Volar Surface Of Forearm Research Articles

Evaluation of skin prick test reactivity in children with allergic diseases: A cross sectional study

Allergic diseases are developed through complex interaction between exposure to environmental substances and genetic susceptibility. The prevalence of allergic diseases has increased during last decade globally. The present cross sectional study was designed to evaluate the skin prick test reactivity in children with allergic diseases. A total of 400 children between age group 1-12 years were recruited. The Skin prick tests (SPT) using 14 standardized allergen extracts were conducted in the volar surface of forearm. Majority children had asthma (52.5%), followed by atopic dermatitis (22.75%) and allergic rhinitis (15.75%). Food habits triggering allergic conditions in 76% children, environmental factors in 4.75% children, pets in 8.25% and indoor conditions in 11% children. Skin prick test was positive to egg (13.5%), milk (22%), wheat (9.75%), apple (4.5%), cereals (6.5%), cat (18%), dog (6%), blatella (9.5%), aspergillus fumigatus (9.5%), fungi (12.75%), Dermatophytes farina (24.75%), Dermatophytes pteromyssinus (23.75%), Blomia tropicalis (9.5%) and Bermuda grass (13.75%). Determination of allergen sensitization patterns in children with atopic disease is crucial for selecting proper preventive and therapeutic strategies which helps to improve quality of life of in children.

Síndrome do pronador redondo associada à síndrome do nervo interósseo anterior: relato de caso

A síndrome do pronador redondo é caracterizada por dor vaga na superfície volar do antebraço, com parestesias na área de inervação sensitiva do nervo mediano e achados motores mínimos. A síndrome do nervo interósseo anterior é uma paralisia motora pura dos músculos inervados por esse nervo: o flexor longo do polegar, o flexor profundo dos dedos indicador e médio e o pronador quadrado. Normalmente, os resultados de estudos eletrodiagnósticos são normais em pacientes com síndrome do pronador redondo e anormais em pessoas com síndrome do nervo interósseo anterior. A síndrome do pronador redondo é um diagnóstico controverso e ela é normalmente tratada cirurgicamente. A síndrome do nervo interósseo anterior é cada vez mais pensada como uma neurite, que muitas vezes resolve espontaneamente após observação prolongada. As indicações cirúrgicas para descompressão do nervo incluem sintomas persistentes por mais de 6 meses em pacientes com síndrome do pronador redondo ou por um período mínimo de 12 meses, sem sinais de melhora motora, em pacientes com síndrome do nervo interósseo anterior.

Evaluation of the inner thigh as site for mantoux test among children in Owerri South Eastern Nigeria

Background: Mantoux test, a type IV hypersensitivity reaction, is commonly used to screen children for possible tuberculosis. It is applied on the volar surface of forearm. Sunlight ultraviolet rays (UV) have recently been shown to induce immunosuppression that alters the skin response to Mantoux test negatively. Objective: The study aimed to evaluate the inner thigh as a possible site for Mantoux test in children attending Federal Medical Centre Owerri whom their primary attending Physicians requested a Mantoux test. Methods: This was a cross sectional study conducted between June and October 2011. Concomitant intradermal injection of 0.1ml of purified protein derivative on the volar aspect of the forearm and the inner thigh was carried out. Induration was measured concurrently in 106 consecutive children, between the ages of 3months and 15 years. Using volar surface of forearm as gold standard, values of inner thigh induration at a set cut-off was determined. Students’t test, Pearson correlation coefficient and the Chi square were used to compute data. Results: The mean diameter of induration on the inner thigh (12.51 ±3.44mm) was higher than mean diameter of induration on the volar surface of the arm (11.03±6.34mm). This is however not statistically significant. There were (29) children who had reactive induration on the inner thigh whilst 19 had similar induration on the volar surface of the forearm. In the presence of factor(s) that negatively affects the response of the skin to Mantoux test; the inner thigh induration yield was higher. There was a strong positive correlation between the two site measurements. Conclusions: The inner thigh as a site for Mantoux test in children has shown potential for higher yield. Keywords: Sunlight, Inner thigh, Mantoux test, TB, Children

Epidermal thymic stromal lymphopoietin predicts the development of atopic dermatitis during infancy

Epidermal thymic stromal lymphopoietin predicts the development of atopic dermatitis during infancy

An Investigation Into the Magnitude of the Current Window and Perception of Transcutaneous Electrical Nerve Stimulation (TENS) Sensation at Various Frequencies and Body Sites in Healthy Human Participants

Strong nonpainful transcutaneous electrical nerve stimulation (TENS) is prerequisite to a successful analgesic outcome although the ease with which this sensation is achieved is likely to depend on the magnitude of current amplitude (mA) between sensory detection threshold (SDT) and pain threshold, that is, the current window. To measure the current window and participant's perception of the comfort of the TENS sensation at different body sites. A repeated measure cross-over study was conducted using 30 healthy adult volunteers. Current amplitudes (mA) of TENS [2 pulses per second (pps); 30 pps; 80 pps] at SDT, pain threshold, and strong nonpainful intensities were measured at the tibia (bone), knee joint (connective tissue), lower back [paraspinal (skeletal) muscle], volar surface of forearm (nerve) and waist (fat). The amplitude to achieve a strong nonpainful intensity was represented as a percentage of the current window. Data were analyzed using repeated measures analysis of variance. Effects were detected for body site and frequency for SDT (P<0.001, P=0.018, respectively), current window (P<0.001, P<0.001, respectively), and strong nonpainful TENS as a percentage of the current window (P=0.002, P<0.001, respectively). The current window was larger for the knee joint compared with tibia (difference [95% confidence interval]=12.76 mA [4.25, 21.28]; P=0.001) and forearm (10.33 mA [2.62, 18.40]; P=0.006), and for the lower back compared with tibia (12.10 mA [1.65, 22.52]; P=0.015) and forearm (9.65 mA [1.06, 18.24]; P=0.019). The current window was larger for 2 pps compared with 30 pps (P<0.001) and 80 pps (P<0.001). Participants rated strong nonpainful TENS as most comfortable at the lower back (P<0.001) and least comfortable at the tibia and forearm (P<0.001). TENS is most comfortable and easiest to titrate to a strong nonpainful intensity when applied over areas of muscle and soft tissue.

Test of sensory nerve in patients with Kennedy disease

To study the electrophysiological and pathological features of Kennedy disease (KD) and to make sure the functional and anatomical change of the sensory nerve of KD patients. Electrophysiological and pathological tests were performed in 14 KD patients, including electromyogram, conduction velocities of median, ulnar, peroneal, tibial, and sural nerves, trigemino-cervical reflex (TCR), contact heat evoked potential (CHEP), and biopsy of the sural nerves. During TCR, the patients lay on the back, holding the heads slightly raised to make the sternocleidomastoid muscles contract slightly. Electrical stimuli were applied to the infraorbital nerves and recording electrodes were placed in the sternocleidomastoid muscles. For CHEP, contact heat was delivered via a circular thermode to excite selectively nociceptors with a rapid rising time at 70 degrees C/s to elicit pain and CHEP. Thermal stimuli were sent at 54.5 degrees C to three body sites: skin of back of hand, proximal volar forearm, and C7. The CHEPs were recorded from Cz and Pz. The sensory conduction velocity and latency were almost normal, while the amplitude of the sensory nerve action potential (SNAP) declined to 0.65 - 2.85 microV. The latency of trigemino-cervical reflex was longer than normal with the onset peak latency of (38.9 +/- 7.0) ms. The configuration was asymmetric. The onset peak latencies when the skin of the back of hand, volar surface of forearm, and C7 were stimulated were (613 +/- 57), (595 +/- 32), and (489 +/- 37) ms respectively. Biopsy of the sural nerves showed that the large myelinated nerve fiber was decreased. Sensory nerve is involved in the patients with Kennedy disease, including the large and small fibers.

The mantoux test: should we change the site?

Recent studies have shown that sunlight-induced immunosuppression negatively alters the skin response to mantoux test. This study aimed to compare the response of the skin to mantoux test over the volar forearm surface, the traditional site, which is exposed to sunlight and the inner thigh, an area which is not. In all, 45 children had the mantoux test administered using 0.1 mL of 5TU purified protein derivative. Reactive induration to the mantoux test was recorded in five of these children. The average induration of the volar surface was 8.2 mm, while that at the inner thigh was 11.6 mm. The results have highlighted the potential of an enhanced mantoux test result, if parts of the body that are not exposed to high doses of ultraviolet light are used as the site for mantoux test.

Evaluation of the relationship between cockroach sensitivity and house-dust-mite sensitivity in Turkish asthmatic patients

Exposure to cockroach has been identified as an important source of indoor allergens in patients with asthma and allergic rhinitis. We evaluated the relationship between cockroach sensitivity and other allergens in patients with asthma. A total of 114 patients, defined asthma according to GINA, were enrolled in this study. A questionnaire including age, sex, duration of asthma, history of cockroach presence at home, and total IgE, blood eosinophil count, pulmonary function tests, standard skin prick test additional cockroach and shrimp allergen were performed. There were 84 (73.7%) female and 30 (26.3%) male patients with a mean age of 38.1+10.1 years. The average duration of asthma was 7.7+7.2 years. Sixty five (57%) patients were determined atopic and 49 (43%) nonatopic. Pollen allergen was the most common allergen in 59 (51.8%) patients with asthma, and second common allergen was mite allergen in 43 (37.7%) patients. Cockroach sensitivity were detected in 23 (20.2%) of 114 all asthmatics and 23 (35%) of atopic asthmatics. High rates of house-dust-mite allergy (73.9%) was determined in patients with cockroach sensitivity (P<0.05), while we found no relationship with other allergens. There was no difference for cockroach sensitivity between rural and urban population. Cockroach sensitivity was more common in mild bronchial asthmatics and a female predominance was observed. In addition, there was no association between shrimp and cockroach sensitivity. As a result, a high rate of cockroach sensitivity alone or with mite sensitivity was seen in patients with bronchial asthma in Turkish population. Because of cross-reactivity between mites and cockroach, cockroach sensitivity should be investigated in patients with house-dust-mite allergy. In addition, a high rate of cockroach sensitivity, in terms of IgE sensitization, may be important for the development of new sensitizations.

Frequency of IgE-mediated respiratory diseases in type 1 diabetes mellitus (DM1)

Rationale A negative association has been observed between Th1 and Th2 mediated diseases. The purpose of this study was to verify the frequency of atopy in patients with DM1. Methods The ISAAC written questionnaire was applied for in 90 outpatients with DM1 in order to establish the prevalence of asthma and rhinoconjunctivitis symptoms, and compare with those obtained from previous survey. Serum total IgE and specific IgE antibodies to D. pteronyssinus were determined by Pharmacia Immunocap®. A panel of six common aeroallergens was used for skin prick tests (SPT) in volar forearm surface. A positive SPT was considered if wheal cross diameters were ≥2mm. Results Ages ranged from 3 to 19 years (median 11.7) and 47 (52%) were male. The prevalence of wheezing in the past 12 months was 12.2%; 26.7% referred nose and eye symptoms in the past 12 months. In 2001 the frequency of these symptoms in 13-14 year-old schoolchildren of Curitiba was respectively 18.7% and 17%. A positive skin test and specific IgE levels ≥0.7 kU/L were observed in 29.5% and 31.3% respectively, with a significant association between them (p<0.001). Upper and lower respiratory symptoms were also associated with a positive SPT (p<0.05). Conclusions Atopy does coexist with DM1 suggesting that Th1 and Th2 phenomenon are independent in those conditions. The frequency of rhinitis was higher than the frequency of asthma in DM1.

Procedure for the evaluation of the bioavailability of topical formulations in vivo as the rate and extent to which the active drug product is transferred from the vehicle to the skin

AbstractA procedure was developed for the in vivo evaluation of the bioavailability of topical formulations containing a limited amount of the active drug product estimated as the rate and extent to which the drug is released from the vehicle to the skin. It is assumed that drug transfer follows Fick's law of diffusion. The formulation tested was a cream containing 40 μmol/ml (20 mg/ml) of sertaconazole, a novel imidazole antifungal agent, applied to healthy volunteers. Eight 9 cm2 squares were marked in the volar forearm surface and 0.1 ml of the cream was applied to each square by gentle rubbing with a plastic thimble. The actually applied dose was estimated considering the drug amount that adhered to the thimble. Then one area at a time was cleansed at 0, 1, 2, 4, 6, 8, 12, and 24 h and the amount of sertaconazole transferred to the skin was estimated by determination of the amount of drug removed by cleansing. Drug release from the vehicle to the skin increased with time, but then reached a plateau. The maximal amount of drug transferred to the skin was 85.5 ± 3.3% (mean ± S.D.) of the actually applied dose, and this value was considered an expression of the extent of drug release. The rate of release was estimated as the half‐life of the transfer process, which was 1.83 ± 0.76 h. This procedure is suitable for the evaluation of topical formulations containing a limited amount of the active drug product. © 1995 Wiley‐Liss, Inc.