Factors influencing cardiometabolic risk profile in patients with psoriasis.

BACKGROUND: Psoriasis has been associated with metabolic syndrome and with an increased cardiovascular risk especially in patients with severe disease. The goal of this study was to estimate the prevalence of metabolic syndrome and other cardiovascular risk factors and its association with the psoriasis severity, sex and age. METHODS: Consecutive patients with psoriasis were enrolled in a prospective study over a 1-year period. Blood samples were collected. Psoriasis area and severity index (PASI) and body surface area scores and two dermatology quality of life (DQOL) questionnaires were used to evaluate psoriasis severity and the impact of the disease. RESULTS: Altogether 178 patients were included, of whom 44% had moderate-severe psoriasis. The overall prevalence of metabolic syndrome was 30% (men 34%, women 26%) without significant differences between patients with severe and mild disease. Age and menopause appeared to increase the risk for metabolic syndrome. Patients with severe psoriasis smoked more heavily, were more likely to have diabetes or insulin resistance and had higher homocysteine and lower high density lipoprotein cholesterol (HDL-C) levels than patients with mild psoriasis (P < 0.05). In women, a higher waist circumference was observed. Women had higher HDL-C levels and lower smoking and alcohol consumption rates. In accordance with the systematic coronary risk evaluation system, 18% of the patients had a high 10-year risk of fatal cardiovascular disease. CONCLUSIONS: Psoriasis severity was associated with diabetes, insulin-resistance, smoking habit and higher cardiovascular risk. Metabolic syndrome was related to age and menopause but not to psoriasis severity.

Cordons Sanitaires and the Rationalisation Process in Southern Europe (Nineteenth-Century Majorca).

Never before the nineteenth century had Europeans, especially in the south, adopted cordons sanitaires in such great numbers or at such a fast rate. This article aims to analyse the process of the rationalisation and militarisation of the cordons sanitaires imposed in the fight against epidemics during the nineteenth century on the Mediterranean island of Majorca (Spain). These cordons should be understood as a declaration of war by the authorities on emerging epidemics. Epidemics could generate sudden and intolerably high rises in mortality that the new liberal citizenship found unacceptable. Toleration of this type of measure was the result of a general consensus, with hardly any opposition, which not only obtained the support of scientists (especially in the field of medicine) but also of most of the local and provincial political elite, and even of the population at large.