Association of thyroid autoimmunity with acne in adult women.

BACKGROUND: During the last decades an increase has been observed regarding acne in adults and especially women. OBJECTIVE: To evaluate the association between thyroid disorder and the presence of post-adolescent acne in adult women, comparing with healthy controls. METHODS: 107 adult women with post-adolescent acne and 60 healthy controls were included. Complete blood count and standard biochemical profile of C-Reactive Protein (CRP) and levels of thyroid hormones and antibodies [triiodothyronine (T3), thyroxine (T4), thyroid stimulating hormone (TSH), free T3 (FT3), free T4 (FT4), antithyroglobulin antibodies (anti-TG) and anti-thyroid peroxidase antibodies (anti-TPO)] were determined in all subjects of both the acne and control groups. A thyroid ultrasound was also performed. RESULTS: There was a statistically significant difference (P=0.008) in the prevalence of positive anti-TG antibodies, with 25.2% of the acne group and 8.3% of the control group having elevated (>40 U/mL) anti-TG levels, respectively. Adult women with acne had a statistically significant increased relative risk to have high levels of anti-TG in comparison with healthy controls (odds ratio 3.89, P=0.011). This association was independent of age. Values for TSH, FT4, FT3, T4 and anti-TPO did not significantly differ between the two groups. No significant difference was found regarding the thyroid ultrasound findings. Although there was no significant difference between cases and controls regarding CRP levels, it is interesting that we observed a significant elevation in CRP in those acne patients who had positive antithyroglobulin antibodies. CONCLUSIONS: It is likely that thyroid autoimmunity might be more frequent in the adult acne patients and this should be kept in mind when screening women with post-adolescent acne.

Peritoneal dialysis without a physical peritoneal dialysis unit.

UNLABELLED: Under certain circumstances when patients need peritoneal dialysis (PD) but no physical unit or official staff are available, one has to improvise ways to serve such patients. In this study we describe our experience with such patients without a physical peritoneal dialysis unit. PATIENTS AND METHODS: Since 1997 we trained 33 patients, mean age 61.7 +/- 12.8 years old. Catheter implantation was done in another hospital on them as out-patients. We used trained nurses made available by the company that supplies the PD solution. After 2004 the whole training was done at patients' home, after having been accepted by the patients. RESULTS: Catheter implantation was successful in all 33 patients. Catheter was removed from 2 patients (one and 4 years after implantation) because of relapsing peritonitis in the first and fungal infection in the second. The overall peritonitis rate was 0.18 episodes/patient year or one episode every 63.5 patient months. Actuarial patient survival was 90%, at one year, 83% at second year and 55% at third year. First and second year technique survival were 96%, and 90% respectively. CONCLUSION: Our results, should encourage those who want to provide peritoneal dialysis to their patients even when a physical peritoneal dialysis unit is not available.

Five-year survival in comparable HD and PD patients: one center's experience.

Several studies have yielded conflicting results regarding morbidity and mortality in peritoneal dialysis (PD) and hemodialysis (HD) patients. We performed a retrospective analysis in end-stage renal disease (ESRD) patients in our department, who were equally distributed between HD and PD, in order to compare 5-year survival probabilities and hospitalization rates in the two modalities. Of the total 94 new ESRD patients who initiated dialysis in our department from January 1995 to December 2000, 48 were allocated to PD and 46 to HD. All patients were followed up for five years. There were no significant differences regarding demographics and serious co-morbidities upon dialysis initiation between HD and PD patients. Unadjusted 5-year survival probability in as-treated analysis was higher in PD patients (0.79 vs 0.6, p=0.04), whereas there was no significant difference in intent-to-treat analysis between HD and PD patients (p=0.5). Hospitalization rates were similar in both modalities. Despite the small number of patients included in our study, it seems that when HD and PD are both available in one department they have equivalent results regarding morbidity and mortality rates. Therefore we suggest that, when possible, PD and HD should be equally offered to all ESRD patients.