OVERHEATING IN BED AS AN IMPORTANT FACTOR IN MANY COMMON DERMATOSES

Background. Extensive questioning of patients with a wide variety of skin disorders led to the impression that nocturnal overheating was probably an important factor in the initiation and the perpetuation of many skin disorders. Methods. In order to test the hypothesis, 12 “clean-skinned” subjects (6M/6F) aged 18 to 45 years were monitored electronically every 30 seconds during an 8 hour sleep period (2300 to 0700 hours), sleeping under a standard 10 tog duvet. Results. All the subjects were too hot by 3 to 4°C. All showed changes in their EEG patterns with reduced REM sleep, increased awakenings, and all showed changes in their sleep stage patterns. In addition, they all showed evidence of increased sweating in the “heat-sink” area. Conclusions. The mechanisms where by such changes could be implicated in the precipitation and perpetuation of skin disease are discussed. “Lifestyle” modification as a very effective, noninvasive, therapeutic regime is recommended. Further research along these lines would probably be very valuable and instructive.     

Dermatomyositis in a patient with high grade papillary urothelial carcinoma of urinary bladder

Inflammatory myopathies like dermatomyositis are associated with increased incidence of malignancies. This association has been commonly reported with malignancies of ovaries, gastro‐intestinal tract, breast and non‐Hodgkin's lymphomas but occurrence of dermatomyositis with bladder cancer has been rarely reported. We report a patient with carcinoma bladder who developed dermatomyositis while being treated for the bladder cancer.     

VENTILATORY EFFECTS OF LAPAROSCOPY UNDER GENERAL ANAESTHESIA

We have studied 14 female patients undergoing elective laparoscopyunder general anaesthesia with peritoneal insufflation of carbondioxide in order to examine changes in physiological deadspace(\/D^phys), arterial to end-tidal carbon dioxide partial pressuredifference (Pa_CO2-PE'_CO2) and Pa_CO2. V_CO2 increased after insufflationof carbon dioxide with a mean (SD) maximum increase of 32 (28)% compared with thepreinsufflation value. Pa_CO2increased also,with a mean (so) maximum increase of 0.6 (0.58) kPa immediatelybefore carbon dioxide deflation. VD^phys and (Pa_CO2- PE_CO2) increasedduring laparoscopy, but this was not significant (P > 0.05).