The association between psoriasis and chronic obstructive pulmonary disease: a systematic review and meta-analysis.

INTRODUCTION: Psoriasis is a chronic T-cell-mediated inflammatory and proliferative skin disease. Chronic obstructive pulmonary disease (COPD) is an inflammatory disease of the airways. COPD has been studied as a comorbidity of psoriasis, but the association needs further study, hence the objective of this study. EVIDENCE ACQUISITION: A systematic review was performed using the database PubMed and 155 records were found including the ones found through references. Seven records were found eligible for this study including six observational studies and one experimental study with a total of 229,075 participants. The odds ratio of COPD in patients with psoriasis and healthy subjects was analysed using a random effects model. EVIDENCE SYNTHESIS: The pooled data showed a significant association (OR=1.77, 95% CI [1.32; 2.39]) between psoriasis and COPD with high inter-study heterogeneity (I2=96%). Sub-analyses of the different types of studies (cohort study: OR=2.53 [2.43; 2.63], case-control study: OR=1.6 [0.03; 100.96] and cross-sectional study: OR=1.57 [0.58; 4.22]) and smoking status (OR=1.7 [0.69; 4.14]) were also performed to further examine the association. CONCLUSIONS: There is a significant association between psoriasis and COPD, but the underlying mechanism and how smoking status affects the results remain unclear and need further study. Physicians should be aware of the risk and its seriousness to provide better and more targeted treatment.

Sequential treatment with secukinumab and ustekinumab in a patient with severe psoriasis and recent history of cerebral malignant melanoma metastasis.

This report of a 53-year-old woman with severe psoriasis treated with biologic therapy despite recent history of malignant melanoma with cerebral metastasis suggests that biologic therapy for chronic inflammatory diseases may be an option for selected patients with recent cancer.

Patient-reported outcomes (PROs) in chronic urticaria.

Chronic urticaria is an itching skin disease which persists for more than 6 weeks. Chronic urticaria has great impact on the daily life of the patient, and the fluctuating nature of the symptoms complicates the monitoring and treatment of the disease. Currently, there are no reliable biomarkers to identify and measure disease activity in chronic spontaneous urticaria. Consequently, use of patient-reported outcomes (PROs) is crucial when evaluating and monitoring different aspects of chronic urticaria such as disease activity/severity, disease control, and quality of life. We present an overview of seven different PROs used in chronic urticaria and highlight their strengths, limitations, and use in clinical practice and research.

Hospital admission interviews are time-consuming with several interruptions.

INTRODUCTION: The admission interview is an important procedure to reduce medication errors. Studies indicate that physicians do not spend much time on the interview and that the major obstacles are lack of time and heavy workload. The aim of this study was to measure the time physicians spend on admission interviews and to describe factors that affect time consumption. MATERIAL AND METHODS: This time study was conducted at an acute medicine department. Physicians conducting admission interviews were observed, and time consumption was recorded. RESULTS: Fifty admission interviews were observed; they lasted an average of 45 (range 8-84) minutes. The effective time consumption was 32 (range 7-59) minutes. Fifteen (range 3-41) minutes were spent on actually interviewing and examining the patient and compiling the medication history. It took zero to five (mean 2.2) minutes to collect the medication history. The number of interruptions per interview was zero to nine (mean two); they were mostly caused by phone calls from physicians or nurses or by nurses asking for advice on problems with other patients. The mean duration of an interruption was 7.1 minutes. CONCLUSION: Physicians spend an average of 45 minutes on admission interviews and are interrupted up to nine times. Only a few minutes are spent on collecting the medication history. Though the quality of the interviews and the actual error rate were not assessed, the observed working conditions may imply a high potential for medication errors.