Retinal migraine (ophthalmic migraine, ocular migraine, anterior visual pathway migraine) is a rarely encountered medical condition, but with an interesting and complex clinical presentation. The goal of this article is to compile the literature on retinal migraine, detailing nomenclature, pathophysiology, differential diagnosis, and medical investigations including newer imaging modalities, like optical coherence tomography (OCT). We will approach topics of great concern such as risk factors, complications, treatment, and management of this condition. Retinal migraine is mainly a diagnosis of exclusion and it must be isolated from transient monocular vision loss (TMVL) developed from other causes, for instance, papilledema, giant cell arteritis, carotid artery disease (amaurosis fugax), intermittent angle closure glaucoma, and others. Its treatment is similar to migraine treatment; topiramate, amitriptyline, and nortriptyline are some of the pharmacological drugs successfully used.
Million people worldwide are affected by the hepatitis C virus (HCV). The highest incidence of illness was between 1945 and 1975. It was also estimated that 70% of those people were not tested for the disease. Most recent treatment concepts are safe, highly effective and have a vital public health influence by achieving a viral constant response in a significant proportion of treated patients. It helps reduce liver fibrosis, liver cancer risk and dissemination. With its increased population incidence, HCV becomes a serious public health problem. This review discusses the current literature in this field in terms of the importance of screening of HCV, follow-up, treatment and includes considerations in specific populations such as patients with cirrhosis, with HIV/HCV co-infection, patients with HBV/HCV co-infection and with renal damage.
Multiple sclerosis is a chronic autoimmune disease, characterized by the appearance of demyelinating lesions with inflammatory character in the CNS. Given the unpredictable evolution of the disease, numerous attempts have been initiated to find some pathogenic factors and by default targeted treatment methods. The intestinal microbiota of these patients is often significantly altered compared to the healthy population and given the complex connections between the intestine and the central nervous system, the idea of causality between dysbiosis and this condition was launched. The intestinal mucosa represents the interface between the external environment and the organism, so that it is considered the starting point of some local immunological processes but with systemic resonance, especially neurological. The classic medication scheme widely used to treat MS nowadays can also affect the integrity of the intestinal mucosa by breaking the fine balance at this level. Data from recent studies around the subject open new treatment opportunities around preserving the intestinal microbiota and strategies like vitamin A intake and fat-soluble vitamin D supplementation, probiotic complexes or faecalis microbiota transplantation appear more promising and easier to apply in daily clinical practice.
One of the great dreams of humanity has been the improvement of its behavioural, affective and emotional status. Depression represents the suffering of beings over their existential course, as a point of passage between the human condition and its destiny. The attempts of psychiatry to introduce efficient and increasingly performing antidepressants represent one of medicine’s great achievements. At the same time, antidepressant overdosing may lead to cardiotoxic manifestations presenting lethal risks as consequences [1]. We hereby present the case of a patient that was poisoned with tianeptine, ingested for suicidal purposes, who survived repetitive episodes of ventricular fibrillation, electrically converted to sinusal rhythm. The GC/MS analytical diagnosis played an essential part in detecting tianeptine in the biological samples. The rapid and very competent therapeutic intervention allowed for the patient’s survival, despite further complications. A review of main tianeptine information is also presented, as this type of intoxication may have deadly consequences.
Pregnancy-specific dermatoses are a heterogeneous group of inflammatory dermatoses associated exclusively with pregnancy. Although these dermatoses are rare, it raises problems in medical practice because of their appearance, being difficult to diagnose, treat and the possibility of the fetus being affected. Pemphigoid Gestationis (PG) is a rare, autoimmune, strongly pruritic, vesiculobullous dermatosis with a strong impact on the patient. Polymorphic Eruption of Pregnancy (PEP) is a benign, self-limited inflammatory skin disorder that usually affects first pregnancy in the third trimester or immediately in the postpartum period. Other dermatoses associated with pregnancy include: Intrahepatic Cholestasis of Pregnancy (ICP), Atopic Eruption of Pregnancy (AEP) and Pruritic Folliculitis of Pregnancy (PFP). We will extensively present PG and PEP, to draw attention to the importance of correct diagnosis and the implications of treatment during pregnancy.
Introduction: Matrix metalloproteinases (MMPs) are key enzymes involved in degradation of extracellular colagen matrix during periodontal disease progression. The aim of our work was to study the levels of MMP-1, MMP-2, MMP-7, MMP-9 and MMP-10 in saliva of patients with chronic periodontitis. Materials and methods: The study included 22 patients with chronic periodontal disease and 15 controls. We collect unstimulated whole saliva from all volunteers included in the study. Salivary levels of mentioned MMPs were analyzed using magnetic bead-based multiplex assays and Luminex technology. Results: MMP-1, MMP-7, MMP-9 and MMP-10 present statistically increased salivary levels at patients with periodontal disease versus the control group (p<0.05). Salivary level of MMP-2 at patients with chronic periodontitis was increased but statistically insignificant compared with healthy subjects (p=0.1). Conclusions. The increased level of these enzymes in patients diagnosed with periodontal disease reflects their implication in periodontal tissue degradation. Saliva is an excellent fluid useful in monitoring the severity of this oral disease that affects about half of the adult population around the world.
