Psoriasis in childhood and adolescence: evaluation of demographic and clinical features

BACKGROUND: The present study was aimed to define the gender ratio, familial occurrence, age of onset, precipitating factors, clinical types, nail and joint involvement of psoriasis in childhood and adolescence in Turkey. METHODS: A total of 61 children with psoriasis under 18 years old were evaluated retrospectively, for age, gender, age of disease onset, family history, concomitant disease, the clinical type of psoriasis, clinical localization, nail and joint involvement and treatment modalities. RESULTS: Of the patients, 23 (37.70%) were boys and 38 (62.30%) were girls. Mean age was 9.28 +/- 4.02 years in girls and 11.18 +/- 3.85 years in boys (9.96 +/- 4.03 years in all children). Mean age at the onset of the disease was 6.81 +/- 4.11 years in girls and 7.03 +/- 4.28 years in boys (6.89 +/- 4.14 years in all patients). In 14 (23%) cases, a positive family history was detected. The most frequent probable triggering factors were upper respiratory tract infections (14.8%) and positive throat culture for A group ss-hemolytic streptococcus (21.3%). Frequency of emotional stress and psychiatric morbidity were 54% and 9.8%, respectively. The most frequent localizations at onset were trunk (44.3%), extremities (54.0%), and scalp (36.0%). Three children (4.9%) had a history of dissemination from psoriatic diaper rash. In total, 51 (83.6%) patients presented with psoriasis vulgaris, eight (13.1%) with generalized pustular psoriasis, and the remaining two (3.3%) with erythrodermic psoriasis. CONCLUSION: The incidence of psoriasis among dermatological patients in childhood and adolescence was 3.8%. The disease tends to appear earlier in girls than boys. The authors suggested that stress and upper respiratory infections are the most important triggering factors in childhood and adolescence psoriasis.     

Does prophylactic sotalol and magnesium decrease the incidence of atrial fibrillation following coronary artery bypass surgery: a propensity-matched analysis

Background  

Atrial fibrillation can occur in up to 40% of patients undergoing coronary surgery.     

The Medicare and Clinical Laboratories Improvement Act of 1967 proficiency testing requirements and its relationship to the private sector

The Health Care Financing Administration of the US Department of Health and Human Services is the federal agency that has the responsibility for the administration of the Medicare and Clinical Laboratories Improvement Act of 1967 programs, including the promulgation of standards for clinical laboratories. The Health Care Financing Administration has been working with the Centers for Disease Control of the US Public Health Service to develop uniform standards for proficiency testing programs for the two regulatory programs. The current standards were developed on the premise that a combination of factors, including personnel standards, record-keeping, management requirements, quality control standards, and external quality assurance measures such as proficiency testing, could be used to make decisions on reimbursing facilities for tests or to allow a facility to test in interstate commerce. These programs were regulatory in nature and provided punitive actions for failure to comply with the standards established for participation or licensure. The provision of consultation and training was not the primary focus of the program, even if it was a desirable outcome. The private sector organizations and the regulated industry, on the other hand, viewed their programs as designed for educational and self-improvement purposes rather than for any regulatory or punitive functions. Therefore, the approaches for the regulatory agencies and the professional community have differed.