A retrospective study of patient outcomes and satisfaction following pinnaplasty.

INTRODUCTION: Up to 5% of all children have prominent ears. Psychological distress and bullying adversely affect these children and can cause significant social exclusion. In times of austerity, cosmetic procedures such as surgical correction of prominent ears are felt to be an unnecessary cost to the health service. MATERIALS AND METHODS: A retrospective case note review of all patients undergoing pinnaplasty was undertaken. Postoperative outcomes were compared against the Royal College of Surgeons of England standards. The Glasgow Benefit Inventory, a validated post-intervention questionnaire, was then posted out to all patients. RESULTS: A total of 72 patients were identified. Average age at procedure was 13 years. Eleven patients were above the age of 19 years. Twenty-eight patients were male and forty-four female. Sixty-two cases underwent bilateral pinnaplasty. No patients developed hematoma, and there were no readmissions within 30 days of surgery. Twenty-nine patients responded to the questionnaire (40%), of whom 27 reported a positive impact on their psychosocial well-being with a mean score of 36. CONCLUSION: Pinnaplasty offers patients an opportunity to alleviate the psychological distress of bullying and harassment secondary to the appearance of prominent ears.

Separation of statistical poly[(N-vinyl pyrrolidone)-co-(vinyl acetate)]s by reversed-phase gradient liquid chromatography.

Although size exclusion chromatography (SEC) has been used successfully to determine the molecular weight distribution (MWD) of statistical poly[(N-vinyl pyrrolidone)-co-(vinyl acetate)]s [PVPVAs], SEC cannot separate the copolymers according to their chemical composition. In this article, the separation of commercial PVPVAs with varying chemical compositions is reported, by aqueous reversed-phase gradient liquid chromatography (RPLC) using polystyrene-divinylbenzene-based wide pore columns. RPLC-SEC cross-fractionation indicates the presence of molar mass dependant effects during RPLC separation due to broad MWD for the copolymer studied; therefore the width of the RPLC peak could not be associated entirely with chemical composition distribution of the copolymer. Coupling of RPLC with online FTIR spectroscopy reveals the increase of VA content with increasing THF gradient, an indication of interaction mechanism between VA repeating units and the stationary phase for water soluble PVPVAs. Separation of water insoluble PVPVAs and PVAs by the RPLC are possibly based on both interaction and precipitation/redissolution mechanisms.

Recovered, in recovery or recovering from substance abuse? A question of identity.

There has always been widespread debate on how people with past substance abuse problems choose to identify themselves with regards to their recovery and the terms used to associate with that identity. Most of the disagreement over these terms is rooted on whether recovery is seen as an ongoing process ("recovering" or "in recovery") or a life event that can be mastered ("recovered"). This article discusses these three controversial terms and attempts to make them available as terms that one can use or identify with by presenting different perspectives on the topic of recovery. Some of these perspectives may be unconventional when compared to traditional views of the recovery process, but they are the realities of many individuals who have had a past experience with substance abuse and may be confronted with prejudice when voicing their recovery in a past tense. The article makes comparisons between the DSM IV and the Big Book of AA and discusses identity vs labels and the influence of the medical community on this controversial topic.

Severe influenza B myocarditis and myositis.

OBJECTIVE: To report an influenza B infection with associated myocarditis and severe skeletal myositis. DESIGN: Case report. SETTING: Cardiac intensive care unit in a university-affiliated children's hospital. PATIENT: A 4-yr-old girl. RESULTS: The patient was successfully supported with extracorporeal membrane oxygenation for profound myocardial dysfunction and a combination of plasmapheresis and continuous venovenous hemodialysis for rhabdomyolysis and acute renal failure. CONCLUSIONS: This case provides a reminder that patients presenting with viral illness or myoglobinuria accompanied by renal failure, with or without associated myocarditis, may be demonstrating symptoms of influenza B.

Iron supplementation increases disease activity and vitamin E ameliorates the effect in rats with dextran sulfate sodium-induced colitis.

Inflammatory bowel disease is often associated with iron deficiency anemia and oral iron supplementation may be required. However, iron may increase oxidative stress through the Fenton reaction and thus exacerbate the disease. This study was designed to determine in rats with dextran sulfate sodium (DSS)-induced colitis whether oral iron supplementation increases intestinal inflammation and oxidative stress and whether the addition of an antioxidant, vitamin E, would reduce this detrimental effect. Four groups of rats that consumed 50 g/L DSS in drinking water were studied for 7 d and were fed: a control, nonpurified diet (iron, 270 mg, and dl-alpha-tocopherol acetate, 49 mg/kg); diet + iron (iron, 3000 mg/kg); diet + vitamin E (dl-alpha-tocopherol acetate, 2000 mg/kg) and the diet + both iron and vitamin E, each at the same concentrations as above. Body weight change, rectal bleeding, histological scores, plasma and colonic lipid peroxides (LPO), plasma 8-isoprostane, colonic glutathione peroxidase (GPx) and plasma vitamin E were measured. Iron supplementation increased disease activity as demonstrated by higher histological scores and heavier rectal bleeding. This was associated with an increase in colonic and plasma LPO and plasma 8-isoprostane as well as a decrease in colonic GPx. Vitamin E supplementation decreased colonic inflammation and rectal bleeding but did not affect oxidative stress, suggesting another mechanism for reducing inflammation. In conclusion, oral iron supplementation resulted in an increase in disease activity in this model of colitis. This detrimental effect on disease activity was reduced by vitamin E. Therefore, the addition of vitamin E to oral iron supplementation may be beneficial.