Treatment Options for Pediatric Psoriasis

Psoriasis is a multifactorial inflammatory papulosquamous disease affecting 0.5% to 2% of paediatric population. Paediatric psoriasis, presenting similarly to adult psoriasis, significantly reduces patients’ quality of life, often requiring individualized treatment approach for each patient. Combination and rotational therapy are helpful in reducing toxicity and maximizing efficacy. Patients with mild and limited disease respond well to topical treatment with steroids or vitamin D analogues, unlike moderate and severe psoriasis where sufficient remission is rarely achieved. Therefore phototherapy, systemic immunomodulators, or biologic agents are next line of treatment to be considered. There is a limited data available on the use and long-term safety of biologics in the paediatric population. Biologic agents must be administered by experienced dermatologists, only in patients with moderate-to-severe plaque psoriasis, intolerant or refractory to other systemic conventional disease-modifying treatment or phototherapy, or if those agents are contraindicated. Psoriasis is a multifactorial inflammatory papulosquamous disease affecting 0.5% to 2% of paediatric population. Paediatric psoriasis, presenting similarly to adult psoriasis, significantly reduces patients’ quality of life, often requiring individualized treatment approach for each patient. Combination and rotational therapy are helpful in reducing toxicity and maximizing efficacy. Patients with mild and limited disease respond well to topical treatment with steroids or vitamin D analogues, unlike moderate and severe psoriasis where sufficient remission is rarely achieved. Therefore phototherapy, systemic immunomodulators, or biologic agents are next line of treatment to be considered. There is a limited data available on the use and long-term safety of biologics in the paediatric population. Biologic agents must be administered by experienced dermatologists, only in patients with moderate-to-severe plaque psoriasis, intolerant or refractory to other systemic conventional disease-modifying treatment or phototherapy, or if those agents are contraindicated. </div

INFLUENCE OF HORMONAL STATUS AND MENSTRUAL CYCLE PHASE ON PSYCHOPATOLOGY IN ACUTE ADMITTED PATIENTS WITH SCHIZOPHRENIA

Background: The gender differences in onset, symptom severity, and outcome of schizophrenia are now thought to support the hypothesis that sex hormones may also have a role in etiology, as well as treatment, of schizophrenia. A number of reproductive hormones may be implicated, including testosterone, progesterone, or luteinising hormone, and thus it is important to acknowledge that there is a complex interplay of hormones occurring. This study was introduced to highlight the effect of the menstrual cycle, and sex hormones on female patients with schizophrenia. Subjects and methods: The sample consisted of 31 consecutively acute admitted women, aged 18 to 45 years with schizophrenia diagnosed by DSM-5 criteria. The sample consisted of women who were regulary menstruating and to be undergoing regular hormonal fluxes. Each subject was enrolled and received psychopathology and hormone (estradiole, progesterone, testosterone) assessments. Psychopathology was measured with Positive end Negative Syndrome Scale (PANSS). The subjects were divided into folicular (high estrogen) and luteal (low estrogen) phase admissions. Data were analyzed by regression analysis and t-test for independent samples. Values are given as means ±SD. Results: There were no differences between the folicular and luteal phase admission grups with regard to age, duration of illness and age at onset of illness. We found that significantly more women were admitted during the luteal (low estrogen) phase of menstrual cycle (68%) as compared to follicular (high estrogen) phase (32%). Conclusion: There was a significant increase in hospital admissions in the luteal phase of menstrual cycle in women suffering from exacerbation of schizophrenia. The influence of particulary sex hormones (estrogen, progesterone and testosterone) on admission rate and clinical psychopatology was found insignificant

Prva analiza teških metala u perima sivih čaplji Ardea cinerea iz hrvatskih kolonija

This study represents the first analysis of heavy metals: lead and cadmium, as well as two metalloids: arsenic and selenium, in the feathers of Grey Herons breeding in Croatia. The Grey Heron was chosen as a model apex predator of the wetland ecosystem due to high trophic level, feeding habits, long lifespan and abundance. Sampling was conducted during the 2019 breeding season in April and May from six Grey Herons colonies in Croatia (Mrsunjski lug, Kopački rit, Piljenice, Kravarsko, Čepin, Slovinci), whose environment is heavily influenced by rivers Danube, Drava and Sava tributaries. The primary and secondary flight feathers were collected under the colonies as shed feathers or from dead birds. The feathers are a suitable non-invasive method for metal and metalloid analysis, and can reflect internal concentrations, depending on the metal. In the Slovinci colony, we measured the highest lead (Pb) and cadmium (Cd) concentrations (2194.53 ± 416.20 μg kg-1 dw and 79.30 ± 9.37 μg kg-1 dw, respectively). The highest arsenic (As) and selenium (Se) concentrations were found in the Čepin colony (359.70 ± 301.46 μg kg-1 dw and 3375.61 ± 2502.80 μg kg-1 dw, respectively). All the measured levels of heavy metals and metalloids are below concentrations that can cause adverse health effects in birds.Antropogenim aktivnostima povećava se razina metala i polumetala u okolišu rezultirajući njihovim zagađenjem. Mjerenje teških metala i polumetala neinvazivnim metodama dobar je pokazatelj stanja okoliša. U radu su predstavljeni rezultati prve analize teških metala: olova i kadmija te dva metaloida: arsena i selena u perju sivih čaplji Ardea cinerea koje se gnijezde u Hrvatskoj. Uzorkovanje pera sivih čaplji provedeno je tijekom sezone gniježđenja, u travnju i svibnju 2019. iz šest hrvatskih kolonija (Mrsunjski lug, Kopački rit, Piljenice, Kravarsko, Čepin i Slovinci). Primarna i sekundarna letna pera odraslih ptica prikupljena su ispod kolonija. Najveće koncentracije olova (Pb) zabilježene su u perju iz Slovinaca (2194,53 ± 416,20 μg kg-1 suhe tvari) i Kopačkog rita (1955,85 ± 1373,07 μg kg-1 suhe tvari). U Čepinu su izmjerene najviše koncentracije arsena (As; 359,70 ± 301,46 μg kg-1 suhe tvari) i selena (Se; 3375,61 ± 2502,80 μg kg-1 suhe tvari), a najviša razina kadmija (Cd) izmjerena je u koloniji Slovinci (79,30 ± 9,37 μg kg-1 suhe tvari). Sve izmjerene razine metala i polumetala su ispod koncentracija koje se smatraju toksičnima za ptice. Preliminarni rezultati ovog istraživanja ukazuju na relativno nisku zagađenost okoliša kontinentalne Hrvatske, no potrebna su dodatna istraživanja i uspostava kontinuiranog praćenja metala i polumetala u okolišu te njihov utjecaj na vršne predator

Occurence of pharmaceuticals in surface water

Pharmaceuticals constitute a large group of human and veterinary medicinal organic compounds which have long been used throughout the world. According to their therapeutic activity they are classified in several groups: antibiotics, analgesics/antipyretic, CNS (Central nervous system) drugs, cardiovascular drugs, endocrinology treatments, diagnostic aid-adsorbable organic halogen compounds. Pharmaceuticals are designed to have a physiological effect on humans and animals in trace concentrations. Pharmaceuticals end up in soil, surface waters and eventually in ground water, which can be used as a source of drinking water, after their excretion (in unmetabolized form or as active metabolites) from humans or animals via urine or faeces. The possible fates of pharmaceuticals once they get into the aquatic environment are mainly three: (i) ultimately they are mineralized to carbon dioxide and water, (ii) the compound does not degrade readily because it is lipophilic and is partially retained in the sedimentation sludge and (iii) the compound metabolizes to a more hydrophilic molecule, passes through the wastewater treatment plant and ends up in receiving waters (which are surface waters, mainly rivers). These compounds exhibit the highest persistence in the environment. In recent years, and in particular after the use of the advanced measurement technologies, many pharmaceuticals have been identified worldwide and detected at ng/L levels (trace concentrations) in the aquatic environment, and are considered as an emerging environmental problem due to their continuous input and persistence in the aquatic ecosystem even at low concentrations

INFLUENCE OF SERUM TESTOSTERONE LEVEL ON AGGRESSION IN WOMEN WITH SCHIZOPHRENIA

Background: Unlike in female population, the effect of testosterone on aggression in men has been investigated countless times so far. A scarce number of studies have examined the effect of testosterone on aggression in women. The results obtained so far are inconsistent for some studies indicated a positive, whilst others showed a negative correlation. Since testosterone turned out to be an important factor related to aggression in men, the aim of our study was to investigate whether this correlation existed in aggressive female patients with schizophrenia. Subjects and methods: The sample consisted of 120 women, aged from 18 to 45 years, diagnosed with schizophrenia by DSM-5 criteria. Those who were breastfeeding or suffered from specific hormonal or other physical disorders were excluded from the study. They were divided into two groups of 60 - those with aggressive behavior and those with nonaggressive behavior. Psychopathology was measured by several tests (Positive and Negative Syndrome Scale - PANSS, Overt Aggression Scale - OAS and PANSS Extended Subscale for Aggression Assessment). Serum testosterone hormone assays were performed. Statistical data analysis was done by parametric statistical tests, Kolmogorov-Smirnov test, Student\u27s t-test and simple linear regression. All data were presented as mean values and corresponding standard deviations (SD). Results: Testosterone levels didn\u27t differ significantly between aggressive and nonaggressive subjects. There were no significant differences between testosterone levels in suicidal aggressive subjects compared to nonsuicidal aggressive respondents (t=0.616; p=0.540). The largest number of subjects in both groups had referent testosterone levels. Conclusions: Despite expecting a significant effect of testosterone levels on aggression in women with schizophrenia, conducted by previous studies, no correlation has been found testosterone levels

Vitiligo in Croatia: A Case Report

Vitiligo is an acquired, chronic, multifactorial disorder which involves complex interactions between genetic risk factors and environmental triggers. It is characterized by scattered circumscribed depigmented macules and patches anywhere on the skin that result from loss of functional melanocytes. According to our statistical data, 1.6% of the general population in Croatia suffers from vitiligo, but varies based on region. It affects all age groups equally, with female patients being more affected (53.95%) than male patients, and no difference in severity of vitiligo. We present a case of a sudden onset of vitiligo vulgaris from a female patient in her twenties, treated at the Department of Dermatology and Venereology. Her 12-year-old brother simultaneously developed acrofacial vitiligo, six months after their mother died in a car accident. She has been previously diagnosed with type I diabetes and autoimmune endocrinopathies. The depigmented patches covered approximately 60% of her body, with Koebner response on trauma. Although no characteristic UV fl uorescence was detected on the affected area, histopathological and immunohistochemical analyses revealed a complete loss of melanocytes, while Langerhans` and dermal dendritic cells replaced the DOPA-positive melanocytes. TSH levels were elevated, and the ultrasound showed thyroid enlargement, which substantiated for a hypothyroidism therapy. Treatment by systemic corticosteroids for a 6 month period was successful in stabilizing the disease

Polifenoli iz vinskog taloga kao nove funkcionalne bioaktivne tvari za prevenciju oksidacijskog stresa i hiperlipidemije

The study examines the potential of wine industry by-product, the lees, as a rich mixture of natural polyphenols, and its physiological potential to reduce postprandial metabolic and oxidative stress caused by a cholesterol-rich diet in in vivo model. Chemical analysis of wine lees showed that their total solid content was 94.2 %. Wine lees contained total phenols, total nonflavonoids and total flavonoids expressed in mg of gallic acid equivalents per 100 g of dry mass: 2316.6±37.9, 1332.5±51.1 and 984.1±28.2, respectively. The content of total anthocyanins expressed in mg of cyanidin-3-glucoside equivalents per 100 g of dry mass was 383.1±21.6. Antioxidant capacity of wine lees determined by the DPPH and FRAP methods and expressed in mM of Trolox equivalents per 100 g was 259.8±1.8 and 45.7±1.05, respectively. The experiment lasted 60 days using C57BL/6 mice divided in four groups: group 1 was fed normal diet and used as control, group 2 was fed normal diet with added wine lees, group 3 was fed high-cholesterol diet (HCD), i.e. normal diet with the addition of sunflower oil, and group 4 was fed HCD with wine lees. HCD increased serum total cholesterol (TC) by 2.3-fold, triacylglycerol (TAG) by 1.5-fold, low-density lipoprotein (LDL) by 3.5-fold and liver malondialdehyde (MDA) by 50 %, and reduced liver superoxide dismutase (SOD) by 50 %, catalase (CAT) by 30 % and glutathione (GSH) by 17.5 % compared to control. Conversely, treatment with HCD and wine lees reduced TC and LDL up to 1.4 times more than with HCD only, with depletion of lipid peroxidation (MDA) and restoration of SOD and CAT activities in liver, approximating values of the control. HDL levels were unaffected in any group. Serum transaminase activity showed no hepatotoxic properties in the treatment with lees alone. In the proposed model, wine lees as a rich polyphenol source could be a basis for functional food products without alcohol.U radu je istražena moguća uporaba vinskog taloga, polifenolima bogatog otpadnog proizvoda u industriji vina, u prehrani i ispitan je njegov fiziološki učinak na smanjenje oksidacijskog stresa uzrokovanog konzumacijom hrane bogate kolesterolom na modelu in vivo. Kemijskom je analizom utvrđeno da je udjel čvrste tvari u vinskom talogu bio 94,2 %; ukupnih fenola 2316,6±37,9; neflavonoida 1332,5±51,1 i flavonoida 984,1±28,2 mg u 100 g suhe tvari, izražen kao ekvivalent galne kiseline. Udjel ukupnih antocijana bio je 383,11±21,6 mg u 100 g suhe tvari, izražen kao ekvivalent cijanidin-3-glukozida. Ukupni antioksidacijski potencijal određen pomoću metode DPPH bio je (259,8±1,8) mM Trolox ekvivalenta u 100 g suhe tvari, a pomoću metode FRAP (45,7±1,05) mM u 100 g suhe tvari. Kvalitativni udjel polifenola određen je HPLC-om. Miševi C57/Bl6 hranjeni su tijekom 60 dana jednim od tipova prehrane: (i) normalnom hranom (kontrolna skupina), (ii) hranom s dodatkom ekstrakta vinskog taloga (1 g suhe tvari po kg po danu), (iii) hranom s velikim udjelom kolesterola (2 % kolesterola u 2 mL ulja po životinji po danu), i (iv) hranom bogatom kolesterolom (kao skupina 3) s dodatkom ekstrakta vinskog taloga (kao skupina 2). Kolesterolom bogata ishrana povećala je (p<0,05) razinu ukupnog kolesterola u serumu za 2,3; triacilglicerida za 1,5; LDL kolesterola za 3,5 puta, zatim je povećala razinu malondialdehida u jetri (p<0,05) i reducirala aktivnost superoksid dismutaze za 50 %, katalaze za 30 % i glutationa za 17,5 % u odnosu na kontrolni uzorak. Ishrana bogata kolesterolom s dodatkom ekstrakta vinskog taloga smanjila je (p<0,05) razinu ukupnog i LDL kolesterola za 1,4 puta u odnosu na skupinu hranjenu hranom bogatom kolesterolom, uz smanjenje (p<0,05) razine lipidne peroksidacije (malondialdehida) i aktiviranje superoksid dismutaze i katalaze u jetri, s vrijednostima sličnim onima u kontrolnoj skupini. Vrijednosti HDL kolesterola nisu se mijenjale. Serumska aktivnost transaminaza nije pokazala hepatotoksičnost izolata vinskog taloga. U predloženom je eksperimentalnom modelu utvrđeno da je vinski talog bogat izvor polifenola, te da se može upotrijebiti za proizvodnju funkcionalne hrane bez alkohola

Epidemiology of Prostate Cancer in the Mediterranean Population of Croatia – A Thirty-Three Years Retrospective Study

Prostate cancer is a major public health problem of the male population in all the developed countries1. This non-skin cancer is the foremost one facing man today. Prostate cancer has become the second leading cause of cancer death2. In this study we investigated changes in the prostate carcinoma incidence and manifestation during a thirty-three years period. The study included 1,226 cases of prostate cancer diagnosed from 1972 to 2005 in the Primorsko-Goranska County, Croatia. The age-adjusted incidence of prostate cancer increased from 1.69 per 100,000 men annually in 1972 to 137.58 per 100,000 men annually in 2005, which is an 81.4-fold increase. The percentage of patients with bone metastases on the first medical examination decreased from 1972 (75%) to 2005 (15%). The most of the patients with bone metastases at the first medical examination were between 30 and 50 years old. Early detection measures, such as prostate specific antigen testing and transrectal ultrasound guided prostate biopsy combined with the raised public awareness of the disease, most probably resulted in an increase of incidence