scholarly journals Pustular psoriasis and arthropathy in a patient with HIV infection. Clinical case

2021 ◽  
Vol 24 (2) ◽  
pp. 151-160
Author(s):  
Elizaveta G. Nekrasova ◽  
Valery V. Dubensky ◽  
Vladislav V. Dubensky ◽  
Olga A. Alexandrova ◽  
Eатерина S. Muraveva
Keyword(s):  
Hiv Infection ◽  
Clinical Case ◽  
Negative Impact ◽  
Pustular Psoriasis ◽  
Morphological Examination ◽  
X Ray ◽  
Additional Challenge ◽  
Additional Section ◽  
Distal Interphalangeal ◽  
Index 2

The article presents a clinical case of pustular psoriasis and arthropathy in a patient with HIV infection. The diagnosis of psoriasis was confirmed by morphological examination. Signs of arthropathy were confirmed by X-Ray: presence of oligoarthritis of the distal interphalangeal joints of the fingers and feet was seen. Dactylitis severity ― 23 points, the Ritchie index ― 2, DLQI ― 28. The clinical course of psoriasis and its treatment in HIV-infected patients was considered after taking into account the data from literature and the patients current condition and observation. The above observation of a combination of several clinical forms of psoriasis (vulgar, pustular and arthropathy) in patients with HIV infection is an illustration of the features of the course and comorbidity of chronic dermatosis and AIDS, due to the influence of the infectious process, immunosuppression and ART. The development of pustular form and arthropathy creates the additional challenge of prescribing basic systemic treatment for severe and complicated psoriasis in an HIV-infected patient due to the presence of contraindications due to comorbidity. The glucocorticosteriod selected by the committee was effective on the skin and joint pathological processes, without having any negative impact on the course and treatment of the HIV infection. Such cases require further study and development of methods for the treatment of patients with comorbidity and their inclusion in an additional section in the clinical recommendations for the diagnosis and treatment of psoriasis.

Disseminated lung disease in elderly patient with multimorbidity and HIV infection (clinical case)

2019 ◽  
pp. 53-55
Author(s):  
E. V. Yakovleva
Keyword(s):  
Differential Diagnosis ◽  
Hiv Infection ◽  
Lung Diseases ◽  
Clinical Case ◽  
Immune Status ◽  
Pneumocystis Pneumonia ◽  
Interstitial Lung Diseases ◽  
Hiv Screening ◽  
X Ray ◽  
Attending Physician

Disseminated lung diseases have similar non-specific manifestations in various etiologies, pathogenesis, and morphology. Pulmonary dissemination is the concept of X-ray, there are no pathognomonic symptoms on a radiograph that are inherent in a particular disease with pulmonary dissemination, therefore, in real clinical practice, differential diagnosis in pulmonary dissemination is the prerogative of the physician. Diseases that are manifested by pulmonary dissemination can be classified by dissemination of infectious causes (tuberculosis, HIV-associated dissemination, fungal lesions), malignant pulmonary lesions (carcinomatosis, cancer lymphangitis), cardiogenic dissemination and interstitial lung diseases. In recent years, the incidence of allergic interstitial lung diseases has increased. Infectious lesions of the lungs in patients with HIV infection and reduced immune status in many cases also have a disseminated form and cause difficulties in the differential diagnosis of tuberculosis. The article presents a clinical case of pneumocystis pneumonia in an HIV-infected patient with pulmonary dissemination syndrome on X-ray. The difficulties of the diagnostic search with low compliance of the patient and the physician are shown (a patient registered with HIV for 10 years hid this fact of his history from the attending physician and gave a written refusal to get tested for HIV fibrobronchoscopy). The possibility of introducing compulsory HIV screening for all patients admitted to the hospital with disseminated processes in the lungs has been considered.

scholarly journals X-RAY DIAGNOSTICS OF BRAIN DAMAGE IN UNIDENTIFIED HIV INFECTION

2021 ◽  
pp. 9-14
Author(s):  
A.V. Sudarkina ◽  
◽  
A.P. Dergilev ◽  
А.А. Kuzovkova ◽  
A.P. Nadeev ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Hiv Infection ◽  
Brain Damage ◽  
Clinical Examination ◽  
Clinical Case ◽  
Brain Lesions ◽  
X Ray ◽  
Undiagnosed Hiv ◽  
Neuroimaging Techniques

Brain damage can be observed at any stage of HIV infection, and the spectrum of its causes is extremely diverse. Neuroimaging techniques play a key role in assessing brain lesions. The article describes a clinical case of multifocal brain damage in a patient with undiagnosed HIV infection, discusses the possibilities of various methods of radiation examination for differential diagnosis, demonstrates the most important role of a comprehensive clinical examination for making a diagnosis.

Morphological features of endo- and myometrium in patients with uterine leiomyoma and infertility

2020 ◽  
pp. 33-37
Author(s):  
M.A. Flaksenberg ◽  
◽  
Keyword(s):  
Uterine Leiomyoma ◽  
Negative Impact ◽  
Reproductive Function ◽  
Cell Types ◽  
Underlying Disease ◽  
Reproductive Organs ◽  
Pathological Process ◽  
Simple Type ◽  
Morphological Examination ◽  
Blastocyst Implantation

The objective: determination of morphofunctional features of leiomatous nodes and endometrium in women with uterine leiomyoma and infertility to restore reproductive function and prevent recurrence of the underlying disease. Materials and methods. In order to restore reproductive function and prevent recurrence of the underlying disease, morphofunctional features of leiomatous nodes and endometrium in women with uterine leiomyoma and infertility were determined. Thirty samples of leiomyomatous nodes and endometrium were examined, among which 15 were obtained from women with multiple uterine leiomyoma and infertility and 15 samples from women with uterine leiomyoma with isolated uterine leiomyoma. During the study, a general-histological method was used for staining with hematoxylin-eosin and picrofuxin by van Gizon, as well as immunohistochemical methods. Histological examination of the endometrium was performed according to conventional protocol, taking into account the day of the menstrual cycle and R.W. Noyes criteria. Results. In the morphological examination of leiomyomatous nodes in the vast majority of cases the presence of uterine leiomyomas of simple and cell types or their combination was established. In women with multiple uterine leiomyoma, simple-type leiomyoma (53.3%) was predominant, and in patients with isolated leiomyoma the signs of cellular uterine leiomyoma (66.7%) were more frequently found. In 80.0% of women with uterine leiomyoma revealed pathology of the endometrium, such as glandular and glandular-fibrous polyps, simple and complex atypical endometrial hyperplasia, which confirms the theory about the only pathogenetic mechanisms of the emergence of hyperplastic processes of female organs. In 66.7% of women with multiple leiomyomas, signs of chronic endometritis have been found, which exacerbates the pathological process and can have a negative impact on the reproductive function, such as secretory endometrial transformation and impaired blastocyst implantation, and explains a much higher percentage of infertility in the group. Conclusion. In women with impaired reproductive function, patients with uterine leiomyoma, it is necessary to conduct a study of the receptivity of the reproductive organs, namely - the endometrium and leiomatous nodes. This will make it possible to use one or another method of treatment in order to restore reproductive function and prevent recurrence of the underlying disease. Keywords: infertility, uterine leiomyoma, endometrium, receptive apparatus.

scholarly journals Reliable Learning with PDE-Based CNNs and DenseNets for Detecting COVID-19, Pneumonia, and Tuberculosis from Chest X-Ray Images

Mathematics ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 434
Author(s):  
Anca Nicoleta Marginean ◽  
Delia Doris Muntean ◽  
George Adrian Muntean ◽  
Adelina Priscu ◽  
Adrian Groza ◽  
...  
Keyword(s):  
Transfer Learning ◽  
Negative Impact ◽  
X Ray ◽  
Domain Specific ◽  
Direct Training ◽  
Public Data ◽  
Normal Chest ◽  
Chest X Ray ◽  
The Stability ◽  
Definition Of

It has recently been shown that the interpretation by partial differential equations (PDEs) of a class of convolutional neural networks (CNNs) supports definition of architectures such as parabolic and hyperbolic networks. These networks have provable properties regarding the stability against the perturbations of the input features. Aiming for robustness, we tackle the problem of detecting changes in chest X-ray images that may be suggestive of COVID-19 with parabolic and hyperbolic CNNs and with domain-specific transfer learning. To this end, we compile public data on patients diagnosed with COVID-19, pneumonia, and tuberculosis, along with normal chest X-ray images. The negative impact of the small number of COVID-19 images is reduced by applying transfer learning in several ways. For the parabolic and hyperbolic networks, we pretrain the networks on normal and pneumonia images and further use the obtained weights as the initializers for the networks to discriminate between COVID-19, pneumonia, tuberculosis, and normal aspects. For DenseNets, we apply transfer learning twice. First, the ImageNet pretrained weights are used to train on the CheXpert dataset, which includes 14 common radiological observations (e.g., lung opacity, cardiomegaly, fracture, support devices). Then, the weights are used to initialize the network which detects COVID-19 and the three other classes. The resulting networks are compared in terms of how well they adapt to the small number of COVID-19 images. According to our quantitative and qualitative analysis, the resulting networks are more reliable compared to those obtained by direct training on the targeted dataset.

Distal interphalangeal Joint Arthrodesis using only Kirschner Wires in small distal Phalanges

2021 ◽  
Vol 53 (05) ◽  
pp. 462-466
Author(s):  
Jun-Ku Lee ◽  
Soonchul Lee ◽  
SeongJu Choi ◽  
Dong Hun Han ◽  
Jongbeom Oh ◽  
...  
Keyword(s):  
Distal Phalanx ◽  
Bony Union ◽  
Dash Score ◽  
Medical Database ◽  
X Ray ◽  
Wire Fixation ◽  
Distal Interphalangeal ◽  
K Wires ◽  
Quick Dash

Abstract Purpose To report the clinical and radiographic results of arthrodesis of relatively small-sized distal interphalangeal joints (DIPJs) using only K-wire fixation. Patients and methods Between January 2000 and December 2018 28 arthrodesis in 21 patients (9 males and 12 females with an average age of 52.1 years) with relatively small-sized DIPJs were performed using only K-wires. Data on patient’s characteristics, such as age, sex, affected finger, and the number and size of the used k-wires were collected from the medical database. The narrowest diameter of the cortex and medulla of the distal phalanx was measured on preoperative plain radiographs. The time to union and the arthrodesis angle was determined using serial X-ray radiography follow-up. Preoperatively and at the latest follow-up examination, pain using the visual analogue scale (VAS) and the quick DASH score was registered. In addition, complications were investigated. Results Average follow-up period was 11.4 months. The small finger was mostly affected (n = 12; 42.9 %). The narrowest diameters of the distal phalanx cortex and the medulla measured on preoperative X-ray images were 2.8 mm (SD 0.5) and 1.2 mm (SD 0.4), respectively. Seven fusions were done with use of 1 K-wire, 20 with 2 (71.4 %), and 1 with 3 K-wires. The most common K-wire sizes were 1.1-inch (24 K-wires = 48 %), and 0.9 inch (21 K-wires = 42 %) The preoperative VAS score and quick DASH score improved from 6.1 (range: 0–9) and 25.8 (range: 2–38) to 0.4 (range: 0–2) and 3.4 (range: 0–10.2), respectively. 25 (89.3 %) out of 28 fingers achieved bony union in an average of 96.1 days (range: 58–114) with three non-union. Conclusion Arthrodesis of small DIPJs with K-wire fixation has a high success rate. Therefore, we suggest K-wire fixation as an acceptable alternative for patients with a small phalanx which may be at risk of mismatch with bigger implants. However, concerns remain in terms of fusion delay with K-wire only fixation.

scholarly journals Magnetar X-ray emission mechanisms

2012 ◽  
Vol 8 (S291) ◽  
pp. 160-160
Author(s):  
Silvia Zane
Keyword(s):  
Spectral Analysis ◽  
Physical Interpretation ◽  
Spectral Properties ◽  
Gamma Ray ◽  
X Ray ◽  
Spectral Components ◽  
Self Consistent ◽  
Photon Index ◽  
Index 2 ◽  
Surface Fields

AbstractSoft gamma-ray repeaters (SGRs) and anomalous X-ray pulsars (AXPs) are peculiar X-ray sources which are believed to be magnetars: ultra-magnetized neutron stars which emission is dominated by surface fields (often in excess of 1E14 G, i.e. well above the QED threshold).Spectral analysis is an important tool in magnetar astrophysics since it can provide key information on the emission mechanisms. The first attempts at modelling the persistent (i.e. outside bursts) soft X-ray (¡10 keV) spectra of AXPs proved that a model consisting of a blackbody (kT 0.3-0.6 keV) plus a power-law (photon index 2-4) could successfully reproduce the observed emission. Moreover, INTEGRAL observations have shown that, while in quiescence, magnetars emit substantial persistent radiation also at higher energies, up to a few hundreds of keV. However, a convincing physical interpretation of the various spectral components is still missing.In this talk I will focus on the interpretation of magnetar spectral properties during quiescence. I will summarise the present status of the art and the currents attempts to model the broadband persistent emission of magnetars (from IR to hard Xrays) within a self consistent, physical scenario.

scholarly journals MENTAL DISORDERS AND THEIR INFLUENCE ON THE COMMITMENT TO OBSERVATION IN THE INFECTIONIST IN HIVINFECTED PATIENTS WITH EARLY SYPHILIS

2018 ◽  
Vol 10 (2) ◽  
pp. 69-80 ◽  
Author(s):  
E. M. Chumakov ◽  
N. N. Petrova ◽  
V. V. Rassokhin
Keyword(s):  
Mental Disorders ◽  
Hiv Infection ◽  
Brain Damage ◽  
Negative Impact ◽  
Minor Role ◽  
Syphilis Infection ◽  
Addictive Disorders ◽  
Early Syphilis ◽  
Organic Brain ◽  
Epidemiological Characteristics

HIV and syphilis have similar epidemiological characteristics which causes a high level of combined infection. Both STDs affect the central nervous system early after infection. Mental disorders occur with a high incidence in HIV-infected patients and patients with syphilis, but data on the effect of combined HIV and syphilis infection on mental disorders are found only in single articles. Objectives. The goal is to study mental disorders and their effect on the commitment to observation in the infectionist in HIV-infected patients with early syphilis. Materials and methods. A comparative study of 148 patients (65 HIV-infected patients with syphilis, 50 patients with syphilis monoinfection, 33 HIV-infected patients, seronegative for syphilis) was carried out. We used clinical, psychopathological, follow-up, psychometric, laboratory and statistical methods of investigation. Results. It was found that mental disorders occur in the majority (83%) of HIV-infected patients with syphilis with the predominance of affective (54%) and addictive (48%) disorders. In HIV-infected patients with early neurosyphilis, psychogenic reactions developed statistically significantly more often than in HIV-infected patients with early syphilis. In contrast, there were no statistically significant differences in the incidence of addictive, affective, personality disorders and mental disorders due to organic brain damage in patients with early neurosyphilis and early syphilis in the case of co-infection with HIV infection. Mental disorders due to organic brain damage had a mixed genesis (including infectious) in all cases and were associated and caused by the already existing HIV infection. HIV-infected patients with syphilis, in general, were characterized by the low commitment to observation in the infectionist which were influenced by the following factors: social maladjustment, drug abuse and criminal activity. Discussion. The frequency of detected mental disorders in the examined HIV-infected patients with syphilis (83,1%) corresponded to the literature on the incidence of mental illness in HIVinfected patients inSt. Petersburg(85,6%), but was higher than the prevalence of mental disorders in patients with syphilis (68%). Given the established influence of neurosyphilis mono-infection on the development of mental disorders due to organic brain damage, it can be concluded that the disease with early neurosyphilis is important in the development of mental disorders of organic genesis. But the weight of this factor is insufficient in case of co-infection with HIV and early neurosyphilis and can only have additional significance in the development of mental disorders and the key factor is HIV-infection action. Mental disorders (addictive disorders and cognitive impairment) adversely affect the commitment to observation in the infectionist of HIV-infected patients with syphilis, therefore timely correction of mental disorders may be one of the factors improving compliance of patients. Conclusions. The study found a minor role of early neurosyphilis (as opposed to HIV infection) on the formation of mental disorders in the case of a combination of these infections. At the same time, it was found that addictive and cognitive symptomatic complexes have a negative impact on the probability of reference to an infectious disease specialist for initiating therapy in HIV-infected patients with syphilis.

scholarly journals Pleural pathology in HIV-infected patients: features of morphological diagnostics

Morphologia ◽  
2021 ◽  
Vol 15 (3) ◽  
pp. 109-118
Author(s):  
I.V. Liskina ◽  
L.M. Zagaba
Keyword(s):  
Hiv Infection ◽  
Clinical Diagnosis ◽  
Molecular Genetic ◽  
Unknown Etiology ◽  
Pleural Effusions ◽  
Cd4 Cells ◽  
Morphological Examination ◽  
Genetic Studies ◽  
Pleural Tuberculosis ◽  
Morphological Diagnostics

Background. The progression of HIV infection is accompanied by the development of opportunistic diseases, including pleural effusions of various origins. Morphological examination of pleura tissue in cases of pleural effusion serves as the basis for establishing the etiology of the pathological process and, therefore, the final clinical diagnosis. Objective – analysis of results of morphological diagnostics of pleura lesions in HIV-infected patients in comparison with other laboratory tests and clinical diagnosis. Methods. 103 cases of pleurisy of various origins were studied. Pleural biopsies were obtained by various types of minimally invasive diagnostic interventions with subsequent morphological examination. Results were compared with the available data of microbiological and molecular genetic studies of pleural biopsies. Results. At the time of hospitalization the preliminary clinical diagnosis was pleurisy of unknown etiology in 96,1 % of cases. A combined disease was diagnosed – hepatitis C in a third of all observations according to the results of laboratory tests. Due to routine staining with hematoxylin and eosin, tuberculosis lesions of the pleura were diagnosed in 59,2 %, the second most frequent was the diagnosis of nonspecific pleurisy, 20,4 %. According to the duration of the process, acute pleural tuberculosis was established in 19,7 % of cases, the subacute form of tuberculosis pleurisy – in 54,1 % of cases, and chronic pleural tuberculosis was established in 22,9 % of cases. In 17,5 % of cases, in order to clarify the etiology of pleurisy, additional histochemical staining for infectious agents was performed. The results of microbiological and molecular genetic studies were established in 76,7 % of cases. The greatest number of M. tuberculosis detection was obtained during the culture study of the biopsy material and exudates. When comparing the final clinical diagnosis and the level of CD4 cells in peripheral blood, it was found that in most cases (74,5 %) pleural effusions developed at low counts of CD4 cells, less than 350/l. Conclusion. Tuberculosis predominates in the etiological structure of pleural effusions in patients with HIV infection. Pleural tuberculosis can be the main secondary disease or be combined with pulmonary tuberculosis. In second place in terms of frequency of occurrence, nonspecific pleurisy was diagnosed as a complication of the main secondary disease. Pleural effusions develop when CD4 cell counts are low. Morphological diagnostics of pleural lesions is the main research method in the diagnostic algorithm of cases of pleural effusions of unknown etiology against the background of HIV infection.

A rare case of xanthogranulomatous pyelonephritis in a child with a doubling of the upper urinary tract (clinical case)

2019 ◽  
pp. 79-82 ◽  
Author(s):  
N. B. Kireeva ◽  
D. A. Alyautdinova ◽  
N. Yu. Orlinskaya
Keyword(s):  
Acute Pyelonephritis ◽  
Clinical Case ◽  
Wilms Tumor ◽  
Left Kidney ◽  
Kidney Injury ◽  
Xanthogranulomatous Pyelonephritis ◽  
Lower Segment ◽  
Morphological Examination ◽  
Kidney Tumors ◽  
Single Observation

Xanthogranuomatous pyelonephritis (CP) is an aggressive form of interstitial nephritis, including purulentdestructive and proliferative processes in the kidney to form granulomatous tissue. The difficulty of diagnosis of CP, low illumination of this problem in the literature are the reason for the publication of even a single observation. The exact diagnosis of the disease can be established only with morphological examination and, as a rule, after surgical treatment. The clinical observation of the treatment of the child 15 years xanthogranulomatous pyelonephritis, inpatient Nizhny Novgorod regional children's teaching hospital. A boy M. at the age of 15 years entered the clinic of acute pyelonephritis (fever up to 38–39°С, abdominal pain and left side). From anamnesis it is known that at the age of one year the child was diagnosed with recurrent leukocyturia. Urological examination revealed hydronephrosis of the lower half of the double kidney on the left. At the age of 7 he was operated on (due to negative dynamics), reconstructive surgery was performed – prilohanochnaya pyeloplasty on the lower segment of the double kidney on the left. In the subsequent exacerbations of pyelonephritis was not. 6 years after hepatitis and kidney injury (contusion), there was a significant increase in dilation of the abdominal system of the lower segment of the left kidney with exacerbation of secondary pyelonephritis. According to intravenous urography, MSCT, MRI (performed to exclude Wilms tumor), the absence of the function of the lower segment of the kidney with a sharp increase in its size was determined. After the preoperative examination, the left kidney was examined, in which the signs of xanthogranulomatous pyelonephritis (renal tissue of bright yellow color), lower left heminephroureterectomy were found, the Diagnosis was confirmed by morphological examination. In the postoperative period, a cyst of the lower pole of the kidney was formed, cured by percutaneous drainage, sclerosing under ultrasound control, followed by recovery. Thus, this clinical case demonstrates the complexity of the diagnosis of CP, which often occurs under the mask of a variety of diseases, including acute pyelonephritis and kidney tumors. Reliable diagnosis of xanthogranulomatous pyelonephritis is possible only with the help of histological examination of pathological tissues.

Sign in / Sign up

Export Citation Format

Share Document