The objective of this study was to evaluate the efficacy of a commercially available anti-itch lo... more The objective of this study was to evaluate the efficacy of a commercially available anti-itch lotion containing 1% pramoxine hydrochloride versus control lotion in the treatment of uremic pruritus in adult hemodialysis patients. This was a randomized, double-blind, controlled comparative trial set in a community hemodialysis center. The study population comprised 28 individuals (mean age 53.5) with moderate to severe uremic pruritus who had been receiving hemodialysis for at least 3 months. All participants were recruited from one community hemodialysis center. Topical anti-itch lotion containing 1% pramoxine was applied twice daily to all affected areas of pruritus for 4 weeks. The main outcome measure was a reduction in itch intensity. Secondary outcomes included increases in the investigator's global assessment and improvement in skin hydration. There was a 61% decrease in itch intensity in the treatment group, whereas a 12% reduction in itch intensity was observed in the control group. The rate of decline in itching was also greater in the treatment arm versus the control arm. No significant differences were displayed in other studied disease-related variables. Our study shows that individuals using pramoxine 1% lotion experienced a reduction in pruritus to a greater degree than those using the control lotion. This safe, convenient and effective topical lotion may potentially benefit the large number of patients affected by pruritus associated with end-stage renal disease.
Journal of The American Academy of Dermatology, 2006
Adherence to topical medications is poorly characterized. Electronic monitors can provide objecti... more Adherence to topical medications is poorly characterized. Electronic monitors can provide objective adherence data, but these monitors are not designed to work with tubes of medications. We sought to adapt standard electronic monitors to commonly used medication tubes. An adapter was created to fit over standard medication tubes. Screw threads on the adapter were designed to fit standard electronic monitors. Adapters and monitors were tested with tubes of gel, ointment, and cream over an 8-week test period during which the adapters were opened and closed twice daily. The adapters were easily mated to both plastic and aluminum topical medication tubes. The bond between the adapter and the tube was maintained throughout the study. Electronic monitors were 100% accurate at identifying medication events over the study period. We conclude that adapting existing electronic monitors to medication tubes should facilitate a much better understanding of adherence to topical treatment.
Journal of The American Academy of Dermatology, 2006
Frequent tanning has reinforcing properties. We tested whether opioid antagonism blocks potential... more Frequent tanning has reinforcing properties. We tested whether opioid antagonism blocks potential reinforcing effect of indoor tanning in 8 frequent tanners and 8 infrequent tanner control subjects. Opioid blockade reduced ultraviolet preference in frequent tanners. Four of 8 frequent tanners, but no infrequent tanners, exhibited withdrawal-like symptoms with naltrexone administration. A limitation of this study is its small size.
Abstract: Skin cancer is a large and growing problem in the United States. Sun and other ultravi... more Abstract: Skin cancer is a large and growing problem in the United States. Sun and other ultraviolet (UV) light exposures play a key role in the development of skin cancer. Pediatricians can play an important role in counseling patients and are in a position to help educate children and their families about skin cancer. The purpose of this review is to familiarize pediatricians with the magnitude of the skin cancer problem and the evidence that ultraviolet light exposure, particularly indoor tanning, contributes to this problem. We reviewed the literature on ultraviolet light and skin cancer (based on a MEDLINE search of articles using the headings “ultraviolet light” and “skin cancer”) and found that skin cancer is the most rapidly growing cause of cancer deaths in the United State. There is strong epidemiologic evidence for the relationship between UV exposure and nonmelanoma skin cancer and growing evidence for the relationship between indoor tanning and melanoma. We recommend that pediatricians counsel children and their parents about UV protection. Measures such as use of sunscreen and hats for outdoor play, both at home and in school, should be encouraged.
Journal of The American Academy of Dermatology, 2004
Investigations into tanners&a... more Investigations into tanners' reasons for tanning have focused primarily on the perception of improved appearance. Reported relaxing effects of tanning suggest the possibility of a physiologic effect of UV that drives tanning behavior. We sought to determine if there is a physiologic reinforcing effect of UV exposure, separate from appearance motivation, that may contribute to tanning behavior. We determined the reinforcing effect of UV light in a series of controlled, blinded, repeated-choice trials of UV carefully designed to separate as cleanly as possible reinforcing effects of UV exposure from other factors including perceived benefits of having a tan. A total of 14 young adults who used tanning beds regularly were exposed to otherwise identical UV and non-UV tanning bed stimuli on Mondays and Wednesdays for 6 weeks. On Fridays, participants had concurrent access to the two beds. The primary dependent variable was the percentage of choice sessions during which more UV than non-UV tanning was chosen. In all, 12 participants chose additional tanning exposure on Fridays and, of these, 11 consistently used the UV bed for that exposure. Of the total 41 occasions when participants chose to tan on Friday, 39 sessions (95%) were for the UV bed and only two for the non-UV bed. A more relaxed and less tense mood was reported after UV exposure compared with after non-UV exposure (P=.008 and P=.002, respectively). When exposed to UV and non-UV under blinded conditions, frequent tanners can distinguish the two conditions and undertake further UV exposure, indicating that UV is a reinforcing stimulus. The relaxing and reinforcing effects of UV exposure contribute to tanning behavior in frequent tanners and should be explored in greater detail.
The oxidation resistance of the carbon–ceramic composites developed using green coke-based carbon... more The oxidation resistance of the carbon–ceramic composites developed using green coke-based carbon and carbon black as carbon source, boron carbide, and micro- and nano-silicon carbide was carried out in the temperature range of 800 to 1,200 °C. Silicon carbide particulate as such and silicon carbide obtained by the reaction of green coke and silicon provided micro silicon carbide while silicon and carbon black and sol–gel silica and carbon black used as silicon carbide precursors led to the formation of nano-silicon carbide. The oxidation resistance of these composites at 800 to 1,200 °C for 10 h showed that the size of the silicon carbide influenced the oxidation resistance. The weight gain due to protective coating formed on oxidation was higher in composites containing nano-silicon carbide as compared to the composites containing micro silicon carbide.
Carbon-micro or nano silicon carbide–boron carbide (C-micro or nanoSiC–B4C) composites were prepa... more Carbon-micro or nano silicon carbide–boron carbide (C-micro or nanoSiC–B4C) composites were prepared by heating the mixtures of green coke and carbon black as carbon source, boron carbide and silicon at temperature of 1,400 °C. Green coke reacts with silicon to give micron sized silicon carbide while the reaction between silicon and carbon black gives nano silicon carbide in the resulting carbon–ceramic composites. The green coke was coated with a suitable coal tar pitch material and used to develop carbon-(micro or nano) silicon carbide–boron carbide composites in a separate lot. The composites were characterized for various properties including oxidation resistance. It was observed that both types of composites made from uncoated as well as pitch-coated green coke exhibited good oxidation resistance at 800–1,200 °C. The density and bending strength of composites developed with pitch-coated green coke improved significantly due to the enhanced binding of the constituents by the pitch.
Carbon–copper composites with varying copper to carbon ratio of 0.66–1.5 (by weight) were develop... more Carbon–copper composites with varying copper to carbon ratio of 0.66–1.5 (by weight) were developed from coal-tar-pitch-derived green coke (as such or modified with natural graphite) as carbon source and electrolytic grade copper powder at different heat treatment temperatures (HTTs) of 1000–1400 °C. The physical, mechanical, and electrical properties differ depending upon the HTT and also on copper to carbon ratio (Cu/C). The composites prepared at HTT of 1100 °C having Cu/C ratio of 0.66 and 0.9 exhibited a high bending strength of 150 and 140 MPa, bulk density of 2.63 and 2.81 gm/cm3, electrical resistivity of 1.6 and 0.96 m Ω cm and shore hardness of 88 and 84, respectively, in spite of well-known inadequate wettability between copper and carbon. Increasing the temperature from 1100 °C for processing of the composites deteriorated the properties mainly due to the loss of copper through melting above 1100 °C as revealed by X-ray, scanning electron microscopy, thermal analysis and EDAX studies.
BACKGROUND Following the popularity of facial cosmetic procedures to reverse the signs of aging, ... more BACKGROUND Following the popularity of facial cosmetic procedures to reverse the signs of aging, cosmetic procedures that rejuvenate the hand are being sought. Irregular surface pigmentation, prominence of superficial veins and tendons, thinning of the dermis, and loss of subcutaneous fat typically characterize aging of the hand.OBJECTIVES To develop the Hand Grading Scale for objective quantification of the severity of hand aging and to establish the reliability of this photonumeric scale for clinical research and practice.MATERIALS AND METHODS The Hand Grading Scale is a 5-point photonumeric rating scale that was developed to objectively quantify the severity of aging of the hand. Nine experts rated photographs of 35 subjects, twice, with regard to the aspect “hand aging” in comparison with morphed images. Inter- and intrarater variability was assessed by computing intraclass correlation coefficients.RESULTS The agreement between the experts was considerably high. Bubble plots (bivariate scatter plots) demonstrated linearity in judgment by the experts.CONCLUSION The 5-point photonumeric scale generated spans the severity of hand aging for which patients most commonly seek correction. The scale is well stratified for consistent rating.
BACKGROUND Melomental folds, or marionette lines, are one of the consequences of facial aging. Th... more BACKGROUND Melomental folds, or marionette lines, are one of the consequences of facial aging. The curvilinear wrinkles formed because of facial movements and the aging process extend downward from the oral commissures.OBJECTIVES To develop the Marionette Lines Grading Scale for objective quantification of the severity of melomental folds and to establish the reliability of this photonumeric scale for clinical research and practice.MATERIALS AND METHODS A 5-point photonumeric rating scale was developed to objectively quantify the severity of melomental folds. Nine experts rated photographs of 35 subjects, twice, with regard to marionette lines in comparison with morphed images. Inter- and intrarater variability was assessed by computing intraclass correlation coefficients.RESULTS The agreement between the experts was high. Bubble plots (bivariate scatter plots) demonstrated linearity in judgment by the experts.CONCLUSION The 5-point photonumeric scale generated spans the severity of marionette lines for which patients commonly seek correction. The scale is well stratified for consistent rating.
OBJECTIVES To develop the Lip Fullness Grading Scale for objective quantification of lip volume f... more OBJECTIVES To develop the Lip Fullness Grading Scale for objective quantification of lip volume for a reliable assessment and to establish the reliability of this photonumeric scale for clinical research and practice.MATERIALS AND METHODS A 5-point photonumeric rating scale was developed to objectively quantify fullness of upper and lower lip separately. Nine experts rated photographs of 35 subjects, twice, separately for upper and lower lip. Inter- and intrarater variability was assessed by computing intraclass correlation coefficients.RESULTS Agreement between the experts was high. Bubble plots (bivariate scatter plots) demonstrated linearity in judgment by the experts.CONCLUSION The 5-point photonumeric scale generated spans the fullness of the upper and lower lip for which patients commonly seek correction. This scale is well stratified, with low intra- and interrater variability.
The objective of this study was to evaluate the efficacy of a commercially available anti-itch lo... more The objective of this study was to evaluate the efficacy of a commercially available anti-itch lotion containing 1% pramoxine hydrochloride versus control lotion in the treatment of uremic pruritus in adult hemodialysis patients. This was a randomized, double-blind, controlled comparative trial set in a community hemodialysis center. The study population comprised 28 individuals (mean age 53.5) with moderate to severe uremic pruritus who had been receiving hemodialysis for at least 3 months. All participants were recruited from one community hemodialysis center. Topical anti-itch lotion containing 1% pramoxine was applied twice daily to all affected areas of pruritus for 4 weeks. The main outcome measure was a reduction in itch intensity. Secondary outcomes included increases in the investigator's global assessment and improvement in skin hydration. There was a 61% decrease in itch intensity in the treatment group, whereas a 12% reduction in itch intensity was observed in the control group. The rate of decline in itching was also greater in the treatment arm versus the control arm. No significant differences were displayed in other studied disease-related variables. Our study shows that individuals using pramoxine 1% lotion experienced a reduction in pruritus to a greater degree than those using the control lotion. This safe, convenient and effective topical lotion may potentially benefit the large number of patients affected by pruritus associated with end-stage renal disease.
Journal of The American Academy of Dermatology, 2006
Adherence to topical medications is poorly characterized. Electronic monitors can provide objecti... more Adherence to topical medications is poorly characterized. Electronic monitors can provide objective adherence data, but these monitors are not designed to work with tubes of medications. We sought to adapt standard electronic monitors to commonly used medication tubes. An adapter was created to fit over standard medication tubes. Screw threads on the adapter were designed to fit standard electronic monitors. Adapters and monitors were tested with tubes of gel, ointment, and cream over an 8-week test period during which the adapters were opened and closed twice daily. The adapters were easily mated to both plastic and aluminum topical medication tubes. The bond between the adapter and the tube was maintained throughout the study. Electronic monitors were 100% accurate at identifying medication events over the study period. We conclude that adapting existing electronic monitors to medication tubes should facilitate a much better understanding of adherence to topical treatment.
Journal of The American Academy of Dermatology, 2006
Frequent tanning has reinforcing properties. We tested whether opioid antagonism blocks potential... more Frequent tanning has reinforcing properties. We tested whether opioid antagonism blocks potential reinforcing effect of indoor tanning in 8 frequent tanners and 8 infrequent tanner control subjects. Opioid blockade reduced ultraviolet preference in frequent tanners. Four of 8 frequent tanners, but no infrequent tanners, exhibited withdrawal-like symptoms with naltrexone administration. A limitation of this study is its small size.
Abstract: Skin cancer is a large and growing problem in the United States. Sun and other ultravi... more Abstract: Skin cancer is a large and growing problem in the United States. Sun and other ultraviolet (UV) light exposures play a key role in the development of skin cancer. Pediatricians can play an important role in counseling patients and are in a position to help educate children and their families about skin cancer. The purpose of this review is to familiarize pediatricians with the magnitude of the skin cancer problem and the evidence that ultraviolet light exposure, particularly indoor tanning, contributes to this problem. We reviewed the literature on ultraviolet light and skin cancer (based on a MEDLINE search of articles using the headings “ultraviolet light” and “skin cancer”) and found that skin cancer is the most rapidly growing cause of cancer deaths in the United State. There is strong epidemiologic evidence for the relationship between UV exposure and nonmelanoma skin cancer and growing evidence for the relationship between indoor tanning and melanoma. We recommend that pediatricians counsel children and their parents about UV protection. Measures such as use of sunscreen and hats for outdoor play, both at home and in school, should be encouraged.
Journal of The American Academy of Dermatology, 2004
Investigations into tanners&a... more Investigations into tanners' reasons for tanning have focused primarily on the perception of improved appearance. Reported relaxing effects of tanning suggest the possibility of a physiologic effect of UV that drives tanning behavior. We sought to determine if there is a physiologic reinforcing effect of UV exposure, separate from appearance motivation, that may contribute to tanning behavior. We determined the reinforcing effect of UV light in a series of controlled, blinded, repeated-choice trials of UV carefully designed to separate as cleanly as possible reinforcing effects of UV exposure from other factors including perceived benefits of having a tan. A total of 14 young adults who used tanning beds regularly were exposed to otherwise identical UV and non-UV tanning bed stimuli on Mondays and Wednesdays for 6 weeks. On Fridays, participants had concurrent access to the two beds. The primary dependent variable was the percentage of choice sessions during which more UV than non-UV tanning was chosen. In all, 12 participants chose additional tanning exposure on Fridays and, of these, 11 consistently used the UV bed for that exposure. Of the total 41 occasions when participants chose to tan on Friday, 39 sessions (95%) were for the UV bed and only two for the non-UV bed. A more relaxed and less tense mood was reported after UV exposure compared with after non-UV exposure (P=.008 and P=.002, respectively). When exposed to UV and non-UV under blinded conditions, frequent tanners can distinguish the two conditions and undertake further UV exposure, indicating that UV is a reinforcing stimulus. The relaxing and reinforcing effects of UV exposure contribute to tanning behavior in frequent tanners and should be explored in greater detail.
The oxidation resistance of the carbon–ceramic composites developed using green coke-based carbon... more The oxidation resistance of the carbon–ceramic composites developed using green coke-based carbon and carbon black as carbon source, boron carbide, and micro- and nano-silicon carbide was carried out in the temperature range of 800 to 1,200 °C. Silicon carbide particulate as such and silicon carbide obtained by the reaction of green coke and silicon provided micro silicon carbide while silicon and carbon black and sol–gel silica and carbon black used as silicon carbide precursors led to the formation of nano-silicon carbide. The oxidation resistance of these composites at 800 to 1,200 °C for 10 h showed that the size of the silicon carbide influenced the oxidation resistance. The weight gain due to protective coating formed on oxidation was higher in composites containing nano-silicon carbide as compared to the composites containing micro silicon carbide.
Carbon-micro or nano silicon carbide–boron carbide (C-micro or nanoSiC–B4C) composites were prepa... more Carbon-micro or nano silicon carbide–boron carbide (C-micro or nanoSiC–B4C) composites were prepared by heating the mixtures of green coke and carbon black as carbon source, boron carbide and silicon at temperature of 1,400 °C. Green coke reacts with silicon to give micron sized silicon carbide while the reaction between silicon and carbon black gives nano silicon carbide in the resulting carbon–ceramic composites. The green coke was coated with a suitable coal tar pitch material and used to develop carbon-(micro or nano) silicon carbide–boron carbide composites in a separate lot. The composites were characterized for various properties including oxidation resistance. It was observed that both types of composites made from uncoated as well as pitch-coated green coke exhibited good oxidation resistance at 800–1,200 °C. The density and bending strength of composites developed with pitch-coated green coke improved significantly due to the enhanced binding of the constituents by the pitch.
Carbon–copper composites with varying copper to carbon ratio of 0.66–1.5 (by weight) were develop... more Carbon–copper composites with varying copper to carbon ratio of 0.66–1.5 (by weight) were developed from coal-tar-pitch-derived green coke (as such or modified with natural graphite) as carbon source and electrolytic grade copper powder at different heat treatment temperatures (HTTs) of 1000–1400 °C. The physical, mechanical, and electrical properties differ depending upon the HTT and also on copper to carbon ratio (Cu/C). The composites prepared at HTT of 1100 °C having Cu/C ratio of 0.66 and 0.9 exhibited a high bending strength of 150 and 140 MPa, bulk density of 2.63 and 2.81 gm/cm3, electrical resistivity of 1.6 and 0.96 m Ω cm and shore hardness of 88 and 84, respectively, in spite of well-known inadequate wettability between copper and carbon. Increasing the temperature from 1100 °C for processing of the composites deteriorated the properties mainly due to the loss of copper through melting above 1100 °C as revealed by X-ray, scanning electron microscopy, thermal analysis and EDAX studies.
BACKGROUND Following the popularity of facial cosmetic procedures to reverse the signs of aging, ... more BACKGROUND Following the popularity of facial cosmetic procedures to reverse the signs of aging, cosmetic procedures that rejuvenate the hand are being sought. Irregular surface pigmentation, prominence of superficial veins and tendons, thinning of the dermis, and loss of subcutaneous fat typically characterize aging of the hand.OBJECTIVES To develop the Hand Grading Scale for objective quantification of the severity of hand aging and to establish the reliability of this photonumeric scale for clinical research and practice.MATERIALS AND METHODS The Hand Grading Scale is a 5-point photonumeric rating scale that was developed to objectively quantify the severity of aging of the hand. Nine experts rated photographs of 35 subjects, twice, with regard to the aspect “hand aging” in comparison with morphed images. Inter- and intrarater variability was assessed by computing intraclass correlation coefficients.RESULTS The agreement between the experts was considerably high. Bubble plots (bivariate scatter plots) demonstrated linearity in judgment by the experts.CONCLUSION The 5-point photonumeric scale generated spans the severity of hand aging for which patients most commonly seek correction. The scale is well stratified for consistent rating.
BACKGROUND Melomental folds, or marionette lines, are one of the consequences of facial aging. Th... more BACKGROUND Melomental folds, or marionette lines, are one of the consequences of facial aging. The curvilinear wrinkles formed because of facial movements and the aging process extend downward from the oral commissures.OBJECTIVES To develop the Marionette Lines Grading Scale for objective quantification of the severity of melomental folds and to establish the reliability of this photonumeric scale for clinical research and practice.MATERIALS AND METHODS A 5-point photonumeric rating scale was developed to objectively quantify the severity of melomental folds. Nine experts rated photographs of 35 subjects, twice, with regard to marionette lines in comparison with morphed images. Inter- and intrarater variability was assessed by computing intraclass correlation coefficients.RESULTS The agreement between the experts was high. Bubble plots (bivariate scatter plots) demonstrated linearity in judgment by the experts.CONCLUSION The 5-point photonumeric scale generated spans the severity of marionette lines for which patients commonly seek correction. The scale is well stratified for consistent rating.
OBJECTIVES To develop the Lip Fullness Grading Scale for objective quantification of lip volume f... more OBJECTIVES To develop the Lip Fullness Grading Scale for objective quantification of lip volume for a reliable assessment and to establish the reliability of this photonumeric scale for clinical research and practice.MATERIALS AND METHODS A 5-point photonumeric rating scale was developed to objectively quantify fullness of upper and lower lip separately. Nine experts rated photographs of 35 subjects, twice, separately for upper and lower lip. Inter- and intrarater variability was assessed by computing intraclass correlation coefficients.RESULTS Agreement between the experts was high. Bubble plots (bivariate scatter plots) demonstrated linearity in judgment by the experts.CONCLUSION The 5-point photonumeric scale generated spans the fullness of the upper and lower lip for which patients commonly seek correction. This scale is well stratified, with low intra- and interrater variability.
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