דו״ח מאומת

Ultraviolet (UV) radiation is an etiologic factor for the development of nonmelanoma skin cancers and also possibly melanoma. The American Academy of Dermatology currently recommends the daily use of sunscreens with a sun protection factor (SPF) of 15 or above. The SPF numerical rating is an in vivo, standardized measure of sunscreen efficacy. SPF assessment predominantly reflects the ability of a product to screen UVB radiation. The physical and biologic properties of UVA radiation are relevant as UVA contributes to photoimmunosuppression and photocarcinogenesis. An ideal sunscreen assessment system would address both UVB and UVA protection. However, the SPF rating should continue to serve as the major determinant of sunscreen efficacy.…

PMID: 11705089

Sunscreen is widely used for ultraviolet radiation protection. Studies validate sun protection factors (SPFs) to prevent ultraviolet (UV)-induced skin changes such as melanoma and squamous cell carcinoma (SCC). Few studies examine sunscreen's impact on endocrine and immune system dysregulation, the production of radical oxygen species, and whether the ingredients deteriorate under prolonged exposure. We present an investigation of sunscreen labels and how ingredients impact sun safety and human health. A review of the literature was conducted using Embase and PubMed to examine sunscreen safety, efficacy, and use to prevent UV-induced skin damage. Increasing sunscreen reapplication, wearing protective clothing, and limiting exposure can reduce the incidence of skin cancer. Inorganic sunscreens form barriers to block UV light, but without titanium dioxide (TiO…

PMID: 38633930

To evaluate whether the use of "breathable" panty liners (BPLs) alters the normal vaginal flora, increases the incidence of bacterial vaginosis and/or vaginal candidiasis, or causes vulvar irritation. A randomized controlled trial assessed the vaginal ecosystem of women without complaints of vaginal discharge. The study group (n=53) wore BPLs for 10-12 hours each day for 75 consecutive days, whereas the control group (n=54) wore only their usual underwear. At each of 6 visits during 3 menstrual cycles, participants underwent gynecologic examination with colposcopic evaluation and pH measurement, in addition to assessment of vaginal microbial flora, intensity of inflammatory processes, and presence of vaginal candidiasis/bacterial vaginosis in Gram-stained smears. After 75 consecutive days of BPL use, 40/44 (90.9%) and 42/44 (95.5%) women reported no complaints of vaginal discharge or vulvar itching/burning, respectively. There was no significant difference between the study group and the control group with regard to positive vaginal fungus cultures (5/44 [11.4%] vs 8/50 [16.0%]; P=0.7848) or bacterial vaginosis (3/44 [6.8%] vs 2/50 [4.0%]; P=0.7974) at the end of the study period. After 75 days of BPL use, there was no significant increase in vulvovaginal candidiasis, bacterial vaginosis, vulvovaginal irritation, or vulvovaginal inflammation.…

PMID: 21798535

Knowledge of female genital anatomy and physiology is often inadequate or incorrect among women. Precise patient-physician conversations can be inhibited by a reluctance or inability to speak accurately about the vulva and vagina, with the terms often being used interchangeably. There is a paucity of scientific evidence and clinical guidelines to support women and physicians in ensuring best practices in feminine hygiene. In this review, the unmet needs in the field are highlighted. Evidence is provided for the complex array of physiological and pathological systems, mechanisms and behaviours that either protect or, if inappropriate, predispose the vulva and vagina to infections, irritation or other conditions. The need for attention to perineal health is recommended, given the interdependence of perineal and vulvar microbiota and the risk of colonic pathogens reaching the vulva and the vagina. Differences in feminine hygiene practices can vary widely across the world and among varying age groups, and suboptimal habits (such as vaginal douching or the use of certain cleansers) can be associated with increased risks of vulvar and vaginal conditions. Critical areas for discussion when advising women on their intimate health include: advice surrounding aesthetic vulvar cosmetic trends (such as depilation and genital cosmetic surgery), bowel health and habits, and protection against sexually transmitted infections. Routine, once-daily (maximum twice-daily) washing of the vulva with a pH-balanced, mild cleanser is optimal, ideally soon after bowel voiding, when feasible. Due to the finely balanced ecosystems of the vulva, the vagina and the perineal area, a scientific and clinical perspective is essential when determining the most appropriate vulvar cleansers based on their components. Correct intimate care may contribute to improved genital and sexual health and overall well-being. An increased awareness of correct practices will empower women to be the advocates of their own intimate health.…

PMID: 38396383

The use of soaps and synthetic detergent (syndet) bars has been associated with skin dryness and aggravation of dermatologic conditions. A number of factors, including chemical structure, pH, and cleansing ability, have been implicated in this phenomenon. Many bars contain agents designed to ameliorate the irritancy of the bar and/or provide a skin benefit. Clinical studies have shown that soaps are generally quite irritating while syndets can range from mild to harsh. The addition of skin benefit/mildness agents such as glycerin, cocoa butter, mineral oil, or lanolin has little effect on the irritancy potential of a bar since minimal amounts of these agents are deposited on the skin. The excessive removal of skin lipids by harsh soaps and detergents can result in superficial dryness. The key to gentle cleansing is to start with a mild cleansing product and avoid overuse.…

PMID: 3608584

Compared to adults, newborns' skin has a thinner epidermis and stratum corneum with decreased hydration levels, higher transepidermal water loss, and a pH variation between 5.5 and 7.5. These characteristics can predispose to the occurrence of dryness, infections, and dermatological conditions. Water and liquid soap with adequate formulation have shown to be beneficial and safe for newborns' skin. However, studies evaluating the effect of bar soap, products widely used in Brazil and Latin America, are unknown. Therefore, the objective of this study was to compare the effects of liquid and bar soaps on the term newborns' skin. This randomized controlled, parallel, single-blind clinical trial was conducted at a public university hospital in São Paulo, Brazil. 100 healthy term newborns with no congenital anomalies, acute diseases, or dermatological conditions were randomized to use liquid soap (experimental group) or bar soap (control group). Skin pH, transepidermal water loss, stratum corneum hydration, sebum content, and skin condition were assessed before and after the first bath, at 48 h, 14 days, and 28 days after birth. These evaluations were performed on the forearm, abdomen, buttocks, and thigh. In addition, the mother's perception of soap use was also evaluated. Data of 100 newborns were analyzed by intention to treat. The rate of retention was 53%. Newborns exposed to the liquid soap presented significantly better skin acidification (p < 0.001) and significantly better stratum corneum hydration (p < 0.001) than the skin of newborns exposed to the bar soap, regardless of the area evaluated. There were no significant differences in transepidermal water loss, sebum content, dryness, erythema, or skin breakdown and the mother's perceptions of the use of the soaps. Newborns in the experimental group presented better skin acidification and stratum corneum hydration when compared to newborns in the control group.…

PMID: 38262395

Cerumen lubricates and protects the external auditory canal, but excess accumulation can lead to ear fullness, itching, otalgia, discharge, hearing loss, and tinnitus. Cerumen should be treated whenever symptoms are present or if it limits diagnosis by preventing a needed otoscopic examination. Clinicians should evaluate for cerumen impaction in those using hearing aids and patients with intellectual disability. Cerumen impaction can be treated with cerumenolytics, ear irrigation, and manual removal with instrumentation. Aural foreign bodies can cause ear fullness, otalgia, discharge, and hearing loss. They are more common in children than adults. The most common type of aural foreign bodies in children is jewelry, followed by paper products, parts of pens or pencils, desk supplies (eg, erasers), BBs or pellets, and earplugs or earphones. In adults, the most common aural foreign bodies are cotton swabs or cotton, followed by hearing aid parts and jewelry or ear accessories. Patients should avoid using cotton tip applicators in the external auditory canal. Alligator forceps, small right angle hooks, and ear irrigation commonly are used to remove aural foreign bodies in an outpatient clinic setting, but the choice depends on the type of foreign body. Soft and irregularly shaped objects can be removed without referral to an otolaryngologist. Patients with hard, spherical, or cylindrical objects should be referred to an otolaryngologist if previous removal attempts have failed or if there is ear trauma to avoid worsening its position in the ear canal.…

PMID: 39018128

Background and objectives The use of cotton swabs for ear cleaning is a widespread practice among parents, often perceived as a convenient and effective method to remove earwax. However, there is increasing concern regarding the health risks associated with cotton swab use, particularly in children. These risks include ear canal damage, infections, earwax blockage, and even eardrum perforation. This study aims to assess the prevalence of cotton swab use among parents in the Western Region of Saudi Arabia, evaluate their awareness of the potential health risks, and explore the factors influencing ear hygiene practices for children. Methods This cross-sectional study was conducted between July and August 2024, targeting 705 parents residing in the Western Region of Saudi Arabia. Participants were selected randomly, with exclusion criteria that included individuals under the age of 18 and more. A validated, reliability-tested online questionnaire in Arabic was used to collect data. The questionnaire consisted of 25 questions designed to gather demographic information and evaluate parents' knowledge, attitudes, and practices related to the use of cotton swabs for ear cleaning, as well as their awareness of the associated health risks. Statistical analysis was performed using SPSS version 23.0 (IBM Corp., Armonk, USA). Categorical data were analyzed using chi-square and Fisher's exact tests, with a significance level set at p < 0.05 for all statistical analyses. Results A total of 705 parents participated in the study, of whom 66.2% were female. The majority (29.3%) were aged between 36 and 45 years, and 82% were married. Most participants (72%) had university degrees, and 82.4% worked in non-medical professions. A significant majority (96.7%) were Saudi nationals. Regarding cotton swab use, 28.3% of parents reported using cotton swabs to clean the inside of their children's ears, with many also using them to clean both the inside and outside of the ear. The most common reason for using cotton swabs was earwax removal (30.2%). Most parents (37.9%) had used cotton swabs for over five years, and 60.4% reported using them less than once a day. Despite the widespread use of cotton swabs, 72% of participants acknowledged the associated risks, including earwax buildup, infections, and eardrum perforation. However, only 58.5% had received prior health education about these risks, with otolaryngologists being the primary source of information. Notably, 13% of parents reported complications related to cotton swab use, with ear pain being the most common (61%). Conclusion This study highlights that, despite moderate awareness of the risks, the use of cotton swabs remains prevalent among parents in the Western Region of Saudi Arabia. The findings underscore the need for targeted health education initiatives led by healthcare professionals to promote safer ear hygiene practices. Raising awareness of the risks associated with cotton swabs and advocating for safer alternatives could help reduce reliance on cotton swabs and minimize ear-related complications in children.…

PMID: 41080376

Background and objective The waxy substance secreted in the ear canal of mammals, including humans, is known as ear wax; it is also known by the medical term cerumen. It protects against germs, fungi, and water, helps with cleansing and lubrication, hydrates, and protects the skin of the human ear canal. The purpose of using cotton earbuds (Q-tips) is to clean the ear auricle (external part), relieve itching, and remove any excess water among other things; however, many people have been mistakenly using them for cleaning deeper spots in the ear, leading to some serious complications. Cotton earbud misuse has been documented to be the most common cause of accidental penetrating trauma of the eardrum among children. In this study, we aimed to determine the level of awareness of parents about the use of Q-tips among children and its consequences in the Jazan region, Saudi Arabia. Methods  This was a cross-sectional study involving 391 participants conducted from February 2023 to April 2023 in the Jazan region. While all parents in the Jazan region were eligible to be included in the study, only those who responded to our survey questionnaire were recruited. Since our research focused on parents, participants who were aged less than 18 years and those who had never married were excluded. A validated questionnaire tested for reliability was used in the study. The association between the level of awareness about Q-tips use and the sociodemographic characteristics of the parents was evaluated using the chi-squared test. A p-value ≤0.05 was considered statistically significant. Results Out of the 391 individuals included in the survey, two-thirds (67.5%) were male and 32.5% were female, and most of them were married (89.8%). Regarding the knowledge of cotton bud use among the participants, we found that 12.3% agreed and 34% strongly agreed that cotton buds should be used to clean the ears. Furthermore, 74.9% of the participants knew that cotton buds could cause ear infections, 80.8% knew that cotton buds could cause eardrum perforation, and 79.3% knew that cotton buds could push ear wax deeper into the ear. We found that 152 (57.6%) of the male and 91 (71.7%) of the female participants used cotton buds on their own (p=0.011). Moreover, 176 (66.7%) of the male participants thought that cotton buds can damage their child's ear while 69 (54.3%) of the female participants thought the same (p=0.048). When the participants were asked if they thought that the use of cotton buds caused complications, 155 (58.7%) of the males and 55 (43.3%) of the females said yes (p=0.015). Conclusions The parents in the Jazan region had a relatively good level of knowledge about ear cleaning using cotton buds among children. Nevertheless, we found a poor level of awareness about using cotton buds as the primary tool for cleaning the ears. Of note, 62.7% of the respondents knew that cotton buds could damage the ear, and 55% of the respondents thought that the use of cotton buds causes complications. However, 62.1% of the respondents still reported using it, and 50.1% of the respondents erroneously believed that it is beneficial to clean the ears with cotton buds. Otolaryngologists have always warned the public regarding the use of Q-tips and the complications they can cause. However, people are still ignorant as well as careless about these facts.…

PMID: 37727172

Rhinitis medicamentosa (RM) is a condition induced by overuse of nasal decongestants. The term RM, also called rebound or chemical rhinitis, is also used to describe the adverse nasal congestion that develops after using medications other than topical decongestants. Such medications include oral beta-adrenoceptor antagonists, antipsychotics, oral contraceptives, and antihypertensives. However, there are differences in the mechanism through which congestion is caused by topical nasal decongestants and oral medications. Very few prospective studies of RM have been performed and most of the knowledge about the condition comes from case reports and histologic studies. Histologic changes consistent with RM include nasociliary loss, squamous cell metaplasia, epithelial edema, epithelial cell denudation, goblet cell hyperplasia, increased expression of the epidermal growth factor receptor, and inflammatory cell infiltration. Since the cumulative dose of nasal decongestants or time period needed to initiate RM has not been conclusively determined, these medications should only be used for the shortest period necessary. Validated criteria need to be developed for better diagnosis of the condition. Stopping the nasal decongestant is the first-line treatment for RM. If necessary, intranasal glucocorticosteroids should be used to speed recovery.…

PMID: 16784007

One type of non-allergic non-infectious rhinitis is represented by a heterogeneous group of rhinitis medicamentosa, which can be divided into several pathogenetic types. The most common rebound nasal congestion associated with the use of topical decongestants. Excessive use of intranasal decongestants leads to a decrease in the number of alpha-adrenoreceptors on the surface of cell membranes and uncoupling their connection with the G-protein and the development of tachyphylaxis. To prevent the development of rebound nasal congestion caused by topical decongestants, it is important to limit the frequency of their use. In most cases, the duration of the use of vasoconstrictor drugs should be limited to 5-7 days, according to Patient information leaflets for the drugs. However, in patients who have had a history of episodes of rebound nasal congestion, which develops including the previously indicated periods, the duration of decongestant therapy should be limited to 3 days. Rhinitis associated with local inflammation is caused by the intake of acetylsalicylic acid (ASA) or other non-steroidal anti-inflammatory drugs. Currently, the so-called "aspirin triad" is well known - a combination of bronchial asthma, rhinosinusitis (often polyposis) and intolerance to ASA. Neurogenic rhinitis develops due to the use of drugs that violate vascular tone, for example, antihypertensive drugs or type 5 phosphodiesterase inhibitors. Drug-induced rhinitis has a significant impact on the patient's quality of life: nasal congestion, rhinorrhea, secondary night apnea, insomnia as a result of nasal breathing disturbances, headaches, irritability, weakness after sleepless nights disturb patients to a large extent. Timely diagnosis and withdrawal of a provocative drug, the use of topical corticosteroids in case of severe rhinitis are the basis of the treatment of rhinitis medicamentosa. In severe cases, there is a need, including surgical treatment, such as, for example, submucosal laser destruction of the lower nasal concha. Один из типов неаллергического неинфекционного ринита представлен гетерогенной группой лекарственно-индуцированных ринитов, которые можно разделить на несколько патогенетических типов. Наиболее часто встречается медикаментозный ринит, связанный с применением топических деконгестантов. Избыточное применение интраназальных деконгестантнов приводит к уменьшению количества альфа-адренорецепторов на поверхности мембран клеток, разобщению связи их с G-белком и развитию тахифилаксии. Для предупреждения развития медикаментозного ринита, вызванного топическими деконгестантами, важно ограничить частоту их применения. В большинстве случаев длительность применения сосудосуживающих препаратов должна быть ограничена 5—7 днями, согласно инструкции к лекарственным препаратам. Однако у пациентов, у которых в анамнезе уже были эпизоды медикаментозного ринита, развивающегося в том числе ранее указанных сроков, длительность терапии деконгестантами должна быть ограничена 3 сут. Ринит, ассоциированный с локальным воспалением, вызывается приемом ацетилсалициловой кислоты (АСК) или других нестероидных противовоспалительных препаратов. В настоящее время хорошо известна так называемая «аспириновая триада» — сочетание бронхиальной астмы, риносинусита (чаще полипозного) и непереносимости АСК. Нейрогенный ринит развивается вследствие применения препаратов, нарушающих сосудистый тонус, например антигипертензивных препаратов или ингибиторов фосфодиэстеразы 5-го типа. Лекарственно-индуцированный ринит оказывает значимое влияние на качество жизни пациента: заложенность носа, ринорея, вторичное ночное апноэ, бессонница как следствие нарушения носового дыхания, головные боли, раздражительность, слабость после бессонных ночей беспокоят пациентов в значительной степени. Своевременная диагностика и отмена провоцирующего лекарственного средства, применение топических кортикостероидов в случае тяжелого ринита являются основой терапии лекарственно-индуцированного ринита. В тяжелых случаях возникает необходимость в том числе и в хирургическом лечении, таком как, например, подслизистая лазерная деструкция нижних носовых раковин.…

PMID: 32628388

Rhinitis medicamentosa is the state of chronic congestion experienced from the prolonged or excessive use of nasal vasoconstrictors, typically used in the treatment of nasal congestion. Although a minor ailment, nasal congestion is a bothersome symptom for many allergic and non-allergic rhinitis sufferers. To alleviate symptoms, patients turn to over-the-counter topical nasal decongestants, with imidazolines often being the active ingredient of choice, as they provide rapid and long-lasting symptom relief, via vasoconstriction within the nasal mucosa. When used correctly, nasal vasoconstrictors are considered safe. However, misuse and deviation away from the recommended frequency of dose or maximum length of treatment can result initially in acute rebound congestion and if continued, rhinitis medicamentosa (RM). The pathophysiology and mechanisms of RM have not been fully elucidated and are complicated by difficulties in determining where the underlying disease ends, and RM begins. RM is characterised by the presence of chronic nasal congestion which responds less effectively and for progressively shorter periods to nasal vasoconstrictor treatments. Consequently, patients try to relieve symptoms by taking the nasal vasoconstrictor more frequently or at higher doses, which ultimately exacerbates the congestion further and creates a dependency on the nasal vasoconstrictor. Why RM develops is unclear, hypothesised mechanisms include structural, functional and inflammatory changes in the nasal mucosa, changes in receptor sensitivity or innervation pathways. To which extent this is solely in response to the use of imidazoline derivates or related to the presence of preservatives in topical nasal treatments is yet to be determined. Although treatment options exist for RM, prevention may be the best medicine. Provision of better education around the use of nasal vasoconstrictions, coupled with preservative free formulations and lowest possible dose delivery, may help to reduce the likelihood of developing the disease from the outset, reducing the burden on both the patient and healthcare providers.…

PMID: 41394157