Eczema

German children put in daycare before 2 years old might be at a greater risk of developing eczema. Researchers followed 3,097 kids from birth to 6 and found 13 percent of East German kids were diagnosed with eczema by 4 compared to 8 percent of kids in West Germany. It was also noted that 55 percent of kids from East Germany attended daycare in their first two years compared to 6 percent in West Germany. The rates of both eczema and early daycare attendance are higher among East German children. After all factors were considered, children who attended early daycare were 56 percent more likely to develop the skin condition that is characterized by a scaly, itchy and reddish rash. Stress and exposure to more allergens and microorganisms have been suggested as possible causes.

“I am leaving now for health reasons; the new Yas Island road runs right behind my tennis court and all the diesel lorries roar up and down it all day long. I have had chronic bronchitis and asthma and most recently eczema. The road really affected my health quite rapidly and I just couldn’t do it any more. We had been thinking about moving for a while because Billy is now two and we want him to get to know his grandparents. Another important factor is schooling, now that schooling is so expensive here. We also want Billy to be able to slide around in the mud and get dirty.

“We are looking forward to a sense of normality but will miss seeing our son sit on the beach at The Club eating ice cream. It’s certainly not going to be the same down Skegness way.

“We will also miss the diversity of people we have met here, people from all over the world, as well as dining in posh hotels and restaurants and the consistency of the weather. I don’t have to worry here about the weather when it comes to work.

“I’m looking forward to the rain and being able to go and buy the newspaper, stop at the pub for a nice meal, and be able to go and play in parks and fields with Billy.

“I don’t have a job lined up yet but if things don’t work out or we can’t stand the weather we have a place on Reem Island that will be ready soon so we can always move back. A lot of people seem to do that; they realise they were better off over here and are disappointed with what they find back home.

“We had a lovely way of life here and we’re very sad to leave Abu Dhabi but we’re looking forward to a fresh start. I have a sister here and lots of friends so we’re not leaving completely, we’ll always have links here.

*****

Charlotte Weatherall has lived in Dubai for three and a half years working for Mina Seyahi (The Westin Hotel) as marketing manager. She is moving to Scotland to work for the Cameron House Golf Resort near Loch Lomond.

“Dubai is an amazing place and it offers a fantastic lifestyle; I’m going to miss a lot of things, not least the weather. When I last lived in Scotland I developed seasonal affective disorder, but that was on the west coast and I am hoping things will be different at Loch Lomond. I remember I had a half-hour commute in the dark each way to and from work and it was so cold and miserable I didn’t even want to get out of the car to put petrol in it. It has been amazing living here, not having to wear three hats at once to protect you from the wind and the rain. But I am not dreading the weather. When I went back for my interview the whole landscape was covered in snow – it was the most romantic scene.

“I remember I first arrived in Dubai in the dead of night and so didn’t appreciate the scale of the city until the following morning. The first day I took a Big Bus tour. I had no idea what to expect. I saw a pharmacy and stocked up on shampoo and conditioner. I wasn’t sure I was ever going to be able to buy it again.

“Dubai is wonderful and bright but I miss a lot of things such as cross-country mountain biking and going for long walks with my dog. What I am most looking forward to is flying back to Manchester and driving to Yorkshire to the little village where my parents live and spending a few days there; going for walks along the river with my dog Poppy and Marks & Spencer food shopping. I can’t wait to see what Poppy’s reaction will be; she’s never seen a sheep or a cow. I think she will be blown away by the place.

What were these Harvey men like as Jews? Dave and his four siblings — especially his bachelor brother, Alfred, who lived with he and his family and ran a large furniture company — were considered “the embodiment of the Jewish ideal of citizenship … the highest type of the loyal and true American(s),” responsible for “in large degree, the increasing respect and understanding that the non-Jewish community maintained for the Jew,” according to Jewish press reports at the time (quoted in Frank Adler’s “Roots in a Moving Stream: The Centennial History of Congregation B’nai Jehudah of Kansas City, Missouri, 1870-1970.”). Alfred ran United Jewish Charities in Kansas City for 18 years, and was known to give up to half his salary to charity. Dave worked with his brother at UJC — which often partnered with the local Catholic Charities where Ford Harvey and his wife, Judy, were leaders — but was also active in the nascent YM-YWHA movement, which led to the creation of Jewish Community Centers, which he saw as havens “for those who can’t afford the more expensive form of Jewish clubs.” The Benjamin brothers (there was another, Harry, who also worked at Fred Harvey) helped their sister, Fannie, found one of the country’s first Jewish summer camps for needy immigrant children, starting in 1907, which came to be known as “Bittersweet Camp.” Dave was also involved in making sure Jewish charities helped all who were in need.

“I try to follow the teachings of Judaism,” he said, “by helping my brother, and I don’t think that help should be limited to my Jewish brother.”

Dave was apparently not as much of a shul-goer as his brother Alfred and did, like many Jews of his day, get interested in Christian Science as an alternative form of spirituality. He said it helped heal his eczema. In fact, according to historian Frank Adler, the controversial rabbi at Benjamin’s synagogue, B’nai Jehudah, Harry Mayer, was one of only two members of the Reform clergy’s governing body to vote against a WWI-era “resolution stating one could not be both a good Jew and a Christian Science practitioner.” Most contemporary members of the Benjamin family in Kansas City, Los Angeles and elsewhere practice Judaism; a few still practice Christian Science.

Alfred died in 1923. A rabbi and a Catholic priest presided at the funeral, and outside B’nai Jehudah a mourner was overheard saying “I would rather be Alfred Benjamin than anyone I know.” An Alfred Benjamin Memorial fountain was erected in Swope Park. After that, Dave did his best to take his brother’s place in the philanthropic community, cutting back his commitments to Fred Harvey to devote more time to good works. A decade later — on March, 10, 1933 — he and his wife were in Los Angeles when that city was rocked by an earthquake registering 6.3 on the Richter scale. They were fine. The Journal-Post headline read the next day, “David Benjamin Telephones Calmly as Earthquake Showers Plaster.” But weeks later, in the privacy of his Kansas City home, he took ill while playing cards and died of a heart attack.

Little is known about Schweizer’s religious beliefs — a lifelong bachelor, he apparently did become more active in the Jewish community in Albuquerque as he grew older, both with the local chapter of B’nai Brith and the Reform congregation Temple Albert, in whose cemetery he was buried. But he played a crucial role in one of the most famous Jewish-American events of the 20th Century.

In December 1930, Albert Einstein left Germany to spend the winter lecturing at Cal Tech just as Hitler’s Nazi Party was making its first significant election showing. He first sailed to New York, where he celebrated Chanukah with a huge throng at Madison Square Garden, and then spent time on the west coast. In March, 1931, he decided to make what had become the quintessential American pilgrimage — to see the Grand Canyon.

He was met there by a contingent of Hopi Indians, who Einstein assumed were local natives — not realizing that most of them worked for Fred Harvey. Herman Schweizer was also there, both to meet the renowned scientist and to act as translator because Einstein was still more comfortable speaking German.

As with all visiting dignitaries, the Hopi planned to present Einstein with a headdress and make him an honorary chief of the tribe. But they had no idea who he was.

CHILDREN with a dry night cough, eczema or who wheeze with exercise have more than eight times the risk of asthma attack under anaesthetic. The situation can be fatal if corrective drugs fail.

The same factors put affected children at four times the risk that their vocal cords will lock up while under sedation, a situation that requires the prompt use of muscle-relaxing drugs to allow air back into the lungs.

The findings – the result of Australian research involving nearly 10,000 children undergoing operations at a Perth hospital – suggest doctors can more accurately predict which children are at highest risk for bad reactions by asking whether they share these risk factors.

The research also indicates that a child who has recently had a cold or another airway infection is at increased risk for an anaesthetic reaction for only two weeks afterwards – the first time doctors have had a clear idea of how long the post-infectious danger period lasts.

Serious adverse events are extremely rare among children under anaesthetic.

The research, published yesterday in the British medical journal The Lancet, showed that 1392, or 15 per cent, of the 9297 children for whom full data was available had respiratory adverse events during or soon after their operations.

However, pediatric anaesthetist Britta von Ungern-Sternberg, who ran the study at Perth’s Princess Margaret Hospital for Children, said most of these events were minor and transient, and only a tiny sub-group experienced lasting harm.

“It’s pinpointed the risk factors – how we can predict the children who are going to have complications,” she said.

The researchers collected data, using questionnaires, on all children who had general anesthesia for surgical or medical interventions at Princess Margaret Hospital for Children from Feb. 1, 2007, to Jan. 31, 2008. All told, 9,297 questionnaires were available for analysis, they reported.

Over the study period, they reported, 1,392 (or 15%) of the children had perioperative respiratory adverse events, including 193 with bronchospasm, 351 with laryngospasm, 332 with airway obstruction, 919 with oxygen desaturation, 687 with coughing, and 58 with stridor.

Urgent procedures, the researchers reported, were riskier than elective procedures, at 17% versus 14%, leading to a relative risk of 1.2 with a 95% confidence interval from 1.1 to 1.3, which was significant at P=0.001.

The researchers found that a positive respiratory history — defined as a nocturnal dry cough, wheezing during exercise, wheezing more than three times in the past 12 months, or a history of present or past eczema — was associated with an increased risk of adverse events. Specifically, such a history:

• Increased the risk of bronchospasm more than eight-fold. The relative risk was 8.46, with a 95% confidence interval from 6.18 to 11.59, which was significant at P<0.0001.
• Increased the risk of laryngospasm four-fold. The relative risk was 4.13, with a 95% confidence interval from 3.37 to 5.08, which was significant at P<0.0001.
• Increased the risk of perioperative cough, desaturation, or airway obstruction three-fold. The relative risk was 3.05, with a 95% confidence interval from 2.76 to 3.37, which was significant at P<0.0001.

As well, they reported, upper respiratory tract infection was associated with an increased risk, but only when symptoms were present or when the infection occurred less than two weeks before the procedure.

If at least two family members had asthma or atopy, or smoked, that also increased the risk significantly (at P<0.0001 for all).

The risk was lower with intravenous induction of anesthesia compared with inhalational induction, with inhalational compared with intravenous maintenance of anesthesia, with airway management by a specialist pediatric anesthetist compared with a resident, and with the use of a face mask compared with tracheal intubation. All differences were significant at P<0.0001.

The findings generally accord with previous studies, but raise several questions, according to Jerrold Lerman, MD, of Women and Children’s Hospital of Buffalo, in Buffalo, N.Y.

For instance, Lerman said in an accompanying commentary, it’s not clear whether the practice described in the study is consistent with current practice in large urban pediatric centers, where surgery for children with some of the risk factors — high temperature and green runny nose — is usually cancelled, while it was not in the study.

“Unsurprisingly, these children developed perioperative respiratory adverse events,” he wrote.

Because the study took place in a single institution, its external validity might be challenged, Lerman argued, but nevertheless it “adds an interesting perspective” on the understanding of perioperative respiratory adverse events.

There are many reasons behind itching, such as: skin dryness (the most common cause), contact with irritants, shaving, allergic reaction to any foreign matter; anemia and other systemic disorders (including skin cancer), diabetes, thyroid abnormality, cancers, kidney and liver problems, skin disease; bites such as from chiggers or mosquitoes, mites, lice and louse, scabies, chickenpox (varicella), hives or urticaria, pregnancy, menopause and lastly, psychiatric problems. The most common causes are aging, atopic eczema, excessive sweating, showering more than once a day, bathing for long periods of time, washing with hot water and using non-moisturising soaps.

Itching that lasts longer than a few days or that comes and goes repeatedly without an apparent cause generally needs testing. Medications that produce itching include morphine and codeine, aspirin, ibuprofen and other meds in this group called NSAIDS, anti-malaria drugs and a significant number of medications that cause itching by affecting the kidney and liver.

Itching during pregnancy occurs in 1-15 per cent of pregnancies and it is more common in the last three months of pregnancy and with twins. It usually disappears after delivery.

The majority of itching does not need medical examination and you can easily find the cause. For instance, for your child’s itching look at the skin carefully — you can identify dry skin, rashes, stings and bites or any skin irritant. To prevent dry skin and itching, use sunscreen as long as you’re outside and don’t forget to protect your lips.

Instead of showering take baths, and make it brief in lukewarm water rather than hot water; use bath oil and a gentle soap; never forget to moisturise your skin immediately after your bath while it’s still damp; avoid prolonged exposure to excessive humidity and keep your living area dry; wear loose, cool and light clothes; do not rub or scratch an affected area. If it’s not manageable clip your fingernails; put a cold material/wrap on to the area.

Your moisturiser should be colourless and odourless because additives that provide colour or scent may irritate the skin and even cause itching. Coating an affected area with soothing components like calamine, menthol, eucalyptus, camphor and chamomile may help as well. Always keep your moisturiser close and be sure to use it frequently  because it prevents water evaporating from the skin and affected areas.

For very dry and itchy hands, apply a thin layer of proper moisturiser and wear thin cotton gloves to bed. If your itching still does not subside after this, try a nonprescription 1 per cent hydrocortisone cream on small itchy areas for a short time. Oral anti-itch drugs, according to your doctor’s suggestion, such as antihistamines (loratadine, diphenhydramine) and a few numbers of anti-depressant medications (doxepin) may help.

And most importantly, remember — if you feel itchy all over your body surface, and there is no obvious cause, or association to fever, swelling or tenderness, and if it has interfered with your daily routine, lose no time and consult a doctor.