Effect of Weight Loss on the Severity of Psoriasis: A Randomized Clinical Study.

Effect of Weight Loss on the Severity of Psoriasis: A Randomized Clinical Study.

JAMA Dermatol. 2013 May 29; 1-7
Jensen P, Zachariae C, Christensen R, Geiker NR, Schaadt BK, Stender S, Hansen PR, Astrup A, Skov L

IMPORTANCE Psoriasis is associated with adiposity and weight gain increases the severity of psoriasis and the risk of incident psoriasis. Therefore, we aimed to measure the effect of weight reduction on the severity of psoriasis in obese patients with psoriasis. OBJECTIVE To assess the effect of weight reduction on the severity of psoriasis in overweight patients. DESIGN Sixty obese patients with psoriasis from our dermatology outpatient clinic were enrolled in a prospective randomized clinical trial in which they were allocated to a control group or an intervention group. SETTING University hospital outpatient dermatology clinic. PARTICIPANTS We included 60 of 69 eligible overweight patients with psoriasis (body mass index [calculated as weight in kilograms divided by height in meters squared], 27-40; aged 25-71 years). INTERVENTIONS The intervention group received a low-energy diet (LED) (800-1000 kcal/d) for 8 weeks to induce weight loss, followed by 8 weeks of reintroduction of normal food intake, reaching 1200 kcal/d. The control group was instructed to continue eating ordinary healthy foods. MAIN OUTCOMES AND MEASURES Psoriasis Area and Severity Index (PASI) after 16 weeks, with Dermatology Life Quality Index (DLQI) as a secondary end point. RESULTS The median PASI for all patients was 5.4 (interquartile range, 3.8-7.6) at baseline. At week 16, the mean body weight loss was 15.4 kg (95% CI, 12.3-18.5 kg; P < .001) greater in the intervention group than in the control group. The corresponding mean differences in PASI and DLQI, also in favor of the LED group, were -2.0 (95% CI, 4.1 to -0.1; P = .06) and -2.0 (95% CI, -3.6 to -0.3; P = .02), respectively. CONCLUSIONS AND RELEVANCE Treatment with an LED showed a trend in favor of clinically important PASI improvement and a significant reduction in DLQI in overweight patients with psoriasis. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01137188. HubMed – eating


Biliary Atresia in Children With Aberrations Involving Chromosome 11q – 2 Case Reports.

J Pediatr Gastroenterol Nutr. 2013 Jun 7;
Ma?gorzata R, Piotr C, Krystyna C, Joanna CK, Aleksandra M, Diana K, Joanna P

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Intractable hiccup accompanying pleural effusion: reversible clipping of an intrathoracic phrenic nerve.

Surg Laparosc Endosc Percutan Tech. 2013 Jun; 23(3): 357-9
Kim JJ, Sa YJ, Cho DG, Kim YD, Kim CK, Moon SW

Hiccup is usually a self-limiting condition, and can be treated with medications and physical maneuvers. However, hiccup episodes continuing for days or weeks can be incapacitating, and disturb work, sleep, and eating. Therefore, timely therapeutic intervention is needed to achieve early resolution of this treatable condition. We report on a successful phrenic nerve block for intractable hiccups, which consisted of thoracoscopic nerve clipping under general anesthesia and reversal under local anesthesia. This method has the advantage of assured diaphragmatic functional recovery while controlling intractable hiccups. HubMed – eating


Childhood feeding difficulties: a randomized controlled trial of a group-based parenting intervention.

J Dev Behav Pediatr. 2013 Jun; 34(5): 293-302
Adamson M, Morawska A, Sanders MR

: Difficulty with feeding is common during early childhood. Behavioral techniques have shown considerable utility for difficult feeding, although large-scale studies of behavioral parenting interventions with typically developing young children, and in group formats, are limited.: The current study aimed to evaluate the efficacy of a group-based, behavioral family intervention for typically developing healthy children with problem eating via a fully randomized 2-group design.: Ninety-six families of children aged 1.5 to 6 years with feeding difficulties participated in a trial of Hassle Free Mealtimes Triple P (A. Morawska and M.R. Sanders, unpublished data, 2008) in regional and metropolitan Queensland (Australia).: Results support the utility of a group-based behavioral parenting program for childhood feeding issues, with significant improvements to the mealtime and general behavior of target children, the mealtime and general practices of parents, parental confidence and cognitions, compared with a waitlist control. Six-month follow-up data and clinical and reliable change indices support the intervention’s utility. Parents were also highly satisfied with the program.: The current study provides evidence of the efficacy of a group-based behavioral family intervention for mealtime difficulties, including observational and more extended outcome measures. Future directions and clinical implications of this research are discussed. HubMed – eating