Risk of connective tissue disease, morphoea and systemic vasculitis in patients with hidradenitis suppurativa.

BACKGROUND: Hidradenitis suppurativa (HS) has been associated with auto-inflammatory conditions, yet the risk of developing connective tissue disease (CTD), morphoea and systemic vasculitis has not been well-characterized. OBJECTIVES: We sought to evaluate the risk of developing CTD, morphoea and systemic vasculitis in patients with HS. METHODS: Using claims data, we identified patients with HS and used 2 : 1 risk-set sampling to identify patients without HS. Patients with existing CTD were excluded. Patient follow-up lasted until first occurrence of the following events: the occurrence of outcome (i.e. systemic lupus erythematosus, morphoea, systemic sclerosis, Sjogren's Syndrome and systemic vasculitis), death, disenrolment or end of data stream. Hazard ratios (HR) of developing CTD, morphoea and systemic vasculitis were computed after 1 : 1 propensity score (PS) matching. RESULTS: After 2 : 1 risk-set sampling, we identified 78 122 HS patients and 156 247 non-HS comparators. The mean follow-up was 540 days. After PS matching, HS patients had an increased risk of systemic lupus erythematosus HR = 1.63 (1.31-2.03) and morphoea HR = 2.02 (1.32-3.11), compared to non-HS patients. We did not observe an increased risk for systemic sclerosis HR = 0.90 (0.59-1.44), Sjogren's Syndrome HR = 0.91 (0.73-1.14) or systemic vasculitis HR = 0.87 (0.64-1.20). CONCLUSION: In this population-based study, we observed an increased risk of developing systemic lupus erythematous and morphoea subsequent to a first-recorded diagnosis of hidradenitis suppurativa.

Dental utilization disparities in a Jewish context: reasons and potential solutions.

UNLABELLED: Demographic discrepancies in dental healthcare utilization and access to care have historically been studied and attributed to such factors as socioeconomic status, race, and ethnicity. Such potential discrepancies and contributing factors amongst the Jewish population have been little explore. OBJECTIVE: To examine the frequency of dental visits among Jewish subgroups and explored possible explanatory factors for differences in dental healthcare utilization, such as financial constraints, dental anxiety, religious perspectives on health, lack of perceived need, poor accessibility, and scheduling conflicts. BASIC RESEARCH DESIGN: Cross-sectional study. PARTICIPANTS: A religiously diverse non-clinical sample of 169 Jews completed measures on demographics, dental visit frequency, dental anxiety, and general religiousness. RESULTS: On average, Orthodox Jews visit the dentist less often than non-Orthodox Jews (OR = 0.43) and Ultra-Orthodox Jews markedly less (OR = 0.23). Moreover, differences between these groups in dental visits were largely mediated by differences in dental anxiety, poor accessibility, lack of perceived need and scheduling conflicts. CONCLUSION: These results identify a population that is at risk for poor oral health and suggests possible preventive and corrective interventions.

Members' Feedback After a Spiritual Group Psychotherapy for Inpatient, Residential, and Intensive Treatment (SPIRIT).

Six hundred and fifty-four inpatients who participated in a spiritual group therapy intervention provided qualitative feedback regarding what helped them and what could be improved. Patients revealed that enjoying a sense of connection with other people and a sense of openness in the groups and simply talking about spirituality with other people was helpful to them. Many group members requested that groups go on for a longer amount of time than 12 sessions, to have longer sessions, and to have more frequent meetings. In addition, members described improvements that could be made to the group, including members' being better screened, leaders preventing individual members from dominating discussions or from being quiet or leaving the group early, and members' wanting more structure as well as more open discussion. The findings highlight the importance of connection, openness, and spirituality when implementing spiritual group interventions in hospital settings. Implications for future research, training, and clinical interventions are discussed.

Hyperglycemia associated with high, continuous infusion rates of total parenteral nutrition dextrose.

A retrospective study was performed to determine whether there is an increased incidence of hyperglycemia in patients not predisposed to hyperglycemia (n = 102) who receive total parenteral nutrition (TPN) dextrose in excess of 4 to 5 mg/kg/min. Of the 37 subjects administered dextrose at > 5 mg/kg/min, 18 exhibited hyperglycemia. None did so who received dextrose at < or = 4 mg/kg/min (n = 19). TPN dextrose infusion rate was positively correlated with blood glucose concentration, over and above other variables considered in a multiple regression, including kcal/kg administered, furosemide or dopamine use, gender, age, or diagnosis. Thus, TPN dextrose infusion rates > 4 to 5 mg/kg/min increase risk of hyperglycemia.

Progressive and self-induced relaxation training: their relative effects on subjective and autonomic arousal to fearful stimuli.

Compared progressive relaxation training (PRT), self-induced relaxation training (SRT), and a rest quietly (RQ) control condition on measures of tonic physiological arousal and phasic physiological and subjective reactions to fearful stimuli. The Mutilation Anxiety Questionnaire was used to identify 48 male and female participants for the two training assessment sessions. Evaluation of tonic reductions in sympathetic arousal indicated: In session one, PRT and SRT were equivalent; in session two, PRT was superior to SRT. Evaluation of subjective response to fearful stimuli favored PRT/SRT over RQ for low, moderately stressful stimuli; PRT was superior to SRT for the most stressful stimuli. An analysis of reported practice between sessions indicated a negative relationship between practice of relaxation skills and response to stressful tonic physiological arousal and attenuating subjective response to stressful stimuli. The interaction between the cognitive and physiological systems and its implication for therapy are discussed.