Prevalence of acne rosacea in a rheumatic skin disease subspecialty clinic.

There are many causes of malar erythema besides the classic butterfly rash of acute cutaneous lupus erythematosus (LE). Twenty-one patients (6.7% of new patient visits) referred to a dermatology department-based rheumatic skin disease subspecialty clinic over a 5-year period in whom a diagnosis of cutaneous LE had been entertained were found to have diagnoses other than autoimmune connective tissue diseases. Sixteen of the patients in this cohort (76%) had acne rosacea (rosacea), while the remaining five had other dermatologic disorders. Review of their records revealed that upon referral nine of these 21 patients (43%) had positive antinuclear antibody (ANA) assays, most with insignificant or marginal titers by our laboratory standards. On repeat ANA testing in our laboratory, all of these patients had insignificant ANA titers. Physicians may be giving too much weight to low-titer ANAs in assessing patients with isolated malar erythema. These issues are discussed in the overall context of the differential diagnosis of malar erythema. A simple punch skin biopsy can be very helpful in distinguishing cutaneous LE from other causes of malar erythema.     

Successful treatment of periungual warts using photodynamic therapy: a pilot study

AIM: The aim of this pilot study was an investigation on photodynamic therapy (PDT) whether it is a good alternative for treating periungual and subungual warts of the hands. STUDY DESIGN: Twenty patients (mean age: 30.5 years) with a total of 40 periungual and subungual warts were treated with PDT. A photosensitizer, 20%delta-aminolevulinic acid was applied on the warts. After a mean incubation time of 4.6 h (SD: 1.2), the warts were irradiated with the VersaLight for 5-30 min (15.2 +/- 4.3 min). RESULTS: After a mean of 4.5 treatments a mean clearance of 100% was achieved in 90% of the patients. One patient (5%) showed a clearance of 50% and another showed no improvement. The subungual or periungual location of the wart had no influence on the number of treatments or end result (P > 0.05). There were two recurrences during the mean follow-up period of 5.9 months (SD: 7.6). Besides mainly pain and hyperpigmentation, most treatments had no side-effects. CONCLUSION: PDT can offer a good alternative for treating periungual warts of the hands. Larger studies are indicated.     

Expanding the Spectrum of Acquired Cerebral Hemiatrophy

The authors report a 50-year-old man with progressive left hemispheric atrophy, cognitive decline, infrequent seizures, and spells suggestive of complicated migraine. They discuss the association between migraine and cerebral hemiatrophy and suggest that the spectrum of acquired cerebral hemiatrophy may be broader than what has been commonly recognized.     

Cutting edge technology to enhance nursing classroom instruction at Coppin State University.

Educational technologies have changed the paradigm of the teacher-student relationship in nursing education. Nursing students expect to use and to learn from cutting edge technology during their academic careers. Varied technology, from specified software programs (Tegrity and Blackboard) to the use of the Internet as a research medium, can enhance student learning. The authors provide an overview of current cutting edge technologies in nursing classroom instruction and its impact on future nursing practice.     

Breastmilk intake and growth in infants from two to ten months

Longitudinal measurements of breastmilk intake in 48 Cambridge infants showed that intake reached a peak of 824 g/24 h in boys and 741 g/24 h in girls in the third and fourth months, respectively. Regression analysis demonstrated that, in the early months, the infants' weight accounted for a major part of the variance in breastmilk intake. Infants in non-manual social classes received more breastmilk and started solids later than those in manual groups. In the early months weight gain showed a relative increase compared to growth standards, but later infancy was characterized by a progressive deceleration in weight and length gain. Adiposity, as measured by triceps skinfold thickness differed most markedly from growth charts and was only equivalent to the tenth standard centile at all ages. The lower skinfold thickness measurements are considered to be more appropriate to breastfed infants in general.     

Multiple coronary artery-left ventricular fistulae: clinical, angiographic, and pathologic findings

Multiple fistulae between all 3 major coronary arteries and the left ventricle were found at cardiac catheterization in a 69-year-old woman presenting with typical angina. Subsequent necropsy showed abnormal intramyocardial vessels communicating with the left ventricular lumen. This is the first report to document clinical, angiographic, and pathologic findings in this anomaly.     

Is commercial alcohol availability related to adolescent alcohol sources and alcohol use? Findings from a multi-level study.

PURPOSE: To examine whether compliance with underage sales laws by licensed retail establishments is related to underage use of commercial and social alcohol sources, perceived ease of obtaining alcohol, and alcohol use. METHODS: In 2005, alcohol purchase surveys were conducted at 403 off-premise licensed retail establishments in 43 Oregon school districts. A survey also was administered to 3,332 11th graders in the districts. Multi-level logistic regression analyses were used to examine relationships between the school district-level alcohol sales rate and students' use of commercial and social alcohol sources, perceived ease of obtaining alcohol, past-30-day alcohol use, and heavy drinking. RESULTS: The school district-level alcohol sales rate was positively related to students' use of commercial alcohol sources and perceived alcohol availability, but was not directly associated with use of social alcohol sources and drinking behaviors. Additional analyses indicated stronger associations between drinking behaviors and use of social alcohol sources relative to other predictors. These analyses also provided support for an indirect association between the school district-level alcohol sales rate and alcohol use behaviors. CONCLUSIONS: Compliance with underage alcohol sales laws by licensed retail establishments may affect underage alcohol use indirectly, through its effect on underage use of commercial alcohol sources and perceived ease of obtaining alcohol. However, use of social alcohol sources is more strongly related to underage drinking than use of commercial alcohol sources and perceived ease of obtaining alcohol.     

When in vitro fertilization fails: a prospective view.

New reproductive technologies such as in vitro fertilization (IVF) offer much hope to infertile couples, yet the odds for success are not high. In this study we examine the experiences of a cohort of women undergoing IVF or a related technology at three points in time: before technological intervention, approximately one month after the first failed cycle, and six months later. We consider the women's expectations and experiences and discuss implications of the findings for social work practice.