scholarly journals REM-associated bradyarrhythmia (a clinical case)

2021 ◽  
Vol 27 (5) ◽  
pp. 583-590
Author(s):  
D. V. Pakhomova ◽  
M. V. Agaltsov ◽  
E. Yu. Andreenko ◽  
O. M. Drapkina
Keyword(s):  
Atrioventricular Block ◽  
Management Strategy ◽  
Clinical Case ◽  
Correct Diagnosis ◽  
Young Age ◽  
Strategy Choice ◽  
Structural Abnormalities

The article presents an observation of a rare clinical arrhythmia — REM-associated advanced atrioventricular block 2nd degree. The absence of structural abnormalities of the heart, the young age and the need for additional methods of instrumental examination for diagnosis (polysomnography, test with the active orthostasis test) are important features of the case. Despite the orphan nature of this arrhythmia, the correct diagnosis is important for the choice of the management strategy choice.

Middle ear tuberculosis - clinical case

ORL ro ◽  
2016 ◽  
Vol 2 (1) ◽  
pp. 12-14
Author(s):  
A. Sandul ◽  
M. Buracovschi ◽  
N. Buracovschi
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Human Population ◽  
Clinical Case ◽  
Correct Diagnosis ◽  
Tuberculous Otitis Media ◽  
Type V

Tuberculosis is one of the oldest pathologies that affect human population, being a significant cause of morbidity/mortality in several countries. Middleear tuberculosis is a rare pathology, often misdiagnosed because of an atipic evolution, as a result leading to severe complications. This paper presents a case of tuberculous otitis media complicated with facial nerveparalysis House Brackmann type V in a patient who underwent multiple middleear surgeries before correct diagnosis was established.  

COVID-19-associated orthostatic hypotension syndrome: direct and indirect mechanisms of development

2021 ◽  
Vol LIII (3) ◽  
pp. 64-70
Author(s):  
Elena G. Mendelevich ◽  
Alsu A. Saifeeva ◽  
Artur I. Kurbanov
Keyword(s):  
Nervous System ◽  
Orthostatic Hypotension ◽  
Clinical Case ◽  
Clinical Observation ◽  
Thrombus Formation ◽  
Correct Diagnosis ◽  
Aim Analysis ◽  
Angiotensin Converting Enzyme 2 ◽  
Mechanisms Of Development ◽  
Near Future

Background. The article presents an observation of the clinical case of orthostatic hypotension that developed after an infection caused by the SARS-CoV-2 virus. The issues of etiology, pathogenesis, diagnosis are outlined. The complexity of diagnosis at the stage of clinical observation is due to the comorbidity of possible mechanisms and the difficulty of determining the primary factor. Taking into account the study of variants of direct and indirect action of this 2019-nCoV, the description of the clinical observation of orthostatic hypotension supplements the data on the spectrum of manifestations of this disease. Aim. Analysis of the clinical case of the development of orthostatic hypotension in the post-acute period of COVID-19. Material. When conducting a literature review on the selected topic, various sources were considered. The search depth was over 7 years. For the recruitment of literature, Internet platforms UpToDate, PubMed, Medscape were used. Russian and foreign sources were studied. Methods. Anamnesis collection, objective research, specialized tests, laboratory and instrumental research methods, study of disease history, literature sources on orthostatic hypotension and the effect of COVID-19 on the autonomic nervous system. Results. The analysis of this case with the determination of the leading mechanism of orthostatic hypotension is extremely difficult. Probably, there is a combination of factors: direct and indirect effects on the nervous system at COVID-19. The direct effect is associated with the interaction of the virus with the angiotensin converting enzyme 2 receptors in the nervous system, which causes a significant increase in the concentration of bradykinin and the development of hypotension. An indirect effect is due to both increased thrombus formation with the development of PE, and autonomic dysfunction, within the framework of secondary polyneuropathy of fine fibers. Conclusion. It is likely that in the near future the number of such patients in the practice of doctors will increase, therefore, timely and correct diagnosis of these conditions, with their careful management, will be the fundamental postulates in the recovery of patients. Drawing attention to this topic will possibly expand our understanding of the spectrum of complications of COVID-19 and will greatly complement the information available today.

scholarly journals The clinical case of dorsopathy and hypertension in young age and treatment issues

2016 ◽  
Vol 0 (10(206)) ◽  
pp. 61-65
Author(s):  
I. I. Kniazkova ◽  
A. A. Nesen ◽  
V. V. Maziy ◽  
A. A. Bozhok ◽  
Zh. Yu. Sharkadi
Keyword(s):  
Clinical Case ◽  
Young Age

Desmoid tumor of the anterior abdominal wall in a female (Clinical case)

2018 ◽  
pp. 116-118
Author(s):  
M.V. Makarenko ◽  
◽  
D.O. Govseyev ◽  
S.V. Gridchin ◽  
N.H. Isaeva ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Desmoid Tumor ◽  
Clinical Case ◽  
Anterior Abdominal Wall ◽  
Correct Diagnosis ◽  
Final Diagnosis ◽  
Histological Findings ◽  
History Of ◽  
Slow Growing ◽  
Wall Tumor

Desmoid tumors (also called desmoids fibromatosis) are rare slow growing benign and musculoaponeurotic tumors. Although these tumors have a propensity to invade surrounding tissues, they are not malignant. These tumors are associated with women of fertile age, especially during and after pregnancy and postoperative surgeries. Our clinical case is interesting because of the rarity of the pathology and the difficulties in setting the correct diagnosis. The patient, with a history of laparoscopic myomectomy (2012), was preparing for a routine surgery for the endometrioma of the anterior abdominal wall, according to the results of the ultrasound and computed tomography. After surgical treatment, the final diagnosis was changed, based on the histological findings. Key words: desmoid tumor, abdominal wall tumor, fibroid.

Fulminant diabetes mellitus and concomitant enterovirus infection: a clinical case

2020 ◽  
Vol 26 (2) ◽  
pp. 125-132
Author(s):  
T. V. Saprina ◽  
N. N. Musina ◽  
S. V. Vtorushin ◽  
N. V. Krakhmal’ ◽  
Yu. V. Rogovskaya
Keyword(s):  
Diabetes Mellitus ◽  
Management Strategy ◽  
Clinical Case ◽  
Rapid Development ◽  
Fulminant Type 1 Diabetes ◽  
Pancreatic Cells ◽  
Total Destruction ◽  
Fulminant Diabetes ◽  
Fulminant Type

Fulminant type 1 diabetes mellitus is a subtype of diabetes mellitus. It is characterized by the extremely rapid development of hyperglycemia and ketoacidosis because of the near-total destruction of pancreatic -cells. A clinical case of lethal, type 1, fulminant diabetes mellitus is presented. The patient management strategy and possible causes of the adverse course and outcome of the disease are analyzed.

scholarly journals Multimorbidity in Pediatric Dermatology: Clinical Case

2020 ◽  
Vol 19 (6) ◽  
pp. 483-489
Author(s):  
Nikolay N. Murashkin ◽  
Alexander I. Materikin ◽  
Eduard T. Ambarchian ◽  
Roman V. Epishev ◽  
Leonid A. Opryatin ◽  
...  
Keyword(s):  
Genetic Testing ◽  
Autosomal Recessive ◽  
Clinical Case ◽  
Correct Diagnosis ◽  
Molecular Genetic ◽  
Final Diagnosis ◽  
Molecular Genetic Testing ◽  
Pediatric Dermatology ◽  
Dominant Type ◽  
Recessive Type

Background. Nowadays, dermatoses with mixed clinical picture and resistant to classical management become more common. The presence of various genetic disorders typical for most chronic dermatoses may indicate possible combination of several nosologies.Clinical Case Description. The article presents the clinical case of multimorbid condition in 10 years old patient who has nucleotide variants in CARD14 and EXPH5 genes. Mutations in CARD14 gene are typical for patients with type 2 psoriasis and pityriasis rubra pilaris (autosomal dominant type), while mutations in EXPH5 gene are typical for patients with non-specific epidermolysis bullosa (autosomal recessive type). Mutation in the TGM1 gene that is described in patients with congenital ichthyosis (autosomal recessive type), pathogenic mutations in KRT74 gene typical for ectodermal dysplasia, hypotrichosis and uncombable hair syndrome, and mutations in the KRT86 gene typical for monilethrix were also revealed. Medical history taking and histological examination as well as clinical data evaluating are crucial for correct diagnosis. They allow to understand the absence of the such manifestations in relatives and reveal various pathological processes in the epidermis. Molecular genetic testing with new generation sequencing (NGS) helps to finally establish the diagnosis and determine the further tactics for patient management.Conclusion. Multidisciplinary approach and use of high-technology methods of examination and treatment (such as molecular genetic testing and biological therapy) are required for final diagnosis in severe forms of chronic dermatosis resistant to treatment and for decision on correct tactics for the further management of such patients.

scholarly journals A Rare Case of Juvenile X-Linked Retinoschisis

2021 ◽  
Vol 48 (4) ◽  
pp. 28-32
Author(s):  
E. Mermeklieva ◽  
P. Vasileva
Keyword(s):  
Rare Case ◽  
Clinical Case ◽  
Correct Diagnosis ◽  
Field Testing ◽  
Clinical Findings ◽  
Fundus Photography ◽  
Visual Field Testing ◽  
Full Field ◽  
Pattern Electroretinography ◽  
Retinal Dystrophies

Abstract Aim: To present a rare clinical case of X-linked retinoschisis, confirmed clinically, electrophysiologically and genetically. Material and methods: A 12-year-old boy underwent detailed ophthalmic examination including fundus photography, full-field, multifocal and pattern electroretinography, visual field testing, optical coherence tomography, which established the clinical diagnosis, confirmed also genetically. Results: The clinical findings included a slight loss of vision, central and paracentral scotomas, a characteristic spoke-wheel pattern appearance of the macula in fundoscopy and the pathognomic appearance of splitting of the retinal layers in the macula with foveal schisis with cystic spaces on OCT. Reduced cone and rod ERG responds were detected with the characteristic decreasing of b-ware near the isoelectric line. The genetic analysis found that the patient was hemizygous for the missense mutation c.598G>A (p.Arg200Cys) of RS1 gene, coming from his asymptomatic mother. Conclusion: The comprehensive clinical, electrophysiological and genetic testing of patients with rare hereditary retinal dystrophies is essential for the correct diagnosis and the choice of therapeutic approach.

scholarly journals VATS-resection of the lower lobe of the left lung as a result of treatment of the long-term consequences of postponed foreign body aspiration in the child’s airways: Clinical case

2020 ◽  
pp. 90-95
Author(s):  
M. Opanasenko ◽  
◽  
L. Levanda ◽  
A. Tereshkovich ◽  
I. Liskina ◽  
...  
Keyword(s):  
Foreign Body ◽  
Respiratory Tract ◽  
Clinical Case ◽  
Foreign Bodies ◽  
Correct Diagnosis ◽  
Left Lung ◽  
Lower Lobe ◽  
Physical Exertion ◽  
Recurrent Pneumonia ◽  
The Right

Introduction. Foreign bodies in the airways are a very urgent problem that occurs at any age and quite often requires an urgent and sometimes urgent assessment of the situation, examination, and making the right decision. According to statistics, most often foreign body in airway are found in childhood. In about 95–98% of cases, this pathology is recorded in children aged 1.5 to 3 years. This is due to the behavior of children, their anatomical and physiological characteristics and underdevelopment of protective reflexes. Among all cases of foreign body in airway, foreign bodies of the larynx are found in 12%, trachea – in 18%, bronchus – in 70% of cases. In 80% of cases, CTs enter the right bronchus, as it is a broader and more direct continuation of the trachea. The correct diagnosis is established early after CT aspiration in 40–57% of patients. The mortality rate varies, according to different authors, from 2 to 15%. Clinical case. The boy V., born in 2008. was admitted to the Department of Pediatric Pulmonology on May 30, 2019, with complaints of frequent unproductive cough, mainly daytime, increasing with physical exertion, sometimes subfibril body temperature, weakness, lethargy, decrease appetite. These complaints have been observed for the third time in the last six months. Diagnosis: Foreign body B10 of the left lung. Conclusions. Aspiration of a foreign body into the respiratory tract most often occurs in early childhood (1–3 years). The clinical picture in the early stages is asymptomatic, and over time it leads to the development of inflammatory changes in the lungs, are treated conservatively. Given the complexity of diagnosis, aspiration of a foreign body can lead to frequent recurrent pneumonia, the formation of bronchiectasis in the lower parts of the lungs, which may require surgical treatment. The gold standard of diagnostics is fibrobronchoscopy and spiral computed tomography of the thoracic cavity (SCT OGK), with the help of which, early after aspiration, a foreign body can be detected and subsequently excluded from the respiratory tract. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of an participating institution.The informed consent of the child’s parents was obtained from the studies. No conflict of interest was declared by the authors. Key words: child, lungs, foreign body.

scholarly journals Rare dermatological diseases: Devergie disease

2020 ◽  
Vol 22 (7) ◽  
pp. 54-56
Author(s):  
Kristina T. Plieva ◽  
◽  
Elena V. Denisova ◽  
Maksim A. Bobrov ◽  
Dzerassa R. Mildzikhova ◽  
...  
Keyword(s):  
Key Words ◽  
Rare Disease ◽  
Histological Examination ◽  
Clinical Case ◽  
Correct Diagnosis ◽  
Clinical Manifestations ◽  
Dermatological Diseases ◽  
Pityriasis Rubra Pilaris

Devergie disease, or pityriasis rubra pilaris, is a poorly studied and rare disease, which prevalence is estimated at about 1 in 400 thousand. The article provides relevant data on the classification of Devergie disease, features of the course and clinical manifestations of each of the 6 types of the disease, as well as the ap-proximate occurrence of these types. Erythroderma can occur in Devergie disease, but data on the incidence of this manifestation vary significantly. The article presents a clinical case of type 1 Devergie disease. This case is of particular interest, since the disease began not according to the classical scheme, i.e., with appearance of an erythematous spot, but with extensive areas of erythroderma. This case is intended to draw attention to the fact that dermatological diseases do not always develop in a typical way, and the correct diagnosis often requires a histological examination. Key words: pityriasis rubra pilaris, Devergie disease, erythroderma, clinical case. For citation: Plieva K.T., Denisova E.V., Bobrov M.A. et al. Rare dermatological diseases: Devergie disease. Consilium Medicum. 2020; 22 (7): 54–56. DOI: 10.26442/20751753.2020.7.200187

scholarly journals Pulmonary lesions in visceral toxocariasis in children in the phthisiatric practice (clinical case)

2021 ◽  
Vol 16 (3) ◽  
pp. 245-250
Author(s):  
O.M. Raznatovska ◽  
Yu.V. Mironchuk
Keyword(s):  
Differential Diagnosis ◽  
Blood Test ◽  
Clinical Case ◽  
Clinical Symptoms ◽  
Correct Diagnosis ◽  
White Blood Cells ◽  
Left Lung ◽  
Lung Lesion ◽  
Pediatric Tuberculosis ◽  
Tuberculin Tests

Background. The clinical and radiological picture of pulmonary tuberculosis has many common features with a large number of diseases. Therefore, differential diagnosis is very important when detecting tuberculosis. The purpose of the work: on the example of a clinical case to present the complexity of the differential diagnosis between pulmonary lesion in visceral toxocariasis and tuberculosis in children. Results. The child was diagnosed with an infiltrate in the third segment of the left lung with lesions of the intrathoracic lymph nodes, which is characteristic of the primary tuberculosis. The volatility of the infiltrate was not determined. All general blood test hadn’t shown an increase in eosinophils and white blood cells. According to the literature data, the appearance of persistent and prolonged eosinophilia with the development of eosinophilic leukemoid reactions of the blood, an increase in the level of leukocytes are the main and one of the constant manifestations of toxocariasis. The child was diagnosed with moderate hepatomegaly, which is cha­racteristic for both diseases. The patient was registered at a pediatric tuberculosis clinic due to a shift in tuberculin tests. At the time of hospitalization, there were not reasons to suspect visceral toxocariasis. Due to the examination data, first of all the absence of bacterial excretion and negative tuberculin tests, and the pre­sence in the child’s house of the dogs and cats, it was decided to recommend the consultation of the infectionist to exclude any parasitic disease. At the end, the correct diagnosis was established in this child at time and the necessary treatment was prescribed. Conclusions. This clinical case demonstrates the difficulties of differential diagnosis of visceral toxocariasis in lung lesion and tuberculosis. First of all, this is due to the asymptomatic clinical picture of toxocariasis, the diagnosis of which was established by X-ray data, blood test for IgG antibodies to Toxocara and epidemiological history. Given the fact that toxocariasis includes a large spectrum of masks of various diseases, and children who are infected by Toxocara do not have specific clinical symptoms, doctors should remember to prescribe the additional examination for the presence of parasitic diseases, including toxocariasis, especially if pets live in the child’s home.

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