Clinical characteristics of haemorrhagic fever with renal syndrome in children

From January 1988 to September 1989, seven patients (4 girls and 3 boys, aged 3–12 years) with haemorrhagic fever with renal syndrome (HFRS) were hospitalised at the University Children's Hospital in Belgrade. In four patients the disease appeared as a family outbreak, the others were sporadic cases. In six patients the clinical presentation was suggestive of HFRS, as they had fever with headache, myalgia, sore throat and gastrointestinal illness followed by renal abnormalities. However, severe haemorrhagic syndrome with petechia, haematoma, haematemesis and melaena was present in one patient only. Renal disease presented as nephritic syndrome and/or acute renal failure. Five patients recovered after 2–3 weeks without sequellae, one patient had decreased renal function 17 months after the start of the disease and the remaining patient died. In six patients the diagnosis of HFRS was confirmed serologically by a significant rise in antibody titres against hantaviruses, while in the patient with the fatal and fulminant course of the disease, the diagnosis was established on the basis of epidemiological and autopsy findings. We suggest that children living in endemic areas who develop an ill-defined, febrile and gastrointestinal disease with renal dysfunction should be evaluated for HFRS.     

Studies of chemical and biological properties of 99mTc-DMS (dimercaptosuccinic acid) — Renal imaging agent

Studies of the chemistry of preparation of tin chelate 2.3-dimercaptosuccinic acid (DMS) complexed with ^99mTc with respect to its biological properties have been made. We have varied molar ratio of reactants (DMS:Sn/II/), concentration of Sn-DMS chelate and pH of ^99mTc-DMS injection solution and examined their influence on biodistribution. Biodynamics of labeled solution at time intervals of from 0.5 to 4 h have also been measured. Animal experiments were carried out on mice and rats.Radiochemical purity was checked by paper chromatography, thin-layer chromatography, and gel-filtration through Bio-Gel P-2.A sterile, pyrogen-free lyophilized kit for labeling, stable for 6 months, was made on the basis of achieved results.The results of its clinical application are also reported.Report presented at the I European Congress of Nuclear Medicine, Lausanne, May 12/15, 1976     

Posttraumatic stress disorder and platelet serotonin measures

The role of serotonin (5HT) in the pathophysiology of posttraumatic stress disorder (PTSD) has been suggested by the overlap in clinical symptoms between PTSD and psychiatric conditions in which a serotonin dysfunction is implicated, as well as by the therapeutic efficiency of 5HT-related drugs (antidepressants, selective serotonin reuptake inhibitors and monoamine oxidase inhibitors) in alleviating symptoms in PTSD. In the present study, the blood platelet, which has been proposed as a peripheral model for the central serotonergic neurons, has been used to search for alterations in 5HT mechanisms in PTSD. Platelet serotonin level and kinetics of serotonin transporter and monoamine oxidase (MAO-B) were assessed in 63 combat-related PTSD patients and 43 sex and age-matched control subjects. A significant reduction in maximal velocity of platelet MAO-B (approx. 30%), with no changes in the enzyme affinity was observed in our patient sample. Conversely, no alterations in kinetic parameters (V(max), K(m)) of platelet serotonin transporter, as well as in platelet 5HT level, were found in the PTSD group.     

War wounds to the foot

Thirty-nine patients with foot injuries were admitted to the Clinic for Orthopedic Surgery in Lovran during the war against Croatia. All of them were soldiers wounded by antipersonnel mines. All of the patients were treated using the same protocol. Primary wound care included debridement, necrectomy, and three-dimensional external fixation with or without Kirschner wires. External fixation facilitated postoperative wound care, prevented vicious contracture position, and made fracture healing possible with early weight bearing.     

Increased activity of lymph node cells in experimental thermal injury: changes in accessory cells in injured area-draining lymph nodes

Accessory cell content and some of their functional characteristics were determined in regional lymph nodes which drain burn injury (DLN) in rats. Increase in percentages of non-specific esterase-positive cells and NBT+ macrophages and in numbers of dendritic cells were noted in cytospin preparations of draining lymph node cells (DLC) 24 and 72 h following thermal injury. An accumulation of B cells was also noted in the DLN paracortex region at these time points. Enrichment of ED1+ (rat macrophage marker) cells was noted in the adherent DLC population. Increased activity of interleukin-1 (IL-1) in conditioned medium from adherent DLC population and the increased stimulatory capacity of whole DLC or dendritic cell enriched-DLC fraction were noted in functional assays. Enrichment in accessory cells and an increase in their functional activity could contribute to the endogenous activity of regional lymph nodes which drain burned areas.     

Nonsteroidal antirheumatic agents--present status and perspectives

The non-steroidal anti-inflammatory drugs (NSAID) are most commonly used drugs in rheumatology. NSAID effectively reduce the pain and inflammation. However, the use of NSAIDs is associated with various gastrointestinal side effects. The discovery of the two COX isoforms, namely COX1 (constitutive) and COX2 (inducible) led to the search for specific COX2 inhibitors with better gastrointestinal safety. Beside the simply gastrointestinal safety the issue point to the still not resolved questions about coxibs effects on the constitutive COX2 function in brain, kidney and the reproductive tract, as well as vigilance in post-marketing surveillance.     

News in the treatment of rheumatic diseases

Rheumatic diseases are frustrating issue for the rheumatologists because ethiologic remedy is still missing and much more, they are great socio-economic burden for patients and society. In the last 10 years there was bustling endeavour in creating new products with exact known action. This article deal the new options to treat rheumatoid arthritis with leflunomide, infliximab, etanercept and anakinra and osteoarthritis with hyaluronan, diacerhein, glucosamino sulphate, chondroitin sulphate and avocado/soya unsaponifiables. In particular patients all mentioned products have their place in the treatment plan but critical risk-benefit assessment is needed.