Background/Aims: Prurigo nodularis (PN) has multiple reported disease associations, and this study analyzes the demographics, clinical distribution and underlying etiologies in an Asian cohort. Methods: A 1-year retrospective study was carried out on PN patients with extensive lesions (≥10) who attended a specialized itch clinic. Results: 37 patients (46% male, median age 53 years) were included. In all patients, an underlying etiologic factor associated with pruritus could be identified. 49% (n = 18) of patients had a single attributable etiology, whilst 51% (n = 19) had multiple etiologies. Among all patients, dermatological disease was the most common cause (82%), of which endogenous eczema comprised the majority of cases (54%), followed by systemic disease (38%). Conclusions: All patients with extensive PN had identifiable factors associated with pruritus in this study, and a dermatological condition was the predominant etiology in both patients with mono- and multifactorial disease. A significant number of patients had underlying systemic causes.
In clinical settings, HIV rapid tests were less sensitive in high-income countries compared with low-income countries, missing about one in seven infections, possibly because of the larger proportion of acute infections in targeted populations. This suggests that in high-income countries, HIV rapid tests should be used in combination with fourth-generation EIA or NAAT tests, except in special circumstances. Prospective Registration of Systematic Reviews registration number CRD42015020154.Supplementary video link: http://links.lww.com/QAD/A924.
Despite offering an effective PNO service in our centre, ultimately only 4% of MSM with syphilis had at least 1 partner notified by the PNO with patients declining the PNO service and anonymous partners posing the major barriers. Alternative patient initiated methods for improving partner notification for syphilis among MSM using newer communication technologies are required.
These data suggest that gonorrhoea prevalence in heterosexual men is low and stable, despite annual increases in notifications. Guidelines in most countries recommend restricting testing to groups or populations with prevalence over 1%, symptomatic individuals or those at increased epidemiological risk. These data indicate gonorrhoea testing should not automatically accompany chlamydia screening in low-risk heterosexual men.
Virtually all bodily functions are controlled by electrical signals in nerves and muscles. Electrical stimulation can restore missing signals but this has been difficult to achieve practically because of limitations in the bioelectric interfaces. Wireless, injectable microdevices are versatile, robust and relatively inexpensive to implant in a variety of sites and applications. Several variants are now in clinical use or under development to perform stimulation and/or sensing functions and to operate autonomously or with continuous coordination and feedback control.
Kinesthesia is a sense of body posture and motion that arises from the interactions among the musculoskeletal system, a rich set of biological proprioceptors and the sensorimotor nervous system that mediates between them. This paper describes implantable sensor modalities to replace normal proprioceptors in feedback control. They can be packaged into miniature, wireless neural stimulators called BIONs. Their digitized signals can be transmitted efficiently to the external control system, which must then mediate between the sensing and stimulation functions in the available set of implants. This interaction will be perceived by the user of the prosthesis through residual sensory modalities such as proprioceptors in muscles and joints still under voluntary control and direct vision, as well as by a sense of effort in issuing commands to the prosthesis. These rich sources of information may be expected to induce a sense of kinesthesia similar that associated with manipulation of mechanically active tools and prosthetic limbs, perhaps obviating the need for more direct presentations of sensory data to the central nervous system.
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