Vasiljevaitė, Vaiva

Naktinė enurezė – tai vyresnių nei 5 metų vaikų nevalingas šlapinimasis miegant nakties metu. Naujausi tyrimai atskleidžia, kad šis sutrikimas dažnai yra susijęs su nepakankama vazopresino sekrecija, padidėjusiu šlapimo pūslės raumenų aktyvumu ar sutrikusiu pabudimo refleksu. Be to, stebima sąsaja su obstrukcine miego apnėja bei neuropsichiatriniais sutrikimais, tokiais kaip dėmesio stokos ir hiperaktyvumo sutrikimas (ADHD). Efektyviausi gydymo būdai - enurezės žadintuvas ir desmopresinas, o gydymo pasirinkimas priklauso nuo individualių paciento savybių.

Background: Clinical evidence, after recent clinical trials, has showed that anti-vascular endothelial growth factor (VEGF) therapy can be first-line option, but intravitreal steroids maintain a important role in the treatment of diabetic macular edema (DME). This manuscript aims to provide a comprehensive overview of treatment mechanisms of actions, treatment options, prognosis and ongoing clinical studies related to the treatment of DME, with intravitreal steroids therapy. Methods: A systematic review of randomized controlled trials, real-world studies, and systematic re¬views was conducted using PubMed, ScienceDirect, and the Cochrane Library. Inclusion criteria focused on studies from 2015 to 2025 that assessed intravitreal steroid efficacy in DME patients. A total of 6 studies (N = 262 patients) met the eligibility criteria. Results: Intravitreal corticosteroids demonstrated significant improvements in visual acuity and reductions in central macular thickness (CMT). Dexamethasone (DEX) implants provided sustained drug release over six months, leading to a mean gain of 6-12 letters and a reduction of -155 to -243 pm in CMT. Triamcinolone acetonide (TA) showed short-term efficacy with improvements lasting up to three months. Fluocinolone acetonide (FA) implants offered long-term benefits, maintaining visual gains over 36 months, but carried a higher risk of intraocular pressure (ЮР) elevation and cataract formation. Adverse events included increased ЮР (20-30% of cases) and cataract progression. Conclusion: Intravitreal corticosteroids are an effective second-line treatment for DME, particularly in cases where anti-VEGF therapy is insufficient. DEX implants offer a balance between efficacy and safety, TA provides a cost-effective short-term option, and FA implants are beneficial for chronic DME cases. Treatment selection should be tailored to individual patient needs, weighing benefits against potential adverse effects.

Introduction Autoimmune polyglandular syndrome (APS), a rare autoimmune disease, requires diagnosis of at least 2 out of 3: primary adrenal insufficiency (PAI), autoimmune thyroiditis, and type 1 diabetes mellitus (1) Case presentation This report details a 7-year-old with recurrent vomiting initially treated with rehydration, probiotics, and a low-fat diet. Despite efforts, the patient's condition worsened, leading to multiple hospitalizations. Laboratory results showed elevated liver enzymes, but inflammatory markers were normal. Although symptoms temporarily improved with intravenous hydration and Omeprazole, they recurred. Distinct features like skin hyperpigmentation and a positive Chvostek sign raised APS suspicion. After symptom summary, glucocorticoid and mineralocorticoid therapy for PAI was initiated two months after the first signs at the university hospital. Associated conditions, including hypothyroidism and hypocalcemia, were detected during the assessment. Genetic testing confirmed APS diagnosis, revealing no specific variants. [...].

Introduction Glaucoma is a progressive neurodegenerative disorder that affects the optic nerve, causing vision loss [1]. It is the leading cause of irreversible blindness worldwide [2]. The vascular theory of glaucoma suggests that vascular dysfunction and low perfusion pressure contribute to the disease [3, 4]. There is a positive relationship between intracranial pressure (ICP) and glaucoma [5, 6]. Changes in blood flow can also affect the optic nerve [7]. Understanding the complex interplay between ICP, blood flow and optic nerve health is essential for improving the ability to prevent and treat glaucoma. [...].

Introduction Diabetic macular oedema (DME), is characterized by the accumulation of exudative intraretinal fluid in the macular area [1,2]. Symptoms typically manifest as metamorphopsia and progressive vision loss [3]. Prolonged diabetes-related hyperglycemia leads to retinal changes, causing increased vessel permeability and closure, triggering VEGF production, causing oedema [4] [...].