Search

BACKGROUND: Men between the ages of 20 and 34 years are at highest risk for testicular cancer yet many lack knowledge and confidence in performing self-examination. The Self-Efficacy to Perform Testicular Self-Examination Scale (SEPTSES) is a 7-item questionnaire to be completed by men, which is designed to measure their confidence in self-examining their testicles. The purpose of this methodological study was to determine the validity and reliability of this self-report measure. METHODS: Content validity of the scale and clarity of items were established with a panel of experts. The SEPTSES and three valid scales of related constructs were completed by two samples of men (homeless [n = 150] and non-homeless [n = 156]) aged 18–34 years. RESULTS: A single factor explained 51.5% of the variance of the scale and Cronbach’s alpha was satisfactory (a = 0.84). Construct validity was further supported by significant correlations with the other three scales; further support was established by a significant difference in mean scores between the two samples [t (303) = −5.44, p < 0.001]. CONCLUSION: The SEPTSES is a valid, unidimensional scale and it can be used in further research and in clinical practice as an assessment of this aspect of men’s health.

The limited contact dynamic compression plate and partial contact plate were designed to decrease contact with cortical bone in an attempt to decrease cortical ischemia, remodeling, and eventual porosis under the plate after use of standard dynamic compression plates. This study quantified cortical bone blood flow beneath the plate with these three different designs in a sheep tibia fracture model. In 18 skeletally immature sheep, the right tibia was fractured and then was internally fixed with an interfragmentary screw and a dynamic compression plate, limited contact dynamic compression plate, or partial contact plate. At 12 weeks, cortical bone perfusion was assessed with laser Doppler flowmetry in nine areas beneath the plate. The baseline (before fracture) cortical bone cell flux averaged 100 +/- 60 mV. After fracture, this decreased to 60 +/- 48 mV (p < 0.0003); immediately after plating, the perfusion averaged 29 +/- 25 mV (p < 0.01). Cortical bone perfusion then increased to 106 +/- 52, 165 +/- 71, and 163 +/- 71 mV at 2, 6, and 12 weeks after fracture (p < 0.001 for all when compared with values after plating). No significant differences in cortical perfusion were seen between the types of plate. Cortical porosity under the plate was assessed with digital density analysis of microradiographs of this region. No significant difference was seen between the types of plate in this analysis or in biomechanical and disulphine blue perfusion analysis. Thus, no significant advantage was seen for the new plate designs used in this model. This lack of advantage may be a result of the immature animals used in the study, the protocol for blood flow measurement, the invasive periosteal stripping employed to create the fracture, or all three. However, as advantages with the new plate designs have been seen in other studies, this area warrants further investigation.

Clinical experience with calcipotriene has shown its efficacy in the treatment of psoriasis, both alone1-5and in combination with other agents. This double-blind, placebo-controlled study was designed to provide clinical experience in the United States with once-daily treatment of plaque-type psoriasis with 0.005% calcipotriene ointment. Patients and Methods. Two hundred thirty-five otherwise healthy nonpregnant patients, aged 18 to 86 years (mean, 45.1 years), with stable plaque-type psoriasis covering 5% to 20% of skin surface and showing plaque elevation of at least 4 on a 9-point scale, were entered into a randomized, double-blind, clinical trial of 0.005% calcipotriene ointment applied once a day for 8 weeks. Scaling, erythema, plaque elevation, and physician's global assessment were scored on a 9-point scale. Patients were evaluated at baseline and at weeks 1, 2, 4, 6, and 8 of treatment (Figure 1). Results. Forty percent of patients treated with the active drug and 2.2%

REPORT OF A CASE A 53-year-old woman with Down's syndrome was referred from a nursing home for evaluation of a severe diffuse rash. She had lived in the same institution for nine years. She had a seven-year history of a nonspecific dermatitis and dry skin. Four months previously, she had been treated with lindane lotion on two occasions with minimal benefit. Subsequently, betamethasone diproprionate was applied to the hands and elbows regularly with some improvement until one month previously, when her dermatitis worsened. One week prior to evaluation, a lotion containing triamcinolone acetonide was applied for two days. On the third day her hands became red and swollen. Heavy crusts formed "overnight" on the swollen areas. She developed a diffuse erythroderma within a few days. Allergic contact dermatitis was suspected, and the steroid lotion therapy was discontinued. At the time of our evaluation, her treatment consisted of clear water compresses