A hypothesis: Role of physical factors in pathophysiology of rhinophyma - Focus on habitual mechanical trauma.

BACKGROUND: Rhinophyma is a skin disorder which causes nose enlargement and deformation due to proliferation of sebaceous glands and connective tissue. It is not only an aesthetic problem but may also lead to impaired nasal breathing and problems with liquids intake. HYPOTHESIS: Although rhinophyma is considered to be a subtype of rosacea, here we hypothesise whether it is a separate disease with mechanical trauma as a main reason of the disease progress. METHODS: 22 patients with diagnosed rhinophyma were qualified for the study. All patients were physically examined and detailed patients' medical history was obtained. Patients were asked to answer a number of questions regarding their usual skin care, purification procedure as well as handling of the nose and nasal cavity. Results were subjected to statistical analysis. RESULTS: Due to our observations there is a group of patients who have never presented any typical symptoms of rosacea while they are now suffering from rhinophymatous changes. Most of those patients confirmed longlasting mechanical nose cleaning which included any skin lesions removal by squeezing and nose picking which resulted in local skin inflammation, swelling, pain or itching. CONCLUSION: It is suspected that many different factors may induce rhinophyma development. In our opinion, mechanical repetitive trauma is one of the most important. Therefore we encourage physicians to include adequate questions while taking medical history from the patient and implement proper recommendations for nasal care as soon as possible.

Effect of subacute poisoning with bifenthrin on locomotor activity, memory retention, haematological, biochemical and histopathological parameters in mice.

UNLABELLED: Bifenthrin (BIF) is a pyrethroid (PYR) insecticide. The target point for PYR's toxic action are voltage sensitive sodium channels in the central nervous system (CNS). Intoxication with PYRs results in motor activity impairment and death in insects. Although PYRs are considered to be safe for mammals, there were numerous cases of pyrethroid poisoning in humans, animals and pets described. The general population is chronically exposed to PYRs via grain products, dust and indoor air. Therefore new questions arise: whether PYRs act in a dose-additive fashion in the course of subacute poisoning, are there other target organs (but brain) for BIF and if there is one common mechanism of its' toxic action in different organs. The objective of this work was to characterize the effect of BIF at the doses of 4 or 8 mg/kg injected intraperitoneally (i.p.) daily for 28 consecutive days on memory and motor activity, hematological, biochemical and histopathological parameters in mice. BIF at the doses of 8 mg/kg or 4 mg/kg of body mass was administered i.p. daily to the mice for 28 consecutive days. Motor function was measured on day 1, 7, 14 and 28 and memory retention was tested in a passive avoidance task on day 2, 7, 14 and 28. BIF significantly impaired memory retention on day 2. BIF decreased locomotor activity at every stage of the experiment in a single dose depending manner. No behavioral cumulative effect was observed. Subacute poisoning with the higher dose of BIF caused anaemia, elevated white blood cell count (WBC), elevated alanine transaminase (ALT), superoxide dismuthase (SOD), and decreased glutathione peroxidase (GPx) activity. Lymphocyte infiltrates were visualized in the livers. IN CONCLUSION: subacute poisoning with BIF decreases locomotor activity in a single dose proportionate manner. BIF damages also the liver and alters blood morphology. The possible common mechanism of these effects can be oxidative stress.

The epidemiology and management of severe hypertension.

Hypertension guidelines stress that patients with severe hypertension (systolic blood pressure (BP) > or = 180 or diastolic BP > or = 110 mm Hg) require multiple drugs to achieve control and should have close follow-up to prevent adverse outcomes. However, little is known about the epidemiology or actual management of these patients. We retrospectively studied 59 207 veterans with hypertension. Patients were categorized based on their highest average BP over an 18-month period (1 July 1999 to 31 December 2000) as controlled (<140/90 mm Hg), mild (140-159/90-99 mm Hg), moderate (160-179/100-109 mm Hg) and severe hypertension. We examined severe hypertension prevalence, pattern, duration, associated patient characteristics, time to subsequent visit, percentage of visits with a medication increase, and final BP control and antihypertensive medication adequacy. Twenty-three per cent had > or = 1 visit with severe hypertension, 42% of whom had at least two such visits; median day with severe hypertension was 80 (range 1-548). These subjects were significantly older, more likely black, and with more comorbidities than other hypertension subjects. Medication increases occurred at 20% of visits with mild hypertension compared to 40% with severe hypertension; P<0.05). At study end, 76% of patients with severe hypertension remained uncontrolled; severe hypertension subjects with uncontrolled BP were less likely to be on adequate therapy than those with controlled BP (43.7 vs 45.4%). Among hypertensive veterans, severe hypertension episodes are common. Many subjects had relatively prolonged elevations, with older, sicker subjects at highest risk. Although, follow-up times are shorter and antihypertensive medication use greater in severe hypertension subjects, they are still not being managed aggressively enough. Interventions to improve providers' management of these high-risk patients are needed.

Survival in end stage renal disease: calcium carbonate vs. sevelamer.

BACKGROUND AND OBJECTIVE: There is concern regarding long-term excess calcium intake in end-stage renal disease populations. Because calcium carbonate is an over-the-counter (OTC) medication, few studies have been able to track its use. The Veterans Health Administration (VA) tracks national pharmacy data for both OTC and prescription drugs. We thus compared survival in incident dialysis patients on sevelamer and calcium carbonate phosphate binders. METHODS: This was a retrospective cohort study of veterans initiating haemodialysis using existing VA databases. Patients were divided into calcium only (n = 769) and sevelamer only (n = 608) groups, then followed for up to 2 years until FY03 end. Survival was modelled using Cox regression adjusting for age, gender, race, marital status, service-connected disability, region, diabetes, hypertension and Charlson index. Stability of findings was examined using propensity score analysis. RESULTS: Sevelamer only vs. calcium only subjects were younger (respective mean ages 59.6 and 63.0, P < 0.001) with fewer comorbidities (Charlson index 3.8 and 4.5, P < 0.001). By study end, 24% of sevelamer and 30% of calcium subjects had died. Comparing sevelamer to calcium, the unadjusted hazard ratio for death was 0.62 (95% CI 0.50-0.76); the adjusted hazard ratio was 0.67 (CI 0.54-0.84). Propensity score analysis revealed similar results, with a hazard ratio of 0.65 (CI 0.54-0.80). CONCLUSIONS: In a national incident dialysis cohort, sevelamer treatment was associated with improved survival compared with calcium carbonate. Further research should investigate whether the worse survival with calcium is a long-term consequence of increased calcium accumulation.

DNA adducts in squamous cell cervical carcinomas associated with HPV infection.

UNLABELLED: The aim of the study was qualitative and quantitative evaluation of DNA adducts in squamous cell cervical carcinomas associated with oncogenic HPV infection. MATERIAL: The study material consisted of oncogenic tissue collected during the surgeries of seven women aged 37 to 52 who were undergoing surgical treatment due to squamous cell cervical carcinoma. The control group consisted of 3 tissue fragments from morphologically normal cervix collected from patients undergoing surgery due to uterine myomas. METHODS: DNA from the tissues was isolated using Genomic Prep Plus kit from A&A Biotechnology, Austria. Amplification reactions detecting HPV DNA presence in the tissue fragments were performed using specific starters allowing for amplification of conservative genome fragments within L1, E6 and E7 Papilloma viruses. After extraction, the DNA specimens underwent enzymatic digestion to nucleotides and marked on the 5' end using gamma32P-post labeling technique. Division and quantitative evaluation of DNA adducts was performed using thin-layer chromatography (TLC) on PEI-cellulose plates. Qualitative radioactivity measurements were performed using Bio-Imaging analyzer in quantitative mode. RESULTS: In all fragments, including the control, HPV 16 and/or 18 DNA was found. Mean adduct content in cervical carcinoma tissues was 289 adducts per 10(9) nucleotides and was higher than mean adduct content in control tissues (57 adducts per 10(9) nucleotides). CONCLUSIONS: The study results suggest that the content of DNA adducts in squamous cell cervical cancer associated with HPV infection may serve as a molecular marker of oncogenesis in this organ.

The meaning of the methylation of genomic DNA in the regulation of gene expression levels.

INTRODUCTION: Methylation of genomic DNA is one of the major mechanisms that deactivates genes and regulates their tissue-specific transcription levels. Its patterns are based on clonal inheritance that occurs in the early stages of embryogenesis. All changes in the DNA methylation levels occurring especially in the promoter region of the genes, which involve hypo- as well as hyper-methylation, lead to cell differentiation and growth disorders. Therefore it can become an impulse that initiates different pathological processes including carcinogenesis. MATERIAL AND METHODS: The purpose of this review was to present the recent knowledge concerning methylation of genomic DNA based on recent references and authors' experience. RESULTS AND CONCLUSION: Genome stability disorders could be caused either by mutations, which damage the structure of the genes and have not been formerly removed, or as the consequence of an epigenetic mechanism. Methylation plays a decisive role in the activity of many genes and could be a natural weapon of an organism against the expression of foreign genetic material that degrades the original genome structure.

Delta aminolevulinic acid urinary excretion in rural region inhabitants.

The purpose of the work was to estimate to what extent the inhabitants of a typical agricultural region are exposed to the influence of lead compounds. 132 people at the age of 9 to 74 were included in the research. Urinary delta aminolevulinic acid (ALA) excretion was determined. The highest excretion of ALA was observed among the examined who were up to 18 years old, while the lowest was among those who were above 60 years old. These differences, however, were not statistically significant.

Vitamin E influence on selected parameters in rats after ochratoxin A intoxication.

The aim of the research was to evaluate vitamin E influence on ochratoxin A (OTA) toxicity based on analysis of selected parameters of white and red cell system in rats. The animals were divided into groups: I--control, II--treated with OTA, III--treated with OTA and vitamin E. In group II a significant decrease in the values of hematocrit, hemoglobin level, red and white cell counts was observed. In group III an average hematocrit, hemoglobin level were significantly lower than in control group, nevertheless they were higher than in group II.

Should noncardiac chest pain be treated empirically? A cost-effectiveness analysis.

BACKGROUND: Chest pain is a common clinical problem, but up to 30% of patients who present with chest pain lack coronary disease. Subsequent investigation often reveals an esophageal source for the pain, with gastroesophageal reflux disease identified most frequently. Controversy exists regarding whether to establish the cause or to empirically treat as reflux. OBJECTIVE: To assess the cost-effectiveness of empirical treatment in patients with noncardiac chest pain. METHODS: Decision analysis was used to compare a strategy of empirical treatment as reflux using an H-blocker or proton pump inhibitor with initial investigation for gastrointestinal causes over a period of up to 16 weeks and over a period of more than a year. The prototype patient was an outpatient with chest pain and a normal coronary angiogram. Gastrointestinal investigations included an upper gastrointestinal tract series, endoscopy, manometry, 24-hour pH monitoring, and provocation tests. The main outcome measure was direct medical costs per case treated from a third-party payer perspective. RESULTS: Total medical costs were $2,187 per case treated for the initial investigation arm and $849 for the empirical treatment arm in the 8- to 16-week model. One-way sensitivity analyses revealed that the model was robust; the treatment arm was less expensive in all cases. At just over a year empirical treatment remained dominant. CONCLUSIONS: An initial therapeutic trial with antisecretory agents for patients with noncardiac chest pain is cost-effective compared with investigation for gastrointestinal causes in the short term of weeks, with cost savings persisting beyond a year.

Postheparin serum lipolytic activity in psoriatic males.

INTRODUCTION: As numerous papers have presented many disturbances of blood lipid composition and changes in lipolytic enzyme activity, it was considered appropriate to investigate the postheparin lipolytic activity in serum of psoriatic males. The course of serum lipolytic process provoked by intravenous application of heparin was observed by measuring the concentration of the major substrates and products: triglycerides (TG), free fatty acids (FFA) and glycerol (G) before intravenous bolus of heparin 10 units per 1 kg b.w. and after 30 minutes. MATERIAL AND METHODS: The study group consisted of 30 psoriatic males with mean age 29.7 +/- 9.6 and mean BMI 24.2 +/- 3.3 and was compared with 35 healthy males with corresponding mean age and mean BMI. The release of glycerol and FFA and the reduction of TG concentrations following intravenous heparin were observed. RESULTS: Psoriatic sera demonstrated higher concentrations of triglycerides, glycerol and free fatty acids before and after the lipolysis compared with the controls. The course of postheparin lipolysis in psoriatic males seems to be changed as compared with the control group.

Investigations on magnesium and chromium antagonism in the skin of experimental animals.

Investigations were performed over 30 days on 25 male rats Wistar breed divided into five groups. Animals received intraperitoneally (i.p.) potassium dichromate (KDCH) 5 mg/kg (basal doses, b.d.), 2 mg/kg (0.4 b.d.) and 100 mg Mg Cl2/kg body weight (b.w.). In performed investigations the highest concentration of chromium in animal skin 1.17 +/- 0.11 micrograms/g was observed by i.p. administration of KDCH 5 mg/kg b.w. Simultaneous i.p. administration of KDCH 5 mg/kg b.w. and MgCl2 100 mg/kg b.w. resulted in significant lower concentration of chromium (in comparison to the preceding group) in animal skin: 0.8 +/- 0.2 microgram/g (p < 0.001). In i.p. administration of KDCH in the doses of 0.4 b.d. the concentration of Cr in the skin amounted to 0.55 +/- 0.1 microgram/g. Values of Cr in the skin in exposed groups were significantly higher than in the control group, (p < 0.001).

The influence of selenium on the reproduction of rats.

Selenium is a vestigial element indispensable for man and animal, having adverse effects when in bigger quantities. Among the diseases resulting from selenium deficiency in animals the most important are nutritional muscular dystrophy, exudative disthesis (most common in poultry), and nutritional hepatic dystrophy. In the man chronic intoxication occurs most of all, which is observed in selenium bearing regions. Taking into consideration geographic distribution on some of the diseases beneficial influence of selenium is observed in cardiac and vascular diseases, and hypertension. The correlation between selenium deficiency and mortality caused by neoplasm is also notable. It is unquestionable that selenium inhibits the activity of enzymes, especially those containing sulfohydryl groups. The stabilization of lysosomal membranes leads to the presumption that selenium prevents peroxidation processes in tissues and cell membranes. The influence of selenium on reproduction is also worth noticing. Its supply turns out to be effective in cases of infertility of sheep, and partly in rats, pigs, and poultry. The embryo dies in pigs fed on fodder poor in selenium and vitamin E. The degeneration of the ovaries and placenta accretion occur in cows in cases of selenium deficiency. The excess of selenium can affect negatively the reproductive system. The element is thought to be a teratogenic agent. Since it permeates through the placenta and lactic gland easily, the symptoms of selenosis appear in new-born animals; many of them have developmental anomalies occurring at the same time. In birds the decrease in laying eggs and their incubation occur in case of selenium deficiency.

[Evaluation of school children's health status in Lublin during the years 1969-1988]. / Ocena stanu zdrowia mlodziezy szkolnej miasta lublina w latach 1969-1988.

The research has been carried out in the primary schools of Lublin. The state of health of children and youth has been evaluated in the course of 20 years. Together there have been analyzed 48,416 (28.7%) health cards of children classified to dispensary groups. The total number of children and youth in primary schools is 168,614. There has been found: a) an increase in the number of children suffering from sight disorders on the average by 3% each 5 years; b) a considerable increase (71.2%) in locomotive organ diseases; c) the least number of children and youth classified to dispensary groups was in the years 1974-1975 (25.3%) and in 1979-1980 (24.41%) in comparison with the earlier years 1969-1970 (31.15%) and the later ones 1984-1985 (32.49%) and 1987-1988 (29.99%).