Reply to: Gabapentin: A promising therapy for uremic pruritus in hemodialysis patients: A randomized-controlled trial and review of literature

PMID = 2768713

Isotretinoin use for acne vulgaris is associated with increased serum uric acid levels

A few previous case reports related vitamin A and retinoid use with elevated serum uric acid (SUA) levels. Recently, a population based study showed an independent positive correlation of serum retinol with SUA levels. Despite increasing importance of SUA in a number of disease states, no study has examined the association between retinoids and SUA. We aimed to evaluate the effect of pharmacologic dose isotretinoin on SUA level. This was a cohort study in which 51 consecutive adult patients with severe acne vulgaris who were prescribed oral isotretinoin treatment (0.5mg/kg) were included. Dermatologic examination was performed and SUA levels were measured at study inclusion for each participant, and then repeated at the first and second months of therapy. SUA levels at first month and second month were significantly higher than baseline SUA levels (p: 0.001, 0.007, respectively). SUA levels at second month were higher than SUA levels at first month, but the difference did not reach statistical significance. This study is the first to show that pharmacologic dose oral isotretinoin treatment significantly increased SUA levels. Since hyperuricemia is associated with renal disease, hypertension, atherosclerosis and metabolic syndrome as well as gout, it is important for the dermatologist to be aware of this potential adverse effect of isotretinoin particularly in vulnerable patients

Anesthetic management of a pediatric patient during surgical excision of primary cerebral hydatid cyst

Hydatid cysts develop in humans with the transmission of Echinococcus Granulosus or more rarely Echinococcus Multilocularis. The disease develops in the liver 50-75%, and in the lungs 15-35% of the cases. Intracranial hydatid cyst is seen 0.5-3% of the cases. In this case report, we aimed to present the anesthetic approach and possible anaphylactic reaction in a giant primary intracranial hydatid cyst. A five years and eight months old boy (19 kg, 114 cm) was admitted to the emergency room with complaints of a headache, nausea, vomiting, and deviation of the eyes for about 1 month. Fundus examination revealed bilateral disc elevation and severe papillary edema. Cranial magnetic resonance imaging showed a large hydatid cyst in the right parietal lobe. The patient was scheduled for craniotomy by the neurosurgeons. After induction and endotracheal intubation, 1 mg.kg-1 pheniramine hydrogen maleate and 1 mg.kg-1 methylprednisolone were administered as a protective measure against anaphylaxis. The cyst excised by Dowling method, and no rupture observed. The patient, who did not have any perioperative complication, was extubated and followed in the intensive care unit of neurosurgery department. Cerebral hydatid cyst is rare and usually seen in children. This could be explained by the presence of right-to-left shunts. The gold standard in the treatment of cerebral hydatid cysts is surgical removal. In order to prevent recurrence and anaphylactoid reaction, the cyst should be removed without rupturing it. The hemodynamic changes with cyst rupture are seen milder in the patients receiving prophylactic treatment. [Med-Science 2018; 7(2.000): 443-5

Hypertension as an autoimmune and inflammatory disease.

Hypertension that is considered idiopathic is called essential hypertension and accordingly has no clear culprit for its cause. However, basic research and clinical studies in recent years have expanded our understanding of the mechanisms underlying the development of essential hypertension. Of these, increased oxidative stress, both in the kidney and arterial wall, closely coupled with inflammatory infiltration now appear to have a prominent role. Discovery of regulatory and interleukin-17-producing T cells has enabled us to better understand the mechanism by which inflammation and autoimmunity, or autoinflammation, lead to the development of hypertension. Despite achieving considerable progress, the intricate interactions between oxidative stress, the immune system and the development of hypertension remain to be fully elucidated. In this review, we summarize recent developments in the pathophysiology of hypertension with a focus on the oxidant stress-autoimmunity-inflammation interaction

Hypertension as an autoimmune and inflammatory disease.

Hypertension that is considered idiopathic is called essential hypertension and accordingly has no clear culprit for its cause. However, basic research and clinical studies in recent years have expanded our understanding of the mechanisms underlying the development of essential hypertension. Of these, increased oxidative stress, both in the kidney and arterial wall, closely coupled with inflammatory infiltration now appear to have a prominent role. Discovery of regulatory and interleukin-17-producing T cells has enabled us to better understand the mechanism by which inflammation and autoimmunity, or autoinflammation, lead to the development of hypertension. Despite achieving considerable progress, the intricate interactions between oxidative stress, the immune system and the development of hypertension remain to be fully elucidated. In this review, we summarize recent developments in the pathophysiology of hypertension with a focus on the oxidant stress-autoimmunity-inflammation interaction