Determination of melanocyte-stimulating hormone in urine and blood

Patterns of exacerbations of chronic non-infectious uveitis in pregnancy and puerperium

PURPOSE

To determine patterns of exacerbations of recurrent non-infectious uveitis during pregnancy and puerperium.

DESIGN

Retrospective cohort study.

METHODS

The medical records of 32 women with a history of chronic non-infectious uveitis, who were pregnant during their follow-up at the Ocular Immunology and Uveitis Service of the Massachusetts Eye and Ear Infirmary, from 1983 through 2003, were reviewed. The uveitis relapse rate during pregnancy was compared to the relapse rate during pregnancy-free periods in these women and to the relapse rate in a control group of women of childbearing age with recurrent non-infectious uveitis.

RESULTS

Among the 32 women who were pregnant during follow-up (40 pregnancies), the rate of flare-ups during pregnancy (1.0 recurrence per year) was lower than that observed during non-pregnant periods (2.4 per year; p<0.001) and lower than that observed in the non-pregnant control group (3.1 per year; p<0.001). Flare-ups were most frequent in the first trimester of pregnancy and decreased markedly in the second and third trimesters (2.3, 0.5, and 0.4 recurrences per year, respectively; p<0.001).

CONCLUSIONS

Pregnancy is associated with lower numbers of flare-ups of non-infectious uveitis compared to the non-pregnant state. If flare-ups do occur during pregnancy, they happen predominantly in the first trimester.

Oral and vulvar changes in pregnancy

The endocrinologic, immunological, and vascular changes that occur during pregnancy are far-reaching. These systemic factors produce profound local impact on the physiology and pathology of the oral cavity, vagina, and vulva. Physiological changes can be expected and tolerable or of such severity that they are viewed as pathological. Existing disease can be exacerbated and dermatoses specific to pregnancy can erupt. Each of these conditions can pose potentially challenging treatment considerations.

Cosmetic aspects of pregnancy

There are a vast number of changes to the female body that occur during pregnancy, to which any pregnant woman will attest. The changes, although considered, for the most part, physiological and not pathological, are quite distressing to many women. This chapter serves to review those changes and comment on their physiological origins. Most of these changes can be definitively or inferentially linked to the dramatic hormonal changes that take place to support a pregnancy. Comments are also made about treatment as they pertain to pregnant women. In addition, a brief discussion about performing cosmetic procedures during pregnancy is included.

Aesthetic considerations in patients of color

This article focuses on the aesthetic cutaneous considerations in analyzing and treating the aging face in patients of color. Initially some of the physiologic differences between dark and light pigmented skin are elucidated. Hair conditions that lead to aesthetic unacceptance are discussed as are facial enhancing cosmetic procedures, with special emphasis on people of color. Information on treatment of dandruff, xanthelasma, and melasma in people with dark skin is also presented.

Paraneoplastic syndromes, tumor markers, and other unusual features of malignant melanoma

Malignant melanoma is a neoplasm associated with a wide variety of paraneoplastic syndromes. In this review the many paraneoplastic syndromes associated with malignant melanoma are critically reviewed. Unusual nonparaneoplastic associations with malignant melanoma and tumor markers for malignant melanoma are discussed.

Physiologic skin changes in pregnancy

Pregnancy produces many skin changes, some of which are specifically related to pregnancy (dermatoses of pregnancy) and others that are more common and called physiologic. These physiologic skin changes usually do not impair the health of the mother or the fetus; nevertheless, some can be cosmetically significant and of importance to the dermatologist.

Plasma concentrations of alpha-melanotropin in the rat during the acquisition and extinction of conditioned avoidance behaviour and during the acquisition of maze learning behaviour

Concentrations of immunoassayable alpha-melanotropin in plasma were increased above control levels during the acquisition of conditioned avoidance behaviour but not during the extinction of this behaviour. There were no significant variations in levels of alpha-melanotropin in plasma during the acquisition of reward motivated maze learning behaviour. Throughout the latter test hormone concentrations were increased above normal levels. Non-specific stress was thought to be an important factor in the production of increases in concentrations of alpha-melanotropin in plasma. Acute physical stress, such as that caused by the electric foot shock of the avoidance studies, produced the greatest increases, while the smaller increase noted during maze learning was attributed to the stress of the chronic food deprivation schedule used in this test. The data did not support a role for systemic melanotropin in the processes of learning and memory as there were no consistent correlations between levels of alpha-melanotropin in plasma and the parameters of learning in the tests. Although a role for stress-induced alpha-melanotropin release from the pituitary gland in the enhancement of attention was thought possible, actions of exogenous melanotropins on behaviour could be due to effects on melanotropin-containing systems present within the central nervous system.