RESUMEN
Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in children and uveitis is its most important extra-articular manifestation. Evidence-based recommendations are available only to a limited extent and therefore JIA associated uveitis management is mostly based on physicians experience. Consequently, treatment practices differ widely, both nationally and internationally. Therefore, an effort to optimize and publish recommendations for the care of children and young adults with rheumatic diseases was launched in 2012 as part of the international project SHARE (Single Hub and Access Point for Pediatric Rheumatology in Europe) to facilitate clinical practice for paediatricians and (paediatric) rheumatologists. The aim of this work was to translate published international SHARE recommendations for the diagnosis and treatment of JIA associated uveitis and to adapt them for use in the Czech and Slovak Republics. International recommendations were developed according to the standard methodology of the European League against Rheumatism (EULAR) by a group of nine experienced paediatric rheumatologists and three experts in ophthalmology. It was based on a systematic literature review and evaluated in the form of an online survey and subsequently discussed using a nominal group technique. Recommendations were accepted if > 80% agreement was reached (including all three ophthalmologists). A total of 22 SHARE recommendations were accepted: 3 on diagnosis, 5 on disease activity assessment, 12 on treatment and 2 on future recommendations. Translation of the original text was updated and modified with data specific to the czech and slovak health care systems and supplemented with a proposal for a protocol of ophthalmological dispensarization of paediatric JIA patients and a treatment algorithm for JIA associated uveitis. Conclusion: The aim of the SHARE initiative is to improve and standardize care for paediatric patients with rheumatic diseases across Europe. Therefore, recommendations for the diagnosis and treatment of JIA-associated uveitis have been formulated based on the evidence and agreement of leading European experts in this field.
Asunto(s)
Artritis Juvenil , Uveítis , Artritis Juvenil/complicaciones , Artritis Juvenil/diagnóstico , Artritis Juvenil/terapia , Niño , República Checa/epidemiología , Europa (Continente) , Humanos , Eslovaquia/epidemiología , Uveítis/diagnóstico , Uveítis/epidemiología , Uveítis/etiología , Adulto JovenRESUMEN
Case report l4-year-old girl with bacterial meningitis. Neuroinfection started after late-treated vestibular inflammation, caused by Streptococcus pneumoniae. Clinical manifestation was complicated with thrombosis of arteria carotis interna in the left side. Neurologic topic symptomatology fell back. It was due by transformed communications by arteria communicans anterior from opposite site.
Asunto(s)
Trombosis de las Arterias Carótidas/complicaciones , Meningitis Neumocócica/complicaciones , Adolescente , Arteria Carótida Interna , Femenino , HumanosRESUMEN
Listeria species are Gram-positive bacilli, present in food and in the environment (soil, water). Most of them are fortunately low-virulent, so there is no risk for healthy people. However, in special circumstances, they can be pathogenic, in immunocompromised individuals. Septicaemia in pregnancy is not dangerous for women, but for the foetus, so delayed diagnosis will lead to spontaneous abortion, intrauterine death or eventually to premature labour. We report in our paper case of Listeria septicaemia in a pregnant woman in the third trimester of the pregnancy. Thanks to early diagnosis and subsequent causal antibiotic treatment, we were able to prevent the development of congenital infection and a healthy baby was born.