Is there an association between economic performance and public satisfaction in health care?

Earlier studies on the association between health systems’ economic performance and public satisfaction were based on between-countries comparisons. This approach can be challenged as it ignores the fact that subjective measures like ‘satisfaction’ might be relative. Cohort analysis is a way of dealing with this issue as it focuses on within-countries comparisons. The association between change in satisfaction with health care systems and change in economic performance, determined by an output-orientated constant returns to scale DEA Malmquist model over the period 1995 to 2000/2002 using OECD data, is explored. The results show that a health care systems’ economic performance is not associated with public satisfaction.     

Dermatography as a new treatment for alopecia areata of the eyebrows

Background Alopecia areata is considered to be an autoimmune disease. It consists of patchy hair loss of the scalp and the eyebrows, making it a disfiguring condition. This 10-year study was designed to assess the usefulness of the treatment of the eyebrows with dermatography as a relatively quick and simple method to obtain a cosmetically satisfactory result. Materials and methods The eyebrow areas were covered with a halftone pattern of tiny dots of color pigments, using a Van der Velden Derma-injector, without anesthesia. On average, two to three dermatography sessions of 1 h were required. The follow-up was 4 years. Results Thirty three patients, most of whom had been previously treated with a sensitizer such as dinitrochlorobenzene (DNCB), were treated with dermatography. Four patients had also been treated by a beautician with a crude form of tattooing. The results in 30 patients were excellent. In three patients the results were good. Conclusions Dermatography is a technique offering a good alternative for time-consuming, troublesome treatment modalities that often have considerable side-effects. With dermatography, no side-effects were found.     

Renal remodelling in dietary protein modified rat polycystic kidney disease

Dietary protein restriction slows progression of the Han:SPRD-cy rat model of polycystic kidney disease. We undertook studies to examine the relative changes in interstitial and tubular pathology as a result of feeding an 8% casein (LP) diet to Han:SPRD-cy rats. Archival tissue from a previous study comparing LP and 20% casein (NP) diets was examined morphometrically after immunohistochemical or histochemical staining for apoptosis, proliferation antigens, interstitial fibrosis, and macrophage infiltration. Expression of common extracellular matrix genes was measured by Northern analysis. Animals fed LP diet demonstrated reduced tubular epithelial remodelling compared with animals fed NP diet by both proliferating cell nuclear antigen-positive cells (57.5 vs. 71.6 cells/mm epithelium, P=0.007) or apoptosis (31.2 vs. 35.6 cells/mm epithelium, P=0.006). Interstitial pathology demonstrated that LP feeding was associated with proportionately greater reductions in interstitial fibrosis (0.3 vs. 1.3 ml/kg body weight, P=0.003), interstitial cellularity (361 vs. 604 cells/high-power field, P=0.0002), and interstitial macrophages (67 vs. 149 cells/high-power field, P=0.0002). Northern analysis only revealed significantly lower levels of monocyte chemoattractant protein mRNA (P=0.04) in animals fed the LP diet. Dietary protein restriction modifies both tubule and interstitium, with significant impact upon interstitial inflammation and fibrosis in the Han:SPRD-cy rat. Received: 24 April 1998 / Revised: 10 November 1998 / Accepted: 11 November 1998