Pictorial representation of illness and self measure (PRISM): an effective tool to assess the burden of psoriasis.

BACKGROUND: Psoriasis has a negative impact on patient's' quality of life, which may reflect the physical and psychosocial impact of the disease. However, little is known about the perceived burden of disease. Pictorial Representation of Illness and Self Measure (PRISM), a pictorial tool, was developed to measure this global suffering. Capturing quality of life impairments in psoriasis is an integral part of assessing the overall disease severity and planning effective treatment strategies. OBJECTIVE: To validate Pictorial Representation of Illness and Self Measure (PRISM) in psoriasis patients. METHODS: An investigator initiated, prospective cohort study was performed in 108 outpatients with psoriasis to validate PRISM as an appropriate tool; Reliability was assessed in a cohort with controlled stable disease, repeated after 1 hour and after a 3-month follow-up phase; Convergent validity determined by correlation against measures of life quality (DLQI) and reported severity of psoriasis (PASI, PGA and BSA) was performed. RESULTS: For PRISM, we found a high reliability for short-term measurements (ICC = 0.98, P < 0.001) and for follow-up assessments at 3 months (ICC = 0.76, P < 0.001). Our investigation showed significant differences between patients with clear to minimal (PGA 0, 1), mild (PGA 2) and moderate-to-severe disease (PGA 3, 4) and significant (P < 0.001) correlation with DLQI, PGA, PASI and BSA (ρ = -0.62, -0.54, -0.44 and -0.39 respectively). CONCLUSION: PRISM is a highly reliable tool and new approach to assess perceived burden of patients with psoriasis. It is easy to use and we recommend the application as an additional outcome measure in clinical trial settings.

Serum ceruloplasmin as a marker in prostate cancer.

AIM: Serum acid phosphatase and prostate specific antigen have been utilized as disease markers in prostate cancer, one of the commonest cancers of the elderly. Serum ceruloplasmin (Cp) increases in cancer patients; it may be a reliable marker for prostate cancer, but few data are available on specificity and sensitivity of Cp values. METHODS: Serum prostate specific antigen (PSA) and Cp was determined in Greek patients suffering from histologically proven prostate carcinoma or benign hyperplasia. The results were compared with those in controls matched for sex and age. RESULTS: In all studied subjects with a prostate cancer, serum Cp values were higher than age-matched healthy controls; they were also higher in cases with benign hyperplasia. No difference in serum Cp was noted among patients with earlier and advanced stages of the tumor. No difference in Cp was also found between benign hyperplasia and normal controls. There exists a significant difference in serum PSA between both prostate cancer and benign hyperplasia cases. There exists also a difference between benign hyperplasia cases and controls. CONCLUSION: It is suggested that serum Cp may complement the biochemical screening in prostate carcinoma, especially in cases where this cancer is not accompanied by elevation of serum PSA. However, it is not of help in differentiating prostate cancer from prostate benign hyperplasia.

Epidemiologic characteristics of hepatitis A virus infections in Greece.

The major epidemiologic characteristics of hepatitis A virus (NAV) infections in Greece were studied in a sample of 877 Air Force recruits, 19-25 years old coming from every geographic region of Greece. Antibodies to HAV (anti-HAV) were detected by solid phase radioimmunoassay in 83.8% of the recruits. Antibody frequency varied significantly in the various geographic regions of Greece and was inversely related to the size of the community. It was further shown that the prevalence of HAV infection was highly related to the recruit's social class and years of education as well as number of siblings and number of persons per room. These findings in accordance with previous reported data show that hepatitis A is hyperendemic and should be regarded as a childhood infection in Greece. Prevailing socioeconomic, hygienic living and housing conditions should be considered as the main epidemiologic determinants of HAV infections.