Cutaneous lupus erythematosus, skin or systemic autoimmune disease?

The authors present the different clinical forms of cutaneous lupus erythematosus and their prognostic relevance, along with discusson of the uncommon subtypes of the disease. Furthermore, in addition to the lupus specific cutaneous symptoms, the nonspecific cutaneous manifestations are also reviewed. The newest diagnostic criterias and the EDF therapeutic guideline are summarized.

The Mystery of Diabetic Cardiomyopathy: From Early Concepts and Underlying Mechanisms to Novel Therapeutic Possibilities

Diabetic patients are predisposed to diabetic cardiomyopathy, a specific form of cardiomyopathy which is characterized by the development of myocardial fibrosis, cardiomyocyte hypertrophy, and apoptosis that develops independently of concomitant macrovascular and microvascular diabetic complications. Its pathophysiology is multifactorial and poorly understood and no specific therapeutic guideline has yet been established. Diabetic cardiomyopathy is a challenging diagnosis, made after excluding other potential entities, treated with different pharmacotherapeutic agents targeting various pathophysiological pathways that need yet to be unraveled. It has great clinical importance as diabetes is a disease with pandemic proportions. This review focuses on the potential mechanisms contributing to this entity, diagnostic options, as well as on potential therapeutic interventions taking in consideration their clinical feasibility and limitations in everyday practice. Besides conventional therapies, we discuss novel therapeutic possibilities that have not yet been translated into clinical practice.

A Parkinson-kór gyógyszeres kezelésének kérdéseiről

Despite the continuous development of diagnosis and treatment of patients with Parkinson’s disease and the arrival of new therapeutic options in recent years the treatment and care of people with Parkinson’s disease especially in the advanced stage remains a major challenge for neurologists specialized in movement disorders. The treatment of Parkinson’s disease is adversely affected by several factors: the disease progresses relentlessly, the symptoms and rate of progression, other concomitant non-motor symptoms, and the appearance of complications caused by treatment show great heterogeneity. Based on all these factors it is difficult to develop and apply a uniform routine therapeutic guideline. This summary seeks to shed light on aspects of the treatment of Parkinson’s disease particularly in advanced-stage cases drawing on data from a professional college recommendation and the literature.

The Approach of Traditional Persian Medicine to Treatment of Anal Fissure

The common disorder of anal fissure is a painful linear crack in lining of anus. So-called Shiqaq-e-maghad in Persian medical manuscripts has different etiologically-oriented therapies. The aim of this study was to describe the therapeutic guideline for anal fissure in Persian Medicine. Six manuscripts including al-Hawi fi al-Tibb, Qanun fi-Tibb, Qarabadin Kabir, Tibb Akbari, Makhzan-al-Adviah and Exir-e Azam were searched using the keyword of Shiqaq-e-maghad. Although the exact etiology of anal fissure is still uncertain, it has been suggested that a local trauma may cause spasm in internal sphincter of anus leading to a local ischemia and anal fissure. Based on traditional viewpoint, dystemperament, defecation problem, hemorrhoid, inflammation, fullness of veins, and trauma are reasons of anal fissure needing four types of medication including anti-inflammatory drugs, emollients, wound healing agents, and selective remedies. Considering neglected points of traditional outlook will broaden the paths to cure anal fisher.

Usability of Elective Laparoscopic Sigmoidectomy and Feasibility of Single-Incision Laparoscopic Surgery for Sigmoid Volvulus: Report of Three Cases

A therapeutic guideline for sigmoid volvulus (SV) has not been established, and the most recommended surgical procedure for SV has not been determined. Our objective is to assess the usability of elective laparoscopic sigmoidectomy and the feasibility of single-incision laparoscopic surgery for SV following endoscopic reduction. SV typically affects the elderly and accounts for 1% to 7% of intestinal obstructions in Western countries. We report on 3 patients with SV who underwent elective laparoscopic sigmoidectomy following endoscopic reduction, and we first describe single-port surgery for SV. We discuss the 3 patients (a 79-year-old male, an 88-year-old female, and a 67-year-old female) with SV who underwent elective laparoscopic sigmoidectomy following endoscopic reduction. All 3 patients underwent laparoscopic sigmoidectomy, and 2 patients underwent single-port laparoscopic surgery without complications. Recurrence of volvulus was not seen during the course of 12 to 24 months. In experienced hands, elective laparoscopic sigmoidectomy after colonoscopic detorsion is a valuable alternative, and single-port surgery is also feasible.