Greater Prevalence In Males Research Articles

Correlation between systemic inflammatory response index and thyroid function: 2009-2012 NHANES results.

This study investigates the relationship between the Systemic Inflammatory Response Index (SIRI) and thyroid function. Utilizing data from the National Health and Nutrition Examination Survey (NHANES) 2009-2012, we excluded participants lacking SIRI or thyroid function data, those under 20 years, and pregnant individuals. SIRI was determined using blood samples. We conducted weighted multivariate regression and subgroup analyses to discern the independent relationship between SIRI and thyroid function. The study included 1,641 subjects, with an average age of 47.26±16.77 years, including 48.65% males and 51.35% females. The population was divided into three SIRI-based groups (Q1-Q3). Q3, compared to Q1, exhibited higher age-at-onset, greater male prevalence, and increased levels of FT3, FT4, TT4, leukocytes, and triglycerides. This group also showed a higher incidence of diabetes, hypertension, and smoking. Notably, Q1 had lower LDL and HDL levels. SIRI maintained a positive association with FT4 (β = 0.01, 95% CI = 0.00-0.03, P for trend = 0.0071), TT4 (β = 0.20, 95% CI = 0.10, 0.31, P for trend=0.0001), and TPOAb (β = 8.0, 95% CI = 1.77-14.30, P for trend = 0.0120), indicating that each quartile increase in SIRI corresponded to a 0.01 ng/dL increase in FT4, a 0.2 g/dL increase in TT4, and an 8.03 IU/mL rise in TPOAb. The subgroup analysis suggested the SIRI-thyroid function correlation was influenced by hypertension. Inflammation may impact the development and progression of thyroid function disorders. Proactive anti-inflammatory treatment might mitigate thyroid abnormalities.

Study of Prevalence of Oral Diseases in The Population of District Buner Khyber Pakhtunkhwa, Pakistan

Background: Oral diseases, prevalent globally, pose significant health challenges, especially in regions with limited healthcare resources. District Buner, in Khyber Pakhtunkhwa, Pakistan, is one such area where oral health has received minimal attention. The study of oral diseases in this region is crucial for understanding the health needs of its population and for implementing effective public health interventions. Objective: This study aimed to assess the prevalence and types of oral diseases in District Buner and to identify the major contributing factors to these conditions, thereby informing targeted healthcare strategies. Methods: A cross-sectional study was conducted from October 2019 to October 2020 in all tehsils of District Buner. Data collection was based on questionnaires administered to both dentists and patients. Approximately 20 to 25 dentists from various healthcare facilities, including government hospitals and private clinics, participated in the study. The questionnaires for dentists consisted of ten open-ended questions, while those for patients included fifteen close-ended questions. The sample size was 508 individuals, representing various age groups and genders. Data analysis involved descriptive and inferential statistical methods to determine prevalence rates and associations. Results: The study revealed that the most common oral diseases were dental caries (90%), gingivitis (63%), periodontitis (59%), pulpitis (43%), TMJ disorders (23%), and oral cancer (5%). Dental caries was notably prevalent across all age groups, with a higher incidence in children. Gingivitis was observed more in females, particularly during pregnancy. Periodontitis and gingivitis showed a greater prevalence in males, often associated with smoking. Pulpitis was more common in females, while TMJ disorders were evenly distributed among genders. Oral cancer was the least prevalent disease. Conclusion: The study underscores the critical need for improved oral health awareness and preventive care in District Buner. The high prevalence of various oral diseases, influenced by factors such as dietary habits, smoking, and gender-specific issues, calls for comprehensive public health strategies. These strategies should include education on oral hygiene, increased access to dental care, and integration of oral health into general healthcare services.

Celastrol Supplementation Ablates Sexual Dimorphism of Abdominal Aortic Aneurysm Formation in Mice.

Abdominal aortic aneurysms (AAAs) are permanent dilations of the abdominal aorta with 4-5 times greater prevalence in males than in females. The aim of this study is to define whether Celastrol, a pentacyclic triterpene from the root extracts of Tripterygium wilfordii, supplementation influences angiotensin II (AngII)-induced AAAs in hypercholesterolemic mice. Age-matched (8-12 weeks old) male and female low-density lipoprotein (Ldl) receptor-deficient mice were fed a fat-enriched diet supplemented with or without Celastrol (10 mg/kg/day) for five weeks. After one week of diet feeding, mice were infused with either saline (n = 5 per group) or AngII (500 or 1000 ng/kg/min, n = 12-15 per group) for 28 days. Dietary supplementation of Celastrol profoundly increased AngII-induced abdominal aortic luminal dilation and external aortic width in male mice as measured by ultrasonography and ex vivo measurement, with a significant increase in incidence compared to the control group. Celastrol supplementation in female mice resulted in significantly increased AngII-induced AAA formation and incidence. In addition, Celastrol supplementation significantly increased AngII-induced aortic medial elastin degradation accompanied by significant aortic MMP9 activation in both male and female mice compared to saline and AngII controls. Celastrol supplementation to Ldl receptor-deficient mice ablates sexual dimorphism and promotes AngII-induced AAA formation, which is associated with increased MMP9 activation and aortic medial destruction.

A national overview of paediatric and adolescent and young adult surgical neuro-oncology in Pakistan.

To build a comprehensive brain tumour database that will allow us to analyse in detail the prevalence, demographics, and outcomes of the disease in paediatric, adolescent, and young adult age groups. A national cross-sectional study was conducted at 32 centres, and data regarding patient demographics and brain tumours were collected. This data was then stratified based on age groups, healthcare sectors, socioeconomic status, tumour types, and surgical outcomes. Most of the patients who were diagnosed with brain tumours belonged to a lower socioeconomic background and went to public sector hospitals. More males were diagnosed with and treated for brain tumours in the paediatric, adolescent, and young adult populations. The most common tumour in the paediatric population was medulloblastoma (23.7%) and the most common tumour in the adolescent (27.8%) and young adult population (34.7%) was glioma. Significant improvement in KPS scores were seen for: craniopharyngioma (p = 0.001), meningioma (p < 0.0005) and pituitary adenoma (p < 0.0005). This study shows that in all three age groups, there was a greater prevalence in males. Most of the patients belonged to a lower-middle-income class background and most patients presented to public sector hospitals. Greater knowledge of these parameters unique to each age group is the key to understanding and alleviating the burden of disease. Cancer registries, specifically brain tumour registries that keep up-to-date records of these patients, are essential to identify and keep track of these unique parameters to advance medical research and treatment strategies, ultimately lowering the disease burden.

A PRIMARY EMPYEMA OF UNKNOWN DURATION DUE TO ANAEROBIC GRAM-NEGATIVE BACILLUS HAFNIA ALVEI

TOPIC: Chest Infections TYPE: Medical Student/Resident Case Reports INTRODUCTION: Empyema is the presence of pus or bacteria in the pleural space. Incidence is increasing gradually with higher rates in the elderly with a greater prevalence in males [1]. Empyema is a fatal infection with a mortality rate of 20% [2]. Anaerobic Enterobacteriaceae accounting for less than 6% of empyema cases, are an infrequent cause [1]. CASE PRESENTATION: An 80-year-old male with a history of coronary disease, hypertension, hyperlipidemia, peripheral vascular disease, moderate aortic stenosis, a former smoker was seen at the pulmonary clinic for intermittent dyspnea with right-sided abdominal fullness of unknown duration and no symptoms of infection. He had significant asbestos exposure from his shipyard work. Around six months back, he underwent superior mesenteric artery (SMA) stenting for chronic abdominal angina. He was taking a super enzyme supplement to enhance his digestion. Chest x-ray review revealed right-sided effusion, which was also present before SMA stenting (Figure A1-2). A diagnostic thoracentesis showed brownish-green fluid with analysis indicative of empyema (Figure B). His blood work was normal. He was admitted, and a pigtail catheter was inserted into the right pleural space with purulent fluid drainage. He also underwent fibrinolysis. The pleural fluid culture grew Hafnia alvei sensitive to quinolones, aminoglycoside, and carbapenems (Amp C resistance pattern). At discharge, computed tomography and x-ray of the chest revealed empyema resolution, and the chest tube was removed (Figure C1-2). The initial antibiotic ertapenem was transitioned to levofloxacin for one month at discharge. At four weeks after discharge, his symptoms had entirely resolved DISCUSSION: H. alvei is a gram-negative facultative motile anaerobe of the Enterobacteriaceae family, a commensal in the gastrointestinal (GI) tract of humans and animals. It colonizes the oropharynx in humans [3]. It produces a cytolytic toxin, a virulent factor, causing acute gastroenteritis. It is a rare cause of nosocomial and community-acquired infection with a preference for biliary tree infection and has lower mortality [4-5]. In patients with multiple comorbidities and immunosuppressed, it causes extraintestinal diseases such as endophthalmitis, bronchopneumonia, gastroenteritis, and meningitis [5]. The infection source is the GI tract via gut translocation or oropharynx venous drainage draining into the heart and forced into the visceral pleura or alveolar capillary bed [5-6]. In our patient, another source could be the contaminated supplement (it contains Ox bile) CONCLUSIONS: In primary empyema of remote duration and an infrequent cause, a possible source could be the GI tract or the oropharynx. Clinicians should be aware of supplement contents that could be a source of infection REFERENCE #1: Godfrey MS, Bramley KT, Detterbeck F. Medical and Surgical Management of Empyema. Semin Respir Crit Care Med. 2019;40(3):361-74 REFERENCE #2: Corcoran JP, Wrightson JM, Belcher E, DeCamp MM, Feller-Kopman D, Rahman NM. Pleural infection: past, present, and future directions. Lancet Respir Med. 2015;3(7):563-77 REFERENCE #3: Fazal BA, Justman JE, Turett GS, Telzak EE. Community-acquired Hafnia alvei infection. Clin Infect Dis. 1997;24(3):527-8 DISCLOSURES: No relevant relationships by Phillip Beck, source=Web Response no disclosure on file for Wilson Grace; No relevant relationships by Ethan Karle, source=Web Response No relevant relationships by AARON MILLER, source=Web Response No relevant relationships by Shakuntala Patil, source=Web Response No relevant relationships by SACHIN PATIL, source=Web Response No relevant relationships by ANTONY RAWINDRARAJ, source=Web Response

Evolution of welfare indicators of pigs housed in deep bedding systems during growing and finishing phases: assessment of good health principles and housing conditions

The aim of the study was to monitor the evolution of welfare indicators of pigs throughout growing and finishing phases housed in a deep bedding system by principles of good health and housing. In all, 16,500 animals, distributed in 15 facilities, were evaluated over a 4-month period. Three assessments were carried out in each facility by a single evaluator, according to the following time distribution: phase one (75 to 85days old), phase two (86 to 161days old), and phase three (162 to 180days old). Only the parameters related to good health and good housing were considered. Data were analyzed by logistic regression for longitudinal data. Poisson distribution was used on the coughing and sneezing data, with subsequent chi-square analysis. There were no cases of poor body condition, shivering, panting, huddling, tail biting, pumping, twisted snout, rectal prolapse, lameness, and skin conditions. The final evaluations were associated with greater chances of hernia and bursitis, with greater prevalence in males than in females. The prevalence of wound and manure on the body parameters was influenced by the interaction of the evaluation and animal category. The incidence of coughing and the number of animals presenting this symptom gradually increased, becoming considerably higher in the final stage of evaluation. Health-related problems change throughout the production cycle. The evaluation of a broad and reliable view on animal welfare allows for the most appropriate management of production systems using deep bedding.

Greater Male Prevalence of Juvenile ADHD: Recent Research on Possible Biological Causes

Greater Male Prevalence of Juvenile ADHD: Recent Research on Possible Biological Causes

Gender-specific association of functional prodynorphin 68 bp repeats with cannabis exposure in an African American cohort.

BackgroundCannabis use disorders (CUDs) cause substantial neuropsychiatric morbidity and comorbidity. There is evidence for gender-based differences in CUDs, for instance, a greater prevalence in males than in females. The main active component of cannabis is delta 9-tetrahydrocannabinol (delta 9-THC), a partial agonist of the cannabinoid type 1 receptor. Preclinical studies show that genetic or pharmacological manipulation of the kappa opioid receptor/dynorphin system modulates the effects of delta 9-THC.MethodsIn this case-control study of adult African Americans (n=476; 206 females, 270 males), we examined the association of the functional prodynorphin 68 bp (PDYN 68 bp) promoter repeats with categorical diagnoses of cannabis dependence (Diagnostic and Statistical Manual of Mental Disorders-IV criteria), as well as with a rapid dimensional measure of maximum lifetime cannabis exposure (the Kreek–McHugh–Schluger–Kellogg cannabis scale).ResultsThe PDYN 68 bp genotype (examined as short–short [SS], short–long [SL], or long–long [LL], based on the number of repeats) was not significantly associated with categorical cannabis-dependence diagnoses, either in males or in females. However, in males, the PDYN 68 bp SS+SL genotype was associated with both greater odds of any use of cannabis (p<0.05) and earlier age of first cannabis use, compared to the LL genotype (ie, 15 versus 16.5 years of age; p<0.045). Males in the SS+SL group also had greater odds of high lifetime exposure to cannabis, compared to the LL group (p<0.045). Of interest, none of the aforementioned genetic associations were significant in females.ConclusionThis study provides the first data on how the PDYN 68 bp genotype is associated with gender-specific patterns of exposure to cannabis. Overall, this study shows that PDYN 68 bp polymorphisms affect behaviors involved in early stages of nonmedical cannabis use and potentially lead to increasing self-exposure. These data may eventually lead to improvements in personalized medicine for the prevention and treatment of highly prevalent CUDs and neuropsychiatric comorbidities.

Liver injury correlates with biomarkers of autoimmunity and disease activity and represents an organ system involvement in patients with systemic lupus erythematosus

Liver disease (LD), defined as ≥2-fold elevation of aspartate aminotransferase (AST) or alanine aminotransferase (ALT), was examined in a longitudinal study of systemic lupus erythematosus (SLE) patients. Among 435 patients, 90 (20.7%) had LD with a greater prevalence in males (15/39; 38.5%) than females (75/396; 18.9%; p=0.01). SLE disease activity index (SLEDAI) was greater in LD patients (7.8±0.7) relative to those without (5.8±0.3; p=0.0025). Anti-smooth muscle antibodies, anti-DNA antibodies, hypocomplementemia, proteinuria, leucopenia, thrombocytopenia, and anti-phospholipid syndrome were increased in LD. An absence of LD was noted in patients receiving rapamycin relative to azathioprine, cyclosporine A, or cyclophosphamide. An absence of LD was also noted in patients treated with N-acetylcysteine. LFTs were normalized and SLEDAI was diminished with increased prednisone use in 76/90 LD patients over 12.1±2.6months. Thus, LD is attributed to autoimmunity and disease activity, it responds to prednisone, and it is potentially preventable by rapamycin or N-acetylcysteine treatment.

Pre-participation screening for hypertrophic cardiomyopathy in young athletes

Aims: This literature review seeks to explore the efficacy of pre-participation screening (PPS) in identifying hypertrophic cardiomyopathy (HCM) and preventing sudden cardiac death (SCD) in young athletes within the UK. Background: SCD accounts for half of all cardiovascular mortality in persons under 30 years and HCM is the leading cause of exercise-related cardiovascular death in young athletes. Substantial interest persists regarding the effectiveness of PPS and the necessity for universal legislation and implementation. Findings: PPS of young athletes identified HCM (and other cardiovascular disease) that could have prevented SCD. Electrocardiography (ECG) had virtuous impact when included within PPS. However, echocardiography—noted as gold standard assessment of HCM—was largely insignificant. SCD had greater prevalence in males than females, yet there was significant ethnic underrepresentation. PPS lacked consistency. Conclusion: PPS is universally divisive and present legislative application in the UK remains unfounded. There is evidence highlighting the efficacy of PPS identifying HCM (and other cardiovascular disease), and thus preventing SCD in young athletes. ECG inclusion could have benefits in PPS. However, further studies targeting age, sex, ethnicity, cost analysis and consistency are imperative before PPS is mandated. Relevance to clinical practice: Essential practical, psychological and ethical implications govern PPS implementation, illustrating expert clinical nursing support and prospective intervention in SCD aftermath.

The X-Linked Hypothesis of Brain Disorders

In this article, we propose an X-linked hypothesis of brain disorders that postulates a neuronal origin of those neurodegenerative and psychiatric disorders with a greater male prevalence. The hypothesis is based on the accumulated genetics and genomic evidence linking X chromosome genes and transcripts to neuronal cells. The behavioral genetics literature has long pointed to the link between postsynaptic protein complexes coded on chromosome X and mental retardation. More recently, novel genomic evidence has emerged of X-linked mRNA overexpression of neuronal source in the human brain. We review the evidence for this hypothesis and its consistency with the distribution across genders of brain disorders of known aetiology. We then provide examples of the utilization of this hypothesis in the investigation of the pathophysiology of complex brain disorders in both the stratification of disease cohorts and the development of realistic preclinical models. We conclude by providing a general framework for testing its validity, which will be exploited in future studies, and provide future directions for research.

Sexually dimorphic responses to early adversity: implications for affective problems and autism spectrum disorder.

During gestation, development proceeds at a pace that is unmatched by any other stage of the life cycle. For these reasons the human fetus is particularly susceptible not only to organizing influences, but also to pathogenic disorganizing influences. Growing evidence suggests that exposure to prenatal adversity leads to neurological changes that underlie lifetime risks for mental illness. Beginning early in gestation, males and females show differential developmental trajectories and responses to stress. It is likely that sex-dependent organization of neural circuits during the fetal period influences differential vulnerability to mental health problems. We consider in this review evidence that sexually dimorphic responses to early life stress are linked to two developmental disorders: affective problems (greater female prevalence) and autism spectrum disorder (greater male prevalence). Recent prospective studies illustrating the neurodevelopmental consequences of fetal exposure to stress and stress hormones for males and females are considered here. Plausible biological mechanisms including the role of the sexually differentiated placenta are discussed.

Endovascular Repair of Abdominal and Thoracic Aortic Aneurysms

Aortic aneurysms remain a challenging problem for patients and physicians. There have been major advances in the treatment of large-vessel aneurysms during the past 10 years. The surgical armamentarium used to treat these aneurysms now includes an endovascular approach that allows the insertion of a graft to exclude the aneurysm sac from blood flow. The endovascular repair of abdominal and thoracic aortic aneurysms has become a viable alternative to open repair and is often the approach of choice for high-risk patients. In this review, we examine the endovascular treatment of abdominal and thoracic aortic aneurysms. Abdominal aortic aneurysms (AAAs) are a formidable diagnosis for patients. This is a life-threatening condition that mandates consideration of repair. A ruptured AAA has a mortality rate approaching 90%; however, when an AAA is repaired electively, the mortality drops to less than 5%.1–3 There is, therefore, a clear advantage to treating these aneurysms before they rupture. Because this disease affects 4% to 7% of adults over the age of 65 years, with a far greater prevalence in males than females, clinicians will encounter this problem more frequently as the population ages.4 AAAs usually develop in patients with a history of arteriosclerosis or smoking. Patients present for repair when it is discovered that there is a dilation of their abdominal aorta to a diameter 1.5 times normal. The result is a weakened aortic wall that is at increased risk of rupture. The pathogenesis of this aortic wall change likely involves enzymes responsible for elastin and collagen breakdown.5 Recent research has focused on the role of metalloproteinase-9 (MMP-9). Aneurysm presence and size have been correlated with MMP-9 levels. Other investigators are looking into the inflammatory and autoimmune mechanisms involved in aneurysmal disease.6 Another area of research is in the molecular genetics of AAAs, …

Abuse and Neglect in Older Men

Elder abuse and mistreatment is a growing national concern. While victims and perpetrators are both men and women, much of the focus has been on women. Reports of the gender distribution of elder mistreatment conflict with some studies citing a greater prevalence in males and others showing a female predominance. The article summarizes the research on elder mistreatment, emphasizing the gender distribution. Older men are more likely to be victims of neglect, particularly abandonment. We use case vignettes to illustrate these major research findings. We also present data from a series of focus group interviews that included older men. The comments of the men about elder mistreatment were analyzed and are presented in this article. Through these findings we show that more research is needed to understand the similarities and differences between male and female victims of elder abuse and mistreatment.

Age-related clinical severity at diagnosis in 1705 patients with ulcerative colitis: a study by GISC (Italian Colon-Rectum Study Group).

Clinical-endoscopic parameters of UC presentation were studied in 1705 out-patients, observed consecutively in 17 Italian gastroenterology centers (males 60.2%; average age at diagnosis 38.5 +/- 16.4 years), and were subdivided arbitrarily into quartile age groups at diagnosis (0-25, 26-35, 36-50, >50). A significantly greater prevalence in males, increasing with age, was shown at diagnosis (P = 0.0002), which seems to correlate with the condition of being an ex-smoker, most frequently found in males. The greater frequency of exsmokers could also, in part, justify the second peak of incidence in old age. Greater colitis extent, greater clinical activity, and greater use of steroids as the first therapeutic step are shown to prevail among younger patients and among women (P = 0.02 and P = 0.019, respectively). The same is observed for symptoms mainly representing clinical severity such as diarrhea, fever, and weight loss (P = 0.004; P = 0.006; P = 0.009, respectively). This study confirms the UC risk factor represented by the condition of being an ex-smoker and shows a greater severity of illness on diagnosis in younger patients.

Physical Activity Play: The Nature and Function of a Neglected Aspect of Play

In this review, we consider the nature and possible developmental functions of physical activity play, defined as a playful context combined with a dimension of physical vigor. We distinguish 3 kinds of physical activity play, with consecutive age peaks: rhythmic stereotypies peaking in infancy, exercise play peaking during the preschool years, and rough-and-tumble play peaking in middle childhood. Gender differences (greater prevalence in males) characterize the latter 2 forms. Function is considered in terms of beneficial immediate and deferred consequences in physical, cognitive, and social domains. Whereas most theories assume that children's play has deferred benefits, we suggest that forms of physical activity play serve primarily immediate developmental functions. Rhythmic stereotypies in infancy are hypothesized to improve control of specific motor patterns. Exercise play is hypothesized to function primarily for strength and endurance training; less clear evidence exists for possible benefits for fat reduction and thermoregulation. In addition, there may be cognitive benefits of exercise play that we hypothesize to be largely incidental to its playful or physical nature. Rough-and-tumble play has a distinctive social component; we hypothesize that it serves primarily dominance functions; evidence for benefits to fighting skills or to emotional coding are more equivocal. Further research is indicated, given the potentially important implications for children's education, health, and development.

Physical Activity Play: The Nature and Function of a Neglected Aspect of Play

In this review, we consider the nature and possible developmental functions of physical activity play, defined as a playful context combined with a dimension of physical vigor. We distinguish 3 kinds of physical activity play, with consecutive age peaks: rhythmic stereotypies peaking in infancy, exercise play peaking during the preschool years, and rough-and-tumble play peaking in middle childhood. Gender differences (greater prevalence in males) characterize the latter 2 forms. Function is considered in terms of beneficial immediate and deferred consequences in physical, cognitive, and social domains. Whereas most theories assume that children's play has deferred benefits, we suggest that forms of physical activity play serve primarily immediate developmental functions. Rhythmic stereotypies in infancy are hypothesized to improve control of specific motor patterns. Exercise play is hypothesized to function primarily for strength and endurance training; less clear evidence exists for possible benefits for fat reduction and thermoregulation. In addition, there may be cognitive benefits of exercise play that we hypothesize to be largely incidental to its playful or physical nature. Rough-and-tumble play has a distinctive social component; we hypothesize that it serves primarily dominance functions; evidence for benefits to fighting skills or to emotional coding are more equivocal. Further research is indicated, given the potentially important implications for children's education, health, and development.

Physical Activity Play: The Nature and Function of a Neglected Aspect of Play

In this review, we consider the nature and possible developmental functions of physical activity play, defined as a playful context combined with a dimension of physical vigor. We distinguish 3 kinds of physical activity play, with consecutive age peaks: rhythmic stereotypies peaking in infancy, exercise play peaking during the preschool years, and rough-and-tumble play peaking in middle childhood. Gender differences (greater prevalence in males) characterize the latter 2 forms. Function is considered in terms of beneficial immediate and deferred consequences in physical, cognitive, and social domains. Whereas most theories assume that children's play has deferred benefits, we suggest that forms of physical activity play serve primarily immediate developmental functions. Rhythmic stereotypies in infancy are hypothesized to improve control of specific motor patterns. Exercise play is hypothesized to function primarily for strength and endurance training; less clear evidence exists for possible benefits for fat reduction and thermoregulation. In addition, there may be cognitive benefits of exercise play that we hypothesize to be largely incidental to its playful or physical nature. Rough-and-tumble play has a distinctive social component; we hypothesize that it serves primarily dominance functions; evidence for benefits to fighting skills or to emotional coding are more equivocal. Further research is indicated, given the potentially important implications for children's education, health, and development.

The permissive effect of sebum in seborrhoeic dermatitis: an explanation of the rash in neurological disorders

The hypothesis that sebum permits the growth of Pityrosporum ovale, and hence the development of seborrhoeic dermatitis, was tested by observing whether a reduction of sebum production by isotretinoin would improve the disorder. In 10 male patients with seborrhoeic dermatitis, treatment with isotretinoin for 6 weeks reduced the mean sebum excretion rate by 70% and improved the severity of the rash, but with a site difference in magnitude of response. It is concluded that the residual pool of sebum is important for the growth of P. ovale and that, within the physiological range, sebum has a permissive effect on the growth of this yeast. Variation in the pools of residual sebum explains a number of features of the disease such as site of involvement and greater prevalence in males than females. The pathological increase in the residual pool of sebum due to immobility explains the frequent occurrence of seborrhoeic dermatitis in patients with a variety of neurological disorders.