Quality of life following percutaneous transluminal angioplasty for claudication

Basal cell carcinoma (BCC) is the most common type of skin cancer and the incidence of BCC is expected to rise, with increased demand on dermatology resources. Little is known of the effect on people's lives of having skin cancer. The aim of this study was to quantify the handicap caused gy basal cell carcinomas before and after therapy. Forty-four patients (22 males, mean age = 65 yrs, range = 35-81 yrs) with 48 BCCs were recruited and 37 patients completed the study. Each patient completed the UK Sickness Impact Profile (UKSIP) and the Dermatology Life Quality Index (DLQI) at the initial visit to the dermatology clinic, 1 week after treatment and 3 months after treatment. Lesions had been present for a mean of 25 months (range = 1-240 months), their mean diameter was 9.6mm (range = 3-35mm) and the sites were head and neck (79%), trunk (17%) and limbs (4%). There was no relationship between the quality of life score and size of lesion. Overall the scores at presentation were very low, rising 1 week after treatment and falling to below the initial scores at 3 months (mean UKSIP 0.4%, 0.7%, 0.13%; mean DLQI 5.3% 8.7%, 1.2%). BCCs cause little handicap. This may explain the delay in seeking medical attention and should be considered in planning public health education about BCCs.     

As number of patients grows, so do critical problems facing MDs who provide dialysis

The growth in the number of dialysis patients in Canada is causing a critical shortage of resources. The low transplantation rate and an increase in the number of patients, combined with insufficient funding to expand facilities, threatens access to the expensive but life-sustaining therapy. Michel Martin, who recently underwent a kidney transplant, looks at the situation facing dialysis patients in Quebec and Ontario.     

Rupture or stress injury of the flexor tendon pulleys? Early diagnosis with MRI

In node-positive breast carcinoma, the presence of tumour cells in the efferent vessels (EV) of the axillary nodes (positive EV status) was shown to be of poor prognosis in 1979. Later the presence of nodal micrometastases was also related to survival. This report describes a new subgroup in this system that is of potential therapeutic interest. It consisted of the 40% of the EV-positive cases with micrometastases (< 0.2 cm2) in their nodes, in addition to nodes with macrometastases. In them the difference in prognosis associated with EV status no longer held. Their prognosis did not differ markedly from that in the EV-negative patients. In the absence of such 'additional' micrometastases, the prognostic difference was still highly significant. There was also some indication that the presence of micrometastases consisting of embolic tumour growth alone may be associated with early death in EV-negative cases, in keeping with the prognosis in cases with lone micrometastases.     

Enhancement Effects in the Percutaneous Absorption of Alprazolam Through Human Skin in vitro

The enhancement effects of some chemicals on the percutaneous absorption of alprazolam through human skin was investigated in vitro. Linoleic acid, oleic acid, Comperlan F® (linoleic acid diethanolamide), Comperlan KD® (coconut fatty acid diethanolamide) and Ethomeen C12® (bis-(2-hydroxyethyl)cocamine) were evaluated for their enhancing effect either as neat solvents or combined with propylene glycol. The effects of skin pretreatment with the enhancers on the percutaneous absorption of alprazolam from a drug suspension in an aqueous gel were also investigated: skin pretreatment with some enhancers has shown potentially interesting aspects. The determination of alprazolam partitioning into untreated and pretreated horny layer supported the idea that, with oleic and linoleic acid, a contribution to the modification of the diffusional resistance of the skin was given by an increase of the drug solubility in the stratum coraeum.     

Effect of crack-growth mechanism on the prediction of fracture load of adhesive joints

This paper presents observations regarding the cracking behavior of tensile-loaded structural adhesive joints. Experiments showed that fracture occurred by the development and propagation of a damage zone, rather than a single, sharp crack, and that the presence of the adhesive spew fillet did not affect the fracture load of the adhesive joints studied. For joints bonded with the mineral-filled epoxy Cybond 4523GB (American Cyanamid), there was approximately 5 mm of subcritical crack propagation prior to final fracture. Fracture-load predictions based on the initial uncracked geometry made in previous papers were unaffected by this small change in geometry. For joints bonded with the rubber-toughened epoxy Permabond ESP 310, approximately 50 mm of subcritical crack propagation was observed. It was again found that predictions made in previous papers on the basis of the initial geometry gave a good estimate of the final fracture load even though this subcritical crack propagation significantly altered the geometry, and thus the applied energy release rates. The effect of shear deformations of the adherends was also investigated, and it was found that shear deformations could be neglected in engineering calculations for joints subject to remote tensile loading.