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The association between exposure to head injury and increased risk of neurodegenerative disease, specifically chronic traumatic encephalopathy (CTE), is widely recognized. Historically, this was largely considered a phenomenon restricted to boxers, with more recent case series identifying further 'high risk' individuals, such as former American footballers, or military personnel. However, in all cases thus far reported, it is clear that it is the exposure to head injury which is associated with increased dementia risk, and not the circumstances or environment of exposure. As such, there is considerable potential for under-recognition of CTE in patients presenting with neurodegenerative disease, particularly where head injury exposure might have been historical and through sport. This article reviews current understanding of CTE and, via an illustrative case in rugby union, highlights the value of a detailed history on head injury and also draws attention to imaging studies in assessing patients with neurodegenerative disease. [ABSTRACT FROM AUTHOR]

Background. The Consultation and Relational Empathy (CARE) Measure is a validated patient-rated measure of consultation quality in the UK. [ABSTRACT FROM PUBLISHER]

The article presents a case study of a 65-year-old South Asian woman with numerous lesions on her limbs. The patient has been administered with oral prednisolone after she was diagnosed with lobular panniculitis, however rapid recurrence of the lesions occurred following her decision to stop the medicine. Dermatomyositis (DM) has been suggestive based on the histopathological features of the lesions. The condition of the patient improves due to the combination of methotrexate and prednisolone.

Aim To assess the efficacy and safety of the selective oxytocin receptor antagonist epelsiban in the treatment of premature ejaculation ( PE). Methods Double-blind, randomized, parallel-group, placebo-controlled, stopwatch-monitored, phase 2, multicenter study ( GSK557296; NCT01021553) conducted in men (N = 77) 18-55 years of age, with PE defined as per International Society for Sexual Medicine consensus definition. Patients provided informed consent prior to a 4-week un-medicated run-in to determine baseline intravaginal ejaculatory latency times ( IELT) recorded in an electronic diary. Patients needed to make a minimum of four intercourse attempts and have a mean IELT <65 seconds to be considered for randomization. Men with moderate-to-severe erectile dysfunction were excluded from the study. Eligible patients were randomized to placebo, epelsiban 50 mg, or 150 mg, taken 1 hour before sexual activity. Active treatment IELT times were recorded in an electronic diary, along with subjective measures of intercourse satisfaction, over an 8-week treatment period. The Modified Index of Premature Ejaculation and International Index of Erectile Function were completed at study visits. Main Outcome Measures Stopwatch timed IELT recordings and a modified version of the patient-reported outcome questionnaire the IPE were used in this study to determine the effect of epelsiban when taken orally prior to intercourse in subjects diagnosed with PE. Results The baseline (mean) IELT for patients pretreatment was (0.52, 0.63, and 0.59 minutes) for placebo, epelsiban 50 mg and 150 mg, respectively. On-treatment, average geometric least squares means of the median IELT values (mean) were slightly higher in the 50 mg and 150 mg groups (0.72 and 0.69 minutes), respectively, vs. the placebo group (0.62 minutes). Headache was the most common adverse event, and rates were similar across all groups. Conclusions Epelsiban 50 mg and 150 mg were well tolerated, but did not result in a clinically or statistically significant change in IELT in men with PE, compared with placebo. Shinghal R, Barnes A, Mahar KM, Stier B, Giancaterino L, Condreay LD, Black L, and McCallum SW. Safety and efficacy of epelsiban in the treatment of men with premature ejaculation: A randomized, double-blind, placebo-controlled, fixed-dose study. J Sex Med 2013;10:2506-2517. [ABSTRACT FROM AUTHOR]