Psoriasis in childhood and adolescence: evaluation of demographic and clinical features

BACKGROUND: The present study was aimed to define the gender ratio, familial occurrence, age of onset, precipitating factors, clinical types, nail and joint involvement of psoriasis in childhood and adolescence in Turkey. METHODS: A total of 61 children with psoriasis under 18 years old were evaluated retrospectively, for age, gender, age of disease onset, family history, concomitant disease, the clinical type of psoriasis, clinical localization, nail and joint involvement and treatment modalities. RESULTS: Of the patients, 23 (37.70%) were boys and 38 (62.30%) were girls. Mean age was 9.28 +/- 4.02 years in girls and 11.18 +/- 3.85 years in boys (9.96 +/- 4.03 years in all children). Mean age at the onset of the disease was 6.81 +/- 4.11 years in girls and 7.03 +/- 4.28 years in boys (6.89 +/- 4.14 years in all patients). In 14 (23%) cases, a positive family history was detected. The most frequent probable triggering factors were upper respiratory tract infections (14.8%) and positive throat culture for A group ss-hemolytic streptococcus (21.3%). Frequency of emotional stress and psychiatric morbidity were 54% and 9.8%, respectively. The most frequent localizations at onset were trunk (44.3%), extremities (54.0%), and scalp (36.0%). Three children (4.9%) had a history of dissemination from psoriatic diaper rash. In total, 51 (83.6%) patients presented with psoriasis vulgaris, eight (13.1%) with generalized pustular psoriasis, and the remaining two (3.3%) with erythrodermic psoriasis. CONCLUSION: The incidence of psoriasis among dermatological patients in childhood and adolescence was 3.8%. The disease tends to appear earlier in girls than boys. The authors suggested that stress and upper respiratory infections are the most important triggering factors in childhood and adolescence psoriasis.     

Does prophylactic sotalol and magnesium decrease the incidence of atrial fibrillation following coronary artery bypass surgery: a propensity-matched analysis

Background  

Atrial fibrillation can occur in up to 40% of patients undergoing coronary surgery.     

Histological findings in erosive prepyloric changes

To study the histology of erosive prepyloric changes (EPC), 5 bioptic specimens per examination were obtained from the prepyloric mucosa during 161 upper endoscopies in persons with and without EPC. The macroscopic erosions of EPC grade 3 were histologically verified in 88% of the cases. Histologically diagnosed erosions were always accompanied by an element of acute inflammation. The incidence of acute inflammation increased with increasing grades of EPC, from 5% in grade 0 and 1, through 26% in grade 2, to 96% in grade 3. The incidence of chronic inflammation was 0 in grade 0, 50% in grade 1, 46% in grade 2, and 90% in grade 3. On the whole, gastritis was found in 98% of the cases with EPC grade 3, as compared with approximately 50% in grades 2 and 1. Fibrosis was diagnosed in all the cases. The mean thickness of the foveolar layer increased with increasing grades of EPC, the values being significantly higher in grades 2 and 3 than in grade 0, with, however, considerable overlapping between groups. Cimetidine was found to have no effect on the histological features of chronic/acute inflammation and erosion.     

Haemorrhagic effects of unfractionated and two low molecular weight heparins, enoxaparin and fragmin, in rats.

The effects on primary haemostasis of unfractionated heparin and of the two low molecular weight heparins, enoxaparin and fragmin, were compared in two rat models, one employing the gastric mucosa and the other the tail skin. All three heparin preparations prolonged the bleeding time and increased the blood loss dose dependently. The prolongation of the bleeding time per unit dose caused by unfractionated heparin was significantly greater than the prolongation caused by either one of the two low molecular weight heparins. In the gastric mucosa, but not in the tail skin, enoxaparin prolonged the bleeding time significantly less than fragmin (p less than 0.05).