Subject(s)
Bandages/adverse effects , Leg Ulcer/complications , Peroneal Neuropathies/etiology , Chronic Disease , Humans , Male , Middle AgedSubject(s)
AIDS-Related Opportunistic Infections/drug therapy , Antiviral Agents/administration & dosage , Cryotherapy , Cytosine/analogs & derivatives , Cytosine/administration & dosage , Molluscum Contagiosum/drug therapy , Organophosphonates , Organophosphorus Compounds/administration & dosage , AIDS-Related Opportunistic Infections/complications , Adult , Cidofovir , Combined Modality Therapy , Humans , Male , Molluscum Contagiosum/complicationsABSTRACT
Isotretinoin is well recognised to cause hyperlipidaemia. This is most obvious during the second month of a 4-month course. Since there are no long-term data on lipid profiles, we have identified 30 subjects who have received 3 or more courses of isotretinoin. They had been exposed to a median of 24.5 months (range 12-103) isotretinoin therapy with a median total cumulative dose of 350 mg/kg (range 152-1221). The median serum cholesterol pre-treatment was 4.6 mmol/L (range 3-6.4). This compared to a median of 4.5 mmol/L (range 3-6.4) just prior to starting the final course. The median triglyceride levels before treatment and pre-final course were 0.8 mmol/L (range 0.3-1.7) and 0.92 mmol/L (range 0.4-2.6) respectively, indicating no significant change in cholesterol or triglyceride concentrations when measured prior to the first and last courses. In addition there was no correlation between cholesterol or triglyceride concentration before the final course of isotretinoin and the total cumulative dose of isotretinoin. We conclude that there appears to be little risk of causing hyperlipidaemia by prolonged therapy with isotretinoin in patients with acne.
Subject(s)
Hyperlipidemias/chemically induced , Isotretinoin/adverse effects , Lipoproteins/blood , Acne Vulgaris/diagnosis , Acne Vulgaris/drug therapy , Adolescent , Adult , Age Distribution , Child , Cholesterol, HDL/blood , Cholesterol, LDL/blood , Cohort Studies , Dose-Response Relationship, Drug , Drug Administration Schedule , Female , Humans , Hyperlipidemias/epidemiology , Incidence , Isotretinoin/therapeutic use , Male , Middle Aged , Probability , Retrospective Studies , Risk Assessment , Sensitivity and Specificity , Sex Distribution , Statistics, NonparametricSubject(s)
Aldehydes/adverse effects , Dermatitis, Allergic Contact/epidemiology , Dermatitis, Allergic Contact/etiology , Perfume/adverse effects , Aldehydes/pharmacology , Allergens/adverse effects , Allergens/pharmacology , Cohort Studies , Cyclohexenes , Dermatitis, Allergic Contact/diagnosis , Female , Humans , Incidence , Male , Mass Screening , Patch Tests , Probability , Risk Assessment , Sensitivity and Specificity , United Kingdom/epidemiologySubject(s)
Allergens/adverse effects , Clothing/adverse effects , Dermatitis, Allergic Contact/diagnosis , Facial Dermatoses/diagnosis , Nickel/adverse effects , Adult , Dermatitis, Allergic Contact/etiology , Diagnosis, Differential , Facial Dermatoses/chemically induced , Female , Forehead , Humans , Patch TestsSubject(s)
Acne Vulgaris/complications , Dermatologic Agents/adverse effects , Herpes Labialis/complications , Isotretinoin/adverse effects , Acne Vulgaris/drug therapy , Acyclovir/therapeutic use , Administration, Oral , Adult , Antiviral Agents/therapeutic use , Dermatologic Agents/therapeutic use , Herpes Labialis/drug therapy , Humans , Isotretinoin/therapeutic use , MaleSubject(s)
Acne Vulgaris/psychology , Family Health , Somatoform Disorders/etiology , Adolescent , Adult , Female , Follow-Up Studies , HumansABSTRACT
Doctors are sometimes faced with adult patients who lack the mental capacity to consent to treatment. In a questionnaire, 120 doctors in a district general hospital were asked what action they would take if such a patient had a clear need for elective treatment. Of the 89 who replied, 57 said they would seek consent from relatives or others; 11 of these, nevertheless, stated that treatment could proceed without such consent. These results, and inquiries about other options, pointed to widespread misunderstanding of the law. In English law, no one can give legally valid consent on behalf of another adult. When an individual is unable to give consent, common law allows a doctor to protect a patient's best interests by treating him or her in accordance with a responsible body of medical opinion.