Clinical case of the treatment of venous leg ulcers in a patient with Sjogren disease

Relevance. Trophic ulcers on the background of systemic diseases are characterized by long flow and cause greater difficulties in treatment due to the reduced regenerative capabilities of the body. As a result of taking hormones muscles and skin become atrophic changes. Thinning and dry skin are particularly susceptible to trauma. Trophic ulcers in systemic connective tissue diseases often have no specific signs. Indicate systemic disease can atypical localization (thighs, buttocks, torso, upper extremity, head, mucosa of the oral cavity) wound, long for ulcers, with no tendency to regenerate, the big help in diagnostics renders the identification of syndromes, evidence of systemic autoimmune lesions of organs and tissues (polyarthritis, polyserositis, damage internal organs). Purpose: description of the case of the treatment of the patient with Sjogren disease. Materials and methods. In this report a clinical case of treatment of ulcers of the tibia on the background of long-term hormonal therapy. Patient more than 20 years of suffering from Sjogren's disease. Diagnosis of Sjogren’s disease (chronic, moderate activity (II) expressed stage), dry keratoconjunctivitis, parenchymatous parotitis, xerostomia, Raynaud's Syndrome, trophic ulcer of left tibia and varicose disease of the lower extremities, 2. Sjogren’s disease - a systemic autoimmune disease characterized by involvement of exocrine glands, mainly salivary and lacrimal, with the gradual development of secretory failure, combined with various systemic manifestations. Local treatment of trophic ulcers took place against the background therapy of the underlying disease. In the first stage for cleansing the surface of trophic ulcers used for the contact controlled cryodestruction was carried out hydropressing treatment of the wound. The result - on the 5th day the wound was completely cleansed from necrotic tissue. Further, the local treatment consisted in the creation of optimal conditions for regeneration. After 4 weeks the wound is almost completely epithelization. Conclusions. When Sjogren's disease treatment of ulcerative defects of the skin of the lower extremities takes place on the background of long-term hormonal medications. An important condition for wound healing is to decrease the dose of hormones to the minimum necessary. In this clinical observation in local treatment was applied the technique of contact controlled cryodestruction of pathological tissues on the surface of the ulcer.

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Vasculitis and collagen vascular diseases

10.1093/med/9780198569381.003.0862 ◽

2011 ◽

Author(s):

Neil Scolding

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Systemic Disease ◽

Central Nervous System Involvement ◽

Disease Diagnosis ◽

The Body ◽

Therapeutic Trial ◽

Collagen Vascular Diseases ◽

Diagnosis And Management ◽

Neurological Features

That part of the clinical interface between neurology and general medicine occupied by inflammatory and immunological diseases is neither small nor medically trivial. Neurologists readily accept the challenges of ‘primary’ immune diseases of the nervous system: these tend to be focussed on one particular target such as oligodendrocytes or the neuro-muscular junction present in predictable ways, and are amenable as a rule to rational, methodological diagnosis, and occasionally even treatment. This is proper neurology.‘Secondary’ neurological involvement in diseases mainly considered systemic inflammatory conditions—for example, SLE, sarcoidosis, vasculitis, and Behçet’s—is a rather different matter. It may be difficult enough to secure such a diagnosis even when systemic disease has previously been diagnosed and new neurological features need to be differentiated from iatrogenic disease, particularly drug side effects or the consequences of immune suppression. But all the diseases mentioned may present with and confine themselves wholly to the nervous system; they may mimic one another, and pursue erratic and unpredictable clinical courses. In central nervous system disease, diagnosis by tissue biopsy is potentially hazardous and unattractive. Few neurologists enjoy excesses of confidence or expertise when faced with such clinical problems: the cautious diagnostician is perplexed, and the evidence-based neuroprescriber confounded. Unsurprisingly, great variations in approaches to diagnosis and management are seen (Scolding et al. 2002b).But rheumatologically inclined general, renal or respiratory physicians, comfortable when managing inflammation affecting their system or indeed other parts of the body designed to support the nervous system, are generally also ill at ease when faced with neurological features whose differential diagnosis may be large, particularly given the near universal diagnostic non-specificity of either imaging or CSF analysis.Here then is the subject material for this chapter: the diagnosis and management of central nervous system involvement in inflammatory and immunological systemic diseases (Scolding 1999a). In not one of these neurological conditions has a single controlled therapeutic trial been reported, and much that is published on these conditions is misleading or inaccurate. And yet the frequency with which the diagnosis is only confirmed or even first emerges at autopsy bears stark witness to both the severity and evasiveness of these disorders.

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Use of negative pressure in the treatment of anaerobic non-clostridial perineal infection

Wounds and wound infections The prof B M Kostyuchenok journal ◽

10.25199/2408-9613-2021-8-3-42-45 ◽

2021 ◽

Vol 8 (3) ◽

pp. 44-47

Author(s):

B. A. Salazar Mun'oz

Keyword(s):

Diabetes Mellitus ◽

Negative Pressure ◽

Clinical Case ◽

Negative Pressure Wound Therapy ◽

Local Treatment ◽

Complex Treatment ◽

Wound Therapy

The article presents a clinical case of a successful complex treatment anaerobic non-clostridial perineal infection in a 54-year-old patient with long-term diabetes mellitus. Particular attention is paid to the possibilities of local treatment using negative pressure wound therapy in the management of this patients category.

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Long term EIT based compliance monitoring in COVID-19 patients

Current Directions in Biomedical Engineering ◽

10.1515/cdbme-2021-2082 ◽

2021 ◽

Vol 7 (2) ◽

pp. 323-326

Author(s):

Imanol Isasa Reinoso ◽

Rongqing Chen ◽

András Lovas ◽

Knut Moeller

Keyword(s):

Electrical Impedance ◽

Disease Diagnosis ◽

The Body ◽

Respiratory Complications ◽

Impedance Tomography ◽

Non Invasive ◽

Phenotype Classification ◽

Continuous Technology

Abstract The COVID-19 is a viral infection that causes respiratory complications. Infected lungs often present ground glass opacities, thus suggesting that medical imaging technologies could provide useful information for the disease diagnosis, treatment, and posterior recovery. The Electrical Impedance Tomography (EIT) is a non-invasive, radiationfree, and continuous technology that generates images by using a sequence of current injections and voltage measurements around the body, making it very appropriate for the study to monitor the regional behaviour of the lung. Moreover, this tool could also be used for a preliminary COVID-19 phenotype classification of the patients. This study is based on the monitoring of lung compliances of two COVID-19-infected patients: the results indicate that one of them could belong to the H-type, while the other is speculated belongs to L-type. It has been concluded that the EIT is a useful tool to obtain information regarding COVID-19 patients and could also be used to classify different phenotypes.

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Saliva: Physiology and Diagnostic Potential in Health and Disease

The Scientific World JOURNAL ◽

10.1100/tsw.2010.38 ◽

2010 ◽

Vol 10 ◽

pp. 434-456 ◽

Cited By ~ 61

Author(s):

Sebastien J. C. Farnaud ◽

Ourania Kosti ◽

Stephen J. Getting ◽

Derek Renshaw

Keyword(s):

Communicable Disease ◽

Systemic Disease ◽

Disease Diagnosis ◽

Antimicrobial Activities ◽

Human Saliva ◽

The Body ◽

Viable Alternative ◽

Indirect Detection ◽

Oral Disease ◽

Diagnostic Potential

Saliva has been described as the mirror of the body. In a world of soaring healthcare costs and an environment where rapid diagnosis may be critical to a positive patient outcome, saliva is emerging as a viable alternative to blood sampling. In this review, we discuss the composition and various physiological roles of saliva in the oral cavity, including soft tissue protection, antimicrobial activities, and oral tissue repair. We then explore saliva as a diagnostic marker of local oral disease and focus particularly on oral cancers. The cancer theme continues when we focus on systemic disease diagnosis from salivary biomarkers. Communicable disease is the focus of the next section where we review the literature relating to the direct and indirect detection of pathogenic infections from human saliva. Finally, we discuss hormones involved in appetite regulation and whether saliva is a viable alternative to blood in order to monitor hormones that are involved in satiety.

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Features of Diagnosis and Treatment of the Drug-Induced Glaucoma Clinical Case

Ophthalmology in Russia ◽

10.18008/1816-5095-2019-3-399-407 ◽

2019 ◽

Vol 16 (3) ◽

pp. 399-407 ◽

Cited By ~ 1

Author(s):

I. L. Simakova ◽

A. N. Kulikov ◽

I. A. Tikhonovskay ◽

M. V. Sukhinin ◽

R. D. Berezin ◽

...

Keyword(s):

Clinical Case ◽

Systemic Disease ◽

Drug Induced ◽

The Past ◽

Medical Institutions ◽

Key Points ◽

Corticosteroid Drugs ◽

Chronic Blepharitis

Purpose: To describe the interesting and fairly rare due to its features clinical case of secondary glaucoma caused by prolonged use of corticosteroids in the composition of ocular drops and ointments for the treatment of chronic blepharitis. Key points: The features of this case are the young age of the patient, as well as late diagnosis of steroid glaucoma and concomitant systemic disease in the form of psoriatic spondylitis, despite regular examinations of the patient by ophthalmologists from various medical institutions over the past two years in connection with the treatment of chronic blepharitis with frequent exacerbations in both eyes. The abolition of corticosteroid drugs, complex treatment in combination with immunocorrection, systemic therapy of psoriatic spondylitis and surgical treatment of glaucoma in both eyes led to long-term remission of chronic blepharitis, stabilization of the glaucomatous process and improvement of the patient’s quality of life. Conclusion: Ophthalmologists should monitor the level of intraocular pressure in all patients who are treated with drugs containing corticosteroids

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Defining the Competence of Psychologists with a View to Public Accountability *

European Psychologist ◽

10.1027/1016-9040.2.4.293 ◽

1997 ◽

Vol 2 (4) ◽

pp. 293-300 ◽

Cited By ~ 4

Author(s):

Ype H. Poortinga ◽

Ingrid Lunt

Keyword(s):

Scientific Knowledge ◽

Professional Training ◽

Professional Competence ◽

Codes Of Ethics ◽

The Body ◽

The European Union ◽

Rigorous Evaluation ◽

Judicial Proceedings ◽

Psychological Knowledge

In national codes of ethics the practice of psychology is presented as rooted in scientific knowledge, professional skills, and experience. However, it is not self-evident that the body of scientific knowledge in psychology provides an adequate basis for current professional practice. Professional training and experience are seen as necessary for the application of psychological knowledge, but they appear insufficient to defend the soundness of one's practices when challenged in judicial proceedings of a kind that may be faced by psychologists in the European Union in the not too distant future. In seeking to define the basis for the professional competence of psychologists, this article recommends taking a position of modesty concerning the scope and effectiveness of psychological interventions. In many circumstances, psychologists can only provide partial advice, narrowing down the range of possible courses of action more by eliminating unpromising ones than by pointing out the most correct or most favorable one. By emphasizing rigorous evaluation, the profession should gain in accountability and, in the long term, in respectability.

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Ixekizumab in the Management of Non-Selected Out Patients with Moderate to Severe Psoriasis -New Data and Personal Clinical Experience

Medical & Clinical Research ◽

10.33140/mcr.03.03.05 ◽

2018 ◽

Vol 3 (3) ◽

Keyword(s):

Clinical Experience ◽

Personal Experience ◽

Therapeutic Response ◽

Systemic Disease ◽

Severe Psoriasis ◽

Adequate Treatment ◽

Scalp Psoriasis ◽

Number Of Patients ◽

Genital Psoriasis

Introduction: Too many patients with moderate to severe psoriasis do not receive adequate treatment. This means a vast undersupply in the treatment of patients with psoriasis. Only biologics fulfill the whole range of the treatment of psoriasis – psoriasis does not affect only skin but the whole organism: It is a systemic disease! Between the biologics are evident differences concerning the effect. Discussion: Based on broad personal experience in the management of patients with moderate to severe psoriasis new data from clinical studies with ixekizumab are examined. This contains new data on long-term-efficacy of ixekizumab, effectiveness in special localizations (scalp psoriasis, nail psoriasis, palmoplantar psoriasis, genital psoriasis) as well as safely data and experience on patients switched to ixekizumab from other biologics. Personal clinical experience is based on >300 non-selected outpatients with moderate to severe psoriasis, >250 patients on biological therapies, > 50 patients with ixekizumab. Conclusions: Focusing on a relevant number of patients switched from secukinumab to ixekizumab due to first or secondary loss of efficacy significant differences between both IL-17A-inhibitors mainly in terms of efficacy and speed of therapeutic response are shown. Finally the correlation between PASI-90-/PASI-100 response and significant changes in DLQI are highlighted.

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STUDIES IN THE SUPPOSED GOITROGENOUS EFFECT OF TAP WATER IN HELSINKI

Acta Endocrinologica ◽

10.1530/acta.0.xxxiii0630 ◽

1960 ◽

Vol XXXIII (IV) ◽

pp. 630-636

Author(s):

F.-E. Krusius ◽

P. Peltola

Keyword(s):

Tap Water ◽

Physiological Saline ◽

Normal Weight ◽

The Body ◽

Iodine Uptake ◽

Redistilled Water ◽

Detectable Difference ◽

Term Administration ◽

Long Term Experiment

ABSTRACT The study reported here was performed in order to examine the tap water of Helsinki for its alleged goitrogenous effect. In a short-term, 24-hour experiment with rats, kept on an iodine-poor diet, we noticed no inhibition of the 4-hour 131I uptake, as compared with that of animals receiving physiological saline instead of tap water. Two similar groups of rats receiving 1 and 2 mg of mercazole in redistilled water showed a distinct blockage of the 4-hour uptake, which proved the effect of this substance. In a long-term experiment of 5 weeks' duration there was no detectable difference in the body weight, thyroid weight and the 4-hour 131I uptake when the rats receiving tap water or distilled water to which 0.45 per cent of sodium chloride was added were compared with each other. Replacement of tap water by a 10 mg per cent solution of mercazole in redistilled water enlarged the thyroid to double its normal weight and increased the 131I uptake to approximately five times that of the controls. Thus our experiments failed to demonstrate any goitrogenous effect in the tap water of Helsinki. Changes similar to those produced by a long-term administration of mercazole, i. e. an enlargement of the thyroid and an increased thyroidal iodine uptake, have been shown to be due to milk collected from goitrous areas. The observations here reported confirm the importance of milk in the genesis of the goitre endemia of Helsinki. Attention is further called to the fact that a thyroidal enlargement combined with an increased thyroidal iodine uptake cannot always be taken as a sign of iodine deficiency because similar changes may be produced by the administration of goitrogens.

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