St Thomas' Hospital

About: St Thomas' Hospital is a healthcare organization based out in London, United Kingdom. It is known for research contribution in the topics: Population & Pregnancy. The organization has 12105 authors who have published 15596 publications receiving 624309 citations. The organization is also known as: St Thomas's Hospital & St. Thomas's.

Psychological and educational interventions for atopic eczema in children

Abstract: Atopic eczema is an itchy inflammatory skin condition which affects the quality of life of children with eczema and their parents; it can affect up to 15% of school children in the UK. Psychological and educational approaches to treating eczema have been used to complement medication in managing eczema by, for example, promoting relaxation and educating parents and children to understand the condition and their role in its successful management. However, the effectiveness of these approaches has not been systematically reviewed. The main finding of the review is that there is currently only limited research evidence about the effectiveness of educational and psychological approaches when used with medicines for the treatment of childhood eczema. We were only able to include one study on the effectiveness of psychological approaches in the review. We included four educational studies, of which three identified that education decreased the severity of the eczema, and one study found that education improved quality of life for parents of children with eczema. Relaxation methods reduced the severity of the eczema, compared to discussion only, in the psychological study. Two different approaches have been used to deliver education; one led by a nurse and the other by a team of health professionals. Due to weaknesses in the quality of most of the research studies and the fact that different measures were used to evaluate effectiveness of the approaches, we cannot draw strong conclusions about whether psychological and educational approaches work or which is the best approach to use. More details are needed about the psychological and educational approaches used, to allow a greater understanding of the key factors that might help reduce eczema. Better description of the research methods used are also needed. Research priority should also be given to comparing the relative cost effectiveness of health professionals educating parents either in teams or by nurses alone. No adverse effects have been reported. Limitations of the review: We were able to find only five studies eligible for inclusion in the review and we were not able to combine findings from these studies due to the different ways in which effectiveness of the approaches were measured.

Hand eczema severity and quality of life: a cross-sectional, multicentre study of hand eczema patients

Abstract: Background and Objectives: Hand eczema is a chronic disease with negative impact on quality of life (QoL). In this study, QoL in hand eczema patients is assessed and related to age, sex, severity, and diagnostic subgroups. Methods: A total of 416 patients with hand eczema from 10 European patch test clinics participated in the study. Data on QoL were obtained from a self-administered questionnaire using the Dermatology Life Quality Index (DLQI). Severity was assessed by a scoring system (Hand Eczema Severity Index, HECSI) as well as frequency of eruptions and sick leave due to hand eczema. Results: No significant difference was found between males and females with respect to QoL [DLQI median values and 25/75 percentiles for males and females being 7.0 (3-14) and 8.0 (3-13), respectively], although males were more severely affected than females (P < 0.025). A significant positive correlation was found for hand eczema severity and age (P < 0.001), while no significant correlation was found for QoL and age. QoL was found increasingly reduced when sick leave was getting higher (P < 0.001). A statistically significant correlation between QoL (as measured by DLQI) and hand eczema severity as measured by HECSI was found (P < 0.001). No significant difference in QoL was found between diagnostic subgroups. Conclusions: QoL was found markedly negatively affected in hand eczema patients and was significantly correlated to disease severity. No significant difference in QoL was found between males and females, in spite of significantly more severe eczema in males, indicating that QoL in female patients is more easily affected.

The effect of topical corticosteroids on refractive outcome and corneal haze after photorefractive keratectomy. A prospective, randomized, double-blind trial.

Abstract: In this study, we report the results of a prospective, double-blind trial to determine whether high-dose topical corticosteroids have an effect on refractive outcome or anterior stromal haze after photorefractive keratectomy. A total of 113 patients were allocated randomly to either placebo- or steroid-treated groups (0.1% dexamethasone metasulphobenzoate for 3 months) and underwent either -3.00-diopter (D) or -6.00-D procedures. At 6 weeks, the mean change in refraction was significantly greater in the steroid-treated group than in the placebo-treated group (-3.00-D group, P = .0015; -6.00-D group, P = .0011). However, when corticosteroids were discontinued at 3 months, this difference became statistically insignificant. There was no statistically significant effect on anterior stromal haze at any stage. Since long-term use of corticosteroids to maintain the initial beneficial effect on refraction would be unacceptable, we conclude that these agents should not be used after photorefractive keratectomy.