Hippokratia
-
Optimal glycemic control is well known to reduce effectively the risk of micro vascular complications both in type 1 and type 2 diabetes mellitus. However the role of glycemic control in decreasing the risk of myocardial infarction and ischemic stroke, the leading causes of death in patients with diabetes, has been so far controversial. ⋯ Nevertheless such a strategy could be potentially harmful for T2 diabetics with long duration of sub optimal glycemic control and already established CV complications. Treatment targets in these patients should be individualized taking into account other aspects of glycemic control and diabetes complications such as hypoglycemia and autonomic neuropathy.
-
Allergy prevention remains a vexing problem. Food sensitization frequently occurs early in life and is often the first sign of future atopic disease. Therefore, interventions to prevent food allergies and the development of the atopic phenotype are best made early in life. ⋯ Several dietary manipulations in infancy, such as prolonged breast feeding, maternal avoidance diets during pregnancy and lactation, the use of hypoallergenic formulas, have been proposed as ways of altering the Th1/Th2 balance in infants, with varying degrees of success. Studies have examined whether food atopy can be prevented by controlling the intake of highly allergenic foods by a high-risk infant from a variety of sources, that is, both direct ingestion and indirect ingestion through the breast milk. The previous studies showed that in high risk infants who are unable to be completely breast fed, there is evidence that prolonged feeding with a hydrolysed formula compared to a cow's milk formula reduces infant and childhood allergy and infant cow's milk allergy ,while other studies reported that an antigen avoidance diet for high risk mothers is unlikely to reduce the atopic diseases in their children substantially, and that such a diet may adversely affect maternal and/or fetal nutrition.
-
M. pneumoniae is a common cause of respiratory tract infections (RTIs) of variable severity especially in children. New diagnostic techniques offered more reliable information about the epidemiology of infection by this pathogen. ⋯ During our study period, M. pneumoniae was the second causative agent of RTIs after RSV. The proportion of children with M. pneumoniae RTIs increased with age, while most cases were reported during summer and autumn.
-
Von Meyenburg Complexes (VMCs) is a rare clinicopathologic entity, consisting of small (<1.5cm), usually multiple and nodular cystic lesions. VMCs typically cause no symptoms or disturbances in liver function and thus in most instances they are diagnosed incidentally. We present four VMCs cases, each with a distinct clinical presentation. ⋯ In the other two cases, in a 60-year-old woman and a 25-year-old man, the clinical presentation was implicative of an infectious hepatic process reminiscent of cholangitis and liver abscesses respectively. In each case the diagnosis was based on magnetic resonance imaging and magnetic resonance cholangiopancreatography findings showing multiple hyper-intense cystic nodules not communicating with the biliary tree. Physicians should be aware of the entire clinical spectrum of VMCs and its unique radiologic features in order to differentiate VMCs from other cystic liver lesions.
-
The worldwide incidence of kidney failure is on the rise and treatment is costly. Kidney failure patients require either a kidney transplant or dialysis to maintain life. This review focuses on the economics of alternative dialysis modalities such as haemodialysis (HD) and peritoneal dialysis (PD). ⋯ The cost effectiveness of alternative modalities is reviewed. Examples of statistical models and simulation approaches, studying the increase of the life expectancy in terms of the quality adjusted life years (QALYs) and the incremental cost paid are also presented. Corresponding results originated from different regions of the world are also briefly shown.