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- Baldaque-Silva, Francisco, et al.
(författare)
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Endoscopic assessment and grading of Barrett's esophagus using magnification endoscopy and narrow band imaging: Impact of structured learning and experience on the accuracy of the Amsterdam classification system
- 2013
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Ingår i: Scandinavian Journal of Gastroenterology. - : Informa UK Limited. - 1502-7708 .- 0036-5521. ; 48:2, s. 160-167
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Tidskriftsartikel (refereegranskat)abstract
- Objective. Several classification systems have been launched to characterize Barrett's esophagus (BE) mucosa using magnification endoscopy with narrow band imaging (ME-NBI). The good accuracy and interobserver agreement described in the early reports were not reproduced subsequently. Recently, we reported somewhat higher accuracy of the classification developed by the Amsterdam group. The critical question then formulated was whether a structured learning program and the level of experience would affect the clinical usefulness of this classification. Material & methods: Two hundred and nine videos were prospectively captured from patients with BE using ME-NBI. From these, 70 were randomly selected and evaluated by six endoscopists with different levels of expertise, using a dedicated software application. First, an educational set was studied. Thereafter, the 70 test videos were evaluated. After classification of each video, the respective histological feedback was automatically given. Results. Within the learning process, there was a decrease in the time needed for evaluation and an increase in the certainty of prediction. The accuracy did not increase with the learning process. The sensitivity for detection of intestinal metaplasia ranged between 39% and 57%, and for neoplasia between 62% and 90%, irrespective of assessor's expertise. The kappa coefficient for the interobserver agreement ranged from 0.25 to 0.30 for intestinal metaplasia, and from 0.39 to 0.48 for neoplasia. Conclusion: Using a dedicated learning program, the ME-NBI Amsterdam classification system is suboptimal in terms of accuracy and inter- and intraobserver agreements. These results reiterate the questionable utility of corresponding classification system in clinical routine practice.
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- Morgardt-Ryberg, Kristina, et al.
(författare)
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Patch testing with a textile dye mix - a multicentre study.
- 2014
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Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873. ; 71:4, s. 215-223
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Tidskriftsartikel (refereegranskat)abstract
- Disperse dyes are well-known contact sensitizers. However, they are not included in the majority of commercially available baseline patch test series.
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| 7. |
- Naldi, Luigi, et al.
(författare)
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Prevalence of Self-reported Skin Complaints and Avoidance of Common Daily Life Consumer Products in Selected European Regions.
- 2014
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Ingår i: JAMA Dermatology. - : American Medical Association (AMA). - 2168-6084 .- 2168-6068. ; 150:2, s. 154-162
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Tidskriftsartikel (refereegranskat)abstract
- IMPORTANCE Skin disorders are common in the general population, and they may be associated with significant disability. The use of daily skin products may affect the appearance and severity of skin conditions. OBJECTIVES To assess the prevalence of reported itchy rash lasting longer than 3 days among the general population and to evaluate lifetime avoidance of different types of consumer products because of skin problems. DESIGN, SETTING, AND PARTICIPANTS The European Dermato-Epidemiology Network (EDEN) Fragrance Study comprised a large descriptive epidemiological survey of the general population conducted in 6 European regions from August 20, 2008, to October 10, 2011. Participants were a random sample of individuals aged 18 to 74 years, based on electoral precincts. The participants were interviewed using a standardized questionnaire. EXPOSURES Lifetime exposure to products of common use was considered, including toiletry items that remained on the skin or were rinsed off and household and functional items. MAIN OUTCOMES AND MEASURES The 1-month, 1-year, and lifetime age-standardized prevalence rates of itchy rash that lasted longer than 3 days. RESULTS In total, 12 377 individuals (53.9% female; median age, 43 years) were interviewed. The overall prevalences of itchy rash were 19.3% (95% CI, 18.6%-20.0%) during the month preceding the interview, 31.8% (95% CI, 31.0%-32.6%) during the preceding year, and 51.7% (95% CI, 50.8%-52.6%) over a lifetime. In addition, the percentage of individuals who reported avoidance of any product varied from 37.0% for products intended to be left on the skin to 17.7% for household or functional products. CONCLUSIONS AND RELEVANCE Our findings confirmed the magnitude of skin problems among the general population reported in other surveys. Although itchy rash is a nonspecific manifestation, it may be considered in epidemiological surveys to reflect a constellation of skin conditions and to summarize the burden of these conditions on general health.
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| 8. |
- Pontén, Ann, et al.
(författare)
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Patch testing with 2.0% (0.60 mg/cm(2) ) formaldehyde instead of 1.0% (0.30 mg/cm(2) ) detects significantly more contact allergy.
- 2013
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Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873. ; 68:1, s. 50-53
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Tidskriftsartikel (refereegranskat)abstract
- Background.The currently used patch test concentration for formaldehyde is 1.0% (wt/vol) in water. However, clinical experience and previous studies suggest that 1.0% might be insufficient for detecting an optimized number of clinically relevant cases of contact allergy to formaldehyde. Objectives.To validate earlier patch test results for comparison of 1% (wt/vol) and 2% (wt/vol) formaldehyde in water, and to investigate co-reactivity with quaternium-15. Materials and methods.In 12 dermatology clinics, 3591 patients were routinely patch tested simultaneously with 2.0% (wt/vol) (0.60 mg/cm(2) ) and 1.0% (wt/vol) (0.30 mg/cm(2) ) formaldehyde. Micropipettes were used for delivering the exact dosage of the allergen. Results.Significantly more patients reacted to 2.0% formaldehyde than to 1.0% (3.4% versus 1.8%, p < 0.001). Overall, there were no sex differences between those reacting positively to 2.0% and 1.0%. Of 25 quaternium-15-positive patients, 4 (0.1%) reacted positively without reacting to formaldehyde. Conclusion.On the basis of the results of this multicentre study, as well as of previous studies, it can be suggested that 2.0% (wt/vol) in water formaldehyde should be used in routine patch testing in the baseline series.
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- Rossi, Marta, et al.
(författare)
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Design and Feasibility of an International Study Assessing the Prevalence of Contact Allergy to Fragrances in the General Population: The European Dermato-Epidemiology Network Fragrance Study
- 2010
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Ingår i: Dermatology. - : S. Karger AG. - 1421-9832 .- 1018-8665. ; 221:3, s. 267-275
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Tidskriftsartikel (refereegranskat)abstract
- Background/Aims: Data on contact allergy to fragrances in the general population are limited. Data from allergological services suggest that the frequency of contact allergy to fragrances is increasing. The European Dermato-Epidemiology Network (EDEN) Fragrance Study aims to obtain reliable data on the prevalence of contact allergy to fragrances and other sensitizers of the European baseline series, in the general population of different geographical areas of Europe. We report the methodology and the reliability of instruments adopted and discuss the feasibility based on a pilot phase. Methods: Descriptive epidemiology survey. A random sample from the general population is selected and interviewed, and is offered patch testing in a randomized way. We specifically enquire about any skin rash reported during the previous year, and any history of reactions to products that may contain the sensitizer and/or a history of avoidance of the same products. Patch test data are linked to the questionnaire information to define clinical relevance. Results: The questionnaire showed high test-retest reliability in 94 individuals. Patch test reading also showed a high level of interrater reliability. During the pilot phase, a total of 589 participants were recruited. Conclusions: The EDEN Fragrance Study is feasible and able to provide useful data on fragrance allergy. Copyright (C) 2010 S. Karger AG, Basel
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- Sosted, Heidi, et al.
(författare)
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Contact allergy to common ingredients in hair dyes
- 2013
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Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873. ; 69:1, s. 32-39
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Tidskriftsartikel (refereegranskat)abstract
- Background p-Phenylenediamine (PPD) is the primary patch test screening agent for hair dye contact allergy, and approximately 100 different hair dye chemicals are allowed. Objectives To examine whether PPD is an optimal screening agent for diagnosing hair dye allergy or whether other clinically important sensitizers exist. Methods Two thousand nine hundred and thirty-nine consecutive patients in 12 dermatology clinics were patch tested with five hair dyes available from patch test suppliers. Furthermore, 22 frequently used hair dye ingredients not available from patch test suppliers were tested in subgroups of approximate to 500 patients each. Results A positive reaction to PPD was found in 4.5% of patients, and 2.8% reacted to toluene-2,5-diamine (PTD), 1.8% to p-aminophenol, 1% to m-aminophenol, and 0.1% to resorcinol; all together, 5.3% (n=156). Dying hair was the most frequently reported cause of the allergy (55.4%); so-called temporary henna' tattoos were the cause in 8.5% of the cases. p-Methylaminophenol gave a reaction in 20 patients (2.2%), 3 of them with clinical relevance, and no co-reaction with the above five well-known hair dyes. Conclusions Hair dyes are the prime cause of PPD allergy. PPD identifies the majority of positive reactions to PTD, p-aminophenol and m-aminophenol, but not all, which justifies additional testing with hair dye ingredients from the used product.
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