The Evaluation of Contact Sensitivity with Standard and Cosmetic Patch Test Series in Rosacea Patients

BACKGROUND: Rosacea is a common dermatosis characterized by erythema, telangiectasia, papules and pustules. OBJECTIVE: We aimed to evaluate contact sensitivity in the rosacea patients. METHODS: We included 65 rosacea patients and 60 healthy volunteers in the study. The patient and control groups were patch tested with European baseline series and cosmetic series. RESULTS: A positive reaction to at least 1 allergen in the European standard series was found in 32.3% of rosacea patients and 20.0% of subjects in the control group while the relevant numbers were 30.8% of rosacea patients and 10% of controls with the cosmetic series (p=0.08). In total, we found a positive reaction to at least 1 allergen in 38.5% of patients and 25.0% of controls (p=0.15). We did not find a statistically significant relationship between a positive reaction to 1 allergen in total and the gender, skin type, rosacea type, ocular involvement, age and disease duration. There were more symptoms in patients with a positive reaction to allergens (p < 0.001). CONCLUSION: Contact sensitivity was detected more common in rosacea patients. Patch testing may be useful in the treatment and follow up of rosacea patients especially if symptoms such as itching, burning and stinging are present.

Simple clinical risk score for no-reflow prediction in patients undergoing primary Percutaneous Coronary Intervention with acute STEMI

Objectives: To identify the STEMI patients at high risk in terms of no-reflow during percutaneous coronary intervention [PCI] with a simple risk score system that can be used before reperfusion. Methods: Total 173 patients who had undergone primary or rescue percutaneous coronary intervention following the diagnosis of STEMI, were classified as "no-reflow" developers and "no-reflow" non-developers, during the procedure. The pre-procedural ECGs, laboratory parameters, demographic data, time for the treatment, and the treatment methods were evaluated with univariate analysis. The independent predictors were identified by multivariate logistic regression analysis among the no-reflow risk factors. Using the independent predictors, we developed a simple risk score system proportional to area under the ROC [AUROC] curves. Results: The independent predictors of "no-reflow" phenomenon were identified as follows: high values of blood glucose at reference; long symptom-onset-to-balloon-time; and low lymphocyte count. The incidence rates of "no-reflow" in patients with low [0-1], moderate [2-3] and high [4-6] risk factors were 13.3%, 40.0%, and 46.7%, respectively. The risk score system demonstrated a good risk prediction between patients with various risk levels of the development of "no-reflow" with a c-statistics of 0.734 [95% CI 0.654-0.814]. Conclusion: The development of "no-reflow" which is an adverse event in STEMI treatment can be predicted efficiently by simple clinical risk scoring method

Effects of Sleep Disorders on Hemoglobin A1c Levels in Type 2 Diabetic Patients / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Studies have reported the presence of sleep disorders in approximately 50-70% of diabetic patients, and these may contribute to poor glycemic control, diabetic neuropathy, and overnight hypoglycemia. The aim of this study was to determine the frequency of sleep disorders in diabetic patients, and to investigate possible relationships between scores of these sleep disorders and obstructive sleep apnea syndrome (OSAS) and diabetic parameters (fasting blood glucose, glycated hemoglobin A1c [HbA1c], and lipid levels).</p><p><b>METHODS</b>We used the Berlin questionnaire (BQ) for OSAS, the Epworth Sleepiness Scale (ESS), and the Pittsburgh Sleep Quality Index (PSQI) to determine the frequency of sleep disorders and their possible relationships with fasting blood glucose, HbA1c, and lipid levels.</p><p><b>RESULTS</b>The study included 585 type 2 diabetic patients admitted to family medicine clinics between October and December 2014. Sleep, sleep quality, and sleep scores were used as the dependent variables in the analysis. The ESS scores showed that 54.40% of patients experienced excessive daytime sleepiness, and according to the PSQI, 64.30% experienced poor-quality sleep. The BQ results indicated that 50.20% of patients were at high-risk of OSAS. HbA1c levels correlated significantly with the ESS and PSQI results (r = 0.23, P < 0.001 and r = 0.14, P = 0.001, respectively), and were significantly higher in those with high-risk of OSAS as defined by the BQ (P < 0.001). These results showed that HbA1c levels were related to sleep disorders.</p><p><b>CONCLUSIONS</b>Sleep disorders are common in diabetic patients and negatively affect the control of diabetes. Conversely, poor diabetes control is an important factor disturbing sleep quality. Addressing sleep disturbances in patients who have difficulty controlling their blood glucose has dual benefits: Preventing diabetic complications caused by sleep disturbance and improving diabetes control.</p>

Scalp Dermatoscopic Findings in Androgenetic Alopecia and Their Relations with Disease Severity

BACKGROUND: Clinicians are searching for new methods to diagnose and predict the course of androgenetic alopecia noninvasively. OBJECTIVE: Our aim is to evaluate trichoscopic findings and their relations with disease severity in androgenetic alopecia. METHODS: The videodermatoscopic findings of 143 female and 63 male patients with androgenetic alopecia were compared with each other, with those of healthy subjects (n=100), and with those of patients with other nonscarring alopecias (n=208). Mann-Whitney U-test, chi2 analyses, and logistic regression analysis were used for statistical analysis. RESULTS: No statistically significant relation was found between trichoscopic findings and severity in male androgenetic alopecia (MAGA) on the basis of the modified Hamilton Norwood scale (among 7 degrees); however, multihair follicular unit and perifollicular pigmentation were related to low severity whereas white dots, honeycomb pattern pigmentation, and brown dots were related to high severity. On the other hand, according to the Ludwig classification, arborizing red lines were related to low severity and brown dots were related to high severity, whereas there was no difference in stages between the Ebling and Olsen classifications in female androgenetic alopecia (FAGA). In the characteristic trichoscopic findings in this study, perifollicular pigmentation was found as a normal feature of the scalp, whereas multihair follicular unit and honeycomb pigment pattern, which were previously considered as normal features, were observed to be related to androgenetic alopecia. CONCLUSION: No relation was found between MAGA severity and trichoscopic findings, as well as between FAGA severity according to different disease severity classifications and trichoscopic findings.