Cutaneous protothecosis developed in a 63-year-old Japanese female. The patient had a long history of steroid use for bronchial asthma. A tender, swollen, erythematous plaque with white papules covered the dorsal aspect of the patient's right hand. Histopathological examination showed typical protothecosis with numerous "mulberry-like" sporangia positive for periodic acid-Schiff stain. The pathogen was identified as Prototheca wickerhamii. After a 6-week course of 150-200mg/day itraconazole (ITCZ) therapy, the patient's culture was negative for P. wickerhamii. No recurrence was seen after 12 weeks of ITCZ therapy. This case of protothecosis and those of 16 patients are summarized. All the patients had lived in mid-to southern Japan.Only 12 cases of protothecosis treated with ITCZ have been reported in the literature; 8 of these cases were cured with ITCZ therapy alone. In cases treated with ITCZ at no more than 100mg/day, medication was typically needed for 2 months; most of the cases treated with ITCZ at 200mg/day were successfully cured within 2 months. A 2-month course of ITCZ at 200mg/day appears to be adequate treatment for human protothecosis.
To investigate whether kinesiophobia with pregnancy-related lumbopelvic pain at late pregnancy influenced depressive symptoms at 1 month after delivery. Method: Final participants were 43 pregnant women who experienced pregnancy-related lumbopelvic pain at late pregnancy and completed self-reported questionnaires at late pregnancy and 1 month after delivery. The Tampa Scale for Kinesiophobia was used to evaluate kinesiophobia, and depressive symptoms were assessed using the Self-Rating Depression Scale. We divided participants into two groups (depression and no-depression) using the score of the Self-Rating Depression Scale at 1 month after delivery. Univariate analysis and multiple logistic regression analysis identified kinesiophobia at late pregnancy as an independent predictor of depression at 1 month after delivery. Results: In univariate analysis, kinesiophobia at late pregnancy was significantly higher in the depression group than in the no-depression group (P= .033). In multiple logistic regression analysis, kinesiophobia at late pregnancy were significantly associated with depression at 1 month after delivery even after adjusting for confounding factors (Odds Ratio, 1.25; 95% Confidence Interval, 1.03-1.52). Conclusion: Results found that kinesiophobia at late pregnancy negatively influenced depressive symptoms at 1 month after delivery, suggesting that approaches to treat kinesiophobia at late pregnancymight reduce the risk of onset of postpartum depressive symptoms.
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