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  • 1
    Electronic Resource
    Electronic Resource
    Treatment outcome and incidence of psychiatric disorders in dermatological out-patients (2003)
    Oxford, UK : Blackwell Science Ltd
    Journal of the European Academy of Dermatology and Venereology 17 (2003), S. 0 
    Details
    ISSN: 1468-3083
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective  Epidemiological studies have shown that the prevalence of psychiatric disorders among dermatological patients is high. We aimed at estimating the short-term incidence of psychiatric disorders among patients with skin disease.Methods  The 12-item General Health Questionnaire (GHQ-12) was used to identify subjects free from psychiatric morbidity at their first dermatological visit. The GHQ-12 was administered again after 1 month during a computer-assisted telephone interview.Results  A total of 277 subjects was included in the study. At the follow-up interview, 21 (7.6%) were found to have significant psychiatric morbidity. Only lack of improvement was associated with increased incidence of psychiatric morbidity (13.6%), with an odds ratio of 3.1 (95% confidence interval 1.2–7.8), after adjustment for gender, age, educational level and clinical severity.Conclusions  Physicians should devote special attention to the risk of psychiatric complications in patients who have not improved with treatment.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1468-3083.2003.00619.x
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  • 2
    Electronic Resource
    Electronic Resource
    Assessing psychological distress in patients with skin diseases: reliability, validity and factor structure of the GHQ-12 (2001)
    Oxford, UK : Blackwell Science Ltd
    Journal of the European Academy of Dermatology and Venereology 15 (2001), S. 0 
    Details
    ISSN: 1468-3083
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: We studied reliability, validity and factor structure of the 12-item General Health Questionnaire (GHQ-12) in dermatological patients.〈section xml:id="abs1-3"〉〈title type="main"〉MethodsSubjects attending a dermatological outpatient clinic were administered the GHQ-12 and the Skindex-29. A random subsample was mailed another copy of the questionnaires to be completed within 1 week.〈section xml:id="abs1-4"〉〈title type="main"〉ResultsA total of 2579 subjects completed the GHQ-12. The internal consistency of the GHQ-12 was high (Cronbach’s α = 0.88). Test–retest reliability on 137 subjects was also fairly satisfactory (intraclass correlation coefficient = 0.72), notwithstanding a re-test artefact probably related to reassurance from the physician. Evidence of construct validity was provided by the pattern of correlation between scores on the GHQ-12 and on the scales of Skindex-29, which were as hypothesized. Also, GHQ-12 scores of patients in different clinical groups varied as hypothesized, with patients affected by inflammatory skin diseases scoring significantly higher than patients with isolated skin lesions. We obtained both a two-factor and a three-factor solution: the latter seemed theoretically more appropriate, although the first may have practical advantages. A ‘social dysfunction’ factor emerged in both analyses, while the other items loaded on a ‘general dysphoria’ factor or on two separate factors interpreted as ‘anxiety’ and ‘loss of self-esteem’.〈section xml:id="abs1-5"〉〈title type="main"〉ConclusionsThe GHQ-12 is a reliable and valid instrument with a factor structure that is quite stable across different samples as well as across diverse cultures. Its brevity and easiness of completion make it a useful tool to assess psychological distress in dermatological patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1468-3083.2001.00336.x
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  • 3
    Electronic Resource
    Electronic Resource
    Equipotentiality of the Amphibian Eye Primordia. (1931)
    [s.l.] : Nature Publishing Group
    Nature 127 (1931), S. 163-164 
    Details
    ISSN: 1476-4687
    Source: Nature Archives 1869 - 2009
    Topics: Biology , Chemistry and Pharmacology , Medicine , Natural Sciences in General , Physics
    Notes: [Auszug] THE experiments referred to below are concerned with the problem of the regulative power of embryonic anlage, the study of which has been taken to prove the equipotentiality of the eye primordia in amphibian embryos in the stages following the closure of the medullary folds. In Pleurodeles ...
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1038/127163b0
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  • 4
    Electronic Resource
    Electronic Resource
    Electron transfer in the Ru(bpy)"3^2^+MV^2^+ system in acetonitrile-water mixtures. Dependence on transfer distance, ionic strength and temperature
    Amsterdam : Elsevier
    Journal of Photochemistry and Photobiology A: Chemistry 51 (1990), S. 179-195 
    Details
    ISSN: 1010-6030
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Chemistry and Pharmacology
    Type of Medium: Electronic Resource
    URL: http://linkinghub.elsevier.com/retrieve/pii/1010-6030(90)87052-D
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  • 5
    Electronic Resource
    Electronic Resource
    The impact of skin diseases on patients: comparing dermatologists' opinions with research data collected on their patients (2003)
    Oxford, UK : Blackwell Science Ltd
    British journal of dermatology 148 (2003), S. 0 
    Details
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary Background Research data suggest that the detection of psychiatric disorders by dermatologists is not completely satisfactory, and that patients and dermatologists often assess patients' quality of life differently. Given that expectations influence perception and cognitia, these discrepancies might at least in part descend from conceptual models of skin disease that are prevalent among dermatologists. Objectives We explored to what degree dermatologists' opinions about quality of life and prevalence of psychiatric disorders in several dermatological conditions corresponded to the actual data collected on their patients. Methods All dermatologists working in a large institution were asked to express on a five-point scale their opinion about the quality of life and the prevalence of depressive and anxiety disorders in different skin conditions. Physicians' opinions were then compared with the results of a large research project on quality of life and psychological well-being in dermatological out-patients performed in their institution some months before. Results Forty-six dermatologists (82%) agreed to participate and completed the research questionnaire. We observed a fairly good concordance between dermatologists' opinion about the impact of the various skin conditions on patients' lives and survey data on quality of life impairment. With regard to psychiatric morbidity, we found that dermatologists believe that psychiatric disorders are substantially less frequent than they actually are in many skin conditions. Conclusions The belief that psychiatric morbidity is rare in patients with certain skin conditions might hamper, at least in part, the recognition of psychiatric disorders in these patients. Dermatologists probably should be more alert to the question of psychiatric morbidity in their patients. Allocating more space to this issue in training programmes for dermatologists might favour a shift in their conceptual models of skin disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2133.2003.05306.x
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  • 6
    Electronic Resource
    Electronic Resource
    Sensitivity of the Dermatology Life Quality Index to clinical change in patients with psoriasis (2003)
    Oxford, UK : Blackwell Science Ltd
    British journal of dermatology 149 (2003), S. 0 
    Details
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary  Background Quality of life is increasingly recognized as an important outcome measure in dermatology. The Dermatology Life Quality Index (DLQI) is a self-administered questionnaire designed to measure the impact of skin diseases on patients' quality of life. Objectives To assess the responsiveness of the DLQI to variations in clinical status as measured by the Self-Administered Psoriasis Area and Severity Index (SAPASI) in a large sample of in-patients with psoriasis. Methods The SAPASI and the DLQI were completed by 359 in-patients with psoriasis at hospital admission and 4 weeks after discharge. Changes in SAPASI scores were used to categorize patients as improved, unchanged or worsened. Next, these groups were compared with one another with regard to the change in DLQI scores. Results Four weeks after discharge, both mean SAPASI scores and mean DLQI scores were significantly lower than at admission (P 〈 0·001). In improved patients, the DLQI score decreased significantly more than in worsened patients (P 〈 0·001), and tended to decrease more than in unchanged patients (P = 0·07). The difference in DLQI score change between improved patients and unchanged or worsened patients grouped together was highly significant (P 〈 0·001); also, it remained significant or nearly significant when the analysis was performed on subsets of patients based on gender and age range. Conclusions This study contributes to building evidence of validity for the DLQI, because the instrument demonstrated the ability to detect small but meaningful changes in clinical status over time in a large sample of patients with psoriasis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2133.2003.05378.x
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  • 7
    Electronic Resource
    Electronic Resource
    Factors associated with patient satisfaction with care among dermatological outpatients (2001)
    Oxford, UK : Blackwell Science Ltd
    British journal of dermatology 145 (2001), S. 0 
    Details
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background It has been shown that poor patient satisfaction can lead to poor adherence to treatment with consequently poor health outcomes. In order to improve the quality of care perceived by the patient and thus the health outcome, it is important to understand which are the main factors influencing patient satisfaction. Objectives To examine factors associated with patient satisfaction with care among dermatological out-patients. Methods This longitudinal study is based on a sample of dermatology out-patients. The independent effects on patient's satisfaction of patient characteristics (sociodemographic characteristics, disease severity, quality of life) and of specific aspects of provided health care (the time the physician spent with patients, physician's interpersonal skills, etc.) were examined by multiple logistic regression. Results A total of 1389 out-patients were selected at random and invited to participate. Of the 722 patients who agreed to participate, 424 fulfilled the inclusion criteria and 396 of these patients (93·4%) completed the study. Overall satisfaction was reported by 60·0% of patients. The likelihood of overall satisfaction was found to be significantly and independently increased by the physician's ability to give explanations and to show empathy for the patient's condition, and by the older age of patients. The likelihood of satisfaction also increased with increasing disease severity, but decreased with symptom-related poor quality of life. The lowest level of satisfaction was found among patients whose symptom-related quality of life was worse than the clinical severity rated by the dermatologist. Conclusions Improving the physician's interpersonal skills can increase patient satisfaction, which is likely to have a positive effect on treatment adherence and health outcomes. Dermatologists succeeded better in establishing a good relationship with clinically more severely affected patients than with patients who were clinically mildly affected despite their quality of life being impaired. Thus, the inclusion of a patient-rated quality of life can be a useful measure in dermatology, as it enables clinicians to perceive the patients' perception of their health status.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2133.2001.04445.x
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  • 8
    Electronic Resource
    Electronic Resource
    Psychiatric morbidity in dermatological outpatients: an issue to be recognized (2000)
    Oxford, UK : Blackwell Science Ltd
    British journal of dermatology 143 (2000), S. 0 
    Details
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background There is a high prevalence of psychiatric disorders in dermatological outpatients. Objectives To estimate the magnitude of this problem and to identify a set of variables associated with the presence of psychiatric disorder. Methods All adults attending the outpatient clinics of a dermatological hospital on predetermined days were given a questionnaire comprising the Skindex-29 and the 12-item General Health Questionnaire (GHQ-12). Results In total, 4268 questionnaires were given at admission, and 3125 were returned. Of these, 546 were blank or incomplete, leaving 2579 respondents (response rate 60·4%). Using a stringent cut-off threshold (≥ 5) for psychiatric case identification with the GHQ-12, scored in the conventional way, the overall prevalence of psychiatric morbidity was 25·2% (95% confidence interval 23·6–27·0%). We found a higher prevalence of psychiatric disorders in women and in widows/widowers, controlling for age. Health-related quality of life was a much stronger predictor of psychiatric morbidity than physician-rated clinical severity. High prevalence rates (〉 30%) were observed among patients with acne, pruritus, urticaria, alopecia and herpesvirus infections, and in subjects without objective signs of dermatological disease. Conclusions Our study has depicted the situation that is actually faced by dermatologists in their everyday practice, where they are in a unique position to recognize psychiatric morbidity and to take appropriate measures. The GHQ-12, being easy for patients to compile and for physicians or nurses to score, may be a practical tool to increase identification of patients with substantial psychological distress or formal psychiatric disorder in order to provide more comprehensive and appropriate intervention.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2133.2000.03831.x
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  • 9
    Electronic Resource
    Electronic Resource
    Antibodies against human herpesvirus 8 in subjects with non-venereal dermatological conditions (2000)
    Oxford, UK : Blackwell Publishing Ltd
    British journal of dermatology 143 (2000), S. 0 
    Details
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background  Human herpesvirus 8 (HHV8) is considered as the infectious cofactor involved in the pathogenesis of Kaposi's sarcoma (KS). Its seroprevalence and modes of transmission in the general population are still undetermined. Objectives We aimed to estimate the prevalence of HHV8 infection in a population at low risk for sexually transmitted diseases. Methods We conducted a seroepidemiological survey on randomly selected individuals attending the dermatology department of a teaching hospital in Rome. Of 257 patients, 248 had their blood analysed for anti-HHV8 antibodies and 201 completed a standardized interview. Serological analysis was performed by an immunofluorescence assay able to detect antilytic antibodies. Results We found an overall seroprevalence of 15·7% (95% confidence interval, CI 11·4–20·9%), similar in men and women (15·1% vs. 16·3%) and higher at older ages. Seropositivity was not related to sexual habits, while it was significantly associated with a history of hepatitis (seroprevalence 34·6%, adjusted odds ratio, OR 4·08, 95% CI 1·52–11·00) and with a diagnosis of non-melanoma skin cancer (42·9%, OR 4·20, 95% CI 1·26–14·02) or atypical naevi (35·3%, OR 6·21, 95% CI 1·85–20·86). Conclusions Our data suggest that a non-sexual mode of transmission of HHV8 infection is plausible in an Italian population at low risk for sexually transmitted diseases and that other factors, besides differences in prevalence of HHV8 infection, may be involved in the epidemiology of classical KS. The unexpectedly high seropositivity rates in subjects with non-melanoma skin cancer and atypical naevi should be viewed with caution and require confirmation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2133.2000.03699.x
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  • 10
    Electronic Resource
    Electronic Resource
    Prevalence of hyperimmunization against tetanus in Italians born after the introduction of mandatory vaccination of children with tetanus toxoid in 1968 (1993)
    Springer
    Infection 21 (1993), S. 80-82 
    Details
    ISSN: 1439-0973
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung In Italien wurde 1968 die Pflichtimpfung der Kinder gegen Tetanus eingeführt. Bei 17,3% von 214 nach 1968 geborenen Personen mit Tetanus-Immunität wurde eine Hyperimmunisierung (〉5 IU/ml) nachgewiesen. Im Vergleich zu einer früheren Studie mit vor 1968 geborenen Personen, bei der sich 10,8% als hyperimmunisiert erwiesen, ist insgesamt ein signifikanter Anstieg (p〈0,01) an Hyperimmunisierungen zu verzeichnen. Bei Aufschlüsselung der Daten nach Regionen findet sich eine signifikante Zunahme an Hyperimmunisierungen in Mittel- und Süditalien (p〈0,01 bzw. 〈0,05), aber nicht in Norditalien. Zu der Größe der Familie (Odds ratio=2,16; C. I. 95%=0,5–7,6) oder den Ausbildungsjahren des Vaters (Odds ratio=1,83; C. I. 95%=0,6–5,3) ergaben sich keine Beziehungen. Zwischen der Stadt- und Landbevölkerung waren keine Unterschiede festzustellen. Die undifferenzierte Routine-Auffrischimpfung gegen Tetanus bei bereits voll Immunisierten in manchen Regionen ist unnötig und mit der Gefahr von Überempfindlichkeitsreaktionen verbunden.
    Notes: Summary Systematic mandatory immunization of children against tetanus was started in Italy in 1968. Prevalence of tetanus hyperimmunization (〉5 IU/ml) was assessed among 214 immune subjects born after 1968 and found to be 17.3%. This figure is significantly higher (p〈0.01) than the 10.8% found in a previous study of subjects born before 1968. This increase is statistically significant in the Center (p〈0.01) and in the South (p〈0.05) of Italy, but not in the North. Hyperimmunization is not associated with family size (odds ratio 2.16; C. I. 95%=0.5–7.6) or the father's years of education (odds ratio 1.83; C. I. 95%=0.6–5.3). No difference was found between urban and rural areas of residence. Indiscriminate administration of booster doses of tetanus vaccine in hyperimmune subjects in some areas could result in unnecessary vaccinations, which can cause hypersensitivity reactions.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01710736
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