Svirskaitė, Kamilė

Introduction Influenza viruses are RNA viruses of the Orthomyxoviridae family and are classified as types A– D [1,2]. Influenza A and B viruses circulate among humans, mainly A(H1N1) and A(H3N2), and B/Victoria and B/Yamagata lineages [3]. They cause acute febrile illness with systemic and respiratory symptoms [4]. In high-risk groups, including older adults, young children, pregnant women, people with chronic diseases, immunocompromised patients, influenza can lead to severe or life-threatening complications [5,6]. Case Presentation A young boy developed bilateral visual deterioration after a viral illness. This case was evaluated retrospectively, and data on influenza testing and subtype was unavailable. Bestcorrected visual acuity was 0.8 OD and 0.9 OS (previously 1.0 bilaterally). Slit-lamp examination showed no anterior segment abnormalities. Perimetry revealed central scotomas in both eyes and additional peripheral defects in the right eye. Optical coherence tomography showed mild retinal nerve fiber layer thickening in the left eye and parafoveal hyperreflective changes in both maculae. The patient was diagnosed with maculopathy post Influenza OU and treated with nepafenac eye drops. All findings resolved within fourteen days. Discussion Seasonal influenza affects up to 20% of the global population annually and causes 290,000–650,000 deaths [7,8]. Influenza is primarily a respiratory infection and only occasionally causes ocular complications, indicating that other infectious or inflammatory etiologies should be excluded when eye symptoms occur [9]. Conjunctivitis is most common, but uveitis, retinopathy, neuro-ophthalmic damage, and macular detachment have also been reported, caused by direct viral invasion or immune responses [10]. According to European guidelines, antiviral treatment is indicated mainly in patients with severe or high-risk influenza, and there are no specific recommendations for antiviral therapy based solely on ocular involvement [11]. Non-steroidal anti-inflammatory therapy was used in this case to suppress a presumed post-infectious inflammatory response [12]. Conclusions Influenza may affect both systemic and ocular health, so early recognition, specific diagnosis and appropriate management are essential to prevent long-term sequelae.

Stenozuojantis tenosinovitas, dar vadinamas spragsinčiu pirštu, yra pirštų sausgyslių arba jų dangalų uždegimas, kuris dažniausiai atsiranda ilgą laiką reguliariai atliekant tam tikrus plaštakos judesius: griebiant, gniaužiant, dir­bant kompiuteriu, rašant, grojant klavišiniais instrumen­tais [2]. Svarbūs ir kiti rizikos veiksniai: reumatoidinis artritas, mikrotraumos, infekcija, cukrinis diabetas, poda­gra [3]. Veikiant rizikos veiksniams, sustorėja skaidulinis A1 žiedas, progresuoja sausgyslės trauma ir uždegimas, kol pacientai pradeda skųstis skausmu, atliekant tam ti­krus judesius, judesių ribotumu, piršto strigimu [2]. Ligos diagnostikai dažnai pakanka anamnezės bei klinikinių simptomų įvertinimo. Priklausomai nuo būklės, liga gali būti gydoma konservatyviu arba chirurginiu būdu [6]. Šio darbo tikslas – išanalizuoti ir aptarti stenozuojančio tenosinovito rizikos veiksnius, diagnostikos ypatybes bei gydymo principus.

Išmaniaisiais telefonais naudojasi vis didesnė žmonių populiacija – tiek vaikai, tiek pagyvenusieji. Vis dažniau aprašomi atvejai, kai pacientai atvyksta į gydymo įstaigą dėl laikino regos sutrikimo viena akimi, nurodę, kad prieš tai naudojosi išmaniuoju telefonu. Diagnozuoti išmaniojo telefono sukeltą laikiną aklumą galima iš anamnezės, ta­čiau labai svarbu pacientą, kuris nurodo tokius simpto­mus, ištirti, atmesti kitas monokulinio aklumo priežastis bei pasiūlyti prevencines priemones.

Akių vokai − svarbią funkciją atliekanti sritis − ne tik reguliuoja į akis patenkančios šviesos kiekį, tačiau veikia ir kaip barjeras − saugo akis nuo pažeidimų bei galimos infekcijos. Įvykus vokų traumai, gali atsirasti įvairių simptomų: nepakankamas akies drėkinimas, ašarų drenažo sutrikimai bei paciento netenkinantis estetinis vaizdas [1]. Dėl šių priežasčių būtina tiksli diagnostika ir efektyvus gydymas. Pagrindiniai gydymo principai yra atkurti anatominį struktūrų vientisumą, suteikti kuo labiau pacientą tenkinantį funkcinį bei estetinį rezultatą. Šio tyrimo tikslas − išanalizuoti ir aptarti dažniausiai pasitaikančias viršutinių ir apatinių vokų traumas, jų etiologiją, traumų mechanizmus, diagnostikos ypatybes bei gydymo principus.

Aim To identify and evaluate risk factors of very low birth weight infants who developed NEC. Methods Retrospective single center study of 91 newborns with NEC, who were treated between 2016 and 2021 in Kaunas Clinics. Different risk factors were analyzed. In prospective study all very low birth weight (<1500 g) infants are enrolled and followed up. Patients are divided into two groups: control and the ones who develop NEC during the study. The following biological samples are collected: blood, stool, mother’s milk in order to identify risk markers. Results Retrospectively 91 patients with NEC were included in the study, 73 very low birth weight (VLBW) ˂ 1500 g and 18 > 1500 g. Mortality rate was 30 (41,1%) in VLBW group. Early onset NEC (˂7 days) was diagnosed in group with > 1500 g and late onset NEC (> 7 days) in group with ˂ 1500 g. Chorioamnionitis during pregnancy was more often seen in VLBW group 20(27,4%). No association was found between delivery mode or nutrition. In prospective study, during 7 months period, 30 newborns ˂1500 g were included. The median gestational age was 27,8 week’s, median birth weight – 986,1 g. NEC developed in 4 newborns and 1 was operated. Conclusions Our findings showed that lower gestational age, lower birth weight, infection during pregnancy is associated with NEC. Future prospective studies are planned to better understand the process of this disease.