Long-term urethral catheterisation: guidelines for community nurses.

An estimated 3% of people living in the community and 12% of those living in residential care use long-term urethral catheterisation for the management of urine drainage. This article provides an overview of safe practice for catheterisation in the community setting, highlighting the need for competent and safe patient assessments. It also aims to provide a rationale for product choices.

Zeaxanthin-based dietary supplement and topical serum improve hydration and reduce wrinkle count in female subjects.

BACKGROUND: Dietary modification, through supplementation and elimination diets, has become an area of interest to help slow skin aging, reduce symptom severity or prevent reoccurrence of certain dermatologic conditions [Clinical Dermatology vol. 31 (2013) 677-700]. Free radical components (reactive oxygen species or ROS) or lipid peroxide (LPO) is involved in the pathogenesis and progression of accelerated skin aging when prolonged oxidative stress occurs. The use of antioxidant-related therapies such as nutraceuticals is of particular interest in restoring skin homeostasis. Antioxidant carotenoid zeaxanthin is concentrated in the eye and skin tissue and believed to decrease the formation of ROS associated with UV light exposure. With zeaxanthin, phytoceramides, and botanical extracts an oral and topical test product (with zeaxanthin, algae extracts, peptides, hyaluronate) have been developed to improve the appearance and condition of skin when used as directed. METHODS: Subjects were divided into three groups: two tests (skin formula 1 - oral product alone (ZO-1), skin formula 2- oral product with topical product (ZO-2 + ZT)), and one placebo control. The study consisted of a washout visit, baseline (randomization), week two (2), week four (4), week six (6), week eight (8), and week twelve (12). Key parameters measured were as follows: fine lines, deep lines, total wrinkles, wrinkle severity, radiance/skin color (L, a*, b*), discolorations, and skin pigment homogeneity. RESULTS: Thirty-one subjects completed the twelve-week study; no adverse events were recorded during the study. Statistically significant improvements from baseline mean hydration score were observed in active groups at weeks 2, 6, and 8. A statistically significant difference was observed between mean differences from baseline scores for total wrinkle count at week 4 for the combination active groups compared to placebo. A statistically significant difference from baseline scores for fine lines count was also observed at the week 4 visit compared to placebo for both active groups. Statistically significant differences from baseline scores for average wrinkles severity were seen for week 12 visit for both active groups compared to placebo. CONCLUSION: We have shown that the combination of zeaxanthin-based dietary supplement plus a topical formulation produces superior hydration to that of placebo. Additionally, we have shown that the combination of oral and topical combination vs. oral alone has superior abilities to improve parameters associated with facial lines and wrinkles compared to placebo, although the dietary supplement alone proved most effective in reducing wrinkle count and severity.

Prostatectomy: information provision and education for patients.

Following the diagnosis of prostate cancer, information should be imparted to ensure an informed decision regarding treatment can be made. The impact of a cancer diagnosis could lead men to opt for surgical intervention without fully understanding the consequences of treatment. Effective communication of evidence-based information can assist men to fully understand the consequences of treatment. Radical prostatectomy, whether robotically assisted laparoscopic or retropubic, will lead to quality-of-life issues with functional outcomes such as erectile dysfunction and urinary incontinence being at the forefront. Issues should be discussed and communicated in depth so that frustration and regret following treatment are avoided. A cautious approach to information provision should be considered so the patient does not feel in a position of information overload. Advanced communication skills are of utmost importance to ensure information is tailored to suit individual needs, as no one model of information giving suits all. This article is a rapid literature search relating to post-prostatectomy functional outcomes and how communication and information giving before treatment assists with acceptance of treatment outcomes.

Does active surveillance lead to anxiety and stress?

For men with prostate cancer (PC), patient care and treatment recommendations should not focus solely on the disease but should also take into account the views of the patient. The diagnosis and consequences of monitoring or treatment should be fully explained. Recommending Active Surveillance (AS) for the monitoring of a proven low-risk, low-volume prostate cancer should ensure that the psychological impact of AS is taken into account and included in a holistic approach to patient and disease management. This article is a rapid literature search relating to AS, and how the psychological impact of a cancer diagnosis may influence patient choice.

Management of urinary incontinence in a patient with multiple sclerosis.

Patient care and clinical research looking at urinary incontinence associated with neurological disorders remains under-resourced. With heightened awareness, improved management decisions could be made that would lead to better patient outcomes. With the responsibility that clinical governance conveys, it is vital that an awareness of the risks associated with continence management are identified and minimized. These objectives can be achieved through the formation of a strong evidence base for practice - this will, in turn, allow better planning of care and easier anticipation of potential problems. This article reviews the literature to analyse the care received by a patient with multiple sclerosis and to consider what would have been best practice in this case, proposing alternative treatment options that could have been made available.