OBJECTIVETo delineate the influence of transcutaneous electrical nerve stimulation (TENS) on heat pain threshold and vibration threshold in human.

METHODSTwenty healthy, young subjects, aged from 20 to 39, participated in the study. They were randomly allocated into either TENS or placebo group. Thirty minutes of conventional TENS (200 micro s pulses at 100 Hz and 2 - 3 times sensory threshold) or placebo stimulation was applied to the acupuncture points (LI4) on each subject's left hand. Heat pain and vibration thresholds were measured using Medoc TSA-2001 and VSA-3000 respectively on the thenar eminence of each subject's left hand. These assessments were done at 30, 20 and 10 minutes before and 0, 10, 20, 30, 40 and 50 minutes after 30 minutes of TENS or placebo treatment.

RESULTSThis study showed a significant increase in heat pain threshold by 0.81 degrees C and 1.54 degrees C respectively at 0 (P = 0.002) and 20 minutes (P = 0.004) after 30 minutes of TENS application to the LI4 acupoint of young healthy subjects, compared with placebo stimulation. Interestingly, no significant difference in vibration threshold was found between the TENS and placebo groups.

CONCLUSIONThe effect of TENS on the acupoint is to reduce pain but not tactile (specifically vibration) sensibility.

Acupuncture Points ; Adult ; Female ; Hot Temperature ; Humans ; Male ; Pain Threshold ; physiology ; Transcutaneous Electric Nerve Stimulation ; Vibration

Nerve regeneration after injury requires proper axon alignment to bridge the lesion site and myelination to achieve functional recovery. Transplanted scaffolds with aligned channels, have been shown to induce axon growth to some extent. However, the penetration of axons into the microchannels remain a challenge, influencing the functional recovery of regenerated nerves. We previously demonstrated that the size of microchannels exerts significant impact on Schwann cells (SCs) migration. Here we demonstrate that migration of SCs promotes, significantly, the dorsal root ganglion (DRG) neurons to extend axons into three-dimensional channels and form aligned fascicular-like axon tracts. Moreover, the migrating SCs attach and wrap around the aligned axons of DRG neurons in the microchannels and initiate myelination. The SCs release growth factors that provide chemotactic signals to the regenerating axons, similar to the response achieved with nerve growth factor (NGF), but with the additional capability of promoting myelination, thereby demonstrating the beneficial effects of including SCs over NGF alone in enhancing axon penetration and myelination in three-dimensional microchannels.
Axons* ; Diagnosis-Related Groups ; Ganglia, Spinal ; Intercellular Signaling Peptides and Proteins ; Myelin Sheath ; Nerve Growth Factor ; Nerve Regeneration ; Neurons ; Schwann Cells*

INTRODUCTIONTreatment of acute lymphoblastic leukaemia (ALL) using intensive chemotherapy has resulted in high cure rates but also substantial morbidity. Infective complications represent a significant proportion of treatment-related toxicity. The objective of this study was to describe the microbiological aetiology and clinical outcome of episodes of chemotherapy-induced febrile neutropaenia in a cohort of children treated for ALL at our institution.

MATERIALS AND METHODSPatients with ALL were treated with either the HKSGALL93 or the Malaysia-Singapore (Ma-Spore) 2003 chemotherapy protocols. The records of 197 patients who completed the intensive phase of treatment, defined as the period of treatment from induction, central nervous system (CNS)-directed therapy to reinduction from June 2000 to January 2010 were retrospectively reviewed.

RESULTSThere were a total of 587 episodes of febrile neutropaenia in 197 patients, translating to an overall rate of 2.98 episodes per patient. A causative pathogen was isolated in 22.7% of episodes. An equal proportion of Gram-positive bacteria (36.4%) and Gram-negative bacteria (36.4%) were most frequently isolated followed by viral pathogens (17.4%), fungal pathogens (8.4%) and other bacteria (1.2%). Fungal organisms accounted for a higher proportion of clinically severe episodes of febrile neutropaenia requiring admission to the high-dependency or intensive care unit (23.1%). The overall mortality rate from all episodes was 1.5%.

CONCLUSIONFebrile neutropaenia continues to be of concern in ALL patients undergoing intensive chemotherapy. The majority of episodes will not have an identifiable causative organism. Gram-positive bacteria and Gram-negative bacteria were the most common causative pathogens identified. With appropriate antimicrobial therapy and supportive management, the overall risk of mortality from febrile neutropaenia is extremely low.

Candidiasis ; epidemiology ; Chemotherapy-Induced Febrile Neutropenia ; epidemiology ; microbiology ; Child ; Cohort Studies ; Escherichia coli Infections ; epidemiology ; Gram-Negative Bacterial Infections ; epidemiology ; Gram-Positive Bacterial Infections ; epidemiology ; Humans ; Influenza, Human ; epidemiology ; Klebsiella Infections ; epidemiology ; Mycoses ; epidemiology ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; drug therapy ; Pseudomonas Infections ; epidemiology ; Retrospective Studies ; Singapore ; epidemiology ; Staphylococcal Infections ; epidemiology ; Virus Diseases ; epidemiology

BACKGROUND

Seborrheic keratosis is a common benign skin tumor treated with invasive methods like electrodessication, cryotherapy, or surgery. Topical therapy with trichloroacetic acid (TCA) may be a cheaper, non-invasive alternative with less complications. While TCA has been studied for other skin conditions, more research is needed on its use for seborrheic keratosis.

OBJECTIVE

To compare the safety and efficacy of one time application of 80% TCA peel to 65% TCA peel in the clearance of raised seborrheic keratosis in Filipino patients.

METHODOLOGY

One hundred one patients were randomized to either 80% or 65% TCA groups. Each participant underwent one session of treatment and was followed up after a month. Pre- and post-test size and thickness of lesions were compared between groups.

RESULTS

Based on Physician’s Lesion Assessment (PLA), both concentrations of TCA achieved high treatment success (TCA80: 66.7%, TCA65: 68%, p-value 0.89). A similar trend was observed based on Subject’s Self-Assessment (TCA80: 74%, TCA65: 74.5%, p-value 0.95). Similar reductions in lesion size and thickness were observed in both concentrations. In terms of safety, pain, pruritus, and erythema were mostly observed during and immediately after treatment, with little to no adverse events observed after 1 month in both groups.

CONCLUSION

One time application of either 80% or 65% TCA is effective in decreasing the size and thickness of seborrheic keratosis with little to no complications 1 month post- treatment. Both concentrations were safe, causing minimal and non-persistent pain, pruritus, and erythema immediately after application.

Human ; Keratosis, Seborrheic ; Trichloroacetic Acid

Aedes ; Animals ; Female ; Humans ; Microcephaly ; epidemiology ; Pregnancy ; Pregnancy Complications, Infectious ; epidemiology ; therapy ; Public Health ; Zika Virus ; Zika Virus Infection ; epidemiology ; therapy ; transmission

Anemia, Aplastic ; therapy ; Bone Marrow Transplantation ; statistics & numerical data ; China ; Cooperative Behavior ; Family ; Hematopoietic Stem Cell Transplantation ; statistics & numerical data ; Hemoglobinopathies ; therapy ; Hong Kong ; Humans ; Immunologic Deficiency Syndromes ; therapy ; Leukemia ; therapy ; Lymphoma ; therapy ; Malaysia ; Myelodysplastic Syndromes ; therapy ; Peripheral Blood Stem Cell Transplantation ; statistics & numerical data ; Philippines ; Singapore ; Thailand ; Tissue Donors ; statistics & numerical data ; Transplantation, Autologous ; statistics & numerical data ; Transplantation, Homologous ; statistics & numerical data

Topical corticosteroids (TC) are among the most commonly prescribed topical agents and are used to treat various dermatoses. This study aimed to determine the prevalence, factors associated and reasons patients inappropriately use TC. Incidence of AE and risk of the development of AE due to inappropriate TC. Out-patient dermatology patients in a tertiary hospital in the Philippines were screened for TC use and interviewed using a questionnaire. Descriptive analysis and logistic regression to determine odds ratios were done. Out of 801 patients recruited, 260 (32%) used TC. Among those who used TC, 147 (56.53%) inappropriately used TC. Among the factors associated with inappropriate use of TC were: 1) Diagnosis of dermatitis as primary dermatosis (OR = 2.82, 95% CI 0.497, 1.276), 2) Lack of awareness of the FDA advisory (OR = 2.1, 95% CI 1.245, 3.601), 3) Lack of knowledge that TC cannot be applied for prolonged periods (OR = 5.5, 95% CI 3.201, 9.334), and 4) Lack of knowledge that TC use can result into AE (OR = 4.5, 95% CI 2.637, 7.657). Relatives and friends as source of information (OR=437, 95% CI 25.997, >1000), procurement (OR=60, 95% CI 3.081, >1000) and instruction (OR=337, 95% CI 19.827, >1000) were highly associated with inappropriate use. Twenty-two percent of those who inappropriately used TC self-medicated upon recommendation by family and friends. Hypopigmentation was the most common AE. There is a 3.8 times (OR= 3.8, 95% CI: 1.918, 7.662) likelihood for a person who has inappropriately used TC to have an AE as compared to a person who has appropriately used TC. There is a need to educate the general public regarding proper TC use. Patient encounters at the clinic may be a good opportunity to reinforce guidelines on the use of TC.
Adrenal Cortex Hormones ; Philippine