Mesotherapy with Bicalutamide: A New Treatment for Androgenetic Alopecia.

Bicalutamide is a selective androgen receptor antagonist. To date, it has been used orally with good efficacy results, but not in mesotherapy. In our center, we assessed whether patients undergoing bicalutamide mesotherapy showed positive responses and tolerated the local administration of bicalutamide. Six premenopausal women, with a mean age of 35.7 years and clinical diagnosis of Olsen Grade II or III female androgenetic alopecia accompanied by significant seborrhea were treated with 1 ml bicalutamide 0.5% mesotherapy. Three monthly sessions were performed. A subtle improvement in hair density was described after the third session. The overall satisfaction of the patients with the treatment was 6.3, on a scale of 1-10. Premenopausal women require several therapeutic approaches to combat severe androgenetic alopecia. Our data showed that bicalutamide mesotherapy was well tolerated and welcomed by the patients; we, therefore, provide a new tool for the management of this pathology.

Algorithm proposal for hair transplantation in fibrosing alopecia pattern distributidon.

Fibrosing alopecia pattern distribution (FAPD) is a recently described disease, wherein the clinical, trichoscopic, and histologic characteristics of non-scarring alopecia, such as androgenic alopecia, and lichenoid inflammatory cicatricial alopecia are reported. The lack of uniformity in the diagnostic criteria can result in FAPD overdiagnosis. The characteristic findings of loss of follicular openings on trichoscopy and fibrosis on histopathology are crucial, as they are necessary to diagnose cicatricial inflammatory lichenoid alopecias.  Hair transplantation in FAPD can be controversial. The scarce publications in this realm do not reach a clear consensus in favor or against the surgical approach. Thus, the presence of histological lichenoid inflammatory infiltrates could make this therapeutic option less suitable. There have been few reports on hair transplantation in other lymphocytic lichenoid inflammatory alopecias, such as lichen planus pilaris (LPP) and frontal fibrosing alopecia (FFA)  Based on those data, an algorithm for the indication of hair transplantation in FAPD is proposed. The algorithm optimizes the results of the treatment and achieves the greatest coverage of the alopecic area.

Mean platelet volume does not seem to relate to thrombosis or posterior uveitis in Behçet's disease.

Behçet's disease (BD) is a chronic inflammatory disorder in which thrombosis and posterior ocular involvement occur in about 30% of patients, whose ethiology is unknown. It has not been established whether mean platelet volume (MPV), a marker of platelet activation, is involved in the pathogenesis of thrombotic events and posterior uveitis in these patients. We aimed to analyze whether there are differences in MPV in BD patients when compared with controls and its relation with the presence of thrombosis and posterior uveitis. We determined MPV and platelet count, along with C-reactive protein (CRP) and cardiovascular risk factors (because of their influence on MPV) in 89 BD patients (of which 24 had thrombosis and 23 had posterior uveitis) and 89 sex- and age-matched healthy controls. BD patients showed statistically higher MPV than controls: 10.98 ± 1.19 fL vs. 10.60 ± 1.21 fL (P = 0.044) and higher CRP: 5.9 ± 8.9 mg/L vs. 1.4 ± 1.7 mg/L (P = 0.001). The percentage of hyperlipemia and diabetes was higher in cases than in controls (P = 0.032, P = 0.013, respectively). No differences in MPV were observed when comparing: patients with and without thrombosis: 11.8 ± 1.27 fL vs. 10.94 ± 1.28 fL (P = 0.654); with and without posterior uveitis: 10.76 ± 1.18 fL vs. 11.03 ± 1.30 fL P = 0.398; with CRP and cardiovascular risk factors (P > 0.05). MPV correlated negatively with platelet count (r = -308, P < 0.01), but not with CRP (r = -0.22, P = 0.772). MPV seems to relate to neither thrombosis nor posterior uveitis in BD patients.

[Behçet disease: study of 74 patients]. / Enfermedad de Behçet: estudio de 74 pacientes.

BACKGROUND AND OBJECTIVE: Behçet disease (BD) has a low prevalence in the Spanish population. Only a few reports have been published on the clinical features of BD in our country. The aim of this study is to determine the type and frequency of these features of BD in a population of patients in the Community of Valencia. PATIENTS AND METHOD: We retrospectively studied clinical data from patients with BD diagnosed between 1990 and 2005 in La Fe, General and Doctor Peset Universitary Hospitals. All Patients fulfilled the International Study Group Criteria for the diagnosis of BD. Statistical analysis was carried out using the chi2 test. RESULTS: Seventy four patients (40 male and 34 female) were studied. The most frequent manifestations were oral (98.5%) and genital aphthae (82.4%), followed by cutaneous lesions (64.2%), ocular lesions (42.5%), fever (39.4%) and vascular manifestations (28.4%). Venous manifestations were more frequent than arterial events. Gastrointestinal lesions occurred more frequently in females compared with males (p = 0.002). Vascular and ocular manifestations were more severe in males than in females. With respect to cardiovascular risk factors, 32.4% of patients were smokers, 20.3% were hyperlipidemic, 19% hypertensive, 13.5% obese and 9.5%diabetic. Cardiovascular risk factors were not related to thrombotic events or posterior uveitis in these patients (p > 0.05). CONCLUSIONS: BD in patients in the community of Valencia is characterized by a variety of clinical manifestations similar to other geographical areas. Gastrointestinal manifestations occur more frequently in female patients, and venous thrombotic manifestations were more frequent than arterial events. Cardiovascular risk factors do not seem to play a role in the development of thrombotic events and posterior uveitis in these patients.

Enfermedad de Behçet: estudio de 74 pacientes / Behçet disease: study of 74 patients

Fundamento y objetivo: La enfermedad de Behçet (EB) es una entidad clínica poco prevalente en España. Son escasos los artículos publicados sobre datos epidemiológicos y manifestaciones clínicas en nuestro país. El objetivo del presente estudio ha sido conocer las características de las manifestaciones clínicas de la EB en la Comunidad Valenciana. Pacientes y método: Se recogieron datos de los pacientes diagnosticados entre 1990 y 2005 de EB en los Hospitales Universitarios La Fe, General y Doctor Peset de Valencia. Todos los pacientes cumplían los criterios diagnósticos del Grupo de Estudio Internacional para el diagnóstico de la EB. Las diferencias entre sexos se analizaron mediante el test de la *2. Resultados: Formaron el grupo de estudio 74 pacientes (40 varones y 34 mujeres). Las manifestaciones clínicas más frecuentes fueron las aftas orales (98,5%) y genitales (82,4%), seguidas de las cutáneas (64,2%), oculares (42,5%), fiebre (39,4%) y vasculares (28,4%), con predominio de las trombosis venosas sobre las arteriales. Sólo las manifestaciones gastrointestinales fueron más frecuentes en el sexo femenino (p = 0,002). Las alteraciones vasculares y oculares fueron más graves en los varones. En cuanto a la prevalencia de los factores de riesgo cardiovascular, el 32,4% de los pacientes eran fumadores, un 20,3% presentaba hiperlipemia; un 19%, hipertensión; un 13,5%, obesidad, y un 9,5%, diabetes, aunque no se observó asociación entre éstos y los episodios trombóticos ni la uveítis posterior (p > 0,05). Conclusiones: Los resultados obtenidos fueron similares a los de otras áreas geográficas. Destacan la mayor frecuencia de manifestaciones digestivas en mujeres y el predominio de los episodios trombóticos venosos sobre los arteriales. Los factores de riesgo cardiovascular no parecen desempeñar un papel en el desarrollo de episodios trombóticos ni uveítis posterior en estos pacientes

Background and objective: Behçet disease (BD) has a low prevalence in the Spanish population. Only a few reports have been published on the clinical features of BD in our country. The aim of this study was to determine the type and frequency of these features of BD in a population of patients in the Community of Valencia. Patients and method: We retrospectively studied clinical data from patients with BD diagnosed between 1990 and 2005 in La Fe, General and Doctor Peset Universitary Hospitals. All patients fulfilled the International Study Group criteria for the diagnosis of BD. Statistical analysis was carried out using the *2 test. Results: Seventy four patients (40 male and 34 female) were studied. The most frequent manifestations were oral (98.5%) and genital aphthae (82.4%), followed by cutaneous lesions (64.2%), ocular lesions (42.5%), fever (39.4%) and vascular manifestations (28.4%). Venous manifestations were more frequent than arterial events. Gastrointestinal lesions occurred more frequently in females compared with males (p = 0.002). Vascular and ocular manifestations were more severe in males than in females. With respect to cardiovascular risk factors, 32.4% of patients were smokers, 20.3% were hyperlipidemic, 19% hypertensive, 13.5% obese and 9.5% diabetic. Cardiovascular risk factors were not related to thrombotic events or posterior uveitis in these patients (p > 0.05). Conclusions: BD in patients in the Community of Valencia is characterized by a variety of clinical manifestations similar to other geographical areas. Gastrointestinal manifestations occur more frequently in female patients, and venous thrombotic manifestations were more frequent than arterial events. Cardiovascular risk factors do not seem to play a role in the development of thrombotic events and posterior uveitis in these patients

Activated protein C levels in Behçet's disease and risk of venous thrombosis.

Behçet's disease is a multi-systemic inflammatory disorder of unknown cause. Most abnormalities have been associated with endothelial injury caused by vasculitis. Thrombosis occurs in about 25% of patients, although the mechanism is unknown. The objective of this study was to evaluate the protein C activation system in Behçet's disease and its correlation with venous thromboembolism (VTE). Thirty-nine patients (12 with VTE) and 78 age- and sex-matched controls were included in the study, and levels of protein C, protein S, activated protein C (APC), protein C inhibitor (PCI), soluble thrombomodulin (TM), antithrombin (AT), alpha(1)-antitrypsin, fibrinogen, factor VIII, von Willebrand factor (VWF) and C-reactive protein (CRP) were measured. APC and TM levels were significantly lower in patients than in controls, whereas protein S, AT, alpha(1)-antitrypsin, fibrinogen, factor VIII, VWF and CRP levels were significantly higher in patients than in controls. APC, PCI and TM levels were lower in patients with VTE (0.65 +/- 0.19 ng/ml, 86% +/- 22% and 15.5 +/- 7.1 ng/ml respectively) than in those without VTE (0.78 +/- 0.17 ng/ml, 100% +/- 15% and 22.1 +/- 15.3 ng/ml) (P < 0.05). In patients, APC levels below 0.75 ng/ml (10th percentile of the control group) increased the risk of VTE about fivefold (odds ratio = 5.1; 95% confidence interval = 1.1-23.4). These results show that reduced APC levels are associated with the high incidence of VTE in Behçet's disease.

[Influenza vaccine and health-care workers: strategies to achieve compliance in a tertiary hospital]. / Vacuna antigripal y personal sanitario: estrategias para aumentar las coberturas en un hospital de tercer nivel.

BACKGROUND: The effectiveness of immunization of health-care workers (HCWs) to reduce nosocomial transmission of influenza is well established. The objective of this study is to evaluate HCWs vaccination rates in a tertiary hospital. PATIENTS AND METHOD: Data of influenza immunization rates among HCWs during two consecutive campaigns have been examined. A descriptive analysis of coverage by age, sex, occupation and job areas is performed. RESULTS: Vaccination rates ranged from 12.7 to 14.7%. Vaccine acceptance among medical residents was significantly higher than in other occupation categories (31.5 and 25.5%, respectively). HCWs at maternal and pediatric areas showed higher immunization rates. CONCLUSIONS: Despite active immunization campaigns, influenza vaccination rates among HCWs are quite low.

Vacuna antigripal y personal sanitario: estrategias para aumentar las coberturas en un hospital de tercer nivel / Influenza vaccine and health-care workers: strategies to achieve compliance in a tertiary hospital

FUNDAMENTO: La efectividad de la inmunización del personal sanitario en la reducción de la transmisión nosocomial del virus influenza es un hecho bien documentado. El objetivo de este estudio es analizar las coberturas de vacunación antigripal en el personal sanitario de un hospital de tercer nivel. SUJETOS Y MÉTODO: Se analizan los datos de dos campañas sucesivas de vacunación y se realiza un análisis descriptivo de las coberturas según edad, sexo, categoría laboral y área de trabajo. RESULTADOS: Las coberturas alcanzadas han sido del 12,7 y del 14,7 por ciento, respectivamente. Los médicos residentes son el colectivo profesional con mayor aceptación de vacunación (coberturas del 31,5 y el 25,5 por ciento, respectivamente), así como el personal que trabaja en el área Maternoinfantil. CONCLUSIONES: La cobertura de vacunación antigripal en el personal sanitario es muy baja a pesar de la utilización de estrategias de inmunización activa. (AU)