Background and Aims: Homocysteine is a sulphur amino acid derived from methionine. Epidemiological studies show an association between hyperhomocysteinemia and an increased cardiovascular risk, a fact that has also been confirmed in patients with chronic renal failure. This study, conducted in stage 5 chronic kidney disease patients, seeks to define the prevalence of hyperhomocysteinemia, evaluate the Clearance of homocysteine with dialysis, and describe the frequency of the mutation in the mutilen-tetrahydrofolate reductase enzyme and its relationship with plasma levels of homocysteine.Methods: The reduced percentage of homocysteine and Clearance of urea were analysed every six months for seven years in patients on dialysis. Urea and total homocysteine in plasma were measured in each of these studies and the type of dialyser - low or high permeability - used and the dialysis duration was determined.A molecular study of the gene coding for mutilen-tetrahydrofolate reductase enzyme was carried out in a group of patients and any C-T point mutation at position 677 of this gene was investigated. Mutation was described as not present, heterozygous for this mutation or homozygous for lactation.Results: Neither the average levels of homocysteine before and after dialysis or the reduction percentage of homocysteine varied with gender, although purification of urea was higher in women. Comparisons of homocysteine levels and percentage reduction in this ratio according to the ultra filtration of the dialyser used showed significant results. The molecular study of the gene in mutilen-tetrahydrofolate reductase enzyme showed that mutation was present in 54.8%: 45.2% with heterozygous polymorphism and 9.7% with homozygous.Conclusions: Patients undergoing hemodialysis were found to have higher levels of urea and its Clearance was greater with the higher the ratio of ultra filtration dialyser. Mutation of the gene in mutilen-tetrahydrofolate reductase enzyme was similar in our patients compared to the general population and had no impact on plasma levels of homocysteine.

The occurrence of psoriasis vulgaris could be associated with higher psychiatric morbidity. In this case report, we present a patient with bipolar mood disorder and psychotic features whose dermatological signs recovered after the psychiatric disorder partial treatment. Dermatological diseases could be associated with psychiatric disorders, and recurrence of psychiatric symptoms might be associated with the recurrence of the skin lesions.

Background and objective-In thyrotoxicosis, changes in urine output and serum creatinine (Cr) concentration has been related to increased glomerular filtration rate (GFR). The aim of this study is to clarify the mechanism of these changes. Methods-Forty-one thyrotoxic patients, 9 male and 32 female with the age range of 16-62 years were selected and body weight, 24-h urine output, serum and urine Cr concentration, and GFR were measured in the thyrotoxic state and two months after treatment. The data was analyzed by student ‘t’ test and paired ‘t’ test. Results-The following parameters were measured and are compared in thyrotoxic and euthyroid states respectively. Body weight: 58.4±10.6 Kg and 61.6±10.4 Kg after receiving anti-thyroid therapy (p<0.001). 24-h urine output: 1430±420 ml, and 1165±450 ml (p <0.001). Serum creatinine concentration: 0.7±0.11 mg/dl, and 0.84±0.13 mg/dl (p<0.001). 24-h urine creatinine concentration: 906±225 mg/l and 1081±285 mg/l (p<0.001). The change in GFR was not statistically significant, being 90.1 ml/min before therapy and 89.5 ml/min in the euthyroid state. Conclusion-Increased urine output and decreased serum creatinine concentration in thyrotoxicosis is not GFR related.