Post‐implantation events of swan‐neck catheters for PD

The first step in PD is the implantation of a peritoneal catheter, a technique that is subject to different possible incidences. We have studied the non‐infectious events or incidences (pericatheter leakage, blood tinged dialysate, catheter displacement, omental wrapping and extra‐peritoneal placement) registered in our unit during a five‐year period (1992–1996) after the implantation of 144 swan‐neck curled catheters in 100 peritoneal dialysis patients, 49 males and 51 females. 70 catheters (48.61 %) were implanted using the blind puncture method and 74 (51.39 %) with the surgical method. All the incidence rates were compared between the two methods to analyse the possible influence of the implantation technique. 21 pericatheter leaks, 19 episodes of blood tinged dialysate, 10 displacements, 7 cases of omental wrapping and 4 extra‐peritoneal placements (all of them after blind punctures carried out by young assistant doctors) were registered, with a total number of 61 incidences (0.42 per catheter). Statistically significant differences were not found either globally or for each type of event when comparing the incidence rates between the two implantation techniques, although extra‐peritoneal placement was close to significant (p = 0.053). None of the incidences were severe. 25 catheters (17.4%) had to be replaced with the removal rates being similar for both techniques. In conclusion, in our experience neither technique shows a clear advantage over the other. Experienced staff members should implant PD catheters.     

Development and validation of nail psoriasis quality of life scale (NPQ10)

Background The chronic and treatment‐resistant nature of nail psoriasis affects patients’ lives not only physically but also psychologically. Although there are scoring systems available for disease severity, there is as yet no scale to evaluate the impact of this condition upon the patients’ quality of life. Objectives This study aims to develop and validate a quality of life scale specifically for nail psoriasis. Methods A questionnaire was developed during a study conducted in France between 2004 and 2005. With the cooperation of l’Association Pour la Lutte Contre le Psoriasis, the questionnaire was sent to a random sample of 4000 of its 17 000 members. Results The response rate was 33%. Of the 1309 questionnaires returned, 795 showed the presence of nail psoriasis and these were eligible. The scale score is obtained by adding together the responses to the 10 questionnaire items and the result is expressed as a percentage. The value of the score obtained is proportional to the functional difficulty experienced. The determination of Cronbach's α coefficient and a Principal Component Factor Analysis show, respectively, very good internal consistency and the unidimensional nature of the scale. Test–retest results on 15 patients showed good reproducibility. Results were validated with reference to the Dermatology Life Quality Index. In this study, the NPQ10 score is significantly influenced by gender (women have a higher score) and by the duration of psoriasis (recent onset implies greater functional difficulty). Finally, the score is much higher when the nail psoriasis affects both the hands and the feet. Conclusion This study confirms a change in the quality of life of patients who have nail psoriasis. The NPQ10 scale, specific to this condition, is simple to use and has the attributes needed in a quality of life scale. The scale must now be tested in longitudinal studies (such as clinical trials) to confirm its ability to measure a change in status.     

No association between nickel allergy and reporting cosmetic dermatitis from mascara or eye shadow: a cross‐sectional general population study

Background In theory, all pigmented make‐up products may contain metal allergens including nickel. Eyelid dermatitis has previously been observed among nickel allergic dermatitis patients following exposure to nickel containing mascara and eye shadow. However, an association between nickel eyelid dermatitis and nickel in make‐up products remains controversial. Objective This cross‐sectional patch test study investigated whether the frequency of self‐reported cosmetic dermatitis from mascara or eye shadow use was higher among nickel allergic Danish women than women without nickel allergy. Methods In 2006, a total of 1843 18–69 year old women completed a postal questionnaire including questions on cosmetic dermatitis and were patch tested with nickel sulphate. Data were analysed by logistic regression analyses and associations were expressed as odds ratios (ORs) with 95% confidence intervals (CIs). Results The prevalence of nickel allergy was similar among women who reported cosmetic dermatitis from eye shadow or mascara and among women who did not report such symptoms. Cosmetic dermatitis was positively associated with self‐reported atopic dermatitis and age. Conclusion Overall, no association between having nickel allergy and reporting cosmetic dermatitis from mascara or eye shadow use was found in the general population. This does not exclude a causal relationship in selected cases.     

Reliability and validity of the dieter's inventory of eating temptations (DIET) in overweight binge eating women

The aim of this study was to evaluate the validity of the Dieter's Inventory of Eating Temptations (DIET). TJye DIET, Tennessee Self-Concept Scale (TSCS), and Binge Eating Scale (BES) were completed by 219 obese, binge-eating women. A 5-factor solution was generated that accounted for 46.9% and 95.0% of the total and common variance, respectively. The DIET demonstrated high internal consistency (alpha=0.93), as did the 5 factors (alphas ranging from 0.71-0.89). The DIET was correlated positively with the TSCS (r=0.212; p=0.002) and negatively with the BES (r=-0.199: p=0.003) suggesting that women who report higher ability to manage problematic diet situations have higher self-esteem and lower binge-related emotional distress. The results of this study suggest that the DIET is a reliable and valid instrument, but the six subscales could probably be reduced to five distinct domains.     

Cerebrovascular reactivity in retinal vasculopathy with cerebral leukoencephalopathy and systemic manifestations

Retinal Vasculopathy with Cerebral Leukoencephalopathy and Systemic manifestations (RVCL-S) is a small vessel disease caused by TREX1 mutations. RVCL-S is characterized by retinal vasculopathy and brain white matter lesions with and without contrast enhancement. We aimed to investigate cerebrovascular reactivity (CVR) in RVCL-S. In this cross-sectional observational study, 21 RVCL-S patients, 23 mutation-negative family members, and 31 healthy unrelated controls were included. CVR to a hypercapnic challenge was measured using dual-echo arterial spin labeling magnetic resonance imaging. Stratified analyses based on age were performed. We found that CVR was decreased in gray and white matter of RVCL-S patients compared with family members and healthy controls (ANCOVA; P < 0.05 for all comparisons). This was most noticeable in RVCL-S patients aged ≥40 years (ANCOVA, P < 0.05 for all comparisons). In RVCL-S patients aged < 40 years, only CVR in white matter was lower when compared to healthy controls (P < 0.05). Gray matter CVR was associated with white matter lesion volume in RVCL-S patients (r = –0.527, P = 0.01). In conclusion, impaired cerebrovascular reactivity may play an important role in the pathophysiology of RVCL-S and may be an useful early biomarker of cerebrovascular disease severity.     

Interference Screw vs. Suture Anchor Fixation for Open Subpectoral Biceps Tenodesis: Does it Matter?

Background  

Bioabsorbable interference screw fixation has superior biomechanical properties compared to suture anchor fixation for biceps tenodesis. However, it is unknown whether fixation technique influences clinical results.     

Variations in clinical decision-making between cardiologists and cardiac surgeons; a case for management by multidisciplinary teams?

Objective  

To assess variations in decisions to revascularise patients with coronary heart disease between general cardiologists, interventional cardiologists and cardiac surgeons     

Binge eating severity, self-concept, dieting self-efficacy and social support during treatment of binge eating disorder.

OBJECTIVE: In treatment of binge eating, measures of self-concept, eating self-efficacy, and social support were examined at 0, 6, and 18 months to determine if improvements in these variables were associated with reductions in binge eating severity. METHOD: Obese adult females (N = 125) were treated for 6 months, with 12 months of maintenance meetings. The Binge Eating Scale (BES), Tennessee Self-Concept Scale (TSC), Dieter's Inventory of Eating Temptations (DIET), and a social support measure (SocSup) were used. RESULTS: Over the first 6 months, improvements in BES were associated with improvements in the TSC and DIET. Over 18 months, improvements in BES were associated with improvements in the TSC, DIET, and SocSup. DISCUSSION: Therapy for binge eating should result in improvement in self-concept and eating self-efficacy, as well as reductions in binge eating. This study showed that self-concept and eating self-efficacy were associated with improvement in binge eating severity. The association with social support did not appear until long-term follow-up. Improvement in self-concept and eating self-efficacy may be processes leading to clinical improvement in this eating disorder, or they may result from changes in binge eating.     

Stiff skin syndrome

Stiff skin syndrome is a rare disorder characterized by pronounced skin induration, mild hypertrichosis and limited joint mobility, predominantly on the buttocks and thighs. Many heterogeneous cases have been reported under the name of stiff skin syndrome. We present a case of stiff skin syndrome from China, the diagnosis based on the patient's typical clinical and histopathological features.     

The safety of hydroquinone

Hydroquinone is one of the most effective molecules for the treatment of hyperpigmentary disorders, with over 40 years of efficacy and safety data. Concerns over its safety have been raised because of the fact that it is a derivative of benzene and because of the long-term side-effects observed with cosmetic products containing high concentrations of hydroquinone. However, despite 40-50 years use of hydroquinone for medical conditions, there has not been a single documented case of either a cutaneous or internal malignancy associated with this drug. This article reviews the evidence for the safety of hydroquinone in the treatment of hyperpigmentation conditions.