清洗外阴致阴茎烫伤被误诊5例

目的:避免阴茎烫伤误诊。我院门诊近3年来共接诊阴茎烫伤后被误诊患者5例,均为清洗外阴时因水温过高而致伤,全部患者自己都不以为是烫伤,经医生再三追问时才被发现。方法:用抗感染加局部外用烧伤膏给予治疗。结果:全部治愈,但使病人精神等方面受到了很大的影响。结论:阴茎烫伤被误诊这一现象必须引起我们临床医师们的高度重视,如在临床发现阴茎红肿疼痛者,一定要追问患者在清洗外阴时是否水温过高,并应想到有被热水烫伤的可能,同时一定要叮嘱患者清洗外阴或用洗剂时水温不可过高。     

Swedish women’s experiences of menopausal transition: A focus group study

ObjectiveThe aim of this study was to examine women’s experience of menopausal transition and their expectations and wishes for support from healthcare. Further, to examine their knowledge about menopause and thoughts about current attitudes in healthcare and in society generally.MethodsData was collected through three focus group interviews with 14 women experiencing menopausal symptoms. The qualitative analysis was transacted through systematic text condensation, where categories were derived from data.ResultsThe women in this study told us about being inadequately prepared for menopause through having insufficient knowledge of the menopausal transition. They experienced lack of clarity about where in the health care system they could get help and that knowledge of menopause varied among healthcare staff. The attitudes to menopause experienced by women in this study were both positive and negative, but they often equated menopause with getting old. To be better prepared for the climacteric transition, the women wanted information from health care professionals and they wanted menopausal care to be easily accessible and local. If needed, it should be possible to access clinics providing specialist care.ConclusionThis work indicates that women want more and improved information about menopause in order to be better prepared. Advice and treatment for menopausal healthcare care should be easily accessible for women. Improved education and care guidelines for menopausal problems can be helpful for healthcare staff.     

Investigating the beneficial experiences of online peer support for those affected by alopecia: an interpretative phenomenological analysis using online interviews

Patients and their family members can find it helpful to share their stories with fellow sufferers. Online groups are particularly useful for those who are shy or self-conscious about how they look. Alopecia UK is a support group for people experiencing hair loss. Their website links to a monitored Facebook group restricted to members. There is not much research into the benefits of online support for skin conditions, so these psychologists from Sheffield in the UK interviewed 12 people who had been helped by the Alopecia UK Facebook group. The usual method for this type of research is “content analysis” in which patient interviews are analysed to identify themes. These researchers used “interpretative phenomenological analysis”. First, they asked participants for a screenshot of a post they had found particularly helpful. Then they asked a set of questions about their experience with the website and with the screenshot. Finally, they analysed the interviews to look for themes expressed both by individuals and by the group. The participants, all women, described how the online forum enabled them to let go of feelings of misery and unattractiveness, to share practical tips about dealing with their appearance, to feel less alone and more normal and to become more accepting of their appearance and more confident socially. A few reported unhelpful comments and inaccurate advice. The study suggests that online peer support can encourage sufferers to adjust to chronic (long-term) conditions by connecting them within a safe and private community. Platforms like this could be used in combination with other therapies.     

What are nevus cells?

Although the term "nevus cell" was introduced nearly a century ago and is used daily in the parlance of general pathology and dermatopathology, writings about the subject indicate that agreement has yet to be reached about the nature of these cells. On the basis of all of the evidence about "nevus cells," morphological and biochemical, that has been accumulated to date, we conclude that they are simply melanocytes.     

Knowledge levels and concerns about oral isotretinoin treatment in the parents of adolescent acne patients

Oral isotretinoin is frequently used in the treatment of young acne patients. However, knowledge levels and attitudes about this treatment have not been studied in the parents previously. We aimed to investigate the knowledge levels and concerns about oral isotretinoin in the parents of adolescent acne patients. We conducted a cross‐sectional study on 136 parents of adolescent patients with moderate to very severe acne vulgaris who answered the questionnaire about oral isotretinoin treatment. Demographic data and acne characteristics were recorded. The parents' knowledge levels and concerns about the treatment process were asked by the questionnaire. Since 32 parents have never heard oral isotretinoin before, they were excluded from the study. Of the remaining 104 parents, 80.8% were female and 19.2% were male. Of the parents, 62.5% had some concerns about oral isotretinoin treatment and 34.6% had no idea whether the drug is suitable for the use of <18 years. 52.9% stated that they think the drug will damage the liver. The most known and worrying side effects were dry lips and vision problems, respectively. The knowledge levels about oral isotretinoin treatment and its side effects were low in the parents of adolescent acne patients, leading to prejudice to the drug.     

Perceptions about oral isotretinoin treatment

There are some studies on the knowledge, beliefs, and perceptions of patients about acne vulgaris, however, there is no sufficient data on patients' beliefs about oral isotretinoin treatment (OIT). The aim of this study was to assess the knowledge, beliefs, and perceptions of the patients with acne vulgaris about the therapy of OIT and its side effects. A total of 214 patients with acne vulgaris in our outpatient clinic were included. Patients who were planned to treat with OIT were asked whether they had information about the treatment and its side effects. It was noted whether the patients accepted treatment after being informed both verbally and written about the OIT details. The study consisted of 133 female and 81 male aged 12–57 years. Most of the patients (78%) stated that they had heard of OIT. The most common source of the information on isotretinoin therapy was friends (57.6%). The dryness was the best‐known side effect. While 86.4% of patients (n: 185) accepted OIT, the group (14.4%) stated that “I have knowledge about side effects.” And refused to use the treatment. Most of the patients agreed to the treatment after explanation of dermatologist. Patients may be educated and informed via reliable medical sources to prevent bias and improve compliance to the treatment.     

Laypersons' perceptual discrimination of pigmented skin lesions

BACKGROUND: Most cutaneous malignant melanomas of the skin are visible and should, at least in theory, be possible to detect with the naked eye. OBJECTIVE: This study was conducted to learn more about laypersons' ability to discriminate between benign pigmented lesions and malignant ones. METHODS: Four groups of laypersons (n = 120) were asked to evaluate pictures of different types of pigmented skin lesions, before and after they received information about the ABCD (asymmetry, border irregularity, color variegation, and diameter greater than 6 mm) criteria, with respect to the necessity of action. RESULTS: The respondents made adequate assessments of melanomas but overestimated the danger of benign pigmented skin lesions. Information about the ABCD criteria enhanced their ability to make adequate assessments. CONCLUSION: People seem to make adequate decisions concerning how to act if they have a melanoma. On the other hand, common moles and dysplastic nevi were harder to discriminate. Providing information to the public about the features of melanomas, in accordance with the ABCD criteria, might help laypersons in their perceptual discrimination of skin lesions.     

STD management by private pharmacies in Hanoi: practice and knowledge of drug sellers

BACKGROUND: Prompt treatment of sexually transmitted infections may reduce the incidence of HIV/AIDS infections. With health sector reforms private pharmacies are increasingly the first and only contact with health delivery services. OBJECTIVES: To find out how patients with STDs are treated at private pharmacies in Hanoi, and what drug sellers know about STD management. METHODS: Five simulated clients were taught to adopt a scenario stating that their friend had a urethral discharge. They visited 60 randomly selected private pharmacies in urban Hanoi and noted all questions asked, advice offered, and treatment given. Afterwards interviewers administered a semistructured questionnaire to all people working in the 60 pharmacies. RESULTS: Drug treatment was given in 84% of the 297 encounters averaging 1.5 drugs and 1.2 antibiotics per encounter. Quinolones were given 188 times. No dispensing was adequate for chlamydia or was in accordance with the national guidelines. No questions were asked in 55% of encounters and no advice was given in 61%. Questions on sexual activity were asked in 23% (69) of cases and about the health of the partner twice (1%). Advice to practise safe sex was given in 1% of encounters and for the partner to seek treatment only once. Of 69 questionnaires administered 51% said they would refer to a doctor, 16% said they would ask about the sexual activity 1% said they would ask about the health of the partner, 7% said they would advise using a condom, and 1% advised telling the partner to seek treatment. Even after prompting, 61% would ask no questions and 80% would give no advice. CONCLUSIONS: Even though 74% of pharmacists and drug sellers know that they should not treat STD patients, 84% actually did. None gave syndromically correct treatment. In both the questionnaire and during the simulated client methods, numbers advising on partner notification and condom use were very poor. Educational or peer awareness interventions are urgently needed among private pharmacists in Vietnam.     

“Men don’t think that far” – Interviewing men in Sweden about chlamydia and HIV testing during pregnancy from a discursive masculinities construction perspective

Objectives: We used qualitative research design to discursively explore expectant fathers’ perceptions of chlamydia and HIV, and their masculinity constructions about testing, and explored how they talked about their potential resistance towards testing and their pre-test emotions.Study design: Twenty men were offered chlamydia and HIV testing at the beginning of their partner’s pregnancy. Those who agreed to be tested were interviewed in-depth; those who declined testing were also interviewed. The interviews were tape recorded and transcribed verbatim. The analysis was inspired by discourse analysis on masculinity.Main outcome: Three discursive themes: Men prefer to suppress their vulnerability to STIs, Body and biology differ between men and women and Men have mixed emotions around STI testing underscore the informants’ conversations and sometimes conflicting thoughts about STI testing.Conclusion: The majority of men talked about pregnancy as a feminine territory, raised uncertainties about men’s roles in the transmission of STIs, and talked about women’s and men’s essentially different bodies and biology, where few men realised that they could infect both their partner and the unborn child. This knowledge gap that men have must become apparent to healthcare providers, and policy makers must give men equal access to the reproductive arena.     

The views of children and young people on the use of silk garments for the treatment of eczema: a nested qualitative study within the CLOTHing for the relief of Eczema Symptoms (CLOTHES) randomized controlled trial

This study reports on a trial from the U.K. to find out if specialised silk clothing improved eczema in children. Eczema is a common skin condition. It affects around one in five children and can cause sore and itchy skin, poor sleep and reduced quality of life. As part of this work the researchers wanted to find out what the children who wore the garments in the study thought of them. They invited 18 children aged between five and 15 years to take part, meeting in small groups and using stories and play to help the children tell the researchers about the garments. All the children and young people had high hopes that the garments would make their skin much better. They expected the garments to feel soft and smooth and were disappointed when they were not like this. They reported that they mostly wore them at night as it was embarrassing to wear them during the day. Some said that the garments were see through. Garments tended to go grey and start to fall apart when they had been worn and washed. A few children found that the garments made their skin more comfortable and helped them sleep better. They were disappointed that the miracle cure they hoped for did not happen. It is important and possible to involve children in studies like this so we can understand what they think about possible treatments for eczema.     

青少年同伴间性话题沟通的研究综述

青少年时期是生长发育的高峰时期,第二性征的出现引发了心理产生一系列的变化,对性产生好奇,也产生迷惑.家庭和学校往往不能通过科学的渠道给予解答,同伴间性话题沟通成为交流思想的一个重要途径.     

Receptivity for probiotic products among premenopausal female students in an African university

OBJECTIVE: The objective of this study was to examine the receptivity for probiotic products among premenopausal female students in an African university. GOAL: The goal of this study was to determine the local knowledge in Nigeria of probiotics and the willingness of young women to use them should they be introduced. STUDY: Closed-ended questionnaires were administered to a sample of 280 participants and these addressed age, marital status, perceived risk of HIV infection for the next 3 years, and history of urogenital infections. The participants were also asked whether they would welcome a probiotic product in oral/vaginal form and in milk-based food products, willingness to purchase and use, how often they would use these products, preference of form, price, and where they would like to buy the products. The second questionnaire was open-ended. It asked the participants to freely list any concerns or worries they had in relation to probiotic products. RESULTS: Of the 280 participants, 55.3% indicated that they believed they were at risk of acquiring HIV within the next 3 years, illustrating the enormity of the problem in Africa and the feelings among women that they cannot easily control sexual relationships and have partners use condoms. Eighty-two percent of the subjects stated they would welcome probiotic products in capsular form for vaginal instillation or to be taken orally to improve vaginal health. Over one third (36%) of women indicated they would be willing to use the probiotic products as part of their daily self-care. One hundred nine (39.6%) respondents were willing to purchase the probiotic products at a reasonable price of 0.08 US dollars per dose, whereas 71.5% were willing to pay up to 0.38 US dollars. Some subjects (25%) raised some concern over safety of probiotics. CONCLUSIONS: The findings revealed that female university students are receptive to probiotic products in Nigeria and indicate strongly a need to consider women's concerns about urogenital health. Furthermore, the study identified a need for appropriate educational materials about probiotics, including benefits and safety information, in an African country suffering severely from the HIV epidemic.     

Surgical management of ingrown toenails – an update overdue

For decades, every year sees a wide number of articles about treatment of ingrown toenails. There is still a debate about the cause of this painful condition. Surgical treatments rely on two main approaches: either narrowing the nail plate or debulking the soft tissues. It is up to the surgeon to select the most appropriate approach in each case. All procedures cited in this article have high cure rates as long as they are properly performed. As with all surgical procedures, they are operator dependent. Chemical cautery is the easiest and most versatile technique that may help in almost all instances for lateral ingrowing. For distal embedding and very hypertrophic and exuberant lateral folds, debulking with secondary intention healing is the most effective and easy to perform, with great results.     

农村父母对未婚年轻成人生殖健康教育的态度和要求

目前,在我国社会中频繁出现的婚前性行为,已对我们的家庭性观念建设和青少年健康成长造成较严重干扰。1993年以来,北京、上海和武汉等地对婚检对象的调查显示,未婚年轻人中发生婚前性行为的比例分别为45.52%、69.3%和64.1%,其中年龄最小的仅     

Basal cell carcinoma and actinic keratoses: patients' perceptions of their disease and current treatments

BACKGROUND: The increasing incidence of nonmelanoma skin cancer constitutes a significant worldwide epidemic. Chronic exposure to ultraviolet light is the predominant risk factor for basal cell carcinoma (BCC), which will make up approximately 80% of new cases of skin cancer per year, and for actinic keratoses (AK), an early manifestation of squamous cell carcinoma. BCC and AK are associated with considerable morbidity, which can be decreased if detected and treated early. METHODS: Patients in the United States (US), Australia, Spain and Germany took part in discussion groups in which they were asked about their knowledge of BCC or AK and current diagnosis and treatment processes. RESULTS: In this study, patients were found to have only a basic understanding of BCC or AK, and furthermore, they were not satisfied with the amount of information provided by their physician about their treatment options, and possible side-effects such as pain and scarring. CONCLUSIONS: Increased public awareness about BCC and AK may potentially aid in their early detection and treatment.     

Assessment of information and education about topical corticosteroids in dermatology outpatient departments: experience from Turkey

BACKGROUND: Topical corticosteroids are commonly used in dermatological practice. The aim of this study was to assess the baseline level of knowledge about topical steroids in a group of dermatology patients and to evaluate the impact of educational materials on patients' level of information. METHODS: A 10-item questionnaire was developed, and 126 patients who were prescribed topical steroids for several dermatologic diseases were asked mostly about side-effects of the drugs. Three different educational methods were used in parallel to the questionnaire: verbal (n = 42), written (n = 42) or verbal and written (n = 42). The same questions were asked again 1 or 2 weeks later. RESULTS: Only 7.1% of the study group mentioned that they were informed by doctors about the side-effects of topical steroids before they were administered. The baseline information scores about topical corticosteroids were higher in high school and college graduates and in those who noted side-effects or who were informed about side-effects before administration. A statistically significant difference was detected between pre- and posteducation scores of patients in the whole group and within the three groups of different educational methods (P < 0.001). Posteducation scores of the combined verbal- and written-educated group were higher than the written-educated group or the verbal-educated group. CONCLUSION: The present study indicated that patient knowledge is enhanced by any kind of educational method, and particularly written information supported by verbal instructions given in dermatology outpatient departments. Moreover, we conclude that the 10-item questionnaire can be used in Turkey to assess patients' knowledge about topical corticosteroids.     

What do young people think about the dangers of sunbathing,skin cancer and sunbeds? A questionnaire survey among Italians

Previous experience in Australia and Sweden showed that public education programs produced substantial changes in people's opinions, attitudes and perceptions about melanoma, non-melanoma skin cancer, sunlight, sunbeds and suntanning. In order to organize effective prevention campaigns, more must be known about the sunbathing habits of children and adolescents. The aim of our study was to assess the knowledge that young people in a southern European country have about sun exposure. A total of 764 young people ranging from 16 to 22 years old (mean age: 19.3+/-1.2 years) responded to a questionnaire. Our study indicates that young people are very aware of the risks associated with sunbathing but that they continue to expose themselves without taking precautions. This suggests that: a) the majority of young Italians are reasonably well-informed but they do not take preventative measures; b) one effective measure could be promotion of the idea that an untanned body is more esthetically pleasing than a tanned one; c) a crucial point in the programming of future safety measures in suntan centers involves rigorous and regular controls.     

How much interest is the internet to patients?

OBJECTIVES: To assess the accessibility of the internet, the level of interest from patients attending genitourinary (GU) medicine clinics, and explore potential concerns about confidentiality. METHODS: Questionnaire based survey of patients attending five GU medicine clinics in England. RESULTS: 41% of GU medicine clinic patients in 1999 had access to the internet (range 31%-52%) with access more common in younger age groups, and less common in women and black Caribbean patients. One in 10 patients (with internet access) had used the internet to find out more about the problem with which they had come to the clinic. 60% of patients replied that information on sexual health on the internet was of interest to them and a high proportion of patients said they would use the internet to access information about GU clinics (64%), book an appointment (64%) or get test results (63%). Almost a quarter of patients who made additional suggestions wanted an interactive website. CONCLUSIONS: A high proportion of patients attending GU clinics have access to the internet with potential uses for health education and service delivery.     

Education at school about sexually transmitted diseases.

Although sex education in West German schools started officically in 1968, a survey of 700 children aged 14 to 15 years showed that they understood more about birth control than about sexually transmitted disease (STD). This contrasts with the rising incidence of gonorrhoea and falling birth rate. There is a general lack of published information of STD and it is proposed that an international body like the IUVDT should be formed to promote the spread of information.