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Hradec Králové, Czech Republic

Celakovska J.,University of Hradec Kralove | Ettlerova K.,Outpatient Clinic | Ettler K.,University of Hradec Kralove | Vaneckova J.,University of Hradec Kralove | Bukac J.,University of Hradec Kralove
Journal of the European Academy of Dermatology and Venereology | Year: 2015

Background A few reports demonstrate the relationship between IgE sensitization to aeroallergens in atopic dermatitis (AD) patients and other allergic diseases and parameters. Objectives The objective of this study was to evaluate, if there is a significant relationship between the sensitization to common aeroallergens in AD patients and the occurrence of asthma bronchiale, rhinitis and other atopic parameters. Methods Sensitization to dust, mites, animal dander and bird feather was examined (skin prick test, specific IgE) and the relationship with the occurrence of asthma bronchiale, rhinitis, duration of AD, family history and onset of AD was evaluated. Results Two hundred and eighty-eight patients were examined - 90 men and 198 women. According to our results, IgE sensitization to animal dander, dust and mites may increase the risk of developing asthma or rhinitis. Persistent lesions of AD occur more often in patients with sensitization to animal dander, mites and dust. Patients with the sensitization to bird feather have the onset of AD more often above 5 years of age and in these patients, there is no relationship with the positive data about atopy in the family history. Conclusion There is a greater likelihood of developing other allergic diseases in atopic dermatitis patients who suffer from sensitisation to animal dander, mites, and dust. Thus, prompt management of atopic dermatitis and allergy to inhallant allergens that develop in early infancy may be a successful method for preventing of atopic march. © 2015 European Academy of Dermatology and Venereology.


Celakovska J.,University of Hradec Kralove | Ettlerova K.,Outpatient Clinic | Ettler K.,University of Hradec Kralove | Vaneckova J.,University of Hradec Kralove
International Journal of Dermatology | Year: 2011

Objective The aim of this study was to evaluate the occurrence of egg allergy in patients over 14years old suffering from atopic eczema and especially to evaluate if egg allergy can deteriorate the course of atopic eczema in this group of patients. Materials and methods Altogether 179 patients suffering from atopic eczema were included in the study: 51 men and 128 women, with an average age of 26.2years (SD 9.5years), with median SCORAD 31.6 (SD 13.3) points. A complete allergological and dermatological examination was performed on all patients, including diagnostic work-up of food allergy to egg [skin prick tests, atopy patch tests (APTs), measurement of specific IgE level to egg yolks or whites]. Open exposure test (OET) with egg was performed in patients with positive results in some of these diagnostic methods. Food allergy to egg was determined according to positive results in the OET or according to sufficient anamnestical data about the severe allergic reaction after the ingestion of an egg. Results An allergy to egg was confirmed in 11 patients out of 179 (6%). Of these patients, only six (3.3%) had a clear improvement in the SCORAD after the elimination of egg. Other triggering factors may cause exacerbation of the atopic eczema in the patients enrolled in the study. Twenty-eight percent of patients were only sensitized to egg without clinical symptoms. ATPs were a useful tool in the diagnosis of food allergy to egg in patients without IgE reactivity. Conclusion Egg allergy may play an important role in the worsening of atopic eczema acting as a triggering-exacerbating factor in a minority of patients. The diagnostic work-up may comprise the challenge tests to confirm the food allergy to egg. © 2011 The International Society of Dermatology.


Vikan A.,Norwegian University of Science and Technology | Hassel A.M.,Tiller Psychiatric Center | Rugset A.,Students Health Care Services | Johansen H.E.,Outpatient Clinic | Moen T.,National Institute of Technology
Nordic Journal of Psychiatry | Year: 2010

Background: Shame is an acknowledged part of several psychopathological conditions, but is underrepresented in clinical research. Cook's Internalized Shame Scale (ISS) is the most promising measure, but has mostly been used for testing small clinical samples biased toward depressive pathology and female participants. Aims: To contribute to establishing indicators of pathological shame in outpatients with depression and anxiety disorder, and to contribute to establishing norms for the ISS in Scandinavia. Method: The ISS was administered to n= 200 gender balanced non-patient and outpatient samples. A total of 100 patients each were diagnosed as suffering from a depression or anxiety disorder. The diagnoses were supported by Beck's Depression (BDI) and Anxiety Inventory (BAI). The analyses used were the principal component analysis (PCA) and confirmatory factor analysis (CFA) for item structure and sample equivalence, ANOVAs, t-tests and MannWhitney non-parametric statistics for index scores, and the receiver operating curve (ROC) for break-off. Results: Patients' ISS score were similar to the results from previous research, the effect size of patientnon-patient difference was 0.68, correlations indicated a higher level of shame in depression than in anxiety, and the BDIBAI correlation was 0.56 for both clinical samples. The PCA showed three factors that were identified as: "Inadequacy", "Emptiness", and "Vulnerability". Conclusions: The ISS is a viable instrument, which indicates a widespread shame pathology in both depressive and anxious out-patients. The instrument may not be uni-dimensional, but exploration of factor variation may be a promising goal for further research. Clinical implications: Assessment of shame should be included in diagnosis and treatment of emotional disorder. © 2010 Informa UK Ltd.


Seibert J.,Outpatient Clinic | Tracik F.,Novartis | Tracik F.,Heinrich Heine University Dusseldorf | Articus K.,Novartis | Spittler S.,Alexianer Krefeld
Neuropsychiatric Disease and Treatment | Year: 2012

Background: Oral cholinesterase inhibitors at doses efficacious for the treatment of Alzheimer's disease (AD) are often prematurely discontinued due to gastrointestinal side effects. In controlled clinical trials, transdermal rivastigmine demonstrated less such effects at similar efficacy. The current study aimed to verify the validity of this data in daily practice. Methods: This was a prospective, multicenter, observational study on transdermal rivastigmine in Germany. Eligible patients were those with AD who had not yet been treated with rivastigmine. Outcome measures were changes in clock-drawing test, Mini-Mental State Examination (MMSE), Caregiver Burden Scale, Clinical Global Impression (CGI), physicians' assessments of tolerability, and the incidence of adverse events (AEs) over 4 months of treatment. Results: In 257 centers 1113 patients were enrolled; 614 women and 499 men, mean age 76.5 years. In 58% of patients AD was treated for the first time and in 42% therapy was switched to transdermal rivastigmine, mostly due to lack of tolerability (13.6%) or effectiveness (26.9%). After 4 months, 67.4% of patients were on the target dose of 9.5 mg/day and 21.8% were still on 4.6 mg/day. MMSE significantly improved in patients with and without pretreatment (ΔMMSE, 0.9 ± 3.4 and 0.8 ± 3.4, respectively, both P, 0.001); the CGI score improved in 60.9% and 61.3% of patients, respectively. Overall 11.7% of patients had AEs, mainly affecting the skin or the gastrointestinal tract; in 1.1% of cases AEs were serious; 14.7% of patients discontinued therapy, 6.0% due to AEs. With rivastigmine treatment the percentage of patients taking psychotropic comedication decreased, particularly in first-time treated rivastigmine patients (from 27.1% to 22.6%; P, 0.001). Conclusion: Results were in line with data from controlled clinical trials. Switching from any other oral acetylcholinesterase inhibitor to transdermal rivastigmine may improve cognition. © 2012 Seibert et al, publisher and licensee Dove Medical Press Ltd.


Sypniewska G.,Nicolaus Copernicus University | Pollak J.,Nicolaus Copernicus University | Strozecki P.,Nicolaus Copernicus University | Camil F.,Nicolaus Copernicus University | And 5 more authors.
American Journal of Hypertension | Year: 2014

background The mechanism that underlies the association between low 25-hydroxyvitamin D [25(OH)D] and hypertension is not well understood; it seems to involve regulation of the renin-angiotensin-aldosterone system and the impact on endothelial function, cardiac remodeling, and subclinical organ damage. Vitamin D supplementation presents an ambiguous effect on endothelial function and arterial stiffness. We assess serum 25(OH)D3, biomarkers of endothelial dysfunction (soluble intercellular adhesion molecule [sICAM], C-reactive protein [CRP], homocysteine [Hcy]) and subclinical organ damage in adults with newly diagnosed untreated hypertension. methods Patients were classified based on ambulatory blood pressure monitoring: 98 had hypertension, whereas in 60 persons BP was normal. Laboratory assays including serum 25(OH)D3, hsCRP, Hcy, sICAM, glucose, insulin, lipids, echocardiography, pulse wave velocity (PWV), intima-media thickness (IMT), and left-ventricular mass (LVM) measurements were performed. results 25(OH)D 3 was significantly lower in hypertensive patients. The logistic regression analysis indicated that 25(OH)D3 reduced the probability of hypertension occurrence after adjusting for body mass index (BMI). 25(OH)D3 in those with hypertension correlated significantly with systolic BP (SBP; r = -0.39), PWV, IMT (r = -0.33), and diastolic BP (r = -0.26). Multiple regression analysis in patients with hypertension revealed that 25(OH)D3 and sICAM accounted for up to 27% of SBP variation after adjusting for age, BMI, and smoking. 25(OH)D3 and either PWV or IMT accounted for 23% of SBP variation. The impact of 25(OH)D3 was 10%. conclusion The impact of 25(OH)D3 on SBP variation, mediated by its effect on endothelial dysfunction and subclinical organ damage, is modest but significant. © American Journal of Hypertension, Ltd 2013.

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