To evaluate the prevalence and the type of liver pathology in children at the time of diagnosis of celiac disease (CD).
Inflammatory bowel disease (IBD) diagnosis and therapy is challenging for every pediatrician, especially when complicated with extraintestinal manifestations. The article reviews current literature on the hepatobiliary manifestations associated with inflammatory bowel disease in the pediatric population.
Glioblastoma, the most malignant astrocytic tumour, is associated with limited survival and thus rare metastases. We analysed a particularly interesting case - a 51-year-old male diagnosed within 2 years with primary and recurrent glioblastoma, isocitrate dehydrogenase (IDH)-wild type, as well as with numerous extra-central nervous system (CNS) metastatic foci. Genetic material obtained from primary and recurrent tumours, as well as from pulmonary metastasis was analysed and compared at a molecular level. Next generation sequencing (NGS) analysis revealed BRAFV600E mutation, detected only in 2-5% of glioblastomas, in both the primary tumour and pulmonary metastases. Importantly, this mutation provides a possible therapeutic option as it constitutes a target for clinically approved inhibitors. This case study not only demonstrates a molecular comparison of primary, recurrent and metastatic glioblastoma, but also emphasizes the need for precise molecular diagnostics, which may facilitate treatment choice, especially in tumours currently lacking efficient treatment.
When medical intervention is necessary, a physician faces a serious dilemma: can he/she perform medical intervention despite the lack of informed consent, or should he/she withdraw from such an intervention? The question is even more difficult when a patient under the influence of alcohol urgently requires a medical intervention. In such cases the possibility to gain informed consent is even more problematic, and such situations are not so rare. In such situations, a doctor must often decide whether to undertake medical interventions despite the lack of informed consent of a patient, if it is justified by patient’s state of health, or to discontinue intervention, exposing him/herself to possible legal liability for such an omission.
In a multidimensional approach two aspects of empathy are distinguished: emotional – sharing affective states of others with concern, and cognitive – taking the perspective of others, leading to an understanding of what the other person feels. The aim of this paper is to review the research on the genetic basis of cognitive and emotional empathy, and to indicate further directions of research in this area. The inheritance of the cognitive aspect of empathy is 0.26, and of the emotional one is 0.30. This means that to a large extent the variability of empathy is shaped by the environment. Although it is indicated that as many as 25 genes (including 37 polymorphisms) are associated with both aspects of empathy including mainly genes encoding oxytocin and vasopressin receptors, and neurotransmitters (e.g. serotonin, dopamine), genes encoding cannabinoids and opioids, there is still a lack of data showing how the genes influence each other, and how they interact with the environment. A group of genes involved in empathizing, closely related to the regulation of gene expression (genes encoding transcription factors, growth and development factors, e.g. BDNF) could possibly fill this gap. The expression of these genes is closely related to the plasticity of the nervous system and may have a direct relationship with the development of empathy not only in the first stages of life, but in various environmental interactions, such as parenting skills training, or educational programs for children, aimed at modeling empathic behavior.
Nutcracker syndrome (NCS) is an unusual cause of haematuria and is defined as compression of the left renal vein between the aorta and superior mesenteric artery, resulting in elevation of left renal vain pressure and collateral vein development. Symptoms of NCS include the following: haematuria, abdominal and left flank pain, pelvic congestion syndrome, and orthostatic proteinuria, although, clinically, gross haematuria may be the only disorder. We report a 13-year-old girl who experienced haematuria for two years with chronic back and abdominal pain. Each urinalysis revealed haematuria (20% dysmorphic). In the presented case Doppler ultrasonography revealed left renal vein dilatation up to the angle between the superior mesenteric artery and the aorta with a diameter of 7 mm in the hilar region. NCS can be easily missed by routine tests in children.
Streszczenie Charakterystyka pracy lekarza dentysty wymaga stosowania różnego rodzaju materiałów i narzędzi w jamie ustnej pacjenta. Z uwagi na brak całkowitej, mechanicznej bariery chroniącej dalsze odcinki układów oddechowego i pokarmowego, mogącymi zdarzyć się powikłaniami zabiegów stomatologicznych są aspiracje i połknięcia. Celowym jest ustalenie właściwego toku postępowania, diagnostyki i leczenia w takich sytuacjach zarówno na fotelu stomatologicznym, jak i w oddziałach specjalistycznych. Na podstawie opisywanych w piśmiennictwie przypadków można stwierdzić, że szczególnie predysponowane do przedostania się do drogi pokarmowej lub oddechowej są wiertła, narzędzia endodontyczne, uzupełnienia protetyczne, zwłaszcza na etapie kontroli w jamie ustnej przed zacementowaniem. Większość połkniętych przedmiotów transportowana jest przez przewód pokarmowy bez żadnych alarmujących dolegliwości. Jednak ostre, spiczaste i wydłużone przedmioty mogą spowodować perforację i uszkodzenia narządów wewnętrznych. Należy bacznie obserwować zachowanie Ingestion and aspiration of foreign bodies in dental practice
Rheumatoid neutrophilic dermatitis is a rare extra-articular manifestation of rheumatoid arthritis, both seropositive and seronegative for rheumatoid factor. The condition most often presents as symmetric erythematous papules, nodules, plaques, and urticaria-like lesions in patients with severe, long-lasting rheumatoid arthritis. We report a case of a 65-year-old man with well-controlled rheumatoid arthritis, who developed rheumatoid neutrophilic dermatitis on the right lower leg. The biopsy of skin lesions revealed an intense, neutrophilic dermal infiltrate, microabscesses, and leukocytoclasis without vasculitis. The patient responded well to pulses of intravenous methylprednisolone. We present this patient due to the rarity of the disease and atypical unilateral manifestation involving the flexural surfaces of the lower leg.
The paper describes the development of the anterior capsulotomy from its early crude beginnings in the 18 h century to the possibility of automated surgery today via continuous curvilinear capsulorhexis (CCC). The reasons for the opening of the capsule have changed from a roughly made tear to allow access to the nucleus for its extraction, to the creation of more regular openings to allow support for intraocular lenses. With the development of continuous circular tears it was possible to be certain to contain the intraocular lens (IOL) in the capsular bag. In recent times we have the ability to achieve precision in size and location with lasers and other technologies. This means the capsulotomy can be used to hold the IOL, which will improve the centration of the optic. This is important in premium lenses and should improve predictability of the effective lens position. All of these changes will be highlighted with appropriate illustrations.
A tradução das obras de Guimarães Rosa teve início ainda durante a vida do autor, que, em muitos casos, ajudava seus tradutores em cartas detalhadas com sugestões e discussões sobre seu processo criativo. Nos Estados Unidos, em particular, a tradução de Rosa para o inglês acontece no contexto da aproximação dos Estados Unidos com a América do Sul entre as décadas de 1940 e 60, embora os efeitos desta iniciativa de tradução de obras latino-americanas não atinjam o Brasil com tanta força (BARBOSA, 1994; LEVINE, 2006; KRAUSE, 2010). Neste artigo, busca-se analisar como as escolhas da tradutora Harriet de Onís podem ter influenciado a recepção da obra de Guimarães Rosa em inglês. Por meio do cotejo do conto “Corpo fechado” (Sagarana, 1946) e sua tradução, “Bulletproof” (Sagarana, 1966), concluiu-se que de Onís tende a domesticar (VENUTI, 1995) o texto de Rosa, naturalizando seu estilo não-convencional e, portanto, negando aos leitores o acesso ao seu projeto estético. Sugerimos, por fim, ser possível que um novo projeto tradutório para Rosa receba mais atenção do público falante de língua inglesa do que a tentativa anterior, ao tornar o texto desafiador para o leitor, sem negar a identidade do texto de partida.