Pub Date : 2022-07-29DOI: 10.15587/2519-4798.2022.261569
P. Kuzyk
Nocardiosis is a rare infectious disease caused by bacteria of the genus Nocardia and characterized by the development of foci of purulent-necrotic inflammation of the lungs, brain, and internal organs. Clinical diagnosis of nocardiosis has objective difficulties. The aim of the study is to highlight a rare clinical case of pulmonary nocardiosis, to analyze mistakes in the clinical diagnostics of the main disease, to discuss the differential diagnosis of nocardiosis. Materials and methods. A clinico-pathological analysis of an inpatient and outpatient medical record card, and the results of an autopsy of a 58-year-old patient who died in an anti-tuberculosis institution from pulmonary nocardiosis has been carried out. Results. According to the anamnesis, the patient suffered from COPD and chronic polyposis rhinitis with hypertrophy of the nasal turbinates for many years. Polypectomy and submucosal resection of the nasal septum were performed in the otolaryngology department. Wegener's granulomatosis was suspected during the intravital pathomorphological examination of nasal polyps, and glucocorticoids were prescribed in the hospital. Histological preparations and biological material of the patient were examined in clinics in Berlin, the diagnosis of “Wegener's granulomatosis” was not confirmed, however, domestic doctors recommended Medrol, which the patient received continuously for 5 years at a dose of 12 mg/day. After 5 years, the patient was admitted to the hospital of a specialized anti-tuberculosis institution in serious condition with a clinical diagnosis: newly diagnosed disseminated tuberculosis of both lungs with disintegration, right-sided spontaneous tension pneumothorax, respiratory insufficiency of the III degree. According to urgent indications, thoracentesis and drainage of both pleural cavities were performed. Despite intensive therapy, the condition worsened, and biological death occurred 11 days after hospitalization. During the post-mortem pathological examination, signs of tuberculosis of both lungs were not detected, nocardiosis of both lungs was diagnosed, which pathomorphologically manifested as multiple foci of purulent-necrotic bronchopneumonia with disintegration. Pathological diagnosis was confirmed by bacteriological and PCR examination of the post-mortem material. The disease developed on the background of wrongly prescribed long-term glucocorticosteroid therapy, which was carried out for the misdiagnosis “Wegener's granulomatosis”. No signs of Wegener's granulomatosis were found at autopsy. The direct cause of death was acute respiratory failure. Conclusion. Thus, pulmonary nocardiosis was not diagnosed in the hospital, the reason for the misdiagnosis was the rarity of the disease and the objective difficulties of diagnostics. A decisive role in the development of nocardiosis was played by erroneously prescribed long-term glucocorticosteroid therapy, which should be considered as a pathology of the therapy
{"title":"Clinico-pathological analysis of a rare case of pulmonary nocardiosis under the mask of disseminated tuberculosis","authors":"P. Kuzyk","doi":"10.15587/2519-4798.2022.261569","DOIUrl":"https://doi.org/10.15587/2519-4798.2022.261569","url":null,"abstract":"Nocardiosis is a rare infectious disease caused by bacteria of the genus Nocardia and characterized by the development of foci of purulent-necrotic inflammation of the lungs, brain, and internal organs. Clinical diagnosis of nocardiosis has objective difficulties.\u0000The aim of the study is to highlight a rare clinical case of pulmonary nocardiosis, to analyze mistakes in the clinical diagnostics of the main disease, to discuss the differential diagnosis of nocardiosis.\u0000Materials and methods. A clinico-pathological analysis of an inpatient and outpatient medical record card, and the results of an autopsy of a 58-year-old patient who died in an anti-tuberculosis institution from pulmonary nocardiosis has been carried out.\u0000Results. According to the anamnesis, the patient suffered from COPD and chronic polyposis rhinitis with hypertrophy of the nasal turbinates for many years. Polypectomy and submucosal resection of the nasal septum were performed in the otolaryngology department. Wegener's granulomatosis was suspected during the intravital pathomorphological examination of nasal polyps, and glucocorticoids were prescribed in the hospital. Histological preparations and biological material of the patient were examined in clinics in Berlin, the diagnosis of “Wegener's granulomatosis” was not confirmed, however, domestic doctors recommended Medrol, which the patient received continuously for 5 years at a dose of 12 mg/day.\u0000After 5 years, the patient was admitted to the hospital of a specialized anti-tuberculosis institution in serious condition with a clinical diagnosis: newly diagnosed disseminated tuberculosis of both lungs with disintegration, right-sided spontaneous tension pneumothorax, respiratory insufficiency of the III degree. According to urgent indications, thoracentesis and drainage of both pleural cavities were performed. Despite intensive therapy, the condition worsened, and biological death occurred 11 days after hospitalization.\u0000During the post-mortem pathological examination, signs of tuberculosis of both lungs were not detected, nocardiosis of both lungs was diagnosed, which pathomorphologically manifested as multiple foci of purulent-necrotic bronchopneumonia with disintegration. Pathological diagnosis was confirmed by bacteriological and PCR examination of the post-mortem material. The disease developed on the background of wrongly prescribed long-term glucocorticosteroid therapy, which was carried out for the misdiagnosis “Wegener's granulomatosis”. No signs of Wegener's granulomatosis were found at autopsy. The direct cause of death was acute respiratory failure.\u0000Conclusion. Thus, pulmonary nocardiosis was not diagnosed in the hospital, the reason for the misdiagnosis was the rarity of the disease and the objective difficulties of diagnostics. A decisive role in the development of nocardiosis was played by erroneously prescribed long-term glucocorticosteroid therapy, which should be considered as a pathology of the therapy","PeriodicalId":21672,"journal":{"name":"ScienceRise: Medical Science","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80213496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-29DOI: 10.15587/2519-4798.2022.262441
Yu.S. Roienko
Adrenocortical tumours of the adrenal glands are formed when the cells of the cortical layer grow. The morphological and histological structure of benign adrenal tumours is variable, which complicates their early diagnosis. The study of the levels of hormones in the adrenal cortex along with the analysis of the symptoms of the disease will allow not only to differentiate hormone-producing tumours, but also to predict the direction of metabolic processes, which will make it possible to choose the right treatment regimen and prevent complications from other organs. The aim of the study is to determine the level of cortisol and aldosterone and assess the state of the pituitary-adrenal and renin-aldosterone systems in patients with various types of adrenocortical adenomas. Materials and methods. The state of the hormonal status of the adrenal cortex was assessed by determining the level of glucocorticoids - cortisol and mineralocorticoids - aldosterone using a direct quantitative enzyme immunoassay. The level of adrenocorticotropic hormone (ACTH) and renin was determined by immunochemical methods using monoclonal antibodies specific for ACTH and renin. Research results. An increase in the level of cortisol was detected against the background of a decrease in the level of ACTH in patients with cortisol-producing adrenocortical adenomas. It is shown that the aldosteronism we discovered in patients with aldosterone-producing adenomas develops against the background of an unchanged renin level and an increase in the aldosterone/renin ratio. Conclusions. The development of hormone-dependent adenomas of the adrenal cortex is accompanied by an imbalance in the work of the pituitary-adrenal and renin-aldosterone systems, the direction of changes of which can serve as a criterion for early diagnosis of adrenocortical adrenal adenomas
{"title":"Glucocorticoids and mineralocorticoids in blood plasma as markers of early diagnostic adrenal cortical tumors","authors":"Yu.S. Roienko","doi":"10.15587/2519-4798.2022.262441","DOIUrl":"https://doi.org/10.15587/2519-4798.2022.262441","url":null,"abstract":"Adrenocortical tumours of the adrenal glands are formed when the cells of the cortical layer grow. The morphological and histological structure of benign adrenal tumours is variable, which complicates their early diagnosis. The study of the levels of hormones in the adrenal cortex along with the analysis of the symptoms of the disease will allow not only to differentiate hormone-producing tumours, but also to predict the direction of metabolic processes, which will make it possible to choose the right treatment regimen and prevent complications from other organs. \u0000The aim of the study is to determine the level of cortisol and aldosterone and assess the state of the pituitary-adrenal and renin-aldosterone systems in patients with various types of adrenocortical adenomas. \u0000Materials and methods. The state of the hormonal status of the adrenal cortex was assessed by determining the level of glucocorticoids - cortisol and mineralocorticoids - aldosterone using a direct quantitative enzyme immunoassay. The level of adrenocorticotropic hormone (ACTH) and renin was determined by immunochemical methods using monoclonal antibodies specific for ACTH and renin. \u0000Research results. An increase in the level of cortisol was detected against the background of a decrease in the level of ACTH in patients with cortisol-producing adrenocortical adenomas. It is shown that the aldosteronism we discovered in patients with aldosterone-producing adenomas develops against the background of an unchanged renin level and an increase in the aldosterone/renin ratio. \u0000Conclusions. The development of hormone-dependent adenomas of the adrenal cortex is accompanied by an imbalance in the work of the pituitary-adrenal and renin-aldosterone systems, the direction of changes of which can serve as a criterion for early diagnosis of adrenocortical adrenal adenomas","PeriodicalId":21672,"journal":{"name":"ScienceRise: Medical Science","volume":"75 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91351832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-29DOI: 10.15587/2519-4798.2022.262067
A. Voitiuk
The study examined the effect of some antiepileptic medications and the disease itself on the hormonal background of young men. The aim of the study was to examine the effect of some antiepileptic drugs and the disease itself on the hormonal background of young men. Methods: This study involved 80 male patients aged 18-44 years. All patients were divided into 4 groups depending on the monotherapy received: carbamazepine (CBZ), valproic acid (VA), levetiracetam (LEV) and oxcarbazepine (OXC). Twenty healthy males aged 18-44 years (31.30 ± 4.07), who met the inclusion criteria, were included in the study as a control group. Venous blood samples (5 mL) were collected in heparinized tubes between 07:00 and 08:00 am after a fasting period of 8 hours for measurement of serum hormones. The levels of estradiol, progesterone, testosterone, and prolactin were determined by chemiluminescence analysis. Results: epilepsy and sexual hormones abnormalities are strictly linked. Moreover, the use of many ASMs (in particular, CBZ, VPA, LEV and OXC) can contribute to these abnormalities in men with epilepsy. Over time, these alterations may result in diminished potency and fertility. Conclusions: the ASMs' therapy may lead to dysregulation of sex hormones and sexual dysfunction in male patients with epilepsy. The use of the liver enzyme inducing AEDs, such as carbamazepine, which increases serum sex hormone binding globulin (SHBG) concentrations. This increase leads to diminished bioactivity of testosterone, which may result in diminished potency and thus reduced fertility. Men taking valproic acid have significantly higher dehydroepiandrosterone levels and lower gonadotropin concentration. This must be considered for the selection of antiepileptic drugs in young male patients. However, the effect of both the disease itself and ASMs’ therapy on hormones in young men requires further research
{"title":"Hormonal background in young men with epilepsy: the influence of pathology and treatment","authors":"A. Voitiuk","doi":"10.15587/2519-4798.2022.262067","DOIUrl":"https://doi.org/10.15587/2519-4798.2022.262067","url":null,"abstract":"The study examined the effect of some antiepileptic medications and the disease itself on the hormonal background of young men. \u0000The aim of the study was to examine the effect of some antiepileptic drugs and the disease itself on the hormonal background of young men. \u0000Methods: This study involved 80 male patients aged 18-44 years. All patients were divided into 4 groups depending on the monotherapy received: carbamazepine (CBZ), valproic acid (VA), levetiracetam (LEV) and oxcarbazepine (OXC). Twenty healthy males aged 18-44 years (31.30 ± 4.07), who met the inclusion criteria, were included in the study as a control group. Venous blood samples (5 mL) were collected in heparinized tubes between 07:00 and 08:00 am after a fasting period of 8 hours for measurement of serum hormones. The levels of estradiol, progesterone, testosterone, and prolactin were determined by chemiluminescence analysis. \u0000Results: epilepsy and sexual hormones abnormalities are strictly linked. Moreover, the use of many ASMs (in particular, CBZ, VPA, LEV and OXC) can contribute to these abnormalities in men with epilepsy. Over time, these alterations may result in diminished potency and fertility. \u0000Conclusions: the ASMs' therapy may lead to dysregulation of sex hormones and sexual dysfunction in male patients with epilepsy. The use of the liver enzyme inducing AEDs, such as carbamazepine, which increases serum sex hormone binding globulin (SHBG) concentrations. This increase leads to diminished bioactivity of testosterone, which may result in diminished potency and thus reduced fertility. Men taking valproic acid have significantly higher dehydroepiandrosterone levels and lower gonadotropin concentration. This must be considered for the selection of antiepileptic drugs in young male patients. However, the effect of both the disease itself and ASMs’ therapy on hormones in young men requires further research","PeriodicalId":21672,"journal":{"name":"ScienceRise: Medical Science","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83204372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-29DOI: 10.15587/2519-4798.2022.262145
S. Prabhala, Annapurna Srirambhatla, Sujatha Pasula
Breast cancer is the most common malignancy in women worldwide and early detection is of utmost importance. In developed countries, mandatory mammographic screening programs help in early detection, whereas, in developing countries cancer is often detected at an advanced stage. The BIRADS guidelines permit a standard approach and follow up for breast lesions. Many newer imaging modalities are being available for better diagnosis. Breast lesions have a varied spectrum and the gold standard for diagnosis of breast cancer is based on histopathological examination of tissue. At times, even on trucut biopsy, it is difficult to categorize the lesion as the tissue studied is limited and some evolving lesions may have overlapping features. As there are limitations to both radiologic and pathologic approaches, the general and accepted way is to combine both modalities to arrive at a diagnosis. The aim: The aim of the study was to find out how well the BIRADS radiological findings correlate with histopathological findings on breast biopsies. Materials and methods: A MEDLINE search for articles published in English language, with key words as breast biopsy histopathology and BIRADS was done for the years between 1985 and 2021. In addition, other cross-referenced articles were also searched for relevant data. Results: There is good correlation between BIRADS category 1, 2 and 5 with the findings on core needle biopsy in breast lumps i.e., good correlation is seen at the end of spectrum of breast lesions in totally benign and unequivocally malignant lesions. But this correlation is lacking in the middle of the spectrum i.e., in borderline/intermediate category of BIRADS. Conclusion: The non-suspicious (BIRADS 1/ 2) and highly suspicious (BIRADS 4C/5) compare very well with the histopathologic findings. It is the grey zone i.e., BIRADS 3/4A which has a wide and variable predictive value for breast cancer when compared with histopathology and imaging study alone is insufficient and mandates histopathology in all such cases
{"title":"Comparison of BIRADS lexicon to breast biopsy findings in low resource countries","authors":"S. Prabhala, Annapurna Srirambhatla, Sujatha Pasula","doi":"10.15587/2519-4798.2022.262145","DOIUrl":"https://doi.org/10.15587/2519-4798.2022.262145","url":null,"abstract":"Breast cancer is the most common malignancy in women worldwide and early detection is of utmost importance. In developed countries, mandatory mammographic screening programs help in early detection, whereas, in developing countries cancer is often detected at an advanced stage. The BIRADS guidelines permit a standard approach and follow up for breast lesions. Many newer imaging modalities are being available for better diagnosis.\u0000Breast lesions have a varied spectrum and the gold standard for diagnosis of breast cancer is based on histopathological examination of tissue. At times, even on trucut biopsy, it is difficult to categorize the lesion as the tissue studied is limited and some evolving lesions may have overlapping features. As there are limitations to both radiologic and pathologic approaches, the general and accepted way is to combine both modalities to arrive at a diagnosis.\u0000The aim: The aim of the study was to find out how well the BIRADS radiological findings correlate with histopathological findings on breast biopsies.\u0000Materials and methods: A MEDLINE search for articles published in English language, with key words as breast biopsy histopathology and BIRADS was done for the years between 1985 and 2021. In addition, other cross-referenced articles were also searched for relevant data.\u0000Results: There is good correlation between BIRADS category 1, 2 and 5 with the findings on core needle biopsy in breast lumps i.e., good correlation is seen at the end of spectrum of breast lesions in totally benign and unequivocally malignant lesions. But this correlation is lacking in the middle of the spectrum i.e., in borderline/intermediate category of BIRADS.\u0000Conclusion: The non-suspicious (BIRADS 1/ 2) and highly suspicious (BIRADS 4C/5) compare very well with the histopathologic findings. It is the grey zone i.e., BIRADS 3/4A which has a wide and variable predictive value for breast cancer when compared with histopathology and imaging study alone is insufficient and mandates histopathology in all such cases","PeriodicalId":21672,"journal":{"name":"ScienceRise: Medical Science","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79782924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-29DOI: 10.15587/2519-4798.2022.262184
I. Tuchkina, R. Blagoveshchensky
The aim of the study was to assess the role of immunological factors in the development of abnormal uterine bleeding in women of reproductive age with extragenital disorders. Materials and methods. The study involved 100 women with abnormal uterine bleeding and accompanying extragenital disorders (main group) and 50 somatically healthy women (control group). Autoimmune antibodies to platelets, phagocytic activity of neutrophil granulocytes, concentration of circulating immune complexes (CICs), total level of membranotropic cytotoxic factors, content of CD4+T-helper subpopulations and cytotoxic CD8+T-killer lymphocytes were evaluated as immunological markers. Results of the study. The study showed that thrombocytopenia, caused by the presence of autoimmune antibodies to their own platelets, can be one of the pathogenic factors of bleeding in women with AUB. In 41 % of women with AUB, phagocytic reactions were found to be intense, which was expressed by an increase in chemotaxis and adhesion functions, and in 46 % of women by an increase in the absorption capacity of phagocytes. In the main group, 48 % of the examined women had insufficient phagocyte enzymatic activity, which was evidenced by a decrease in the index of completion of phagocytosis. In 79 % of women of the main group, violations of the formation and elimination of circulating immune complexes were detected. The formation of low-molecular-weight CICs in 82 % of women of this cohort contributed to the induction of autoimmune reactions. The total content of membranotropic cytotoxic factors, which was evaluated according to the lymphocytotoxic test, exceeded the reference values in 88 % of women of the main group. In the main group, the average content of CD4+ T-helpers was 23 % lower, and the content of suppressor CD8+ T-lymphocytes was twice as low compared to the control group, resulting in a significant increase in the immunoregulatory index by 30 %. Conclusion. The women of the main group with abnormal uterine bleeding were found to have a violation of the functional activity of cellular factors of innate immunity, accompanied by changes in the absorption and digestive capacity of phagocytic cells. Assessment of secondary adaptive reactions showed induction of humoral sensitization and formation of autoimmune reactions (presence of antiplatelet autoantibodies, increase in CICs and LCT, decrease in the subpopulation of CD8+-suppressor T-lymphocytes). The detected violations indicate the pathogenic role of immunological reactions in women with abnormal uterine bleeding
{"title":"The role of immunological factors in the development of abnormal uterine bleeding in women of reproductive age with extragenital disorders","authors":"I. Tuchkina, R. Blagoveshchensky","doi":"10.15587/2519-4798.2022.262184","DOIUrl":"https://doi.org/10.15587/2519-4798.2022.262184","url":null,"abstract":"The aim of the study was to assess the role of immunological factors in the development of abnormal uterine bleeding in women of reproductive age with extragenital disorders. \u0000Materials and methods. The study involved 100 women with abnormal uterine bleeding and accompanying extragenital disorders (main group) and 50 somatically healthy women (control group). Autoimmune antibodies to platelets, phagocytic activity of neutrophil granulocytes, concentration of circulating immune complexes (CICs), total level of membranotropic cytotoxic factors, content of CD4+T-helper subpopulations and cytotoxic CD8+T-killer lymphocytes were evaluated as immunological markers. \u0000Results of the study. The study showed that thrombocytopenia, caused by the presence of autoimmune antibodies to their own platelets, can be one of the pathogenic factors of bleeding in women with AUB. In 41 % of women with AUB, phagocytic reactions were found to be intense, which was expressed by an increase in chemotaxis and adhesion functions, and in 46 % of women by an increase in the absorption capacity of phagocytes. In the main group, 48 % of the examined women had insufficient phagocyte enzymatic activity, which was evidenced by a decrease in the index of completion of phagocytosis. In 79 % of women of the main group, violations of the formation and elimination of circulating immune complexes were detected. The formation of low-molecular-weight CICs in 82 % of women of this cohort contributed to the induction of autoimmune reactions. The total content of membranotropic cytotoxic factors, which was evaluated according to the lymphocytotoxic test, exceeded the reference values in 88 % of women of the main group. In the main group, the average content of CD4+ T-helpers was 23 % lower, and the content of suppressor CD8+ T-lymphocytes was twice as low compared to the control group, resulting in a significant increase in the immunoregulatory index by 30 %. \u0000Conclusion. The women of the main group with abnormal uterine bleeding were found to have a violation of the functional activity of cellular factors of innate immunity, accompanied by changes in the absorption and digestive capacity of phagocytic cells. Assessment of secondary adaptive reactions showed induction of humoral sensitization and formation of autoimmune reactions (presence of antiplatelet autoantibodies, increase in CICs and LCT, decrease in the subpopulation of CD8+-suppressor T-lymphocytes). The detected violations indicate the pathogenic role of immunological reactions in women with abnormal uterine bleeding","PeriodicalId":21672,"journal":{"name":"ScienceRise: Medical Science","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84574803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-29DOI: 10.15587/2519-4798.2022.262638
T. Klymenko, M. Kononovych
The aim of this study was to determine the clinical significance of the levels and dynamics of the urinary 8-hydroxy-2-deoxyguanosine, degree of pulmonary hypertension on choosing the duration and form of respiratory support in premature infants with respiratory distress syndrome in combination with perinatal asphyxia. Materials and methods. The levels of the urinary 8-hydroxy-2-deoxyguanosine (8-OHdG), ng/ml were determined by enzyme immunoassay (ELISA) method and the degree of pulmonary hypertension (PH) - by echocardiography in 60 premature new-borns at 26-32 weeks of gestation on the 1st and the 3rd–5th days of life. A comparative analysis of indicators was carried out in 2 groups: I – 32 children with respiratory distress syndrome (RDS); II – 28 children with RDS combined with perinatal asphyxia. All infants received a respiratory support, depending on the clinical condition, blood gas analyses, and the chest X-ray. Results. The level and dynamics of the urinary 8-OHdG correlated to degree of PH, form, and duration of respiratory support. Children of the group II on the 1st day of life had echocardiogram indicators of mild PH and indicators of the urinary 8-OHdG 2.27±0.39 ng/ml; by 3rd–5th days of life – level of the urinary 8-OHdG increased to 4.10±0.42 ng/ml and the level of PH – to moderate, required 76.2 % longer respiratory support compared to children of the group I. Conclusions. Prematurely born infants with RDS in combination with perinatal asphyxia have a higher oxidative stress (OS) levels and more significant pulmonary hypertension, which requires a longer respiratory support by 76.2 % and more often use of high frequency oscillatory ventilation (HFOV) by 9.3 %
{"title":"Clinical significance of dynamics between oxidative stress levels during mechanical lung ventilation in premature infants with persistent pulmonary hypertension","authors":"T. Klymenko, M. Kononovych","doi":"10.15587/2519-4798.2022.262638","DOIUrl":"https://doi.org/10.15587/2519-4798.2022.262638","url":null,"abstract":"The aim of this study was to determine the clinical significance of the levels and dynamics of the urinary 8-hydroxy-2-deoxyguanosine, degree of pulmonary hypertension on choosing the duration and form of respiratory support in premature infants with respiratory distress syndrome in combination with perinatal asphyxia. \u0000Materials and methods. The levels of the urinary 8-hydroxy-2-deoxyguanosine (8-OHdG), ng/ml were determined by enzyme immunoassay (ELISA) method and the degree of pulmonary hypertension (PH) - by echocardiography in 60 premature new-borns at 26-32 weeks of gestation on the 1st and the 3rd–5th days of life. A comparative analysis of indicators was carried out in 2 groups: I – 32 children with respiratory distress syndrome (RDS); II – 28 children with RDS combined with perinatal asphyxia. All infants received a respiratory support, depending on the clinical condition, blood gas analyses, and the chest X-ray. \u0000Results. The level and dynamics of the urinary 8-OHdG correlated to degree of PH, form, and duration of respiratory support. Children of the group II on the 1st day of life had echocardiogram indicators of mild PH and indicators of the urinary 8-OHdG 2.27±0.39 ng/ml; by 3rd–5th days of life – level of the urinary 8-OHdG increased to 4.10±0.42 ng/ml and the level of PH – to moderate, required 76.2 % longer respiratory support compared to children of the group I. \u0000Conclusions. Prematurely born infants with RDS in combination with perinatal asphyxia have a higher oxidative stress (OS) levels and more significant pulmonary hypertension, which requires a longer respiratory support by 76.2 % and more often use of high frequency oscillatory ventilation (HFOV) by 9.3 %","PeriodicalId":21672,"journal":{"name":"ScienceRise: Medical Science","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85339773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-29DOI: 10.15587/2519-4798.2022.262185
Pasumarthi Pavani Yelamanchili, Madhuri Kurakula, Puwala Sai Kiranmayi, Kelluru Viswanath
Diabetic retinopathy is the leading cause of visual disability in the working-age population of industrialized countries. It is considered the hallmark of generalized microangiopathy occurring in a diabetic patient. The aim: association of Diabetic Retinopathy and CSME with mean values of lipids and Association of the pattern of hard exudates in the fundus in patients with Diabetic retinopathy with or without CSME with mean values of lipids. Materials and methods: 320 eyes of 160 urban diabetic patients who were seen at the OPD, at Pushpagiri Eye Institute, Secunderabad having diabetic retinopathy were included in the study. Detailed history was taken to note the duration of diabetes, hypertension, history of CAD, CVA, CKD. Patients with duration of diabetes >=5 years were enrolled. Thorough work up was done with slit lamp and indirect ophthalmoscope and posterior segment was examined to evaluate the stage of diabetic retinopathy and presence or absence of CSME. Patients with DR were investigated for Fasting Lipid Profile and HbA1c. Results: a total of 320 eyes of 160 patients were included in the study. In patients with CSME, mean values of Total Cholesterol, Triglycerides, LDL, HDL, VLDL were higher in the plaque pattern of hard exudates in the macula compared to Discrete and Circinate. There was a statistically significant difference between the mean values of total cholesterol (p=0.00), triglycerides (p =0.035), ldl(p=0.00) in discrete and plaque patterns. There was slightly higher prevalence of PDR among hypertensives compared to non-hypertensives. There was no significant association between DR stage and hypertension(p=0.628). The correlation between CSME and BCVA could not be determined accurately due to the presence of cataract in most of the patients. Conclusion: this study demonstrated that, diabetic retinopathy is not associated with lipid profile whereas there is statistically significant correlation between mean values of total cholesterol, triglycerides, LDL, VLDL and clinically significant macular edema (CSME)
{"title":"Study of association of diabetic retinopathy with dyslipidemia in type II diabetes mellitus","authors":"Pasumarthi Pavani Yelamanchili, Madhuri Kurakula, Puwala Sai Kiranmayi, Kelluru Viswanath","doi":"10.15587/2519-4798.2022.262185","DOIUrl":"https://doi.org/10.15587/2519-4798.2022.262185","url":null,"abstract":"Diabetic retinopathy is the leading cause of visual disability in the working-age population of industrialized countries. It is considered the hallmark of generalized microangiopathy occurring in a diabetic patient. \u0000The aim: association of Diabetic Retinopathy and CSME with mean values of lipids and Association of the pattern of hard exudates in the fundus in patients with Diabetic retinopathy with or without CSME with mean values of lipids. \u0000Materials and methods: 320 eyes of 160 urban diabetic patients who were seen at the OPD, at Pushpagiri Eye Institute, Secunderabad having diabetic retinopathy were included in the study. Detailed history was taken to note the duration of diabetes, hypertension, history of CAD, CVA, CKD. Patients with duration of diabetes >=5 years were enrolled. Thorough work up was done with slit lamp and indirect ophthalmoscope and posterior segment was examined to evaluate the stage of diabetic retinopathy and presence or absence of CSME. Patients with DR were investigated for Fasting Lipid Profile and HbA1c. \u0000Results: a total of 320 eyes of 160 patients were included in the study. In patients with CSME, mean values of Total Cholesterol, Triglycerides, LDL, HDL, VLDL were higher in the plaque pattern of hard exudates in the macula compared to Discrete and Circinate. There was a statistically significant difference between the mean values of total cholesterol (p=0.00), triglycerides (p =0.035), ldl(p=0.00) in discrete and plaque patterns. There was slightly higher prevalence of PDR among hypertensives compared to non-hypertensives. There was no significant association between DR stage and hypertension(p=0.628). The correlation between CSME and BCVA could not be determined accurately due to the presence of cataract in most of the patients. \u0000Conclusion: this study demonstrated that, diabetic retinopathy is not associated with lipid profile whereas there is statistically significant correlation between mean values of total cholesterol, triglycerides, LDL, VLDL and clinically significant macular edema (CSME)","PeriodicalId":21672,"journal":{"name":"ScienceRise: Medical Science","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86769483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-29DOI: 10.15587/2519-4798.2022.262104
M. V. Priya, Gandi Joseph Benjamin, Rasapalli Vineeth Sagar
International commission of radiation units and measurement point doses to the bladder and rectum in carcinoma cervix patients treated with intracavitary brachytherapy in the department of radiotherapy. The aim: to evaluate two-dimensional point-based dose planning and three-dimensional computed tomography-based dose-volume parameters for high-dose-rate intracavitary brachytherapy of cervical cancer. Materials and methods: prospective study done between the years June 2018 to April 2020, a total of 50 prospectively registered women of non-metastatic carcinoma cervix treated with definitive concurrent chemo-radiotherapy followed by HDR intracavitary brachytherapy who met inclusion criteria were accrued in the study. All women in the study were treated with 50 Gy EBRT then assessment was done for response and adequacy for comfortable insertion of application. Brachytherapy procedure was performed under sedation in the lithotomy position. Results: Median age of the entire group was 54.5 years, majority of them were in their 5th (34 %) or 4th (28 %) decade. Pathologically, all were squamous cell carcinoma. Most common subtype was large cell non keratinizing type (64 %). Major bulk of the study is contributed by stage IIA, IIB, IIIB. All patients were treated with external beam radiotherapy of 50Gy in 25 fractions with 2Gy per fraction followed by high dose rate brachytherapy of 7 Gy per fraction for 3 fractions, one week apart to a total intracavitary brachytherapy dose of 21Gy. Conclusion: Results from the study suggests that rectum ICRU reference points can be surrogate markers for D2cc, but not for bladder and hence reporting should preferably be done in volumetric method rather than reference point doses
{"title":"Comparison of dose volume histograms and international commission of radiation units and measurement point doses to bladder and rectum in carcinoma cervix patients treated with intracavitary brachytherapy in department of radiotherapy","authors":"M. V. Priya, Gandi Joseph Benjamin, Rasapalli Vineeth Sagar","doi":"10.15587/2519-4798.2022.262104","DOIUrl":"https://doi.org/10.15587/2519-4798.2022.262104","url":null,"abstract":"International commission of radiation units and measurement point doses to the bladder and rectum in carcinoma cervix patients treated with intracavitary brachytherapy in the department of radiotherapy.\u0000The aim: to evaluate two-dimensional point-based dose planning and three-dimensional computed tomography-based dose-volume parameters for high-dose-rate intracavitary brachytherapy of cervical cancer.\u0000Materials and methods: prospective study done between the years June 2018 to April 2020, a total of 50 prospectively registered women of non-metastatic carcinoma cervix treated with definitive concurrent chemo-radiotherapy followed by HDR intracavitary brachytherapy who met inclusion criteria were accrued in the study. All women in the study were treated with 50 Gy EBRT then assessment was done for response and adequacy for comfortable insertion of application. Brachytherapy procedure was performed under sedation in the lithotomy position.\u0000Results: Median age of the entire group was 54.5 years, majority of them were in their 5th (34 %) or 4th (28 %) decade. Pathologically, all were squamous cell carcinoma. Most common subtype was large cell non keratinizing type (64 %). Major bulk of the study is contributed by stage IIA, IIB, IIIB. All patients were treated with external beam radiotherapy of 50Gy in 25 fractions with 2Gy per fraction followed by high dose rate brachytherapy of 7 Gy per fraction for 3 fractions, one week apart to a total intracavitary brachytherapy dose of 21Gy.\u0000Conclusion: Results from the study suggests that rectum ICRU reference points can be surrogate markers for D2cc, but not for bladder and hence reporting should preferably be done in volumetric method rather than reference point doses","PeriodicalId":21672,"journal":{"name":"ScienceRise: Medical Science","volume":"59 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88814844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-29DOI: 10.15587/2519-4798.2022.262500
M. Shostatska
The article discloses the characteristics of the degrees of severity of acute intestinal infection in elderly and senile patients with COVID-19. The aim of the article is to substantiate the characteristics of the degrees of severity of acute intestinal infection (AII) in elderly and senile patients with COVID-19. Materials and methods. Conditionally pathogenic microorganisms were detected in the patients of the study group by the bacteriological method. The WHO age classification was used to estimate age. The presence of the definition of a coronavirus infection and comorbid conditions was ascertained based on the following methods: selection of indicators of the immunoenzymatic method, PCR test, measurements the degree of saturation of arterial blood with oxygen by pulse oximetry, heart rate, temperature marks, questionnaires NEWS and ABCD for monitoring the dynamics of the disease in patients. Dehydration scale (CDS) was used to determine the severity of acute intestinal infection. The Charlson comorbidity index was used to characterize comorbid conditions. Statistical methods were used: the Kolmagorov-Smirnov test, the non-parametric Wald Wolfowitz test. The obtained results were performed using the Statistica 13 Trial program. The severity index of COVID-19 has been determined, with the help of which it is possible to identify and sort patients to identify complications and a quick algorithm for the doctor's actions and the conditions of the intensive care unit. The results. Several indicators of the modified NEWS questionnaire were determined, which confirm that the age of patients ≥ 65 years is associated with a more severe course of the disease. It has been established that such comorbid conditions as: damage to peripheral vessels, dementia, the presence of peptic ulcer disease are associated with a milder course of GKI against the background of COVID-19. The incidence of diabetes without damage to the limbs is reliably associated with a more severe course of the disease. Analyzing the indicators of the ABCD system, namely: age of patients, laboratory and instrumental tests, pantry poor conditions, risk factors associated with the severity of the course of COVID-19 were assessed. Conclusions. The total result of the Charlson comorbidity index was determined in patients with AII on the background of COVID-19. The results confirm that such patients have a higher probability and risk of mortality. A direct moderate correlation has been proven between the total result of the NEWS questionnaire and the course of AII, which indicates a higher frequency of the formation of severe forms of the latter in the presence of higher values of the questionnaire and the corresponding more severe course of COVID-19. The results of the severity index of COVID-19 allow us to conclude that the data are associated with an increase in the severity of acute intestinal infection in elderly patients
{"title":"Characteristics of the degrees of severity of the course of acute intestinal infection in elderly patients with COVID-19","authors":"M. Shostatska","doi":"10.15587/2519-4798.2022.262500","DOIUrl":"https://doi.org/10.15587/2519-4798.2022.262500","url":null,"abstract":"The article discloses the characteristics of the degrees of severity of acute intestinal infection in elderly and senile patients with COVID-19. \u0000The aim of the article is to substantiate the characteristics of the degrees of severity of acute intestinal infection (AII) in elderly and senile patients with COVID-19. \u0000Materials and methods. Conditionally pathogenic microorganisms were detected in the patients of the study group by the bacteriological method. The WHO age classification was used to estimate age. The presence of the definition of a coronavirus infection and comorbid conditions was ascertained based on the following methods: selection of indicators of the immunoenzymatic method, PCR test, measurements the degree of saturation of arterial blood with oxygen by pulse oximetry, heart rate, temperature marks, questionnaires NEWS and ABCD for monitoring the dynamics of the disease in patients. Dehydration scale (CDS) was used to determine the severity of acute intestinal infection. \u0000The Charlson comorbidity index was used to characterize comorbid conditions. Statistical methods were used: the Kolmagorov-Smirnov test, the non-parametric Wald Wolfowitz test. The obtained results were performed using the Statistica 13 Trial program. The severity index of COVID-19 has been determined, with the help of which it is possible to identify and sort patients to identify complications and a quick algorithm for the doctor's actions and the conditions of the intensive care unit. \u0000The results. Several indicators of the modified NEWS questionnaire were determined, which confirm that the age of patients ≥ 65 years is associated with a more severe course of the disease. It has been established that such comorbid conditions as: damage to peripheral vessels, dementia, the presence of peptic ulcer disease are associated with a milder course of GKI against the background of COVID-19. The incidence of diabetes without damage to the limbs is reliably associated with a more severe course of the disease. Analyzing the indicators of the ABCD system, namely: age of patients, laboratory and instrumental tests, pantry poor conditions, risk factors associated with the severity of the course of COVID-19 were assessed. \u0000Conclusions. The total result of the Charlson comorbidity index was determined in patients with AII on the background of COVID-19. The results confirm that such patients have a higher probability and risk of mortality. \u0000A direct moderate correlation has been proven between the total result of the NEWS questionnaire and the course of AII, which indicates a higher frequency of the formation of severe forms of the latter in the presence of higher values of the questionnaire and the corresponding more severe course of COVID-19. The results of the severity index of COVID-19 allow us to conclude that the data are associated with an increase in the severity of acute intestinal infection in elderly patients","PeriodicalId":21672,"journal":{"name":"ScienceRise: Medical Science","volume":"56 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81485495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-29DOI: 10.15587/2519-4798.2022.262164
Jabamalai Sheeja, Nagalingam Sangeetha, Bai Selvaraj Saranya
The aim of the study: the present study is to evaluate the accuracy of fine needle aspiration cytology (FNAC) of thyroid swellings and to correlate with histopathological findings to avoid unnecessary surgeries for benign lesions. Methods: this is a prospective study. A total of 55 cases were studied in the Department of Pathology at A.C.S Medical College and Hospital. Fine needle aspiration cytology was done and correlated with histopathological examination. Sensitivity, specificity, and accuracy were calculated. Results: majority were noted among 41-50 years (60 %). Females i.e., 78.1 % (43/55) outnumbered males 21.8 % (12/55). Solitary nodule thyroid in Right lobe is 54.5 % (30/55) and left lobe is 45.4 % (25/55). In the present study 65.4 % (36/55) presented with symptoms for 1month – 1 year. Non neoplastic lesions constituted 76.3 % (42/55) in our study on FNAC. Among non-neoplastic lesions, nodular goiter was most reported and constituted 36.6 % (20/55). Neoplastic lesions constituted 23.6 % (13/55) and among neoplastic lesions follicular neoplasm occupied 9.09 % (05/55). Nodular goiter was most reported and constituted 29.0 % (17/55). Follicular adenoma occupied 20 % (11/55), 9.09 % (05/55) as PTC and 5.4 % (02/55) reported as follicular carcinoma. 1.8 % (01/55) each reported as medullary carcinoma and anaplastic carcinoma. Non-neoplastic lesions constituted 76.3 % (42/55) in our study on FNAC and neoplastic lesions constituted 23.6 % (13/55). Conclusion: FNAC is a minimally invasive, highly accurate and cost-effective procedure. FNAC helps the clinician to diagnose malignant lesions with confidence. It has high rates of specificity and accuracy but comparatively has less sensitivity to diagnose the solitary thyroid nodule. However, it is an important diagnostic tool for further management of patients with thyroid swelling
{"title":"Correlation of fine needle aspiration cytology with histopathological findings in the diagnosis of thyroid swellings","authors":"Jabamalai Sheeja, Nagalingam Sangeetha, Bai Selvaraj Saranya","doi":"10.15587/2519-4798.2022.262164","DOIUrl":"https://doi.org/10.15587/2519-4798.2022.262164","url":null,"abstract":"The aim of the study: the present study is to evaluate the accuracy of fine needle aspiration cytology (FNAC) of thyroid swellings and to correlate with histopathological findings to avoid unnecessary surgeries for benign lesions. \u0000Methods: this is a prospective study. A total of 55 cases were studied in the Department of Pathology at A.C.S Medical College and Hospital. Fine needle aspiration cytology was done and correlated with histopathological examination. Sensitivity, specificity, and accuracy were calculated. \u0000Results: majority were noted among 41-50 years (60 %). Females i.e., 78.1 % (43/55) outnumbered males 21.8 % (12/55). Solitary nodule thyroid in Right lobe is 54.5 % (30/55) and left lobe is 45.4 % (25/55). In the present study 65.4 % (36/55) presented with symptoms for 1month – 1 year. Non neoplastic lesions constituted 76.3 % (42/55) in our study on FNAC. Among non-neoplastic lesions, nodular goiter was most reported and constituted 36.6 % (20/55). Neoplastic lesions constituted 23.6 % (13/55) and among neoplastic lesions follicular neoplasm occupied 9.09 % (05/55). Nodular goiter was most reported and constituted 29.0 % (17/55). Follicular adenoma occupied 20 % (11/55), 9.09 % (05/55) as PTC and 5.4 % (02/55) reported as follicular carcinoma. 1.8 % (01/55) each reported as medullary carcinoma and anaplastic carcinoma. Non-neoplastic lesions constituted 76.3 % (42/55) in our study on FNAC and neoplastic lesions constituted 23.6 % (13/55). \u0000Conclusion: FNAC is a minimally invasive, highly accurate and cost-effective procedure. FNAC helps the clinician to diagnose malignant lesions with confidence. It has high rates of specificity and accuracy but comparatively has less sensitivity to diagnose the solitary thyroid nodule. However, it is an important diagnostic tool for further management of patients with thyroid swelling","PeriodicalId":21672,"journal":{"name":"ScienceRise: Medical Science","volume":"95 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82748285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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