Leber hereditary optic neuropathy (LHON) is a mitochondrial disease leading to optic atrophy due to degeneration of the retinal ganglion cell. A curative treatment is not available at the moment, but a new antioxidant drug, Idebenone, is expected to reduce the progression of the disorder. Two male patients, genetically confirmed with LHON, were clinically, morphologically, and electrophysiologically evaluated, before and three, six, nine and 12 months after starting the treatment. The patient with 3460G>A mutation in mitochondrially-encoded nicotinamide adenine dinucleotide, reduced form (NADH):ubiquinone oxidoreductase core subunit (mtND)1 gene showed an improvement in visual acuity, visual field, and visual evoked potentials with no effect on morphological examinations, while the patient with 11778G>A mutation in mtND4 gene showed no functional, nor morphological recovery after one year of treatment. This study demonstrates that Idebenone, depending on the genetic profile of the disease, may be effective in functional improvement in patients with LHON.
Uveal malignant melanoma is a rare malignant tumor comprising less than 5% of melanoma cases. It is nevertheless the intraocular tumor with the highest incidence in adults, that arises from the melanocytes in the uveal tract. The authors present the case of a patient with locally advanced choroidal melanoma: from presentation to diagnosis, treatment, and prognosis. A 63-year-old female patient presented in the Ambulatory of the Emergency County Hospital, Craiova, Romania, on the February 1, 2021, accusing visual acuity drop and photophobia in her left eye for about three weeks. Pathology examination in Hematoxylin-Eosin (HE) staining reveals a dense cell proliferation, with small and medium spindle cells and pigment production. The following immunohistochemical markers were used in our study: human melanoma black 45 (HMB45), Ki67, cyclin D1, B-cell lymphoma 2 (Bcl2), S100, Wilms' tumor 1 (WT1), p16, and p53. Uveal melanoma is a malignant tumor that can arise in all the uveal components: iris, ciliary body, and choroid. Out of the three components, iris melanomas have the best prognosis, while ciliary body melanomas have the worst prognosis. It is mandatory for the patient to respect the follow-up schedule, as follow-ups can provide early diagnosis of eventual metastasis.
The aim of our study was to assess the factors that influence the level of glycated hemoglobin in children and adolescents with type 1 diabetes (T1D). This study included 122 children and adolescents suffering from T1D who were in the evidence of the First Pediatric Clinic of the Clinical Emergency County Hospital of Craiova between 2003 and 2017. If HbA1c was less than 7.50%, we included patients in the glycemic equilibrium group, and if HbA1c was greater than 7.50%, we considered patients as suffering from unbalanced diabetes. By correlating the glycosylated hemoglobin level with the different parameters used in the study, we observed large/strong positive correlations between HbA1c and duration of diabetes mellitus and also between HbA1c and patient age, HbA1c negative correlation between physical activity, medium/moderate positive correlations between HbA1c and body mass index, weight of the patients and daily insulin dose and the height of the patients included in the study did not show significant correlations. Child and adolescent diabetes management has major adult differences in both insulin and drug treatment, in general, but especially in the need of understanding, counseling and integration specific to these ages.
The aim of our study was to evaluate the clinicopathological features in infants and young children with cow�s milk protein allergy. Cow�s milk protein allergy (CMPA) is one of the most common food allergy in children. Thus, we conducted a descriptive observational study, which was carried out in the First Pediatric Clinic of the Craiova County Emergency Clinical Hospital, in the period 2015-2017, which included 138 infants and young children diagnosed with cow�s milk protein allergy. An improvement in digestive symptomatology during the status period of the disease was observed, especially in what diarrheal stools are concerned as their incidence has decreased. In fact, gastroesophageal reflux is the most common manifestation in infants and children with CMPA, while mean acute otitis is present only in a small number of patients. In conclusion we can say that a good knowledge of the clinicopathological features in children with allergy to cow�s milk proteins allows a superior therapeutic attitude and ensures a normal life for children and infants suffering from this type of allergy.
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