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521. Vitiligo

potent TCS these side-effects such as skin atrophy, telangiectasia, hypertrichosis, acneiform eruptions and striae have been observed. Lower potency classes of TCS and newer class III TCS such as mometasone furoate and methylprednisolone aceponate are largely devoid of these side effects. There are currently no studies available on optimal duration of TCS therapy and on discontinuous applications that could be of help in improving the therapeutic index (7). Expert recommendations In children

2011 European Dermatology Forum

522. A day in the life of a radiologist

-year-old man who developed drenching night sweats not long before his admission. Clinicians have requested needle biopsy of neck lesions and thoracentesis. I have viewed his chest X-ray and CT scan. Among other things, he has bulky mediastinal adenopathy and pleural fluid. I examine his neck and view the ultrasound images just taken. They confirm that the lumps I feel are enlarged lymph nodes. He is hirsute, to the point I prefer that part of his neck be shaved, the less hair to impede biopsy

2017 KevinMD blog

523. Noncontraceptive use of oral combined hormonal contraceptives in polycystic ovary syndrome-risks versus benefits. Full Text available with Trip Pro

Noncontraceptive use of oral combined hormonal contraceptives in polycystic ovary syndrome-risks versus benefits. The use of steroid sex hormones for noncontraceptive benefits has been endorsed by several medical societies. In women with polycystic ovary syndrome (PCOS), hormonal contraceptives are first-line therapy for concurrent treatment of menstrual irregularity, acne, and hirsutism. The association of PCOS with obesity, diabetes, and dyslipidemia frequently brings up the debate regarding

2016 Fertility and Sterility

524. Normal Pubertal Development in Daughters of Women with PCOS: A Controlled Study. Full Text available with Trip Pro

included integrated salivary insulin levels and urinary luteinizing hormone levels.There were no differences in detection rates or mean levels for gonadotropins and sex steroids in timed urinary collections between PCOS daughters and control daughters, nor were there differences in integrated salivary insulin levels. Results showed that 69% of Tanner 4/5 PCOS daughters vs 31% of control daughters had hirsutism defined as a Ferriman-Gallwey score >8 (P = 0.04). There were no differences in body

2016 Journal of Clinical Endocrinology and Metabolism

525. Prescribing of cyproterone acetate/ethinylestradiol in UK general practice: a retrospective descriptive study using The Health Improvement Network. (Abstract)

. Corresponding percentages for acne were 51%, 54% and 55%, respectively. When manually reviewing patient records for a sample of CPA/EE new users (n=200), the acne was recorded in 77% of women, hirsutism in 9.5% and polycystic ovary syndrome in 9.5%. Majority of CPA/EE users had a prior acne diagnosis and/or treatment, 76% (n=2091) in 2011, 79% (n=2296) in 2012 and 78% (n=1834) in 2014. Concomitant use of CPA/EE and another HC was rare, 1% of CPA/EE users in 2011 and fewer than 0.5% of CPA/EE users in both

2016 Contraception

526. Hormonal contraceptives: pharmacology tailored to women's health. Full Text available with Trip Pro

indicated for all forms of hyperandrogenism associated with acne and mild hirsutism. The associations of estradiol/dienogest and estradiol/nomegestrol acetate are the most suitable contraceptives for women with abundant menstrual bleeding and can increase the number of potential users of hormonal contraception.Progress in the provision of new oral contraceptives has improved the risk/benefit ratio, by increasing benefits and reducing risks. The present challenge is to tailor contraceptives to individual

2016 Human Reproduction Update

527. Prostate-Specific Antigen as a Marker of Hyperandrogenism in Women and Its Implications for Antidoping. Full Text available with Trip Pro

increased androgen production.There have been reports of increased PSA expression in women exhibiting hyperandrogenic states, including polycystic ovary syndrome and hirsutism, as well as marked increases in a subset of breast cancer patients. These findings have not only revealed the remarkable diagnostic potential of PSA in a diverse range of clinical conditions but also point to its potential of becoming a useful biomarker of steroid hormone doping among female athletes. Recently, highly sensitive

2016 Clinical Chemistry

528. Defining hyperandrogenism in women with Polycystic Ovary Syndrome: a challenging perspective. Full Text available with Trip Pro

. Metabolic parameters were also investigated and hirsutism was measured by the modified Ferriman-Gallwey (mF-G) score.Three distinct phenotypes were initially defined according to the combination of hirsutism (mF-G ≥ 8) and/or high testosterone (T) (HA), oligo-amenorrhea (OA), and polycystic ovarian morphology (PCOm); OA + PCOm (n = 43), HA + OA (n = 65), and HA + OA + PCOm (n = 45). T, androstenedione (A), and free androgen index (FAI) levels progressively increased in the 3 PCOS phenotypes with respect (...) to the controls, with the highest values in the HA + OA + PCOm phenotype. The various combinations of hirsutism, high T, high A, and high FAI made it possible to categorize the 3 original phenotypes into 8 hyperandrogenic subgroups, characterized by divergent additional steroid profile and metabolic pattern. A total of 90% of patients with PCOS thus proved hyperandrogenic. Interestingly, half the PCOS women originally classified as having the OA-PCOm phenotype were categorized in a hyperandrogenic subgroup

2016 Journal of Clinical Endocrinology and Metabolism

529. Prescribing patterns of combined hormonal products containing cyproterone acetate, levonorgestrel and drospirenone in the UK. Full Text available with Trip Pro

%; and DRSP/EE, 0.27% and 0.56%. Most new users prescribed CPA/EE had a record of acne (51.0% and 79.2% in 2002 and 2010, respectively) or hirsutism (3.0% and 5.0% in 2002 and 2010, respectively); the proportion of new users with a record only for contraception decreased from 32.9% in 2002 to 8.6% in 2010. Among new users prescribed DRSP/EE or LNG/EE in 2010, 43.2% and 30.8% of women, respectively, did not have a record indicating use for contraception.Adherence to prescribing guidelines for CPA/EE has

2016 Journal of Family Planning and Reproductive Health Care

530. Comparison of Drospirenone- with Cyproterone Acetate-Containing Oral Contraceptives, Combined with Metformin and Lifestyle Modifications in Women with Polycystic Ovary Syndrome and Metabolic Disorders: A Prospective Randomized Control Trial. Full Text available with Trip Pro

patients have completed the study. The combination regimen of COCs, metformin, and lifestyle modifications in these patients resulted in a significant decrease in BMI, acne, and hirsutism scores when compared to baseline levels in both groups (P < 0.05). Blood pressure (BP) was significantly different in the CPA group when compared to baseline (75.14 ± 6.77 mmHg vs. 80.70 ± 5.60 mmHg, P < 0.01), and after 6 months of treatment, only the change in systolic BP was significantly different between the two

2016 Chinese medical journal Controlled trial quality: uncertain

531. Fertility-related quality of life from two RCT cohorts with infertility: unexplained infertility and polycystic ovary syndrome. Full Text available with Trip Pro

scores (72.3 ± 14.8) than those with UI (77.1 ± 12.8; P < 0.001); this was true for each domain (except Relational). These differences were largely explained by variation in BMI, hirsutism, household income and age. Women had lower overall FertiQOL scores than their male partners. Males with PCOS partners had higher scores than males with UI (84.9 ± 10.2 versus 83.3 ± 10.8; P = 0.003). Scores were not consistently associated with conception or pregnancy outcome.The use of multiple tests (...) these couples are to the general population must be made with caution.Women with PCOS with elevated BMI and hirsutism scores and with lower socioeconomic status may require more, targeted psychosocial support than those with other diagnoses. Possible attribution of infertility to the male partner appears to result in a lower QOL. There appears to be substantial national variation in FertiQOL scores, with US-based cohorts reporting overall higher QOL.This work was supported by National Institutes of Health

2016 Human Reproduction Controlled trial quality: uncertain

532. Health-related quality-of-life questionnaire for women with polycystic ovary syndrome: a Chinese translation and validation study. (Abstract)

), waist-hip ratio (WHR), hirsutism score, menstrual regularity, and infertility, and the respective subscales. Improvement in PCOSQ scores was seen in women with improvements in BMI and menstrual patterns; however, these findings did not reach statistical significance.The Chinese version of PCOSQ is reliable and valid for use in women with PCOS.The Chinese version of the PCOSQ is reliable and valid for use.© 2016 Royal College of Obstetricians and Gynaecologists.

2016 BJOG

533. Androgen excess: Investigations and management. (Abstract)

Androgen excess: Investigations and management. Androgen excess (AE) is a key feature of polycystic ovary syndrome (PCOS) and results in, or contributes to, the clinical phenotype of these patients. Although AE will contribute to the ovulatory and menstrual dysfunction of these patients, the most recognizable sign of AE includes hirsutism, acne, and androgenic alopecia or female pattern hair loss (FPHL). Evaluation includes not only scoring facial and body terminal hair growth using (...) the modified Ferriman-Gallwey method but also recording and possibly scoring acne and alopecia. Moreover, assessment of biochemical hyperandrogenism is necessary, particularly in patients with unclear or absent hirsutism, and will include assessing total and free testosterone (T), and possibly dehydroepiandrosterone sulfate (DHEAS) and androstenedione, although these latter contribute limitedly to the diagnosis. Assessment of T requires use of the highest quality assays available, generally

2016 Best practice & research. Clinical obstetrics & gynaecology

534. Comparing the Effect of Metformin and Acarbose Accompanying Clomiphene on the Successful Ovulation Induction in Infertile Women with Polycystic Ovary Syndrome. Full Text available with Trip Pro

respectively. In addition, they received 100 mg Clomiphene from third to seventh day of menstruation, during the 3 month treatment period. All the subjects in both groups before and after the treatment were examined for hirsutism, acne, oral glucose tolerance test, serum triglycerides, cholesterol, LDL, HDL. Also, induction of ovulation was assessed by vaginal ultrasound. The Mean of BMI and fasting glucose tolerance test in Acarbose group was less than Metformin group (P = 0.05). The mean of triglycerides

2016 Global journal of health science Controlled trial quality: uncertain

535. Choice, Transparency, Coordination, and Quality Among Direct-to-Consumer Telemedicine Websites and Apps Treating Skin Disease. Full Text available with Trip Pro

was proffered in 48 encounters (77%). Prescription medications were ordered in 31 of 48 diagnosed cases (65%), and relevant adverse effects or pregnancy risks were disclosed in a minority (10 of 31 [32%] and 6 of 14 [43%], respectively). Websites made several correct diagnoses in clinical scenarios where photographs alone were adequate, but when basic additional history elements (eg, fever, hypertrichosis, oligomenorrhea) were important, they regularly failed to ask simple relevant questions and diagnostic

2016 JAMA dermatology (Chicago, Ill.)

536. Classic Case Report of Donohue Syndrome (Leprechaunism; OMIM *246200): The Impact of Consanguineous Mating. Full Text available with Trip Pro

due to infection, and jaundice. Dysmorphic features, abnormalities of the craniofacial region, low birth weight, skin abnormalities, abdominal distension and hypertrichosis were observed. Laboratory examinations showed, hyperinsulinism, increased C-peptide, thrombocytopenia, leucopenia, and anemia.The diagnosis of DS was done based on the combinations of typical dysmorphic characteristics, clinical evaluation, supported by genetic analysis and exaggerated biochemical results. Genetic diagnosis

2016 Medicine

537. Sexual Function and Depressive Symptoms in Young Women With Nonclassic Congenital Adrenal Hyperplasia. (Abstract)

, and dehydroepiandrosterone sulfate were measured. Hirsutism was evaluated according to the modified Ferriman-Gallwey score. Questionnaires assessing female sexual function (Female Sexual Function Index) and the presence and severity of depressive symptoms (Beck Depression Inventory, Second Edition) were completed by each participant.Sexual function and depressive symptoms in young women with NC-CAH.Women with NC-CAH presented increased plasma levels of 17-hydroxyprogesterone, total and free testosterone, androstenedione (...) , and dehydroepiandrosterone sulfate and higher hirsutism scores compared with healthy women. The study group also showed a lower total Female Sexual Function Index score and lower scores in four domains (sexual arousal, lubrication, sexual satisfaction, and dyspareunia). Scores for sexual desire and orgasm correlated with total hirsutism score and testosterone levels. The Beck Depression Inventory questionnaire showed that the total score was higher in women with NC-CAH than in healthy women, correlating

2016 Journal Of Sexual Medicine

538. Comparison of Metformin and Simvastatin Administration in Women With Polycystic Ovary Syndrome Before Intra-Cytoplasmic Sperm Injection Cycle: A Prospective, Randomized, Clinical Trial Study. Full Text available with Trip Pro

drugs improved hirsutism score significantly, but simvastatin better than metformin (Group A, 24.5 ± 3.6 P: 0.0001 VS Group B, 22.9 ± 5.9 P: 0.003). The reduction in body mass index (BMI) was not significant in the groups. Simvastatin reduced some biochemical parameters such as FSH, LH, testosterone, total cholesterol, LDL and increased HDL level significantly, whereas metformin decreased FSH, TG, testosterone and total cholesterol significantly. Overall, respectively 35% and 30% of patients treated

2016 Iranian Red Crescent medical journal Controlled trial quality: uncertain

539. Scar Management in the Pediatric and Adolescent Populations. Full Text available with Trip Pro

Scar Management in the Pediatric and Adolescent Populations. For most children and adolescents who have developed symptomatic scars, cosmetic concerns are only a portion of the motivation that drives them and their caregivers to obtain treatment. In addition to the potential for cosmetic disfigurement, scars may be associated with a number of physical comorbidities including hypertrichosis, dyshidrosis, tenderness/pain, pruritus, dysesthesias, and functional impairments such as contractures

2016 Pediatrics

540. Trends, in Diagnosis and Treatment of Polycystic Ovarian Syndrome by Specialty. (Abstract)

etiologies. Women seen by endocrinologists tended to be prescribed met- formin more often; however, there was no significant difference in the use of hormonal contraceptives, piogli- tazone, and spironolactone among specialties.Across 3 clinical practice specialties commonly evaluating menstrual irregularity and/or hirsutism in young women, patients were consistently diagnosed with PCOS based on appropriate, clinically- accepted criteria. However, no patients seen by gyne- cologists received lipid test

2016 Journal of Reproductive Medicine

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