Renal lupus

U radu je prikazan lupusni nefritis.The nephritis in systemic lupus erythematosus is presented

The history of systemic lupus erythematosus

U ovom radu prezentirana je povijest sistemskog eritemskog lupusa. Povijest SLE sažeta je u tri razdoblja: klasični period otkrivanja vidljivih manifestacija bolesti, neoklasično razdoblje spoznavanja sustavne bolesti te moderno vrijeme koje je pružilo uvid u mehanizme nastanka bolesti i omogućilo objektivniji pristup dijagnostici.In this review paper the history of systemic lupus erythematosus is presented. History of systemic lupus is summarized in three periods, the classical period of discovering the visible manifestations of the disease, the neoclassical period discovering the concept of systemic disease, and modern times, which provided insight into disease mechanisms and facilitated the formation of objective diagnostic approach

The history of systemic lupus erythematosus

U ovom radu prezentirana je povijest sistemskog eritemskog lupusa. Povijest SLE sažeta je u tri razdoblja: klasični period otkrivanja vidljivih manifestacija bolesti, neoklasično razdoblje spoznavanja sustavne bolesti te moderno vrijeme koje je pružilo uvid u mehanizme nastanka bolesti i omogućilo objektivniji pristup dijagnostici.In this review paper the history of systemic lupus erythematosus is presented. History of systemic lupus is summarized in three periods, the classical period of discovering the visible manifestations of the disease, the neoclassical period discovering the concept of systemic disease, and modern times, which provided insight into disease mechanisms and facilitated the formation of objective diagnostic approach

Hip in inlammatory rheumatic diseases

U radu su prikazane promjene na kuku u upalnim reumatskim bolestima.The hip changes in inflammatory rheumatic diseases are presented

The Relationship Between Appearance Satisfaction and Self-Esteem Among High School Students in Eastern Croatia

Due to the imposition of social media, a large number of adolescents face problems related to physical appearance and social contact. The research objectives were to examine the degree of satisfaction of high school students in Eastern Croatia, Vinkovci, regarding their physical appearance and self-esteem based on their gender, type of high school and the differences in socioeconomic status. The study was designed as a cross-sectional research and included 278 students from medical schools and high schools. Data was collected using a survey on the demographic and socio-economic status of participants. The Body Image Questionnaire was used in a modified and validated version in Croatia and contained fourteen questions to examine the level of satisfaction with the body image. Using Rosenberg’s ten-question test, the level of self-esteem was examined. The Median age of students was 18 years. The female students in high school were significantly more concerned about their physical appearance than the male students in the same school (χ² = 23.6, p < 0.001). The linear correlation between the degree of satisfaction regarding physical appearance and self-esteem confirmed the association between body image satisfaction and gender of students in medical schools (r = 0,157; p = 0,04) and students in high school (r = 0,371; p < 0,001). Adolescents in this region of Croatia are not overly concerned about their physical appearance despite relatively decreased self-esteem. Alcohol consumption has proven to be a big problem especially for high school students, which can be a result of stress due to maintaining excellent grades

Clinical features of the SAPHO syndrome and their role in choosing the therapeutic approach: report of four patients and review of the literature

Although the SAPHO (synovitis, acne, pustulosis, hyperostosis, osteitis) syndrome was defined as a distinct entity more than 20 years ago, its classification within the spectrum of inflammatory rheumatic diseases and the proper therapeutic approach are still a matter of debate. We present four patients diagnosed with the SAPHO syndrome treated and followed-up in our Department, demonstrating the diversity of their clinical courses and their responses to different therapeutic approaches. We also review the clinical, laboratory, and imaging features of the SAPHO syndrome described in the relevant literature. Despite the growing quantity of published data on the clinical features of the syndrome and the recognition of two disease patterns (inflammatory and bone remodeling disease), it is still not clear whether these possible disease subsets require different therapeutic strategies. Tumor necrosis factor-alpha (TNF-α) inhibitors have been suggested to be effective in patients with the inflammatory pattern, whereas bisphosphonates seem to be effective in patients with bone remodeling disease; however, this is still a hypothesis not yet confirmed by adequately designed clinical studies. Further research is needed to assess disease features predicting favorable response to the two therapeutic modalities beyond the first line of therapy – TNF-α inhibitors and bisphosphonates.</p

Improvement of overlapping hidradenitis suppurativa and ankylosing spondylitis after the introduction of adalimumab

Hidradenitis suppurativa is a chronic inflammatory disorder characterized by occlusion of the follicular pilosebaceous units of the skin. The treatment options are sometimes very limited and unpleasant odor and abundant drainage complicate the disease. Ankylosing spondylitis is a form of seronegative spondyloarthritis with predominantly axial but also peripheral joint involvement. Both of the conditions lower the patient's quality of life and affect everyday activities. We describe a 39-year-old male patient with both diseases treated with different medications with only a modest result. After the initiation of a tumor necrosis factor α (TNF-α) inhibitor (adalimumab) the patient experienced first the musculoskeletal and later on the skin improvement. The introduction of TNF-α inhibitors should be considered early in the treatment of overlapping hidradenitis suppurativa and the spondyloarthritis spectrum of conditions. Available medical data confirm the positive results and beneficial effect on disease course, activity and, most importantly, quality of life

Metolachlor and Metobromuron - Induced Methaemoglobinemia

An 81-year-old man was admitted in the emergency department approximately four hours after accidental ingestion of an unknown quantity of herbicide »Galex 500 EC«. This product contains 25% of metolachlor and 25% of metobromuron dissolved in xylene. In spite of the fact that the combination of aniline and urea-substituted derivatives is widely used in agriculture as herbicide, there are very few data available about their harmful effects on humans. These agents appear to be mildly toxic, and rarely has a major systemic effect been reported after the poisoning. On admittance, our patient showed remarkable cyanosis and his methaemoglobin level was 38.4% of the total haemoglobin, rising next day to 46.2%. Only mild transient signs of hypoxic effects on central nervous system were observed and the laboratory findings indicated mild haemolysis. Methylene blue was applied intravenously in a dose of 1.5 mg/kg (10 ml, 1% solution) on the second day of admission. Administration of methylene blue was very effective and the patient was discharged from the hospital fully recovered.U radu je prikazano otrovanje metolaklorom i metobromuronom, nastalo nakon slučajne ingestije nepoznate količine kombiniranog herbicida »Galex 500 EC«. Unatoč širokoj primjeni herbicida iz skupine anilida i derivata ureje, nema mnogo podataka o njihovu učinku na ljude. Otrovanja su rijetka zbog njihove relativno niske akutne toksičnosti. U našeg bolesnika kliničkom je slikom dominirala cijanoza, uz methemoglobinemiju koja je premašila 46% vrijednosti ukupnog hemoglobina, što je indiciralo intravensku primjenu 10 ml 1%-tne otopine metilenskog modrila (1,5 mg/kg). Učinak takve terapije bio je vrlo povoljan, cijanoza i znakovi hipoksije središnjega živčanog sustava ubrzo su nestali. Znakova lezije parenhimnih organa nije bilo, a laboratorijski se mogla uočiti blaža hemoliza. Bolesnik je nakon 12 dana otpušten bez trajnih posljedica otrovanja