Effects of Different Therapeutic Approaches on Redox Balance in Psoriatic Patients.

Given that oxidative stress represents an important etiological factor in the pathogenesis of psoriasis, the aim of this study was to assess the effects of different therapeutic approaches, methotrexate, secukinumab, and ustekinumab on systemic oxidative stress biomarkers in psoriatic patients. This study involved 78 psoriatic patients, divided into the group treated with methotrexate (23 patients), secukinumab (28 patients), and ustekinumab (27 patients), and 15 healthy controls. Oxidative stress biomarkers (index of lipid peroxidation measured as TBARS, nitrites (NO2-), superoxide anion radical (O2-), and hydrogen peroxide (H2O2)) and antioxidative defense system (superoxide dismutase (SOD) activity, catalase (CAT) activity, and reduced glutathione (GSH)) were determined spectrophotometrically from the blood before the initiation of therapy in 16th, 28th, and 52nd week. O2- and SOD showed the most prominent changes comparing the psoriatic patients and healthy controls. CAT activity was significantly lower in psoriatic patients, and methotrexate induced a further decline in CAT activity. Ustekinumab induced a significant increase in GSH level after 52 weeks of treatment, while methotrexate reduced GSH. All applied therapeutic options induced a reduction in PASI, BSA, DLQI, and EARP. Biological drugs exert more pronounced antioxidant effects compared to methotrexate, which is most clearly observed in the values of O2- and SOD.

Acute hemorrhagic edema of infancy - is it really a mild, benign disease?

BACKGROUND: Acute hemorrhagic edema of infancy (AHEI) is a rare vasculitis, which presents dramatically as palpable purpuric skin lesions on the limb, face and auricles, with swelling of these parts and low-grade fever, in children up to 2 years of age. To date, approximately 400 cases have been described in the literature. The etiology remains mostly unknown. With or without treatment, AHEI goes to spontaneous recovery within 1-3 weeks, usually without any complications. To our knowledge, compartment syndrome as complication of AHEI has only been reported in one case. We present an unusual case of AHEI with serious complications due to compartment syndrome of the right-hand fingers. CASE: A 16-month-old male child presented with fever and sudden appearance and rapid spread of palpable, painless, non-itching ecchymotic hematomas on the thigh, cheeks, earlobes, forearms, dorsum of hands and feet, with mild edema of these regions. Complete systemic examination and all vital parameters were normal for age. There was no history of bleeding disorders in the family. Except low hemoglobin on complete blood count and increased D-dimer values, all other laboratory investigations were in the normal range. Changes on the right forearm and hand expanded on almost the entire dorsal side and all surfaces of the fingers, with pronounced swelling and formation of bullous lesions, which were spreading and cracking. Skin biopsy confirmed nonspecific small-vessel vasculitis. That required the use of Methylprednisolone, low-molecularweight heparin, antibiotics and debridement of necrotic eschar, with necrectomy of the affected fingers. CONCLUSIONS: Early recognition of AHEI is important to avoid unnecessary investigation and therapy. On the other hand, our reported case warns that unexpected complications may occur.

Improving Oxidative Stability of Cosmetic Emulsions with Plant Extracts: Current Status and Potential.

There are increasing demands for cosmetic emulsions with natural active components such as plant extracts because of their myriad benefits. Quality of cosmetic emulsions may be affected by distribution and storage processes, which can lead to peroxidation of lipid components. Lipid peroxidation results in undesirable alterations in efficacy, texture, and appearance of the cosmetic product, thus indicating a need to find a safe and potent compound to be added in products to postpone oxidation processes. In that sense, the current article gives an overview of parameters influencing oxidative stability of emulsions, as well as methods for assessing the oxidative stability. Emphasis is given to the usage of plant extracts rich in phenolics for improving oxidative stability of cosmetic emulsions. Application of plant extracts in cosmetic emulsion is promising because of their significant antioxidant properties which may delay lipid peroxidation during storage. Plant species are a valuable source of biologically active compounds that might be exploited in the cosmetic and pharmaceutical industry.

Atopic dermatitis: the impact of personality properties of affected children and parental styles of care.

BACKGROUND: Atopic dermatitis is a frequent, chronic, pruritic, inflammatory skin disease that usually begins in early childhood. It is a somato-psychic disease which is influenced by the family environment and related emotional instability (neuroticism), however, relevant data are sparse. OBJECTIVES: To determine the impact of personality properties of affected children and parental styles of care on the severity of atopic dermatitis. MATERIALS AND METHODS: The study was conducted on 80 patients diagnosed with atopic dermatitis, treated at the Center for Dermato-venereology of the Pediatric Clinic, Clinical Center "Kragujevac", Central Serbia. The study included children aged 8 to 13 years, of both sexes, with a diagnosis of atopic dermatitis based on the SCORAD index. The EMBU scale was used to assess parental behaviour, and HANES1 and HANES2 scales were used to assess basic dimensions of personality (neuroticism and stability). The Student-t, Chi-square, ANOVA, and Cronbach's alpha coefficient were used for statistical analyses (p < 0.05 was considered significant). RESULTS: A statistically significant difference in average score values for both mothers and fathers was observed for the scales, Overprotection (p = 0.007) and Emotional warmth (p = 0.001), but not for Rejection (p = 0.073), Favouring (p = 0.128) or Inconsistency (p = 0.083). CONCLUSION: We suggest that the therapeutic programme for atopic dermatitis requires improvement, with the addition of psychological testing and subsequent psychotherapy to standard diagnostic procedures.

Ursodeoxycholic acid for treatment of cholestasis in patients with hepatic amyloidosis.

BACKGROUND: Amyloidosis represents a group of different diseases characterized by extracellular accumulation of pathologic fibrillar proteins in various tissues and organs. Severe amyloid deposition in the liver parenchyma has extrahepatic involvement predominantly in the kidney or heart. We evaluated the effect of ursodeoxycholic acid, in four patients with severe hepatic amyloidosis of different etiologies, who presented with increased alkaline phosphatase and gamma-glutamyl transferase. CASE REPORT: The study included four patients who presented with amyloidosis-associated intrahepatic cholestasis. Three of them had renal amyloidosis which developed 1-3 years before cholestasis occurred, the remaining one having intrahepatic cholestasis as the primary sign of the disease. Amyloidosis was identified from liver biopsies in all patients by its specific binding to Congo red and green birefringence in polarized light. The biochemical nature and the class of amyloid deposits were identified immunohistochemically. In addition to their regular treatment, the patients received 750 mg ursodeoxycholic acid per day. After 2-4 weeks all patients had a significant decrease of serum alkaline phosphatase and gamma-glutamyl transferase, and their general status significantly improved. CONCLUSION: Treatment with ursodeoxycholic acid may be beneficial in patients with hepatic amyloidosis, and do extend indications for the use of ursodeoxycholic acid in amyloidotic cholestatic liver disease.

[Relationship between physical activity and some parameters of nutritional state in adolescence].

INTRODUCTION: In the last two decades, an increase in obesity along with a number of co-morbidities has been recorded among children and adolescents. OBJECTIVE: The aim was to investigate if there was a difference in nutritional status between adolescents who were active sportsmen and those who did not engage in sport activities other than regular physical activities at school and if active training could be an independent factor in the prevention of obesity. METHODS: There were 117 male adolescents on average aged 15.4 +/- 1.8 years. The subjects were divided into two groups; 32 active sportsmen engaged in regular training in football and a control group consisting of 85 adolescents engaged in no physical activity except for that at school (two hours per week). In all subjects Body Mass Index (BMI) was determined. The percentage of the total body fat was estimated from the sum of values of skin fold thickness measured at four sites (according to Durnin and Womersley). Lean Body Mass (LBM) was estimated by deducting the triceps skin fold from the upper arm circumference and comparing it to the norms. All collected data were analyzed by descriptive and analytical statistical methods: chi2-test, t-test. RESULTS: Adolescent sportsmen showed a statistically significantly lower BMI and percentage of total body fat than the adolescents in the control group (p < 0.01). A significantly higher LBM was found in the sportsmen (p < 0.01). CONCLUSION: Active participation in sports can be a contributing factor in the prevention of obesity, and it is therefore recommended to combine regular physical activities with an adequate diet. BMI screening of general population can indicate a high number of children and adolescents at risk for obesity or who are already obese.

Bilateral nevus of Ota in a light-skinned woman.

Nevus of Ota is a dermal melanocytosis, clinically localized on skin that is innervated by the first and second branches of the trigeminal nerve. It occurs almost entirely in Asian people. This manifestation is rarely described in light-skinned non-Asian persons. We present a case of bilateral Ota nevus in a 47-year-old light-skinned non-Asian woman.

Gyrate erythema associated with metastatic tumor of gastrointestinal tract.

Figurate or gyrate erythemas are group of skin conditions that present as annular or figurate erythematous papules and plaques with peripheral spreading. Several diseases are included in this group but only two of them are associated with underlying malignancy, erythema annulare centrifugum and erythema gyratum repens. We present a 58-year-old woman with simultaneous presentation of gyrate erythema and skin metastasis from a gastrointestinal tumor that was diagnosed by histopathology and immunohistochemistry as a leiomyogenic gastrointestinal stromal tumor.

Effects of soybean D-LeciVita product on serum lipids and fatty acid composition in type 2 diabetic patients with hyperlipidemia.

BACKGROUND AND AIM: Hyperlipidemia is one of the major risk factors of cardiovascular complication in diabetes. High intake of soy product has been suggested to prevent cardiovascular disease. The purpose of this study was to evaluate if dietary supplement of soybean D-LeciVita product, rich in polyunsaturated phospholipids (with 12% lecithin, 35% soy protein) affects serum lipids and serum and erythrocyte phospholipid fatty acid composition in type 2 diabetic patients. METHODS AND RESULTS: Forty-seven patients (men and post-menopausal women) with isolated hypertriglyceridemia (IHTG) and combined hyperlipidemia (CHL), aged 43-70 years, were given 15g of D-LeciVita powder as a water suspension in a single evening dose during the follow-up period of 12 weeks. Patients kept their diabetic diet relatively constant. Treatment was associated with a significant (p < or = 0.001) decrease in serum total cholesterol and triglyceride levels by 12% and 22%, respectively. LDL-cholesterol decreased by 16% and HDL-cholesterol increased by 11% (p < or = 0.001). Our study shows a 27% decrease in LDL-cholesterol (p < or = 0.001) and a 12% increase in HDL-cholesterol (p < or = 0.01) in CHL type 2 diabetic patients. Triglyceride levels decreased in type 2 diabetic patients with IHTG and CHL by 29% and 13%, respectively (p < or = 0.01 and p < or = 0.05). Our results show decrease in SFA and increase in n-6 and n-3 PUFA in serum and erythrocyte phospholipids. SFA decreased and n-3 PUFA increased in serum and erythrocyte phospholipids in IHTG and CHL groups. CONCLUSION: The present study indicated that added to a regular diet, soybean D-LeciVita product (combination of soy protein and lecithin) is associated not only with lipid-lowering effects but also with more favorable serum phospholipids fatty acid profile in type 2 diabetic patients with hyperlipidemia.

Plasma and erythrocyte phospholipid fatty acids composition in Serbian hemodialyzed patients.

Dyslipidemia is one of the possible risk factors for advanced atherosclerosis in patients with chronic renal failure. Abnormal phospholipid metabolism may play an important role in the progression of atherosclerosis in patients with renal failure. The aim of this study was to determine specific characteristics of plasma and erythrocyte phospholipid content and fatty acid composition in 37 patients with chronic renal failure on hemodialysis (HD). The results were compared with the characteristics of healthy subjects. Briefly, plasma triglyceride (p < 0.001), total cholesterol (p < 0.05), and total phospholipids (p < 0.01) levels were significantly higher and HDL-cholesterol level significantly lower (p < 0.01) in HD patients. Plasma phosphatidylcholine and phosphatidylethanolamine concentration were significantly higher (p < 0.001) in HD patients. The plasma phospholipid fatty acids composition indicated significantly (p < 0.01) higher level of oleic (18:1 n-9) and lower levels of eicopentaenoic (20:5 n-3 EPA) and docosahexaenoic (22:6 n-3 DHA) acids (p < 0.05). However, in HD patients, the relative concentration of plasma phospholipid n-6 polyunsaturated fatty acid (PUFA) was significantly lower (p < 0.05). The fatty acid composition of erythrocyte phospholipid in HD patients was modified with EPA and DHA levels significantly lowered (p < 0.05). Our results demonstrate an abnormal phospholipid metabolism and deficiency of n-3 PUFA in plasma and erythrocyte phospholipids in hemodialyzed patients.

[Assessment of diet therapy effect on blood pressure of obese persons with and without antihypertensive therapy]. / Ispitivanje efekta dijetoterapije na krvni pritisak gojaznih osoba sa i bez antihipertenzivne terapije.

BACKGROUND: Arterial hypertension is a multicausal chronic disease often accompanied by obesity. The aim of this investigation was to examine the effect of diet therapy in the treatment of obese hypertensives with and without antihypertensive therapy. METHODS: The investigation was conducted at the Department of Nutrition on a sample of 110 obese hypertensive patients on diet therapy. Subjects were divided into two groups: the group on diet therapy with antihypertensive drugs E1 (n=78), and the group on diet therapy without pharmacotherapy E2 (n=32). Nourishment state i.e., obesity level was assessed by body mass index (BMI). All the patients belonged to the obese group--BMI > 30 kg/m2. Besides blood pressure values, the following parameters were monitored: serum cholesterol, trygliceride levels and BMI. RESULTS: The obtained results in the group with diet therapy combined with antihypertensive therapy showed highly significant decrease of anthropometrical parameters: body weight (99.14 kg vs. 90.16 kg) (p<0.001) and BMI (37.32 vs. 34.09) (p<0.001); percent body fat (41.97 vs. 38.78) (p<0.001); systolic (154.81 vs. 141.91) (p<0.001), and diastolic pressures (95.42 vs. 87.36) (p<0.001); cholesterol (6.39 vs. 5.99) (p<0.002), and triglycerides concentration (2.69 vs. 2.21) (p<0.019). In the group on single diet therapy, highly significant decrease of body mass (99.33 vs. 90.18) (p<0.001), BMI (34.79 vs. 31.58) (p<0.001), percent body fat (39.27 vs. 36.70) (p<0.001), systolic (148.44 vs. 132.74) (p<0.001), and diastolic pressures (93.97 vs. 82.90) (p<0.001), was achieved, while the differences between initial and final cholesterol and triglyceride concentrations, although observed, were not statistically significant. CONCLUSION: The obtained results implicated that diet therapy significantly helped the normoregulation of both systolic and diastolic blood pressure. Considering this, during physicians' routine practice in the treatment of hypertension, attention should be paid on the reduction of the corresponding level of obesity.

[Role and importance of dietary polyunsaturated fatty acids in the prevention and therapy of atherosclerosis]. / Uloga i znacaj polinezasicenih masnih kiselina u ishrani kod prevencije i lecenja ateroskleroze.

INTRODUCTION: Hyperlipoproteinemia is a key factor in development of atherosclerosis, whereas regression of atherosclerosis mostly depends on decreasing the plasma level of total and LDL-cholesterol. Many studies have reported the hypocholesterolemic effect of linolenic acid. TYPES OF POLYUNSATURATED FATTY ACIDS (PUFA): Linoleic and alpha-linolenic acids are essential fatty acids. The main sources of linoleic acid are vegetable seeds and of alpha-linolenic acid-green parts of plants. alpha-linolenic acid is converted to eicosapentaenoic and docosahexaenoic acid. Linoleic acid is converted into arachidonic acid competing with eicosapentaenoic acid in the starting point for synthesis of eicosanoids, which are strong regulators of cell functions and as such, very important in physiology and pathophysiology of cardiovascular system. Eicosanoids derived from eicosapentaneoic acid have different biological properties in regard to those derived from arachidonic acid, i.e. their global effects result in decreased vasoconstriction, platelet aggregation and leukocyte toxicity. ROLE AND SIGNIFICANT OF PUFA: The n-6 to n-3 ratio of polyunsaturated fatty acids in the food is very important, and an optimal ratio 4 to 1 in diet is a major issue. Traditional western diets present absolute or relative deficiency of n-3 polyunsaturated fatty acids, and a ratio 15-20 to 1. In our diet fish and fish oil are sources of eicosapentaenoic and docosahexaenoic acid. Refined and processed vegetable oils change the nature of polyunsaturated fatty acids and obtained derivates have atherogenic properties.

Effects of different quantities of fat on serum and liver lipids, phospholipid class distribution and fatty acid composition in alcohol-treated rats.

The present study investigated the quantitative effect of dietary fats and ingestion of alcohol on serum and liver lipids, fatty acid bound to phospholipids and their class distribution of male Wistar rats. The rats in C (control) and A (alcohol) groups were fed a standard laboratory diet, HFC (high fat-control) and HFA (high fat-alcohol) groups were fed a high fat diet (standard diet supplemented with 20 g%w/w, sunflower oil: lard mixture 1: 1) for 6 wk. Alcohol-treated rats consumed alcohol at the rate of 9 g/kgbw/d (15-20% energy). Liver phospholipid (PL) content was decreased, and phospholipid/cholesterol liver molar ratio increased in the alcohol treated rats. The proportion of serum sphingophospholipid (Sph) was significantly lower and proportion of phosphatidylcholin (PC) significantly higher in serum PL in alcohol-treated rats. Phospholipid class distribution was unaffected by alcohol feeding in liver. Significantly lower levels of 16:1n-7 and higher levels of 20:5n-3 and 22:4n-6 in the serum PL were observed in the alcohol-treated rats. The groups on the HF diet increased levels of 20:4n-6, 22:4n-6 and total n-6, polyunsaturated fatty acid (PUFA) and decreased levels of 18:1n-9 and total monounsaturated fatty acids (MUFA)in both liver and serum PL, but n-3 fatty acid increased in serum PL and decreased in liver PL compared to groups on the standard diet. Alcohol fat interaction was evident in MUFA and PUFA/SFA in serum PL and n-6, MUFA, PUFA and polyunsaturated/saturated fatty acid ratios (PUFA/SFA) in liver PL. This study showed that the high fat intake in alcohol-treated rats increased levels of 20:4n-6, 22:4n-6 and 20:4/18:2 ratio, and decreased level of 18:1n-9 in liver and serum phospholipids.

[Alpha-linolenic acid and cardiovascular diseases]. / Alfa-linolenska kiselina i kardiovaskularna oboljenja.

IMPORTANCE AND METABOLISM OF ALPHA-LINOLENIC ACID: Alpha-linolenic acid is an essential fatty acid which cannot be produced in the body and must be taken by food. Both in animals and humans, alpha-linolenic acid is desaturated and elongated into eicosapentaenoic and docosahexaenoic acid. It is also incorporated into plasma and tissue lipids and its conversion is affected by levels of linoleic acid. POTENTIAL ROLE IN PATHOGENESIS OF CARDIOVASCULAR DISEASES: Diet enriched in n-3 fatty acids, especially alpha-linolenic acid, reduces the incidence of cardiac death. Studies have shown that alpha linolenic acid prevents ventricular fibrillation which is the main cause of cardiac death. Studies in rats suggest that alpha-linolenic acid may be more effective in preventing ventricular fibrillations than eicosapentaenoic and docosahexaenoic acid. Furthermore, alpha-linolenic acid is the main fatty acid decreasing platalet aggregation which is an important step in thrombosis i.e. non-fatal myocardial infarction and stroke. DIETARY SOURCES AND NUTRITION RECOMMENDATIONS: Dietary sources include flaxseed and flaxseed oil, canola oil, soybean and soybean oil, pumpkin seed and pumpkin oil, walnuts and walnut oil. Strong evidence supports beneficial effects of alpha-linolenic acid and its dietary sources should be incorporated into balanced diet for prevention of cardiovascular diseases. The recommended daily intake is 2 g with a ratio of 5/1 for linoleic/alpha-linolenic acid.