Association between isolated female acne and insulin resistance: A prospective study

PubMed ID: 26373866Background: acne is one of the manifestations of the polycystic ovary syndrome (PCoS). Nowadays hyperinsulinemia and insulin resistance are well-known characteristics of PCoS. the aim of this study was to investigate the relation between isolated female acne and insulin resistance and to determine the effect of hyperandrogenemia in this possible relationship. METHODS: Forty ive women with acne and 24 healthy women aged 25-40 were included in the study. The global acne grading system (GAGS) was used to evaluate acne severity. Blood samples were drawn for measurements of hormone proile, basal insulin and fasting blood glucose (FBG). the oral glucose tolerance test (oGtt) was performed on another day. homeostasis model assessment (Homa) score was used to assess insulin resistance (ir). all subjects underwent abdominopelvic sonography. reSUltS: thirty-six women with acne and 24 healthy women were analyzed after exclusion. Fifteen (42%) patients had moderate acne, 11 (30%) had severe acne and 10 (28%) had very severe acne. Basal insulin, FBG, AUC glucose, AUC insulin and HOMA values were signiicantly higher in patients with acne when compared with the control group (P<0.05). after excluding patients with hyperandrogenemia, we compared the patients (N.=22) and control group with regard to ir; the serum basal insulin, aUC-insulin and aUC-glucose as well as Homa score were still signiicantly higher in patients (P<0.05). CoNClUSioNS: We concluded that there is a relationship between female acne and ir. this association is independent of hyperandrogenemia. anti-insulin drugs may an adjunctive treatment of female acne. © 2015 Edizioni Minerva Medica

Environmental risk factors in pediatric psoriasis: A multicenter case-control study

To analyze the effect of possible risk factors, including breastfeeding, on the development of childhood-onset psoriasis, a multicenter case-control study with prospective collection of data was performed. Using a standard questionnaire, personal and specific variables including family history of psoriasis, maternal and environmental tobacco smoke exposure, body mass index (BMI), exclusive and partial breastfeeding for at least 3 and 12 months, cow's milk intake before 1 year, birth delivery method, and stressful life events were collected during 2009 from 537 patients with psoriasis and 511 controls younger than 18. Overall, patients more frequently reported exposure to environmental tobacco smoke at home and stressful life events in the year preceding the diagnosis than controls. The odds ratios (OR) for smoking and stressful life events were 2.90 (95% confidence interval [CI] = 2.27-3.78) and 2.94 (95% CI = 2.28-3.79), respectively. In addition, children with psoriasis were more likely to have a higher BMI (>26) than controls (OR = 2.52; 95% CI = 1.42-4.49). High BMI, environmental tobacco smoke exposure at home, and stressful life events may influence the development of pediatric psoriasis. © 2011 Wiley Periodicals, Inc

Effects of short- and long-term lithium treatment on kidney functioning in patients with bipolar mood disorder

Lithium (Li) carbonate has been reported to be able to cause some reversible functional changes in the kidney. In this study, the authors aimed to investigate whether the duration of Li treatment is the primary determinant of the changes in renal functioning due to the Li treatment. For this purpose, 10 Li-naive (mean age+/-S.D.: 34.50+/-4.85), 10 short-term (mean age+/-S.D.: 31.77+/-7.61) and 10 long-term (mean age+/-S.D.: 36.60+/-10.15) Li-treated bipolar patients were included in the study. Serum blood urea nitrogen (BUN) and creatinine, urine creatinine levels, creatinine clearance, urine osmolality before and after 8-h water deprivation and urine osmolality after desmopressin injection were measured in all patients. Serum BUN and creatinine levels were within the normal limits and not statistically different among the groups. Creatinine clearance of the long-term Li-treated group was significantly lower than both that of the Li-naive group and that of the short-term Li-treated group. After 8-h water deprivation and also after desmopressin injection, no difference was found among the groups in terms of urine osmolality. However, when each patient was evaluated individually in terms of their renal concentrating ability, partial nephrogenic diabetes insipidus was diagnosed in four patients on long-term and in two patients on short-term Li treatment. To our surprise. hypothalamic diabetes insipidus was also diagnosed in other two patients on long-term Li treatment. These results demonstrate that long-term Li treatment may cause impairment in renal concentrating ability, some of which may originate from the effects of Li on vasopressin on hypothalamic level. and a decrease in glomerular filtration rate (GFR). In the light of these data, we can conclude that long-term administration of Li may be a risk factor for Li-induced renal impairment, which is a progressive effect in nature. (C) 2001 Elsevier Science Inc. All rights reserved

What is the optimal dwell time for maximizing ultrafiltration with icodextrin exchange in automated peritoneal dialysis patients?

PubMedID: 16722026? Background: Icodextrin is increasingly being used in automated peritoneal dialysis (APD) for the long dwell exchange to maintain adequate ultrafiltration (UF). However, the UF reported in the literature varies with different dwell times: from 200 to 500 mL with 12 - 15 hour dwells. In order to maximize UF, it is important to know the relationship between dwell time and UF when using icodextrin in APD patients. With this knowledge, decisions can be made with respect to dwell period, and adjustments to the dialysis prescription can be made accordingly. ? Methods: We prospectively studied this relationship in 36 patients from Canada and Turkey. All patients did the icodextrin day exchange manually after disconnecting themselves from overnight cycler dialysis. Dwell period was increased by 1 hour every week, from 10 to 14 hours. Ultra-filtration was noted for each icodextrin exchange. Mean UF for each week (i.e., dwell period) was compared by repeated measures ANOVA. ? Results: We found no difference in mean UF with increasing dwell time: 351.73 ± 250.59 mL at 10 hours versus 371.75 ± 258.25 mL at 14 hours (p = 0.83). We also compared mean UF between different subgroups and found that males (p = 0.02 vs females) and high transporters (p = 0.04 vs low) had higher mean UF. Further analysis of maximal UF showed no correlation to age, sex, diabetic status, transport category, creatinine clearance, Kt/V, duration on peritoneal dialysis, or duration of icodextrin use. ? Conclusion: Icodextrin-related UF in APD patients is not related to demographic factors and does not increase significantly beyond 10 hours. © 2006 International Society for Peritoneal Dialysis

Ocular side effects associated with systemic isotretinoin

Purpose. To evaluate ocular side effects associated with systemic isotretinoin. Patients and Method. Thirty-five patients with severe recalcitrant acne were enrolled in this prospective study. Isotretinoin was administered at a dose of 0.5-1 mg/kg/day in two divided doses with food for 16 weeks. In all patients, visual acuity, anterior segment examination, intraocular pressure (IOP) measurement, Schirmer I test, tear film break-up time (BUT), and color vision by Famsworth-Munsell (FM) 100 Hue color test were evaluated and microbiological investigation of conjunctival flora and anterior nares were performed. All these eye examinations were repeated before, during, and after treatment with isotretinoin by the same examiner. Results. There was no difference in visual acuity, and fundus examination in any of the cases after administration of the drug. No statistically significant difference was found between averages of IOP measurements and refraction (NS). On the other hand, the differences between FM 100 Hue test scores, Schirmer values, and BUT measurements that were evaluated before and during treatment were statistically significant (p < 0.05). Subjective symptoms such as dryness, itching, and contact lens intolerance occurred in 34% of the patients. Colonization of the conjunctiva and anterior nares by Staphylococcus increased significantly during treatment. All abnormal findings disappeared I month after stopping therapy. Conclusion. There are ocular side effects of isotretinoin that are treatable and they disappear after discontinuation of therapy

Nonrelated living-donor kidney transplantation: medical and ethical aspects.

Several patients with end-stage renal disease went to Bombay for renal transplantation from nonrelated living donors and then returned to Turkey for posttransplantation follow-up. The aims of this study are to evaluate the long-term results of renal transplantation from nonrelated living donors in Turkish patients with end-stage renal disease and to discuss the ethical and social aspects of nonrelated kidney donation. One hundred and twenty-seven patients (89 males, 38 females; mean age 38.1, range 17-63 years) were investigated retrospectively. None of the patients went to Bombay on our advice. All transplantations were performed between 1991 and 1995. The mean follow-up period after transplantation was 34.2 (range 1-68) months. Graft survival rates were 85, 83, and 57% after 3 months and 1 and 5 years, respectively. Patient survival rates were 94, 93, and 92% after 3 months and 1 and 5 years, respectively. Seven patients died within the first 3 months after the transplantation. Surgical problems, infections, acute rejection, ciclosporin nephrotoxicity, and hepatic problems were common complications. We conclude that medical and surgical complications occur frequently in paid kidney transplantation, but most of these complications can be prevented by adequate preoperative management, and precautionary measures should be taken to prevent commercialization of renal transplantation before the spread of emotionally related living kidney donation

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