. - : Wiley. - 0926-9959 .- 1468-3083. ; 21:6, s. 789-794
  • Journal article (peer-reviewed)abstract
    • Background Frequency of testing is known to be low for sexually transmitted infections (STIs) in men aged 20–24 years. The use of mailed, home-obtained urine specimens could increase the uptake of young men and facilitate screening programmes for the detection of asymptomatic Chlamydia trachomatis. Objective The aim of the present study is to evaluate the home screening approach as a tool for recruitment of asymptomatic men for screening of genital C. trachomatis infections. Methods Men aged 19–24 years old (n = 1936) were invited to participate in home-based testing for genital C. trachomatis infection. Persons who agreed to be tested were provided with a testing kit. Self-collected first void urine was sent for testing to the microbiology laboratory. The test result was accessible on the study's web-page 1 week after testing. Individuals with a diagnosed infection were instructed to contact the venereal disease department. Results The response rate was 24% (462/1936). The responders' main reason for not participating was a feeling of being safe regarding STIs (87%; 159/182). The primary reason for this feeling of safety was that the responders were in a steady relationship (59%; 107/159). Having sex outside a steady relationship was reported by 36% (90/250) of the responders. The prevalence of C. trachomatis infection among the responders was 2.02% and the reported history of chlamydial infection was 36% (34/95). Out of the responders, 92% (229/249) were, to varying degrees, concerned about getting STIs; however, the majority (72%; 174/242) estimated the risk to be low. Conclusion Home screening using web-based answer management is a feasible tool for STI screening, which lowers the threshold for people at risk. In this particular population, however, the response rate was too low to be routinely introduced.
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  • El-Nour, H., et al. (author)
  • Neuronal changes in psoriasis exacerbation
  • 2009
  • In: Journal of the European Academy of Dermatology and Venereology. - : Wiley. - 0926-9959 .- 1468-3083. ; 23:11, s. 1240-1245
  • Journal article (peer-reviewed)abstract
    • Background The nervous system contributes to inflammatory skin diseases. Objective The aim of this investigation was to study the neuronal contribution to psoriasis at the remission and exacerbation phases. Methods We examined the expression of the neuronal markers protein gene product 9.5 (PGP 9.5), growth-associated protein-43 (GAP-43) and substance P, in addition to its receptor (R), neurokinin-1R (NK-1R) in psoriatic skin from seven female patients at remission and exacerbation, using immunohistochemistry. Results The number of epidermal PGP 9.5 immunoreactive nerve fibres in the involved skin during exacerbation was decreased (P < 0.01) compared to involved skin at remission and non-involved skin at the exacerbation phase. GAP-43-positive nerve fibres were decreased (P < 0.05) in the involved skin in contrast to non-involved skin, during exacerbation. Substance P expression was seen on both immunoreactive nerve fibres and cells with a down-regulation (P < 0.01) in the number of positive nerve fibres in the involved skin compared to non-involved skin, at the exacerbation phase. The number of substance P-positive cells was slightly lower in the involved skin at exacerbation than at remission. The number of NK-1R immunoreactive cells was increased (P < 0.01) in the involved skin in contrast to non-involved skin, at the exacerbation phase. Conclusion Our findings suggest a crosstalk between the nervous system and inflammation during psoriasis exacerbation in the form of an altered expression of nerve fibres, substance P and its NK-1R.
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32.
  • Grip, L, et al. (author)
  • Substance P alterations in skin and brain of chronically stressed atopic-like mice
  • 2013
  • In: Journal of the European Academy of Dermatology and Venereology. - : Wiley-Blackwell. - 0926-9959 .- 1468-3083. ; 27:2, s. 199-205
  • Journal article (peer-reviewed)abstract
    • Background Stress is known to worsen the symptoms of atopic eczema (AE). Substance P is likely to play an important role in the development and pathogenesis of AE. less thanbrgreater than less thanbrgreater thanObjective To examine a possible connection between chronic mild stress and changes in the expression of substance P and its receptor (R) neurokinin (NK) 1 in the skin and stress-related brain regions in NC/Nga atopic-like mice. less thanbrgreater than less thanbrgreater thanMethods The mice were divided into three groups (eight animals per group): SE (stressed eczematous), NSE (non-stressed eczematous) and SC (stressed control). Ears and brains of the mice were investigated using immunohistochemistry and RT-PCR. less thanbrgreater than less thanbrgreater thanResults In the skin, there was a decrease in the number of substance P immunoreactive nerve fibres in SE compared with SC group. RT-PCR showed a strong tendency to an increase in mRNA for NK1R in the skin of SE compared with NSE mice. There was an increase in the number of mast cells and the degree of their degranulation in the SE compared with both other groups. less thanbrgreater than less thanbrgreater thanA decrease in substance P immunoreactivity in medial hippocampus was found in SE compared with NSE animals. In prefrontal cortex and central amygdala, there were no significant differences in substance P immunoreactivity between the three groups. less thanbrgreater than less thanbrgreater thanConclusion Exposure to chronic mild stress in NC/Nga atopic-like mice may result in altered expression patterns of substance P in the skin and hippocampus.
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33.
  • Kallas, M, et al. (author)
  • Frequency and distribution pattern of melanocytic naevi in Estonian children and the influence of atopic dermatitis
  • 2006
  • In: Journal of the European Academy of Dermatology and Venereology. - : Wiley. - 0926-9959 .- 1468-3083. ; 20:2, s. 143-148
  • Journal article (peer-reviewed)abstract
    • Background: There is a strong correlation between naevus number and prospective melanoma risk. Melanoma is one of the most rapidly increasing cancers in Estonia and primary prevention programmes for melanoma that target risk behaviour in the sun have so far not been launched. Methods: The naevus profile was examined in 549/700 9-year-old Estonian children (282 boys and 267 girls) and the presence of active atopic dermatitis (AD) was registered. Results: There was a wide range of naevi (4-121) and a median total body count of 26. There was no difference in naevus count between boys and girls. No dysplastic naevi were found. Thirty-nine of 549 children (7%) had at least one lesion clinically diagnosed as a congenital naevus. Boys had more naevi on the face (median 4) and trunk (median 12) than girls (median 3 and 9, respectively, P < 0.001). Girls had more naevi on the legs compared with boys (median 4 and 3, respectively, P < 0.01). Fifty-four out of 549 (9.8%) had naevi on the palms and 18/549 (3.3%) on the soles. Children with fair skin, freckles and light hair and eye colours had significantly more naevi than those with darker colours. Thirty-one of 549 (6%) children had AD diagnosed on the examination day and they had a lower total naevus count (median 20) compared with children with no AD (median 27,n = 518, P < 0.05). Conclusions: The naevus situation in Estonian children today might constitute a starting point for evaluating the efficiency of coming preventive measures as a change of naevus number in children might serve as an early marker for a change in melanoma incidence. © 2006 European Academy of Dermatology and Venereology.
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34.
  • Koyi, H, et al. (author)
  • Intratracheal metastasis from malignant melanoma
  • 2000
  • In: Journal of the European Academy of Dermatology and Venereology : JEADV. - : Wiley. - 0926-9959 .- 1468-3083. ; 14:5, s. 407-408
  • Journal article (peer-reviewed)
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35.
  •  
36.
  • Löwhagen, Gun-Britt, 1942, et al. (author)
  • The microenvironment of vulvar skin in women with symptomatic and asymptomatic herpes simplex virus type 2 (HSV-2) infection
  • 2006
  • In: J Eur Acad Dermatol Venereol. - : Wiley. - 0926-9959. ; 20:9, s. 1086-9
  • Journal article (peer-reviewed)abstract
    • BACKGROUND: It is not known why some individuals infected with herpes simplex virus type 2 (HSV-2), experience frequent recurrences, while most of those infected have a completely silent infection. OBJECTIVE: We wanted to study if local factors in the skin could explain this difference. DESIGn 21 HSV-2 seropositive patients, 10 with history of >8 clinical recurrences a year (symptomatics) and 11 without symptoms of genital herpes (asymptomatics) were included. All had to answer a questionnaire. With standardised methods, the skin temperature, pH, and the skin barrier function, expressed as transepidermal water loss (TEWL) and skin capacitance, were measured on labium majus and perineum. Culture for bacteria was performed from the same regions. RESULTS AND CONCLUSION: No significant differences in terms of pH and skin barrier function were registered between symptomatic and asymptomatic patients. Asymptomatic patients had a tendency (0.06) to a higher colonisation with lactobacilli on labium majus than symptomatic patients.
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37.
  • Maroti, Marianne, et al. (author)
  • Quality of life before and 6 weeks after treatment in a dermatological outpatient treatment unit
  • 2006
  • In: Journal of the European Academy of Dermatology and Venereology. - : Wiley. - 0926-9959 .- 1468-3083. ; 20:9, s. 1081-1085
  • Journal article (peer-reviewed)abstract
    • Background: Dermatological disease affects quality of life to a great extent. Treatments are time-consuming and many patients have problems adhering to treatment. Attending an outpatient unit regularly during an intensive treatment period may enable patients to cope with their illness, adhere to treatment and thus improve their quality of life. Objective: To study the effect on quality of life of 6 weeks of regular treatment in the outpatient unit in the County Hospital of Jönköping, by means of a questionnaire and interviews. Methods: The Dermatology Life Quality Index (DLQI) was distributed to 50 consecutive patients with psoriasis, atopic dermatitis or pruritus attending our outpatient treatment unit. Nine of the patients were interviewed during treatment about factors that might influence their quality of life. Results: The DLQI scores before treatment indicated a low quality of life. Women were more affected than men. After 6 weeks of treatment there was a clear improvement, with a 57% reduction in the scores. The answers from the interviews indicated important areas of concern such as withdrawal from public places, adoption of special clothing habits and concern about personal relationships. Conclusion: Dermatological diseases have an important influence on patients' quality of life. Attending an outpatient treatment unit was in this series of cases associated with improved quality of life as measured with the DLQI. © 2006 European Academy of Dermatology and Venereology.
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38.
  • Nylander Lundqvist, Elisabet, et al. (author)
  • Psychological health in patients with genital and oral erosive lichen planus
  • 2006
  • In: Journal of the European Academy of Dermatology and Venereology. - : Wiley. - 0926-9959 .- 1468-3083. ; 20:6, s. 661-666
  • Journal article (peer-reviewed)abstract
    • BACKGROUND: Erosive lichen planus is a severe, recurrent and recalcitrant disease that affects several mucosal areas, mostly the genital area and the mouth, but also, for example, the oesophagus and perianal area. The disease causes serious symptoms, because of the raw, de-epithelialized mucosa and healing with scars/adhesions, which affect the patient's life in many ways. It causes, for example, difficulties in eating, drinking and going to the bathroom. Treatment is complicated and, so far, few therapeutic drugs other than steroids have been reported. OBJECTIVES: As the disease has severe implications on the patient's life it is important to investigate the psychological health of the patients, as well as the influence of stress on their health and wellbeing, in order to improve treatment. STUDY DESIGN, SUBJECTS AND METHODS: Forty-nine consecutive patients with erosive lichen planus were included during a 1-year period. The study was carried out as 'state-of-the-last-month', and stress, state anxiety, depression and 'erosive lichen planus factors', i.e. symptoms affecting daily life, were assessed. RESULTS: Eighty-seven per cent of the patients had symptoms, severely affecting daily life. Unexpectedly, oral symptoms seemed to be the most prominent. Our results showed that depression, anxiety and stress were more common in patients with erosive lichen planus than in a control group. DISCUSSION AND CONCLUSIONS: Erosive lichen planus is a severe disease with symptoms and complications affecting the patient's life. Our results indicate that their psychological health is also affected and emphasize the need for close collaboration between physicians, dentists with special knowledge in oral medicine and counsellors/psychologists to optimize handling of these patients.
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39.
  • Olsen, Birgitta, 1952-, et al. (author)
  • Population-based assessment of Mycoplasma genitalium in Vietnam : low prevalence among married women of reproductive age in a rural area
  • 2009
  • In: Journal of the European Academy of Dermatology and Venereology. - Amsterdam : Wiley-Blackwell Publishing Inc.. - 0926-9959 .- 1468-3083. ; 23:5, s. 533-537
  • Journal article (peer-reviewed)abstract
    • Objective To analyse the prevalence of Mycoplasma genitalium infection in a population-based study among married women from a demographic surveillance site in a rural geographical area of Vietnam.Materials and Methods Women, 18-49 years of age, were randomly selected to participate. DNA was isolated from endocervical swabs sampled from 990 participating women. The M. genitalium MgPa adhesion gene was detected using a real-time PCR with TaqMan probe.Results Eight (0.8% [95% confidence interval, 0.25-1.35%]) of the included women were infected with M. genitalium .Two of these positive women reported clinical symptoms. One additional M. genitalium positive but symptom-free woman, however, showed clinical signs of vaginitis. None of the M. genitalium positive women was concomitantly infected with Chlamydia trachomatis , Neisseria gonorrhoeae , syphilis or HIV. Furthermore, there was no obvious association between M. genitalium infectionand vaginal douching, use of intra-uterine device (IUD), or occurrence of bacterial vaginosis, candidiasis, or Trichomonas vaginalis .Conclusions The prevalence of M. genitalium among married women in Vietnam was relatively low. However, more large, well-designed and appropriately performed studies in other population groups including unmarried women and men, and in other geographical areas, rural as well as urban, are crucial in order to extract any evidence-based conclusions regarding the overall prevalence of STIs, including M. genitalium infections, in the Vietnamese society. The present study compiled with such future studies may form the basis for a national sexual health strategy for prevention, diagnosis, and surveillance of STIs, including M. genitalium infections, in Vietnam.
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40.
  •  
41.
  • Ozolins, D., et al. (author)
  • Diagnostics, surveillance and management of sexually transmitted infections in Europe have to be improved : lessons from the European Conference of National Strategies for Chlamydia Trachomatis and Human Papillomavirus (NSCP conference) in Latvia, 2011
  • 2013
  • In: Journal of the European Academy of Dermatology and Venereology. - : Wiley. - 0926-9959 .- 1468-3083. ; 27:10, s. 1308-1311
  • Journal article (peer-reviewed)abstract
    • Background There is an urgent need for the recognition of sexually transmitted infections (STIs) as a serious public health problem in Europe. The lack of standardization in testing, along with poor reporting and surveillance mechanisms, have resulted in low reported rates of STIs in many European Union (EU) countries, reinforcing the erroneous assumption that STIs are not a major problem. Testing and diagnosis of STIs must therefore be improved and enhanced. Recommendations Reporting of Chlamydia trachomatis infection, gonorrhoea and syphilis should be mandatory, and an integrated surveillance system for C. trachomatis implemented in all European countries. Implementation of the European Centre for Disease Prevention and Control (ECDC) surveillance mechanisms for STIs in all EU countries is highly recommended. A necessary component for successful introduction of the HPV vaccine, as with any vaccination programme is a well-planned and organized information campaign.
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42.
  • Paoli, John, 1975, et al. (author)
  • Results of the 'Euromelanoma Day' screening campaign in Sweden 2008
  • 2009
  • In: Journal of the European Academy of Dermatology and Venereology. - : Wiley. - 1468-3083 .- 0926-9959. ; 23:11, s. 1304-1310
  • Journal article (peer-reviewed)abstract
    • Abstract Background The 'Euromelanoma Day' skin cancer screening campaign is organized annually in several European countries since the year 2000. The national results have not been analysed in a Scandinavian country. Objective Our objective was to analyse the demographic characteristics and risk factors of the screened population during the 'Euromelanoma Day' in Sweden 2008. We also aimed to describe the clinical diagnoses found, the melanomas confirmed histopathologically and the treatments performed. Methods A public health education campaign to promote awareness of skin cancer risk factors and warning signs was carried out. Patients with suspicious lesions were advised to attend the screening. Questionnaires were used to collect relevant demographic, epidemiological and clinical data. Results In total, 2659 patients were screened. Women accounted for 62.3% of all patients; the median age was 57 years (range: 5-100 years); and 91.2% had skin phototypes II-III. Previous skin cancer was reported by 18.4% of all patients and 14.8% had a family history of melanoma. In total, 456 patients were diagnosed clinically with non-melanoma skin cancer. Twenty-four patients had histopathologically confirmed melanomas. Ten were in situ and 8 of the 14 invasive melanomas had a Breslow thickness that was less than 1 mm. Treatment or future medical care was carried out in 45.4% of all patients. Conclusion The 'Euromelanoma Day' campaign attracted many individuals at risk for skin cancer. The detection rate of non-melanoma skin cancer and melanoma was relatively high compared to similar campaigns in other European countries. Most melanomas found had a favourable prognosis. Conflicts of interest None declared.
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43.
  • Paoli, John, 1975, et al. (author)
  • Teaching peripheral nerve blocks for the head and neck area to dermatologists.
  • 2012
  • In: Journal of the European Academy of Dermatology and Venereology : JEADV. - : Wiley. - 1468-3083 .- 0926-9959. ; 26:8, s. 1035-1037
  • Journal article (peer-reviewed)abstract
    • Background Peripheral nerve blocks in the head and neck region can be useful for a large number of surgical or otherwise painful procedures carried out by dermatologists. As anaesthesiologists cannot always be available to help dermatologists place nerve blocks in outpatient settings, training courses for these physicians are warranted. Objectives To present a method of teaching nerve blocks for the face and scalp to dermatologists during residency and/or continuing medical education programmes. Methods Half-day courses with theoretical education, video demonstrations and supervised 'hands-on' training were organized to teach supraorbital/supratrochlear, infraorbital, mental and occipital nerve blocks. The outcome and effects of these training courses were analysed with a survey amongst participants 1-2years after the course. Results All the 20 participants who responded the survey successfully placed at least one type of nerve block during the course. Thirteen of 20 participants (65%) reported to be able to perform all the nerve block techniques at follow-up. Conclusions Dermatologists can learn how to perform nerve blocks for the face and scalp in a safe and controlled manner through half-day courses, including theory, video demonstrations and supervised 'hands-on' training.
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44.
  • Papp, K., et al. (author)
  • Cost-effectiveness evaluation of clobetasol propionate shampoo (CPS) maintenance in patients with moderate scalp psoriasis : A Pan-European analysis
  • 2012
  • In: Journal of the European Academy of Dermatology and Venereology. - : Wiley. - 0926-9959 .- 1468-3083. ; 26:11, s. 1407-1414
  • Journal article (peer-reviewed)abstract
    • Background Scalp psoriasis is a difficult to treat and usually chronic manifestation of psoriasis. The CalePso study showed that CPS (Clobex ® Shampoo) in maintenance therapy of scalp psoriasis (twice weekly) significantly increases the probability of keeping patient under remission during 6 months, compared with vehicle (40.3% relapses vs. 11.6% relapses, ITT). Objective The objective of the study was to assess the cost-effectiveness of a maintenance therapy with CPS vs. its vehicle in nine European countries. Methods A 24-week decision tree model was developed with 4-weekly time steps. The considered population has moderate scalp psoriasis successfully treated with a daily application of CPS up to 4 weeks. Data were taken from the CalePso study and from national experts' recommendations for alternative treatment choices, with their probabilities of success taken from literature to develop country-specific models. Health benefits are measured in disease-free days (DFD). The economic analysis includes drug and physician costs. A probabilistic sensitivity analysis (PrSA) assesses the uncertainty of the model. Results Depending on the country, the mean total number of DFDs per patient is 21-42% higher with CPS compared with vehicle, and the mean total cost is 11-31% lower. The mean costs per DFD are 30-46% lower with CPS compared with the vehicle. The PrSA showed in 1000 simulations that CPS is more effective vs. vehicle in 100% of the cases and less expensive than its vehicle in 80-99% of the cases. Conclusion This model suggests that CPS is cost-effective in maintaining the success achieved in moderate scalp psoriasis patients.
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45.
  •  
46.
  • Shipitsyna, E., et al. (author)
  • Evaluation of polymerase chain reaction assays for the diagnosis of Trichomonas vaginalis infection in Russia
  • 2013
  • In: Journal of the European Academy of Dermatology and Venereology. - : Wiley. - 0926-9959 .- 1468-3083. ; 27:2, s. e217-e223
  • Journal article (peer-reviewed)abstract
    • Background In Russia, the microscopy- and culture-based diagnostics of trichomoniasis is mainly suboptimal. Recent years, domestically produced diagnostic PCR assays have been implemented; however, any evaluation of these PCRs has never been internationally reported. Objective To assess the performance characteristics of PCR assays developed and currently used in Russia to detect Trichomonas vaginalis. Materials and methods Five PCR assays were assessed on 448 samples (317 vaginal and 131 male urethral) collected from symptomatic attendees of youth centres (n = 415) and patients of a dermatovenereological dispensary that were previously diagnosed with trichomoniasis (n = 33). As reference assay, a sensitive and specific real-time multiplex PCR was used. Results T. vaginalis DNA was detected in five (all females) of the 415 patients of youth centres (1.2%). All 33 patients previously diagnosed at the venereological dispensary proved to be true positive. For 445 (99.3%) of these 448 samples identical results were obtained by all PCRs, 35 positive and 410 negative. The three discordant samples were positive in all PCRs except one conventional PCR assay. The sensitivities of the PCRs were 94.3-100% and 66.7-100% for vaginal and urethral swabs, respectively. All evaluated assays were 100% specific. The detection limits of the different PCRs ranged from 0.1 to 5 genome equivalents per reaction. Conclusion The PCR assays currently used in Russia for the detection of T. vaginalis have in general high sensitivities and excellent specificities for both vaginal samples and urethral samples from males.
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47.
  • Shipitsyna, E, et al. (author)
  • Evaluation of six nucleic acid amplification tests used for diagnosis of Neisseria gonorrhoeae in Russia compared with an international strictly validated real-time porA pseudogene polymerase chain reaction
  • 2009
  • In: Journal of the European Academy of Dermatology and Venereology. - : Wiley. - 0926-9959 .- 1468-3083. ; 23:11, s. 1246-1253
  • Journal article (peer-reviewed)abstract
    • Background In Russia, laboratory diagnosis of gonorrhoea has been mainly based on microscopy only and, in some settings, relatively rare suboptimal culturing. In recent years, Russian developed and manufactured nucleic acid amplification tests (NAAT) have been implemented for routine diagnosis of Neisseria gonorrhoeae. However, these NAATs have never been validated to any international well-recognized diagnostic NAAT. Objective This study aims to evaluate the performance characteristics of six Russian NAATs for N. gonorrhoeae diagnostics. Materials and methods In total, 496 symptomatic patients were included. Five polymerase chain reaction (PCR) assays and one real-time nucleic acid sequence based amplification (NASBA) assay, developed by three Russian companies, were evaluated on urogenital samples, i.e. cervical and first voided urine (FVU) samples from females (n = 319), urethral and FVU samples from males (n = 127), and extragenital samples, i.e. rectal and pharyngeal samples, from 50 additional female patients with suspicion of gonorrhoea. As reference method, an international strictly validated real-time porA pseudogene PCR was applied. Results The prevalence of N. gonorrhoeae was 2.7% and 16% among the patients providing urogenital and extragenital samples, respectively. The Russian NAATs and the reference method displayed high level of concordance (99.4-100%). The sensitivities, specificities, positive predictive values and negative predictive values of the Russian tests in different specimens were 66.7-100%, 100%, 100%, and 99.4-100%, respectively. Conclusions Russian N. gonorrhoeae diagnostic NAATs comprise relatively good performance characteristics. However, larger studies are crucial and, beneficially, the Russian assays should also be evaluated to other international highly sensitive and specific, and ideally Food and Drug Administration approved, NAATs such as Aptima Combo 2 (Gen-Probe).Conflicts of interest None declared.
  •  
48.
  • Shipitsyna, E, et al. (author)
  • First evaluation of polymerase chain reaction assays used for diagnosis of Mycoplasma genitalium in Russia
  • 2009
  • In: Journal of the European Academy of Dermatology and Venereology. - : Wiley. - 0926-9959 .- 1468-3083. ; 23:10, s. 1164-1172
  • Journal article (peer-reviewed)abstract
    • Background Diagnosis of Mycoplasma genitalium is entirely based on nucleic acid amplification tests (NAATs). In Russia, several M. genitalium polymerase chain reaction (PCR) assays have been developed; however, any evaluation of their performance has never been performed. Objective To assess the performance of five PCRs developed and currently used in Russia for diagnosis of M. genitalium. Materials and methods Vaginal swabs and first voided urine samples (FVUs) from 281 females and urethral swabs and FVUs from 125 males were analysed using three conventional PCRs and two real-time PCRs developed by three Russian companies. As reference tests, a real-time PCR targeting the MgPa adhesin gene was used; positive results were confirmed by two conventional PCRs targeting the 16S rRNA gene and MgPa gene, respectively. For evaluation of detection limits and analytical specificities, a blinded control panel consisting of dilutions of six strains of M. genitalium and 14 other Mycoplasma species was tested. Results The prevalence of M. genitalium was 2.5% among females and 9.6% among males. The highest sensitivity (71.4-100% in different specimens) was exhibited by one real-time PCRs. Conventional PCRs from two manufacturers failed to detect M. genitalium in any of the seven positive female FVUs. All tests had a 100% clinical specificity; however, one cross-reacted with Mycoplasma pneumoniae. Conclusions Only one of the five Russian PCRs displayed reasonable sensitivity for all specimen types, but the specificities of all assays were high. Accordingly, improvements regarding sensitivity of all the tests are needed. However, larger studies, including other populations, evaluating these assays are crucial.
  •  
49.
  • Shipitsyna, E., et al. (author)
  • Sexual behaviours, knowledge and attitudes regarding safe sex, and prevalence of non-viral sexually transmitted infections among attendees of youth clinics in St. Petersburg, Russia
  • 2013
  • In: Journal of the European Academy of Dermatology and Venereology. - : Wiley. - 0926-9959 .- 1468-3083. ; 27:1, s. e75-e84
  • Journal article (peer-reviewed)abstract
    • Background Adolescents and young adults are at increased risk of sexually transmitted infections (STIs). Knowledge of STI prevalence and risk factors are essential tools to elaborate preventive strategies. However, internationally reported studies on epidemiology of STIs among the youth in Russia are mainly lacking. Objectives To ascertain sexual behaviours, knowledge and attitudes about safe sex and prevalence and correlates with STIs in attendees of youth clinics in St. Petersburg, Russia. Methods A total of 301 women and 131 men, who self-referred for STI testing, completed a questionnaire and were screened for Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, and Trichomonas vaginalis using nucleic acid amplification tests. Results The overall STI prevalence was 16.9%, and similar in the female patients and male patients (15.6% and 19.8% respectively). C. trachomatis, N. gonorrhoeae, M. genitalium and T. vaginalis were detected in 13%, 2.5%, 4.6% and 1.2% of the attendees respectively. The men displayed riskier sexual behaviours and worse knowledge and attitudes regarding safe sex compared to the women, with the most distinguishing features being younger age at first intercourse (P < 0.0005), higher numbers of sex partners during lifetime (P = 0.001) and latest 6 months (P < 0.0005), more frequently consuming alcohol (P < 0.0005), poorer knowledge of STI/HIV prevention measures (P < 0.0005), and less positive attitudes towards safe sex (P = 0.001). However, no significant predictors of STI positivity were found in the men. In the women, the strongest predictors of STI positivity were young age (1519 years) and multiple sex partners (=2) during latest 6 months. Conclusions The overall prevalence of STIs among users of STI services at youth clinics in St. Petersburg was high. Comprehensive epidemiological data on STI prevalence and sexual behaviour correlates are necessary to initiate new and strengthen existing STI prevention programmes for the youth, in Russia as well as in many other settings.
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50.
  • Synnerstad, Ingrid, et al. (author)
  • Low risk of melanoma in patients with atopic dermatitis
  • 2008
  • In: Journal of the European Academy of Dermatology and Venereology. - : Wiley. - 0926-9959 .- 1468-3083. ; 22:12, s. 1423-1428
  • Journal article (peer-reviewed)abstract
    • Background: There is a possible association between atopy and cancer based on the concept of atopic diseases as a hyper-reactive state of the immune system. Melanoma is an immunogenic tumour, and since patients with atopic dermatitis (AD) are subjected to local and systemic immunosuppressives, it would be expected to find an influence of AD on the melanoma risk. There is a positive correlation between the number of naevi and melanoma risk, and children and adults with AD have fewer naevi than controls although many patients receive ultraviolet treatment. Objective: This study aims to investigate the melanoma risk in a retrospective cohort of AD patients compared with the population. Study design: 6280 AD patients born 1935–1979 visited five Dermatology clinics during 1986–2004. Mean follow-up time was 36.7 years (SD 6.9) corresponding to 230 742 person-years at risk. The cohort file was linked to the National Cancer register. Results: Six AD patients with melanoma were identified, and the Poisson regression analysis adjusted for age group, sex and year resulted in an incidence rate ratio of 0.49 (95% confidence interval: 0.27–1.35, P = 0.08) for the AD group compared with the total population in the region. Conclusion: A low risk to develop melanoma was found in AD patients. However, the results must be interpreted with caution since the small number of expected cases of melanoma makes the risk estimate sensitive to chance effects. We hypothesize that formation of naevi and progression to melanoma is counteracted by the inflammatory process in the skin of AD patients.
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