Diagnosis and management of pseudohypoparathyroidism and related disorders: first international Consensus Statement

This Consensus Statement covers recommendations for the diagnosis and management of patients with pseudohypoparathyroidism (PHP) and related disorders, which comprise metabolic disorders characterized by physical findings that variably include short bones, short stature, a stocky build, early-onset obesity and ectopic ossifications, as well as endocrine defects that often include resistance to parathyroid hormone (PTH) and TSH. The presentation and severity of PHP and its related disorders vary between affected individuals with considerable clinical and molecular overlap between the different types. A specific diagnosis is often delayed owing to lack of recognition of the syndrome and associated features. The participants in this Consensus Statement agreed that the diagnosis of PHP should be based on major criteria, including resistance to PTH, ectopic ossifications, brachydactyly and early-onset obesity. The clinical and laboratory diagnosis should be confirmed by a molecular genetic analysis. Patients should be screened at diagnosis and during follow-up for specific features, such as PTH resistance, TSH resistance, growth hormone deficiency, hypogonadism, skeletal deformities, oral health, weight gain, glucose intolerance or type 2 diabetes mellitus, and hypertension, as well as subcutaneous and/or deeper ectopic ossifications and neurocognitive impairment. Overall, a coordinated and multidisciplinary approach from infancy through adulthood, including a transition programme, should help us to improve the care of patients affected by these disorders

The effect of perceived organisational justice on job satisfaction and burnout levels of haemodialysis nurses

Background: Organisational justice influences job satisfaction, the performance of individuals and the functioning of institutions. The lack of evidence-based studies investigating the relationship between hemodialysis nurses' perceptions of organisational justice, job satisfaction and burnout has created a research gap in this area. Objective: To investigate the effect of perceived organisational justice on professional satisfaction and burnout levels of haemodialysis nurses and to identify any relation ship with individual and organisational factors. Material and Methods: The study was designed as a multi-centre descriptive study. The data were collected using the ‘personal information form’, the Organisational Justice Scale’, the ‘Maslach Burnout Inventory’ and the ‘Minnesota Satisfaction Questionnaire’. Results: The distributive justice scores decreased as the depersonalisation scores of the nurses increased. As the personal accomplishment scores of the nurses increased, the interactional justice scores also increased. It was observed that the job satisfaction scores increased as the sub-dimensional scores of the organisational justice scale increased and exhaustion decreased. Conclusion: It was detected that there was a significant relationship between the organisational justice perception of nurses and their job satisfaction and level of burnout. Institutions are encouraged to adopt a fair policy towards nurses and promote personal development. © 2019 European Dialysis and Transplant Nurses Association/European Renal Care Associatio

Surface-Sensitive Microwear Texture Analysis of Attrition and Erosion

Scale-sensitive fractal analysis of high-resolution 3-dimensional surface reconstructions of wear patterns has advanced our knowledge in evolutionary biology, and has opened up opportunities for translatory applications in clinical practice. To elucidate the microwear characteristics of attrition and erosion in worn natural teeth, we scanned 50 extracted human teeth using a confocal profiler at a high optical resolution (X–Y, 0.17 μm; Z < 3 nm). Our hypothesis was that microwear complexity would be greater in erosion and that anisotropy would be greater in attrition. The teeth were divided into 4 groups, including 2 wear types (attrition and erosion) and 2 locations (anterior and posterior teeth; n = 12 for each anterior group, n = 13 for each posterior group) for 2 tissue types (enamel and dentine). The raw 3-dimensional data cloud was subjected to a newly developed rigorous standardization technique to reduce interscanner variability as well as to filter anomalous scanning data. Linear mixed effects (regression) analyses conducted separately for the dependent variables, complexity and anisotropy, showed the following effects of the independent variables: significant interactions between wear type and tissue type (P = 0.0157 and P = 0.0003, respectively) and significant effects of location (P < 0.0001 and P = 0.0035, respectively). There were significant associations between complexity and anisotropy when the dependent variable was either complexity (P = 0.0003) or anisotropy (P = 0.0014). Our findings of greater complexity in erosion and greater anisotropy in attrition confirm our hypothesis. The greatest geometric means were noted in dentine erosion for complexity and dentine attrition for anisotropy. Dentine also exhibited microwear characteristics that were more consistent with wear types than enamel. Overall, our findings could complement macrowear assessment in dental clinical practice and research and could assist in the early detection and management of pathologic tooth wear.S. Ranjitkar, A. Turan, C. Mann, G.A. Gully, M. Marsman, S. Edwards, J.A. Kaidonis, C. Hall, D. Lekkas, P. Wetselaar, A.H. Brook, F. Lobbezoo and G.C. Townsen