Outcome predictors of platelet-rich plasma injection for moderate carpal tunnel syndrome
Platelet-rich plasma (PRP) injections have been used by doctors to treat carpal tunnel syndrome (CTS), a condition wherein pain is sensed in the hands and fingers when pressure is applied on the wrist nerve. Treatment of mild-to-moderate carpal tunnel syndrome is successful with CTS.
This retrospective study aims to determine the PRP injections' predictive factors in individuals with moderate CTS.
In this study, 71 patients with moderate CTS each received one single PRP treatment. The patients were reviewed at three and six months; with the following results: Visual analogue scale (VAS) score decreases of 50% or less (a good outcome), or a VAS score decrease <50% of pre-injection scores (poor outcome). To identify the predictive variables, a binary logistic regression was applied to significant variables between groups.
The findings were that the baseline body weight (BW), distal motor latency (DML), sensory nerve conduction velocity (SNCV), and cross-sectional area (CSA) of the median nerve were significantly different between the groups in the third month.
In this study, the odds ratios (ORs) of all features were significant, with the exception of SNCV (BW, OR:0.911; P=0.016; DML, OR:0.383; P=0.028; CSA, OR:0.694; P=0.003), which remained significant in the sixth month (BW, OR:0.909; P =0.004; DML, OR: 0.530; P=0.011; CSA, OR:0.828; P=0.032).
In conclusion, for moderate CTS, there are more optimal outcomes following the perineural injection of PRP.
Generalised pustular psoriasis: Quality and readability of online health information
The multisystemic condition known as generalised pustular psoriasis (GPP) can have detrimental repercussions that are possibly fatal. The quality of online health information (OHI) becomes increasingly crucial as the number of patients seeking medical information online increases.
This study is one of the first to examine the quality, comprehensiveness, and usability of online health information for GPP.
Mirroring other earlier research examining OHI, the authors investigate five key search terms for GPP. Two of these were common terms, and three were medical.
For each of the terms searched, the results were evaluated based on HONcode accreditation, an enhanced DISCERN analysis and a number of readability indices. The authors searched 500 websites.
The results showed that 84 of the websites were HONcode-accredited. Mean DISCERN scores of all websites were 74.9% and 38.6% for website reliability and treatment sections, respectively, demonstrating key gaps in comprehensiveness and reliability of GPP specific OHI.
Only 4 out of 100 websites evaluated for readability were written at the NIH-recommended sixth-grade level. The authors noted that the academic websites were significantly more difficult to read than the governmental websites.
In conclusion, results show that there is a gap of patient information, especially for those with lower health literacy who may already be at increased risk of not having access to timely medical care.
Association of homelessness and skin conditions: a Danish population-based cohort study
Previous research studies has shown a direct link between homelessness and an increased risk of skin conditions.
There is a lack of representative studies of diagnosis-specific information on skin conditions in people experiencing homelessness. The aim of this study was to examine the association between homelessness and diagnosed skin conditions, prescribed medication, and type of consultation.
For this cohort study, the authors included data from the Danish nationwide health, social, and administrative registers from January 1 1999, to December 31 2018. Included in this study were people with Danish origin living in Denmark aged at least 15 years. Homelessness was measured by homeless shelter contacts. The inclusion was any diagnosis of a skin disorder and specific skin disorders recorded in the Danish National Patient Register.
The authors evaluated diagnostic consultation type (ie dermatologic, non-dermatologic, and emergency room) and dermatological prescriptions were also studied. There was a total of 5 054 238 individuals included in the study.
The results showed that 759 991 received a skin diagnosis and 38 071 individuals experienced homelessness. A 2·31 times higher IRR of all diagnosed skin conditions were linked with homelessness. This was higher for non-dermatological and emergency room consultations. Homelessness was also associated with a lowered IRR of a skin neoplasm diagnosis compared to those that were not homeless. By end of the study, 2·8% individuals who were homeless had a skin neoplasm diagnosis and 5·1% in individuals that were not experiencing homelessness.
In conclusion, individuals that are experiencing homelessness have ‘higher rates of diagnosed skin conditions, but a lower occurrence of skin cancer diagnosis’.
Stress and its impairment of skin barrier function
The main function of skin is to provide a barrier to water loss and percutaneous penetration of exogenous substances. Any compromise of the skin barrier can lead to dryness, itchiness, or even pathogenic conditions.
The aim of this study was to explore the relationship among psychological stress, skin homeostasis, sleep quality, and emotion.
This prospective observational study was conducted using a random sample of medical students from Shanghai Medical College, Fudan University.
The authors administered a set of questionnaires to participants. These included the validated Chinese version of Pittsburgh Sleep Quality Index (PSQI), the Beck Anxiety Inventory (BAI), and the Beck Depression Inventory-II (BDI). The skin barrier function was determined using the transepidermal water loss (TEWL), hydration of skin. Also collected were dermoscopic images of the nose along with infraorbital skin.
The authors examined emotional state, skin homeostasis, and sleep quality of medical students at different points of the semester. Links between the variables were also explored.
The results of the study highlighted that during the semester, the sleep quality and severity of anxiety of the medical students became significantly worse. The authors noted that this was closely related to the impaired skin barrier function. The authors found that an irregular schedule and stress can aggravate dark circles.
In conclusion, the authors state that psychological stress inflict harm to the skin barrier as a result of poor sleep quality.