scholarly journals Possibilities of diagnostic scales in patients with acute appendicitis in the conditions of an infectious hospital

Author(s):  
Vyacheslav P. Zemlyanoy ◽  
Vyacheslav A. Melnikov ◽  
Mikhail M. Nahumov ◽  
Yuliya V. Letina ◽  
Agata Yu. Zemlyanskaya

Currently, diagnostic scales are being actively developed to help doctors diagnose and make decisions regarding the treatment tactics of certain diseases. In particular, there are diagnostic scales for acute appendicitis. However, we found no publications describing the results of assessing the sensitivity of diagnostic scales for acute appendicitis in relation to patients admitted to infectious diseases hospitals, as well as the results of comparing the sensitivity of these scales in patients in general surgery and infectious diseases hospitals. Thus, based on the sufficient clinical material, we have analyzed the results of comparing the sensitivity of some diagnostic scales of acute appendicitis in relation to patients in general surgical hospitals and patients being treated in hospitals with an infectious profile. The results of the study show that the sensitivity of diagnostic scales in relation to acute appendicitis in patients treated in infectious diseases wards is lower than in patients in surgical departments of the general profile. The following result may be explained by masked course of acute appendicitis (when simulating the symptoms of acute intestinal infection), as well as the blurred clinical picture of acute appendicitis in patients with acute and chronic infectious diseases.

2021 ◽  
Vol 162 (38) ◽  
pp. 1526-1532
Author(s):  
András Zóka ◽  
Béla Kádár ◽  
Eszter Vad

Összefoglaló. A fertőzésekhez kapcsolódó immunológiai kórképekre különösen jellemző, hogy mind etiológiai tényezőikben, mind klinikai képükben rendkívül heterogének. Az átfedő és inkomplett megjelenési formák nem ritkák, ami a diagnosztika standardizálását nehezíti. Egyes, a fertőzésekhez opcionálisan kapcsolódó tünetek megfigyelése már több mint egy évszázaddal ezelőtt elvezetett a gócelmélet megszületéséhez, amely eredeti formájában leginkább elnagyolt és naiv feltételezéseken alapult. Folyamatosan bővülő ismereteink ugyanakkor egyre több esetben támasztják alá, hogy az átvészelt, esetleg krónikus vagy perzisztáló fertőzések, illetve a mikrobiom összetétele számos ponton lehet befolyással immunológiai, metabolikus és endokrin homeosztázisunkra. A jelen munkában az ismert összefüggéseket, illetve a meghaladott feltételezéseket is röviden érintve megkíséreljük a rendelkezésre álló ismereteken keresztül áttekinteni a fertőzésekhez kapcsolódó immunológiai jelenségek szürkezónáját, azon kórtani folyamatokat és tüneteket, amelyek létezése igazolható, de terápiás következményeik az egyén szintjén egyelőre bizonytalanok. Orv Hetil. 2021; 162(38): 1526–1532. Summary. Immunologic phenomena related to infections are well known to be truly heterogeneous, both regarding their etiology and the clinical picture. Overlapping symptoms and incomplete presentations are not seldom, which often constitute diagnostic challenge. Certain, optional complications of infectious diseases led to the creation of the focal infection theory more than a century ago, although only on the basis of assumptions derived from elusive and naive theories. However, an expanding body of evidence ever since did underline the impact of previous and persistent infections on the immunologic, metabolic and endocrine homeostasis. Besides briefly touching the well-defined diseases, as well as the outdated theories of this field, we aim to provide an overview of the grey zone of infection-related immunologic phenomena, the existence of which is biologically well established, however, their true significance on an individual basis remains uncertain. Orv Hetil. 2021; 162(38): 1526–1532.


2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
João Paulo Nunes Drumond ◽  
André Luis Alves de Melo ◽  
Demétrius Eduardo Germini ◽  
Alexander Charles Morrell

Endometriosis in the vermiform appendix is a rare condition that affects women of childbearing age. The clinical picture can simulate inflammatory acute abdominal pain, especially acute appendicitis. Laboratory and imaging tests may assist in the diagnosis but are not conclusive. This article reports a case of acute appendicitis caused by appendiceal endometriosis for which laparoscopic appendectomy and diagnostic confirmation were performed after histopathological analysis.


2021 ◽  
Vol 8 (8) ◽  
pp. 2267
Author(s):  
İsmail Hasirci ◽  
Mehmet E. Ulutas ◽  
Gurcan Simsek ◽  
Alpaslan Sahin ◽  
Kemal Arslan ◽  
...  

Background: During the pandemic, the decision on delaying elective surgeries was implemented country-wide, and emergency surgeries were excluded from this scope. In this study, the patients diagnosed with COVID-19 and who underwent an emergency general surgery operation were evaluated regarding indications, demographic characteristics, and preoperative and postoperative clinical features.Methods: In the study, emergency surgeries performed by the department of general surgery between 1st June and 30th September, when our center cared only patients diagnosed with COVID-19, were reviewed retrospectively.Results: A total of 13 patients, 7 women and 6 men, were included in this study. The most common surgical diagnosis was acute appendicitis (9/13). For all of the patients with appendicitis, a conventional appendectomy procedure was performed. 2 patients were diagnosed with an incarcerated femoral hernia and then operated (2/13). One patient was operated on due to a sharp object injury, and one due to an acute abdomen caused by a perforation. Only 3 of the operated patients developed postoperative wound site complications (23%). No mortality was observed by the end of a 15-day follow-up.Conclusions: The most common cause of emergency surgeries during the pandemic, changelessly, remains to be acute appendicitis. Besides, cases of trauma, perforated peptic ulcer, and incarcerated hernia are also commonly encountered. While the pandemic continues full steam, these conditions that are associated with the pandemic but among causes of mortality and morbidity other than COVID-19 and that may require an emergency surgery should be considered. All emergency surgical procedures should continue to be performed punctually by using necessary protective types of equipment.


Author(s):  
Олексій Кузнєцов

Introduction. Seasonal allergic rhinitis is AZ of mucous membranes (primarily the conjunctiva of the eye and nasal mucosa), due to hypersensitivity to aerosol allergens of plant pollen and fungi spores, the concentration of which in the air periodically becomes prijenosnog. The leading clinical manifestation of SAR is considered as allergic conjunctivitis. According to statistics, about 70-90% of patients with SAR develops Pulawy conjunctivitis, characterized by itching of eyes, eyelids, their redness, photophobia, lacrimation. Clinically important is the combination of SAR and conjunctivitis. Although the SAR attention usually emphasize on nasal symptoms, more than 80% of patients, as practice shows, suffer from symptoms from the eyes. According to the European and North American researchers, more than 70% of patients with SAR suffer from eye and nasal symptoms, and their severity the majority of patients assessed asmoderate or severe.Materials and methods. Clinical and anamnestic study was done in 120 patients aged from 19 to 45 years. All the studied patients were divided according to the degree of severity of the disease: 58 patients with moderate course of seasonal allergic rhinitis and conjunctivitis (EYE), which caused Pilica ambrosia and 62 patients with severe SARK, which pilca caused by ragweed. Of these, 43 (35,8%) women, 77 (64.1%) of men aged 19 to 25 years – 76 (63.3 per cent), from 25 to 45 years – 44 (36.6%) patients. The control group consisted of 30 healthy people.Research results. The differentiation of the history of infectious diseases patients. In the studied patients SARK with moderate current, acute respiratory illness (ARI) was observed in 54 (26,9%) patients, varicella – 16 (8,0%), mumps – 12 (6,0%), measles in 11 (5,5%), viral hepatitis in 4 (1,9%) patients, acute bronchitis 36 (17,9%), pneumonia – 17 (8,5%), the scarlet fever in 6 (2.9%) and intestinal infection in 7 (3,5%), sore throat – 25 (12,4%), otitis in 13 (6,5%) patients. In patients with severe SARK, ARI was observed in 59 (23,3%) patients, varicella – 24 (9,5%), mumps – in 18 (7.1 percent), measles – in 16 (6.3 percent), viral hepatitis in 7 (2.8%) and acute bronchitis – in 43 (17%), pneumonia in 19 (7,5%), scarlet fever in 8 (3,2%), intestinal infection in 9 (3,6%), angina 32 (12,6%), otitis media – in 18 (7.1 per cent) patients.Analyzing the structure of infectious diseases in the anamnesis in the studied patients SARK need to emphasize that their structure is dominated infection in the upper respiratory tract and broncho-pulmonary system that leads to depletion of nonspecific and specific immunity factors, formation of secondary immunodeficiency in these systems.Discussion of research. In the study of biochemical parameters of blood in patients with SARK in the period of aggravation established that the greatest changes are observed from endogenous cholesterol and phospholipids, which may indicate the failure of the macrophage link of immunity. At the same time, β-lipoproteins and NIK was increased only in the group of patients with severe SARK. The increase of phospholipids in serum of patients with severe SARK can point to the implementation of late phase allergic inflammation in cellular tissue structure of the nasal mucosa.Conclusions. Conducted research of history data, the structure of comorbidity, laboratory parameters allergological studies have shown that SARK is formed on the background of progressive sensitization and allergization of the organism, which is implemented in the manifestation of allergic reactions, forming the severity of SARK, and on the strength of the immune response to a variety of ecoalign that define the types of immunopathological reactions in this cohort of patients.


2021 ◽  
pp. 11-19
Author(s):  
V. P. Zemlyanoy ◽  
B. V. Sigua ◽  
V. A. Melnikov ◽  
M. M. Nakhumov ◽  
Yu. V. Letina

The results of the analysis of medical records of 148 patients with acute appendicitis who were treated in the surgical departments of an infectious diseases hospital and in a general surgical hospital are presented. The patients were divided into 3 groups: I (main) — patients with a confirmed infectious disease, II (occult) — patients with excluded infectious disease, III (comparison group) — patients of a general surgical hospital. Patients treated in an infectious diseases hospital were admitted mainly within 24 hours from the onset of the disease, while patients with a general surgical profile — in the interval from 6 to 24 hours from the onset of symptoms. In the structure of morphological forms of acute appendicitis in infectious patients, gangrenous appendicitis prevailed, and phlegmonous appendicitis among general surgical patients. Peritonitis, which is the most frequent complication of acute appendicitis, was registered in group I in 53 (96,4 %) cases, in group II in 35 (71,4 %) cases, and in group III in 16 (36,4 %) cases, moreover, the patients of the infectious diseases hospital predominantly developed purulent forms, and the patients of the general surgical hospital developed serous peritonitis.


1927 ◽  
Vol 23 (1) ◽  
pp. 66-73
Author(s):  
N. N. Nazarov

Pathological processes in the gallbladder, duodenum and stomach on the one hand, and in the internal genitalia of women on the other, indeed often create a clinical picture of a disease full of uncertainties. In looking for a solid basis for practical measures, sometimes obviously urgent, in such cases, not without good reason, the surgeon fixes his attention, among others, on a possible disease of the appendix of the appendix. In other cases, the inflammatory process in the appendix itself, accompanied by symptoms not quite peculiar to this disease, does not allow to exclude the possibility of disease also in the mentioned areas above and below the appendix.


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