Posterior laryngeal clefts

2021 ◽  
Vol 20 (3) ◽  
pp. 70-76
Author(s):  
P. V. Pavlov ◽  
◽  
M. L. Zakharova ◽  
M. R. Abubakarova ◽  
A. P. Ivanov ◽  
...  

The posterior laryngeal cleft is a rare congenital malformation of the larynx, with an estimated incidence of 1 in 10,000–20,000 children born alive. Despite the apparent obviousness of the pathology, the diagnosis of the posterior cleft of the larynx often causes difficulties, which is associated with a variety of clinical symptoms, primarily due to the varying prevalence of the pathological process. Objective: To analyze the results of treatment of patients with congenital laryngeal cleft. Materials and methods: A retrospective analysis of case histories of children in the department of otolaryngology of the clinic of the St. Petersburg State Pediatric Medical University, from 2003 to 2018, diagnosed with congenital malformation of the larynx, posterior laryngeal cleft, was performed. Results: Normal respiration and nutrition through the natural pathways was achieved in 13 children with type I cleft and in 2 with type IIIa. Three patients with IIIa and IIIb types of clefts could not be rehabilitated due to severe concomitant somatic and neurological pathology, for which they continue treatment with relevant specialists at the present time. Conclusions: Rehabilitation of patients with laryngeal cleft of type IIIa and IIIb, especially in the presence of severe concomitant somatic and neurological pathology, does not always give positive results.

2021 ◽  
Vol 2021 (4) ◽  
pp. 27-42
Author(s):  
T. O. Pertseva ◽  
L. I. Konopkina ◽  
K. O. Bielosludtseva ◽  
O. O. Shchudro ◽  
K. V. Fuhol

VENTILATION AND DIFFUSIONAL DISORDERS IN PERSONS AFTER COMMUNITYACQUIRED PNEUMONIA, ASSOCIATED WITH CORONAVIRUS DISEASE (COVID-19). POSSIBILITIES OF INHALATION THERAPY T. O. Pertseva, L. I. Konopkina, K. O. Bielosludtseva, O. O. Shchudro, K. V. Fuhol Dnipro State Medical University, Dnipro, Ukraine Abstract. The aim of the study was to evaluate the results of our own observations of persons after communityacquired pneumonia associated with coronavirus disease (COVID-19), to determine options of functional disorders that may be observed in the post COVID-19 period, and to justify the possibility of inhalation therapy in patients with certain clinical symptoms in the post COVID-19 period, and demonstrate its effectiveness. Materials and methods. The results of our own observations are presented in the form of descriptions of ten clinical cases of functional state of the respiratory system in persons after community-acquired pneumonia associated with COVID-19. Conclusions. At the end of the acute period of COVID-19, the ventilatory function of the lungs in patients may be different: normal, with restrictive disorders (varying degrees of severity), with obstructive disorders (usually mild), with mixed disorders (without prevalence of certain types of changes, or with prevalence, most often, restrictive disorders). In this case, impaired diffusion capacity of the lungs is an extremely common phenomenon. Most likely, in COVID-19 in a certain category of patients, not only interstitial lung tissue but also bronchial tree tissue (mucous membrane, submucosal layer, muscles, vessels) may be involved in the pathological process. It is possible that this process may be of autoimmune origin. If there are bronchoobstructive disorders in the post COVID-19 period, patients should be prescribed bronchodilator therapy; long-acting β2 -agonists, in particular formoterol, may be the drugs of choice. If there is a long-term recovery of lung tissue structure, given that coronavirus disease is an autoimmune disease, the use of inhaled corticosteroids should be considered individually. The combined drug Bufomix Easyhailer® , prescribed according to the indications, has shown good efficacy and safety in the management of the patient in the post COVID-19 period. Key words: coronavirus disease; COVID-19; pneumonia, associated with COVID-19; post COVID-19 period; spirometry; diffusion lung capacity of carbon monoxide; DLCO.


Author(s):  
E. A. Nikolaeva ◽  
A. N. Semyachkina

Veltischev Researchand Clinical Institutefor Pediatricsofthe Pirogov Russian National Research Medical University, Moscow, Russia The article presents modern data on the most common monogenic connective tissue disease – Ehlers–Danlos syndrome. The authors describe two previous classifications of the syndrome: Berlin (1988) classification, which distinguishes 11 types of the disease, and Beyton (1998) classification, which includes 6 types of the syndrome and takes into account the results of molecular genetic studies. Particular attention is paid to a new classification, proposed by the International Consortium in 2017. This classification is based on the clinical and molecular genetic data and unites 13 types of Ehlers–Danlos syndrome, divided in 7 groups (A–G), depending on the main molecular defect. This defect determines the violation of various collagen structures (primary, spatial, cross-linking) and others constituents of the connective tissue (myomatrix, glycosaminoglycans, complement component, etc.). The classification provides general clinical symptoms for all types of the disease and comprehensive information on the specific signs of each of the 13 types of the syndrome.The authors discuss approaches to the pathogenetic therapy of the syndrome, the possibilities of symptomatic treatment, including both medications of different spectrum of action, and physiotherapeutic measures, exercise therapy. The complex of the listed therapeutic measures is aimed at stabilizing the main pathological process, preventing complications, improving the patient’s quality of life and social adaptation. The authors emphasize that correct patient management, targeted medical supervision and medical genetic counseling requires molecular genetic verification of the diagnosis.


2012 ◽  
Vol 140 (11-12) ◽  
pp. 732-737 ◽  
Author(s):  
Ivan Golubovic ◽  
Zoran Vukasinovic ◽  
Predrag Stojiljkovic ◽  
Zoran Golubovic ◽  
Sonja Stamenic ◽  
...  

Introduction. Open segmental fractures of the tibia are rare but severe injuries. In these fractures the wide zone of injury (damage of all structures of the lower leg) creates very unsuitable biological conditions for healing of the fracture. Objective. The aim of our work was to present the results of treatment of patients with segmental open fractures of the tibia treated by external fixation. Methods. We analyzed treatment results of 21 patients with open segmental tibial fractures who were treated using the method of external fixation at the Clinical Center Nis from January 1, 1995 to July 31, 2010. The average age of the patients was 53 years; the youngest patient was 27 years and the oldest one 80 years. According to the Gustilo open fracture classification, there were 3 (14.3%) type I, 6 (28.6%) type II, 8 (38.1%) type IIIA, and 4 (19.0%) type IIIB. All the patients were treated by a unilateral type Mitkovic external fixator by Traffix Company. Results. Union was attained in 16 (76.2%) fractures without severe complications (pseudoarthrosis, chronic osteitis and angular deformities of over 10 degrees). Among severe complications associated with open segmental tibial fractures, in two cases we registered septic pseudoarthrosis, in one aseptic pseudoarthrosis and in two large angular deformities of the tibia after union, with a valgus of over 10 degrees and extremity shortening of over 2 cm which required additional surgery. Conclusion. External fixation by the use of Mitkovic external fixator is one of the methods of choice in the treatment of open segmental tibial fractures, which incorporated with antibiotic therapy provides good biomehanical conditions for segmental fracture healing that enables good stability of the segmental tibial fracture and decreases the risk of deep infections.


2012 ◽  
Vol 9 (5) ◽  
pp. 55-59
Author(s):  
A A Tsyvkina ◽  
L V Luss ◽  
S V Tsarev ◽  
N V Shartanova

Background. To study of efficacy, tolerability and safety of nasal spray Prevalin in the treatment of allergic rhinitis patients. Methods. 30 patients with allergic rhinitis in the age of18 till 45 years were observed. Prevalin was given as one insufflation into each nasal cavity 3 times a day for 21 days. Results of treatment were assessed by the dynamics of clinical symptoms and the results of functional methods . Results. The positive clinical effect was observed in 22 patients (73,3%), using Prevalin. Clinical effect was characterized by the restoration of nasal breathing, reduce swelling of the nasal mucosa. We did not establish a good result of treatment in 8 patients. Conclusion. The study demonstrated clinical efficacy and safety of spray Prevalin.


2021 ◽  
Author(s):  
Magen E. Francis ◽  
Una Goncin ◽  
Andrea Kroeker ◽  
Cynthia Swan ◽  
Robyn Ralph ◽  
...  

AbstractCOVID-19 (coronavirus disease 2019) caused SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection is a disease affecting several organ systems. A model that captures all clinical symptoms of COVID-19 as well as long-haulers disease is needed. We investigated the host responses associated with infection in several major organ systems including the respiratory tract, the heart, and the kidneys after SARS-CoV-2 infection in Syrian hamsters. We found significant increases in inflammatory cytokines (IL-6, IL-1beta, and TNF) and type II interferons whereas type I interferons were inhibited. Examination of extrapulmonary tissue indicated inflammation in the kidney, liver, and heart which also lacked type I interferon upregulation. Histologically, the heart had evidence of mycarditis and microthrombi while the kidney had tubular inflammation. These results give insight into the multiorgan disease experienced by people with COVID-19 and possibly the prolonged disease in people with post-acute sequelae of SARS-CoV-2 (PASC).


2020 ◽  
Vol 28 (2) ◽  
pp. 48-54
Author(s):  
Al'fiya K. Imayeva ◽  
Tagir I. Mustafin

In all variants of the destructive form of pancreatitis, the involvement of adipose tissue of both para-pancreatic and distant localization was noted. In this case, it is necessary to improve the pathological diagnosis of acute destructive pancreatitis. The aim of the study was to develop new techniques for postmortem examination of those who died from complications of acute pancreatitis. Pathological studies were supplemented by the methods proposed by the authors, which made it possible to clarify the spread of the infectious agent through the retroperitoneal tissue. The scheme proposed by the authors for recording changes in the tissue of the pancreas and surrounding tissues after a contrast study made it possible to clarify the main ways of propagation of the purulent-necrotic process along the retroperitoneal tissue. The results of postmortem examination of 67 deaths from complications of acute pancreatitis are presented. Based on the study, 5 types of acute destructive pancreatitis were identified. In type I, the pathological process involves the right half of the retroperitoneal tissue, including the mesentery root of the small intestine, the para-pancreatic region, the right para-kidney and sub-hepatic space. The second type is characterized by the presence of inflammatory and destructive changes in the fiber of the right lateral canal, the actual retroperitoneal space on the right and the mesentery root of the transverse colon. Purulent-necrotic changes in para-pancreatic, left perineal tissue, mesentery of the transverse colon, also in peritoneum were typical for type III acute destructive pancreatitis. For type IV disease, in addition to areas of involvement as in type III, involvement of the pelvic tissue and the left sections of the retroperitoneal space itself were noted. The spread of the infectious agent to both the right and left parts of the retroperitoneal tissue was defined as type V acute destructive pancreatitis.


2020 ◽  
Vol 19 (4) ◽  
pp. 32-36
Author(s):  
O. Bodnar

Pyrrhic disease is a congenital anomaly that occurs during embryogenesis due to the fixation of the splenic angle of the colon by a short and highly located left transverse-diaphragmatic ligament, creating a sharp bend and forming a "wellbore". In this case the passage of feces on a cross colon becomes difficult, there is also its sagging to a small pelvis. This pathology is characterized by paroxysmal pain (aggravated by exercise and after eating) and prolonged constipation, which progresses over time. Hilaiditis syndrome is a rather rare pathology in which there is an interposition of the hepatic angle of the colon between the liver and the diaphragm. There are permanent and intermittent localizations. The work generalizes the experience of evaluation of clinical manifestations and remote results of treatment of children with chronic colostasis caused by fixation abnormalities of the colon. 58 children were detected to have Payre’s disease, with Cyilaiditi’s syndrome – 3 children. 24 patients with Payre’s disease and 2 Cyilaiditi’s syndrome were operated on. To assess the effectiveness of surgery, children were divided into two groups: I group – comparative and II group - experienced. In I group (n=12 children) – the analysis of surgical treatment was performed traditionally. In II group (n=14 children) – the analysis of surgical treatment was conducted by means of the methods proposed. Traditional surgical treatment of Payre’s disease in children was followed by relapse of chronic constipation in 45,45%, pain in 50%, flatulence in 33,33% and failure of the ileocoecal closing apparatus in 100% of children. Unsatisfactory outcomes of surgical treatment of Cyilaiditi’s syndrome was observed in a child from the comparative group. Relapse of clinical symptoms to a lesser degree than before the surgery was found in 1 child from the experienced group. To treat Payre’s disease the following operation is proposed: intersection of the left diaphragm-colon ligament, resection of transverse colon and colofixation of the left bending of the colon. To treat Cyilaiditi’s syndrome (in case of dolichoascendocolon) the following operation is suggested: hepatopexy, resection of the right bending of the colon with ascending transversal anastomosis “end to end”, fixing of right bending of the colon. Their reasonability is being proved.


Author(s):  
Arumugam P. ◽  
Swathandran Hamsavardhini ◽  
Ravishankar J.

Background: ABO discrepancies occur whenever the results of red cell grouping and serum grouping are in disagreement. The reasons for discrepancies both clinical and technical have to be sorted out. Further analysis is essential to resolve such discrepancies. If discrepancies are encountered, the interpretation of the ABO grouping has to be delayed until the same has been resolved. The aim of the study was to resolve ABO discrepancies encountered, by serological work up.Methods: All cases of discrepant samples received between August 2014 and May 2016 at the Department of Transfusion Medicine, The Tamilnadu Dr. MGR Medical University, Chennai, India were analyzed to determine the etiology by serological workup.Results: A total of twenty-one samples were analyzed and resolved. Fifteen cases of Type IV discrepancy, two cases of Type II discrepancy, one case Type III discrepancy, one case Type I discrepancy and two cases of technical errors were identified.Conclusions: ABO discrepancies can be resolved serologically if properly worked up. As ABO blood grouping is indispensible in blood transfusion service, it is imperative to resolve such discrepancies before transfusion.


2021 ◽  
Vol 25 (4) ◽  
pp. 540-544
Author(s):  
Obadeh Bassam Abdel-Rahman Al-Qaraleh ◽  
V. I. Stepanenko ◽  
T. G. Kryvonis ◽  
V. S. Shkolnikov ◽  
S. V. Prokopenko

Annotation. Exacerbation and aggravation of psoriasis increases the chances of neurosis, depression, can significantly impair mental health through social stigma and leads to social isolation and maladaptation, a significant reduction in quality of life. Studying this problem from the standpoint of comparative assessment of the distribution of character accentuations in patients with different dermatoses can provide insight into how a certain level of adequacy of psychological adaptive response is associated with organic pathological process or genetically existing expression of certain traits. The aim of the study was to found the features of indicators of expression and features of accentuated personality traits in men with psoriasis without taking into account somatotype and in representatives of meso- and endo-mesomorphic somatotypes. Men aged 22 to 35 years, patients with psoriasis (n=100, including 32 with mild and 68 with severe course) at the Department of Skin and Venereal Diseases with a course of postgraduate education National Pirogov Memorial Medical University, Vinnytsya and Military Medical Clinical Center of the Central Region, conducted an anthropometric survey by V. V. Bunak Estimation of the expression and features of accentuated personality traits made according to G. Shmishek The reliability of the difference between the values between the independent quantitative values was determined using the U-Mann-Whitney test. In healthy subjects, taking into account and without taking into account the somatotype, it is seen that the type of physique did not significantly affect the severity of individual traits and their combinations in this group of people. With the increase in the course of psoriasis among subjects without somatotype, there is a decrease in the percentage of persons with hyperthymic and demonstrative and an increase – with emotional, pedantic, anxious, cyclothymic, excitable, dysthymic and exalted type of character accentuation; among patients of mesomorphic somatotype there is a decrease in the percentage of people with stuck and demonstrative and an increase – with emotional, pedantic, anxious, cyclothymic, excitable, dysthymic and exalted type of character accentuation; among patients of endo-mesomorphic somatotype there is a decrease in the percentage of people with hypertension and an increase – with stuck, demonstrative and excitable type of character accentuation. All this maintains a pathologically high level of affective tension, which disrupts the autonomic balance in the body, can be a pathogenic factor in the development of psychosomatic illness and leads to ineffective treatment of psoriasis.


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