Platelet distribution width as a novel indicator of disease activity in systemic lupus erythematosus.

BACKGROUND: Significance of platelet distribution width (PDW) and mean platelet volume (MPV) in assessing disease activity of systemic lupus erythematosus (SLE) remains unclear. This study was aimed to evaluate PDW and MPV as potential disease activity markers in adult SLE patients. MATERIALS AND METHODS: A total of 204 study participants, including 91 SLE patients and 113 age- and gender-matched healthy controls, were selected in this cross-sectional study. They were classified into three groups: control group (n = 113), active SLE group (n = 54), and inactive SLE group (n = 37). Demographic, clinical, and laboratory data were analyzed. RESULTS: In patient group, PDW was statistically higher than that in control group (13.54 ± 2.67 vs. 12.65 ± 2.34, P = 0.012), and in active group, PDW was significantly increased compared to inactive group (14.31 ± 2.90 vs. 12.25 ± 1.55, P < 0.001). However, MPV was significantly lower in SLE group than in control group (10.74 ± 0.94 vs. 11.09 ± 1.14, P = 0.016). PDW was positively correlated with SLE disease activity index (P < 0.001, r = 0.529) and erythrocyte sedimentation rate (P = 0.002, r = 0.321) and negatively correlated with C3 (P < 0.001, r = -0.419). However, there was no significant association between MPV and these study variables. A PDW level of 11.85% was determined as a predictive cutoff value of SLE diagnosis (sensitivity 76.9%, specificity 42.5%) and 13.65% as cutoff of active stage (sensitivity 52.6%, specificity 85.3%). CONCLUSION: This study first associates a higher PDW level with an increased SLE activity, suggesting PDW as a novel indicator to monitor the activity of SLE.

Comparison between photodynamic therapy with topical application of 5-aminolevulinic acid and CO2 laser therapy in the treatment of cervical condylomata acuminate: a randomized controlled trial.

The present study aimed to evaluate the efficacy of photodynamic therapy with topical applied 5-aminolevulinic acid (ALA-PDT) for the treatment of cervical condylomata accuminate (CA). 161 Patients with cervical CA were randomly divided into ALA-PDT group and CO2 laser (control) group. Patients (n=89) in the ALA-PDT group were treated with topical 5% ALA under occlusive dressing for 3 h followed by irradiation with semiconductor laser at a dose of 1000 J/cm(-2) and a power of 100 mW. Patients were treated 2 weeks later if necessary. Patients (n=72) in the control group were treated with CO2 laser. The treatment was repeated at 1-week interval when necessary. No response rate, complete response rate (CR) and recurrence rate of wart lesions as well as rate of eradication of HPVs were analyzed. The CR rate was 90.2% in the ALA-PDT group and 96.2% in the control group. The eradication rate was 90.2% in the ALA-PDT group and 65.8% in the control group after 3 months of follow-up. Both the eradication rate and recurrence rate in the ALA-PDT group were significantly lower than those in the control group (P<0.001). The adverse event in patients receiving ALA-PDT was mainly mild bleeding. ALA-PDT is a more effective and well-tolerated treatment for cervical CA compared with conventional CO2 laser therapy.

Evaluation of photodynamic therapy using topical aminolevulinic acid hydrochloride in the treatment of condylomata acuminate.

OBJECTIVES: To investigate the efficacy and safety of topical application of 5-aminolaevulinic acid (ALA) photodynamic therapy (PDT) for the treatment of condylomata acuminata (CA) in larger population. METHODS: Patients with CA were given a treatment of ALA-PDT once a week for 3 weeks and followed up at 4, 8, 12 and 24 weeks after the treatment finished. RESULTS: In 531 patients, a clearance rate was observed 95.27%. The rates rouse with PDT cycles. The clearance rate of three PDT cycles was significant higher than one PDT cycles (P < 0.001) and two PDT cycles (P < 0.001). The clearance rate (88.73%) of small lesions (diameter small than 5mm) was significant higher than that (97.74%) of larger lesions (P < 0.001). The clearance rate varied with the location of the lesions. The clearance rate of urethral meatus was highest and that of perianal was lowest. Follow-up for patients with complete response lasted for 24 weeks. The recurrence rate was 5.65%, 11.30%, 15.07%, 15.44% and 16.20% after 1, 4, 8, 12 and 24 weeks. The recurrence rate varied with the location of the lesions. The recurrence rate of perianal was highest and that of labium was lowest. The side effects mainly included flare, pain, erosion, ulcer, and hyperpigmentation. The adverse reaction rate was 7.72%, 8.10%, 2.26%, 0.94% and 0.19%. Sexual dysfunction and urethral malformations were not observed during the 24 weeds visit. CONCLUSION: Topical application of ALA-PDT is a simple and as effective therapy with a lower incidence of adverse effects in the treatment of condylomata acuminata.

Evaluation of photodynamic therapy using topical aminolevulinic acid hydrochloride in the treatment of condylomata acuminata: a comparative, randomized clinical trial.

OBJECTIVES: To determine the safety and efficacy of photodynamic therapy (PDT) with topical application of 20% wt/vol aminolevulinic acid hydrochloride (ALA) in the treatment of condylomata acuminata (CA). STUDY DESIGN: Patients with CA were randomly allocated into the ALA-PDT group and the CO(2) laser group in an allocation ratio of 3 : 1. The treatment was repeated weekly if necessary, but no more than 3 times. The primary efficacy endpoint was the wart clearance rate 1 week after the last treatment. The recurrence rate was evaluated at weeks 4, 8 and 12 after the treatment ended. The clinical response to therapy and adverse effects were recorded. RESULTS: A total of 91 patients with CA were enrolled in the clinical trial. Of these 90 (98.9%) patients completed the trial (67 in the ALA-PDT group, and 23 in CO(2) laser group). By 1 week after the last treatment, the complete clearance rate was 95.93% in the ALA-PDT group and 100% in CO(2) laser group (P>0.05). The clearance rate of CA at male urethral orifice was 100% in the ALA-PDT group and 100% in the CO(2) laser group (P>0.05). The overall recurrence rate calculated by the end of the entire follow-up period was significantly lower in the ALA-PDT group than that in the CO(2) laser group (9.38% vs 17.39%, P<0.05). Moreover, there was no systemic adverse event in either group. The proportion of patients with adverse effects in the ALA-PDT group (8.82%) was also significantly lower than that in the CO(2) laser group (100%, P<0.05). The side-effects in patients treated with ALA-PDT mainly included mild burning and/or stinging restricted to the illuminated area. CONCLUSION: The results confirmed that topical application of ALA-PDT is a simpler and as effective therapy with a lower incidence of adverse effects in the treatment of CA compared with conventional CO(2) laser therapy.