Medicina
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Stargardt disease is a juvenile macular degeneration most often inherited in an autosomal recessive pattern, characterized by decreased vision in the first 2 decades of life. This report presents a clinical case of Stargardt disease: a 10-year-old female patient complained of blurry vision, and in a 4-year period, her visual acuity was reduced from OD=0.3 and OS=0.3 to OD=0.08 and OS=0.1, respectively. A genetic analysis revealed a rare combination of 2 homozygous recessive mutations in the ABCA4 gene, which caused Stargardt disease. The presence of different genetic mechanisms leading to a severe disease phenotype can challenge molecular geneticists, ophthalmologists, and genetic counselors.
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The aim of this study was to investigate the trend of antidepressant use and analyze the daily cost of antidepressants in Wuhan, China. ⋯ Antidepressants were increasingly used over the study period. Among them, SSRIs followed by SNRIs were the most commonly used. After the approval for the treatment of depression, TCMs were generally accepted by physicians and patients. The low-cost advantage allowed TCAs to be used in the antidepressant therapy.
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Comparative Study
Quality of life after sentinel lymph node biopsy versus complete axillary lymph node dissection in early breast cancer: a 3-year follow-up study.
The rating of life quality may belong to the method of surgical treatment: after the axillary lymph node dissection patients may suffer from arm symptoms; after sentinel lymph node biopsy women may highlight the anxiety about the success of radical treatment. The aim was to assess the influence of sentinel lymph node biopsy on the quality of life of the patients with early stage breast cancer compared with total axillary lymph node dissection. ⋯ The women who underwent sentinel lymph node biopsy experienced better quality of life than the patients who underwent axillary lymph node dissection.
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Brugada syndrome was described in 1992 as a new clinical and electrocardiographic syndrome involving susceptibility to ventricular arrhythmias and sudden cardiac death in patients with no obvious structural heart disease. Brugada syndrome is characterized by a hereditary anomaly in the sodium ion channel (mutation of the SCN5A gene) identified by a wide QRS associated with the ST-segment elevation and the T‑wave inversion in the right precordial leads. The Brugada-like electrocardiographic pattern can be caused by sodium channel-blocking drugs and electrolyte disorders. ⋯ This article describes 8 cases of pseudoanteroseptal myocardial infarction in acute renal insufficiency with hyperkalemia. The ST-segment elevation related to hyperkalemia is resolved by the reduced serum potassium level. Clinicians should recognize that hyperkalemia is one of the etiologies of the Brugada-like electrocardiographic pattern.
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The literature lacks data about the evaluation of throat-related symptoms proving chronic tonsillitis as the most common indication for adult tonsillectomy. Therefore, the aim of this study was to assess the most important throat-related symptoms suggestive of chronic tonsillitis in adults. ⋯ Tonsillar cryptic debris and enlarged regional lymph nodes along with recurrent tonsillitis could support the diagnosis of chronic tonsillitis in adults when considering tonsillectomy.