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Selected AbstractsEosinophilic fasciitis: demographics, disease pattern and response to treatment: report of 12 cases and review of the literatureINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 1 2008Lindsay Bischoff Senior Medical Student Background, Eosinophilic fasciitis is a rare scleroderma-like illness. The clinical spectrum of the disease has evolved since its initial description. Methods, We identified all patients diagnosed with eosinophilic fasciitis over the past 10 years at our scleroderma clinic. Demographics, disease pattern, serologies, tissue pathology and reponse to treatment were all recorded. Results, Twelve patients with eosinophilic fasciitis were identified in our clinic over the past 10 years. The mean age at diagnosis was 49.8 ± 9.8 years, with nine female and three male patients. The first symptoms were noticed at an average of 8.8 ± 6.1 months before diagnosis. The mean initial absolute peripheral blood eosinophil count was 1188 ± 1059 cells/L. Two patients had a monoclonal gammopathy, and two had positive ANA titers. All patients received corticosteroids, 10 of whom received the equivalent dose of > 20 mg/day of prednisone for more than a month. Five patients received hydroxychloroquine, two received methotrexate, one received cyclosporine, one received topical tacrolimus, and one received sulfasalazine. At a mean follow up of 17.6 months (range 2,94 months), 8 patients had a good response to treatment, 2 patients had no effect, and 2 patients had a poor response to treatment. Conclusion, High dose corticosteroid treatment lasting longer than a month with or without an immunosuppressive agent helped most patients with eosinophilic fasciitis, best results seen in those patients who were initiated treatment early on after their first symptoms. [source] To sample or eradicate?JOURNAL OF APPLIED ECOLOGY, Issue 4 2008A cost minimization model for monitoring, managing an invasive species Summary 1Considerable effort is expended by national and local governments to exclude alien species via detection and eradication of invading populations, but these efforts are not necessarily designed in the most economically or biologically efficient manner. 2Using the invasion of the European strain of the gypsy moth Lymantria dispar into the USA as a case study, we develop an analytical model to determine the optimal trap density for detecting isolated infestations. Most models focus on monitoring or eradication costs only; our model considers the costs of both detection and eradication when determining the best monitoring strategy. 3The model assumes that all isolated populations must be located and eradicated by the conclusion of a programme. For programmes lasting longer than 1 year, it is more worthwhile to proactively monitor and manage rather than to wait until the programme is over. 4For a management programme of a given length, optimal trap density is most influenced by the growth rate of the infestation. Optimal trap densities are lowest for infestations with very low growth rates (because they remain small and therefore are less expensive to eradicate) or very high growth rates (because they are easier to detect), and highest for infestations with moderate growth rates (because they are neither inexpensive to eradicate nor easy to detect). 5Our model is useful in setting a baseline level of monitoring for isolated incidents of gypsy moth invasion. Analysis of data in two US states show that actual trap densities are far higher than the optimal densities from the model. The difference suggests risk aversion may play a role in real systems. 6Synthesis and applications. Our model suggests that we can improve the efficiency of detection and eradication programmes for isolated infestations by optimizing detection effort relative to infestation growth rates and management programme duration. It also clearly demonstrates the importance of balancing the costs and benefits of both detection and eradication when developing invasive species monitoring programmes. [source] Beneficial effect of hyperbaric oxygen on island flaps subjected to secondary venous ischemia,MICROSURGERY, Issue 2 2002Thomas J. Gampper M.D. The potential for hyperbaric oxygen therapy (HBO) to decrease the untoward effects of a secondary ischemic event was studied in the rat superficial epigastric flap model. The secondary venous ischemic flap was created by cross-clamping the vascular pedicles for 2 h. Twenty-four hours later, the flap was reelevated and the venous pedicle was occluded for 5 h. Thirty-two rats were divided into three groups. In experimental group 1, animals received HBO treatment immediately prior to the initial flap elevation and ischemia at 2 atmosphere pressures for 90 min. In experimental group 2, the rats underwent a similar course except for a second 90-min HBO course immediately prior to the secondary venous occlusion. The rats without HBO therapy were used as controls. The results showed that all control flaps were nonviable at 1 week by clinical inspection and fluorescein injection. Complete flap survival occurred in 20% of group 1 flaps and 30.8% of group 2 flaps. Partial flap survival occurred in the rest of the flaps in these two groups, with mean survival areas of 48% and 55%, respectively. In conclusion, HBO treatments significantly increase the survival of flaps subjected to a secondary ischemia, even if administered before the primary ischemia. Administering HBO prior to secondary venous ischemia was marginal, which may be due to the effect of O2 given by HBO not lasting longer than 5 h. © 2002 Wiley-Liss, Inc. MICROSURGERY 22:49,52 2002 [source] Prevalence and impact of musculoskeletal disorders in New Zealand nurses, postal workers and office workersAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 5 2009Helen Harcombe Abstract Objectives: To describe the prevalence, characteristics and impact of musculoskeletal disorders (MSDs) in New Zealand nurses, postal workers and office workers. Methods: A postal survey asked participants about MSDs, (low back, neck, shoulder, elbow, wrist/hand or knee pain lasting longer than one day), and demographic, physical and psychosocial factors. Nurses were randomly selected from the Nursing Council database, postal workers from their employer's database and office workers from the 2005 electoral roll. Results: The response rate of potentially eligible participants was 58% (n=443). Participants were aged 20,59 years; 86% were female. Over the 12 months prior to the survey 88% of respondents had at least one MSD lasting longer than a day and 72% reported an MSD present for at least seven days. Of the 1,003 MSDs reported, 18% required time off work and 24% required modified work duties. In the month prior to the survey 17% of MSDs made functional tasks difficult or impossible. Low back, neck and shoulder pain prevalence did not differ by occupation. Postal workers had the highest prevalence of elbow and wrist/hand pain; nurses of knee pain. Conclusions: The high prevalence of MSDs among these workers indicates that they are indeed in ,at risk' occupations. In each occupational group MSDs encompass a range of anatomical sites, however the overall pattern of MSDs differs by occupation. MSDs have a significant impact on activities at work and home. Implications: Primary and secondary prevention strategies should encompass a range of anatomical sites and specifically target different occupational groups. [source] Healthcare service use in adolescents with non-specific musculoskeletal painACTA PAEDIATRICA, Issue 8 2010Stefano Masiero Abstract Aim:, To estimate occurrence of non-specific musculoskeletal pain in a wide population sample of Italian adolescents, and to investigate their use of healthcare services (seeking of medical attention, referral for diagnostic tests and treatment use). Methods:, We investigated 7542 high-school adolescents (aged between 12 and 16 years) by a structured questionnaire and consisting of personal data, presence of pain, health provider consulted, referral for diagnostic tests and compliance with the prescribed treatments. Results:, In 3399 (45.1%) reported musculoskeletal pain (the most affected sites being the spine and knees), 2525 (74.2%) of whom had sought medical attention. Of the 2525 subjects who had sought healthcare, 1061 (42.0%) had consulted more than one health provider, 2410 (95.4%) had been referred for diagnostic tests, and some form of treatment had been recommended for 2445 (96.8%), but only 1694 (69.2%) had complied with prescribed therapies. The most important factors linked to health seeking behaviour were pain intensity, pain lasting longer than 3 months, injury, interruption to or absence of physical activity and localization in the spine and knee. Conclusion:, Non-specific musculoskeletal pain is a frequent event in Italian adolescents and that a large number of these subjects consult a healthcare service. [source] | ||||||||||