scholarly journals Predictors and diagnosis of cardiac autonomic nervous dysfunction in patients with type 1 and type 2 diabetes mellitus

10.14341/8156 ◽  
2017 ◽  
Vol 20 (3) ◽  
pp. 185-193 ◽  
Author(s):  
Kirill A. Popov ◽  
Alla Y. Tokmakova ◽  
Irina Z. Bondarenko

Diabetic cardiovascular autonomic neuropathy (DCAN) is a diabetic complication characterised by early dissemination of sympathetic and parasympathetic, small-fibre neuronal degeneration. DCAN is the most dangerous and insidious complication that influences the clinical course and mortality rate of diabetes; however, it is often underestimated and not recognised by practitioners. Medical history and a physical examination are not sufficient for diagnosing DCAN. Laboratory diagnosis and the instrumental methods used to evaluate DCAN are time-consuming and not always available. Early detection of DCAN in diabetic patients is important for the early implementation of therapy. Today, there is no uniform diagnostic algorithm for DCAN in patients with various disorders of carbohydrate metabolism. This is due to the insufficient number of clinical trials and limitations of current protocols. This review presents an overview of the clinical and experimental studies of DCAN. The epidemiology, clinical manifestations, risk factors and underlying pathogenesis of DCAN are considered. The advantages and disadvantages of conventional and new diagnostic methods are discussed.

2017 ◽  
Vol 55 (7) ◽  
pp. 2009-2017 ◽  
Author(s):  
Blaine A. Mathison ◽  
Bobbi S. Pritt

ABSTRACT Malaria is a potentially life-threatening disease requiring rapid diagnosis and treatment. Although microscopic examination of thick and thin blood films remains the gold standard for laboratory diagnosis, rapid antigen tests and nucleic acid amplification methods may also play a useful role in detection of acute infection. This review discusses the advantages and disadvantages of the commonly used diagnostic methods and provides important practice points for optimal malaria test utilization.


2018 ◽  
Vol 7 (3) ◽  
pp. 67-74
Author(s):  
Jin Zhang

AbstractMycoplasma pneumoniae(MP) is an important pathogen of community-acquired pneumonia in children. As a type of self-limited disease, most MP infections cause mild clinical symptoms, but they can also lead to severe pneumonia or extrapulmonary complications. The resistance rate of MP has increased in recent years. Early and rapid diagnosis of MP infection is important for the treatment and prognosis of the disease. Current methods for diagnosing MP infection include isolation culture, serological diagnosis, and molecular biological diagnosis. This review summarizes the recent research progress in the internal and external laboratory diagnoses of MP infection both at home and abroad and the advantages and disadvantages of various diagnostic methods.


Gut Pathogens ◽  
2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Lin-Yuan Chen ◽  
Xiao-Yu Pang ◽  
Hemant Goyal ◽  
Rui-Xia Yang ◽  
Hua-Guo Xu

AbstractHepatitis delta virus (HDV) is a defective single negative chain RNA virus, as its envelope protein synthesis is dependent on hepatitis B virus (HBV). Studies have consistently shown that coinfection of HBV and HDV is the most serious form of viral hepatitis, with accelerated progression to liver cirrhosis and hepatocellular carcinoma. About 74 million of HBV surface antigen (HBsAg) positive patients worldwide are also co-infected with HDV. Besides, patients with intravenous drug use and high-risk sexual behavior are at higher risk of HDV infection. Therapeutic schedules for HDV are limited, and relapse of HDV has been observed after treatment with pegylated interferon alpha. To reduce the transmission of HDV, all people infected with HBV should be screened for HDV. At present, several serological and molecular detection methods are widely used in the diagnosis of HDV. However, due to the lack of international standards diagnostic results from different laboratories are often not comparable. Therefore, the true prevalence of HDV is still unclear. In this manuscript, we have analyzed various factors influencing the estimation of HDV prevalence. We have also discussed about the advantages and disadvantages of currently available HDV laboratory diagnostic methods, in order to provide some ideas for improving the detection of HDV.


2004 ◽  
Vol 107 (6) ◽  
pp. 539-557 ◽  
Author(s):  
Sajad A. HAYAT ◽  
Billal PATEL ◽  
Rajdeep S. KHATTAR ◽  
Rayaz A. MALIK

Independent of the severity of coronary artery disease, diabetic patients have an increased risk of developing heart failure. This clinical entity has been considered to be a distinct disease process referred to as ‘diabetic cardiomyopathy’. Experimental studies suggest that extensive metabolic perturbations may underlie both functional and structural alterations of the diabetic myocardium. Translational studies are, however, limited and only partly explain why diabetic patients are at increased risk of cardiomyopathy and heart failure. Although a range of diagnostic methods may help to characterize alterations in cardiac function in general, none are specific for the alterations in diabetes. Treatment paradigms are very much limited to interpretation and translation from the results of interventions in non-diabetic patients with heart failure. This suggests that there is an urgent need to conduct pathogenetic, diagnostic and therapeutic studies specifically in diabetic patients with cardiomyopathy to better understand the factors which initiate and progress diabetic cardiomyopathy and to develop more effective treatments.


2021 ◽  
Vol 8 (2) ◽  
pp. 46-57
Author(s):  
A. A. Karpov ◽  
S. S. Smirnov ◽  
L. A. Shilenko ◽  
G. A. Plisko ◽  
N. V. Krotova ◽  
...  

Pulmonary embolism (PE) is the third most common cardiovascular disease. It is still associated with high hospital mortality, as well as with the development of acute and chronic complications. Treatment and prevention of PE and its complications requires high-tech approaches aimed at improving the prognosis of patients. In this regard, experimental studies aimed at studying the pathogenesis, improving diagnostic methods and searching for new pharmacological substances for the prevention and treatment of PE are in demand from the point of view of clinical practice. Considering the current trends in preclinical research, experimental work on rodents — mice, rats, hamsters, as well as on medium-sized laboratory animals (rabbits) is becoming more and more common. The use of these animal species is ethically acceptable and economically viable. The choice of a specific type of animal and a method for modeling PE is primarily determined by the objectives of the study. This article provides an overview of the main approaches to modeling PE, as well as discusses the advantages and disadvantages of each method. Special attention is paid to the modeling of chronic thromboembolic pulmonary hypertension (CTEPH) as one of the most dangerous complications of PE. The work analyzed publications from 1978 to 2020, in which PE was simulated in rodents and medium laboratory animals.


2021 ◽  
Vol 179 (6) ◽  
pp. 89-93
Author(s):  
R. Sh. Muslimov ◽  
Sh. N. Danielyan ◽  
I. E. Popova ◽  
N. R. Chernaya

Aortic esophageal fistula (AEF) is a rare but extremely life-threatening condition requiring immediate surgical treatment. The mortality rate among such patients may exceed 60 %, including after surgical treatment. Etiological and pathogenetic mechanisms of AEF are complex and various, but in most cases, they are associated with chronic aortic diseases. The second group of etiological factors of AEF includes trauma of esophagus wall by foreign bodies, malignant neoplasms of the esophagus or mediastinum. AEF may also occur as a result of surgical interventions on the aorta and esophagus. The difficulties of early diagnosis are primarily associated with non-specific clinical manifestations of AEF and the lack of unified protocol for the examination of patients with the first-time upper gastrointestinal tract bleeding. The described reasons in some cases can lead to an inaccurate diagnosis, which entails a loss of time. Among the instrumental diagnostic methods, the most informative is the combination of esophagogastroduodenoscopy and computed tomography of the chest with intravenous contrast enhancement. Each of these methods has its advantages and disadvantages, and allows to identify a number of direct and indirect signs of pathological communication between the aorta and the esophagus.


2020 ◽  
Vol 101 (4) ◽  
pp. 530-537
Author(s):  
D D Gaynetdinova ◽  
A A Novoselova

Duchenne muscular dystrophy (DMD) is an X-linked progressive disease from the group of primary myopathies caused by mutations in the DMD gene and a lack of dystrophin protein in the muscle fiber in males. The review considered the prevalence of pathology, the most common causes of dystrophinopathy, and the role of dystrophin not only in the functioning of muscles but also in the architectural organization of the Central nervous system. The disease classification based on stages and forms, initial clinical manifestations of the early and late stages of the disease, as well as neuropsychological, orthopedic, respiratory and cardiovascular disorders, are described in detail. The relevant to date diagnostic algorithm for suspected DMD, biochemical blood analysis, genetic, morphological (immunocytochemical staining of muscles with dystrophin antibodies) and instrumental (ultrasound, MRI) methods of examination are presented in detail. Particular attention in the diagnosis of DMD and objectification of disorders is given to assessment tests [Baileys and Griffiths scales, Albert's Test of Infant Posture and Motor Assessment Scale, Expanded Hammersmith Functional Motor Scale (HFMSE), the Gross Motor Function Measure (GMFM), and the 6-minute walk test (6MWT)]. The review presents the advantages and disadvantages of modern invasive and non-invasive diagnostic techniques of the disease, indicating their reliability and the possibility of application at early stages, including prenatal. In conclusion, the treatment of DMD and its most frequent complications, both widely used in practice and at the stage of clinical research, is highlighted. It was emphasized the importance of rehabilitation measures that improve the duration and quality of life of patients with DMD. The main task of analyzing available sources on the most pressing issues of Duchenne muscular dystrophy was to stimulate research and social activity in resolving unsolved problems today.


Author(s):  
Дмитрий Валериевич Судаков ◽  
Елена Анатольевна Фурсова ◽  
Олег Валериевич Судаков ◽  
Наталья Владимировна Якушева ◽  
Артём Николаевич Шевцов

Статья посвящена особенностям выявления новой коронавирусной инфекции у пациентов хирургического профиля (с различной патологией) на уровне приемного отделения БУЗ ВО ВОКБ №1. Данная тематика является весьма актуальной, так как в 2020 году весь мир, в том числе и Россия, столкнулись с новой эпидемиологической угрозой - угрозой новой коронавирусной инфекции. Данная вирусная инфекция показала свою высокую контагиозность и тяжесть течения, обусловленную быстрым развитием целого ряда осложнений. Своевременное выявление пациентов с подобной инфекцией стало одной из первоочередных задач, так как ее выполнение способно помочь сохранить здоровье и жизни медицинского персонала. Интерес к выявлению больных коронавирусной инфекцией в приемном отделении многопрофильного стационара на основании лишь клинических проявлений и результатов лабораторной диагностики обусловлен еще и внутренним регламентом лечебного учреждения и особенностью работы кабинетов компьютерной томографии. Объектами исследования послужило 150 пациентов, мужчин и женщин, поступающих в приемное отделение БУЗ ВО ВОКБ №1 с различной хирургической патологией. В зависимости от последующего обследования все пациентки были разделены на 3 группы по 50 человек. В первую группу вошли пациенты, диагноз которым подтверждался ПЦР-диагностикой; во вторую группу вошли 50 человек, диагноз которым подтверждался наличием антител; третью группу составили пациенты, диагноз новой коронавирусной инфекции у которых не был подтвержден ни при инструментальных, ни при лабораторных методах диагностики. Подробно собирался анамнез, в том числе и эпидемиологический, проводился подробный анализ основных клинических проявлений и результатов лабораторной диагностики (включая ОАК, Б/Х крови, специфические исследования на новую коронавирусную инфекцию). Были установлены основные клинические проявления новой вирусной инфекции, среди которых, наиболее часто встречаемыми стали повышенная температура тела, кашель, слабость и утомляемость. Среди лабораторных показателей крови ведущее место заняли исследование лейкоцитоза при лимфоцитопении, увеличение СОЭ, D-димера и С - реактивного белка. Данная статья представляет интерес для практикующих врачей большинства специальностей, работающих в приемных отделениях многопрофильных стационаров и в поликлиниках. По результатам работы планируется продолжение исследования с большей выборкой пациентов и более узкой патологией The article is devoted to the peculiarities of detecting a new coronavirus infection in surgical patients (with various pathologies) at the level of the admission department of BUZ VO VOKB № 1. This topic is very relevant, since in 2020 the whole world, including Russia, faced a new epidemiological threat - the threat of a new coronavirus infection. This viral infection has shown its high contagiousness and severity of the course, due to the rapid development of a number of complications. Timely identification of patients with such an infection has become one of the priority tasks, since its implementation can help preserve the health and lives of medical personnel. The interest in identifying patients with coronavirus infection in the admission department of a multidisciplinary hospital based only on clinical manifestations and the results of laboratory diagnostics is also due to the internal regulations of the medical institution and the peculiarity of the work of computed tomography rooms. The objects of the study were 150 patients, men and women admitted to the admission department of BUZ VO VOKB № 1 with various surgical pathologies. Depending on the subsequent examination, all patients were divided into 3 groups of 50 people each. The first group included patients whose diagnosis was confirmed by PCR-diagnostics; the second group included 50 people whose diagnosis was confirmed by the presence of antibodies; the third group consisted of patients whose diagnosis of a new coronavirus infection was not confirmed either by instrumental or laboratory diagnostic methods. Anamnesis was collected in detail, including an epidemiological one, a detailed analysis of the main clinical manifestations and results of laboratory diagnostics (including CBC, B / C blood, specific studies for a new coronavirus infection) was carried out. The main clinical manifestations of a new viral infection were established, among which, the most common were fever, cough, weakness and fatigue. Among laboratory blood parameters, the leading place was taken by the study of leukocytosis in lymphocytopenia, an increase in ESR, D-dimer and C - reactive protein. This article is of interest to practicing doctors of most specialties working in the admissions departments of multidisciplinary hospitals and polyclinics. Based on the results of the work, it is planned to continue the study with a larger sample of patients and a narrower pathology


2003 ◽  
Vol 16 (1) ◽  
pp. 37-64 ◽  
Author(s):  
Christopher D. Paddock ◽  
James E. Childs

SUMMARY Ehrlichia chaffeensis is an obligately intracellular, tick-transmitted bacterium that is maintained in nature in a cycle involving at least one and perhaps several vertebrate reservoir hosts. The moderate to severe disease caused by E. chaffeensis in humans, first identified in 1986 and reported for more than 1,000 patients through 2000, represents a prototypical “emerging infection.” Knowledge of the biology and natural history of E. chaffeensis, and of the epidemiology, clinical features, and laboratory diagnosis of the zoonotic disease it causes (commonly referred to as human monocytic ehrlichiosis [HME]) has expanded considerably in the period since its discovery. In this review, we summarize briefly the current understanding of the microbiology, pathogenesis, and clinical manifestations associated with this pathogen but focus primarily on discussing various ecological factors responsible for the recent recognition of this important and potentially life-threatening tick-borne disease. Perhaps the most pivotal element in the emergence of HME has been the staggering increases in white-tailed deer populations in the eastern United States during the 20th century. This animal serves as a keystone host for all life stages of the principal tick vector (Amblyomma americanum) and is perhaps the most important vertebrate reservoir host for E. chaffeensis. The contributions of other components, including expansion of susceptible human populations, growth and broadening geographical distributions of other potential reservoir species and A. americanum, and improvements in confirmatory diagnostic methods, are also explored.


1996 ◽  
Vol 7 (5) ◽  
pp. 321-325 ◽  
Author(s):  
Renuka Bhatt ◽  
Mary Abraham ◽  
Dino Petrin ◽  
Gary E Garber

Trichomonas vaginalisinfection is the most commonly encountered sexually transmitted disease. There is a need for more accurate and rapid laboratory diagnostic methods, leading to better control and treatment strategies. Various virulence factors such as adherence, contact-independent factors, hemolysis and acquisition of host macromolecules have been shown to play a role in the pathogenesis of this infection. Detection of the factors that are only present in the pathogenic isolates of trichomonads will lead to a better understanding of the epidemiology of this pathogen. Culture technique is highly specific compared with microscopic techniques, but it is time consuming. Immunological techniques lack proper correlation with clinical manifestations. The application of monoclonal antibodies, either singly or in a group that recognizes a common antigen, along with methods such as detection of common DNA fragment from clinical specimens, may have a promising future in the laboratory diagnosis of trichomoniasis.


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