The effect of isotretinoin on triglycerides and liver aminotransferases

BACKGROUND: Isotretinoin has been used to treat the most severe cases of acne; however, it may provoke adverse events in mucocutaneous and hepatic tissues, lead to alterations in lipid levels and cause teratogenicity. OBJECTIVE: The objective of this study was to evaluate the profile of changes in alanine aminotransferase (ALT), aspartate aminotransferase (AST) and triglyceride levels in patients who had been treated with oral isotretinoin dispensed by the São Mateus/ES pharmacy for special drugs. METHODS: A retrospective, observational, longitudinal study was conducted by carrying out a secondary analysis of each patient's data. RESULTS: Of the 130 patients who received isotretinoin between January and December 2009, only 70 were actually treated for 3 months or more and handed in the results of their laboratory tests. Of these 70 patients, 39 (55.7%) were female. The mean age of the women (23.9 years) was higher than the mean age of the men (20.1 years). There was a statistically significant increase in the levels of triglycerides (87.01 ± 48.25 versus 105.32 ± 48.76 mg/dL), AST (20.44 ± 6.26 versus 24.38 ± 11.92 U/L) and ALT (18.24 ± 8.31 versus 23.34 ± 20.03 U/L) performed prior to and 3 months or more after oral isotretinoin treatment. After treatment with oral isotretinoin, triglyceride levels had increased beyond the normal range in 11% of the patients, while 8.6% had elevated AST levels and 7.3% had increased ALT levels. CONCLUSION: The results in this population show that the use of oral isotretinoin for the treatment of acne may result in altered triglyceride, AST and ALT levels. These findings are in accordance with data published previously in the scientific literature, confirming the need to monitor these patients.

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Frailty among middle-aged and older Canadians: population norms for the frailty index using the Canadian Longitudinal Study on Aging

Age and Ageing ◽

10.1093/ageing/afaa144 ◽

2020 ◽

Author(s):

Mario Ulises Pérez-Zepeda ◽

Judith Godin ◽

Joshua J Armstrong ◽

Melissa K Andrew ◽

Arnold Mitnitski ◽

...

Keyword(s):

Longitudinal Study ◽

Normative Data ◽

Frailty Index ◽

Secondary Analysis ◽

Population Based ◽

Deficit Accumulation ◽

Starting Point ◽

Males And Females ◽

The Mean ◽

Global Population

Abstract Background frailty is a public health priority now that the global population is ageing at a rapid rate. A scientifically sound tool to measure frailty and generate population-based reference values is a starting point. Objective in this report, our objectives were to operationalize frailty as deficit accumulation using a standard frailty index (FI), describe levels of frailty in Canadians ≥45 years old and provide national normative data. Design this is a secondary analysis of the Canadian Longitudinal Study on Aging (CLSA) baseline data. Setting/participants about 51,338 individuals (weighted to represent 13,232,651 Canadians), aged 45–85 years, from the tracking and comprehensive cohorts of CLSA. Methods after screening all available variables in the pooled dataset, 52 items were selected to construct an FI. Descriptive statistics for the FI and normative data derived from quantile regressions were developed. Results the average age of the participants was 60.3 years (95% confidence interval [CI]: 60.2–60.5), and 51.5% were female (95% CI: 50.8–52.2). The mean FI score was 0.07 (95% CI: 0.07–0.08) with a standard deviation of 0.06. Frailty was higher among females and with increasing age, and scores >0.2 were present in 4.2% of the sample. National normative data were identified for each year of age for males and females. Conclusions the standardized frailty tool and the population-based normative frailty values can help inform discussions about frailty, setting a new bar in the field. Such information can be used by clinicians, researchers, stakeholders and the general public to understand frailty, especially its relationship with age and sex.

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Reliability of Laboratory Tests for the Control of Oral Anticoagulation

Thrombosis and Haemostasis ◽

10.1055/s-0038-1647716 ◽

1974 ◽

Vol 32 (02/03) ◽

pp. 483-491

Author(s):

E. A Loeliger ◽

M. J Boekhout-Mussert ◽

L. P van Halem-Visser ◽

J. D. E Habbema ◽

H de Jonge

Keyword(s):

Human Brain ◽

Laboratory Tests ◽

Test Procedure ◽

Rabbit Brain ◽

Normal Range ◽

Test Procedures ◽

Discrimination Power ◽

Power Of The Test ◽

Assay Procedure ◽

Low Sensitivity

SummaryThe present study concerned the reproducibility of the so-called prothrombin time as assessed with a series of more commonly used modifications of the Quick’s onestage assay procedure, i.e. the British comparative reagent, homemade human brain thromboplastin, Simplastin, Simplastin A, and Thrombotest. All five procedures were tested manually on pooled lyophilized normal and patients’ plasmas. In addition, Simplastin A and Thrombotest were investigated semiautomatically on individual freshly prepared patients’ plasmas. From the results obtained, the following conclusions may be drawn :The reproducibility of results obtained with manual reading on lyophilized plasmas is satisfactory for all five test procedures. For Simplastin, the reproducibility of values in the range of insufficient anticoagulation is relatively low due to the low discrimination power of the test procedure in the near-normal range (so-called low sensitivity of rabbit brain thromboplastins). The reproducibility of Thrombotest excels as a consequence of its particularly easily discerned coagulation endpoint.The reproducibility of Thrombotest, when tested on freshly prepared plasmas using Schnitger’s semiautomatic coagulometer (a fibrinometer-liJce apparatus), is no longer superior to that of Simplastin A.The constant of proportionality between the coagulation times formed with Simplastin A and Thrombotest was estimated at 0.64.Reconstituted Thrombotest is stable for 24 hours when stored at 4° C, whereas reconstituted Simplastin A is not.The Simplastin A method and Thrombotest seem to be equally sensitive to “activation” of blood coagulation upon storage.

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Immunologic Assessment of Patients Treated with Bovine Fibrin as a Hemostatic Agent

Thrombosis and Haemostasis ◽

10.1055/s-0038-1650687 ◽

1996 ◽

Vol 76 (06) ◽

pp. 0925-0931 ◽

Cited By ~ 36

Author(s):

John F Carroll ◽

Keith A Moskowitz ◽

Niloo M Edwards ◽

Thomas J Hickey ◽

Eric A Rose ◽

...

Keyword(s):

Coagulation Factors ◽

Allergic Reactions ◽

Factor V ◽

Normal Range ◽

Serum Samples ◽

Human Fibrinogen ◽

Bovine Thrombin ◽

Thrombotic Complications ◽

The Mean ◽

Clinically Significant

SummaryTwenty-one cardiothoracic surgical patients have been treated with fibrin as a topical hemostatic/sealing agent, prepared from bovine fibrinogen clotted with bovine thrombin. Serum samples have been collected before treatment with fibrin and postoperatively between 1 and 9 days, 3 and 12 weeks, and 6 and 8 months. The titers of anti-bovine fibrinogen antibodies, measured by ELISA specific for immunoglobulins IgG or IgM, increased to maximal values after about 8 or 6 weeks, respectively. After 8 months, IgG titers were on average 20-fold lower than the mean maximal value, while IgM titers returned to the normal range. IgG was the predominant anti-bovine fibrinogen immunoglobulin as documented by ELISA, affinity chromatography and electrophoresis. Anti-bovine fibrinogen antibodies present in patients reacted readily with bovine fibrinogen, but did not cross-react with human fibrinogen as measured by ELISA or by immunoelectrophoresis. A significant amount of antibodies against bovine thrombin and factor V has been found, many cross-reacting with the human counterparts. No hemorrhagic or thrombotic complications, or clinically significant allergic reactions, occurred in any patient, in spite of antibody presence against some bovine and human coagulation factors. The treatment of patients with bovine fibrin, without induction of immunologic response against human fibrinogen, appeared to be an effective topical hemostatic/sealing measure.

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Influence of Acute Myocardial Infarction and rt-PA Therapy on Circulating Fibrinogen

Thrombosis and Haemostasis ◽

10.1055/s-0038-1651605 ◽

1993 ◽

Vol 69 (04) ◽

pp. 321-327 ◽

Cited By ~ 3

Author(s):

E Seifried ◽

M Oethinger ◽

P Tanswell ◽

E Hoegee-de Nobel ◽

W Nieuwenhuizen

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Thrombolytic Agent ◽

Degradation Products ◽

Maximum Plasma ◽

Normal Range ◽

Fibrinogen Degradation Products ◽

Fibrin Degradation Products ◽

Rebound Phenomenon ◽

The Mean

SummaryIn 12 patients treated with 100 mg rt-PA/3 h for acute myocardial infarction (AMI), serial fibrinogen levels were measured with the Clauss clotting rate assay (“functional fibrinogen”) and with a new enzyme immunoassay for immunologically intact fibrinogen (“intact fibrinogen”). Levels of functional and “intact fibrinogen” were strikingly different: functional levels were higher at baseline; showed a more pronounced breakdown during rt-PA therapy; and a rebound phenomenon which was not seen for “intact fibrinogen”. The ratio of functional to “intact fibrinogen” was calculated for each individual patient and each time point. The mean ratio (n = 12) was 1.6 at baseline, 1.0 at 90 min, and increased markedly between 8 and 24 h to a maximum of 2.1 (p <0.01), indicating that functionality of circulating fibrinogen changes during AMI and subsequent thrombolytic therapy. The increased ratio of functional to “intact fibrinogen” seems to reflect a more functional fibrinogen at baseline and following rt-PA infusion. This is in keeping with data that the relative amount of fast clotting “intact HMW fibrinogen” of total fibrinogen is increased in initial phase of AMI. The data suggest that about 20% of HMW fibrinogen are converted to partly degraded fibrinogen during rt-PA infusion. The rebound phenomenon exhibited by functional fibrinogen may result from newly synthesized fibrinogen with a high proportion of HMW fibrinogen with its known higher degree of phosphorylation. Fibrinogen- and fibrin degradation products were within normal range at baseline. Upon infusion of the thrombolytic agent, maximum median levels of 5.88 μg/ml and 5.28 μg/ml, respectively, were measured at 90 min. Maximum plasma fibrinogen degradation products represented only 4% of lost “intact fibrinogen”, but they correlatedstrongly and linearly with the extent of “intact fibrinogen” degradation (r = 0.82, p <0.01). In contrast, no correlation was seen between breakdown of “intact fibrinogen” and corresponding levels of fibrin degradation products. We conclude from our data that the ratio of functional to immunologically “intact fibrinogen” may serve as an important index for functionality of fibrinogen and select patients at high risk for early reocclusion. Only a small proportion of degraded functional and “intact fibrinogen”, respectively, is recovered as fibrinogen degradation products. There seems to be a strong correlation between the degree of elevation of fibrinogen degradation products and the intensity of the systemic lytic state, i.e. fibrinogen degradation.

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Platelet Suruival and Function in Rats with Enhanced Thrombotic Tendency

Thrombosis and Haemostasis ◽

10.1055/s-0038-1660122 ◽

1985 ◽

Vol 54 (04) ◽

pp. 739-743 ◽

Cited By ~ 2

Author(s):

Federica Delaini ◽

Elisabetta Dejana ◽

Ine Reyers ◽

Elisa Vicenzi ◽

Germana De Bellis Vitti ◽

...

Keyword(s):

Arachidonic Acid ◽

Nephrotic Syndrome ◽

Platelet Function ◽

Laboratory Tests ◽

Thrombus Formation ◽

The Other ◽

Mean Survival Time ◽

The Mean ◽

And Function ◽

Thrombotic Tendency

SummaryWe have investigated the relevance of some laboratory tests of platelet function in predicting conditions of thrombotic tendency. For this purpose, we studied platelet survival, platelet aggregation in response to different stimuli, TxB2 and 6-keto-PGFlα production in serum of rats bearing a nephrotic syndrome induced by adriamycin. These animals show a heavy predisposition to the development of both arterial and venous thrombosis. The mean survival time was normal in nephrotic rats in comparison to controls. As to aggregation tests, a lower aggregating response was found in ADR-treated rats using ADP or collagen as stimulating agents. With arachidonic acid (AA) we observed similar aggregating responses at lower A A concentrations, whereas at higher AA concentrations a significantly lower response was found in nephrotic rats, despite their higher TxB2 production. Also TxB2 and 6-keto-PGFlα levels in serum of nephrotic rats were significantly higher than in controls. No consistent differences were found in PGI2-activity generated by vessels of control or nephrotic rats.These data show that platelet function may appear normal or even impaired in rats with a markedly increased thrombotic tendency. On the other hand, the significance of high TxB2 levels in connection with mechanisms leading to thrombus formation remains a controversial issue.

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Kaolin-Activated Euglobulin Lysis Time (KELT)

10.1055/s-0038-1665655 ◽

1979 ◽

Author(s):

H Greig

Keyword(s):

No Value ◽

Clinical Assessment ◽

Fibrinolytic Activity ◽

Factor Xii ◽

Plasminogen Activation ◽

Normal Range ◽

Control Subjects ◽

Lysis Time ◽

Euglobulin Lysis Time ◽

The Mean

The most commonly used test for clinical assessment of fibrinolytic activity is the Euglobulin Lysis Time (ELT). However the normal range is very wide, the long times are inconvenient and detection of inhibition is impossible. An attempt has been made to utilise the acceleration of the ELT when kaolin is present, to devise a test with shorter times, a narrower normal range, and better precision. The Euglobulin lysis time was carried out by a modification of the method of NILSSON and OLOW, after precipitation of the euglobulin in the absence of kaolin (ELT) and in the presence of 1 mg. kaolin/ml. plasma (KELT). In 14 control subjects the mean, SD, and range for the ELT were 168.6’, 54.6’, 84-290’; the corresponding values for the KELT were 60.3’, 8.3’ and 46-74’. However, it was found that there was no correlation between the ELT value and the corresponding KELT (’r’ = -0.021); on the contrary, the longer the ELT, the greater the shortening produced by kaolin and there is a direct correlation between the ELT and the shortening of the lysis time by kaolin; ’r’ = 0.988. It is concluded that the KELT has no value as a clinical measure of fibrinolytic activity; further, the results suggest that kaolin may remove an inhibitor(s) of plasminogen activation as well as initiating Factor XII - mediated plasminogen activation.

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Profil Penyakit Malaria Di Rumah Sakit Islam Siti Rahmah Padang Tahun 2018

Health & Medical Journal ◽

10.33854/heme.v2i2.546 ◽

2020 ◽

Vol 2 (2) ◽

pp. 08-15

Author(s):

Rahma Triyana ◽

Salmi Salmi

Keyword(s):

Observational Study ◽

Frequency Distribution ◽

Cross Section ◽

Laboratory Tests ◽

Age Group ◽

Normal Range ◽

Cross Sectional ◽

West Sumatra ◽

Severity Of The Disease

Malaria is one of the health problems in Indonesia, especially West Sumatra. Determination of the description of Malaria disease in an area is needed to determine the spread and severity of the disease. This study aims to determine the frequency distribution according to age, sex and place of residence, description of the types of Plasmodium causes of Malaria and hematological features in Malaria patients at Siti Rahmah Padang Hospital in 2018. This type of research is a descriptive observational study with an approach or design cross section (cross sectional). The frequency distribution of Malaria sufferers in Siti Rahmah Padang Hospital in 2018 according to the highest age was in the age group 21-30 years as many as 28 cases (36.8%), the highest sex among men was 46 (60.5%) and the highest number of residences was found in Koto Tangah sub-district there were 31 cases (40.8%). The type of Plasmodium found in Malaria cases in Siti Rahmah Padang Hospital in 2018 was P. vivax (73 cases (96.05%)) and P. falciparum (3 cases (3.95%)). The results of laboratory tests on Hb, hematocrit, platelet and leukocyte levels in Malaria positive patients in Siti Rahmah Padang Hospital in 2018 were in the normal range.

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Profil Penyakit Malaria di Rumah Sakit Islam Siti Rahmah Padang Tahun 2018

Health & Medical Journal ◽

10.33854/heme.v2i2.452 ◽

2020 ◽

Vol 2 (2) ◽

pp. 08-15

Author(s):

Rahma Triyana Y ◽

Salmi Salmi

Keyword(s):

Observational Study ◽

Frequency Distribution ◽

Cross Section ◽

Laboratory Tests ◽

Age Group ◽

Normal Range ◽

Cross Sectional ◽

West Sumatra ◽

Severity Of The Disease

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Assessment of nutritional status of students of medical institute according to the blood biochemical parameters

Sanitarnyj vrač (Sanitary Inspector) ◽

10.33920/med-08-2007-07 ◽

2020 ◽

pp. 55-63

Author(s):

Rofail Rakhmanov ◽

Elena Bogomolova ◽

Mariya Shaposhnikova ◽

Mariya Sapozhnikova

Keyword(s):

Nutritional Status ◽

Lower Boundary ◽

Density Lipoprotein ◽

Blood Parameters ◽

Medical Institute ◽

Specific Situation ◽

Mathematical Methods ◽

Normal Range ◽

Mean Values ◽

The Mean

The biochemical blood parameters characterizing the students ’nutritional status were evaluated: protein, lipid, carbohydrate metabolism, a number of minerals. The mean values, errors of the mean, median (Me), boundary (Q) and the range of 25–75 percentiles were determined. In 9.1 % of students and 28.6 % of students, the total protein was increased. Creatinine in men was in the upper normal range, in women — at the upper limit of normal, of which 46.2 % was higher than normal. The interval Q25–75 of uric acid in students is determined in the lower normal zone. In 40.0 % of men, decreased high-density lipoprotein cholesterol (Q25–75 corresponded to 1.15–1.79), in women — below normal, Q25–75 5 was 1.3–1.5, decreased in 73.3 %. Me and Q25–75 iron were in the lower normal range; 14.1 % of men and 13.2 % of women are below normal. Me sodium and potassium at the level of the lower boundary of the norm, Q25–75 in the lower zone of the norm: in 16.0 % and 15.4 % of students the levels are reduced. Calcium is slightly above the lower limit of the norm, Q25–75–2.1–2.24, indicating an insufficient intake in the whole group; 25.0 % are below normal. The border of the 25th percentile of magnesium is at the level of the lower border of the norm, in 19.2 % it is reduced. 7.2 % lack of chlorine. Phosphorus is normal, but Q25–75 is in the upper zone; 17.9 % increased. Biochemical markers can identify individuals with metabolic disorders of nutrients. Statistical indicators — the median, the boundaries of 25–75 quartiles and their scope characterize the metabolism of macronutrients and minerals in the group and subgroups of students. Laboratory and mathematical methods can provide a basis for identifying the specific causes of these changes. For this, you can use the questionnaire method of studying the nutrition of students, possibly using the developed questionnaires for a specific situation.

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A multicenter prospective hospital-based cohort study on the efficacy and safety of pitavastatin.

Current Diabetes Reviews ◽

10.2174/1573399817666201228164243 ◽

2020 ◽

Vol 17 ◽

Author(s):

Abdullah Shehab ◽

Asim Ahmed Elnour ◽

Akshaya Srikanth Bhagavathula ◽

Joseph Pulavelil Kurian ◽

Gazi Hassan ◽

...

Keyword(s):

Cohort Study ◽

Adverse Events ◽

United Arab Emirates ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Low Density ◽

Efficacy And Safety ◽

Onset Diabetes ◽

The Mean ◽

New Onset

Aims: We aim to investigate the efficacy and safety of pitavastatin 4 mg in a population of people living in the United Arab Emirates (UAE). Background: Pitavastatin is a member of the HMG-CoA reductase inhibitors family which was approved for use in adult subjects with primary hyperlipidemia or mixed dyslipidemia. To date, no published studies have assessed the efficacy and safety of pitavastatin in the United Arab Emirates. Objective: The main objective of the current study was to investigate the efficacy and safety of pitavastatin in subjects with dyslipidemia for primary prevention of cardiovascular diseases based on total cardiovascular risk. Methods: This was a multicentre (four private hospitals) prospective cohort study to analyze data on the use of pitavastatin for dyslipidemia in adult outpatients in Abu Dhabi and Dubai emirates, United Arab Emirates. We have followed-up the clinical profiles of subjects in four hospitals for six-weeks during the period from June 2015 to June 2017. Efficacy was based on the evaluation of the mean (± standard deviation) change in low-density lipoprotein cholesterol between baseline and week six after the initiation of pitavastatin therapy. Safety was reported as the incidence of adverse events occurred with the use of pitavastatin and the development of new-onset diabetes. Results: A total of 400 subjects who were receiving pitavastatin 4 mg were included. The mean age of subjects was 50.7 ±10.8 years, of these 79.0% were males. At the baseline, the mean level of total cholesterol was 185.4 ±41.5 mg/dL, low density lipoprotein was 154.9 ±48.55 mg/dL, high-density lipoprotein cholesterol was 40.5 ±11.23 mg/dL and fasting blood glucose was 115.0 (±16.63) mg/dl. At the end of six weeks, low density lipoprotein levels significantly decreased to 112.09 ±41.90 mg/dl (standard mean difference [SMD] (-42.8%), 95% CI: -42.88 [-49.17 to -36.58] mg/dl, P <0.001), while high density lipoprotein levels improved (SMD, 95% CI: 1.77% [0.25 to 3.28] mg/dl, P <0.022). There were 55 subjects (13.7%) reported various adverse events such as myalgia (7.5%), sleep disorders (2.5%), and myopathy (2.2%). Furthermore, 4 (1.0%) have had developed new-onset diabetes post six-weeks of initiation of pitavastatin therapy. Conclusion: Pitavastatin 4 mg had howed robust efficacy in reducing LDL-C levels and improving HDL-C levels in subjects with dyslipidemias. The use of pitavastatin was associated with a low discontinuation rate, fewer adverse events, and very limited cases of new-onset diabetes.

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