Photoallergic contact dermatitis from ketoprofen induced by drug-contaminated personal objects

BACKGROUND: Photoallergic contact dermatitis from ketoprofen has been recognized since the mid-1980s. Skin reactions have been reported to continue weeks after discontinuation of ketoprofen. One reason for this could be residual ketoprofen in the skin, which has been shown in a skin biopsy specimen. OBJECTIVE: We sought to report on 3 cases of photoallergic contact dermatitis from ketoprofen in topical anti-inflammatory gels and on relapses of dermatitis appearing after use of ketoprofen-contaminated objects. METHODS: We patch and photopatch tested, with standard series, the anti-inflammatory gel, ketoprofen, and its ingredients in serial dilutions and extracts of personal objects. We performed chemical investigations of personal objects with thin-layer chromatography, high-pressure liquid chromatography, and gas chromatography-mass spectrometry. RESULTS: Photoallergy was demonstrated to ketoprofen, which was detected in personal objects. CONCLUSION: Relapses of photoallergic contact dermatitis in patients photoallergic to ketoprofen can be induced by ketoprofen-contaminated objects such as bandages and slippers.     

Cognitive behavior therapy (CBT) in anxiety disorders

This review examines CBT as a leading evidence-based psychotherapy. It describes briefly the major components of CBT: exposure, reduction of safety behaviors, attention focus modification and cognitive restructuring. Specific CBT strategies suited for the main anxiety disorders are reported (specific phobias, panic disorder and agoraphobia, social phobia, generalized anxiety disorder, obsessive compulsive disorder and post-traumatic stress disorder). The review emphasizes the efficiency of the use of CBT as a psychotherapeutic method in anxiety disorders. Finally, it points to the lack of the use of CBT in Israel and recommends its wide use in the mental health service here.     

White matter preservation after spinal cord injury in ICAM-1/P-selectin-deficient mice

We have previously demonstrated that mice deficient in ICAM-1 and P-selectin (ICAM-1/PS-/-) have improved functional recovery after spinal cord injury (SCI), compared to injured controls. In this study the spinal cords from wild-type and ICAM-1/PS-/- mice were evaluated histopathologically 14 days after severe compression-type SCI. Following injury there was an atrophy of the spinal cord. Significant sparing of total cross-sectional area was noted in ICAM-1/PS-/- mice compared to injured controls at the site of compression and in the distal peri-injury zone. Likewise, significant preservation of white matter area, as measured by Luxol staining, was found in mutant mice at the site of injury and in the proximal peri-injury zone. Gray matter damage was investigated by microtubule-associated protein 2 immunohistochemistry. Following severe SCI, a trend of gray matter sparing was noticed in ICAM-1/PS-/- animals. Quantitation of iba1 immunohistochemistry revealed that microglial reaction was significantly suppressed in the mutant animals. Astroglial reaction, visualized by GFAP immunostaining, did not differ between groups. Our results indicate that ICAM-1 and P-selectin are involved in autodestructive events provoked by the initial injury but the precise underlying mechanisms remain obscure.     

Effect of carbohydrate feeding on insulin action in skeletal muscle after surgical trauma in the rat

Metabolic stress after surgery is associated with peripheral insulin resistance. Recent studies have suggested that preoperative glucose can ameliorate postoperative decreases in insulin-stimulated glucose disposal. In the present experiments, we used a bowel-resection model of surgical trauma to test the hypothesis that elevations of serum insulin induced by preoperative oral glucose or ad libitum feeding affects postoperative insulin-stimulated glucose uptake in skeletal muscle. Insulin-stimulated glucose transport was measured in vitro in soleus muscles after surgical trauma in fasted rats given oral glucose or water before surgery. Insulin-stimulated glucose transport was also assessed in vitro in fasted or fed traumatized rats and non-traumatized control animals. In addition, stress hormones (glucagon, corticosterone, and adrenaline) were measured before and after surgical trauma in fasted rats and rats fed ad libitum. In vitro skeletal-muscle insulin sensitivity and responsiveness were reduced postoperatively in fasted animals that received oral glucose loads before bowel resections and in rats fed ad libitum or fasted before surgery versus non-traumatized rats (all P < 0.05). Stress-hormone concentrations after trauma did not differ between fed and fasted animals. In the current study, insulin sensitivity and responsiveness were reduced in isolated skeletal muscles after bowel resection, but neither preoperative glucose supplementation nor free intake of mixed nutrients ameliorated the development of postoperative insulin resistance.     

Regular disappearance of the human papillomavirus genome after conization of cervical dysplasia by carbon dioxide laser

OBJECTIVE: We wished to evaluate the effectiveness of treatment of cervical dysplasia by laser conization in relation to persistence of human papillomavirus after treatment. STUDY DESIGN: Of 203 women referred to colposcopy because of an abnormal Papanicolaou smear, 149 women could be followed up for 3 years. A total of 108 women were treated by carbon dioxide laser excision, 4 women were treated by carbon dioxide laser evaporation, and 37 women were merely followed up. Cervical samples were taken before treatment and at follow-up 3 years later and were analyzed by nested general primer polymerase chain reaction for human papillomavirus deoxyribonucleic acid. RESULTS: Among women treated by laser conization, 82 (73.2%) had positive results for human papillomavirus deoxyribonucleic acid before treatment. Three women (2.7%) had a positive finding at follow-up, but no woman had the same human papillomavirus type on both occasions. Eighty-eight women had grade 1 to grade 3 cervical intraepithelial neoplasia before treatment, whereas during follow-up only 2 squamous cells atypias were found. CONCLUSION: The human papillomavirus genome present before treatment was regularly cleared, and there was also no recurrence of dysplasia. The results suggest that human papillomavirus testing is useful for monitoring the efficacy of treatment and that treatment modalities resulting in clearance of human papillomavirus should be favored.     

Chronic sorrow in next of kin of patients with multiple sclerosis

The well-being of patients' next of kin can be an important factor with regard to the care and rehabilitation of patients with multiple sclerosis (MS). The aim of this qualitative study was to explore the presence and meaning of chronic sorrow in a group of next of kin of patients with MS. Using a semistructured interview guide as a basis, 44 next of kin were interviewed. The results showed that 35 (80%) of the participants were considered to have chronic sorrow based on predetermined criteria. Three main themes characterized the meaning of chronic sorrow: loss of security, loss of sense of community in family life, and loss of joy and recreation. This study indicates that nurses need to devote greater attention to the well-being of next of kin, offering support programs to help them cope with chronic sorrow.     

Early Contact versus Separation: Effects on Mother–Infant Interaction One Year Later

Background: A tradition of separation of the mother and baby after birth still persists in many parts of the world, including some parts of Russia, and often is combined with swaddling of the baby. The aim of this study was to evaluate and compare possible long‐term effects on mother‐infant interaction of practices used in the delivery and maternity wards, including practices relating to mother‐infant closeness versus separation. Methods: A total of 176 mother‐infant pairs were randomized into four experimental groups: Group I infants were placed skin‐to‐skin with their mothers after birth, and had rooming‐in while in the maternity ward. Group II infants were dressed and placed in their mothers’ arms after birth, and roomed‐in with their mothers in the maternity ward. Group III infants were kept in the nursery both after birth and while their mothers were in the maternity ward. Group IV infants were kept in the nursery after birth, but roomed‐in with their mothers in the maternity ward. Equal numbers of infants were either swaddled or dressed in baby clothes. Episodes of early suckling in the delivery ward were noted. The mother‐infant interaction was videotaped according to the Parent‐Child Early Relational Assessment (PCERA) 1 year after birth. Results: The practice of skin‐to‐skin contact, early suckling, or both during the first 2 hours after birth when compared with separation between the mothers and their infants positively affected the PCERA variables maternal sensitivity, infant's self‐regulation, and dyadic mutuality and reciprocity at 1 year after birth. The negative effect of a 2‐hour separation after birth was not compensated for by the practice of rooming‐in. These findings support the presence of a period after birth (the early “sensitive period”) during which close contact between mother and infant may induce long‐term positive effect on mother‐infant interaction. In addition, swaddling of the infant was found to decrease the mother’s responsiveness to the infant, her ability for positive affective involvement with the infant, and the mutuality and reciprocity in the dyad. Conclusions: Skin‐to‐skin contact, for 25 to 120 minutes after birth, early suckling, or both positively influenced mother‐infant interaction 1 year later when compared with routines involving separation of mother and infant.     

Evaluation of an oral health education program for nursing personnel in special housing facilities for the elderly. Part II: Clinical aspects

In Sweden, efforts are being made to create strategies for evaluating realistic dental treatment needs among the elderly, who are retaining more natural teeth. These strategies focus on the importance of maintaining adequate oral hygiene. Elderly in long-term-care facilities often depend on nursing personnel for carrying out daily oral hygiene procedures. Therefore, the nursing personnel's knowledge about and attitudes toward oral health make oral health education for health care professionals an important concern. The purpose of this study was to evaluate the clinical oral health outcome in residents after their caregivers had undergone a one-session, four-hour oral health education program. The study consisted of an intervention with a pre- and a post-test and was carried out in three municipalities in the southwestern part of Sweden. A newly developed oral health screening protocol was carried out for 170 subjects living in long-term-care facilities both before and 3–4 months after nursing personnel had attended an oral health education program. Following the Intervention, a statistically significant improvement was recorded for changes in oral mucosal color, a modi-fled plaque index which measured oral hygiene status, and a mucosal index which recorded mucosal inflammation. This study indicated that a limited, one-session, four-hour oral health education, offered to caregivers within long-term-care facilities, had a positive impact on the oral health status of residents.     

Transverse displacement of the proximal segment after bilateral sagittal osteotomy: a comparison of lag screw fixation versus miniplates with monocortical screw technique.

PURPOSE: The purpose of the present study was to compare lag screw fixation versus miniplates with monocortical screw technique with respect to the amount of transverse displacement of the proximal segment after bilateral sagittal osteotomy (BSO) for mandibular advancement surgery. PATIENTS AND METHODS: We conducted a multicenter, retrospective investigation of 82 patients who underwent a mandibular advancement with BSO and rigid internal fixation. Forty-five patients from Denmark and Sweden, the miniplate fixation group, received a rigid fixation consisting of miniplates with monocortical screws. Thirty-seven patients from the Mayo Clinic, the lag screw fixation group, received a rigid fixation with lag screw fixation of the mandible. The transverse displacement and angulation of the proximal segments were measured on posterior-anterior cephalometric radiographs, using the best-fit method. RESULTS: After BSO, 44 of 45 patients in the miniplate fixation group showed an increased transverse intergonion distance with a mean of 5.0 mm and an increase transverse interramus width with a mean of 2.4 mm. Thirty-six of 37 patients in the lag screw fixation group had an increased intergonial width with a mean of 5.6 mm, and 35 of 37 patients showed an increased transverse interramus width with a mean of 3.3 mm. t tests showed that there were no significant differences between the 2 groups with respect to these 2 variables. CONCLUSIONS: Our results indicate that transverse displacements of the proximal segments occur after BSO surgery with both miniplate or lag screw fixation technique. Attention and future studies should focus on possible complications that transverse displacement of the proximal segment may cause.