Intraocular non-Hodgkin lymphoma mimicking uveitis

Uveitis is an intraocular inflammation that affects the middle eye layer and causes permanent structural damage and loss of visual function. It is most commonly caused by non-infectious factors, while infection occurs in 10-20% of uveitis cases. However, there is no actual intraocular inflammation in 3-5% of patients with clinical manifestations of uveitis. In these patients, some neoplastic and non-neoplastic processes may manifest as uveitis

Eye in rheumatic diseases

Upalne očne bolesti često su dio kliničke slike brojnih sustavnih reumatskih poremećaja. Štoviše, pojava očne bolesti može prethoditi drugim manifestacijama reumatskog poremećaja i biti prvi znak sustavne bolesti. Kod već poznate reumatske bolesti, očna upala može biti pokazatelj stupnja sustavnog poremećaja. Stoga multidisciplinarni pristup, pravovremena i točna dijagnoza, te odgovarajuća terapija ovih očnih upalnih bolesti omogućavaju očuvanje vidne funkcije, poboljšanje zdravlja i spašavanje života bolesnika.Ocular inflammatory diseases are frequently a part of clinical features of numerous systemic rheumatic disorders. Furthermore, appearance of ophthalmic disease can precede the other manifestation of rheumatic disorders and can be the first sign of systemic disease. At the alredy known rheumatic disease, ocular inflammation may demonstrate the grade of systemic disorder. Therefore multidisciplinary approaches, timely and correct diagnosis, as well as appropriate therapy these ocular inflammatory conditions enable visual function protection, health improvement and life saving

Procjena standarda novorođenačke skrbi prediktivnim modelom za retinopatiju nedonoščadi temeljenim na prirastu tjelesne mase

Care of extremely premature infants is in constant need for evaluation and progress. WINROP, a predictive model based on weight gain, has been developed to reduce the number of stressful examinations for retinopathy for prematurity. Validation studies of WINROP emphasize the difference of applicability in neonatal units of various practice. The aim of the study was to assess the standard of neonatal care by WINROP. Data on extremely premature infants were collected from medical records and entered in WINROP. High- and low-risk WINROP distribution and retinopathy of prematurity outcomes were analyzed. Fifty-four infants, gestational age ≤28 weeks, were included in the study after exclusion of weight related comorbidities. High risk was noted in 74% (n=40) of infants with 24% (n=13) developing retinopathy of prematurity requiring treatment. In low alarm group, there were 3 cases with severe disease. In conclusion, WINROP is not just a provider of predictive information on the severity of retinopathy of prematurity. High-risk alarm indicates the need of adjustment of nutritional strategies. Infants without pathological growth morbidities who develop severe retinopathy of prematurity in low-risk group point to other risk factors for retinopathy of prematurity to be evaluated and changed in future practice.Skrb o izrazito nezreloj nedonoščadi zahtijeva stalnu procjenu i napredak. Prediktivni model temeljen na prirastu tjelesne mase WINROP razvijen je u svrhu smanjenja stresnih pregleda u probiru za retinopatiju nedonoščadi. Validacijske studije WINROP-a naglašavaju razliku u primjenjivosti u neonatalnim jedinicama različitih standarda. Cilj studije bio je procijeniti standard n eonatalne skrbi upotrebom WINROP-a. Podatci o ekstremno nezreloj nedonoščadi prikupljeni su iz medicinske dokumentacije i uneseni u WINROP. Analizirana je podjela visokog i niskog rizika prema WINROP-u i ishoda retinopatije nedonoščadi. U studiju je bilo uključeno 54 nedonoščadi gestacijske dobi ≤28 tjedana nakon isključenja supostojećih bolesti povezanih s tjelesnom masom. Visoki alarm zabilježen je u 74% (n=40) djece, a 24% (n=13) razvilo je retinopatiju nedonoščadi koja je zahtijevala liječenje. U skupini niskog alarma zabilježena su 3 slučaja s teškom bolešću. Dakle, WINROP ne pruža samo prediktivnu informaciju za ozbiljnost retinopatije nedonoščadi. Alarm visokog rizika ukazuje na potrebu prilagodbe prehrambenih strategija. Nedonoščad bez patoloških poremećaja rasta koja su razvila ozbiljnu retinopatiju nedonoščadi u skupini niskog rizika upućuje na druge čimbenike rizika za retinopatiju nedonoščadi za procjenu i promjenu u budućoj praksi

Analysis of the impact of position in fatigue cracks on the fracture toughness of thick-walled pressure vessel material

AbstractThe testing of fracture toughness thick-walled pressure vessel material showed a vast range of different results. Pressure vessels were made by hot plastic deformation treatment. Three sets of specimens were cut-out from the vessel, each having a same orientation of fatigue cracks in relation to the vessel axis. Fracture toughness tests were performed on the SENB specimens in accordance with ASTM 1820-11. The results showed a large range of different results, even within each sets of specimens. The results of fracture toughness in the initiation zone of stable crack growth were processed by means of Weibull statistical analysis. Based on these results of a direction distribution coefficient m was obtained and results reliability interval of fracture toughness was defined

Slab postnatalni porast tjelesne mase kao prediktor retinopatije nedonoščadi

The purpose of this study was to re-evaluate cut-off values used in screening for retinopathy of prematurity (ROP) in Croatia and to propose postnatal weight gain as an additional criterion, based on the Colorado Retinopathy of Prematurity prediction model. Medical records of 267 premature infants from the Zagreb University Hospital Centre that underwent ROP screening between January 2009 and December 2010 were reviewed retrospectively. Collected data included gestational age, birth weight, sex, weekly weight measurements and fundus examination records. Results showed the cut-off values of gestational age (GA) and birth weight (BW) used in Croatia to be appropriate and postnatal weight gain in the first 28 days could be used as an additional criterion on screening in the following way: net weight gain in the first 28 days of ≤932 g for prediction of any form of ROP and of ≤660 g for prediction of severe ROP should be added to the existing criteria of GA (≤32 weeks) and/or BW (≤1500 g). Infants with a non-physiological postnatal weight gain are exception. This is the first Croatian study to propose postnatal weight gain as an additional criterion on ROP screening and requires further validation on a larger sample of Croatian infants.Svrha ovoga istraživanja bila je procijeniti granične vrijednosti koje se koriste u probiru na retinopatiju nedonoščadi (ROP) u Hrvatskoj te predložiti postnatalni porast tjelesne mase kao dodatni kriterij, po uzoru na algoritam Colorado Retinopathy of Prematurity (CO-ROP). Retrospektivno su analizirani podaci 267 nedonoščadi praćene u sklopu programa probira na ROP u Kliničkom bolničkom centru Zagreb od siječnja 2009. do prosinca 2010. godine. Prikupljeni podaci uključivali su gestacijsku dob (GD), porođajnu masu (PM), spol, tjedna mjerenja tjelesne mase i praćenja nalaza na očnoj pozadini. Rezultati studije pokazali su da su granične vrijednosti za gestacijsku dob i porođajnu masu koje se koriste u Hrvatskoj primjerene za ovu populaciju te da postnatalni porast tjelesne mase u prvih 28 dana može poslužiti u programu probira na ROP na sljedeći način: uz postojeće kriterije, GD ≤32 tjedna i/ili PM ≤1500 g, dodati kriterij i/ili postnatalni porast tjelesne mase u 28 dana ≤932 g za predikciju bilo kojeg oblika ROP-a odnosno ≤660 g za predikciju teškog oblika ROP-a. Iznimka su djeca s nefiziološkim porastom tjelesne mase. Ovo istraživanje je prva hrvatska studija koja predlaže postnatalni porast tjelesne mase kao dodatni kriterij u programu probira na ROP i zahtijeva dodatna ispitivanja na većem uzorku hrvatske nedonoščadi

COMPLICATION AND PROGNOSIS OF JUVENILE IDIOPATHIC ARTHRITIS ASSOCIATED UVEITIS IN THE ERA OF MODERN IMMUNOMODULATORY TREATMENT

JIA is the most common rheumatic disease of childhood and JIA-U is its most frequent and most devastating extraarticular manifestation. This form of uveitis is usually asymptomatic, chronic anterior uveitis, often accompained with complications. JIA-U is the main cause of vision loss and even blidness in childhood. Thus, screening for JIA-U in all JIA patients and early treatment is of prime importance. Over the last 15-20 years, ever since IMT has been used, studies generally show trends toward decrease of JIA-U onset, complications frequency, improvement of prognosis and remission achievement. Despite evident improvements, over 20% JIA-U patients still develop complications in long-term follow-up. Moreover, about 50% JIA-U patients continue to have active uveitis in adulthood. Therefore, JIA-U is still associated with high risk of late sequelae and visual acuity loss, functionally and structurally eye damage and quality of life impairment

COMPLICATION AND PROGNOSIS OF JUVENILE IDIOPATHIC ARTHRITIS ASSOCIATED UVEITIS IN THE ERA OF MODERN IMMUNOMODULATORY TREATMENT

JIA is the most common rheumatic disease of childhood and JIA-U is its most frequent and most devastating extraarticular manifestation. This form of uveitis is usually asymptomatic, chronic anterior uveitis, often accompained with complications. JIA-U is the main cause of vision loss and even blidness in childhood. Thus, screening for JIA-U in all JIA patients and early treatment is of prime importance. Over the last 15-20 years, ever since IMT has been used, studies generally show trends toward decrease of JIA-U onset, complications frequency, improvement of prognosis and remission achievement. Despite evident improvements, over 20% JIA-U patients still develop complications in long-term follow-up. Moreover, about 50% JIA-U patients continue to have active uveitis in adulthood. Therefore, JIA-U is still associated with high risk of late sequelae and visual acuity loss, functionally and structurally eye damage and quality of life impairment

Expression and prognostic value of putative cancer stem cell markers CD117 and CD15 in choroidal and ciliary body melanoma

AIMS: The aim of the present study was to immunohistochemically investigate the expression and prognostic significance of putative cancer stem cell markers CD117 (c-kit), CD34, CD20 and CD15 in a cohort of patients with primary choroidal and ciliary body melanoma. ----- METHODS: The immunohistochemical expression of these markers was evaluated using 3,3'-diaminobenzidine tetrahydrochloride (DAB) and 3-amino-9-ethylcarbazole (AEC) chromogens on paraffin-embedded tissue samples from 40 patients who underwent enucleation in the period from 1985 through 2000. Thirty-one patients had adequate tissue specimens for the analysis. ----- RESULTS: CD117 overexpression was observed in 12 of the 31 samples (39%) when AEC chromogen was used and in 14 of 26 (54%) samples when DAB was used. CD15 positivity was seen in three out of 30 (10%) samples with AEC and in six out of 26 (23%) samples with DAB. CD20 and CD34 exhibited no positivity in the tested samples. During the average follow-up time of 8.7 years (range 0.5-22 years), 17 patients (55%) died due to metastatic disease. The Kaplan-Meier plots showed a significantly shorter overall and disease-free survival in CD117-positive patients when the AEC chromogen was used. CD15 expression was not associated with patients' survival. In multivariate analysis, patients expressing the CD117 AEC had 4.13 times higher risk of lethal outcome in comparison with CD117 AEC negative patients. ----- CONCLUSIONS: Our retrospective cohort study has for the first time demonstrated a small proportion of CD15-positive uveal melanomas. CD117 AEC overexpression was associated with a worse outcome in patients with choroidal and ciliary body melanoma. Further studies should confirm the validity of these observations and their potential for targeted treatment modalities

Promjene broja druza i središnje mrežnične debljine u bolesnika sa senilnom makularnom degeneracijom kroz dvije godine

Age-related macular degeneration (ARMD) is the leading cause of blindness in developed world but there are still much unknown facts about the disease itself. Age, genetic factors and smoking are the three main risk factors for the development of ARMD, but the exact pathophysiological mechanism of the disease remains unknown. Current high resolution optical coherence tomography devices provide ample new information on retinal layers, drusen characteristics and their interaction. In this study, we analyzed 44 eyes with drusiform dry ARMD using high resolution optical coherence tomography over a 2-year period. Our results showed a statistically significant increase in drusen number in both females and males in the 2-year period. On average, increment by 4 and 5 drusen per eye during the 2-year period was recorded in female and male patients with drusiform dry ARMD, respectively. Also, statistical analysis of the central retinal thickness showed that women with drusiform dry ARMD had a statistically significantly thinner macula than their male counterparts.Iako je senilna makularna degeneracija (SMD) vodeći uzrok sljepoće u razvijenom svijetu, još uvijek postoje mnoge nepoznanice oko nastanka i tijeka bolesti. Visoka životna dob, genetska predispozicija i pušenje najvažniji su čimbenici rizika za nastanak bolesti. Moderna optička koherentna tomografi ja visoke rezolucije (engl. optical coherence tomography, OCT) pruža mnogo novih informacija o retinalnim slojevima, karakteristikama druza i njihovoj uzajamnoj interakciji. U ovom istraživanju usporedili smo nalaze OCT u 44 oka bolesnika koji boluju od suhe druziformne SMD kroz razdoblje od 2 godine. Otkrili smo da se broj druza kroz 2 godine kod žena prosječene dobi od 70 godina uvećao za 4 druze, dok se kod muškaraca prosječne dobi od 68 godina broj druza u istom razdoblju povećao za 5 druza. Uspoređujući centralnu retinalnu debljinu kod muškaraca i žena otkrili smo da žene imaju statistički značajno tanju centralnu retinalnu debljinu od muškaraca