An exploratory study of challenges and successes in implementing adapted family-based treatment in a community setting

Abstract

Although family-based treatment (FBT) is accepted as the first-line treatment for adolescent anorexia nervosa, studies show that it is infrequently used by clinicians in community settings. To elucidate some of the barriers to implementing this evidence-based treatment, mixed (quantitative and qualitative) methods were used in this exploratory study to examine therapist experiences with FBT. Twelve clinicians (N = 12) at a community treatment center retrospectively reported on their experiences with FBT training and supervision in FBT. A subset of clinicians (n = 7) additionally completed a structured interview about their experiences in using FBT. Results demonstrate that therapists endorsed certain common misconceptions about FBT prior to training, but that negative beliefs about FBT decreased after its implementation in their setting. These findings suggest that increased education about evidence-based treatments may diminish negative stereotypes about such treatments, which may ultimately increase their uptake in community settings. Sustainability of FBT is discussed in the context of how this community setting incorporated FBT principles into their ongoing clinical practice.

http://bit.ly/2GDF2pi

The relationship between self‐esteem and hair transplantation satisfaction in male androgenetic alopecia patients

Summary

Background

Frustrated with the embarrassing appearance, patients with androgenetic alopecia (AGA) suffer from poor quality of life and low self‐esteem. Moreover, several researches indicate that self‐esteem is an important factor affecting outcomes of cosmetic surgery.

Objective

This retrospective study aims to investigate the impact of hair transplantation on patients' self‐esteem and satisfaction with appearance, as well as relationship between self‐esteem and patient satisfaction which includes preoperative and postoperative satisfaction.

Methods

The preoperative and 9‐month postoperative self‐esteem were evaluated by Rosenberg Self‐Esteem Scale (RSES), and preoperative satisfaction indicators (satisfaction with appearance, visual age and expected visual age) were assessed by Face‐Q scale. At the same time, postoperative satisfaction indicators (satisfaction with appearance, visual age, satisfaction with decision, psychological well‐being, and social function) were reevaluated as well.

Results

Of the 1106 male AGA patients, 875 completed a 9‐month postoperative questionnaire. Compared with preoperative scores, postoperative scores of self‐esteem and satisfaction with appearance showed an increase of 1.56 and 30.25 respectively (P < 0.05). Subgroup analysis showed that patients with high self‐esteem level trended to have higher scores of postoperative satisfaction with appearance (P = 0.129), psychological well‐being (P = 0.168), social function (P = 0.027), and satisfaction with decision (P = 0.043) compared with patients with low and average self‐esteem level.

Conclusion

Hair transplantation significantly elevated self‐esteem level and increased satisfaction with appearance of AGA patients. Meanwhile, patients with low self‐esteem level trended to have worse postoperative satisfaction. Thus, apart from ensuring the quality of operation, plastic surgeons should offer guidance based on patients' psychological state to improve postoperative satisfaction.

http://bit.ly/2BBGzqa

Inflammation and allergic disease: An irrefutable combination

http://bit.ly/2SgEJSx

A cross-sectional study of the prevalence of food allergies among children younger than ages 14 years in a Beijing urban region

http://bit.ly/2Ad4egu

Clinical updates in aspirin-exacerbated respiratory disease

http://bit.ly/2SjuOM0

New and evolving therapies for hereditary angioedema

http://bit.ly/2AeCect

Update on peanut allergy: Prevention and immunotherapy

http://bit.ly/2SgEJC1

Clinical burden of asynchrony in patients with asthma when using metered-dose inhalers for control

http://bit.ly/2AfedSz

Effect of inhaled corticosteroids on serum periostin levels in adult patients with mild-moderate asthma

http://bit.ly/2SgEGGl

Systemic reaction rates with omalizumab, subcutaneous immunotherapy, and combination therapy in children with allergic asthma

http://bit.ly/2AgWb2i

Anaphylaxis risk factors for hospitalization and intensive care: A comparison between adults and children in an upstate New York emergency department

http://bit.ly/2SgEEyd

A cross-sectional, population-based survey of U.S. adults with symptoms of chronic rhinosinusitis

http://bit.ly/2AdK0mR

Direct oral amoxicillin challenge without preliminary skin testing in adult patients with allergy and at low risk with reported penicillin allergy

http://bit.ly/2SkxJ7s

Pearls and pitfalls of food challenges in infants

http://bit.ly/2AgW5Yu

For the Patient

http://bit.ly/2SiR1tJ

Abstracts presented at the New England Society of Allergy, October 20‐21, 2018, Plymouth MA

http://bit.ly/2AeC9FH

Multivector functioning muscle transfer using superficial subslips of the serratus anterior muscle for longstanding facial paralysis

Various donor muscles have been identified for restoring facial function due to longstanding facial paralysis. Donor muscles, such as the gracilis and latissimus dorsi, are frequently used and often produce one or two reliable vectors of force. There are drawbacks to using these muscles including the instability of separating multivector functioning muscle units and limited amount of muscle contraction. Serratus anterior muscle transfer has the advantages of multiple independently functioning motor units that can be created with a single neurovascular pedicle.

http://bit.ly/2SjmN9S

Building a scale for measuring burden of hand eczema: BoHEM

Publication date: Available online 23 December 2018

Source: Journal of the American Academy of Dermatology

Author(s): François Maccari, Khaled Ezzedine, Anne Claire Fougerousse, Stéphanie Mérhand, Charles Bordet, Caroline Jacobzone, Charles Taieb

http://bit.ly/2Acz60V

Use of a prognostic gene expression profile test for T1 cutaneous melanoma: will it help or harm patients?

Publication date: Available online 23 December 2018

Source: Journal of the American Academy of Dermatology

Author(s): Michael A. Marchetti, Edmund K. Bartlett, Stephen W. Dusza, Christopher K. Bichakjian

http://bit.ly/2ScWj9X

Physical characterization of the hair of Mexican women

Abstract

Hairs collected from 257 Mexican women, residing in Mexico City, were characterized by instrumental measurements for comparison to more‐commonly reported Caucasian, Asian and African hairs. Subjects were subdivided into 5 age groups and their hairs were characterized by fiber dimension, shape and tensile strength. Results show that Mexican hair appears to be intermediate of Asian and Caucasian hair in diameter and cross‐sectional ellipticity. Such findings seem in line with the early and late ethnic origins of Mexican people. Results also illustrate and confirm the large intra and inter‐individual variability within any single hair property. Unexpectedly high levels of hair tensile damage were sometimes encountered.

This article is protected by copyright. All rights reserved.

http://bit.ly/2QJvuxD

Exploring the Emotional and Behavioural Reactions to Receiving Personalised Melanoma Genomic Risk Information: A Qualitative Study

Summary

Background

There is a need for greater understanding of the spectrum of emotional and behavioural reactions that individuals in the general population may experience in response to genomic testing for melanoma risk.

Objectives

To explore how individuals in the general population respond to receiving personalised genomic risk of melanoma.

Methods

Semi‐structured interviews were undertaken with 30 participants (aged 24‐69 years, 50% female, 12 low‐risk, 8 average‐risk, 10 high‐risk) recruited from a pilot trial in which they received personalised melanoma genomic risk information. We explored participants' emotional and behavioural responses to receiving their melanoma genomic risk information. The qualitative data were analysed thematically.

Results

Many participants reported a positive response to receiving their melanoma genomic risk, including feelings of happiness, reassurance and gaining new knowledge to help manage their melanoma risk. Some participants reported short‐term negative emotional reactions that dissipated over time. Most individuals, particularly those who received average or high‐risk results, reported making positive behaviour changes to reduce their melanoma risk. Emotional and behavioural responses were linked to participants' expectations for their risk result, their pre‐existing perception of their own melanoma risk, their existing melanoma preventive behaviours and their genomic risk category.

Conclusions

Personalised melanoma genomic risk information alongside education and lifestyle counselling is favourably received by people without a personal history and unselected for a family history of melanoma. Participants described increased knowledge and awareness around managing skin cancer risk and improved sun protection and skin‐examination behaviours. Any initial feelings of distress usually dissipated over time.

This article is protected by copyright. All rights reserved.

http://bit.ly/2rQTrnG

A randomised controlled proof‐of‐concept trial of digoxin and furosemide in adults with cutaneous warts

Summary

Background

Topical Ionic Contra‐Viral Therapy (ICVT) comprised of digoxin and furosemide inhibits the potassium influx on which DNA viruses rely for replication. Therefore, ICVT was hypothesised to be a potential novel treatment for cutaneous warts.

Objectives

To assess clinical efficacy, safety and tolerability of ICVT in adults with cutaneous warts. Secondary objective was to gain insight into underlying working mechanism of ICVT.

Methods

Treatment with ICVT was assessed for efficacy, safety and tolerability in a single‐ centre, randomised, double‐blind, placebo‐controlled phase 2A trial. Eighty adult subjects with at least 2 cutaneous warts (plantar or common) were randomised to one of 4 treatments: digoxin + furosemide (0.125%), digoxin (0.125%), furosemide (0.125%) or placebo and administered the gel once daily for 42 consecutive days. Pre‐defined statistical analysis was performed with a mixed model analysis of covariance.

Results

Wart size and HPV load reduction was achieved in all active treatment groups. A statistically significant reduction in wart diameter of all treated warts was shown in the digoxin + furosemide treatment group versus placebo (‐3.0mm; 95% CI ‐4.9 to ‐1.1mm; p=0.002). There was a statistically significant reduction in HPV load of all treated warts in the digoxin + furosemide group compared to placebo (‐94%; 95% CI ‐100 to ‐19; p=0.03). With wart size reduction, histologically and immunohistochemically defined viral characteristics disappeared from partial and total responding warts.

Conclusions

This study demonstrates proof‐of‐concept for the efficacy of topical ICVT in adults with cutaneous warts.

This article is protected by copyright. All rights reserved.

http://bit.ly/2LBinsI

Naevoid acanthosis nigricans or RAVEN (rounded and velvety epidermal naevus) and mosaic FGFR3 and FGFR2 mutations

Abstract

we read with interest the article by Larsabal et al.¹ describing two cases of RAVEN (rounded and velvety epidermal naevus) or naevoid acanthosis nigricans (NAN) associated with mosaic p.Arg252Asn FGFR3 and p.Ser252Trp FGFR2 mutations, adding to a probable case of RAVEN/NAN with comedones linked to the previously reported p.Ser252Trp FGFR2 mutation.² In the past two years, we had the opportunity to perform molecular analysis for FGFR2 and FGFR3 in seven unrelated patients with RAVEN/NAN and wish to add our experience.

http://bit.ly/2rPAulp