Sophia Georgala

Raised β-endorphin serum levels in children with atopic dermatitis and pruritus

Atopic dermatits (AD) is a pruritic cutaneous inflammatory condition. As pruritus and pain are very close symptoms, we determined the β-endorphin serum concentrations in 21 atopic children with pruritus (group A) and 20 children with healed AD without pruritus (group B). Twenty-five healthy school children were the control group. The β-endorphin serum concentrations (14.95 ± 2.75 pmol/l) in group A were statistically (P < 0.001) elevated in our patients compared to controls (8.85 ± 2.39 pmol/l) whereas these in group B were not elevated (9.4 ± 2.46 pmol/l). We suggest that the elevated β-endorphin concentrations in atopic patients with pruritus confirm the hypothesis that there is an increased activity of their opioid system and that an opioid antagonist might block itching which is their major clinical symptom.

Psychological and sympatho‐adrenal status in patients with cystic acne

Patients with cystic acne (CA) frequently report feeling self conscious, anxiety and social isolation.

The Effect of Isotretinoin on Biotinidase Activity

Background: Among the reaction and effects of isotretinoin, mucocutaneous reactions, xerosis and erythema of the skin as well as elevation of liver enzymes and lipids except high density lipoprotein have been reported. Objective: Since biotinidase is mainly produced in the liver and partial biotinidase deficiency causes dermatological manifestations, seborrheic dermatitis, alopecia etc., isotretinoin side effects in relation to biotinidase activity were studied. Methods: Forty-two (n = 42) patients with severe cystic acne had liver function tests, lipid estimations, serum biotin as well as biotinidase activity evaluations before (value 1) and on the 30th day (value 2) of treatment with isotretinoin monotherapy (Roaccutane 0.5 mg/kg/24 h). The same laboratory tests were evaluated in 50 controls only once. Moreover, the effect of isotretinoin on a known plasma biotinidase activity was evaluated after incubation in vitro with various concentrations of the drug. Results: A statistically significant elevation of liver enzymes and lipids, except high density lipoprotein, was observed at the end of this study. On the contrary, biotinidase activity was found to be significantly decreased as compared to the initial values (value 1 = 4.70 ± 0.89 nmol/min/l, value 2 = 2.50 ± 0.8 nmol/min/l, p < 0.001) and to controls (5.2 ± 0.9 nmol/min/l vs. value 2 = 2.50 ± 0.8 nmol/min/l, p < 0.001). Additionally, biotin levels showed no significant alterations and the in vitro incubation of the enzyme with various concentrations of the drug exhibited no effect on its activity. Conclusion: It is suggested that isotretinoin isomers-metabolites act in the liver, resulting in low biotinidase activity.

L‐carnitine supplementation in patients with cystic acne on isotretinoin therapy★

Patients with cystic acne (CA) on Isotretinoin (Iso) therapy might present muscular symptoms as side effect of the drug. Myalgia, weakness, hypotension are also some of the main characteristics of carnitine (car) deficiency.

Isotretinoin therapy induces DNA oxidative damage.

Abstract Background: Isotretinoin (Iso) is currently indicated for the treatment of cystic acne (CA) and is related to marked teratogenicity. Aim: The aim of the study was to evaluate the relationship between total antioxidant status (TAS) and a serum marker of DNA oxidative damage, 8-hydroxy-2-desoxyguanosine (8-OHdG), in patients on Iso treatment. Patients and methods: Patients with CA (n=18) were evaluated before and 45days after Iso (0.5mg/kg per day) treatment and non-diseased controls (n=22) were tested only once. Plasma TAS levels and 8-OHdG were measured spectrophotometrically and with an immunoassay, respectively. Liver biochemical parameters and muscle enzymes were measured on a blood chemistry analyzer. Results: TAS levels were significantly (p<0.0001) lower in patients before treatment (921±124μmol/L) compared with those after treatment (1335±93μmol/L) and in controls (1536±126μmol/L). In contrast, 8-OHdG serum levels were two-fold higher in patients after treatment (0.21±0.03ng/mL) than before treatment (0.11±0.02ng/mL) and three-fold higher than in controls (0.07±0.01ng/mL; p<0.0001). Negative correlations were found between TAS and 8-OHdG (r=−0.754, p<0.0001) in patients before therapy and positive correlations were found between creatine kinase (CK) and 8-OHdG (r=0.488, p<0.001) and liver enzymes after Iso treatment. Conclusions: High serum levels of 8-OHdG in patients on Iso therapy may be due to a direct effect of Iso on liver, muscle and skin epidermal cells. Regular evaluation of 8-OHdG in sera of patients, especially of women of reproductive age, on Iso treatment could be a sensitive follow-up biomarker of DNA oxidation.

Evaluation of serum lipoprotein(a) levels in Greek schoolchildren

This study aimed to provide associations of age and gender with serum lipoprotein(a) [Lp(a)] levels and percentile distribution data for Greek children. In total, 3298 children (1590M, 1708F, aged 6–14 y) participated in the study. Lp(a) levels were evaluated with an immunosorbent assay. Mean Lp(a) levels were 153–157 mg l‐1 for boys and 146–151 mg l‐1 for girls, and median levels 133–139 mg l1 for boys and 100–108 mg l‐1 for girls.

Raised serum levels of β-endorphin in chronic urticaria

Background Attempts to elucidate the pathophysiology of chronic urticaria and its relation with stress have implicated many factors among which the increased activity of the opioid system seems to be particularly interesting.

Gonorrhoea control programme in Athens, 1974–98

A prominent theme today is the influence of dynamically changing demographic and sociocultural forces on the spread of sexual transmitted diseases (STDs). In most industrialised countries the incidence of classic STDs such as gonorrhoea has been declining rapidly among the educated middle and upper classes.1,2 The aim of this study was to evaluate a gonorrhoea case finding programme which took place in Athens from 1974 to 1998 (25 years). The study was approved by the Greek ethics committee. The gonorrhoea case finding and treatment programme took place between 9 am and 12 noon on 6 days per week between 1 January 1974 and 31 December 1998. People were recruited for examination in “A Syngros” Hospital, Athens, then taken to the same hospital for further investigation and treatment. ### DIAGNOSTIC TESTS Direct microscopy and culture were the mainstay of gonorrhoea diagnosis. Samples could be Gram stained and examined by light microscopy to yield a diagnosis within 5 minutes. Accuracy varied with the site sampled and the experience of the microscopist. If there was a strong likelihood of infection and if presumptive treatment had not been given, a second or even third set of cultures performed on subsequent occasions maximised detection.3 Isolation of gonococci was also improved by the parallel use of selective and non-selective media. In practice, acceptable results were active with moderately selective media. …

Plasma biotinidase levels in patients with cystic acne under isotretinoin treatment

Sensitization was initiated with a 2% solution of diphencyprone applied to a small area (4 cm diameter) on one side of the scalp. The patient was advised not to wash the scalp for 3-4 days. Once the patient was sensitized, 0.01 % solution was applied to one side of the scalp weekly. The concentration was increased (0.025%, 0.05%, 0.075% etc.) at each weekly visit until erythema and pruritus which lasts for 36 h was achieved. The whole scalp was treated when the concentration resulting in adequate response was established. The patients were advised that treatment would continue for 8 months and would be stopped if there was no hair growth after that time. Regrowth of hair was achieved in 18 patients with alopecia areata, in eight patients with alopecia totalis and in one patient with alopecia universalis (Fig. 1; Table 1). Prognosis depends on the type of alopecia, however, there was no statistically significant difference between the duration of alopecia in those who experienced hair regrowth and those who did not. Cervical iymphadenopathy was observed in all 17 patients who responded to the contact allergen. Depigmented patches in the skin of the scalp and nape of the neck were observed in one patient (2%). We have found diphencyprone to be an effective, safe therapy for mild, moderate and severe forms of alopecia areata and alopecia totalis. However, continuing evaluation of the long-term safety of this chemical is required.