1/7. alopecia in three women of Southeast Asian descent with chronic renal failure: possible association with erythropoietin use.Recombinant human erythropoietin (Epo) has been used successfully to correct the anemia caused by chronic renal failure in patients undergoing dialysis, as well as the anemia associated with other conditions, including cancer therapy. Despite its benefits, it can be associated with adverse side effects. These include hypertension, headaches, increased seizure activity, clotted vascular access, and occasional thromboembolic events, such as myocardial infarction or stroke. We report a potentially new side effect associated with Epo of a cosmetic nature. Three Southeast Asian women with chronic renal failure developed diffuse, nearly total, hair loss during erythropoietin use. Two cases were strongly associated with Epo use, and a third had other intercurrent illnesses as well. alopecia may be associated with Epo use in certain ethnic populations.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/7. A case study of telephone interpersonal counseling for women with breast cancer and their partners.PURPOSE/OBJECTIVES: To present a case study of one woman with breast cancer and her partner to provide a firsthand account of an innovative telephone interpersonal counseling intervention. DATA SOURCES: Journal articles, book chapters, research data, and transcriptions of telephone counseling sessions. DATA SYNTHESIS: Substantial evidence exists that face-to-face psychosocial interventions improve psychological adjustment and health-related quality of life for patients with cancer. Yet psychosocial interventions are not offered routinely, and many patients with cancer do not use face-to-face counseling mechanisms. The telephone may be an innovative and effective method of delivering interventions, and telephone-delivered interpersonal counseling may be an especially effective intervention for women with breast cancer and their partners. CONCLUSIONS: Despite the fact that the telephone counseling occurred over a brief period of time, the woman and her partner in this case study reported substantial positive changes in their own distress (e.g., symptoms such as depression and anxiety) and the nature of their relationships with each other and their children. This is precisely the effect that would be predicted by interpersonal theories of psychological distress. These results were not atypical for other women and their partners who participated in the study. IMPLICATIONS FOR NURSING: family members play a significant role in supporting women through the breast cancer experience; thus, nurses should assess the emotional distress of both partners during the course of treatment and, if needed, provide critical education and referral to psychosocial interventions. This woman and her partner clearly benefited from the intervention, resulting in improved symptom management and quality of life. Although this intervention requires additional training in the advanced practice nursing role, some techniques of the intervention can be used by all nurses, regardless of specialty training.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/7. Reversible alopecia universalis during treatment with PEG-interferon and ribavirin for chronic hepatitis c.The combination of PEG-interferon and ribavirin is currently recommended for the treatment of chronic hepatitis c, which is a common cause of morbidity and mortality worldwide. hair disorders have often been described during interferon therapy, which include reversible hair discoloration, hypertricosis and alopecia. ribavirin is reported to cause photoallergic reactions. We report two cases of alopecia universalis, with complete hair loss extended to the whole body, secondary to PEG-interferon and ribavirin combination therapy for chronic hepatitis c virus infection. Both female patients were infected by genotype 1 and presented alopecia during the second half of a 48-week therapy, concurrently with low levels of ferritin and thyroid dysfunction (patient 1) or depression (patient 2). Patient 1 withdrew from the therapy on week 26 and, due to the occurrence of maculo-erythematous cutaneous eczema, underwent corticosteroid therapy with complete hair regrowth. Patient 2 completed the scheduled therapy and showed a spontaneous complete hair regrowth. It should be noted that in spite of an early (within 4 weeks of therapy) virological response, patient 1 had a disease relapse after therapy withdrawal and corticosteroid therapy, while patient 2 maintained a sustained virological response. In conclusion, interferon therapy may trigger reversible alopecia universalis in susceptible patients. However, given the benign and reversible nature of this side effect, patients who achieve a virological response should be strongly advised to complete the treatment in order to prevent disease relapse.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/7. Calvarial erosion after scalp expansion.A case is described of tissue expansion of the scalp with resultant erosion of the outer table and diploe of the calvaria. This resorption may have resulted from a prolonged period of expansion, excessive tension from inflation, and/or the nature or location of the defect. In cases of scalp expansion where the loose areolar space has become obliterated, periodic limited computed tomographic scanning may be useful to monitor the integrity of the skull. Postexpansion protective headgear may be indicated in selected patients.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
5/7. Follicular mucinosis: a detailed morphologic and immunopathologic study.Two patients with the benign type of follicular mucinosis (FM) are presented. Their clinical features and course were characteristic for this subgroup of FM. light and electron microscopy, direct immunofluorescence, and immunoperoxidase cell marker studies were undertaken to characterize the nature of the disease process. light microscopy confirmed the follicular outer root sheath and sebaceous gland epithelial degenerative changes. The infiltrating inflammatory cells were morphologically benign. Electron microscopy detailed the cellular associations in the areas of degenerative change. Disattached keratinocytes were closely apposed to significant numbers of macrophages and langerhans cells. Direct immunofluorescence studies demonstrated primarily complement (C3) and fibrinogen/fibrin in areas of reticular degeneration. Immunoperoxidase studies revealed large numbers of T cells and macrophages and a striking increase in the number of langerhans cells in the affected follicular epithelium. The findings suggest that cell-mediated immune mechanisms may play a role in the pathogenesis of this disorder.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
6/7. ectodermal dysplasia and abnormal thumbs.Two unrelated children, a girl and a boy, with alopecia, anomalous cutaneous pigmentation, abnormal thumbs, and endocrine disorders, including short stature and delayed bone age in one patient and juvenile onset diabetes mellitus in the other, are described. In one instance, the mother and the maternal grandmother had similar abnormalities, although of a less severe nature. Both children had normal nails and no unusual susceptibility to infections. We believe these two patients represent a previously undescribed syndrome of ectodermal dysplasia that may be inherited as an autosomal-dominant trait.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
7/7. Dry skin lesions with marked hair loss in a case of BL leprosy. A case report.skin lesions of leprosy that are anaesthetic, well defined, limited in number and dry with significant hair loss generally fit into the paucibacillary (PB) spectrum. The bacteriological index (BI) is expected to be negative or low. We have reported a case who presented with such findings but whose BI readings were high. Together with the biopsy findings the patient was classified as having borderline (BL) leprosy. The role of the skin smear examination and the misleading nature of some clinical features are highlighted. The authors feel that skin smear examinations should be performed on all leprosy patients at the time of diagnosis.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |