Atopic Dermatitis and Comorbidity

Atopic dermatitis is the most common chronic inflammatory skin disease. It is often the first indicator of allergic diseases, and a certain percentage of patients are affected by allergic rhinitis and/or asthma as a consequence. The study aimed to investigate the link between atopic dermatitis and comorbidity in family medicine. In the specialist family medicine practice Osijek, a retrospective study was conducted in the period from January 1, 2016 to July 1, 2017 on the percentage of patients with atopic dermatitis in the total number of patients, and their comorbid diseases. The data source was the E-chart. The results showed that 195 (10.53%) out of 2056 patients had atopic dermatitis, 80 (41%) patients had atopic dermatitis and allergic rhinitis, 34 (17.4%) asthma, 132 (67.7%) infections, 59 (30.3%) gastrointestinal disturbances, and 68 (34.3%) had mental disorders. Patients up to 18 years old were more likely to have infections, and adult patients were exposed to chronic stress. The most commonly used drug was loratadine (60.5%), while mometasone was the most commonly administered topical drug (40%). The result of this research showed the steps of the ˝atopic march˝. Atopic dermatitis is followed by changes in the skin and its progression to other organ systems in most of the patients.

Nodular lymphoid hyperplasia complicated with ileal Burkitt's lymphoma in an adult patient with selective IgA deficiency

•

Burkitt's lymphoma in adults can occur on the basis of nodular lymphoid hyperplasia.

•

Nodular lymphoid hyperplasia is associated with selective IgA deficiency.

•

Nodular lymphoid hyperplasia associates IgA deficiency with Burkitt's lymphoma.

Introduction

Primary lymphomas of the small intestine are rare. Burkitt's lymphoma (BL) occurs sporadically in adults. Nodular lymphoid hyperplasia (NLH) is a rare disorder characterized by diffuse nodular lesions, which represent hyperplastic lymphoid follicles, and it is often associated with immunodeficiency syndromes.

Presentation of case

We present a 38-year-old male patient in a state of surgical emergency, suspected of Crohn’s disease, who had an unusual combination of NLH and BL of the proximal ileum. Furthermore, retrospectively analyzed documentation revealed selective IgA deficiency.

Discussion

Association between NLH and intestinal lymphomas in patients with immunodeficiency syndromes was indicated before. This case report supports the notion on NLH as a transition state between immunodeficiency and intestinal lymphomas.

Conclusion

This is one of the first case reports which presents the combination of NHL and BL. The awareness of the existence of this rare combination, especially in young adult males, can improve the diagnostic accuracy and the treatment management.

A coincidence of HLA-B27 negative spondyloarthritis and paravertebral non-Hodgkin's lymphoma--a lesson to be learnt from the past experience

We reported a case of a 71-year-old woman with progressive low back pain and neurologic symptoms of lower extremities, who in the background had the coexistence of spondyloarthritis (SpA) and non Hodgkin's lymphoma of the paravertebral location. This example describes a situation where SpA with minimal sacroiliac joints affection has nevertheless led to the overt axial SpA. This situation included undifferentiated or reactive SpA, as well as unusual disease context, presented with late-life disease onset, older age, female gender and no obvious hereditary predisposition. This combination of comorbid factors could allow environmental and disease-specific factors to accumulate over time and to, by modifying the primary, low-penetrant genetic background, lead to the development of lymphoma. By achieving better understanding of disease pathophysiology dynamic, we will be able to improve our capabilities to navigate biologic therapy in the future, in order to prevent the development of both, overt SpA and lymphoproliferative disease.

Knowledge discovery of drug data on the example of adverse reaction prediction

BACKGROUND

Antibiotics are the widely prescribed drugs for children and most likely to be related with adverse reactions. Record on adverse reactions and allergies from antibiotics considerably affect the prescription choices. We consider this a biomedical decision-making problem and explore hidden knowledge in survey results on data extracted from a big data pool of health records of children, from the Health Center of Osijek, Eastern Croatia.

RESULTS

We applied and evaluated a k-means algorithm to the dataset to generate some clusters which have similar features. Our results highlight that some type of antibiotics form different clusters, which insight is most helpful for the clinician to support better decision-making.

CONCLUSIONS

Medical professionals can investigate the clusters which our study revealed, thus gaining useful knowledge and insight into this data for their clinical studies.

Incidence and prevalence of inflammatory bowel disease in Vukovarsko-Srijemska County, Croatia, 1991-2000 and 2001-2010: a population-based study

Inflammatory bowel diseases (IBD), Crohn's disease (CD) and ulcerative colitis (UC), were retrospectively assessed on the incidence and prevalence in Vukovarsko-Srijemska County, continental Croatia. There were a total number of 150 patients, 119 with UC and 31 with CD. Of them, 79.3% were patients with UC, indicating a predominant participation of UC in the sample. Comparisons between the period of surveillance, 2001-2010, and the decade before, 1991-2000, showed a significant increase in the incidence rates of both, UC and CD (UC 3.5, CD 0.95, 2001-2010, and UC 1.0, CD 0.45, 1991-2000). Comparison of this study with that performed in Primorsko-Goranska County, coastal Croatia, revealed different distribution patterns of IBD. In Primorsko-Goranska County, significantly higher incidence and prevalence rates of UC and CD and rather equal ratios between two diseases, were observed. The results are indicative of the differences between more developed Western and less developed Eastern parts of Croatia.

Epidemiology and clinical presentation of inflammatory bowel disease in Zadar County, Croatia

Results of the retrospective, population-based study, 2000-2010, on inflammatory bowel disease, ulceratice colitis (UC) and Crohn's disease (CD), from Zadar County, have been presented and compared with world experience and comparative data from Primorsko-Goranska and Vukovarsko-Srijemska Counties. The average incidence rates (per 100 000) were 8.2 and 8.4, for UC and CD, respectively. Prevalence rates, at the end of the follow up, were 133.9 for UC and 111 for CD. Constant increase in the incidence rates for both, UC and CD, have been recorded, for CD more prominently in the second part of the follow up, 2006-2010. Prevalence rates have being continuosly rased for both diseases, data for UC exceeding that for CD. Results of data comparison among the counties contribute in favour to the hypothesis of Zadar County as a rapidly developing area and strongly argue against the existence of the North-South gradient between Vukovarsko-Srijemska and Zadar Counties.

Clinical expression of inflammatory bowel diseases--a retrospective population-based cohort study; Vukovarsko-Srijemska County, Croatia, 2010

Clinical characteristics of the cohort of 150 patients with inflammatory bowel diseases, ulcerative colitis (UC) and Crohn's disease (CD), Vukovarsko-Srijemska County, Croatia, were retrospectively assessed. UC was clinically presented with frequent passage of bloody, slimy stools, while preferential symptoms of CD were fever, anemia and severe weight loss, differences reflecting longer duration of symptoms prior to the diagnosis, in patients with CD. The prevalent disease localisations, in patients with UC, were the rectum and the left colon and the anorectum, while the prevailing phenotype, in patients with CD, corresponded with younger adult age at disease onset, ileocolonic localization and stricturing disease behavior Intestinal complications, including perforation, fistula, abscess and ileus, were more prevalent in patients with CD. Of extraintestinal complications, only ankylosing spondylitis and erythema nodosum, reached marginally significant differences, in favor to patients with CD. Shortcomings of this study include the lack of associations and the time-dependent disease projections.