Patient perceptions of clear/almost clear skin in moderate-to-severe plaque psoriasis: results of the Clear About Psoriasis worldwide survey.

BACKGROUND: Therapeutic advances have made the achievement of clear/almost clear skin possible for many patients with moderate-to-severe plaque psoriasis. OBJECTIVE: To determine patient perceptions of the impact of psoriasis and of attaining clear/almost clear skin. METHODS: Global survey of patients with moderate-to-severe psoriasis. RESULTS: A total of 8338 patients from 31 countries participated. The majority (57%) had not achieved self-assessed clear/almost clear skin with their current therapy, and 56% of those who had not met this goal believed it would be impossible to do so. Among the patients who had clear/almost clear skin, 73% had not initiated their current treatment until >1 year after psoriasis diagnosis, and 28% had to wait >5 years. Eighty-four percent of all respondents experienced discrimination and/or humiliation due to psoriasis, and many reported negative effects on work, intimate relationships, sleep and mental health. Patients without clear/almost clear skin reported that such achievement would open new possibilities, such as swimming (58%), a wider choice of clothing (40%), and meeting new people (26%). A limitation of this study, as with any survey-based research, is that selection and recall bias may have been present. Additionally, respondent definitions of clear/almost clear skin were subjective and may have varied. CONCLUSION: Despite the importance of clear/almost clear skin to psoriasis patients, most are still not achieving it, and many are unaware it is possible.

Unilateral or single-session bilateral surgery for correction of medial patellar luxation in small dogs: short and long-term outcomes.

OBJECTIVE: To compare complication rates as well as the short and long-term function of surgical limbs in small dogs with bilateral medial patellar luxation (MPL) undergoing unilateral or single-session bilateral surgery. METHODS: Dogs weighing less than 12 kg with bilateral MPL that underwent unilateral (group U) or single-session bilateral surgery (group B) were retrospectively analysed. Data analysed included signalment, grades of luxation, surgical procedures, duration of surgery and anaesthesia, use of antibiotic medications, hospitalization time, complications, function at short-term follow-up, bone healing, and long-term assessment of function by means of a questionnaire. RESULTS: Twenty-four dogs were included in group U and 27 in group B. Groups were similar in signalment and procedures performed. No significant difference was found in overall, minor, and major complication rates between Group U and Group B, nor in the short and long-term function of surgical limbs. Nine out of 21 dogs developed clinical signs on the contralateral stifle in Group U, of which only three underwent corrective surgery. CLINICAL SIGNIFICANCE: Single-session bilateral surgery could be offered for dogs with bilateral MPL with complication rates and function of operated limbs similar to unilateral surgery.

Globalization and modernization: an obesogenic combination.

Animal research has well established that a link exists between variations in corticosteroids and the proneness to excess body fat accumulation. Accordingly, it is known that adrenalectomy is an efficient approach to counteract weight gain in most animal models of obesity. In humans, the association between variations in corticosteroids, its stress-related environmental effects and the predisposition to obesity is more difficult to demonstrate. In this paper, we propose that this relationship is accentuated by globalization and modernization which favour a labour context imposing additional stress and changes in life habits promoting a positive energy balance. Our main hypothesis is that the increase in knowledge-based work, and the decrease of quality and duration of sleep both induce an increase in cortisolaemia and glycaemia instability, which results in an increase in food intake, a reduction in energy expenditure and body fat gain. The authors of this paper believe that, from a socioeconomic perspective, globalization leads every nation of the world in conflict with itself and may consequently represent a real problem. On one hand, there are preoccupations related to productivity and money making. On the other hand, people have to adopt a daily lifestyle leading to hyperphagia and decreased energy expenditure in order to maintain their economic competitiveness.

Comparison of trot kinetics between dogs with stifle or hip arthrosis.

The purposes of this study were: 1) to describe and compare the trotting gait of normal and lame dogs secondary to stifle (GONOA) or hip (COXOA) osteoarthritis (OA) using multiple ground reaction forces (GRF) parameters, and 2) to pinpoint any characteristic in gait profile ('signatures') which could help to discriminate a lameness secondary to GONOA or COXOA. Fifty-one large breed dogs with OA (19 GONOA, 32 COXOA) and 22 normal dogs were included in the study. The vertical and cranio-caudal (braking-propelling) GRF were collected. The total stance time, and for each orthogonal vector, the peak force, impulse, time to peak, and the rate of limb loading were recorded. Vertical and craniocaudal forces were found to be significantly decreased in both OA groups compared to normal dogs. Vertical, cranial and caudal limb loading were also most often lower for both OA groups. In addition, the vertical and cranial forces were significantly lower in dogs with GONOA compared to COXOA and normal dogs. This study has demonstrated that, at a trotting gait, OA dogs secondary to GONOA and COXOA load their affected limb, brake and propel earlier during the stance phase, but generally with less magnitude than normal dogs. Dogs affected by GONOA also present more severe gait alterations than dogs with COXOA. The vertical and braking specific GRF alterations described may be kinetic 'signatures' linked more to lame dogs secondary to GONOA versus COXOA. Finally, this study has also provided useful baseline GRF data for further clinical and research investigations.