Food allergy in children

© 2016, Serbia Medical Society. All rights reserved. Food allergy represents a highly up-to-date and continually increasing problem of modern man. Although being present in all ages, it most often occures in children aged up to three years. Sensitization most often occurs by a direct way, but it is also possible to be caused by mother’s milk, and even transplacentally. Predisposition of inadequate immune response to antigen stimulation, reaginic or nonreaginic, is of nonselective character so that food allergy is often multiple and to a high rate associated with inhalation and/ or contact hypersensitivity. Also, due to antigen closeness of some kinds of food, cross-reactive allergic reaction is also frequent, as is the case with peanuts, legumes and tree nuts or cow’s, sheep’s and goat’s milk. Most frequent nutritive allergens responsible for over 90% of adverse reactions of this type are proteins of cow’s milk, eggs, peanuts, tree nuts, wheat, soy, fish, shellfish, crustaceans, and cephalopods. Allergy intolerance of food antigens is characterized by a very wide spectrum of clinical manifestations. Highly severe systemic reactions, sometimes fatal, are also possible. The diagnosis of food allergy is based on a detailed personal and family medical history, complete clinical examination, and corresponding laboratory and other examinations adapted to the type of hypersensitivity and the character of patient’s complaints, and therapy on the elimination diet. A positive effect of elimination diet also significantly contributes to the diagnosis. Although most children “outgrow” their allergies, allergy to peanuts, tree nuts, fish, shellfish, crustaceans, and cephalopods are generally life-long allergies

Case Report of Acute Vitamin D Intoxication in an Infant

© 2014, Serbia Medical Society. All rights reserved. Introduction Vitamin D intoxication represents a rare and potentially serious pathological condition caused by the excess of calcium and phosphorus. We are presenting an infant with vitamin D intoxication due to excessive daily administration, as well as therapeutic procedures that prevented its adverse effects. Case Outline A 1.5-month-old female infant, born at term, exclusively breastfed and without any complaints and abnormalities of physical findings, was observed due to the data that during the preceding month, by her mother's mistake, she had received about 200,000 IU of vitamin D3. Laboratory analyses showed a high serum level of 25(OH)D (>400 nmol/L) and calcium (2.72 mmol/L), lowered PTH (6.6 pg/ml) and high urinary calcium/creatinine ratio (1.6), while other findings, including urotract ultrasonography image, were within normal limits. Treatment based on the discontinuation of vitamin D administration, infant's forced water intake, as well as the application of 2-month prednisolone and 4-month pheno-barbitone and furosemide, resulted in complete normalization of the laboratory indicators of vitamin D overdose, as well as the prevention of its adverse effects.Conclusion By timely recognition and adequate treatment, including triple therapy with prednisolone, phenobarbitone and furosemide, adverse effects of acute vitamin D intoxication can be prevente

Comprehensive dissection of prevalence rates, sex differences, and blood level-dependencies of clozapine-associated adverse drug reactions

Clozapine is often underused due to concerns about adverse drug reactions (ADRs) but studies into their prevalences are inconclusive. We therefore comprehensively examined prevalences of clozapineassociated ADRs in individuals with schizophrenia and demographic and clinical factors associated with their occurrence. Data from a multi-center study (n=698 participants) were collected. The mean number of ADRs during clozapine treatment was 4.8, with 2.4% of participants reporting no ADRs. The most common ADRs were hypersalivation (74.6%), weight gain (69.3%), and increased sleep necessity (65.9%), all of which were more common in younger participants. Participants with lower BMI prior to treatment were more likely to experience significant weight gain (>10%). Constipation occurred more frequently with higher clozapine blood levels and doses. There were no differences in ADR prevalence rates between participants receiving clozapine monotherapy and polytherapy. These findings emphasize the high prevalence of clozapine-associated ADRs and highlight several demographic and clinical factors contributing to their occurrence. By understanding these factors, clinicians can better anticipate and manage clozapine-associated ADRs, leading to improved treatment outcomes and patient well-being

Quitting smoking among people dealing with cancer

Introduction It has been proven that tobacco is the most dangerous single risk factor for development of many chronic diseases, cancer or early death. Tobacco smoke has more than 7000 chemicals, at least 250 are known to be harmful and more than 50 are known to cause cancer. Although quit smoking medications – substitution therapy has been approved and officially acknowledged as well as programs for stop smoking, the smoking rate is still very high. More than 1/6 of world population (1.1 billion) are smokers. The aim of this work is to present the importance of carrying out stop smoking programs for patients dealing with cancer. Methods The analysis of epidemiological situation of malignant disease is based on information of incidence and mortality as well as on smoking impacts. Results Researches show that larger part of oncological patients recognizes smoking as harmless and determination of diagnosis motivates these patients to stop smoking. Estimations show that 38% to 65% of cancer patients stop smoking in the first year after confirming diagnosis. Quitting smoking during oncological treatment is related to: better treatment response, reduced risk of complications, better quality of life and reduced risk of disease progression. Quitting smoking among oncological patients will affect long-term health as well by reducing risks of development of other diseases (heart attack, stroke). Conclusions All patients disregarding the stage of disease during oncological treatment may benefit from smoking cessation and have a right to quitting smoking treatment. Health care workers may improve motivation and influence quitting by providing help, giving advice and prescribing medications

Difficulties in preventing repeated genital self-mutilation

© 2016, University of Kragujevac, Faculty of Science. All rights reserved. Self-mutilation is self-inflicted and intentional damage done to one’s body or one’s body parts without a conscious suicidal intention. The first case of genital self-mutilation was published in 1846, and the first scientific description of genital self-mutilation was written by Stroch in 1901. Since the first case has been described, there have been a relatively small number of described cases of genital self-mutilation in both genders; there have been an even smaller number of cases of repeated genital self-mutilation and only a few descriptions of repetitive forms of male genital self-mutilation in the literature. The aim of our study is to present difficulties in preventing repeated male genital self-mutilation of a patient with an intellectual disability who was diagnosed and treated for epilepsy and psychosis in early adult life and had a previous history of self-destructive behaviour during childhood. Previous literature does not contain many repeated cases of male genital self-mutilation. After evaluating the contribution of each individual factor in the aetiology of self-mutilation, we concluded that every individual factor is significant in the aetiology of selfmutilation; however, no single factor, as well as all the factors put together, is not enough for prevention of self-mutilation. Our conclusion is that all the presented factors in our research (intellectual disability, epilepsy, psychosis, self-destructive tendencies in childhood) have their place in the aetiology of male genital selfmutilation, but none of them are determining factors. This confirms that it is necessary to conduct further research in the field of aetiology of male genital self-mutilation, which would contribute towards more adequate prevention

Factors Influencing The Six-Month Mortality Rate In Patients With A Hip Fracture

There are several potential risk factors in patients with a hip fracture for a higher rate of mortality that include: comorbid disorders, poor general health, age, male gender, poor mobility prior to injury, type of fracture, poor cognitive status, place of residence. The aim of this study was to assess the influence of potential risk factors for six-month mortality in hip fracture patients