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COVID-19 , Rosácea , Vacunas contra la COVID-19 , Humanos , SARS-CoV-2 , Vacunación/efectos adversosRESUMEN
CONTEXT: Colonic polyps occur in 30-40% of acromegalic patients, increasing the risk of colon carcinoma. Although debated, there is emerging evidence that metformin may play a protective role in diabetic and non-diabetic patients with colonic polyps and its use in chemoprevention is currently explored. OBJECTIVE: Evaluate the prevalence of colonic polyps in acromegalic patients treated or not with metformin and explore its possible protective role. DESIGN: Exploratory cross-sectional study in two tertiary Italian referral centres. MET: hods: Out of 153 acromegalic patients, we selected 58 patients (36-82 years; f: 33) who had at least one colonoscopy performed within the first 2 years of diagnosis. Presence of colonic polyps/cancer and related risk factors, current metformin and acetylsalicylic acid intake, disease duration, therapies for acromegaly, hormonal and metabolic parameters were assessed. RESULTS: An overall prevalence of 36% polyps was found. Based on the presence of polyps, we identified two groups, comparable for age, BMI, disease duration, glucose, insulin, HOMA-IR, HbA1c, GH and IGF-I levels. Of the patients with polyps (including three adenocarcinomas) only 24% were treated with metformin vs 57% of patients without polyps. Multivariate analysis confirmed a significant negative association between colonic polyps and metformin intake (OR: 0.22, 95% CI: 0.06-0.77, P = 0.01), whereas no significant association was found between polyps and age (P = 0.10), overweight/obesity (P = 0.54), smoking (P = 0.15), acetylsalicylic acid intake (P = 0.99), disease duration (P = 0.96), somatostatin analogues treatment (P = 0.70). CONCLUSIONS: These findings, though deriving from an exploratory study, could suggest a protective role of metformin on the development of colonic polyps in acromegaly, and need to be confirmed in an extended study population.
Asunto(s)
Acromegalia/complicaciones , Pólipos del Colon/prevención & control , Hipoglucemiantes/uso terapéutico , Metformina/uso terapéutico , Adulto , Anciano , Anciano de 80 o más Años , Pólipos del Colon/epidemiología , Pólipos del Colon/etiología , Colonoscopía , Estudios Transversales , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , RiesgoAsunto(s)
Conocimientos, Actitudes y Práctica en Salud , Enfermedades de Transmisión Sexual/psicología , Estudiantes/psicología , Sexo Inseguro/estadística & datos numéricos , Adolescente , Adulto , Albania/epidemiología , Conocimientos, Actitudes y Práctica en Salud/etnología , Humanos , Italia/epidemiología , Masculino , Estudiantes/estadística & datos numéricos , Encuestas y Cuestionarios , Universidades/estadística & datos numéricos , Sexo Inseguro/psicología , Adulto JovenAsunto(s)
Enfermedades de la Boca/epidemiología , Infecciones por Papillomavirus/epidemiología , Fumar/epidemiología , Enfermedad Crónica , Femenino , Genotipo , Homosexualidad Masculina , Humanos , Italia/epidemiología , Masculino , Enfermedades de la Boca/virología , Papillomaviridae/genética , Infecciones por Papillomavirus/virología , Prevalencia , Estudios RetrospectivosRESUMEN
No disponible
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Humanos , Rosácea/etiología , Ivermectina/uso terapéutico , Ácaros/patogenicidad , Factores de RiesgoAsunto(s)
Infecciones por Virus de Epstein-Barr/complicaciones , Exantema/complicaciones , Síndromes Mielodisplásicos/complicaciones , Anciano , Transformación Celular Neoplásica , Infecciones por Virus de Epstein-Barr/diagnóstico , Infecciones por Virus de Epstein-Barr/tratamiento farmacológico , Exantema/diagnóstico , Exantema/tratamiento farmacológico , Exantema/virología , Resultado Fatal , Humanos , Inmunoglobulinas Intravenosas/uso terapéutico , Leucemia Mieloide Aguda/patología , Masculino , Síndromes Mielodisplásicos/patologíaAsunto(s)
Infestaciones por Ácaros/complicaciones , Rosácea/complicaciones , Animales , Bacillus/aislamiento & purificación , Microbioma Gastrointestinal , Humanos , Insecticidas/uso terapéutico , Ivermectina/uso terapéutico , Infestaciones por Ácaros/tratamiento farmacológico , Infestaciones por Ácaros/genética , Ácaros/microbiología , Mutación , Rosácea/genética , Factor de Transcripción STAT1/genéticaAsunto(s)
Liquen Plano Oral , Tacrolimus , Administración Tópica , Humanos , Inmunosupresores , Liquen PlanoRESUMEN
Although neurosyphilis (NS) keeps plaguing worldwide, often with oligosymptomatic and atypical manifestations, the most recent reports fail to provide useful information, like details of the clinical history and even of the previous early therapy. We conducted a survey of the literature of the last 5 years on the clinical presentation of NS, recording the aforementioned inaccuracies. One hundred and thirty-seven articles were collected, reporting on 286 patients. General paresis was the commonest form (49%), often manifesting with cognitive impairment and psychiatric symptoms. Syphilitic meningitis was found in 63 patients (22%), mainly with ocular or auditory involvement. Meningovascular and tabetic form were both found in 12% of cases. Gummatous and epileptic manifestations were rare. Perusal of the literature confirms that NS prevalence is increasing, often with manifestations that are atypical for timing and type of lesions. Unfortunately, many articles are lacking of critical information, like an accurate clinical history and timing of the therapy making difficult to assess the effectiveness of penicillin in preventing NS.
Asunto(s)
Neurosífilis/patología , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neurosífilis/diagnóstico , Encuestas y Cuestionarios , Adulto JovenAsunto(s)
Herpes Zóster/epidemiología , Pitiriasis Rosada/epidemiología , Psoriasis/complicaciones , Adolescente , Adulto , Anciano , Niño , Preescolar , Femenino , Herpes Zóster/complicaciones , Humanos , Italia/epidemiología , Masculino , Persona de Mediana Edad , Pitiriasis Rosada/complicaciones , Prevalencia , Adulto JovenRESUMEN
Telogen effluvium (TE) is heterogeneous disorder. It can be classified into three main categories: the premature teloptosis, the collective teloptosis and the premature entry into telogen. The last category can be divided in three types: the drug induced TE, TE due to dietary deficiencies and the "autoimmune" TE. Despite this heterogeneity, the large majority of TE that arrive at the dermatologist's observation pertain to the autoimmune type, featuring a standard presentation. The typical patient is a woman claiming to have always had a "full head of hair" and reporting her hair to come out suddenly "by the handful". Usually, she is accurate about the date of onset of her shedding. She is in good health, without signs of anorexia nor nutrient deficiencies. She admits to having been in an anxious state for some months, and felt, occasionally or not, a painful or burning sensation at the scalp (trichodynia). Usually, the course of the disorder is chronic but intermittent, with apparent remissions being irregularly intermitted by relapses. The shed hairs do not exhibit telogen roots, but mostly exogen ones. This distinct entity, shares some analogies with alopecia areata, including the triggering role of emotional stress, trichodynia and the frequent association with Hashimoto's thyroiditis. Methods to assess its severity and to monitor treatment are described. In the absence of a documented etiopathogenesis, no treatment can be endorsed, but a course of topical corticosteroids could be tried.