Androgenetic alopecia as an indicator of metabolic syndrome and cardiovascular risk.

Numerous studies have investigated a probable association between androgenetic alopecia (AGA) and cardiovascular disease (CVD) by researching limited and dispersed parameters. We aimed to evaluate both traditional and non-traditional cardiovascular risk factors in male patients with early-onset AGA. This case-control study included 68 participants: 51 male patients with early-onset AGA and 17 healthy male controls. Patients with AGA were classified into three groups according to the Hamilton-Norwood scale and the presence of vertex hair loss. Traditional and non-traditional cardiovascular risk factors were examined in all study subjects. Metabolic syndrome was diagnosed in 25 patients with AGA and in two control subjects (p < 0.05). The carotid intima-media thickness values were found to be significantly higher in patients with vertex pattern AGA than in patients without vertex baldness and controls (p < 0.05). The pulse-wave velocity values were also found to be significantly higher in patients (p < 0.001). A limitation of this study was the small study population. In conclusion, vertex pattern AGA appears to be a marker for early atherosclerosis. This finding supports the hypothesis that early-onset AGA alone could be an independent risk factor for CVD and metabolic syndrome.

The prevalence of Behçet's disease in a city in Central Anatolia in Turkey.

BACKGROUND: The prevalence of Behçet's disease (BD) is much higher in countries along the ancient Silk Route, extending from Japan to Mediterranean countries including Turkey, than in northern Europe and the USA. OBJECTIVES: The present study aimed to investigate the prevalence of BD in Kayseri, a city in Central Anatolia in Turkey. METHODS: This study investigated cross-sectional prevalences of BD in individuals aged >10 years in Kayseri, Turkey, in two stages. The first stage aimed to identify individuals with recurrent oral ulcers (ROUs) through home visits, and the second stage aimed to further examine those with ROUs for the presence of other BD-related manifestations under hospital conditions. The study was conducted using the criteria defined by the International Study Group for Behçet's Disease. The sample size was determined to be 4697 with an expected sampling error of 5.5 per 10,000, with a 95% confidence interval. A standard questionnaire was administered to a total of 5218 individuals. RESULTS: A history of ROU was recorded in 470 (9.0%) of the 5218 residents, and a previous diagnosis of BD was recorded in nine individuals. The prevalence rate of BD was estimated as 17 cases per 10,000 population in Kayseri, Turkey. CONCLUSIONS: The present study contributes towards estimations of prevalences of BD in Turkey and towards raising public awareness about the disease. It also supports previous studies that have reported the world's highest prevalences of BD in Turkey.

P50 variations in Behcet`s patients without neurologic findings.

OBJECTIVE: In the present study, subclinical lesion involvement was investigated using the P50 component in Behcet`s patients without neurological manifestation. METHODS: We performed this clinical research in Erciyes University, Faculty of Medicine between December 2000 and November 2001. The studies were carried out on 18 Behcet`s patients without neurologic findings and 18 volunteers for control. Standard Ag/AgCl electrodes in plastic cups were used for monopolar EEG derivations. They were attached with electrode paste and tape at the Cz (vertex) according to the 10-20 system. The auditory stimuli were delivered in pairs. The P50 waves, which may be taken from approximately 50 msec from the stimuli, were collected by computer system. Amplitudes and latencies of the P50 components were measured in the same system. RESULTS: This study showed that the suppression of P50 responses performed by the test stimuli, was significantly more decreased in Behcet`s patients than the control subjects. CONCLUSION: The decrease of the suppression of the auditory P50 response to repeated stimuli reflects a deficit in the central nervous system`s ability, such as attention, cognition, and sensory input in Behcet`s patients and can be used as a neurophysiological marker in subclinical lesions in these patients.

Cutaneous lupoid leishmaniasis: a case report.

Cutaneous leishmaniasis is a disease transmitted by the sandfly. During the course of the disease, all classical stages of the development of leishmaniasis from small erythematous papules to nodules to ulcerative lesions can be seen. We report a case of lupoid leishmaniasis (LL) treated with daily intramuscular injections of meglumine antimoniate for 20 days with marked improvement of clinical features.

Synovial nitric oxide concentrations are increased and correlated with serum levels in patients with active Behçet's disease: a pilot study.

Behçet's disease (BD) is a relapsing immunoinflammatory vasculitis of unknown etiology characterized by endothelial dysfunction. Articular symptoms and signs are present in about 75% of cases and characterized by seronegative arthritis and nonspecific synovitis. We demonstrated that both serum and erythrocyte nitric oxide (NO(.)) levels, the most abundant free radical in the body, were elevated in BD and associated with disease activity. This study further investigated NO(.) levels in the synovial fluid and serum from patients with active and inactive BD. A total of 23 BD patients with articular involvement (14 men and 9 women) satisfying International Study Group criteria and 15 age- and sex-matched healthy control subjects (9 men and 6 women) undergoing elective arthroscopy were included in this case-control investigation. The synovial fluid and serum were obtained from BD patients and controls. Clinical and laboratory findings including neutrophil count and erythrocyte sedimentation rate (ESR) were used to classify BD patients as active (n = 11) or inactive (n = 12). Synovial as well as serum NO(.) levels were compared between the groups and correlation analysis was performed. Acute phase reactant levels were significantly higher (for each, p < 0.01) in BD patients than control subjects in the active period. The mean synovial NO(.) level in active Behçet's patients (mean +/- SD 76.61 +/- 11.95 micromol/l) was significantly higher than in inactive patients (46.16 +/- 8.89 micromol/l, p < 0.001) and healthy control subjects (39.60 +/-8.03 micromol/l, p < 0.001). The difference between inactive patients and controls was not significant (p > 0.05). Active BD patients had significantly higher serum NO(.) levels (38.84 +/- 9.15 micromol/l) than inactive patients (30.91 +/- 5.88 micromol/l, p = 0.018) and control subjects (28.86 +/- 5.91 micromol/l, p = 0.002). In addition, synovial NO(.) levels were positively correlated with serum levels (r(2) = 0.621, p < 0.001). Increased synovial NO(.) levels in active BD patients probably reflect a nonspecific inflammatory process of the synovium and, therefore, arthralgia and arthritis as a common finding of BD.

Micronucleus evaluation in mitogen-stimulated lymphocytes of PUVA treated patients.

PUVA describes the treatment of patients with psoralens plus an exposure to a source of UV light of 320-400 nm (UVA). Contradictory results have been reported on the chromosomal damage of PUVA when assayed by sister chromatid exchange (SCE) method. Micronucleus (MN) test is used to detect both clastogenic (breaking) and aneugenic (abnormal segregation) effect of physical/chemical agents on the chromosomes. No data have been found on the MN formation in the cells of PUVA treated patients. Frequency of micronuclei in 72 hours cultivated/mitogen-stimulated lymphocytes of patients have been evaluated at zero time and after 20, 40, 60 sessions of PUVA treatment. While the beginning MN frequency was approximately 0.22% (n=23), it raised to approximately 0.32 (n=23), approximately 0.42 (n=14) and approximately 0.53% (n=10) corresponding respectively to 20, 40 and 60 sessions. These sessions correspond reciprocally to 54+/-23, 172+/-48, 300+/-61 joules/cm2 of UVA and 13, 26, 39 mg/kg of 8-metoxypsoralen (8-MOP). While large interindividual variances were apparent, highly significant differences have been observed between initial MN frequency and after that of the 20, 40 and 60 sessions, (p = 0.000, p = 0.004, p = 0.005, reciprocally, Wilcoxon two-related samples test). The coefficient of correlation between MN frequency and UVA doses starting from zero to 60 sessions of treatment has been found as r = 0.61. This indicates a significant relationship between UVA doses and MN frequencies. However, MN inducibility and synergistic property of 8-MOP with UVA should be taken into account. Gradual MN increase during different sessions of PUVA treatment shows that--once appeared--a part of MN at least persist in the cells of patients from a few days to a few weeks. Smoking as a confounding factor seems to increase MN frequency (p = 0.053, Mann-Whitney U-test) in the beginning population, taken as the control population. This is the first report on the kinetics of MN formation during different sessions of PUVA treatment. Based on our results, we concluded that PUVA treatment causes a detectable chromosome damaging effect on the relatively profound cells/tissues of its human users. Therapists should be careful with its use, especially on the patients who may be more susceptible to carcinogenesis (e.g. immunosuppressed and/or elderly subjects).

Lipid peroxidation and erythrocyte antioxidant enzymes in patients with Behçet's disease.

In spite of unknown etiology, it is now accepted that reactive oxygen species (ROS) produced by neutrophils may be related to the pathogenesis of Behçet's Disease (BD). The objective was to investigate whether increased production of ROS may affect erythrocyte oxidant/antioxidant system in patients with BD. The levels of malondialdehyde (MDA), one of the end products of lipid peroxidation, in plasma and erythrocyte, and the activities of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px), antioxidant enzymes, in erythrocyte, also C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were measured in 22 patients in active stage of the disease and also in 30 healthy controls. Increased CRP, ESR, and MDA levels in plasma and erythrocyte and increased SOD but decreased GSH-Px activities in erythrocytes were observed in the patients, when compared to the controls. In addition, significantly positive correlations between plasma and erythrocyte MDA levels, and erythrocyte MDA-CRP, MDA-ESR, MDA-SOD, SOD-ESR and SOD-CRP levels, but negative correlation between plasma MDA and erythrocyte GSH-Px, were found in BD patients. It may be suggested that increased production of ROS in BD, as reflected by higher plasma and erythrocyte MDA levels, may impair erythrocyte membrane integrity and also may lead to the alterations in the erythrocyte antioxidant defense system, as reflected by higher SOD and lower GSH-Px activities in erythrocytes.