Popular works Resource Information. The form Popular works represents a specific category or genre of resources found in University Of Pikeville. Borrow it. Demetri, electronic resource. Herrick, electronic resource. Burns, Neeral L. Shah, electronic resource. Alexander and Karla A. Knight, electronic resource.
Ford, electronic resource. Greenberger with Roanne Weisman, electronic resource. A child of fortune : a correspondent's report on the ratification of the U. Constitution and the battle for a Bill of Rights, Jeffrey St. John ; foreword by Warren E. A dancing matrix : how science confronts emerging viruses, by Robin Marantz Henig.
A diabetic doctor looks at diabetes : his and yours, by Peter A. Lodewick ; foreword by Thomas M. Flood, electronic resource. A field guide to germs, Wayne Biddle. A history of medicine in 50 objects, Gill Paul. A judge's guide to divorce : uncommon advice from the bench, by Roderic Duncan, electronic resource. A layperson's guide to criminal law, Raneta Lawson Mack, electronic resource. A mathematician reads the newspaper, John Allen Paulos.
A mother's guide to raising healthy children-- naturally, Sue Frederick ; foreword by Jay Gordon, electronic resource. A palette of particles, Jeremy Bernstein, electronic resource. A parent's guide to cleft lip and palate, Karlind T. Moller, Clark D. Starr, and Sylvia A. Johnson, electronic resource.
A parent's guide to cystic fibrosis, Burton L. Shapiro and Ralph C. Heussner, Jr, electronic resource. A parent's guide to heart disorders, James H. Moller, William A. Neal, and William R. Hoffman, electronic resource. A parent's guide to kidney disorders, Glenn H. Bock, Edward J. Ruley, and Michael P. This is like flipping a coin to decide which patients are in each group. If you choose to participate in a clinical trial, you will not know which group you will be appointed to.
The chance of any patient getting the new treatment is about 50 percent. You cannot request to receive the new treatment instead of the placebo or sham treatment. Often, you will not know until the study is over whether you have been in the treatment group or the control group. In some trials, neither doctors nor patients know who is getting which treatment.
These types of trials help to ensure that the perceptions of the patients or doctors will not affect the study results. Natural History Studies Unlike clinical trials in which patient volunteers may receive new treatments, natural history studies provide important information to researchers on how sporotrichosis develops over time. A natural history study follows patient volunteers to see how factors such as age, sex, race, or family history might make some people more or less at risk for sporotrichosis.
A natural history study may also tell researchers if diet, lifestyle, or occupation affects how a disease or disorder develops and progresses. Results from these studies provide information that helps answer questions such as: How fast will a disease or disorder usually progress? How bad will the condition become? Will treatment be needed? Not everyone can take part in a clinical trial for a specific disease or disorder. Each study enrolls patients with certain features or eligibility criteria. These criteria may include the type and stage of disease or disorder, as well as, the age and previous treatment history of the patient.
You or your doctor can contact the sponsoring organization to find out more about specific clinical trials and their eligibility criteria. Depending upon the treatment and the examination procedure, you may be required to receive inpatient hospital care. Or, you may have to return to the medical facility for follow-up examinations. These exams help find out how well the treatment is working.
Follow-up studies can take months or years. However, the success of the clinical trial often depends on learning what happens to patients over a long period of time. Only patients who continue to return for follow-up examinations can provide this important long-term information. Recent Trials on Sporotrichosis The National Institutes of Health and other organizations sponsor trials on various diseases and disorders. Because funding for research goes to the medical areas that show promising research opportunities, it is not possible for the NIH or others to sponsor clinical trials for every disease and disorder at all times.
The following lists recent trials dedicated to sporotrichosis. If it is no longer recruiting or has been completed, then you can contact the sponsors to learn more about the study and, if published, the results. Further information on the trial is available at the Web site indicated. Please note that some trials may no longer be recruiting patients or are otherwise closed. Before contacting sponsors of a clinical trial, consult with your physician who can help you determine if you might benefit from participation. Evaluate the tolerance of patients with blastomycosis, histoplasmosis, and sporotrichosis to different doses of itraconazole R51, Determine levels of itraconazole in serum and other body fluids.
Assess the course of illness during itraconazole therapy. Identify a preferred oral fluconazole dose regimen for patients with non-acute histoplasmosis or blastomycosis, or ulcerocutaneous or deep sporotrichosis. Study the safety and efficacy of fluconazole in these patients. Evaluate the efficacy of fluconazole in patients with lymphocutaneous or visceral sporotrichosis. Although only half of the participants in a clinical trial receive the experimental treatment, if the new treatment is proved to be more effective and safer than the current treatment, then those patients who did not receive the new treatment during the clinical trial may be among the first to benefit from it when the study is over.
Experts watch them closely during the study and may continue to follow them after the study is over. In cases where certain diseases or disorders run in families, your participation may lead to better care or prevention for your family members. Clinical Trials 31 What Are the Risks? Clinical trials may involve risks as well as benefits.
Whether or not a new treatment will work cannot be known ahead of time. There is always a chance that a new treatment may not work better than a standard treatment. There is also the possibility that it may be harmful. The treatment you receive may cause side effects that are serious enough to require medical attention. How Is Patient Safety Protected?
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Clinical trials can raise fears of the unknown. Understanding the safeguards that protect patients can ease some of these fears. During a clinical trial, doctors will closely watch you to see if the treatment is working and if you are experiencing any side effects. All the results are carefully recorded and reviewed. In many cases, experts from the Data and Safety Monitoring Committee carefully monitor each clinical trial and can recommend that a study be stopped at any time.
You will only be asked to take part in a clinical trial as a volunteer giving informed consent. If you are eligible for a clinical trial, you will be given information to help you decide whether or not you want to participate. Participation is strictly voluntary. However, you should not enroll if you do not plan to complete the study. Your name will not appear in any reports based on the study. What about Costs? In some clinical trials, the research facility pays for treatment costs and other associated expenses. You or your insurance provider may have to pay for costs that are considered standard care.
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These things may include inpatient hospital care, laboratory and other tests, and medical procedures. You also may need to pay for travel between your home and the clinic. You should find out about costs before committing to participation in the trial. If you have health insurance, find out exactly what it will cover. Why do researchers think the new treatment may be better? What is likely to happen to me with or without the new treatment? Will I need surgery? How often will I have to come back for follow-up exams? What are the short- and long-term risks? What are the possible side effects?
Will it make me feel sick? If so, for how long? How will I get there? What costs are covered by the study? How much will my health insurance cover? Who will be in charge of my care? Do I have time to participate? Are there family members or friends who may benefit from my contributions to new medical knowledge?
Keeping Current on Clinical Trials Various government agencies maintain databases on trials. The U. The site was launched in February and currently contains approximately 5, clinical studies in over 59, locations worldwide, with most studies being conducted in the United States. To access this database, simply go to their Web site www.
While ClinicalTrials. The database is updated regularly, so clinical trials are continually being added. They have been selected to ensure that they are likely to be available from your local or online bookseller or university medical library. These references are usually written for healthcare professionals, so you may consider consulting with a librarian or bookseller who might recommend a particular reference. The following includes some of the most readily available references sorted alphabetically by title; hyperlinks provide rankings, information and reviews at Amazon.
Anderson; Paperback - pages , CenterWatch, Inc. All too often, patients who conduct their own research are overwhelmed by the difficulty in finding and organizing information. The purpose of the following chapters is to provide you an organized and structured format to help you find additional information resources on sporotrichosis.
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In Part II, as in Part I, our objective is not to interpret the latest advances on sporotrichosis or render an opinion. Rather, our goal is to give you access to original research and to increase your awareness of sources you may not have already considered. In this way, you will come across the advanced materials often referred to in pamphlets, books, or other general works. Once again, some of this material is technical in nature, so consultation with a professional familiar with sporotrichosis is suggested. Broadly speaking, there are two types of studies.
The first are peer reviewed. Generally, the content of these studies has been reviewed by scientists or physicians. Peer-reviewed studies are typically published in scientific journals and are usually available at medical libraries. The second type of studies is non-peer reviewed. These works include summary articles that do not use or report scientific results. These often appear in the popular press, newsletters, or similar periodicals.
In this chapter, we will show you how to locate peer-reviewed references and studies on sporotrichosis. We will begin by discussing research that has been summarized and is free to view by the public via the Internet. We then show you how to generate a bibliography on sporotrichosis and teach you how to keep current on new studies as they are published or undertaken by the scientific community. To limit your investigation to research studies and sporotrichosis, you will need to use the advanced search options.
May 15, Contact: American Academy of Family Physicians. E-mail: fp aafp. Website: www. Summary: This journal article for health professionals presents an overview of skin and wound infections, focusing on their features and treatment. Skin infections are common and may be caused by bacteria, fungi, or viruses. Breaks in the skin integrity, particularly those that inoculate pathogens into the dermis, frequently cause or exacerbate skin infections. Bacterial skin infections caused by corynebacteria include erythrasma, trichomycosis axillaris, and pitted keratolysis. Staphylococci may cause impetigo, ecthyma, and folliculitis.
Streptococcal skin infections include impetigo and erysipelas. Human papillomavirus skin infections present as several different types of warts, depending on the surface infected and its relative moisture, and the patterns of pressure. The many dermatomycoses include tinea capitis, tinea barbae, tinea cruris, tinea manus, tinea pedis, and tinea unguium.
Candidal infections occur in moist areas, such as the vulva, mouth, penis, skinfolds, and diaper area. Wounds caused by wood splinters or thorns may results in sporotrichosis. Animal bites may result in complex, serious infections, requiring tetanus and, possibly, rabies prophylaxis in addition to appropriate antibiotic therapy. Volume June Summary: This review article covers fungal infections that have the potential to cause disease of the genitourinary system. The authors also discuss and summarize antifungal therapy. Government supports a variety of research studies relating to sporotrichosis and associated conditions.
You can perform targeted searches by various criteria including geography, date, as well as topics related to sporotrichosis and related conditions. As opposed to clinical trial research using patients, many federally-funded studies use animals or simulated models to explore sporotrichosis and related conditions. In some cases, therefore, it may be difficult to understand how some basic or fundamental research could eventually translate into medical practice. The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references.
(PDF) Sporotrichosis | LASINRANG ADITIA, upahucypidig.ml - upahucypidig.ml
It is also free to the public. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with sporotrichosis, simply go to the PubMed Web site at www. A case report. Source: Indian J Dermatol. No Abstract Available. Author s : Belknap BS. Source: Dermatologic Clinics.
The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication. Studies 43 used as chemotherapeutic agents in the treatment of infectious diseases of man, animals and plants. It is usually a superficial infection of the moist cutaneous areas of the body, and is generally caused by C.
Rarely there is a systemic infection or endocarditis. Called also moniliasis, candidosis, oidiomycosis, and formerly blastodendriosis. The surface of the dermis contains sensitive papillae. Embedded in or beneath the dermis are sweat glands, hair follicles, and sebaceous glands. Formerly called St. Anthony's fire. Characteristics include pustular lesions that rupture and discharge a thin, amber-colored fluid that dries and forms a crust.
This condition is commonly located on the face, especially about the mouth and nose. Its teleomorph is Byssochlamys. A wide range of animals are infected including humans, chimpanzees, cattle, rabbits, dogs, and horses. The root is attached to the descending portions of the pubic bone by the crura, the latter being the extremities of the corpora cavernosa, and beneath them the corpus spongiosum, through which the urethra passes.
The glans is covered with mucous membrane and ensheathed by the prepuce, or foreskin. The penis is homologous with the clitoris in the female. They are causative agents of mycetoma, maduromycosis, and other infections in humans. Tetanus usually occurs after an acute injury, such as a puncture wound or laceration. Generalized tetanus, the most common form, is characterized by tetanic muscular contractions and hyperreflexia.
Localized tetanus presents itself as a mild condition with manifestations restricted to muscles near the wound. It may progress to the generalized form. It includes the specialty of andrology which addresses both male genital diseases and male infertility. They are characterized by a lack of independent metabolism and the inability to replicate outside living host cells.
You have many options to locate books on sporotrichosis. The simplest method is to go to your local bookseller and inquire about titles that they have in stock or can special order for you. Some patients, however, feel uncomfortable approaching their local booksellers and prefer online sources e. In addition to online booksellers, excellent sources for book titles on sporotrichosis include the Combined Health Information Database and the National Library of Medicine.
Once you have found a title that interests you, visit your local public or medical library to see if it is available for loan. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books e. Author: [edited by] Raza Aly, Howard I. In order to find chapters that are specifically dealing with sporotrichosis, an excellent source of abstracts is the Combined Health Information Database.
The books may be accessed in two ways: 1 by searching directly using any search term or phrase in the same way as the bibliographic database PubMed , or 2 by following the links to PubMed abstracts. These phrases are also found in the books available at NCBI. Click on hyperlinked results in the list of books in which the phrase is found. Currently, the majority of the links are between the books and PubMed. In the future, more links will be created between the books and other types of information, such as gene and protein sequences and macromolecular structures.
Oxford Textbook of Rheumatology. Volume 2. Summary: This chapter for health professionals presents an overview of fungal arthritis. The epidemiology and clinical features of fungal arthritis are discussed. Some of the drugs used to treat fungal infections are identified. The clinical features, diagnosis, and treatment of various fungal infections are highlighted.
These include Candida spp. Miscellaneous fungi that have been implicated in joint infections are also identified. General Home References In addition to references for sporotrichosis, you may want a general home medical guide that spans all aspects of home healthcare. The following list is a recent sample of such guides sorted alphabetically by title; hyperlinks provide rankings, information, and reviews at Amazon. This condition can lead to severe dehydration in a matter of hours unless quickly treated.
The liver, lungs, and kidney are the most common areas of infestation. The presence of living worms in the body is mainly asymptomatic but the death of adult worms leads to granulomatous inflammation and permanent fibrosis. Organisms of the genus Elaeophora infect wild elk and domestic sheep causing ischaemic necrosis of the brain, blindness, and dermatosis of the face. The etiologic agent, neisseria gonorrhoeae, was isolated by Neisser in Two polar or principal types are lepromatous and tuberculoid.
It is seen predominantly in women and typically involves the nasal, buccal, and conjunctival mucosa. Malignant neoplasms show a greater degree of anaplasia and have the properties of invasion and metastasis, compared to benign neoplasms. Called also the itch and seven-year itch.
It is caused by eating undercooked meat, usually pork. Among multimedia sources, video productions, slides, audiotapes, and computer databases are often available. In this chapter, we show you how to keep current on multimedia sources of information on sporotrichosis. We start with sources that have been summarized by federal agencies, and then show you how to find bibliographic information catalogued by the National Library of Medicine.
If you see an interesting item, visit your local medical library to check on the availability of the title. Bibliography: Multimedia on Sporotrichosis The National Library of Medicine is a rich source of information on healthcare-related multimedia productions including slides, computer software, and databases. The following multimedia has been indexed on sporotrichosis. Source: John P. Utz, and Richard J. Source: A. Many will subscribe to journals or newsletters published by their professional associations or refer to specialized textbooks or clinical guides published for the medical profession.
In this chapter, we focus on databases and Internet-based guidelines created or written for this professional audience. Publications are typically written by one or more of the various NIH Institutes. The format of these resources varies. Searchable databases, bibliographic citations, full text articles when available , archival collections, and images are all available.
The Combined Health Information Database A comprehensive source of information on clinical guidelines written for professionals is the Combined Health Information Database. Medical Problems in Dentistry. Woburn, MA: Butterworth-Heinemann. Contact: Available from Butterworth-Heinemann. Fax or E-mail: orders bhusa. ISBN: Summary: This chapter on socioeconomic, ethnic, and geographical health issues is from a text that covers the general medical and surgical conditions relevant to the oral health care sciences.
The authors discuss mainly the relevant imported diseases, problems related to social deprivation, and those which religious or ethnic groups may present during oral health care. Topics include infections, including typhoid, paratyphoid, cholera, nonvenereal treponematoses, yaws framboesia , granuloma inguinale donovanosis , lymphogranuloma vereneum, blood-borne viruses, arboviruses, arenaviruses, rhabdoviruses Ebola, rabies , systemic mycoses, Aspergillosis, blastomycosis, coccidioidomycosis, cryptococcosis, histoplasmosis, mucormycosis, rhinosporidiosis, sporotrichosis, systemic candidosis, parasitic infestations, scabies, lice, fleas, malaria, toxoplasmosis, leishmaniasis, trichinosis, echinococcosis, cysticercosis, myiasis, larva migrans, filariasis, trichuriasis, gnathostomiasis, and oral submucous fibrosis.
For each condition, the authors discuss general aspects, diagnosis and management issues, dental aspects, and patient care strategies. The chapter includes a summary of the points covered. Physician Guidelines and Databases 57 and does not know what information is available or how best to search for it. This audience may include physicians and other healthcare providers, researchers, librarians, students, and, increasingly, patients, their families, and the public. The Gateway connects users with multiple NLM retrieval systems while also providing a search interface for its own collections.
The Gateway will provide access to the information found in an increasing number of NLM retrieval systems in several phases. Coffee Break: Tutorials for Biologists30 Some patients may wish to have access to a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process.
The result is an interactive tutorial that tells a biological story. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process. Physician Guidelines and Databases 59 Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals.
Specialized References The following books are specialized references written for professionals interested in sporotrichosis sorted alphabetically by title, hyperlinks provide rankings, information, and reviews at Amazon. Alouf Editor , John H. Set by Gerald L. While a number of hard copy or CD-Rom resources are available to patients and physicians for research purposes, a more flexible method is to use Internet-based databases. In this chapter, we will begin with a general overview of medications.
We will then proceed to outline official recommendations on how you should view your medications. You may also want to research medications that you are currently taking for other conditions as they may interact with medications for sporotrichosis. Research can give you information on the side effects, interactions, and limitations of prescription drugs used in the treatment of sporotrichosis.
Broadly speaking, there are two sources of information on approved medications: public sources and private sources. We will emphasize free-to-use public sources. Taking medicines is not always as simple as swallowing a pill. It can involve many steps and decisions each day. Do not be afraid to ask questions and talk about your concerns.
By taking a moment to ask questions early, you may avoid problems later. Do not hesitate to ask what is important to you about your medicines. You may want a medicine with the fewest side effects, or the fewest doses to take each day. You may care most about cost, or how the medicine might affect how you live or work.
Or, you may want the medicine your doctor believes will work the best. Telling your doctor will help him or her select the best treatment for you. You can also talk to a nurse or a pharmacist. They can help you better understand your treatment plan. Feel free to bring a friend or family member with you when you visit your doctor.
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Talking over your options with someone you trust can help you make better choices, especially if you are not feeling well. Do not forget to tell your doctor about all the medicines you are currently taking not just those for sporotrichosis. This includes prescription medicines and the medicines that you buy over the counter. Then your doctor can avoid giving you a new medicine that may not work well with the medications you take now. When talking to your doctor, you may wish to prepare a list of medicines you currently take, the reason you take them, and how you take them.
One such source is the United States Pharmacopeia. In , eleven physicians met in Washington, D. Pharmacopeia USP.
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The USP currently provides standards for over 3, medications. It covers more than 9, prescription and over-the-counter medications. In parallel, quantitative assessment of the skin barrier was measured using transepidermal water loss TEWL , epidermal moisture content corneometry , and pH. The results of this study should be translated to inform future studies of the functional relationship between host cutaneous barrier function and the skin microbiome of humans and dogs. One dog in each cohort was excluded due to unrelated medical problems.
All cAD subjects had active lesions of superficial bacterial dermatitis and folliculitis at enrollment Figure 1a. The skin was swabbed to sample microbiota at anatomic sites with a predilection for cAD lesions: the pinna, axilla, and groin Figure 1b. The mouth was also sampled, as licking of the skin is a manifestation of pruritus in dogs. Assessment and sampling occurred at three study visits: visit 1 at initial presentation with a flare of cAD and concurrent bacterial dermatitis; visit 2 at the conclusion of 4—6 weeks of culture- and susceptibility-directed oral antimicrobial therapy; and visit 3 at 4—6 weeks following the conclusion of antimicrobial therapy.
Healthy dogs were assessed and sampled contemporaneously. This scoring was performed to assess the relationship between microbiota, skin barrier, and clinical signs at a given site. The components of the site-specific lesion scores, erythema, lichenification, and alopecia, were strongly positively correlated with each other Table S3.
Subject 16 was identified as a minor outlier, with a cumulative lesion score of 45 and a severe phenotype of chronic cAD in which four weeks of therapy was unlikely to alter the degree of chronic dermatitis and scarring. This minor outlier was not removed from any of the subsequent analyses. The skin microbiome of cAD and unaffected control dogs differed at visit 1, prior to commencing treatment. Line in box represents median, boxes represent interquartile range, whiskers represent lowest and highest values within 1.
Percent variability explained by each axis is given. The predominant bacteria on healthy canine skin were Porphyromonas, Staphylococcus, Streptococcus, Propionibacterium, Corynebacterium and genera belonging to the families Neisseriaceae and Moraxellaceae Figure 2B , Figure S2. Though the same taxa were present in cAD and control dogs, the relative abundance of taxa varied dramatically between the two groups.
This trend was similar in the axilla and pinna though it did not reach significance. In the oral cavity the most abundant taxa did not differ significantly between control and cAD dogs and consisted of many anaerobes including Porphyromonas, Conchiformibius, Fusobacterium , unclassified Moraxellaceae, Flavobacterium and unclassified Prevotellaceae Figure 2b , Figure S2. Significant clustering was not associated with patient sex, breed, age, or antimicrobial class used during treatment Figure S3.
These findings suggest that antimicrobial therapy restores diversity of the skin microbiome in cAD, but the effects may dissipate once treatment is withdrawn or if bacterial dermatitis recurs. See Figure 2 for the taxonomic legend. To further examine the relationship between treatment, disease severity, and microbial diversity, correlations between microbial diversity and lesion scores were analyzed.
Corynebacterium spp. Together, these data indicate that antimicrobial therapy normalizes the skin microbiome of cAD. Skin moisture corneometry did not correlate with site-specific lesion scores or alpha diversity metrics. These results demonstrate that concurrent with cAD flares, alpha diversity decreases and is correlated with disease severity, TEWL, and pH. During the treatment of cAD, TEWL and corneometry scores decreased and trended toward the distribution seen in the control group, but were not statistically different between visits 1 and 2 Table S2, Figure S4.
There was no correlation between changes in lesion scores and TEWL between visits 1 and 3, likely due to recrudescence of bacterial dermatitis in some cAD dogs. Skin pH did not differ significantly between dogs with cAD and healthy controls across the three visits. The relationships between Staphylococcus , cAD severity, and treatment in the canine skin microbiome were correlated. Species-level relative abundance y-axis of cultured Staphylococcus isolates d and 16S rRNA sequences using phylogenetic placement e.
Because Staphylococcus species in humans can be commensal S. One microbial culture from a lesional site and axilla in control dogs or when lesions had resolved were performed contemporaneously with microbiome swabs at each visit. The majority of the isolates were identified as S. To speciate and compare 16S rRNA sequence data to cultures, we employed a most recent common ancestor analysis of phylogenetic placement using the pplacer algorithm Matsen et al. The majority of the sequences identified across all samples were attributed to S.
In this spontaneous large animal model of AD, alterations in skin microbiome parallel those observed in AD patients, including increased relative abundance of Staphylococcus spp. The longitudinal dynamics of the skin microbiome of cAD during flare and treatment correlate with changes in cutaneous barrier function. This work unveils the dynamic relationship between cutaneous barrier function and the skin microbiome in mammalian health and disease states.
The contrast may be due to different methodologies employed, geography, and differing selection criteria with dogs in the present study presenting with evidence of bacterial dermatitis and disease flare. Our results are harmonious with longitudinal studies in human AD, where microbial diversity is decreased and Staphylococcus and Corynebacterium predominate during flare states Kong et al.
Human S. By the same token, S. The dog may act as a potential vector of S. Mechanisms of staphylococcal perturbation of the epidermal barrier are still unclear and may be through direct or indirect immunostimulatory means. Mitigation of staphylococcal overgrowth clearly ameliorates disease severity and the epidermal barrier normalizes. However, methicillin and multidrug resistance are now commonplace in both veterinary and human medicine.
The findings presented here may inform future efforts to develop alternative non-antibiotic approaches to controlling staphylococcal burden in skin disease. The same dermatologist examined each patient across all time points. Dogs with cAD were included in the study by fulfilling standardized criteria 5 criteria of Favrot, Favrot et al.
Hensel et al. Dogs with evidence of other underlying systemic disease, an atopic history that was not clearly documented, or evidence of active ecto-parasitic including Demodex spp. All subjects were on a strict flea control regimen. Four dogs with cAD had a history of antibiotic exposure within 45 days before enrollment. Therapy was prescribed as indicated by the attending veterinary dermatologist.
Systemic antimicrobial therapy was prescribed based on aerobic culture and sensitivity at enrollment. See Table S4a—b for specific therapies prescribed for each patient. Healthy dogs were enrolled in the study during the same time period. A subset of dogs were owned by veterinarians and veterinary technicians. Informed consent was obtained from all owners prior to enrollment. All experiments were carried out according to approved Institutional Animal Care and Use Committee protocols.
Site-specific assessment and semi-quantitative scoring of lesion severity was performed and included erythema, lichenification, and self-induced alopecia each made on a 0—5 scale 0-no lesions and 5-most severe. The lesion score was used to assess for changes at a given site that might correlate with microbial shifts or skin barrier function, and not as a means for documenting changes in disease flare. Sampling sites included the axilla, groin, and concave aspect of the pinna.
These sites were chosen as they are sparsely haired allowing for corneometry and tewametry measurements and are cAD predilection sites. Dogs were sampled in lateral recumbency with minimal physical restraint. TEWL measurements were averaged at 1-second intervals for a 30 second period.