Prospective, randomized, double-blind assessment of topical bakuchiol and retinol for facial photoageing.

BACKGROUND: Bakuchiol is a phytochemical that has demonstrated cutaneous antiageing effects when applied topically. Early studies have suggested that bakuchiol is a functional analogue of topical retinoids, as both compounds have been shown to induce similar gene expression in the skin and lead to improvement of cutaneous photodamage. No in vivo studies have compared the two compounds for efficacy and side-effects. OBJECTIVES: To compare the clinical efficacy and side-effect profiles of bakuchiol and retinol in improving common signs of cutaneous facial ageing. METHODS: This was a randomized, double-blind, 12-week study in which 44 patients were asked to apply either bakuchiol 0·5% cream twice daily or retinol 0·5% cream daily. A facial photograph and analytical system was used to obtain and analyse high-resolution photographs of patients at 0, 4, 8 and 12 weeks. Patients also completed tolerability assessment questions to review side-effects. During study visits, a board-certified dermatologist, blinded to study group assignments, graded pigmentation and redness. RESULTS: Bakuchiol and retinol both significantly decreased wrinkle surface area and hyperpigmentation, with no statistical difference between the compounds. The retinol users reported more facial skin scaling and stinging. CONCLUSIONS: Our study demonstrates that bakuchiol is comparable with retinol in its ability to improve photoageing and is better tolerated than retinol. Bakuchiol is promising as a more tolerable alternative to retinol.

Phytophotodermatitis related to carrot extract-containing sunscreen.

Phytophotodermatitis is a clinical diagnosis from phototoxicity of the skin induced by contact with plants or their extracts. Phytophotodermatitis maypresent with burning, erythema, patches, plaques, vesicles, bullae, or hyperpigmented patches in welldemarcated and unusual shapes. Inquiring about occupation, hobbies, and plant or plant extract contact is essential to establishing the diagnosis. Herein we present a case of phytophotodermatitisafter use of carrot extract-containing sunscreen presenting as a hyperpigmented patch in a geometric distribution with accentuation of pigment within the dynamic rhytides.

Building new university hospital--what citizens know and policy makers should be aware of.

Survey of citizens' attitudes in the process of strategic decision making is one of the most important methods for determining health care priorities. We describe the results of a survey carried out in December 2001, with an aim to collect and analyze the attitudes of the citizens and health care professionals toward the possibilities and strategies of construction of the University Hospital in Blato, Zagreb. The first referendum on the construction of the new hospital was conducted among Zagreb citizens in 1982, when they agreed that the new University Hospital was much needed. Zagreb citizens confirmed once again their attitudes toward and opinions on the need to continue the construction of new hospital in the city outskirts. By 1992, when the construction of the hospital was halted due to insufficient financial means, Zagreb citizens had already invested over 150 epsilon million in the project. It is interesting that today, 89.4% of the citizens and 74.5% of physicians agree that the new hospital building should be completed. Also, 66.7% of the citizens and 88% of physicians think that this hospital should be a University hospital that could offer the most complex treatments and medical education. To finish the construction of the new hospital further 200 epsilon million needs to be invested. Survey showed that 71% of citizens and 82.2% of physicians think that funds should be raised from some form of credit or budget rather than by special local tax, additional tax or voluntary tax. This project will significantly determine the future of hospital and health care system in Croatia due to its capacities in terms of space, technology, and staff. Before the decision to continue with the new hospital construction be made, the expected future needs, demands, and supply of the health care services in hospital sector in Zagreb and Croatia should be provided using SWOT analysis for each of existing the facilities.

Involuntary hospitalization and the rights of mental patients in Croatia.

In Croatia, a 1934 law still prescribes that all hospitals are obliged to inform the court of jurisdiction of the involuntary hospitalization of mental patients. The court, after conducting its own inquiry, has to decide whether the continued detention of the patient is justified or whether he or she should be discharged. In practice, however, this law is violated, because some psychiatrists are not aware of it and because others deliberately choose to ignore it, considering involuntary hospitalization to be an exclusively medical issue to be solved within the medical profession. From the point of view of the protection of the basic human rights of mental patients, especially their right to freedom, and in the interests of general legal certainty, the present situation is most unsatisfactory. This article analyses how this unacceptable practice came about and recommends how it should be changed.