BackgroundWork disability is a major public health challenge, with various health conditions leading to long-term sickness and early retirement, placing a substantial burden on individuals and society.ObjectiveThis systematic review aimed to identify key health-related risk factors for work disabilities, highlighting the importance of early prevention strategies.MethodsA systematic literature search was conducted in 06/2023 using MEDLINE via PubMed, EMBASE via OVID, and CINAHL via Cochrane Library Trials. Two independent reviewers screened abstracts and reviewed full-text articles describing risk factors for work disabilities. Data extraction followed PRISMA guidelines, with the databases searched using synonymous keywords for "risk factors" and "work disability".ResultsOf the 61,872 articles identified, 17 met the inclusion criteria. The studies identified several health-related risk factors leading to work disabilities. The most frequently reported conditions were common mental disorders and musculoskeletal disorders, often leading to short- or long-term sick leave. The review highlighted that health-related risk factors frequently co-occur and interact, suggesting that work disability is rarely due to a single factor. The quality of the included studies varied, and many relied on self-reported data, which can introduce bias.Conclusion(Chronic) conditions, particularly mental and musculoskeletal disorders, are significant risk factors for work disability. Primary and secondary prevention measures, such as rehabilitation are crucial to mitigate the need for disability retirement. Future research should focus on prospective cohort studies and a thorough scientific investigation of potential intervention factors to provide decision-makers with information on cost-effective prevention programs.Prospero ID: CRD42023422118.

Objective:A longer life expectancy can lead to a longer working life and is therefore important for the individual and the healthcare system. Therefore, a study group established a Risk-Index Disability-Pension (RI-DP), which assesses the risk of work disability. However, a standardized and well-founded preventive health examination does not yet exist in Germany. Hence, we developed a preventive health examination conducted by physicians and compared it with a questionnaire survey to examine its differences and results in relation to the need for prevention and rehabilitation, taking into consideration the RI-DP. Methods:In this prospective cross-sectional study, n = 1,040 participants (45-59 years) took part in a preventive health examination at the Charité - Universitätsmedizin Berlin/Humboldt-Universität zu Berlin, Germany. A questionnaire survey and preventive health examination, including anthropometric measures, anamnesis, cardiovascular examinations, and blood samples, were conducted independently to determine the need for prevention and rehabilitation. Results:The mean age was 52.93 (sd = 4.17) years, and n = 631 (61%) were men. The questionnaire assessed n = 733 (70%) participants as needing no additional action (green), n = 215 (21%) as needing a prevention program (yellow), and n = 91 (9%) as needing a rehabilitation program (red). In contrast, physicians assessed n = 141 (14%) as 'green', n = 717 (69%) as 'yellow', and n = 181 (17%) as 'red', revealing substantial discrepancies, especially in preventive needs. The leading associations of individual factors on physicians' evaluation were BMI [OR 1.135 (1.094; 1.178)], SBP [OR 1.099 (1.009; 1.197)], smoking status [OR 1.691 (1.212; 2.366)], depressive moods [OR 2.254 (1.565; 3.254)] and physical activity 1-2 h/week [OR 0.618 (0.436; 0.874)], and on the questionnaire: gender male [OR 1.790 (1.057; 3.046)], and depressive moods (OR 4.506 [3.216; 6.322]). This underlines the complementary nature of the two approaches in evaluating health interventions. According to the RI-DP, the participants had the following risk of early retirement: low-risk n = 540 (52%), medium-risk n = 307 (30%), and high-risk n = 193 (19%). Conclusion:The results emphasize the need for combining questionnaire surveys with preventive health examinations to assess health needs comprehensively. Notably, the preventive health examination suggests higher prevention needs compared to the questionnaire, indicating that the questionnaire may not fully capture clinical prevention needs. Clinical trial registration:https://drks.de/search/de/trial/DRKS00030982, identifier DRKS00030982.

This study was performed to evaluate the general health status of employees aged 45–59 years using data from the Ü45-Check study (2021–2024). In addition, the health status of individual occupational groups was assessed to investigate potential associations within these groups. Clinical and occupational data were collected from 1,040 employees aged 45–59 years from Berlin and Brandenburg, Germany, who participated in the Ü45-Check study. The data were derived from a preventive health examination conducted to identify potential preventive or rehabilitation needs. The clinical examination included anthropometric measurements, bioelectrical impedance analysis, handgrip strength, 12-lead resting electrocardiogram, systolic and diastolic blood pressure, anamnesis, and blood analyses. To categorize health status by occupation, the International Standard Classification of Occupations 2008 (ISCO-08) was applied. Data from 1,040 participants (n = 631 male, 61

MASK-air® , a validated mHealth app (Medical Device regulation Class IIa) has enabled large observational implementation studies in over 58,000 people with allergic rhinitis and/or asthma. It can help to address unmet patient needs in rhinitis and asthma care. MASK-air® is a Good Practice of DG Santé on digitally-enabled, patient-centred care. It is also a candidate Good Practice of OECD (Organisation for Economic Co-operation and Development). MASK-air® data has enabled novel phenotype discovery and characterisation, as well as novel insights into the management of allergic rhinitis. MASK-air® data show that most rhinitis patients (i) are not adherent and do not follow guidelines, (ii) use as-needed treatment, (iii) do not take medication when they are well, (iv) increase their treatment based on symptoms and (v) do not use the recommended treatment. The data also show that control (symptoms, work productivity, educational performance) is not always improved by medications. A combined symptom-medication score (ARIA-EAACI-CSMS) has been validated for clinical practice and trials. The implications of the novel MASK-air® results should lead to change management in rhinitis and asthma.

Asthma, rhinitis, and atopic dermatitis (AD) are interrelated clinical phenotypes that partly overlap in the human interactome. The concept of "one-airway-one-disease," coined over 20 years ago, is a simplistic approach of the links between upper- and lower-airway allergic diseases. With new data, it is time to reassess the concept. This article reviews (i) the clinical observations that led to Allergic Rhinitis and its Impact on Asthma (ARIA), (ii) new insights into polysensitization and multimorbidity, (iii) advances in mHealth for novel phenotype definitions, (iv) confirmation in canonical epidemiologic studies, (v) genomic findings, (vi) treatment approaches, and (vii) novel concepts on the onset of rhinitis and multimorbidity. One recent concept, bringing together upper- and lower-airway allergic diseases with skin, gut, and neuropsychiatric multimorbidities, is the "Epithelial Barrier Hypothesis." This review determined that the "one-airway-one-disease" concept does not always hold true and that several phenotypes of disease can be defined. These phenotypes include an extreme "allergic" (asthma) phenotype combining asthma, rhinitis, and conjunctivitis. Rhinitis alone and rhinitis and asthma multimorbidity represent two distinct diseases with the following differences: (i) genomic and transcriptomic background (Toll-Like Receptors and IL-17 for rhinitis alone as a local disease; IL-33 and IL-5 for allergic and non-allergic multimorbidity as a systemic disease), (ii) allergen sensitization patterns (mono- or pauci-sensitization versus polysensitization), (iii) severity of symptoms, and (iv) treatment response. In conclusion, rhinitis alone (local disease) and rhinitis with asthma multimorbidity (systemic disease) should be considered as two distinct diseases, possibly modulated by the microbiome, and may be a model for understanding the epidemics of chronic and autoimmune diseases.

Objective Early identification of health-related risk factors is of great importance for maintaining workability. Screening examinations can help to detect diseases at an early stage and provide more needs-based recommendations. This study aims (1) to assess the individual need for prevention or rehabilitation based on preventive health examinations compared to a questionnaire survey, (2) to assess the results of the preventive health examinations compared to the Risk Index – Disability Pension (RI-DP), (3) to assess the results of the questionnaire survey compared to the RI-DP, (4) to assess the general health status of the sample (target population > 1,000) in German employees aged 45–59, (5) to identify the most common medical conditions. A further study question aims, and (6) to investigate the general health status of the specific occupational groups. Methods Comprehensive diagnostics including medical examination, anamnesis, anthropometric measurements, bioelectrical impedance analysis (BIA), handgrip strength, resting electrocardiogram (ECG), resting blood pressure, pulse wave velocity (PWV), and laboratory blood analyses added by a questionnaire are conducted. The research questions are analyzed in an exploratory manner. Results and conclusion We expect that the results will allow us to formulate recommendations regarding screening for prevention and rehabilitation needs on a more evidence-based level. Clinical Trial Registration : DRKS ID: DRKS00030982.

The melanin fluorescence emitted by pigment cells of the human skin has been a central research topic for decades, because melanin, on the one hand, protects against (solar) radiation in the near-UV range, whereas on the other hand, melanocytes are the starting point for the malignant transformation into melanoma. Until recently, however, melanin fluorescence was not accessible in the context of conventional spectroscopy, because it is ultraweak and is overshadowed by the more intense so-called autofluorescence of endogenous fluorophores. The advent of a new method of laser spectroscopy has made this melanin fluorescence measurable in vivo. A stepwise two-photon absorption with 800 nm photons is used, which more selectively excites melanin (dermatofluoroscopy). Our review summarizes the experimental results on melanin fluorescence of the four types of cutaneous pigment cells from healthy and malignant tissues. Outstanding is the finding that different types of melanocytes (i.e., melanocytes of common nevi, versus dysplastic nevi or versus melanoma cells) show characteristically different fluorescence spectra. The possibilities of using this melanin fluorescence for melanoma diagnosis are shown. Moreover, the uniform fluorescence spectra emitted by different melanoma subtypes are essential. Conclusions are drawn about the molecular processes in the melanosomes that determine fluorescence. Finally, experimental suggestions for further investigations are given.

Older adults, especially men and/or those with diabetes, hypertension, and/or obesity, are prone to severe COVID-19. In some countries, older adults, particularly those residing in nursing homes, have been prioritized to receive COVID-19 vaccines due to high risk of death. In very rare instances, the COVID-19 vaccines can induce anaphylaxis, and the management of anaphylaxis in older people should be considered carefully. An ARIA-EAACI-EuGMS (Allergic Rhinitis and its Impact on Asthma, European Academy of Allergy and Clinical Immunology, and European Geriatric Medicine Society) Working Group has proposed some recommendations for older adults receiving the COVID-19 vaccines. Anaphylaxis to COVID-19 vaccines is extremely rare (from 1 per 100,000 to 5 per million injections). Symptoms are similar in younger and older adults but they tend to be more severe in the older patients. Adrenaline is the mainstay treatment and should be readily available. A flowchart is proposed to manage anaphylaxis in the older patients.

Highly concentrated hyaluronic acid dermal fillers commonly contain 20 mg/ml sodium hyaluronate. The soft tissue filler SF 24 contains 24 mg/ml sodium hyaluronate. It is a viscoelastic gel, which is moderately cross-linked and specifically designed to correct moderate to deep wrinkles and folds of facial skin.To evaluate the long-term safety and effectiveness of the SF 24 for facial augmentation.The primary endpoints were effectiveness and safety, which were measured by investigators' assessment of wrinkle/ fold/ defect severity and reaction severity, respectively. The Global Esthetic Improvement Scale (GAIS) evaluated secondary endpoints, such as patient and physician satisfaction. Data collection occurred at treatment date (day 0) and at each visit set at an interval of 21 days, 121 days, 213 days, and 395 days. A total of 74 individuals (3 male and 71 female) received treatment with SF 24 across five sites. The baseline value (2. 70) of wrinkle and fold severity was reduced to 1.22 directly after treatment and remained improved even after 273 days at 1.59. The improvements compared to baseline were all significant (p < .001). The injection-related reactions were mainly short-term (1-7 days), mild to moderate in severity, and resolved without intervention. SF 24 is safe and effective for facial volume augmentation. It shows long-lasting (9 months) results in treated patients.

Abstract Purpose of Review Atopy is defined as the genetic predisposition to react with type I allergic diseases such as food‐, skin‐, and respiratory allergies. Distinct molecular mechanisms have been described, including the known Th2 driven immune response. IL‐17A (IL‐17) is mainly produced by Th17 cells and belongs to the IL‐17 family of cytokines, IL‐17A to F. While IL‐17 plays a major role in inflammatory and autoimmune disorders, more data was published in recent years elucidating the role of IL‐17 in allergic diseases. The present study aimed to elaborate specifically the role of IL‐17 in atopy. Methods A systematic literature search was conducted in MEDLINE, Embase, and Cochrane Central Register of Controlled Trials, regarding IL‐17 and atopy/allergic diseases. Results In total, 31 novel publications could be identified (food allergy n = 3, allergic asthma n = 7, allergic rhinitis [AR] n = 10, atopic dermatitis [AD] n = 11). In all allergic diseases, the IL‐17 pathway has been investigated. Serum IL‐17 was elevated in all allergic diseases. In AR, serum and nasal IL‐17 levels correlated with the severity of the disease. In food allergies, serum IL‐17E was also elevated in children. In AD, there is a trend for higher IL‐17 values in the serum and skin specimen, while it is more expressed in acute lesions. In allergic asthma, serum IL‐17 levels were increased. In two studies, higher serum IL‐17 levels were found in severe persistent asthmatic patients than in intermittent asthmatics or healthy controls. Only one therapeutic clinical study exists on allergic diseases (asthma patients) using a monoclonal antibody against the IL‐17 receptor A. No clinical efficacy was found in the total study population, except for a subgroup of patients with (post‐bronchodilator) high reversibility. Summary The role of IL 17 in the pathogenesis of allergic diseases is evident, but the involvement of the Th17 cytokine in the pathophysiological pathway is not conclusively defined. IL‐17 is most likely relevant and will be a clinical target in subgroups of patients. The current data indicates that IL‐17 is elevated more often in acute and severe forms of allergic diseases.

Background: Caucasians with red hair and fair skin have a remarkably increased risk of malignant melanoma compared to non-redhead Caucasians. Objectives: With the aim of a reliable melanoma diagnosis in redheads, the application of dermatofluoroscopy was analyzed in 16 patients with red hair. Most of them had been included in a clinical dermatofluoroscopy study for patients with the suspicion of melanoma. We examined whether the 25 lesions of the redheads showed the same characteristic melanin fluorescence spectra for dysplastic nevi and melanomas as those of non-redhead Caucasians or whether there was a different fluorescence pattern. This is important in view of the known significantly altered ratio of eumelanin to pheomelanin in the skin of redheads. Methods: More than 8,000 spatially resolved fluorescence spectra of 25 pigmented lesions were measured and analysed. The spectra were excited by the stepwise absorption of two 800-nm photons (principle of dermatofluoroscopy). Furthermore, the fluorescence spectra of eumelanin and pheomelanin in hair samples were determined in the same way. Results: The evaluation revealed that the melanin fluorescence spectra of dysplastic nevi and melanomas of redheads have the same spectral characteristics as those of non-redhead Caucasians. An accompanying result is that dermatofluoroscopy shows identical fluorescence spectra for eumelanin and pheomelanin. Conclusions: Dermatofluoroscopy proves to be a reliable diagnostic method also for redheads. Our results also explain our recent finding that there is a uniform fluorescence spectroscopic fingerprint for melanomas of all subtypes, which is of particular interest for hypomelanotic and apparently amelanotic melanomas containing pheomelanin.

Purpose of review Allergic skin diseases such as urticaria, atopic dermatitis and allergic contact dermatitis are among the most common skin diseases with severe socioeconomic consequences. The pathogenesis of allergic skin diseases is complex. This review provides an overview of cytocines IL-17, IL-23, IL-31 and IL-33. Recent findings Current research results show a variety of immunological processes in the pathogenesis of the allergic skin diseases, including the role of cytokines. In addition to the Th1 and Th2 immune response, the immune response via Th17 is becoming increasingly important in allergic skin diseases but also the cytokines IL-23, IL-31 and IL-33 have been discussed in the literature recently. Different cytokines promote in a kind of orchestra the different symptoms seen in the different allergic skin diseases, including pruritus, dermatitis, mast cell mediator release and inflammation. Summary We are still in the early stages of understanding pathophysiology of allergic skin diseases and the role of various cytokines in the immune system. With the development of targeted antibodies against the proinflammatory cytokines, the variety of normal therapeutic options can be expected to evolve.

Background and ObjectivesEnergy‐based devices have been widely applied for skin ablation. A novel ablation technique based on thermomechanical principles (Tixel©) has been recently developed. The aim of this study was to examine the wound‐healing process and clinical aspects after thermomechanical skin ablation.Study Design/Materials and MethodsSix female participants were treated with Tixel© on healthy skin of the dorsal side of the right forearm in a single session with a 600 µm protrusion and 12 milliseconds pulse. The treated area was examined with confocal laser scanning microscopy on day 1, 2, 7, and 14 after treatment. Clinical symptoms were evaluated at the same time‐points.ResultsAll patients developed erythema and mild edema on the treated areas, which completely disappeared within 14 days. No post‐inflammatory hyperpigmentation or scarring was observed. Thermomechanical skin ablation resulted in the formation of homogeneous micro‐ablation zones. Two weeks after ablation, the honeycomb patterns of the epidermis in all examined layers was thoroughly restored. Thus, wound‐healing was completed.ConclusionsWound healing after thermomechanical skin ablation is much faster compared with other fractionated ablation methods. Treatment intervals of 2–4 weeks could be recommended. Lasers Surg. Med. © 2020 The Authors. Lasers in Surgery and Medicine published by Wiley Periodicals, Inc.

The melanin fluorescence of skin lesions is measurable with two‐photon excitation, a process termed dermatofluoroscopy, which has shown a shift from the green spectra in benign melanocytic lesions to the red spectra in melanoma. This study addressed the question as to which kind of pigmented lesions can be correctly diagnosed as melanin‐bearing malignant tumors.

ZusammenfassungHintergrundDie Melaninfluoreszenz von Hautläsionen kann mittels Zwei‐Photonen‐Anregung gemessen werden. Dieses als Dermatofluoroskopie bezeichnete Verfahren führt zu einer Verschiebung vom grünen Spektrum bei gutartigen melanozytären Läsionen zum roten Spektrum bei Melanomen. Diese Studie widmete sich der Frage, welche Art von pigmentierten Läsionen korrekt als melaninhaltige maligne Tumoren erkannt werden können.MethodenEs wurden 476 pigmentierte Läsionen, darunter 101 kutane Melanome, dermatofluoroskopisch untersucht. Dazu wurde die Melaninfluoreszenz Punkt für Punkt mit einem Abstand der Messpunkte von 0,2 mm gemessen. Die Ergebnisse der Dermatofluoroskopie wurden als diagnostischer Score mit einem Cut‐off‐Wert von ≥ 28 für die Diagnose melaninhaltiger maligner Tumor angegeben und mit dem Goldstandard der Histopathologie verglichen.ErgebnisseDie Differenz zwischen den diagnostischen Scores verschiedener Hauttumoren war hochsignifikant (p < 0.0001). Der dermatofluoroskopisch ermittelte Score zeigte bei den Melanomen die höchste Sensitivität (92,1 %). Bemerkenswert ist, dass die meisten pigmentierten Basalzellkarzinome (BZK, 88,9 %) als melaninhaltige maligne Tumoren erkannt wurden. Eine höhere Sensitivität für die richtige Diagnose wurde bei älteren Patienten (≥ 53 Jahre, p = 0,003), Patienten mit gebräunter Haut (p = 0,025) und bei Patienten mit Sommersprossen in der Kindheit (p = 0,046) beobachtet.SchlussfolgerungenDie Zwei‐Photonen‐Fluoreszenz ist ein innovatives Verfahren für die Diagnose pigmentierter Hautläsionen mit einer hohen Sensitivität beim Nachweis von Melanomen und pigmentierten BZK.

Background Acne vulgaris (acne), a common inflammatory skin disorder, has its peak incidence between 14 and 19 years of age, with girls frequently developing acne earlier than boys. Over recent years, persistent acne is becoming more prevalent in adult women. Objectives This review and panel discussion addresses challenges in acne management, particularly in adult women. The role which nonprescription acne treatment can play is explored when used as monotherapy or as an adjunctive treatment for acne of all severity. Methods The best available evidence on nonprescription acne treatment was coupled with the opinion of an international expert panel of dermatologists to adopt statements and recommendations discussed in this review. Results All severity of acne has a significant burden on patients. Addressing environmental factors that are important for the individual with acne may help to educate, prevent, effectively manage, and maintain acne, as per the panel. They agreed that the adult female acne population has unique needs because of their aging skin and social environment. Nonprescription acne treatment products may help to balance the efficacy and tolerability of prescription acne treatment. Currently, there are no specific guidelines for how to use nonprescription acne treatment products in these patients. Conclusion The panel agreed that guidelines including nonprescription acne treatment either as monotherapy for mild acne or in combination with prescription treatments for more severe acne would address a significant unmet need.

Acne vulgaris (acne), a common inflammatory skin disorder, has its peak incidence between 14 and 19 years of age, with girls frequently developing acne earlier than boys. Over recent years, persistent acne is becoming more prevalent in adult women.This review and panel discussion addresses challenges in acne management, particularly in adult women. The role which nonprescription acne treatment can play is explored when used as monotherapy or as an adjunctive treatment for acne of all severity.The best available evidence on nonprescription acne treatment was coupled with the opinion of an international expert panel of dermatologists to adopt statements and recommendations discussed in this review.All severity of acne has a significant burden on patients. Addressing environmental factors that are important for the individual with acne may help to educate, prevent, effectively manage, and maintain acne, as per the panel. They agreed that the adult female acne population has unique needs because of their aging skin and social environment. Nonprescription acne treatment products may help to balance the efficacy and tolerability of prescription acne treatment. Currently, there are no specific guidelines for how to use nonprescription acne treatment products in these patients.The panel agreed that guidelines including nonprescription acne treatment either as monotherapy for mild acne or in combination with prescription treatments for more severe acne would address a significant unmet need.

Objective To confirm the robustness and validity of an automatic scoring system, algorithm-based, that grades the severity of nine facial signs through "selfies" smartphones pictures taken by European Caucasian women through dermatological assessments. Methods 157 Caucasian women from three countries (France, Germany, Spain), of different ages (20-75 years), took one "selfie" image by the frontal camera of their smartphones whereas local dermatologists photographed them with the back camera of the same smartphone. The same nine facial signs of these subjects were initially graded by these local dermatologists, using referential Skin Aging Atlases. All 314 "selfies" images were then further automatically analyzed by the algorithm. The severity of facial signs (wrinkles, pigmentation, ptosis, skin folds etc.) were statistically compared to the assessments made by the three dermatologists, taken as ground truth. Results Highly significant coefficients of correlation (P < 0.001) were found in the three cohorts between the grades provided by the system and those from dermatologists in live. The back camera - of a better resolution than the frontal one - seems affording slightly more significant correlations. However, although significantly correlated, the signs of vascular disorders and cheek skin pores present some disparities that are likely linked to the technical diversity of smartphones or self-shootings, leading to lower coefficients of correlations. Conclusion This automatic scoring system offers a promising approach in the harmonization of Dermatological assessments of skin facial signs and their changes with age or the follow up of anti-aging treatments.