肥胖与吸烟对银屑病临床表现和治疗的影响

Objective: To study the impact of obesity and smoking on psoriasis. Design: Cross-sectional study. Setting: University of Utah Department of Dermatology clinics. Patients: A case series of patients with psoriasis enrolled in the prospective Utah Psoriasis Initiative (UPI) (which carefully performs phenotyping of patients with psoriasis) was compared with 3population databases: the Behavioral Risk Factor Surveillance System of theUtah population, the 1998 patient-member survey from the National Psoriasis Foundation, and 500 adult patients who attend our clinics and do not have psoriasis (nonpsoriatic population). Results: The prevalence of obesity in patients within the UPI population was higher than that in the general Utah population (34% vs 18% ; P < .001) and higher than that in the nonpsoriatic population attending our clinics. Assessment of body image perception with a standardized diagram in the UPI group resulted in the median body image score of normal weight at 18 years of age and the onset of psoriasis, but it transitioned to overweight at the time of enrollment in the UPI.Thus, obesity appears to be the consequence of psoriasis and not a risk factor for onset of disease. We did not observe an increased risk for psoriatic arthritis in patients with obesity; furthermore, obesity did not positively or negatively affect the response or the adverse effects of topical corticosteroids, lightbased treatments, and systemic medications. The prevalence of smoking in the UPI population was higher than in the general Utah population (37% vs 13% ; P< .001) and higher than in the nonpsoriatic population (37% vs 25% ; P< .001). We found a higher prevalence of smokers in the obese population within the UPI than in the obese population within the Utah population (25% vs 9% ; P< .001). Conclusions: Patients with psoriasis attending the University of Utah Dermatology Clinics were more likely to be obese and to smoke compared with nonpsoriatic patients and more likely to be obese comparedwith other large cohorts with psoriasis. Smoking appears to have a role in the onset of psoriasis, but obesity does not. The high prevalence of obesity and smoking in a psoriasis cohort has not been previously noted; if confirmed, it supports the prediction that a significant portion of patients with psoriasis will have the comorbid conditions and public health issues of those with obesity and smoke.

人工晶体边缘设计与前囊覆盖度对后囊混浊的影响比较

Purpose To determine whether lens edge design or anterior capsule overlap on the intraocular lens (IOL) has greater effect on posterior capsule opacification (PCO). Design Retrospective cohort clinical study. Methods Retrospective. SETTING: Academic clinical practice.PATIENT POPULATION: The patient population consisted of 259 uncomplicated surgical patients (259 eyes) with no confounding comorbidity and at least 1 year of follow- up after surgical placement of a silicone or hydrophobic acrylic lens. OBSERVATION PROCEDURES: Digital retroilluminated photographs were taken to ascertain PCO, anterior capsular opacification (ACO), previous neodymium:YAG capsulotomy and degree of anterior capsule overlap on the IOL optic. MAIN OUTCOME MEASURES: PCO, ACO, YAG capsulotomy rate, and anterior capsule overlap on the IOL optic. Results One hundred forty- eight digital images (74 silicone and 74 acrylic) were measurable for both anterior capsule overlap and PCO. Complete 360 degrees of anterior capsule overlap on the IOL was associated with decreased PCO (P< .001). A significant negative correlation was found between the degree of anterior capsule overlap and PCO (P< .001). Evaluation of PCO, and YAG capsulotomy rates were similar between acrylic and silicone lenses. Minimal anterior capsule overlap may also be associated with PCO prevention. Conclusions Implanting a lens with complete anterior capsule overlap on the IOL was found to significantly reduce PCO, which advantage appeared to be greater than PCO prevention by a truncated, sharp edge IOL design.