Changes in the parameters of the anterior segment of the eye in pregnant women — literature review

The physiology of pregnancy is a curious issue for specialists from different branches of medicine and science. In this systematic review, the attention was focused on changes in eyes during pregnancy and confinement. To summarise and systematize actual knowledge in eyes’ changes during pregnancy, publications from years 2011–2017 were analysed. Stud­ies about parameters of corneal endothelial cells, corneal biomechanical parameters, keratometric variables, intraocular pressure and biometry of the anterior chamber were compared. The conducted studies demonstrated the unambiguous character of changes only in case of intraocular pressure, which decreased during the II and III trimesters of pregnancy. Inconsistent study methods and low number of examined patients did not enable to draw explicit conclusions in context of other parameters of the anterior segment of the eye in pregnant women. It is indicated to perform further studies on a representative and homogeneous group of female patients

Pregnancy and the eye. Changes in morphology of the cornea and the anterior chamber of the eye in pregnant woman

Objectives: The main goal of the study was to determine whether uncomplicated pregnancy and natural labor exert influence on the cornea and the anterior chamber of the eye. Material and methods: The study included 114 eyes of 57 women in age of 21–35 years old. Only patients in the physiological pregnancy and giving natural birth were recruited into study. Prospective observative examination was performed. Patients were diagnosed twice: in 36 HBD and 6 weeks after labor. Using the Scheimpflug camera (Pentacam system) the following parameters were assessed: central corneal thickness (CCT), keratometric parameters: flat (K1) and steep (K2), astigmatism value and axis, anterior chamber depth (ACD), anterior chamber volume (ACV) and anterior chamber angle (ACA). The statistical analysis was carried out in the StatSoft Statistica 13 program. Results: CCT value is greater in the third trimester than in 6th week after the labour. ACD and ACA values are higher in 36 HBD than in the post-partum period but the difference is not statistically important (p > 0.05). K1, K2, cylindrical refraction error, axis of cylindrical refraction error do not change. Conclusions: Authors claim that it is the result from an increase in water retention in the corneal stroma as a response to hormonal changes. The plasticity of the anterior chamber seen before delivery can be a natural adaptive mechanism of the female body, which counteracts the excessive increase in intraocular pressure in the second stage of delivery

Skin changes during pregnancy. Is that an important issue for pregnant women?

Objectives: The aim of the study was to investigate the prevalence of self-reported skin complaints during pregnancy, applied treatment and the impact on well-being of pregnant women. Material and methods: We asked 1935 women that were maximum 4 years after labor to fill in our questionnaire. The questionnaire included questions concerning the course of pregnancy, observed skin lesions, applied treatment and influence on the quality of life. Results: Skin changes during pregnancy were reported by 1447 patients (74.78%). The prevalence of self-reported skin complaints were as follows: stretch marks (77.4%), acne (21.6%) and recurrent herpes labialis (11.6%). In 43.67% (n = 632) of women who reported dermatological problems during pregnancy the disease caused significant deterioration in their well-being. Only 168 patients (11.61%) received dermatological treatment from their obstetricians. Dermatological con­sultation required 217 patients (14.99%). For 133 of treated women (25.68%) the recommended treatment was expensive. However, in the majority of patients (379; 73.15%) who received treatment the skin changes resolved after therapy. Skin symptoms resolved significantly faster in the treated group (3.5 ± 4.3 week vs 5.8 ± 6.2 week; p < 0.001). Conclusions: Self-reported skin complaints seem to be a relevant problem during pregnancy. Proper skin care as well as appropriate treatment applied by obstetricians and/or dermatologists may help women to recover

The Role of Epigenetic Factors in Psoriasis

Psoriasis is a chronic, systemic, immune-mediated disease with an incidence of approximately 2%. The pathogenesis of the disease is complex and not yet fully understood. Genetic factors play a significant role in the pathogenesis of the disease. In predisposed individuals, multiple trigger factors may contribute to disease onset and exacerbations of symptoms. Environmental factors (stress, infections, certain medications, nicotinism, alcohol, obesity) play a significant role in the pathogenesis of psoriasis. In addition, epigenetic mechanisms are considered result in modulation of individual gene expression and an increased likelihood of the disease. Studies highlight the significant role of epigenetic factors in the etiology and pathogenesis of psoriasis. Epigenetic mechanisms in psoriasis include DNA methylation, histone modifications and non-coding RNAs. Epigenetic mechanisms induce gene expression changes under the influence of chemical modifications of DNA and histones, which alter chromatin structure and activate transcription factors of selected genes, thus leading to translation of new mRNA without affecting the DNA sequence. Epigenetic factors can regulate gene expression at the transcriptional (via histone modification, DNA methylation) and posttranscriptional levels (via microRNAs and long non-coding RNAs). This study aims to present and discuss the different epigenetic mechanisms in psoriasis based on a review of the available literature

The influence of surgical correction of idiopathic scoliosis on the function of respiratory muscles

Background and objective: It is important to introduce respiratory exercises to the therapy of patients after the surgical treatment of adolescent idiopathic scoliosis. Surgical correction is the best way to prevent hypoxia in scoliosis, but whether pulmonary rehabilitation increases the effectiveness of scoliosis surgery has not yet been confirmed. Therefore, the aim of the study was to evaluate the function of respiratory muscles after surgical correction of idiopathic scoliosis. Methods: The study involved 24 patients, aged 13.6 ± 0.6. Maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP) were measured using the Mikro RPM. In all patients, before the procedure, 7 days after and 3 months after the procedure, the MIP and MEP were measured. Results: MIP was the lowest 7 days after the procedure; it was 45.28 cmH2O and was statistically significantly lower compared to the measurement before the procedure (p < 0.001) and 3 months after the procedure (p < 0.001). Conclusions: The degree of curvature of the spine before the procedure does not significantly affect initial values of the strength of respiratory muscles. The level of MIP is not dependent on the type of surger

Hidradenitis suppurativa – biologic therapy and other available treatment options

Hidradenitis suppurativa (HS) is a chronic recurrent inflammatory skin disease that is characterized by painful, recurrent nodules and abscesses. The overall prevalence of HS is estimated to be 11 per 100,000 individuals in the United States and 4% of the world’s population. Women are 3 times more affected than men, especially patients between 18 and 29 years of age. Similarly to acne vulgaris, HS is primarily associated with follicular occlusion, which results from a number of biological processes, including follicular epithelial hyperplasia and hyperkeratinisation. There are numerous available treatment options for cutaneous lesions in the course of HS. A combination of conservative therapy and appropriate surgical treatment conducted by an experienced surgeon ensures the best possible clinical outcomes. Presently, biologic therapy is the most effective pharmacological treatment in patients with moderate to severe course of the disease. Numerous ongoing clinical trials provide hope for greater availability of new biologic therapy methods

Skin manifestations of neuroendocrine neoplasms: review of the literature

Neuroendocrine neoplasms (NENs) are a heterogeneous group of rare tumours derived from peptidergic neurons and specialized neuroendocrine cells capable of secreting various peptides or amines. These cells may be present in endocrine tissue or diffused in the tissues of the digestive or respiratory system. The article reviews the characteristic features of NENs, with particular emphasis on skin manifestations, such as necrolytic migratory erythema (NME), tongue inflammation, angular cheilitis, venous thrombosis and alopecia in glucagonoma; “flushing”, “lion face”, pellagra skin symptoms, “scleroderma-like features without Raynaud’s phenomenon” in carcinoid tumours. The paper also presents the clinical picture of the neuroendocrine tumour of the skin – Merkel cell carcinoma. The aim of this study was to draw attention to the need for precise and comprehensive diagnosis of the patients, with particular emphasis on skin lesions as a revelator of neuroendocrine tumours. This management allows for the early implementation of appropriate treatment