Frequency of Peripheral Arterial Disease in Patients With Chronic Venous Insufficiency.

BACKGROUND: It is estimated that about 15% (10% - 30% in most of the studies) of the total adult population has some aspects of the Chronic Venous Insufficiency (CVI). Frequency of the Peripheral Arterial Disease (PAD) in the adult population is 3% - 4%. Studies dealing with etiopathogenesis of leg ulcers show that between 10% and 18% of all ulcers are of mixed, arterial-venous origin. OBJECTIVES: The purpose of this study was to find out if there is a higher frequency of PAD among CVI patients in comparison with the control group, as well as to discover some common risk factors for CVI and PAD. PATIENTS AND METHODS: This cross-sectional descriptive study was conducted at the dermatovenereological clinic, clinical center of Vojvodina, Serbia. A total of 162 examinees were included. All patients were examined for the existence of CVI and staged according to CEAP (Clinical, etiology, anatomy and patophysiology) classification. In this way, 3 groups were formed: Patients with the mild forms of CVI (stage 1 - 4 by CEAP classification), 57 patients; patients with the severe forms of CVI (stage 5 and 6 by CEAP classification), 55 patients; control group (no CVI), 50 patients. Also, the Ankle Brachial Pressure Index (ABPI) was assessed in all subjects, and its value of ≤ 0.9 was set as criteria for diagnosis of PAD. The same sample was divided according to the presence of PAD into two groups. The most important risk factors for CVI and PAD were identified for each patient through complete examination, medical record and appropriate questionnaire. RESULTS: Our results showed that the risk factors for CVI were high Body Mass Index (BMI), hypertension, predominantly standing position during work and positive family history for CVI. In the same sample it was found that 28 (17.28%) patients had PAD. Relevant risk factors for PAD in the present study were: high BMI, hypertension, diabetes and a positive family history for PAD. Comparison of frequency of PAD among patients with severe forms of CVI and control group showed that this difference was statistically significant (P = 0.0275; OR 3.375; 95% CI 1.125 - 10.12). After multivariate analyses, adjusted odds ratio OR was still statistically significant. CONCLUSIONS: The peripheral arterial disease is more frequent in patients with the severe form of CVI, than in patients without CVI. Concomitant risk factors for CVI and PAD were high BMI and hypertension. In each patient with severe CVI it is necessary to determine the ABPI, in order to exclude the presence of PAD.

Epidemiological and clinical features of erythema infectiosum in children in Novi Sad from 2000 to 2009.

BACKGROUND/AIM: Erythema infectiosum (EI) is a common childhood illness, caused by human parvovirus B19. It occurs sporadically or in epidemics and is characterized by mild constitutional symptoms and a blotchy or maculopapular lacy rash on the cheeks (slapped-cheek) spreading primarily to the extremities and trunk. The aim of our study was to analyse the epidemiological and clinical characteristics of erythema infectiosum in children. METHODS: This study included 88 children observed in the Department of Dermatology of the Institute for Child and Youth Health Care of Vojvodina, in Novi Sad, during the period January 2000-December 2009. We compared the data about the clinical characteristics during and after the outbreak of EI observed from December 2001 to September 2002. The data were retrieved from the hospital database. RESULTS: During the study period, EI was detected in 88 children (44 females and 44 males), 0.213% of the total number of 41,345 children observed in the Department of Dermatology. An outbreak of erythema infectiosum was observed from December 2001 to September 2002, with the peak frequency in April and May 2002 and 39 diagnosed cases, and stable number of cases from 2005 to 2009 (a total of 49 diagnosed cases). The average age of infected children was 7.59 +/- 3.339. Eleven (12.5%) children were referred from primary care pediatricians with the diagnosis of urticaria or rash of allergic origin. The most constant clinical sign was reticular exanthema on the limbs, present in 100% of the cases, followed by 89.77% of cheek erythema. Pruritus was present in 9.09% of the children, mild constitutional symptoms in 5.68% and palpable lymph glands in 3.41% of the children. In all the cases the course of the disease was without complications. CONCLUSION: The results of this study confirm the presence of EI (the fifth disease) in our area with a mild course in the majority of patients. Since the diagnosis of EI is usually based on clinical findings, continuing medical education of primary health care pediatricians is essential for reducing the number of misdiagnosed cases.

Recurrent infections and cows-milk hypersensitivity in a 2-year-old girl with hyper immunoglobulin E syndrome.

The hyperimmunoglobulin E syndrome is a rare complex primary immunodeficiency characterized by high serum IgE levels, eczema, and recurrent infections. We present a case of 2-years-old girl with eczema and repeated bacterial skin and lung infections since the period of infancy. The patient also had eosinophilia, high serum levels of IgE, and cows-milk hypersensitivity. We describe the case, in order to illustrate the difficulty of establishing the diagnosis hyper-immunoglobulin E syndrome in a toddler.

Vitiligo and thyroid dysfunction in children and adolescents.

The link between vitiligo and thyroid disease has been proved in adult patients. The aim of our study was to assess the prevalence of thyroid dysfunction in children and adolescents with vitiligo and to identify any predisposing factors of this association. This retrospective study included 75 children and adolescents with vitiligo: 47 (62.66%) females and 28 (37.33%) males. Physical examination, thyroid ultrasonography and laboratory parameters of thyroid disease were performed in all study subjects. Various degrees of thyroid parameter alterations were found in 19 (25.33%) of 75 patients. Hashimoto's thyroiditis associated with non-segmental vitiligo was present in 11 (14.66%) patients. The most common site of vitiligo onset in patients with Hashimoto's thyroiditis were upper limbs, which was significantly more frequent compared with patients without Hashimoto's thyroiditis (χ(2); P<0.05). Since vitiligo usually appears before the development of thyroid disease, it may be useful to screen the children and adolescents with vitiligo for thyroid autoantibodies.

Influence of different types of electromagnetic fields on skin reparatory processes in experimental animals.

Wound healing is a very complex process, some phases of which have only recently been explained. Magnetic and electromagnetic fields can modulate this process in a non-thermal way. The aim of this research was to compare the influence of constant and pulsed electromagnetic fields and low-level laser therapy (LLLT) on wound healing in experimental animals. The experiment was conducted on 120 laboratory rats divided into four groups of 30 animals each (constant electromagnetic field, pulsed electromagnetic field, LLLT and control group). It lasted for 21 days. Under the influence of the constant electromagnetic field the healing of the skin defect was accelerated in comparison with the control group. The difference was statistically significant in all the weeks of the experiment at the P < 0.01 level. Accelerated healing was also observed under the influence of the pulsed electromagnetic field (P < 0.05). In the group of animals exposed to LLLT, the healing of the skin defect was faster than in the control group. The statistical significance was at the P < 0.05 level. Different types of electromagnetic fields have a promoting effect on the wound healing process.