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Purpose: To evaluate the efficacy and safety of Nd:YAG laser hyaloidotomy in the treatment of premacular subhyaloid haemorrhage (SHH) Material and Methods: The study analyzed the medical records of 37 patients who underwent Nd:YAG hyaloidotomy for premacular SHH between 2014 and 2022. Patients were evaluated based on age, gender, etiology, symptom duration, visual acuity, laser energy, number of shots, complications, and need for additional procedures. The main success criteria were drainage and absorption of SHH, increased visual acuity, need for additional procedures, and post-procedural complications. Results: A study of 37 patients with 39 eyes, with a mean age of 52.03 ± 20.51 years and symptom duration of 10.51 ± 7.43 days, found common etiologies such as proliferative diabetic retinopathy, retinal vein occlusion, retinopathy of valsalva, leukemia, retinal macroaneurysm, hypertensive crisis, choroidal neovascular membrane, and Terson syndrome. The mean laser energy performed was 7.38 ± 2.08 mJ, and the mean number of shots was 4.28 ± 1.87. Nd:YAG laser hyaloidotomy was successful in 87.17% of cases but failed in 2 patients with proliferative diabetic retinopathy, one patient with Terson syndrome, and one patient with leukemia. Visual acuity improved significantly in the 6th month. Conclusion: Nd:YAG laser hyaloidotomy is a cheap, effective, safe, and noninvasive treatment method for the treatment of premacular SHH. It prevents the need for invasive vitreoretinal surgery and its complications. Visual prognosis depends on the etiology of SHH and associated macular changes. [ABSTRACT FROM AUTHOR]

The article describes a rare case of adenovirus infection complicated by diffuse alveolar hemorrhage in a 29 y.o. immunocompetent patient which developed during a trip to Sri Lanka. The course of the disease was accompanied by severe anemia and respiratory insufficiency, etiology of the disease was confirmed by polymerase chain reaction of pharyngeal swabs and sputum sample. After successful supportive treatment, the patient was discharged on the 13th day of hospital stay to continue treatment in the out-patient settings. This case demonstrates the possibility of severe complications in case of adenovirus infection.

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Introduction The term ‘subarachnoid haemorrhage’ (SAH) stands for bleeding into the subarachnoid space, regardless of its source. It may be of primary character when the source of bleeding is situated within the subarachnoid space. Subarachnoid haemorrhage is often described as spontaneous bleeding, mainly in order to differentiate it from post-traumatic bleeding. Objective The aim of the study was to evaluate the concentration of ICAM-1 and VCAM-1 in the blood of patients in the early phase following subarachnoid haemorrhage in terms of searching for markers useful in subarachnoid bleeding diagnostics and monitoring a patient’s clinical state. Material and Methods The study comprised 85 patients (47 women, 38 men), aged 29–81 (average 53±12 years), suffering from subarachnoid haemorrhage. The control group comprised 45 healthy people selected according to gender and age corresponding with the experimental group. Results The study revealed that the concentration of ICAM-1 and VCAM-1 was significantly higher in patients suffering from subarachnoid haemorrhage. Additionally, the concentration of fibrinogen decreased, aPTT was shorter and the concentration of D-dimers increased. The studied parameters did not differ with respect to the age or gender of the patients. It was stated that according to the Hunt and Hess scale, the concentration of ICAM-1 was considerably higher in the group of patients in the most severe neurological state, compared to other patients. It was also observed that the concentration of fibrinogen was significantly higher, aPTT was shorter, and the concentration of D-dimers increased in the afore-mentioned group. Conclusions Evaluation of the concentration of adhesion molecules, as well as values of global tests concerning the coagulation system, may serve as a useful diagnostic tool for SAH.

Introduction. The term ‘subarachnoid haemorrhage’ (SAH) stands for bleeding into the subarachnoid space, regardless of its source. It may be of primary character when the source of bleeding is situated within the subarachnoid space. Subarachnoid haemorrhage is often described as spontaneous bleeding, mainly in order to differentiate it from post-traumatic bleeding. Objective. The aim of the study was to evaluate the concentration of ICAM-1 and VCAM-1 in the blood of patients in the early phase following subarachnoid haemorrhage in terms of searching for markers useful in subarachnoid bleeding diagnostics and monitoring a patient’s clinical state. Materials and method. The study comprised 85 patients (47 women, 38 men), aged 29–81 (average 53±12 years), suffering from subarachnoid haemorrhage. The control group comprised 45 healthy people selected according to gender and age corresponding with the experimental group. Results. The study revealed that the concentration of ICAM-1 and VCAM-1 was significantly higher in patients suffering from subarachnoid haemorrhage. Additionally, the concentration of fibrinogen decreased, aPTT was shorter and the concentration of D-dimers increased. The studied parameters did not differ with respect to the age or gender of the patients. It was stated that according to the Hunt and Hess scale, the concentration of ICAM-1 was considerably higher in the group of patients in the most severe neurological state, compared to other patients. It was also observed that the concentration of fibrinogen was significantly higher, aPTT was shorter, and the concentration of D-dimers increased in the afore-mentioned group. Conclusions. Evaluation of the concentration of adhesion molecules, as well as values of global tests concerning the coagulation system, may serve as a useful diagnostic tool for SAH. [ABSTRACT FROM AUTHOR]

Diffuse alveolar haemorrhage (DAH) is a rare life-threatening complication of systemic lupus erythematosus (SLE), associated with high mortality rates. It usually occurs in patients with an established diagnosis of SLE. It has been reported as the initial presentation of SLE in 11-20% of cases. It occurs most frequently in females. We describe the case of a child, aged 14 years, with fever, asthenia, haemoptysis, dyspnea, anaemia, increased inflammatory markers, positivity to ANA, nDNA, direct Coombs tests, anticardiolipin antibodies and complement factors consumption. Computed tomography (CTscan) of the chest showed bilateral pulmonary alveolar infiltrates. He also developed renal involvement with nephritis later in the course of the disease. He was started on the treatment approved by the Euro Lupus Protocol for critical patients. After starting Mycophenolate Mofetil the clinical and radiological features were improved as was the survival outcome.

Hemophilia A is an inherited, X-linked, recessive disorder caused by deficiency of clotting factor VIII. Intracranial hemorrhage is the leading cause of morbidity and mortality in these patients. Use of factor replacement products and medications had improved outcome in these patients. But in developing countries many such patients are not able to afford factor replacement products. We report a case of traumatic intracerebellar hemorrage in a hemophilia child. This child presented to us as a case of sub-acute intracerebellar hemorrage, he was managed conservatively with six units of fresh frozen plasma transfusion. He improved clinically and on follow-up investigation hematoma was found to have dissolved spontaneously. Through this report we want to emphasize that those cases of hemophilia presenting with acute or sub-acute intracranial bleed, conservative approach through procoagulant transfusion and intravenous fibrinolysis inhibitors should be tried as first line of management. Before daring for surgery sufficient amount of factor replacement should be kept available.

Objective: Subarachnoid haemorrhage is responsible to a great extend for the death rate of patients who are hospitalised in intensive care units (ICU) with haemorrhage. The early detection of its severity plays an important role for the resulting health of the patients. Neurohormone Copeptin is the C-end of pro-arginine vasopressin in plasma has been used as a prognostic marker in a number of various illnesses (acute myocardial infarction, heart and renal failure, acute dyspnoea, intracerebral and subarachnoid haemorrhage, ischaemic stroke, liver cirrhosis, acute pancreatitis). However, its prognostic value in subarachnoid haemorrhage has yet to be valued. The aim of our study was to evaluate copeptin plasma values of patients with subarachnoid haemorrhage hospitalised in the ICU, as a prognostic factor for the severity of this disease., Patients and Methods: We studied 32 patients, 21 male, 11 female, (average age 59±7 years), who were hospitalised in the ICU of Univ. Hospital of Alexandroupolis. Plasma Copeptin values were measured in the Nuclear Medicine Laboratory, with the Radioimmunoassay (RIA) method. The appropriate kit, from Phoenix Pharmaceuticals Inc. (USA), was used., Statistical Analysis: The x(2) student test was used for statistical analysis., Results: The cut-off value of copeptin ranged between 0.4-4.4 pmol/L. 19 patients showed gradual increase of copeptin values, (125-578 pmol/L), with a bad prognosis of the illness (P<0.005). Four of them with extremely high copeptin values died. Decrease of copeptin values for the rest 15 patients were correlated with the improvement of their clinical condition (P<0.005). Eleven patients appeared to have high values, followed by the gradual decrease by a range of 85-12pmol/L, and had a good prognosis of the condition. Two patients with normal values demonstrated to have a good clinical condition., Conclusion: Patients with a gradual increase of copeptin values showed to have bad prognosis of the disease. Four with extremely high copeptin values passed away, while patients with a gradual decrease or a normal amount of copeptin values had good prognosis. It is supported that copeptin values are a reliable prognostic factor in monitoring patients with intracranial haemorrhage.

Introduction: Placental anatomopathologic lesions are usually associated with pregnancy complications and neonatal impaired outcome., Patients and Methods: We included in our study 122 patients with gestational age of 26-35 weeks. From the analysis of three pathological aspects (chorioamnionitis, funisitis and chronic hypoxia), a score was assigned to each lesion depending on the severity of the alteration, to establish a correlation with an impaired neonatal outcome in preterm newborns., Results: We found a correlation between chronic hypoxia and preeclampsia, intrauterine growth restriction and/or small-for-gestational age status at birth. Our results also showed the strong association of fetal placental inflammatory status (chorioamnionitis and funisitis) with premature rupture of membranes, very low birth weight, birth at/before 32 gestational weeks, late-onset sepsis, patent duct arteriosus, intraventricular haemorrhage (IVH) and retinopathy of prematurity (ROP)., Conclusions: We confirm that placental lesions are associated with impaired pregnancy and neonatal outcome. During pregnancy it may be useful to identify some markers of inflammatory status and chronic hypoxia for an early diagnosis and a detailed monitoring of pregnancy course. Placental pathological analysis is very important to predict the risk of developing serious complications of preterm birth as ROP and IVH.