Background: Occupational dermatitis is considered as the second most common occupational disease. It accounts for 25% of all lost workdays. Several international studies reported a prevalence of occupational dermatiti...Background: Occupational dermatitis is considered as the second most common occupational disease. It accounts for 25% of all lost workdays. Several international studies reported a prevalence of occupational dermatitis in healthcare workers between 17% and 55%. This study aims to identify factors that affect the professional outcome of nurses suffering from occupational dermatitis. Methods: This was a multicenter cross-sectional study concerning nurses declared having occupational dermatitis in the central region of Tunisia. A synoptic sheet related to socio-professional and administrative data was completed. A self-administered Questionnaire going over medical and occupational characteristics was completed during a direct interview. Results: The study involved forty nurses working in four public hospitals in the center of Tunisia. Only 37 workers were included in the study. A professional reclassification was introduced among 19 workers (51% of study population). Work-station adaptation was requested in 14 cases (38%). Exposure to allergens in the workplace was eliminated in 20 cases. Two study participants were transferred to other departments (5.4%) and three people retired (8.1%). A statistically significant association was found between professional reclassification and a history of allergic manifestations (p = 0.003). Similarly, a significant association was found between professional reclassification and the allergic agent (p = 0.014). Workstation layout was significantly associated with a history of allergic manifestations (p = 0.039), the palm hand location (p = 0.04), professional eviction (p Conclusion: This study identified the main factors influencing the occupational outcome of nurses suffering from occupational dermatitis. This outcome depended on a history of atopy (especially allergic rhinitis) and sensitization to allergens (thiuram mix).展开更多
Background: Occupational allergic contact dermatitis (ACD) is one of the most frequent diseases on the workplace worldwide. Its national incidence and prevalence were not previously studied in Tunisia. Objective: To a...Background: Occupational allergic contact dermatitis (ACD) is one of the most frequent diseases on the workplace worldwide. Its national incidence and prevalence were not previously studied in Tunisia. Objective: To assess incidence of occupational allergic contact dermatitis and its occupational outcome in Tunisia. Methods: Descriptive epidemiological study of all cases of occupational allergic contact dermatitis reported from 2002 to 2012 in Tunisia and recognized by the medical commissions of the National Health Insurance Fund. Results: 315 cases of occupational ACD were collected representing an annual incidence of 31.65 cases/100.000 workers in the private sector in Tunisia. The mean age of our population was 42.70 ± 9.02 years with a male predominance (sex ratio 3.03). The most affected sectors were the clothing sector (14.3% of cases) and the cement industry (13.7% of cases). Patch tests were positive in 188 patients (59.67%). The most frequently positive allergen was potassium dichromate in 27.3% of the cases. Overall, 25.4% of patients had lost their jobs. After multiple binary logistic regression, job loss had a statistically significant relationship with localization of lesions on the face and on dominant hand. Conclusion: Occupational ACD is frequent in Tunisia and is responsible for an important rate of job loss. Preventive measures must be reinforced, especially the wearing of protective gloves.展开更多
With the rapid development of emergency medicine,emergency physicians are working around the clock,[1]including additional workloads due to sudden public health emergencies and disasters.Occupational risks for emergen...With the rapid development of emergency medicine,emergency physicians are working around the clock,[1]including additional workloads due to sudden public health emergencies and disasters.Occupational risks for emergency physicians are significantly high due to an increasing number of patients with acute and severe diseases,an increased workload.展开更多
Background: Atopic dermatitis (AD) is the most common inflammatory skin disease in children. Treatment of AD is based on skin barrier repair and reduction of inflammation. We analyzed the efficacy and safety of activa...Background: Atopic dermatitis (AD) is the most common inflammatory skin disease in children. Treatment of AD is based on skin barrier repair and reduction of inflammation. We analyzed the efficacy and safety of activated piroctone olamine (APO)—Blue Cap—in children with AD. Materials and Methods: An open-label interventional clinical study was carried out at three clinical centers in Serbia. A total of 58 patients with AD, aged between 3 and 18 years were included and treated with Blue Cap Foam (100 ml;CATALYSIS S.L. Madrid)—Activated Piroctone Olamine—applied twice a day in the affected areas with eczema for 30 days and final assessment at 45 days from baseline. Photographic documentation, clinical evaluation, therapy effectiveness and safety questionnaires were assessed at baseline, 15, 30 and 45 days. Results: Our results demonstrated a significant reduction in signs (erythema, scaling, infiltration, excoriations, xerosis) and symptoms (pruritus) at weeks 2 and 4 of the study. At the end of the study, most patients had moderate (28.6%) to great (62.5%) disappearance of manifestations and moderate (25%) to great (71.4%) skin quality improvement. The effect and tolerability of the therapy were evaluated as very good in 66.1 % and 67.9% and good in about 14.3% and 17.9%, assessed by the investigator and patient, respectively. Three patients experienced a burning sensation at the beginning of the study, the side-effects were resolved as the patients continued applying the foam. After two weeks of cessation of the investigated foam, a significant percentage of patients experienced worsening in the final assessment done by the investigator as well as the participant. In the final assessment, a significantly high percentage (57.1%) of patients had a total reduction of manifestation, and a significant number of participants considered the applied product as treatment success, assessed by the investigator (62.5%) as well as the participants (66.4%). Conclusions: Blue Cap is effective and safe in children with AD, although further large-scale randomized controlled trials should confirm our study findings.展开更多
Research Problem: In Abu Dhabi, limited implementation of OSH Regulations contributes to the general unawareness among employees and workers about occupational hazards and safety measures, resulting in slow responsive...Research Problem: In Abu Dhabi, limited implementation of OSH Regulations contributes to the general unawareness among employees and workers about occupational hazards and safety measures, resulting in slow responsiveness toward enforcement measures and a lack of self-regulatory approaches within companies. Purpose: The purpose of this study is to examine the implementation methods practised in Abu Dhabi with those in developed countries with established OSH regulatory bodies. Methodology: Qualitative and quantitative research methods were employed to gather primary research data. Workers from various industries in Abu Dhabi were sampled on purpose and asked to respond to questionnaires and interviews on OSH protocol awareness and implementation, and circumstances of workplace incidence. Results: The findings of this study showed that the enforcement of OSH requirements in UAE positively correlated to a reduction in the rate of work-related injury and improved business performance. The quantitative research data showed that the energy sector had the highest score (15) while the tourism sector had the lowest score (5.3) in occupational health systems and improvements in business efficiency and productivity. Implications: The outcomes of this study shed light on the importance of implementing OSH Guidelines for companies to empower their safety managers to fully enforce OSH requirements in their organisations. In conclusion, effective OSH enforcement requires cooperation between general workers and OSH managers and facilitation from business owners.展开更多
Background:This study aimed to assess how acupoint catgut-embedding therapy influences Th2-type immune response and the infiltration of CD4^(+)and CD8^(+)cells in DNCB-induced atopic dermatitis in BALB/c mice.It also ...Background:This study aimed to assess how acupoint catgut-embedding therapy influences Th2-type immune response and the infiltration of CD4^(+)and CD8^(+)cells in DNCB-induced atopic dermatitis in BALB/c mice.It also conducted an initial examination of the underlying molecular mechanisms.Methods:Seventy-two mice were randomly divided into four groups:normal control,DNCB-induced atopic dermatitis model(AD),AD with acupoint catgut-embedding treatment(ADA),and AD with sham-acupoint catgut-embedding treatment.After DNCB challenge to induce AD,the ADA group received acupoint catgut-embedding therapy treatment at Zusanli(ST 36)and Quchi(LI 11)acupoints every other week from day 8.Mice in the AD with sham-acupoint catgut-embedding treatment group underwent the same procedure as the ADA group but without catgut implantation.Severity was assessed using SCORAD on treatment days 1,10,and 20.On day 18,nine mice per group were euthanized,and the remaining on day 28.Histopathological changes were observed using hematoxylin-eosin and immunohistochemistry staining.TNF-α,IL-4,IL-6,and IL-13 levels were analyzed by ELISA,and GATA3 and STAT6 protein levels by western blot.Results:After 20 days of acupoint catgut-embedding therapy treatment,mice showed reduced dermatitis scores compared to DNCB-induced AD-like mice.Significant decreases occurred in serum IL-4,IL-6,IL-13,and TNF-αlevels.Skin analysis revealed marked reductions in CD4^(+)and CD8^(+)cell infiltration,as well as GATA3 and STAT6 protein levels.Conclusion:Acupoint catgut-embedding therapy may effectively alleviate atopic dermatitis by suppressing Th2 immune responses via the STAT6-GATA3 pathway and reducing CD4^(+)and CD8^(+)T cell infiltration in skin lesions.展开更多
Objective: To explore the pre-treatment and efficacy analysis of comprehensive anti-inflammatory treatment for lymphedema in patients with irritating contact dermatitis. Method: Convenience sampling method was used to...Objective: To explore the pre-treatment and efficacy analysis of comprehensive anti-inflammatory treatment for lymphedema in patients with irritating contact dermatitis. Method: Convenience sampling method was used to observe the skin of 160 patients with upper limb lymphedema admitted to the lymphedema outpatient department of our hospital. They were divided into an observation group (80 cases) and a control group (80 cases), and both groups received a course of comprehensive anti-inflammatory treatment (20 treatments). The control group received routine skin care;On the basis of the control group, the observation group received pre-treatment of the affected limb skin: Laofuzi herbal ointment was applied externally to the prone areas of irritating contact dermatitis (such as the upper arm, inner forearm, and cubital fossa). Result: The incidence of irritating contact dermatitis in the observation group was significantly lower than that in the control group (P 0.05). Patients in the observation group felt significantly better in terms of comfort, skin moisture, and itching relief after being wrapped with low elasticity bandages than those in the control group (P Conclusion: Preventive treatment can effectively reduce the incidence of irritating contact dermatitis, prolong the time of stress treatment, thereby increasing efficacy and improving patient compliance.展开更多
Competency-based assessments for healthcare professionals are critical for safe and effective client outcomes. Rehabilitation clinical skill competency assessments must be validated and revised to produce safe and ski...Competency-based assessments for healthcare professionals are critical for safe and effective client outcomes. Rehabilitation clinical skill competency assessments must be validated and revised to produce safe and skilled practitioners. The revised American Occupational Therapy Association (AOTA) Fieldwork Performance Evaluation (FWPE) instrument measures occupational therapy student performance to determine readiness for practice. The assessment includes thirty-seven competencies that address both profession specific clinical skills and general professional behavior skills. The objective of this study was to use Rasch methods to explore the use of the revised FWPE in actual fieldwork practice and to determine the instrument’s psychometric properties when separating the item components into two distinct subdomains: General Health Professions Competences and Occupational Therapy-Specific Competencies. Internal construct validity and test reliability were analyzed using data from 149 occupational therapy students after completing their initial Level II A fieldwork clinical internship. This study examined the item difficulty hierarchy, item fit, person-fit to model, person separation index, person separation reliability coefficient, strata, ceiling and floor effect, and unidimensionality of the FWPE instrument as a whole and as two separate domains. With the exception of not meeting the criteria for unidimensionality, the full FWPE instrument and the Occupational Therapy-Specific Competencies subdomain showed acceptable item-level psychometrics for reliability and precision. While the General Health Professions Competencies subdomain showed good item-level psychometrics, it was below the criterion for reliability and only separated the sample into two strata. Results support the validity, reliability, and clinical use of the revised FWPE full instrument and the Occupational Therapy-Specific Competencies subdomain to measure entry-level clinical skill competencies in practice.展开更多
Kenyatta National Hospital (KNH) is the largest public referral hospital with a comprehensive cancer treatment facility in East and Central Africa. Occupational radiation monitoring is a significant technique for demo...Kenyatta National Hospital (KNH) is the largest public referral hospital with a comprehensive cancer treatment facility in East and Central Africa. Occupational radiation monitoring is a significant technique for demonstrating compliance of radiation regulatory limits. The objective of the study was to carry out assessment of occupational radiation exposure among radiotherapy personnel at KNH using thermoluminescence dosimeter, TLD. KNH staff were monitored using dosimeter type TLD-100 made of LiF:Mg,Ti, on monthly basis. The reader system used for analysis was Harshaw 8800. The measurement established the average monthly accumulated occupational personnel dose for KNH to be 0.21 mSv and 0.29 mSv for Hp (10) and Hp (0.07) respectively. The accumulated dose results were within the maximum acceptable dose of 1.67 mSv/month and 41.6 mSv/month for Hp (10) and Hp (0.07) respectively. The investigation results were higher than the acceptable public limit of 0.08 mSv/month. Moreover, incidences were noted where the fetus dose limit 0.42 was also exceeded. Evaluation of statistical dose exposure among doctors, nurses and radiographers’ measurement results were within ±0.02 mSv. The study established the average KNH occupational radiation exposure levels for both Hp (10) and Hp (0.07) were within the ICRU recommendation, validating radiation protection safe practice. Data analysis of healthcare workers did not indicate exposure trend biased to any healthcare profession. Hence radiation risk cut across all professional categories. It is recommended that Radiation Monitoring program be reviewed to include non-clinical staff who access the facility. Radiation reporting should not be limited to one facility, but reflect cases where workers are involved in multiple multiple jobs.展开更多
Background Occupational asthma is a type of asthma caused by exposure to asthma-causing substances in an occupational setting. Its incidence is closely related to the degree of industrial development, but also related...Background Occupational asthma is a type of asthma caused by exposure to asthma-causing substances in an occupational setting. Its incidence is closely related to the degree of industrial development, but also related to the nature of asthma. In some specific industries, such as workers who are exposed to asthmatic isocyanates for a long time, the incidence of occupational asthma can reach 5%-10%, and the incidence of occupational asthma can even reach 50% or higher among workers engaged in the detergent industry who are in contact with proteolytic enzymes for a long time. Objective To analyze the clinical value of early comprehensive rehabilitation nursing for patients with occupational asthma, methods a total of 48 patients with occupational asthma who were admitted from January 2020 to December 2022 were divided into control group and study group by random number table method The disappearance time of chest tightness and shortness of breath, the disappearance time of wheezing and cough, and the FEV1, forced vital capacity (FVC) and peak expiratory flow (PEF) indexes before and after treatment were compared between the two groups after nursing, the disappearance time of clinical symptoms in the study group was shorter than that in the control group, and the levels of FEV1, FVC and PEF were higher than those in the control group, and the P < 0.05 was significantly improved.展开更多
Objective:In order to reveal the potential association between intestinal flora and atopic dermatitis with asthma,the study compares the changes in intestinal flora before and after treatment with antibiotics in child...Objective:In order to reveal the potential association between intestinal flora and atopic dermatitis with asthma,the study compares the changes in intestinal flora before and after treatment with antibiotics in children and explores the risk factors for the disease development in children.The differences between asthma-controlled children and healthy children were also analyzed to investigate whether there was a correlation between the level of control and intestinal flora in asthmatic children.Methods:367 children with atopic dermatitis and asthma were selected,and the control group was healthy children who did not have other skin diseases.Fecal samples were collected from healthy children and children with asthma,and the intestinal flora was tested at Beijing Nebula Medical Testing Laboratory Co.At the same time,50 children were selected according to the inclusion and exclusion criteria to take amide antibiotics during hospitalization,and stool samples were collected before and after taking antibiotics.Results:The proportion of Gram-positive cocci increased and the proportion of Gram-positive bacilli decreased after the administration of antibiotics in children with atopic dermatitis and asthma(P<0.05),and no significant difference was shown in the gender and age of the children(P>0.05).The proportion of family history of atopic dermatitis with asthma was higher in the experimental group(P<0.05).Conclusion:The use of antibiotics in children with atopic dermatitis with asthma showed a positive correlation with changes in intestinal flora.The use of antibiotics may lead to changes in intestinal flora and increase the risk of atopic dermatitis with asthma.Antibiotic use in infancy and childhood is also recognized as a risk factor for atopic dermatitis with asthma.Therefore,the use of antibiotics should be minimized in preventing and treating atopic dermatitis with asthma.展开更多
Objective:To explore the relationship between organizational identification,occupational stress,and insomnia among nurses and to analyze the moderating role of organizational identification between occupational stress...Objective:To explore the relationship between organizational identification,occupational stress,and insomnia among nurses and to analyze the moderating role of organizational identification between occupational stress and insomnia.Methods:Through stratified sampling,720 nurses working in a tertiary A-level hospital in Shandong Province from March to May 2021 were surveyed using an effort-reward imbalance questionnaire,an organizational identification questionnaire,and the Athens Insomnia scale.Results:Organizational identification was negatively correlated with occupational stress and insomnia(r_(1)=-0.121,P_(1)<0.01;r_(2)=-0.144,P_(2)<0.01).Occupational stress was positively correlated with insomnia(r=0.379,P<0.01).Organizational identity significantly moderated nurses’occupational stress and insomnia(β=-0.192,t=-2.558,P<0.05).Conclusion:Occupational stress and organizational identification can predict insomnia.Organizational identification could negatively mediate the relationship between occupational stress and insomnia.Improving organizational identification may help alleviate insomnia symptoms by relieving occupational stress.展开更多
Objective:To explore the clinical evaluation role of the Digits-in-Noise(DIN)test and Hearing Handicap Inventory for Adults Screening(HHIA-S)for patients with occupational noise-induced hearing loss and to observe and...Objective:To explore the clinical evaluation role of the Digits-in-Noise(DIN)test and Hearing Handicap Inventory for Adults Screening(HHIA-S)for patients with occupational noise-induced hearing loss and to observe and analyze their application values.Methods:Fifty patients with suspected occupational noise-induced hearing loss were randomly selected from the Department of Otolaryngology at the hospital as the research target.The collection period for the research cases spanned from January 2022 to November 2023,and all patients had a history of noise exposure.The DIN test and HHIA-S were used for hearing examinations,with clinical,comprehensive diagnosis serving as the gold standard to study their diagnostic performance.Results:The compliance rate of the DIN test was 88.00%,the HHIA-S’s compliance rate was 80.00%,and the combined compliance rate was 94.00%.The compliance rate of the DIN test and the combined compliance rates of the patients were statistically significant compared to the clinical gold standard data(P<0.05),while there was no difference between the compliance rate of the HHIA-S and the gold standard(P>0.05).The data shows that the sensitivity of the combined diagnosis is significantly higher than the sensitivity data of the DIN test and HHIA-S examination alone(P<0.05).Its specificity is 100.00%,and the accuracy data of the joint diagnosis in the degree were higher than those of the DIN test alone(P>0.05)and the HHIA-S alone(P<0.05).Conclusion:For patients with occupational noise-induced hearing loss,the joint evaluation of the DIN test and HHIA-S can significantly improve their diagnostic value with high sensitivity and accuracy.展开更多
Objective: HIV-HBV co-infection is a major public health problem that has not been sufficiently explored in the Central African workplace. The aim of this study was to assess the frequency of HIV-HBV co-infection amon...Objective: HIV-HBV co-infection is a major public health problem that has not been sufficiently explored in the Central African workplace. The aim of this study was to assess the frequency of HIV-HBV co-infection among people who living with HIV (PLHIV) in the infectious and tropical diseases department of the Centre Hospitalier Universitaire de lAmiti Sino-Centrafricaine in Bangui. Methods: A retrospective study was carried out from January 1, 2010 to December 31, 2021 in the Infectious and Tropical Diseases Department at the Amiti Sino-Centrafricaine University Hospital. It included the files of all PLHIV, which included the results of HBV serology. A standardized form was used to collect socio-demographic and professional data by documentary review. Data was analysed using Epi-Info 7 software. Means, proportions were calculated as well as Chi square witch was significant if p-value was below 0.05. Results: The study included 265 patients, 188 were women (70.1%) and 77 men (29.1%), giving a sex ratio of 0.45. Mean age was 35.8 years, higher in men (40 years) than in women (35.8 years) (p 0.0001). The age groups 25 to 34 (37.7%) and 35 to 44 (33.6%) were in the majority (71.3%). The majority of PLHIV were unemployed (57.1%), including housewives (43.0%). HBV prevalence was 14.3%, including 7.2% among the unemployed, who account for half of all co-infections. The search for associations between HIV-HBV co-infection and all socio-demographic characteristics (age, sex, marital status) and socio-professional categories showed no significant difference (p 0.05). Conclusion: PLHIV were predominantly young adults, female, and unemployed;no occupation was significantly associated with co-infection. The vast majority of co-infected people were not covered by the occupational health system (unemployed or informal sector). Urgent action is needed to improve workers access to occupational medicine in CAR.展开更多
As technology continues to revolutionize industries,spawning new economic models and patterns,the internet and digital development have created a wave of new occupations and positions.Statistics show that in 2023,Chin...As technology continues to revolutionize industries,spawning new economic models and patterns,the internet and digital development have created a wave of new occupations and positions.Statistics show that in 2023,China’s total workforce stood at 402 million,with 84 million individuals engaged in new forms of employment.展开更多
Background/Aim: This study evaluated family physicians’ attitudes toward occupational health and disease in Türkiye. Materials and Methods: The study is cross-sectional and descriptive in a quantitative research...Background/Aim: This study evaluated family physicians’ attitudes toward occupational health and disease in Türkiye. Materials and Methods: The study is cross-sectional and descriptive in a quantitative research design. The “Attitude Scale for Physicians toward Occupational Health and Occupational Diseases” developed by Kolcu et al. was used in the study (Cronbach’s α 0.94). Our study aimed to sample the entire country using the stratified sample selection based on geographical region. 349 family physicians were included in the study according to sample size (n: 349). Results: The mean age of the participants in the study was 37.77 ± 8.96 (min: 27, max: 65 years). Of the participants, 65.2% were male. Of the physicians, 33.8% were family medicine specialists, and 38.8% had occupational physician certificates. It was determined that the level of attitude of family physicians toward occupational diseases was insufficient. It was also found that awareness increased as age increased, and awareness and attitude levels did not change according to gender. No significant difference was found in the scale total scores and subdimensions of family physicians’ occupational health and occupational disease attitudes according to the regions they worked in Türkiye. Conclusion: It has been concluded that there is no difference in awareness among family physicians in regions where it is much more important to diagnose an occupational disease, especially in industrial regions. The number of family physicians with occupational physician certificates was very insufficient, and a significant number of those who had occupational physician certificates did not practice occupational medicine.展开更多
Purpose: The purpose of this study was to clarify the relationship and experiences of occupational health nurses (OHNs) and related departments in project development of mental health care for primary treatment in the...Purpose: The purpose of this study was to clarify the relationship and experiences of occupational health nurses (OHNs) and related departments in project development of mental health care for primary treatment in the Japanese occupational health setting. Method: A total of 235 OHNs who are members of the Japan Academy of Occupational Health Nursing were sent an anonymous self-administered questionnaire survey. The questionnaire included items on the following: the OHN’s background, whether the OHN had experience in project development, the communication between the associated departments, the Japanese version of the Work Engagement Scale (UWES-J), occupational assessments, workplace assessments, and the Transtheoretical Model (TTM) for health promotion in companies and the OHN’s working environment. We performed logistic regression analysis to examine the relationship between experience and these harmonious relationships with other associated departments. Result: Responses from 61 OHNs (valid response rate: 25.9%) were analyzed. The mean number of years of service as an OHN was 18.9, and 82% of respondents had experience in project development. The logistic analysis further revealed that OHNs who had experience in project development of mental health care usually had a harmonious relationship with other associated departments. Conclusion: To promote mental health care for workers, OHNs have the capability to create individual and workplace assessments, enhance their work engagement, and make further improvements to their working environment. .展开更多
BACKGROUND Lichen amyloidosis(LA)is a chronic,severely pruritic skin disease,which is the most common form of primary cutaneous amyloidosis.The treatment of LA has been considered to be difficult.LA may be associated ...BACKGROUND Lichen amyloidosis(LA)is a chronic,severely pruritic skin disease,which is the most common form of primary cutaneous amyloidosis.The treatment of LA has been considered to be difficult.LA may be associated with atopic dermatitis(AD),and in this setting,the treatment options may be more limited.Herein,we report four cases of LA associated with AD successfully treated by dupilumab.CASE SUMMARY In this article,we describe four cases of patients who presented with recurrent skin rash accompanied by severe generalized intractable pruritus,diagnosed with refractory LA coexisting with chronic AD.Previous treatments had not produced any apparent improvement.Thus,we administered dupilumab injection subcutaneously at a dose of 600 mg for the first time and 300 mg every 2 wk thereafter.Their lesions all markedly improved.CONCLUSION Dupilumab may be a new useful treatment for LA coexisting with AD.展开更多
BACKGROUND Lichenoid amyloidosis(LA)is a subtype of primary cutaneous amyloidosis characterized by persistent multiple groups of hyperkeratotic papules,usually on the lower leg,back,forearm,or thigh.LA may be associat...BACKGROUND Lichenoid amyloidosis(LA)is a subtype of primary cutaneous amyloidosis characterized by persistent multiple groups of hyperkeratotic papules,usually on the lower leg,back,forearm,or thigh.LA may be associated with several skin diseases,including atopic dermatitis(AD).The treatment of LA is considered to be difficult.However,as there is some overlap in the etiopathogenesis of LA and AD,AD treatment may also be effective for LA.CASE SUMMARY Case 1:A 70-year-old man was diagnosed with severe AD with LA based on large dark erythema and papules on the trunk and buttocks and dense hemispherical millet-shaped papules with pruritus on the extensor side of the lower limbs.He had a long history of the disease(8 years),with repeated and polymorphic skin lesions.Given the poor efficacy of traditional treatments,this patient was recommended to receive dupilumab treatment.At the initial stage,300 mg was injected subcutaneously every 2 wk.After 28 wk,the drug interval was extended to 1 mo due to the pandemic.Follow-up observations revealed that the patient reached an Eczema Area Severity Index of 90(skin lesions improved by 90%compared with the baseline)by the end of the study.Moreover,Investigator's Global Assessment score was 1,and scoring atopic dermatitis index and numeric rating scale improved by 97.7%and 87.5%compared with the baseline,respectively,with LA skin lesions having largely subsided.Case 2:A 30-year-old woman was diagnosed with severe AD with LA,due to dense and substantial papules on the dorsal hands similar to changes in cutaneous amyloidosis,and erythema and papules scattered on limbs and trunk with pruritus,present for 25 years.After 16 wk of dupilumab treatment,she stopped,and skin lesions completely subsided,without recurrence since the last follow-up.CONCLUSION Dupilumab shows rational efficacy and safety in the treatment of severe AD with LA,in addition to benefits in the quality of life of the patients.展开更多
Occupational burnout, even though is a widespread subject of research, remains one of the factors that threaten the implementation and organizational structure of the provided health service. The aim of our study is t...Occupational burnout, even though is a widespread subject of research, remains one of the factors that threaten the implementation and organizational structure of the provided health service. The aim of our study is to investigate the level of burnout among health professionals in Hellenic Red Cross Hospital, one of the biggest Public Hospitals in Athens, Greece. The study population included 116 health workers and was conducted in 2022. The present study, cross-sectional in nature, investigates burnout symptoms in the health-related professionals by measuring the three dimensions of burnout;emotional exhaustion, depersonalization and personal achievements. The overall findings show that people who provide health care services in hospitals are a vulnerable group to burnout syndrome. More specifically, it was found that emotional exhaustion moves at medium to high levels, as did depersonalization, while personal achievements are at moderate to low levels. The findings of the present study indicate that emphasis should be given to increasing the personal achievements of employees, which will in turn reduce emotional exhaustion and depersonalization. Perhaps a more detailed study on this topic could enlighten us about the causes and treatment of burnout syndrome in health professionals.展开更多
文摘Background: Occupational dermatitis is considered as the second most common occupational disease. It accounts for 25% of all lost workdays. Several international studies reported a prevalence of occupational dermatitis in healthcare workers between 17% and 55%. This study aims to identify factors that affect the professional outcome of nurses suffering from occupational dermatitis. Methods: This was a multicenter cross-sectional study concerning nurses declared having occupational dermatitis in the central region of Tunisia. A synoptic sheet related to socio-professional and administrative data was completed. A self-administered Questionnaire going over medical and occupational characteristics was completed during a direct interview. Results: The study involved forty nurses working in four public hospitals in the center of Tunisia. Only 37 workers were included in the study. A professional reclassification was introduced among 19 workers (51% of study population). Work-station adaptation was requested in 14 cases (38%). Exposure to allergens in the workplace was eliminated in 20 cases. Two study participants were transferred to other departments (5.4%) and three people retired (8.1%). A statistically significant association was found between professional reclassification and a history of allergic manifestations (p = 0.003). Similarly, a significant association was found between professional reclassification and the allergic agent (p = 0.014). Workstation layout was significantly associated with a history of allergic manifestations (p = 0.039), the palm hand location (p = 0.04), professional eviction (p Conclusion: This study identified the main factors influencing the occupational outcome of nurses suffering from occupational dermatitis. This outcome depended on a history of atopy (especially allergic rhinitis) and sensitization to allergens (thiuram mix).
文摘Background: Occupational allergic contact dermatitis (ACD) is one of the most frequent diseases on the workplace worldwide. Its national incidence and prevalence were not previously studied in Tunisia. Objective: To assess incidence of occupational allergic contact dermatitis and its occupational outcome in Tunisia. Methods: Descriptive epidemiological study of all cases of occupational allergic contact dermatitis reported from 2002 to 2012 in Tunisia and recognized by the medical commissions of the National Health Insurance Fund. Results: 315 cases of occupational ACD were collected representing an annual incidence of 31.65 cases/100.000 workers in the private sector in Tunisia. The mean age of our population was 42.70 ± 9.02 years with a male predominance (sex ratio 3.03). The most affected sectors were the clothing sector (14.3% of cases) and the cement industry (13.7% of cases). Patch tests were positive in 188 patients (59.67%). The most frequently positive allergen was potassium dichromate in 27.3% of the cases. Overall, 25.4% of patients had lost their jobs. After multiple binary logistic regression, job loss had a statistically significant relationship with localization of lesions on the face and on dominant hand. Conclusion: Occupational ACD is frequent in Tunisia and is responsible for an important rate of job loss. Preventive measures must be reinforced, especially the wearing of protective gloves.
基金Beijing Key Specialized Department for Major Epidemic Prevention and Control (Construction Project)National Major Science and Technology Projects (2017ZX10305501)Beijing Social Science Foundation Planning Project (17SRC019)。
文摘With the rapid development of emergency medicine,emergency physicians are working around the clock,[1]including additional workloads due to sudden public health emergencies and disasters.Occupational risks for emergency physicians are significantly high due to an increasing number of patients with acute and severe diseases,an increased workload.
文摘Background: Atopic dermatitis (AD) is the most common inflammatory skin disease in children. Treatment of AD is based on skin barrier repair and reduction of inflammation. We analyzed the efficacy and safety of activated piroctone olamine (APO)—Blue Cap—in children with AD. Materials and Methods: An open-label interventional clinical study was carried out at three clinical centers in Serbia. A total of 58 patients with AD, aged between 3 and 18 years were included and treated with Blue Cap Foam (100 ml;CATALYSIS S.L. Madrid)—Activated Piroctone Olamine—applied twice a day in the affected areas with eczema for 30 days and final assessment at 45 days from baseline. Photographic documentation, clinical evaluation, therapy effectiveness and safety questionnaires were assessed at baseline, 15, 30 and 45 days. Results: Our results demonstrated a significant reduction in signs (erythema, scaling, infiltration, excoriations, xerosis) and symptoms (pruritus) at weeks 2 and 4 of the study. At the end of the study, most patients had moderate (28.6%) to great (62.5%) disappearance of manifestations and moderate (25%) to great (71.4%) skin quality improvement. The effect and tolerability of the therapy were evaluated as very good in 66.1 % and 67.9% and good in about 14.3% and 17.9%, assessed by the investigator and patient, respectively. Three patients experienced a burning sensation at the beginning of the study, the side-effects were resolved as the patients continued applying the foam. After two weeks of cessation of the investigated foam, a significant percentage of patients experienced worsening in the final assessment done by the investigator as well as the participant. In the final assessment, a significantly high percentage (57.1%) of patients had a total reduction of manifestation, and a significant number of participants considered the applied product as treatment success, assessed by the investigator (62.5%) as well as the participants (66.4%). Conclusions: Blue Cap is effective and safe in children with AD, although further large-scale randomized controlled trials should confirm our study findings.
文摘Research Problem: In Abu Dhabi, limited implementation of OSH Regulations contributes to the general unawareness among employees and workers about occupational hazards and safety measures, resulting in slow responsiveness toward enforcement measures and a lack of self-regulatory approaches within companies. Purpose: The purpose of this study is to examine the implementation methods practised in Abu Dhabi with those in developed countries with established OSH regulatory bodies. Methodology: Qualitative and quantitative research methods were employed to gather primary research data. Workers from various industries in Abu Dhabi were sampled on purpose and asked to respond to questionnaires and interviews on OSH protocol awareness and implementation, and circumstances of workplace incidence. Results: The findings of this study showed that the enforcement of OSH requirements in UAE positively correlated to a reduction in the rate of work-related injury and improved business performance. The quantitative research data showed that the energy sector had the highest score (15) while the tourism sector had the lowest score (5.3) in occupational health systems and improvements in business efficiency and productivity. Implications: The outcomes of this study shed light on the importance of implementing OSH Guidelines for companies to empower their safety managers to fully enforce OSH requirements in their organisations. In conclusion, effective OSH enforcement requires cooperation between general workers and OSH managers and facilitation from business owners.
基金supported by grants from the National Natural Science Foundation of China(Grant No.82260940)the Yunnan Provincial(Traditional Chinese Medicine)Clinical Dermatology Center,12th Five-year Key Construction Discipline of State Administration of Traditional Chinese Medicine“Dai Pharmacy”+1 种基金Open Project of Yunnan Key Laboratory of Dai and Yi Medicines(No.30971101100)Key Laboratory of Chemistry in Ethnic Medicinal Resources,State Ethnic Affairs Commission&Ministry of Education,Yunnan Minzu University.
文摘Background:This study aimed to assess how acupoint catgut-embedding therapy influences Th2-type immune response and the infiltration of CD4^(+)and CD8^(+)cells in DNCB-induced atopic dermatitis in BALB/c mice.It also conducted an initial examination of the underlying molecular mechanisms.Methods:Seventy-two mice were randomly divided into four groups:normal control,DNCB-induced atopic dermatitis model(AD),AD with acupoint catgut-embedding treatment(ADA),and AD with sham-acupoint catgut-embedding treatment.After DNCB challenge to induce AD,the ADA group received acupoint catgut-embedding therapy treatment at Zusanli(ST 36)and Quchi(LI 11)acupoints every other week from day 8.Mice in the AD with sham-acupoint catgut-embedding treatment group underwent the same procedure as the ADA group but without catgut implantation.Severity was assessed using SCORAD on treatment days 1,10,and 20.On day 18,nine mice per group were euthanized,and the remaining on day 28.Histopathological changes were observed using hematoxylin-eosin and immunohistochemistry staining.TNF-α,IL-4,IL-6,and IL-13 levels were analyzed by ELISA,and GATA3 and STAT6 protein levels by western blot.Results:After 20 days of acupoint catgut-embedding therapy treatment,mice showed reduced dermatitis scores compared to DNCB-induced AD-like mice.Significant decreases occurred in serum IL-4,IL-6,IL-13,and TNF-αlevels.Skin analysis revealed marked reductions in CD4^(+)and CD8^(+)cell infiltration,as well as GATA3 and STAT6 protein levels.Conclusion:Acupoint catgut-embedding therapy may effectively alleviate atopic dermatitis by suppressing Th2 immune responses via the STAT6-GATA3 pathway and reducing CD4^(+)and CD8^(+)T cell infiltration in skin lesions.
文摘Objective: To explore the pre-treatment and efficacy analysis of comprehensive anti-inflammatory treatment for lymphedema in patients with irritating contact dermatitis. Method: Convenience sampling method was used to observe the skin of 160 patients with upper limb lymphedema admitted to the lymphedema outpatient department of our hospital. They were divided into an observation group (80 cases) and a control group (80 cases), and both groups received a course of comprehensive anti-inflammatory treatment (20 treatments). The control group received routine skin care;On the basis of the control group, the observation group received pre-treatment of the affected limb skin: Laofuzi herbal ointment was applied externally to the prone areas of irritating contact dermatitis (such as the upper arm, inner forearm, and cubital fossa). Result: The incidence of irritating contact dermatitis in the observation group was significantly lower than that in the control group (P 0.05). Patients in the observation group felt significantly better in terms of comfort, skin moisture, and itching relief after being wrapped with low elasticity bandages than those in the control group (P Conclusion: Preventive treatment can effectively reduce the incidence of irritating contact dermatitis, prolong the time of stress treatment, thereby increasing efficacy and improving patient compliance.
文摘Competency-based assessments for healthcare professionals are critical for safe and effective client outcomes. Rehabilitation clinical skill competency assessments must be validated and revised to produce safe and skilled practitioners. The revised American Occupational Therapy Association (AOTA) Fieldwork Performance Evaluation (FWPE) instrument measures occupational therapy student performance to determine readiness for practice. The assessment includes thirty-seven competencies that address both profession specific clinical skills and general professional behavior skills. The objective of this study was to use Rasch methods to explore the use of the revised FWPE in actual fieldwork practice and to determine the instrument’s psychometric properties when separating the item components into two distinct subdomains: General Health Professions Competences and Occupational Therapy-Specific Competencies. Internal construct validity and test reliability were analyzed using data from 149 occupational therapy students after completing their initial Level II A fieldwork clinical internship. This study examined the item difficulty hierarchy, item fit, person-fit to model, person separation index, person separation reliability coefficient, strata, ceiling and floor effect, and unidimensionality of the FWPE instrument as a whole and as two separate domains. With the exception of not meeting the criteria for unidimensionality, the full FWPE instrument and the Occupational Therapy-Specific Competencies subdomain showed acceptable item-level psychometrics for reliability and precision. While the General Health Professions Competencies subdomain showed good item-level psychometrics, it was below the criterion for reliability and only separated the sample into two strata. Results support the validity, reliability, and clinical use of the revised FWPE full instrument and the Occupational Therapy-Specific Competencies subdomain to measure entry-level clinical skill competencies in practice.
文摘Kenyatta National Hospital (KNH) is the largest public referral hospital with a comprehensive cancer treatment facility in East and Central Africa. Occupational radiation monitoring is a significant technique for demonstrating compliance of radiation regulatory limits. The objective of the study was to carry out assessment of occupational radiation exposure among radiotherapy personnel at KNH using thermoluminescence dosimeter, TLD. KNH staff were monitored using dosimeter type TLD-100 made of LiF:Mg,Ti, on monthly basis. The reader system used for analysis was Harshaw 8800. The measurement established the average monthly accumulated occupational personnel dose for KNH to be 0.21 mSv and 0.29 mSv for Hp (10) and Hp (0.07) respectively. The accumulated dose results were within the maximum acceptable dose of 1.67 mSv/month and 41.6 mSv/month for Hp (10) and Hp (0.07) respectively. The investigation results were higher than the acceptable public limit of 0.08 mSv/month. Moreover, incidences were noted where the fetus dose limit 0.42 was also exceeded. Evaluation of statistical dose exposure among doctors, nurses and radiographers’ measurement results were within ±0.02 mSv. The study established the average KNH occupational radiation exposure levels for both Hp (10) and Hp (0.07) were within the ICRU recommendation, validating radiation protection safe practice. Data analysis of healthcare workers did not indicate exposure trend biased to any healthcare profession. Hence radiation risk cut across all professional categories. It is recommended that Radiation Monitoring program be reviewed to include non-clinical staff who access the facility. Radiation reporting should not be limited to one facility, but reflect cases where workers are involved in multiple multiple jobs.
文摘Background Occupational asthma is a type of asthma caused by exposure to asthma-causing substances in an occupational setting. Its incidence is closely related to the degree of industrial development, but also related to the nature of asthma. In some specific industries, such as workers who are exposed to asthmatic isocyanates for a long time, the incidence of occupational asthma can reach 5%-10%, and the incidence of occupational asthma can even reach 50% or higher among workers engaged in the detergent industry who are in contact with proteolytic enzymes for a long time. Objective To analyze the clinical value of early comprehensive rehabilitation nursing for patients with occupational asthma, methods a total of 48 patients with occupational asthma who were admitted from January 2020 to December 2022 were divided into control group and study group by random number table method The disappearance time of chest tightness and shortness of breath, the disappearance time of wheezing and cough, and the FEV1, forced vital capacity (FVC) and peak expiratory flow (PEF) indexes before and after treatment were compared between the two groups after nursing, the disappearance time of clinical symptoms in the study group was shorter than that in the control group, and the levels of FEV1, FVC and PEF were higher than those in the control group, and the P < 0.05 was significantly improved.
文摘Objective:In order to reveal the potential association between intestinal flora and atopic dermatitis with asthma,the study compares the changes in intestinal flora before and after treatment with antibiotics in children and explores the risk factors for the disease development in children.The differences between asthma-controlled children and healthy children were also analyzed to investigate whether there was a correlation between the level of control and intestinal flora in asthmatic children.Methods:367 children with atopic dermatitis and asthma were selected,and the control group was healthy children who did not have other skin diseases.Fecal samples were collected from healthy children and children with asthma,and the intestinal flora was tested at Beijing Nebula Medical Testing Laboratory Co.At the same time,50 children were selected according to the inclusion and exclusion criteria to take amide antibiotics during hospitalization,and stool samples were collected before and after taking antibiotics.Results:The proportion of Gram-positive cocci increased and the proportion of Gram-positive bacilli decreased after the administration of antibiotics in children with atopic dermatitis and asthma(P<0.05),and no significant difference was shown in the gender and age of the children(P>0.05).The proportion of family history of atopic dermatitis with asthma was higher in the experimental group(P<0.05).Conclusion:The use of antibiotics in children with atopic dermatitis with asthma showed a positive correlation with changes in intestinal flora.The use of antibiotics may lead to changes in intestinal flora and increase the risk of atopic dermatitis with asthma.Antibiotic use in infancy and childhood is also recognized as a risk factor for atopic dermatitis with asthma.Therefore,the use of antibiotics should be minimized in preventing and treating atopic dermatitis with asthma.
文摘Objective:To explore the relationship between organizational identification,occupational stress,and insomnia among nurses and to analyze the moderating role of organizational identification between occupational stress and insomnia.Methods:Through stratified sampling,720 nurses working in a tertiary A-level hospital in Shandong Province from March to May 2021 were surveyed using an effort-reward imbalance questionnaire,an organizational identification questionnaire,and the Athens Insomnia scale.Results:Organizational identification was negatively correlated with occupational stress and insomnia(r_(1)=-0.121,P_(1)<0.01;r_(2)=-0.144,P_(2)<0.01).Occupational stress was positively correlated with insomnia(r=0.379,P<0.01).Organizational identity significantly moderated nurses’occupational stress and insomnia(β=-0.192,t=-2.558,P<0.05).Conclusion:Occupational stress and organizational identification can predict insomnia.Organizational identification could negatively mediate the relationship between occupational stress and insomnia.Improving organizational identification may help alleviate insomnia symptoms by relieving occupational stress.
文摘Objective:To explore the clinical evaluation role of the Digits-in-Noise(DIN)test and Hearing Handicap Inventory for Adults Screening(HHIA-S)for patients with occupational noise-induced hearing loss and to observe and analyze their application values.Methods:Fifty patients with suspected occupational noise-induced hearing loss were randomly selected from the Department of Otolaryngology at the hospital as the research target.The collection period for the research cases spanned from January 2022 to November 2023,and all patients had a history of noise exposure.The DIN test and HHIA-S were used for hearing examinations,with clinical,comprehensive diagnosis serving as the gold standard to study their diagnostic performance.Results:The compliance rate of the DIN test was 88.00%,the HHIA-S’s compliance rate was 80.00%,and the combined compliance rate was 94.00%.The compliance rate of the DIN test and the combined compliance rates of the patients were statistically significant compared to the clinical gold standard data(P<0.05),while there was no difference between the compliance rate of the HHIA-S and the gold standard(P>0.05).The data shows that the sensitivity of the combined diagnosis is significantly higher than the sensitivity data of the DIN test and HHIA-S examination alone(P<0.05).Its specificity is 100.00%,and the accuracy data of the joint diagnosis in the degree were higher than those of the DIN test alone(P>0.05)and the HHIA-S alone(P<0.05).Conclusion:For patients with occupational noise-induced hearing loss,the joint evaluation of the DIN test and HHIA-S can significantly improve their diagnostic value with high sensitivity and accuracy.
文摘Objective: HIV-HBV co-infection is a major public health problem that has not been sufficiently explored in the Central African workplace. The aim of this study was to assess the frequency of HIV-HBV co-infection among people who living with HIV (PLHIV) in the infectious and tropical diseases department of the Centre Hospitalier Universitaire de lAmiti Sino-Centrafricaine in Bangui. Methods: A retrospective study was carried out from January 1, 2010 to December 31, 2021 in the Infectious and Tropical Diseases Department at the Amiti Sino-Centrafricaine University Hospital. It included the files of all PLHIV, which included the results of HBV serology. A standardized form was used to collect socio-demographic and professional data by documentary review. Data was analysed using Epi-Info 7 software. Means, proportions were calculated as well as Chi square witch was significant if p-value was below 0.05. Results: The study included 265 patients, 188 were women (70.1%) and 77 men (29.1%), giving a sex ratio of 0.45. Mean age was 35.8 years, higher in men (40 years) than in women (35.8 years) (p 0.0001). The age groups 25 to 34 (37.7%) and 35 to 44 (33.6%) were in the majority (71.3%). The majority of PLHIV were unemployed (57.1%), including housewives (43.0%). HBV prevalence was 14.3%, including 7.2% among the unemployed, who account for half of all co-infections. The search for associations between HIV-HBV co-infection and all socio-demographic characteristics (age, sex, marital status) and socio-professional categories showed no significant difference (p 0.05). Conclusion: PLHIV were predominantly young adults, female, and unemployed;no occupation was significantly associated with co-infection. The vast majority of co-infected people were not covered by the occupational health system (unemployed or informal sector). Urgent action is needed to improve workers access to occupational medicine in CAR.
文摘As technology continues to revolutionize industries,spawning new economic models and patterns,the internet and digital development have created a wave of new occupations and positions.Statistics show that in 2023,China’s total workforce stood at 402 million,with 84 million individuals engaged in new forms of employment.
文摘Background/Aim: This study evaluated family physicians’ attitudes toward occupational health and disease in Türkiye. Materials and Methods: The study is cross-sectional and descriptive in a quantitative research design. The “Attitude Scale for Physicians toward Occupational Health and Occupational Diseases” developed by Kolcu et al. was used in the study (Cronbach’s α 0.94). Our study aimed to sample the entire country using the stratified sample selection based on geographical region. 349 family physicians were included in the study according to sample size (n: 349). Results: The mean age of the participants in the study was 37.77 ± 8.96 (min: 27, max: 65 years). Of the participants, 65.2% were male. Of the physicians, 33.8% were family medicine specialists, and 38.8% had occupational physician certificates. It was determined that the level of attitude of family physicians toward occupational diseases was insufficient. It was also found that awareness increased as age increased, and awareness and attitude levels did not change according to gender. No significant difference was found in the scale total scores and subdimensions of family physicians’ occupational health and occupational disease attitudes according to the regions they worked in Türkiye. Conclusion: It has been concluded that there is no difference in awareness among family physicians in regions where it is much more important to diagnose an occupational disease, especially in industrial regions. The number of family physicians with occupational physician certificates was very insufficient, and a significant number of those who had occupational physician certificates did not practice occupational medicine.
文摘Purpose: The purpose of this study was to clarify the relationship and experiences of occupational health nurses (OHNs) and related departments in project development of mental health care for primary treatment in the Japanese occupational health setting. Method: A total of 235 OHNs who are members of the Japan Academy of Occupational Health Nursing were sent an anonymous self-administered questionnaire survey. The questionnaire included items on the following: the OHN’s background, whether the OHN had experience in project development, the communication between the associated departments, the Japanese version of the Work Engagement Scale (UWES-J), occupational assessments, workplace assessments, and the Transtheoretical Model (TTM) for health promotion in companies and the OHN’s working environment. We performed logistic regression analysis to examine the relationship between experience and these harmonious relationships with other associated departments. Result: Responses from 61 OHNs (valid response rate: 25.9%) were analyzed. The mean number of years of service as an OHN was 18.9, and 82% of respondents had experience in project development. The logistic analysis further revealed that OHNs who had experience in project development of mental health care usually had a harmonious relationship with other associated departments. Conclusion: To promote mental health care for workers, OHNs have the capability to create individual and workplace assessments, enhance their work engagement, and make further improvements to their working environment. .
文摘BACKGROUND Lichen amyloidosis(LA)is a chronic,severely pruritic skin disease,which is the most common form of primary cutaneous amyloidosis.The treatment of LA has been considered to be difficult.LA may be associated with atopic dermatitis(AD),and in this setting,the treatment options may be more limited.Herein,we report four cases of LA associated with AD successfully treated by dupilumab.CASE SUMMARY In this article,we describe four cases of patients who presented with recurrent skin rash accompanied by severe generalized intractable pruritus,diagnosed with refractory LA coexisting with chronic AD.Previous treatments had not produced any apparent improvement.Thus,we administered dupilumab injection subcutaneously at a dose of 600 mg for the first time and 300 mg every 2 wk thereafter.Their lesions all markedly improved.CONCLUSION Dupilumab may be a new useful treatment for LA coexisting with AD.
基金Supported by National Natural Science Foundation of China,No.81803160Scientific Development Program of Jilin Province,No.20200801078GH.
文摘BACKGROUND Lichenoid amyloidosis(LA)is a subtype of primary cutaneous amyloidosis characterized by persistent multiple groups of hyperkeratotic papules,usually on the lower leg,back,forearm,or thigh.LA may be associated with several skin diseases,including atopic dermatitis(AD).The treatment of LA is considered to be difficult.However,as there is some overlap in the etiopathogenesis of LA and AD,AD treatment may also be effective for LA.CASE SUMMARY Case 1:A 70-year-old man was diagnosed with severe AD with LA based on large dark erythema and papules on the trunk and buttocks and dense hemispherical millet-shaped papules with pruritus on the extensor side of the lower limbs.He had a long history of the disease(8 years),with repeated and polymorphic skin lesions.Given the poor efficacy of traditional treatments,this patient was recommended to receive dupilumab treatment.At the initial stage,300 mg was injected subcutaneously every 2 wk.After 28 wk,the drug interval was extended to 1 mo due to the pandemic.Follow-up observations revealed that the patient reached an Eczema Area Severity Index of 90(skin lesions improved by 90%compared with the baseline)by the end of the study.Moreover,Investigator's Global Assessment score was 1,and scoring atopic dermatitis index and numeric rating scale improved by 97.7%and 87.5%compared with the baseline,respectively,with LA skin lesions having largely subsided.Case 2:A 30-year-old woman was diagnosed with severe AD with LA,due to dense and substantial papules on the dorsal hands similar to changes in cutaneous amyloidosis,and erythema and papules scattered on limbs and trunk with pruritus,present for 25 years.After 16 wk of dupilumab treatment,she stopped,and skin lesions completely subsided,without recurrence since the last follow-up.CONCLUSION Dupilumab shows rational efficacy and safety in the treatment of severe AD with LA,in addition to benefits in the quality of life of the patients.
文摘Occupational burnout, even though is a widespread subject of research, remains one of the factors that threaten the implementation and organizational structure of the provided health service. The aim of our study is to investigate the level of burnout among health professionals in Hellenic Red Cross Hospital, one of the biggest Public Hospitals in Athens, Greece. The study population included 116 health workers and was conducted in 2022. The present study, cross-sectional in nature, investigates burnout symptoms in the health-related professionals by measuring the three dimensions of burnout;emotional exhaustion, depersonalization and personal achievements. The overall findings show that people who provide health care services in hospitals are a vulnerable group to burnout syndrome. More specifically, it was found that emotional exhaustion moves at medium to high levels, as did depersonalization, while personal achievements are at moderate to low levels. The findings of the present study indicate that emphasis should be given to increasing the personal achievements of employees, which will in turn reduce emotional exhaustion and depersonalization. Perhaps a more detailed study on this topic could enlighten us about the causes and treatment of burnout syndrome in health professionals.