Functional capacity and heart rate response: associations with nocturnal hypertension.

BACKGROUND: Absences of normative, 10-20 % declines in blood pressure (BP) at night, termed nocturnal non-dipping, are linked to increased cardiovascular mortality risks. Current literature has linked these absences to psychological states, hormonal imbalance, and disorders involving hyper-arousal. This study focuses on evaluating associations between nocturnal non-dipping and indices of functional cardiac capacity and fitness. METHODS: The current study was a cross-sectional evaluation of the associations between physical capacity variables e.g. Metabolic Equivalent (MET) and Maximum Heart Rate (MHR), Heart rate reserve (HRR), and degree of reduction in nocturnal systolic blood pressure (SBP) or diastolic blood pressure (DBP), also known as 'dipping'. The study sample included 96 cardiac patient participants assessed for physical capacity and ambulatory blood pressure monitoring. In addition to evaluating differences between groups on nocturnal BP 'dipping', physical capacity, diagnoses, and medications, linear regression analyses were used to evaluate potential associations between nocturnal SBP and DBP 'dipping', and physical capacity indices. RESULTS: 45 males and 14 females or 61.5 % of 96 consented participants met criteria as non-dippers (<10 % drop in nocturnal BP). Although non-dippers were older (p = .01) and had a lower maximum heart rate during the Bruce stress test (p = .05), dipping was only significantly associated with Type 2 Diabetes co-morbidity and was not associated with type of medication. Within separate linear regression models controlling for participant sex, MHR (ß = 0.26, p = .01, R(2) = .06), HRR (ß = 0. 19, p = .05, R(2) = .05), and METs (ß = 0.21, p = .04, R(2) = .04) emerged as significant but small predictors of degree of nighttime SBP dipping. Similar relationships were not observed for DBP. CONCLUSIONS: Since the variables reflecting basic heart function and fitness (MHR and METs), did not account for appreciable variances in nighttime BP, nocturnal hypertension appears to be a complex, multi-faceted phenomena.

Effects of vitamin C and early-age thermal conditioning on pituitary adrenocorticotropic hormone cells in broilers chronically exposed to heat stress: an immunohistomorphometric and hormonal study.

The aim of this study was to examine the effects of heat stress (HS) on the pituitary-adrenal axis and whether the treatments with early-age thermal conditioning (ETC) and vitamin C, alone and in combination, could have a beneficial effect in alleviating these effects. For the experiment, 400 one day-old broilers (both sexes) were used, being divided into four groups. The first group was the control (K), the second group (C) consisted of broilers which received vitamin C from the 22nd to the 42nd day via water in the amount of 2.00 g L-1, in the third group (T), broilers were exposed to ETC for a period of 24 hr at a temperature of 38.00 ± 1.00 ˚C and the fourth group (T + C) was the combination of T and C groups. Immunohistochemically positive adrenocorticotropic hormone (ACTH) cells of broilers in all groups were irregular or stellate and distributed in the periphery and central parts of the pituitary gland, as solitary cells or in clusters. In the T + C group of broilers, a significant increase in the area of ACTH cells (18.91%) and their cores (22.75%), and cortisol level in serum compared to the control group was observed. This reaction of broilers in the T + C group facilitated their adaptation to unfavorable consequences of HS. These results suggest that hypothalamic-pituitary-adrenal axis is stimulated after the exposure to chronic HS, enabling successful adaptation of broilers to adverse conditions.

Lichen planus-like dermatosis with Blaschko line distribution: a case report.

The authors describe the case of a healthy 46-year-old woman with a unilateral linear papular band on the left side of the trunk that followed the lines of Blaschko from the lower back extending to the left anterior side of her abdomen. The lesions were flat-topped, slightly elevated, violaceous, agglomerated lichenoid papules. The biopsy specimen demonstrated the typical histology of lichen planus. A working diagnosis of linear lichen planus was confirmed. Because congenital and/or nevoid skin disorders in a blaschkolinear distribution may have a delayed onset after birth, these lesions must be differentiated from acquired dermatoses following the lines of Blaschko. This distinction should be made in cases with isolated lesions, such as the case presented here.

Unusual growth of upper lip squamous cell carcinoma: a case report.

INTRODUCTION: Squamous cell carcinoma is the most common type of lip and oral cavity cancers. In majority of cases it follows quite common course, and after the surgery it does not produce any harm. This case presents unusual and unexpected growth of upper lip squamous cell carcinoma with severe cosmetic problems, and possible health threats. CASE PRESENTATION: A 46-year-old woman noticed on her upper lip "a spot, the size of a wheat grain", which grew rapidly and reached the size of 0.6 cm during a two-week period. The lesion was red, hard and painful, attached to the skin. It was surgically removed, and primary histopathological finding was follicular keratosis. Recurrent tumor appeared seven days after the operation, with the extreme swelling of the upper lip. The patient was sent to a tertiary hospital, where fungal or bacterial infection was excluded. The change on the patient's upper lip reached the size of 5 × 2 cm, as soft, reddish nodular tumor. Squamous cell carcinoma was diagnosed after the histopathological audit. With the second surgical intervention the tumor was removed and the defect reconstructed. CONCLUSIONS: Prognosis of this type of tumor, apart from its size and differentiation level, depends on infiltration in tumor-surrounding tissue, perineural and perivascular spread. Therefore, it is always necessary to analyze the removed skin especially on margins.

Effects of Rusanda Spa balneotherapy combined with calcipotriol on plaque psoriasis.

BACKGROUND/AIM: Treatment of psoriasis is very complex and there are no still universal, nor unique treatment modalities. Apart from conventional treatment, which includes topical calcipotriol (vitamin D3 analogue), balneotherapy is drawing increased attention worldwide. Being part of climatotherapy, balneotherapy is defined as the use of natural environmental factors in the treatment of health conditions, whereas in the treatment of psoriasis it means the use of mineral baths and peloids. The aim of this study was to examine the therapeutic efficacy of mineral waters and peloids of the Rusanda Spa on plaque psoriasis in patients also treated with calcipotriol. METHODS: The study included 60 patients divided into two groups. The first group included patients treated with mineral waters, peloids and calcipotriol in the Rusanda Spa, while the second one included those treated only with calcipotriol. The study took 21 days, and each patient was followed up for at least one month after ending the treatment. The treatment efficacy was measured by psoriasis area severity index (PASI) scores on the days 0, 7, 14 and 21 during the treatment and 30 after the end of the therapy. RESULTS: After a 3-week treatment in the Rusanda Spa, the first group showed a decrease in PASI score by 59.45%, whereas in the group of outpatients treated by calcipotriol it was 39.34%. On the day 30 following the treatment, the first group presented with the PASI score reduction of 58.44%, and the second group of 34.78%. The therapeutic efficacy of mineral waters and peloids combined with calcipotriol showed to be significantly higher in regard to monotherapy with calcipotriol (p < 0.05). In regard to clinical symptoms, the best results were obtained in the reduction of desquamation (p < 0.001). CONCLUSION: The results of our study show that in the treatment of plaque-type psoriasis, topical calcipotriol combined with Spa Rusanda balineotherapy is more effective than topical calcipotriol alone. Randomized controlled trials are needed to confirm the effects of balneotherapy as monotherapy in treatment of this type of psoriasis.

[Presentation of the Department and Clinic of Dermatology and Venereology].

THE DEPARTMENT OF DERMATOVENEROLOGY: The Department of Dermatovenereology was established in 1963, as part of the Department of Internal Medicine with Professor Dimitrije Stanulovic as its head. Since 1983, it has been an independent department of the Faculty of Medicine in Novi Sad. DEPARTMENT ACTIVITIES: The Department participates in undergraduate education of medical and dentistry students (serbian and english language), advanced training of graduate students specializing in dermatovenereology, general medicine, urgent and occupational medicine, pediatrics and subspecialists of oncology. During the period 1969-1999, the Department was included in work of the Department of Dermatovenereology of the Faculty of Medicine in Banja Luka. THE DEPARTMENT HISTORY: The Department of Dermatovenereology of the City Hospital in Novi Sad was founded in the 5th decade of the 20th century, and it was situated in Kisacka street, near the railway station. It became an independent institution: Dermatovenereology Clinic in 1963, part of the Clinical Center of Vojvodina in Novi Sad. THE DERMATOVENEREOLOGY CLINIC TODAY: The Dermatovenereology Clinic is a teaching facility, but also an institution for prevention, diagnosis and therapy of skin diseases of adnexal structures (sebaceous and sweat glands, hair, nails) and sexually transmitted diseases. The Clinic works both as an outpatient and an inpatient facility with male and female wings.

[Diagnostic importance of ultrasound in dermatology]. / Dijagnosticki znacaj ultrazvuka u dermatologiji.

INTRODUCTION: Utilization of 20 MHz ultrasound probes provided application of ultrasound in dermatology-dermatosonography. As a diagnostic tool, ultrasound was first registered in the early fifties of the past century. Great progress of dermatosonography occurred in the mid-nineties with introduction of the first 20 MHz scanner. METHODS OF ULTRASONOGRAPHY IN DERMATOLOGY: Several methods of ultrasonography have been developed: method A, method B, scannibg C method and Doppler ultrasound. They were based on different acoustic features of various tissues. ULTRASOUND IN DIAGNOSTICS: Today, dermatosonography is used in diagnosing: cutaneous neoplasms, inflammatory skin diseases and skin diseases of unknown etiology. Apart from that, it is used in differentiating benign and malignant tumors and may be helpful in monitoring morphea, dermatomyositis, cutaneous sarcoidosis, erythema nodosum, allergic diseases, postthrombotic syndrome, physiologic aging and aging due to sun exposure. It can be used in noninvasive monitoring of local treatment, therapeutic responses and adverse effects. CONCLUSION: Dermatosonography offers valuable possibilities in assessing skin morphology at an intermediate level: between clinical assessment and microscopy.

[Use of a computer program (POSSUM) in examination of residents in a home for developmentally handicapped children and adults in Veternik-Novi Sad for occurrence and diagnostic significance of dysmorphologic signs on the skin]. / Ucestalost i znacaj dijagnostikovanih dismorfoloskih znakova na kozi i prema racunarskom programu (POSSUM) kod sticenika doma za decu i odrasle ometene u razvoju u Veterniku-Novi Sad.

The authors have examined frequency of dysmorphological signs by POSSUM at the Home for developmentally handicapped children and adults in Vetemik--Novi Sad. The aim was to establish possible different hereditary and congenital skin diseases and genetic syndromes in this population. The study was based on the following methods: method of family history including genealogy; dermatoglyphic methods; screening tests methodology in medical genetics; method of cytogenetic analysis; histo-pathological analysis; method of dermatovenerologic, genetic and dysmorphologic examinations of skin diseases by analysis of dysmorphological signs on the skin using a special computer programme. The study included 504 wards with 269 males and 235 females, and sex ratio of 1:1.14 in favour to males. Non-parametric statistics and Log-linear analysis revealed a statistically significant difference between the incidence of dysmorphological signs in the studied group and the Vojvodina population. The obtained incidence of dysmorphological signs in the examined group is presented in tables. Our results regarding the incidence of dysmorphological signs in the examined group showed significantly increased values in comparison to the population of Vojvodina.

Contact allergy to Compositae plants in patients with atopic dermatitis.

To investigate the frequency of Compositae sensitivity is one of the most important goals of current dermatology and allergology. We have patch tested 30 adult patients suffering from "extrinsic" atopic dermatitis with sesquiterpene lactone mix and Compositae mix including Compositae mix individual ingredients, extracts of arnica (Arnica montana), chamomile (Chamomilla recutita), tansy (Tanacetum vulgare), fever few (Tanacetum parthenium) and yarrow (Achillea millefolium) as well as with specific series for patients with atopic dermatitis. All allergens were purchased from Hermal-Trolab (Reinbek, Germany). There were 6 (20%) patients positive to Compositae mix only, and 3 (10%) patients positive to both Compositae mix and sesquiterpene lactone mix. Among 9 Compositae mix-sensitive patients 8 (88.8%) were positive to at least 1 of its individual ingredients: 5 (55.5%) to chamomile, 4 (44.4%) to arnica, 2 (22.2%) to tansy, and 2 (22.2%) to fever few. Among Compositae-sensitive patients 78.8% had other contact allergies, most often to nickel (33.3%). Since our study represents the first report on contact allergy to Compositae among patients with "extrinsic" type of atopic dermatitis, it substantiates the statement that atopy represents a risk factor for Compositae allergy. In conclusion, the overall prevalence of 30% Compositae-sensitive among patients with "extrinsic" atopic dermatitis detected in our study represents a basal sesquiterpene lactone mix detection rate of 10%, reinforced and safely supplemented by 20% by testing with the Compositae mix.

[Psoriasis and autoimmune skin disorders]. / Psorijaza i oboljenja koze autoimunske prirode.

INTRODUCTION: Presuming that psoriasis is an autoimmune skin disease, the aim of this study was to establish its association with other autoimmune skin diseases. The material was obtained at the Dermatovenereological Clinic--Clinical Center Novi Sad. MATERIAL AND METHODS: This 10-year retrospective study (1990-1999) included 1743 psoriasis patients. The control group consisted of 7492 nonpsoriatic dermatological patients. RESULTS: Association of psoriasis with other dermatological diseases of autoimmune nature has been established in 13 (0.74%) patients. The most frequent association was with lichen ruber planus in five patients, with alopecia areata and vitiligo in three patients, and in one with bullous pemphigoid and herpetiform dermatitis. Using Fisher's test no significant association was established. DISCUSSION AND CONCLUSION: According to literature data association of psoriasis with other autoimmune diseases is well known, but rare, which is in accordance with our results. The question arises whether this association is the matter of poor coexistence or the matter of genetic mutations. However, once established, these associations can further highlight the autoimmune nature of psoriasis. The research of autoimmunity would lead us to epithelial cells in thymus, and their badly learnt cognitive function about what is own, and what is not.