Alexithymia and symbolic function in the obese

Based on recent literature in which obesity is considered a psychosomatic disease, the authors present results of a study attempting to identify the degree of alexithymia and symbolic function inhibition in two overweight groups (moderately and morbidly obese) and compare the results with a normal-weight control group. The sample was composed of 95 subjects divided into three groups. The results revealed that the two obese groups were generally more alexithymic and had a higher degree of symbolic function inhibition than normal-weight controls. Nevertheless, the two alexithymia measures used in this study disclosed inconsistent results. The data are discussed in terms of etiological, methodological and treatment implications.     

Medullary carcinoma of the thyroid metastatic to breast.

Medullary carcinoma of the thyroid commonly spreads to the lymphatics and later on in the disease process, to distant sites such as lung, liver and bone. Spread to the breast is rare (only two previous reported cases) and presents a major diagnostic dilemma. We report a case of metastatic medullary carcinoma of the thyroid which presented as a primary breast nodule with ipsilateral axillary lymphadenopathy. Clearly it was important to distinguish this tumour from a breast primary as each are managed differently. Both cytological and radiological investigations were inconclusive but excision biopsy was diagnostic.     

Optometrists Association Australia Universal (entry‐level) and Therapeutic Competency Standards for Optometry 2008

Background: Competency standards for entry‐level to the profession of optometry in Australia were first developed in 1993, revised in 1997 and expanded in 2000 to include therapeutic competency standards. The entry‐level standards cover the competencies required by a person entering the profession without therapeutic endorsement of their registration. The therapeutic competency standards address the additional competencies required for therapeutic endorsement of registration. This paper presents a revised version of the universal (entry‐level) and therapeutic competency standards for the profession of optometry in Australia in 2008. Methods: Expert members of the profession and representatives from schools of optometry, registration boards in Australia, state divisions of Optometrists Association Australia and the New Zealand Association of Optometrists were consulted in the process of updating the standards. Results: Three new elements of competency have been added to the standards. Twenty‐three new performance criteria with associated indicators have been added. Some performance criteria from the earlier document have been combined. Substantial alterations were made to the presentation of indicators throughout the document. The updated entry‐level (universal) and therapeutic competency standards were adopted on behalf of the profession by the National Council of Optometrists Association Australia in November 2008. Discussion: Competency standards are used by Australian and New Zealand registration authorities for the purposes of registration and therapeutic endorsement of registration via the Optometry Council of Australia and New Zealand accreditation and assessment processes. They have also been used as the basis of the World Council of Optometry Global Competency‐Based Model.     

Myocardial visualization on a perfusion lung scan

Myocardial activity was noted on a lung scan performed following the i.v. administration of Tc-99m macroaggregated albumin. The patient had primary pulmonary hypertension with a right-to-left shunt through a functionally patent foramen ovale.     

The effects of maternal age and parity on birthweight: a population-based study in New York City

New York City birth certificates for singletons born from September 1-December 31, 1981 (N = 36,056) were analyzed using multivariate regression techniques. The effects of maternal age and parity on birthweight were assessed. There was a significant progression of birthweight with advancing age. Birthweight similarly increased from parity 1 to parity 3, but dropped markedly in the higher parity groups. On stratification by gestational age, we found that age and parity influence birthweight by affecting fetal growth rather than the length of pregnancy.     

Diurnal variations of corneal topography and thickness

Measurements of central and peripheral corneal thickness, corneal topography, and central corneal curvature were made for 21 subjects at hourly intervals for 12 hr of 1 day for each subject. Values for corneal radius and asphericity were obtained from keratometry and photokeratoscopy, and their stability throughout the day was evaluated. Corneal radius was observed to steepen during the day, whereas asphericity remained constant. Corneal thickness was measured by pachometry and was found to be at its thickest on first awakening. Corneal curvature and central corneal thickness were highly correlated; low correlation was found between corneal asphericity and central corneal thickness. Some subjects exhibited large fluctuations in one or all of the parameters considered.