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Presents a letter to the editor on chronic cutaneous lupus erythematosus.

Possible early side-effects of retinoid treatment on bones were studied with the aid of bone-scintigraphy. Isotretinoin treatment (1.0 mg/kg daily for 4 months) was given to 18 patients with acne. Fifteen patients with psoriasis received etretinate treatment (0.7–1.0 mg/kg/day) for 4 months. In the group treated with isotretinoin, pathological uptake of radiolabel was found in three cases, while in the group treated with etretinate, no bone changes attributable to treatment were found. During isotretinoin treatment, a decrease in growth-plate activity was observed. Bone-scintigraphy is considered to be a suitable method for early screening for bone changes occurring in retinoid treatment. [ABSTRACT FROM AUTHOR]

Background: In the management of chronic diseases, treatment approaches have changed in recent decades. Not only are clinical outcomes assessed but also the patients' perception of their quality of life has become an important aspect., Objectives: The aim of our study was to compare the health-related quality of life (HRQoL) of children with cystic fibrosis (CF) to the HRQoL of asthmatic patients, to assess the level of agreement between parent proxy-report and child self-report and to measure the relationship between spirometry and HRQoL., Material and Methods: 172 children (mean age: 11.61±2.56 years) and their parents completed the questionnaire. The Hungarian version of the Pediatric Quality of Life InventoryTM 4.0 (PedsQLTM 4.0) Generic Core Scale was used to assess HRQoL. Lung function was assessed via spirometry., Results: Significantly lower PedsQLTM scores were measured for CF patients on the psychosocial health (p<0.05), emotional functioning (p<0.005) and school functioning (p<0.01) subscales and the total scale (p<0.05) from the children's self-report. The level of child-parent agreement was fair and moderate in both patient populations [intra-class correlation coefficient range (ICC) asthma=0.29-0.37; ICCCF=0.39-0.59, p<0.001]. The relationship between forced expiratory volume in 1 second (FEV1) and the physical health subscale (r=0.49, p<0.01) was moderate in young (8-12 years) children and also teenagers (13-18 years), with CF (r=0.58, p<0.05) from self-report. We found weak, non-significant correlations between FEV1 and PedsQLTM subscales in children with asthma (8-12 years) (r=-0.01-0.18, ns.)., Conclusions: Children suffering from CF perceive their HRQoL as poorer than children with asthma. In asthmatic patients, it is not sufficient to evaluate clinical outcomes (FEV1); subjective HRQoL should be also estimated in the course of patient care.

Background: A decreased level of vascular endothelial growth factor (VEGF) was previously described in bronchoalveolar lavage fluid (BALF) of adults with interstitial lung diseases (ILD) due to bronchial epithelial cell apoptosis and its proteolytic degradation. Elevated intrapulmonary ferritin was produced by alveolar cells that promoted oxidative injury in such patients., Objectives: In this study, we analyzed the concentrations of VEGF and ferritin in BALF samples of ILD children and studied the relationship between their levels and the degree of inflammation., Methods: BALF and serum concentration of VEGF as well as ferritin and albumin in BALF samples were measured using enzyme-linked immunosorbent assay in children with idiopathic interstitial pneumonia (n = 16), hypersensitivity pneumonitis (n = 11) and idiopathic pulmonary hemosiderosis (n = 3). Twenty-four age- and gender-matched subjects with suspicious foreign body aspiration served as a control group., Results: VEGF per albumin levels in BALF were significantly decreased in ILD children compared to controls (1,075 [784-1,415] pg/mg albumin vs. 2,741 [1,131-4,660] pg/mg albumin, p = 0.0008). These values showed a significant negative correlation with inflammatory markers of total immune cell count in BALF (r = -0.411, p = 0.002) and serum C-reactive protein (r = -0.367, p = 0.006). Although serum VEGF was augmented in ILD children versus controls, no difference was observed among the ILD groups. In addition, BALF ferritin/albumin level (688 [188-1,571] ng/mg albumin vs. 256 [178-350] ng/mg albumin, p = 0.022) was significantly higher than normal in ILD individuals, especially in idiopathic pulmonary hemosiderosis., Conclusion: Depressed VEGF and increased ferritin in BALF may reflect the severity of chronic pulmonary inflammation in altered respiratory epithelium of childhood ILD., (© 2015 S. Karger AG, Basel.)

Fabrication of a complete mandibular denture that offers patient comfort, function, and aesthetics along with stability and acceptable retention remains one of the most challenging procedures in dental practice. Based on a thorough treatment planning and a successful surgical procedure implants have been shown to be reliable abutment for both retention and support of overdentures. During planning important relevant factors must be considered such as old age, systemic diseases, increased financial capability, etc. Implants retained overdentures can be divided into three groups according to the type of support: mucosal, muco-implantal and implantal. Key factors concerning the planning of prosthetic rehabilitation are the number and length of the implants, together with the quality and quantity of the anchoring bone tissue.

Introduction: Cystic fibrosis is a progressive multisystemic disease which affects the quality of life of patients., Aim: The aim of the study was to evaluate quality of life in Hungarian patients with cystic fibrosis., Methods: Validated Hungarian translation of The Cystic Fibrosis Questionnaire - Revised was used to measure quality of life. Clinical severity was determined on the basis of Shwachman-Kulczycki score. Lung function was measured using spirometry., Results: 59 patients were included from five centres in Hungary. The relationships between 8-13 year-old children self-report and parent proxy report was 0.77 (p<0.001) in physical functioning, 0.07 (p<0.001) in emotional functioning, 0.51 (p<0.001) in eating, 0.21 (p<0.001) in treatment burden, 0.54 (p<0.001) in body image, 0.49 (p<0.001) in respiratory symptoms and 0.40 (p<0.001) in digestive symptoms domains., Conclusions: In contrast to physical domains weak correlations were observed between answers obtained from children and their parents in psychosocial domains. The perception of both patients and their parents should be assessed when measuring quality of life in paediatric patients with cystic fibrosis.

Incidence and prevalence of tuberculosis (TB) shows a decreasing tendency in Hungary. The medical care of these patients represents a substantial cost to the health services. We assessed the direct costs of paediatric patients with TB in a Hungarian hospital. Patients participating in the study were 9 children, with an average age of 11.17 +/- 6.34 years. In the study group there were two immigrant patients (22, 23%), two (22, 23%) had multidrug-resistant TB (MDR-TB), five patients (62.5%) were contacts, six (66, 67%) had extrapulmonary tuberculosis and three (33, 34% suffered from other co-morbidities. The average direct cost of pulmonary TB was 2920 Euros, direct cost of MDR-TB was between 7300-9120 Euros. MDR-TB increases one and half times the period spent in hospital, two and half times the cost of inpatient care. Extrapulmonary TB with concomitant disease causes 3-7 times higher expenditures to the health service. According to our results we found significant differences between the cost of actual therapy and resources available; thus the compensation needs to be solved.

The authors describe the prosthodontic rehabilitation of an adult patient with unilateral cleft lip and palate. After the surgical and orthodontic treatment of cleft lip and palate patients the prosthodontic treatment was started to correct the palatal defect, the malocclusion and the missing teeth. The authors emphasize on preliminary steps by using diagnostic casts and try-in dentures and they also suggest other directives in the dental management of cleft lip and palate patients.

In 1993 the Vigano attachment appeared in Hungarian commercial turnover. On the basis of 20 cases observed during one year it can be stated, that the use is simple for dental technicians, the fitting effect is good, requires small place, insertion and removal is easy for elderly and handicapped patients; it is aesthetically satisfying and the design ensures minimum likelihood of repairs.

The authors have examined a precision attachment recently invented in Hungary. They are reporting about the experience gained during clinical examination of dentures made in different classes on the basis of the Fábián and Fejérdy classification of partial edentulousness.

Fourteen male patients suffering from severe psoriasis were treated with 30 to 50 mg/day acitretin during 12 weeks. At the end of the treatment, 6 patients were in remission and 7 showed a marked improvement of the disease. One patient did not show any change. All patients experienced the usual retinoid side effects.

We report on 20 patients suffering from malignant melanoma, who had undergone regional lymph node dissection. In order to make certain that all the lymph nodes had been completely removed, we performed lymphoscintigraphy 3 to 6 weeks after block dissection with the help of a radiopharmacon intercostally or interdigitally applied. We judged the removal to be complete, if neither intercostal nor interdigital application led to any evidence of regional lymph nodes. On the basis of our experiences so far, we consider postoperative lymphoscintigraphy a suitable non-invasive method to check the completeness of block dissection.

Completeness of regional lymph node dissection was controlled in 23 patients with melanoma malignum. For that purpose 3--6 weeks after block-dissection lymph node scintigraphy was performed, by administration of intercostal and interdigital radiopharmacutical. Blockdissection was considered as complete, when neither after intercostal, nor after interdigital administration, any lymph nodes were delineated. On the basis of investigations until now, postoperative lymph node scintigraphy proves to be suitable, held to be a non-invasive method for controlling completeness of blockdissection.