Acta clinica Croatica
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Acta clinica Croatica · Dec 2018
EFFECT OF GROWTH HORMONE THERAPY IN CHILDREN WITH PRADER-WILLI SYNDROME - OUR FIRST EXPERIENCES.
- Prader-Willi syndrome (PWS) is the most common cause of morbid obesity in childhood. It is the consequence of the lack of expression of genes on the paternally inherited 15q11.2-q13 region. Hyperphagia, obesity, short stature, psychomotor retardation and deterioration of behavior predominate in clinical presentation. ⋯ RhGH therapy had no negative effect on glucose and lipid metabolism, nor caused any other adverse effect. Therapy including a customized diet for PWS, along with rhGH therapy, provided a satisfactory growth rate and prevented development of morbid obesity without side effects. This treatment approach would ensure transition of a greater number of PWS patients into adult care, where the multidisciplinary approach in care should be continued.
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- Notalgia paresthetica is a common, although under-recognized condition characterized by localized chronic pruritus in the upper back, most often affecting middle-aged women. Apart from pruritus, patients may present with a burning or cold sensation, tingling, surface numbness, tenderness and foreign body sensation. ⋯ It is widely accepted that notalgia paresthetica is a sensory neuropathy caused by alteration and damage to posterior rami of thoracic spinal nerves T2 through T6. To date, no well-defined treatment has been found, although many treatment modalities have been reported with varying success, usually providing only temporary relief.
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Acta clinica Croatica · Dec 2018
ReviewIRRITANT AND ALLERGIC CONTACT DERMATITIS - SKIN LESION CHARACTERISTICS.
- Contact skin lesions may be the consequences of contact with various irritants or allergens, or due to other factors (e.g., UV radiation, microbials), intrinsic factors (e.g., in autoimmune responses), or even their combination. There are many substances related to irritant contact dermatitis (CD), causing irritant or toxic effects, e.g., chemical and physical agents, plants, phototoxic agents, airborne irritants, etc. Impaired barrier function (e.g., aberrancies in epidermal pH buffering capabilities) also participates by promoting bacterial biofilms and creating an environment favoring sensitization. ⋯ Also, in allergic CD skin lesions, the skin shows different types of immune responses to individual allergens, although clinical manifestations do not depend on the causative allergen type, e.g., nickel stimulates immune activation primarily of the Th1/Th17 and Th22 components. Also important are alarmins, proteases, immunoproteomes, lipids, natural moisturizing factors, tight junctions, smoking, etc. We expect that future perspectives may reveal new pathogenetic factors and scientific data important for the workup and treatment of patients with CD.
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Acta clinica Croatica · Dec 2018
POSTOPERATIVE THINNING OF LAMELLAR DONOR GRAFT AFTER CONVENTIONAL DESCEMET'S STRIPPING AUTOMATED ENDOTHELIAL KERATOPLASTY.
- The purpose of this study was to evaluate postoperative deturgescence of lamellar donor graft after conventional Descemet's stripping automated endothelial keratoplasty (DSAEK). It was a prospective study that included 55 eyes of patients (mean age 70.9±9.4 years; female 61.8%, male 38.2%). ⋯ After performing conventional DSAEK corneal transplantation, surgeons should expect deturgescence of corneal graft and reduction in thickness of lamellae by about 12% of initial thickness according to our results. We found this information important for better planning of surgical procedures and knowing what to expect after surgery, as well as for better cooperation with eye banks when ordering pre-cut corneal tissue.
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- Radiological diagnostic methods have a significant role in the preoperative and postoperative care of patients after kidney transplantation. Improvement and innovations in technology, but also the growing experience of the radiologists who deal with kidney transplant patients as part of the transplant team lead to earlier detection of complications in the postoperative period, which are the leading cause of transplant failure. In this article, we describe, through diagnostic imaging examples, detailed evaluation of all possible complications that can occur after kidney transplantation, with evaluation of different possible diagnostic methods that can be used in the preoperative assessment and postoperative follow up and care of the transplanted patient. The goal of this article is to demonstrate and summarize in detail the possible complications of renal transplantation and how to best diagnostically approach them, with special reference to ultrasound which is the main imaging method for this group of conditions.