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International Journal of Environmental... Jan 2023Baby diaper rash is a common problem, especially allergic contact dermatitis, which could be due to heavy metals, pH, formaldehyde, or allergens in the diapers. This...
Baby diaper rash is a common problem, especially allergic contact dermatitis, which could be due to heavy metals, pH, formaldehyde, or allergens in the diapers. This study reports on the determination of formaldehyde, heavy metals (Pb, As, Co, Cr, Ni, Cu, Zn, Mn, Sr, Fe, and Cd), and pH in diapers purchased from low-, medium-, and high-end stores. Inductively coupled plasma was used to determine the concentrations of heavy metals after extraction using artificial urine and artificial sweat. All heavy metals were found in all diapers except Sr, which was not found in sample M7. All samples had concentrations of heavy metals within the Oeko-Tex limits, except samples H2 and L2, whose Ni concentrations were above permissible limits. Fifty percent of diapers had a formaldehyde concentration above the Oeko-Tex recommended limits. The highest formaldehyde concentration of 17.62 mg/kg was found in diaper M2 and the lowest (ca. 10.4 mg/kg) in H1. All samples had pH values in the alkaline region, with only five samples having pH values within the recommended limits. The research concluded that the diaper rash experienced by some babies, among other factors, could be due to high alkaline skin pH and formaldehyde levels, which are higher than the Oeko-Tex recommended limits.
Topics: Infant; Humans; Diaper Rash; South Africa; Metals, Heavy; Dermatitis, Allergic Contact; Formaldehyde; Environmental Monitoring
PubMed: 36673779
DOI: 10.3390/ijerph20021023 -
Nigerian Journal of Clinical Practice Oct 2022Evaluation of circumcision bleeding cannot depend on the visual change in the diaper. Diapers have different product features and absorbency capacities. The apparent...
BACKGROUND
Evaluation of circumcision bleeding cannot depend on the visual change in the diaper. Diapers have different product features and absorbency capacities. The apparent changes in the diapers may vary according to their absorbent capacity and may not be in parallel with the amount of bleeding. Before significant visual difference occurs, the patient's hemodynamics may be impaired.
AIM
Aim of the study is to evaluate better circumcision bleeding.
PATIENTS AND METHODS
Patients were divided into groups according to 12 different brand diapers of the same size, containing super-absorbent material. The study started by 15/01/2022, and finished by end of 01/03/2022. Diapers with concealed brands were soaked with blood with equal hematocrit value in 100 ml with increments of 5 ml. 252 images were obtained by taking 21 images of each diaper with the same method. The diapers were evaluated colorimetrically, and numerical values were obtained showing the color differences in red, green, and blue and saturation and lightness. Working groups were formed according to 12 different brands of diapers of the same size, containing super-absorbent material. Standard statistical tests were performed using obtained values.
RESULT
: Dry diapers had different weights, volumes, and specific gravities; the diapers with the lowest unit weight were ranked ninth in terms of volume; the diapers with the highest specific gravity were ranked third in terms of thinness. There were significant differences in the blood on the diaper, and significant differences between some groups (p < 0.005); on the other hand, there was not any difference between some other groups (p > 0.05). There was a significant relationship in terms of Analysis of Variance (ANOVA) (P < 0.05 and P < 0.01). Visual graphic examination showed that linear but non-parallel color changes occurred. As the blood load increased, the visual and statistical differences between the diapers became more pronounced, and the curves diverged.
CONCLUSION
Visual evaluation of the color change of the diapers may not give accurate results for bleeding follow-up. If necessary to use diapers after circumcision, it is more appropriate to prefer those with low absorbency capacity. Using fabric or cotton products in cases with bleeding risk may be recommended. If bleeding is suspected, hemogram control is the most appropriate option. Diaper manufacturers should warn consumers of the risk. In conclusion, we should be on the safe side for mortality and morbidity.
Topics: Infant; Male; Child; Humans; Diaper Rash; Infant Care; Hemorrhage
PubMed: 36308243
DOI: 10.4103/njcp.njcp_187_22 -
The American Journal of Case Reports Sep 2022BACKGROUND Fournier's gangrene is an idiopathic form of necrotizing fasciitis involving the genital and perineal regions; it is associated with high complication and...
A 30-Day-Old Infant with Necrotizing Fasciitis of the Perineal Region Involving the Scrotum Due to Methicillin-Resistant Staphylococcus aureus (MRSA) and Extended-Spectrum β-Lactamase (ESBL)-Producing Klebsiella pneumoniae: A Case Report.
BACKGROUND Fournier's gangrene is an idiopathic form of necrotizing fasciitis involving the genital and perineal regions; it is associated with high complication and mortality rates. Rarely, perineal infection may be caused by hospital-acquired antimicrobial-resistant bacteria. This report is of a 30-day-old infant with methicillin-resistant Staphylococcus aureus (MRSA) and extended-spectrum ß-lactamase (ESBL)-producing Klebsiella pneumoniae necrotizing fasciitis involving the perineal region. CASE REPORT A 30-day-old male infant presented to the Emergency Department with rapidly progressive white discoloration of scrotal skin since 3 days prior to admission, progressing from 2-3 white spots to covering two-thirds of the scrotal skin. Pain upon urination was noted, with normal appetite and bowel movements. He had a history of diaper rash 6 days earlier accompanied by fever, and the rash was treated with topical antifungal and corticosteroid ointment. He was born at term by caesarean delivery, with birth weight 2900 g. Laboratory examinations revealed leukocyte count 23 000/µL and CRP 26.8 mg/dL. Hemoglobin was 10.6 g/dL, serum sodium was 134 mEq/L, blood glucose was 80 mg/dL, serum urea was 15 mg/dl, and creatinine was 0.27 mg/dL. Chest and abdominal X-rays were normal. He received broad-spectrum antibiotics and underwent surgical debridement, and necrotic tissue was obtained for biopsy and culture. Histology examination showed non-specific granulation tissue consistent with Fournier gangrene. Soft- tissue culture isolated MRSA and ESBL-K. Antibiotics were changed according to the sensitivity report. Blood and urine cultures were negative. CONCLUSIONS Immediate surgery and antibiotics are essential in treating Fournier gangrene to avoid life-threatening complications. Initial symptoms are non-specific. Diagnosis remains primarily clinical, confirmed by intraoperative macroscopic findings.
Topics: Anti-Bacterial Agents; Antifungal Agents; Blood Glucose; Creatinine; Fasciitis, Necrotizing; Fournier Gangrene; Humans; Infant; Klebsiella pneumoniae; Male; Methicillin-Resistant Staphylococcus aureus; Ointments; Scrotum; Sodium; Urea; beta-Lactamases
PubMed: 36168215
DOI: 10.12659/AJCR.936915 -
The American Journal of Case Reports Aug 2022BACKGROUND Major findings of myelodysplasia, infection, restriction of growth, adrenal hypoplasia, genital phenotypes, and enteropathy (MIRAGE) syndrome is a rare...
BACKGROUND Major findings of myelodysplasia, infection, restriction of growth, adrenal hypoplasia, genital phenotypes, and enteropathy (MIRAGE) syndrome is a rare genetic condition caused by a gain-of-function mutation in the SAMD9 gene. It acts as a growth repressor expressed in the endothelial cells. Pathogenic variants in the SAMD9 gene lead to profound growth-restricting activity intrinsic to the protein, which further reduces cellular proliferation and instigates this growth-limiting condition. Gastrointestinal features include chronic diarrhea, severe diaper rash, and colonic dilatation. Until now, there has been no description of exocrine pancreatic insufficiency as a possible cause of enteropathy in MIRAGE syndrome. CASE REPORT We report a case of MIRAGE syndrome affecting multiple systems in an infant who had severe enteropathy which responded well to porcine-derived pancreatic enzyme supplements despite normal pancreatic fecal elastase level. The infant is being followed up by multidisciplinary teams in our outpatient department. CONCLUSIONS Porcine-derived pancreatic enzyme is beneficial in enteropathy due to MIRAGE syndrome and is worth considering.
Topics: Adrenal Insufficiency; Animals; Endothelial Cells; Feces; Humans; Intracellular Signaling Peptides and Proteins; Pancreatic Elastase; Pancrelipase; Swine
PubMed: 35994417
DOI: 10.12659/AJCR.937057 -
Cureus Jul 2022Langerhans cell histiocytosis presents most frequently in pediatric patients with cutaneous manifestations such as erythematous and scaly papules in the trunk or scalp...
Langerhans cell histiocytosis presents most frequently in pediatric patients with cutaneous manifestations such as erythematous and scaly papules in the trunk or scalp and macerated plaques in intertriginous sites. We present a case of a seven-month-old patient who was brought with complaints of persistent diaper rash. The patient presented with skin fissures in intertriginous areas and pink color papules dispersed widely in the trunk and perineum. The skin biopsy revealed infiltration of abundant histiocytes, eosinophils, lymphocytes, and plasma cells, being CD207, CD1a, and S-100 positive by immunohistochemistry. Due to the diversified presentations of Langerhans cell histiocytosis and its propensity to mimic other dermatological conditions, physicians should have a clinical suspicion of this disease and consider it as a differential diagnosis among common skin diseases in pediatric patients.
PubMed: 35936168
DOI: 10.7759/cureus.26606 -
Drug Delivery Dec 2022Topical conveyance of antifungal agents like itraconazole ITZ has been giving good grounds for expecting felicitous antifungal medicines. The defiance of topical...
Topical conveyance of antifungal agents like itraconazole ITZ has been giving good grounds for expecting felicitous antifungal medicines. The defiance of topical delivery of this poorly water soluble and high-molecular-weight drug, however, mightily entail an adequate vehiculation. ITZ aspasomes, newer antioxidant generation of liposomes, have been designed and enclosed in a cream to ameliorate skin deposition. The proposed creams containing non-formulated ITZ or encapsulated in aspasomes (0.1% or 0.5%) were topically applied in patients with diagnosed diaper dermatitis complicated by candidiasis, tinea corporis (TC), and tinea versicolor (TVC). Placebos (void aspasomal cream and cream base) were also utilized. The obtained results for diaper rash revealed that aspasomal cream (0.5% ITZ) was eminent with respect to complete cure and negative candida culture after 10-day therapy relative to counterparts containing 0.1% ITZ aspasomes or non-formulated ITZ (0.1% and 0.5%). For tinea, the same trend was manifested in terms of 'cleared' clinical response in 90% of patients and absence of fungal elements after 4-week treatment. Relative to non-formulated ITZ, ITZ aspasomal cream was endorsed to be auspicious especially when ITZ concentration was lowered to half commercially available cream concentration (1%), pushing further exploitation in other dermal fungal infections.
Topics: Antifungal Agents; Humans; Itraconazole; Liposomes; Skin; Tinea
PubMed: 35506466
DOI: 10.1080/10717544.2022.2067601 -
MBio Jun 2022Candida albicans is one of the most prevalent human fungal pathogens. Its ability to transition between budding yeast and filamentous morphological forms (pseudohyphae...
Candida albicans is one of the most prevalent human fungal pathogens. Its ability to transition between budding yeast and filamentous morphological forms (pseudohyphae and hyphae) is tightly associated with its pathogenesis. Based on studies, the cAMP-protein kinase A (PKA) pathway is a key regulator of C. albicans morphogenesis. Using an intravital imaging approach, we investigated the role of the cAMP-PKA pathway during infection. Consistent with their roles , the downstream effectors of the cAMP-PKA pathway Efg1 and Nrg1 function, respectively, as an activator and a repressor of filamentation. Surprisingly, strains lacking the adenylyl cyclase, , showed only slightly reduced filamentation despite being completely unable to filament in RPMI + 10% serum at 37°C. Consistent with these findings, deletion of the catalytic subunits of PKA (Tpk1 and Tpk2), either singly or in combination, generated strains that also filamented but not . transcription profiling of C. albicans isolated from both ear and kidney tissue showed that the expression of a set of 184 environmentally responsive genes correlated well with filamentation (, 0.62 to 0.68) genes. This concordance suggests that the and transcriptional responses are similar but that the upstream regulatory mechanisms are distinct. As such, these data emphatically emphasize that C. albicans filamentation is a complex phenotype that occurs in different environments through an intricate network of distinct regulatory mechanisms. The fungus Candida albicans causes a wide range of disease in humans from common diaper rash to life-threatening infections in patients with compromised immune systems. As such, the mechanisms for its ability to cause disease are of wide interest. An intensely studied virulence property of C. albicans is its ability to switch from a round yeast form to filament-like forms (hyphae and pseudohyphae). Surprisingly, we have found that a key signaling pathway that regulates this transition , the protein kinase A pathway, is not required for filamentation during infection of the host. Our work not only demonstrates that the regulation of filamentation depends upon the specific environment C. albicans inhabits but also underscores the importance of studying these mechanisms during infection.
Topics: Candida albicans; Cyclic AMP-Dependent Protein Kinases; Fungal Proteins; Gene Expression Regulation, Fungal; Hyphae
PubMed: 35475642
DOI: 10.1128/mbio.00851-22 -
Journal of Cutaneous Medicine and... 2022Atopic dermatitis (AD) is a chronic, inflammatory skin condition commonly affecting infants with notable sparing of the diaper region. Though sources anecdotally... (Review)
Review
Atopic dermatitis (AD) is a chronic, inflammatory skin condition commonly affecting infants with notable sparing of the diaper region. Though sources anecdotally attribute this sparing to the physical barrier formed by the diaper and the subsequent retention of moisture, urine, sweat and feces, no studies have formally investigated the factors contributing to this sparing phenomenon. We performed a scoping literature review to investigate the factors involved in sparing of AD in the diaper region, namely humidity, scratching, urine, sweat, feces, and microbiome composition. A total of 130 papers met the inclusion criteria, and extracted data were analyzed in an iterative manner. Increased local humidity facilitates protective changes at the cellular level and offsets transepidermal water loss. Exposure to urea from both sweat and urine may contribute to improved moisturization of the skin through its natural humectant properties and ability to modulate gene expression. Introduction of flora in feces contributes to the generation of protective immune responses and outcompetes growth of pathogens such as . Finally, diapers physically prevent scratching, which directly interrupts the itch-scratch cycle classically implicated in AD. Our study reviews factors that may contribute to the sparing of AD in the diaper region in infants. A limitation to our findings is that the studies reviewed here explore the impacts of these factors on AD broadly, and not explicitly in the diaper region. Additional studies investigating this may further our understanding of AD pathogenesis and contribute to the development of effective therapeutics.
Topics: Child; Dermatitis, Atopic; Diaper Rash; Humans; Infant; Infant Care; Skin
PubMed: 35317630
DOI: 10.1177/12034754221088533 -
American Family Physician Mar 2022
Topics: Child; Diaper Rash; Exanthema; Humans; Infant; Infant Care
PubMed: 35289583
DOI: No ID Found