Side effects of retinoid therapy on the quality of vision.

Retinoids are compounds chemically related to vitamin A, which are frequently used in dermatological practice (1). They are characterized by numerous mechanisms of action leading to normalization of keratinocyte proliferation and maturation. They have anti-seborrhoeic, immunomodulatory and anti-inflammatory effects (1, 2). A number of side effects to retinoid treatment have been recorded; one group of such side effects relates to eyes and vision. Dry eye syndrome and blepharoconjunctivitis are the most common side effects, appearing in 20-50 % of patients treated with retinoids. They often contribute to the occurrence of other side-effects such as eye discomfort and contact lens intolerance. Due to the widespread use in clinical practice, the adverse effects, including ocular side effects, should be studied. To confirm the variety of adverse effects of retinoids, several case reports of rare side-effects are presented.

Environmental risks perception--a study of the awareness of families to threats in areas with increased health disorders in children.

INTRODUCTION: Children are at greater risk than adults to experience adverse effects from environmental agents. Significant neurological damage to children can occur even at very low levels of exposure. Reliable protection of children living in areas with high environmental hazards is not possible without their parent's' understanding of where, how and why children's exposures occur. OBJECTIVES: The aim of the presented study was to indicate families' awareness of environmental risks with increased health disorders in children in the chosen area of the Silesian Province. MATERIALS AND METHODS: Rates of development disorders in general, including physical and psychomotor development disorders, in a population of children from the study area were estimated. A questionnaire was used in order to explore through a door-to-door survey the perceptions of environmental risk in a population of 2,491 residents. RESULTS: The presented study shows that the parents' awareness of environmental health risks is not satisfactory. The majority expressed an opinion that the outdoor environment exerts a major influence upon the state of health, but less than 1% of the parents were aware of the indoor environmental risk. CONCLUSION: The most effective way to prevent children's exposure is to teach the community to identify environmental threats and educate them on how to their protect children. The appropriate policies and programmes should be developed and implemented as this seems to be the most effective and cheapest way to prevent children's exposure to environmental risks.

[Computer modeling the dependences of the membrane potential for polymeric membrane separated non-homogeneous electrolyte solutions on concentration Rayleigh number]. / Modelowanie komputerowe zaleinosci potencjalu membranowego generowanego na membranie polimerowej, rozdzielajacej niejednorodne roztwory elektrolityczne od stezeniowej liczby Rayleigha.

On the basis of model equation describing the membrane potential delta psi(s) on concentration Rayleigh number (R(C)), mechanical pressure difference (deltaP), concentration polarization coefficient (zeta s) and ratio concentration of solutions separated by membrane (Ch/Cl), the characteristics delta psi(s) = f(Rc)(delta P, zeta s, Ch/Cl) for steady values of zeta s, R(C) and Ch/Cl in single-membrane system were calculated. In this system neutral and isotropic polymeric membrane oriented in horizontal plane, the non-homogeneous binary electrolytic solutions of various concentrations were separated. Nonhomogeneity of solutions is results from creations of the concentration boundary layers on both sides of the membrane. Calculations were made for the case where on a one side of the membrane aqueous solution of NaCl at steady concentration 10(-3) mol x l(-1) (Cl) was placed and on the other aqueous solutions of NaCl at concentrations from 10(-3) mol x l(-1) to 2 x 10(-2) mol x l(-1) (Ch). Their densities were greater than NaCl solution's at 10(-3) mol x l(-1). It was shown that membrane potential depends on hydrodynamic state of a complex concentration boundary layer-membrane-concentration boundary layer, what is controlled by deltaP, Ch/Cl, Rc and Zeta(s).

[Arterial hypertension among children and teenagers in the Upper Silesia]. / Nadcisnienie tetnicze u dzieci i mlodziezy w populacji slaskiej.

Nowadays arterial hypertension is more frequently observed among children and teenagers then it used to be earlier. Arterial hypertension and obesity are more and more often the main sources of atherosclerosis. The purpose of this work was to assess the patients with the arterial hypertension treated in the Department of Pediatric Cardiology in Katowice in 2003. Patients' age, family history of hypertension, family background and parents' education were taken into consideration. Birth weight, BMI factor, all the sufferings reported by patients, blood pressure measurements results, ABPM, EKG parameters, ECHO+ Doppler parameters, exercise test results, fundus of the eye examination, laboratory investigation results, were also analyzed. Our results show that a positive family history is a very important factor in the development of arterial hypertension among children (44.7%). In our patients' cases the most frequent clinical symptoms are tachycardia (68%) and obesity (59.2%). In conclusion, children and teenagers with hypertension should be successfully treated and those with positive family history of hypertension should be taken under primary prevention in order to decrease the risk of cardiovascular complications.

[Vasovagal syncope--diagnostic difficulties in adolescents]. / Omdlenia wazowagalne--trudnosci diagnostyczne u mlodziezy.

Consciousness disturbances in adolescents may be caused by different reasons. Among them, cardiologic and neurological backgrounds should be considered. The most important diagnostic tests the vasovagal syncopes are: tilt-table test, brain oxygenation measurement, routine and extended elektroencephalography. Performing of these examinations simultaneously may help in determining cause of symptoms. Our patient serves us as an example.

[Characteristics of psychological factors participating in the etiopathogenesis of primary arterial hypertension of children and adolescents]. / Rola czynników psychologicznych w etiopatogenezie pierwotnego nadcisnienia tetniczego u dzieci i mlodziezy.

The article presents summary of psychological examination of patients with the primary arterial hypertension disease who where hospitalized in the Department of Pediatric Cardiology of Silesian Medical University in Katowice. All results were analyzed in comparison with actual literature related to discussed problem--participation of psychosocial factors in the development of arterial hypertension. Psychological tests were performed for 60 patients between 9 and 18 years old. Selected group was analyzed on the following agents: sociodemographic data, intra-familial relations, level ofneuroticism, alexithymia, external and internal irritation, Behavioral pattern "A", learning achievements and data related to selected elements of lifestyle. The choice of above variables comes from their importance of illness' etiopathogenesis in literature. Achieved results proved theoretical expectations about selected group specification. They also showed the necessity of taking primary arterial hypertension referring to children and adolescents in psychosocial context of diagnostic and therapeutic assumptions.

Tilt table testing in obesity.

INTRODUCTION: An imbalance between the sympathetic and parasympathetic nervous systems has been indicated in obesity. The aim of the present study was to evaluate the results of tilt table testing (TT) in obese patients. METHODS: 59 patients with simple obesity (F/M: 50/9; BMI: 36.9+/-3.9 kg/m(2)), and 19 healthy subjects of the control group (F/M: 16/3; BMI: 24.7+/-4.3 kg/m(2)) were examined. Additionally, TT was carried out in 11 patients from the obese group after a 3-month weight reduction treatment. We evaluated HR (heart rate), SBP (systolic blood pressure), DBP (diastolic blood pressure): values at rest, post-inclination values (HRt-1, SBPt-1, DBPt-1), differences between the maximum and minimum values as obtained on TT (HRt-range, SBPt-range, DBPt-range), and % differences of HR (%HRt-increase, %HRt-decrease, %HRt-range). RESULTS: A positive TT response was observed in 10 obese patients, and in none of the controls. Higher differences of HR values were observed in the obese (P<0.05) in comparison to control group. Patients with a positive TT response presented a significant increase in HRt-1, HRt-range, and %HRt-range when compared to negative TT and controls (P<0.02). A 3-month weight reduction treatment resulted in a decrease in HR at rest, and decrease in SBP and DBP-both rest values and values after table-inclination. CONCLUSIONS: A positive TT response is observed more often in patients with simple obesity. HR reaction to tilting varies between the patients and controls. A 3-month weight reduction treatment influences the cardiovascular response to tilting. Our results seem to support the hypothesis of autonomic imbalance in obesity.

[Diagnostic problems in recognizing structural pathology of the heart during the prenatal period]. / Rozpoznawanie patologii strukturalnych serca w okresie prenatalnym--problemy diagnostyczne.

The aim of our study was to analyse the results of echocardiographic examinations of 28 fetuses with structural heart abnormalities referred for echocardiographic examination from January 1996 to May 2001 along with their follow-up. Fetal heart anomalies were diagnosed in 2.1% of all of the examined fetuses (28/1319). Among 28 cases of structural anomalies, there were 23 cases of heart defects, 4 cases of cardiomyopathy, and one case of intracardiac tumors. In 5 cases, heart defects were accompanied by arrhythmias while in 2 cases, heart defects were accompanied by congestive heart failure. Extracardiac malformations coexisted with heart defects in 11 fetuses. Eight newborns were operated shortly after birth. The mortality rate in the examined group was 64%.

Arterial hypertension in children treated at the Katowice Department of Pediatric Cardiology between 1993-2000.

In the literature, one can find a common opinion that 1-3% of the children population suffers from arterial hypertension. This rate depends on the diagnostic criterion and the studied population (age, sex, race etc.). The aim of this work was to present a rather large group (271 patients) treated for hypertension in our centre between 1993-2000. The ranged children from newborns to 18 year olds (mean = 13.75 +/- 4.5 years). In the study period, there is approximately a four fold annual increase in the number of hypertensive patients among all patients of the pediatric cardiology units. On the basis of our material, the rate of arterial hypertension depends on the age of the pediatric patients with as many as 3/4 of the children being teenagers > or = 14 years old. In the teenager group, all cases of essential hypertension were observed. Almost 70% of the studied children were boys. In about half the studied group, hypertensive changes on the eye fundus were found. One can suspect that automatic 24-hour measurement of arterial hypertension (so called "tension Holter") is of great value in children. A number of individual measurements exceeding the norm during "tension Holter" correlated with eye fundus vessel changes. In conclusion more attention should be paid to arterial hypertension in children. For example, in our previous paper published in 2000 it was stated that among 2.3% of "healthy" school children who suffered from arterial hypertension, non of these children were suspected of suffering from arterial hypertension.