ABSTRACT
Objective: haemostatic defect is more common and consistent in occurrence during the progression of renal failure to end - stage renal disease [ESRD]. Although coagulopathy is complex in pathogenesis, a defect in3- brinolytic process plays a critical role in its development
Aim of the work: was to evaluate the fibrinolytic state in end stage renal disease [ESRDI patients before and after Haemodialysis [HD] using tissue plasminogen activator [t-PA] and plasminogen activator inhibitdr-1 [PAI-1] as fibrinolytic activity markers and to evaluate the possible contribution of AVF on fibrinolytic system
Subjects and Methods: this study was carried out on 14 end stage renal disease patients [8 males and 6 females] with age ranging from 30- 65 years [4 7.14 +/- 12.38 years], selected from haemodialysis unit of nephrology, Benha Teaching Hospital. Ten healthy normal volunteers oj matched age and sex were chosen as a control group. TPA and PAI-1 were measured before and after HD from contralateral reins and from venous return of arteriovenous fistula [AVV and from peripheral veins of the control group by ELISA
Results: the results revealed that there were significant' increase in t-PA with significant decrease in PAl-1 in contralateral veins and AVF before HD in ESRD patients when compared to controls. There were significant increase in t-PA with insignificant increase in PAI-l in conmlatera1 veins and AVF after HD when compared to before HD. On the other hand, there were decrease in t-PA [insignificant before HD bur significant after HD] with insignificant increase in PAI-1 [before and after HDI in AVF when compared to contralateral veins
In conclusion: fibrinolysis is enhanced in ESRD patients and further aggravated after HD. Impairment of fibrinolysis tic activity in AVF might lead to fistula thrombotic tendency during haemodidysis
ABSTRACT
Background: there is a controversy about the role of beta-endorphin in the pathogenesis of psoriasis, some reports demonstrated elevated circulating beta-endorphin in psoriatic patients especially with actively spreading plaques while lesion-free patients showed reduction of this neuropeptide. On the other hand, the here is published data denoting that circulating beta endorphin has no primary importance in the manifestation of the psoriasis and that inflammation in psoriatic skin lesions is probably not mediated directly by circulating P-endorphin
Objective: to measure plasma beta-endorphin levels in psoriatic patients and demonstrate whether there are any changes of its peripheral blood levels correlating with the clinical improvement. This in order to determine whether and to which limit this neuropeptide is involved in psoriasis
Subjects and Methods: we measured plasma beta-endorphin concentration by enzyme immunoassay in 46 patients with psoriasis both during the presence of lesions and in symptom Free State. Then compared it with that of 18 non-psoriatic patients with T cell mediated inflammatory diseases [10 atopic dermatitis and 8 systemic sclerosis patients] as control. While 24 age and sex matched, healthy individuals were studied as a negative control
Results: the mean 8- endorphin level of psoriatic patients, atopic dermatitis and systemic sclerosis was significantly higher than healthy controls. After treatment, when the skin lesions cleared in the psoriatic patients there was statistically significant reduction of plasma beta-endorphin level. Significant elevation of beta endorphin was found in patients with long lasting lesions. However, there was no significant difference in P-endorphin levels among patients with and without pruritus, nor in those with and without history of major stress. No significant difference between wide and localized spread lesion. Similarly there was no significant difference between those with high and low PASI scores
Conclusion: beta-endorphin is involved in the pathogenesis of psoriasis. Elevated plasma beta-endorphin levels occurs in psoriasis and decline in these levels parallel to clinical improvement and clearance of psoriatic skin lesions. The increased P-endorphin level in psoriasis is not the results of activation of pituitary-adrenal axis by chronic stress, but is produced in psoriatic skin lesions by inflammatory cells. We hope that in the near future neuropeptides will represent a new approach to skin therapy
ABSTRACT
Background: hirsutism is a clinical condition commonly encountered in the practice of primary care medicine. It is not only a source of psychological discomfort but also a probable sign of an underlying medical problem. The common causes of hirsutism are familial, idiopathic or polycystic ovaries. Dermatologists found that hirsutism has become a noticeable complain among Egyptian adolescent females
Objective: to assess the prevalence of hirsutism and study the most common causes in Egyptian adolescent females
Design: respective random sample of general population attending outpatient clinics and prospective evaluation of hirsute patients referred to our dermatologic clinics. Intervention [s]: Assessment of body hair using the standardized Farriman and Gallwey scoring system and an investigative protocol including detailed clinical assessment with endocrinology workup including estimations of free testosterone dehydroepiandrosterone and 17-alpha hydroxyprogestrone in blood, using the immuno-enzymatic assay [ELISA] and abdominopelvic ultrasound of the ovaries
Result: of 600 adolescent females for whom adequate data were available, 60 cases [10 %] had hirsutism, among them 43 [70.8 %] had mild hirsutism [score of 6 - 9], 15 [25 %] had moderate [score of 10 -14] and 2 [4.2 %] had severe hirsutism [score more than 151. The etiology of hirsutism were idiopathic in 51.7 %, polycystic ovaries in 38.3% drugs in 5 %, combined ovarian and adrenal causes in 3.3 % and adrenal cause in 1.7 %
Conclusions: hirsutism is as common a problem in the Egypt as elsewhere in the world. Idiopathic hirsutism and polycystic ovaries syndrome are the most frequently defined "causes" of hirsutism among Egyptian adolescent females. Whereas congenital adrenal hyperplasia is relatively uncommon cause. We recommended that every case of hirsutism must be investigated thoroughly and the hormonal analysis must be estimated regardless of any obvious causes present as it may indicate a serious underlying medical problem such as tumors of ovaries or adrenals, PCO or Cushing disease