Study of depression and anxiety in patients with asthma and chronic obstructive pulmonary disease.

BACKGROUND: Suggested treatment of patients with COPD and astma requires promotion and psychological dimensions of patients. AIM: Primary objective of this study was to determine frequency of developing anxiety and depression in patients with asthma and chronic obstructive pulmonary disease (COPD) in relation to gender, age and socioeconomic status and to evaluate possible differences between patients with and without high level of anxiety and depression and to find correlation between psychological aspects and disease itself. SUBJECTS AND METHODS: This study included a total of 120 subjects: 60 patients with asthma and 60 patients with COPD. Data were collected using a socio-demographic questionnaire for general information on subjects, standardized Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI). RESULTS: Significant difference was found in the anxiety level in these two groups. Average value for the patients with COPD was 43 (15) and for the patients with asthma 37.5 (15.7). Statistically significant difference was also reported for the depression level among females. In female patients with COPD that level was 13.5 (14.7) and in female patients with asthma 7.5 (11). There is a correlation between anxiety and depression in patients with COPD and asthma, especially among women. CONCLUSION: This study suggests that asthma and COPD are a significant stressor with a risk of developing anxiety and depression.

Ocular Hypotonia and Transient Decrease of Vision as a Consequence of Exposure to a Common Toad Poison.

The common toad produces venom (bufotoxin) that is produced in the parotid gland of the toad as well as in the skin. This toxic compound is a potent inhibitor of Na+/K+-ATPase activity. Physiological effects of bufotoxin are similar to those of digitalis and cause increased heart rate and muscle contractions. Ocular toxicity was described. A 67-year-old female patient was admitted to the emergency service because of sudden vision loss and a burning sensation in both eyes after she had been exposed to the poison of a toad. Slit lamp examination showed conjunctival hyperaemia and signs of ocular hypotonia. Topical antibiotic treatment was administered, and after 24 hours, corneal oedema and ocular hypotonia were in remission. Inhibition of Na+/K+-ATPase is a well-known effect of the toad venom. Na+/K+-ATPase is a part of corneal endothelial cells, ciliary body, and iris, and its inhibition caused by exposure to bufadienolides induces corneal dysfunction, decreased vision, and ocular hypotonia. Effects of bufadienolides on the decrease of ocular pressure appear to be very strong, with quick action. This rarely described effect of the bufotoxin can be used as a basis for further research of toad venom and its pharmacological potential. Purpose. To present a case of a 67-year-old female patient who experienced a sudden decrease in vision after exposure to the poison from a common toad (Bufo bufo).

The First Genetically Confirmed Case of Human Ophthalmomyasis Due to Oestrus ovis (Diptera Oestridae) in Bosnia and Herzegovina.

PURPOSE: Here we present a case of human ophthalmomyasis due to Oestrus ovis in a patient living in an urban area. Dipterians of the Ostridae family may occasionally deposit larvae into the human eye and cause ocular parasitosis called ophthalmomyasis. Cases like this are mostly connected with people who live in close contact with animals, like shepherds, but are rarely presented in urban population. METHODS: The patient was presented at University Clinic due to problems with his left eye, that persist no matter on treatment in local clinic a few days before. During the slit lamp examination larvae was detected and extracted from the conjunctiva. Genomic DNA was isolated from the sample and genetic analysis was performed. RESULTS: Larvae was identified as a first-stage larvae of O. ovis. CONCLUSION: This is the first report of genetically confirmed case of ophthalmomyasis in Bosnia and Herzegovina. In cases like this, clinicians should be aware of possibility of this rarely described presentation of ocular parasitosis since even the urban population can be accidentally affected due to a lack of natural hosts.

CD25+ FOXP3+ and CD4+ CD25+ cells distribution in decidual departments of women with severe and mild pre-eclampsia: Comparison with healthy pregnancies.

PROBLEM: The aim of this study was to quantify and compare the distribution of regulatory CD25+ FOXP3+ and activated CD4+ CD25+ T cells in decidua basalis and parietalis of severe and mild pre-eclampsia (PE) to normal healthy pregnancies. METHOD OF STUDY: Decidual tissue (decidua basalis and parietalis) of 13 women with mild PE, 15 women with severe PE, and 19 women with healthy term pregnancies were analyzed by immunohistochemistry and double immunofluorescence. RESULTS: The total number of CD25+ FOXP3+ cells/mm2 in decidua basalis was decreased in the severe and mild PE versus normal pregnancy group. The total number of CD4+ CD25+ cells/mm2 in decidua basalis was decreased in the severe PE versus normal pregnancy group. The number of CD25+ FOXP3+ and CD4+ CD25+ cells in decidua parietalis was decreased in both PE groups. CONCLUSION: Our data suggest that immunological changes of PE reflect on decidua basalis and parietalis and emphasize the importance of characterizing T cells in both decidual departments.

Concentrations of Selected Cytokines and Vascular Endothelial Growth Factor in Aqueous Humor and Serum of Diabetic Patients.

Purpose: To investigate the aqueous humor and serum levels of selected cytokines and vascular endothelial growth factor (VEGF) in diabetic patients, implicating their role in the pathogenesis of diabetic eye complications.Materials and methods:   Atotal of 65 patients (27 males and 38 females) who underwent cataract surgery were recruited into the study. The study group consisted of 30 cataract patients with type 2 diabetes mellitus, and this group was divided into two subgroups: 14 patients with diabetic retinopathy (DR group) and 16 patients without DR (NDR group). The control group consisted of 35 non-diabetic cataract subjects.Results: Patients in the DR group had significantly higher aqueous humor concentrations of interleukin (IL)-1ß, IL-6, IL-8, IL-10, monocyte chemotactic protein (MCP-1) and VEGF. Likewise, serum concentrations of IL-1ß, IL-6, IL-8, IL-12, TNF-α and IFN-γ were significantly higher in the DR group as compared to the controls. Aqueous humor concentrations of IL-1ß, IL-8, MCP-1 and VEGF were significantly higher in the DR group as compared with the NDR group.Conclusion: Our findings support the hypothesis that chronic inflammation and a disturbance of the immune system play important roles in the pathogenesis of diabetic cataract and DR.

Transient anisocoria in a patient treated with nebulized ipratropium bromide.

PURPOSE: We present a case report of a 44-year old female patient with complicated pneumonia who developed anisocoria after treatment with inhaled ipratropium bromide. Discontinuation of ipratropium bromide treatment led to complete resolution of anisocoria. OBSERVATION: A 44-year old female patient was admitted to the Department of Pulmonology due to high body temperature (40.0 °C), coughing and general weakness. After a general examination and tests the patient was diagnosed with right-sided pneumonia. Since spirometry test showed signs of bronchial obstruction, pulmonologist indicated inhalation therapy with ipratropium bromide. Soon after ipratropium bromide therapy was initiated, the patient noticed enlarged left pupil and stated that some aerosol reached her left eye during the inhalation therapy. After consulting neurology and monitoring neurological signs, ipratropium bromide treatment was discontinued. Twenty-four hours after discontinuing the ipratropium bromide treatment anisocoria was completely resolved. CONCLUSIONS AND IMPORTANCE: Presence of anisocoria may be a concerning neurological sign. If there are no other neurological or ophthalmological signs and symptoms and a recent ipratropium bromide inhalation treatment exists in the patient's history, we should consider iatrogenic side-effect of drugs as a possible reason of anisocoria and possibly spare the patient extensive and invasive diagnostic procedures that can also raise costs of treatment significantly. Observing neurological status and testing with 1% pilocarpine solution may be necessary to determine the etiology of this condition.