Effect of frenotomy on breastfeeding and reflux: results from the BRIEF prospective longitudinal cohort study

paythelady.61 shared this article with you from Inoreader Effect of frenotomy on breastfeeding and reflux: results from the BRIEF prospective longitudinal cohort study Via Latest Results for Clinical Oral Investigations Abstract Objectives To assess the Efficacy of Frenotomy with regard to Breastfeeding and Reflux Improvement (BRIEF) in infants with breastfeeding problems. Materials and methods A cohort of 175 consecutive breastfeeding women with breastfeeding and reflux problems related to a tongue-tie or lip-tie fulfilling the inclusion criteria was longitudinally followed for 6 months. The effect of frenotomy on these problems was studied by a standardized oral assessment and completing the validated Breastfeeding Self-Efficacy Short Form (BSES-SF), nipple pain score (Visual Analogue Scale, VAS), and Infant Gastroesophageal Reflux Questionnaire Revised (I-GERQ-R) questionnaires pre-frenotomy and at 1 week, 1 month, and 6 months' post frenotomy. Results All 175 women completed the 1-month follow-up and 146 women the 6 months' follow-up. Frenotomy resulted in a significant improvement of BSES-SF, nipple pain score, and I-GERQ-R after 1 week, which improvement maintained to be significant after 1 month for BSES-SF and I-GERQ-R, and after 6 months for I-GERQ-R. The improvements were irrespective of the type lip-tie or tongue-tie underlying the breast feeding and reflux problems. No post-operative complications were observed. About 60.7% of infants still was breastfed 6 months after treatment. Conclusions Frenotomy is a safe procedure with no post-operative complications and resulting in significant improvement of breastfeeding self-efficacy, nipple pain, and gastro-oesophageal reflux problems. Clinical relevance Frenotomy of a tongue-tie and or lip-tie can lead to improvement of breastfeeding and reflux problems irrespective of the type of tongue-tie or lip-tie and should be considered by clinicians as a proper tool to resolve these problems if non-interventional support did not help. International trial register ISRCTN64428423 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

investigation of thyroid blood tests and thyroid ultrasound findings of patients with rosacea

pay.thelady61 shared this article with you from Inoreader investigation of thyroid blood tests and thyroid ultrasound findings of patients with rosacea Via Dermatologic Therapy Abstract Background We aimed to investigate the relationship between rosacea and thyroid diseases by analyzing thyroid blood tests and ultrasound findings of our patients recently diagnosed with rosacea. Methods This study was designed as a prospective, single‐center study. Dermatological examination findings, lesion locations were recorded, and rosacea clinical scores were calculated for all study group patients. The control group consisted of completely healthy women presented to our hospital during the study period for check‐up purposes. Serum free thyroxine, free triiodothyronine, thyroid‐stimulating hormone, anti‐thyroglobulin antibody, anti‐thyroid peroxidase antibody levels were measured, and thyroid ultrasound examinations were performed for all study participants. Results The entire study cohort consisted of 123 patients (63 cases and 60 controls). There was no significant difference between the groups in terms of mean patient age (p<0,05). Cheek was the most common lesion location (96.8%). There was no difference between the groups in terms of thyroid‐related laboratory parameters. However, anti‐TPO levels differed significantly with increasing disease severity (i.e., RCSs). There were significant relationships between cheek lesions and fT4 (p=0.021), while nose and chin lesions were associated with fT3 (p=0.01, p=0.001). Thyroid ultrasound findings revealed that rosacea patients tended to have larger thyroid nodules and more heterogeneous thyroid parenchymas than controls. Conclusions Our findings indicate that thyroid blood tests, including thyroid autoantibodies, should be tested and thyroid ultrasounds should be performed in patients diagnosed with rosacea. However, these findings need to be validated by prospective studies conducted in larger patient series with more extended follow‐up periods. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Rituximab in Practice: Clinical Evaluation of Patients with Pemphigus after Rituximab Administration

pay.thelady61 shared this article with you from Inoreader Rituximab in Practice: Clinical Evaluation of Patients with Pemphigus after Rituximab Administration Via Dermatologic Therapy Abstract Pemphigus Vulgaris (PV) is a rare autoimmune blistering disease, which mainly causes mucosal and/or cutaneous lesions. In June 2018, FDA approved Rituximab (RTX)‐ a B‐cell depleting agent‐ for the management of patients with moderate‐to‐severe pemphigus. Although the majority of patients respond well to this drug, some do not reach complete remission with a single cycle of RTX. In this review, following an overview of RTX and its clinical outcomes, we have focused on the possible outcomes after RTX therapy in patients with PV. The response is defined into four main categories; complete responders, partial responders, non‐responders, and paradoxical reactions, based on three possibilities of reaching the consolidation phase after three months, reaching remission until six months, and the ability of corticosteroid tapering in six months after RTX administration. Concerning the safety of RTX, three categories of infusion reactions, short and long‐term side effects are d iscussed. Additionally, we have suggested approaches for the evaluation of clinical and serological responses at different critical time‐points, including one, two, three, and six months after RTX administration. Finally, available markers to predict the response to RTX and research gaps in the field of RTX therapy have been summarized. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The Most Common Allergens

pay.thelady61 shared this article with you from Inoreader The Most Common Allergens According to Skin Prick Test: The Role of Wheal Diameter in Clinical Relevancy Via Dermatologic Therapy Abstract Background The skin prick test (SPT) could be applied as a useful in vivo method for the detection of sensitization in epidemiological and diagnostic studies if the wheal size is ideally evaluated. We focused on SPT wheal size to identify sensitization pattern to common inhalant and food allergens. Methods In this cross‐sectional study, SPT results were obtained from a total of 972 allergic patients. Common allergen extracts for SPT were selected according to the type of allergic diseases, and the geographical pattern. SPT with food allergens was performed for patients with atopic dermatitis (AD) and chronic urticaria (CU). Results A total of 461 male (47.4%) and 511 female (52.6%) participated in this study (median age: 31 years). The majority of individuals were affected with allergic rhinitis (AR) (n=624) and asthma (n=224); while 129 and 67 patients suffered from AD and CU, respectively. The most common aeroallergens were Russian thistle (52.1%) and Lamb's Quarter (50.7%) with the largest wheal diameter. The wheal size of lamb's quarter was significantly different between patients with asthma and AR (P<0.001). In addition, a significant difference was detected in wheal diameter in response to the Russian thistle between patients with AR and AD (P=0.001). Shrimp (23.6%) and Peanut (22.5%) caused the most common food sensitization in patients with AD and CU. Conclusion Having in mind the most common weed pollens including the Russian thistle and Lamb's Quarter, preventive strategies such as removing unwanted weeds or preventing them from growing, avoidance, and specific immunotherapy may be crucial for better disease control. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The risk for severe COVID 19 in patients with autoimmune and/or inflammatory diseases: First wave lessons

pay.thelady61 shared this article with you from Inoreader The risk for severe COVID 19 in patients with autoimmune and/or inflammatory diseases: First wave lessons Via Dermatologic Therapy Abstract Data regarding the risk for severe COVID19 in patients with autoimmune or inflammatory diseases are scarce. To estimate the risk of those patients to develop a more severe COVID19 infection All active patients and those with dermatologic and/or rheumatologic autoimmune/inflammatory diseases were identified in a single tertiary center. The charts of those tested positive for COVID19 between March 1stand May 31st, 2020 reviewed including demographics, co‐morbidities and medications. COVID19 outcome of those with dermatologic and/or rheumatologic autoimmune/inflammatory diseases were compared to COVID19 infected matched controls without an autoimmune/inflammatory background. Overall, 974 of 381 268 active patients were tested positive for COVID19, including 35 out of 13 225 with dermatologic and/or rheumatologic autoimmune/inflammatory diseases. No statistically significant difference in severity of COVID19 infection or mortality rate was found. The rate of asymptoma tic, mild, moderate, severe/critical and fatal COVID19 infection was 11.4%, 37.1%, 22.8%, 11.4% and 17.1% respectively for the patients with autoimmune diseases and 17.8%, 45.8%, 10.9%, 6.8% and 18.4% respectively for the controls . Patients with autoimmune/inflammatory diseases seem not to develop a more severe COVID19 infection than controls. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Hypertrichosis and hair repigmentation in patients receiving interleukin‐17A inhibitors

pay.thelady61 shared this article with you from Inoreader Hypertrichosis and hair repigmentation in patients receiving interleukin‐17A inhibitors Via Dermatologic Therapy View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Adalimumab in the management of hidradenitis suppurativa

pay.thelady61 shared this article with you from Inoreader Real life data on the biopsychosocial effects of Adalimumab in the management of hidradenitis suppurativa: a multi‐centre cross sectional analysis and consideration of a multisystem monitoring approach to follow up Via Dermatologic Therapy Abstract Background Hidradenitis Suppurativa (HS) is a chronic relapsing, remitting disease which results in the formation of inflammatory nodules and pustules in intertriginous areas. HS is a complex disease with known psychosocial impact . Adalimumab is a biologic, used for treatment resistant HS, which working by inactivating TNF‐alpha. Objectives Our primary objective was to determine the effects of Adalimumab on HS‐PGA and DLQI scores in patients with HS that had been on the treatment for at least six months. Our secondary objective was to note and assess the significance of adverse effects and impacts on wider health, namely occupational and social. Methods A retrospective cross‐sectional study was performed using clinic notes from routine follow ups in biologic clinics in three specialist HS centres. Results 77% (n= 78/101) patients demonstrated improvements in their HS‐PGA scores. We also demonstrated significants improvement in the DLQI scores of the patient cohort (p= 0.0001, 95% CI ‐12.8 to ‐5.9) . A total of 31.7% (32/101) patients experienced adverse effects spanning multiple organ systems, with 27.7% (28/101) requiring treatment cessation. Three of these patients stopped due to the worsening of pre‐existing mental health symptoms. Conclusions Adalimumab is effective in reducing HS‐PGA and DLQI scores, but patients still complain of systemic effects necessitating drug cessation in some instances. A holistic and multi‐systemic approach to follow up is required, and there is scope for further studies examining temporal causality in the context of Adalimumab and it's multisystemic physical and psychological effects. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.