A study of Internet searches for medical information in dermatology patients: The patient-physician relationship.

BACKGROUND: The use of the Internet to search for medical information is considered by some physicians as an invasion of their medical domain and a reflection of a lack of trust in their advice and recommendations. OBJECTIVE: The main objective of this study was to estimate the amount of medical information gathered from the Internet and to establish whether these online searches reflect a lower degree of patient satisfaction. PATIENTS AND METHODS: A survey was conducted among 175 patients seen at the melanoma and psoriasis units of San Cecilio University Hospital in Granada, Spain between May 2010 and December 2011. RESULTS: Online searches for medical information were performed by 44.4% of patients who returned correctly completed questionnaires. The main reasons given for these searches were to complement appropriate information provided by the physician (67.3%) and to gather information before consultation with the physician (36.5%). Variables associated with the search for medical information on the Internet in the multivariate analysis were a higher educational level, a higher score on two items in the Need for Cognition Scale, and consultation of mass media other than the Internet. LIMITATIONS: Studies with larger numbers of patients and other diseases, however, are required to confirm these results. CONCLUSIONS: The search for medical information is a widespread reality among patients with psoriasis and melanoma and it is not associated with a poor relationship with the physician. Dermatologists can play a beneficial role by recommending trustworthy Internet sites during the patient's visit and by promoting the development of pages by scientific societies to provide high-quality information.

Descriptive analysis of the economic costs of periprosthetic joint infection of the knee for the public health system of Andalusia.

This study offers a descriptive analysis of the economic costs of Periprosthetic joint infection (PJI) of the knee for the public health system of Andalusia (Spain) The data are based on consecutive patients with PJI treated in our Bone and Joint Infection Unit between January 2005 and January 2010. The total cost for all patients with knee PJI was 4,151,843 $ (3,202,841 €), i.e., a mean cost per patient of 52,555 $ (40,542 €). The mean cost per patient was 24,980 $ (19,270.80 €) for patients with early PJI and rose to 78,111 $ (60,257 €) for those with late PJI. The main cost was for the hospital stay and the specific in-hospital care received, followed by the cost of the surgical procedure.

Lipid levels in patients with lichen planus: a case-control study.

BACKGROUND: Cardiovascular risk factors have been assessed with some skin diseases such as alopecia and psoriasis. Recently, a case-control study found that lichen planus (LP) was associated with dyslipidaemia in a large series of patients. However, no data were presented about lipid values in patients and controls. OBJECTIVE: The objective of this case-control study was to evaluate lipid levels in men and women with lichen planus and in healthy controls, excluding lichenoid drug eruption and treatment for LP such as systemic corticosteroids, retinoid acid or methotrexate. PATIENTS AND METHODS: This case-control study included 160 patients, 80 with LP (40 men and 40 women) and 80 controls consecutively admitted to the outpatient clinic in Dermatology department of San Cecilio Hospital, Granada, Spain. RESULTS: Patients with LP presented higher significant triglycerides values (145.9 vs. 101.5 mg/dL P = 0.0007), total cholesterol values (197.7 vs. 178.4 mg/dL P = 0.001), LDL-C values (120.8 vs. 100.9 mg/dL P < 0.0001) and lower HDL-C values (55.3 vs. 61.9 mg/dL P = 0.004) vs. controls. Adjusted OR for dyslipidaemia in patients with LP was 3.03 (95% confidence interval: 1.49-6.17, P = 0.002). CONCLUSION: The results obtained in this study indicate an association between LP and dyslipidaemia. Lipid levels screening in men or women with LP may be useful to detect individuals at risk and start preventive treatment against the development of cardiovascular disease.

A 5-year-old boy with comedo-like lesions on the right buttock.

A healthy, 5-year-old boy presented with cutaneous lesions on the right buttock, evident at birth. A physical examination revealed plugged pores in a linear distribution with the appearance of comedones and scar areas. Histopathological exam revealed multiple atrophic cystically dilated hair follicles containing abundant keratinous debris and small projections of epithelial cells extending from the wall of the cyst into the surrounding dermis, compatible with nevus comedonicus.

Hypertension and aldosterone levels in women with early-onset androgenetic alopecia.

BACKGROUND: Few studies have analysed the relationship between androgenetic alopecia (AGA) in women and cardiovascular disease. There is reported to be an elevated prevalence of hypertension among men with AGA, and it has been proposed that both phenomena may be explained by the presence of hyperaldosteronism. However, no data on blood pressure (BP) and aldosterone levels in women with AGA have been published to date. OBJECTIVES: The objective of this study was to evaluate aldosterone levels and the presence of systolic and diastolic hypertension in women with early-onset AGA and in healthy controls. PATIENTS AND METHODS: This case-control study included 40 women with AGA and 40 healthy controls from the Department of Dermatology of San Cecilio Hospital, Granada, Spain. RESULTS: Patients with AGA showed significantly higher systolic BP values (139.43 vs. 107.80 mmHg; P < 0.0001), diastolic BP values (87.65 vs. 67.48 mmHg; P < 0.0001) and aldosterone levels (249.55 vs. 155.14 pg mL(-1); P = 0.002) vs. controls, respectively. A positive correlation between aldosterone levels and systolic and diastolic BP values is described. CONCLUSIONS: A higher prevalence of hypertension in women with AGA has been found. The elevated aldosterone values in these patients may contribute, alongside other mechanisms, to the development of AGA and may also explain the higher prevalence of hypertension. BP screening of women with AGA will permit earlier diagnosis of an unsuspected hypertension and initiation of appropriate treatment.