scholarly journals SQUAMOUS CELL PRECANCEROUS LESIONS OF THE VULVA: CURRENT PROBLEMS OF CLASSIFICATION AND DIAGNOSIS

2019 ◽  
Vol 6 (4) ◽  
pp. 172-177
Author(s):  
O. V Chulkova ◽  
Elena G. Novikova ◽  
E. A Chulkova
Keyword(s):  
Squamous Cell ◽  
Precancerous Lesions ◽  
Clinical Manifestations ◽  
Current Data ◽  
Diagnostic Methods ◽  
Clinical Classification ◽  
Modern Treatment ◽  
Vulva Cancer

This article systematizes and analyzes objective difficulties in the diagnosis of precancerous and primary vulva cancer, such as: constant changes in classification and long-term coordination, long-term systematization of clinical manifestations. It also reflects the current data and achievements of virology and molecular biology, which again led to a change in the classification and approaches to the diagnosis and management tactics of patients with squamous cell lesions of the vulva. New predictor markers, currently available for use in conventional routine morphological practice, gave new data on the development of pre-tumor and tumor process of the external genitals. Also in this article, the new clinical classification of vulva diseases is analyzed in detail, a comparison of standard and new diagnostic methods is carried out, which in clinical practice helps to correctly diagnose, determine the extent of the lesion and, depending on the molecular factors of the prognosis, choose an individual modern treatment tactics.

The Epidemilogy of Chronic Venous Ulcer: Some Unanswered Questions

2000 ◽  
Vol 15 (3-4) ◽  
pp. 106-109
Author(s):  
C. V. Ruckley
Keyword(s):  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Clinical Manifestations ◽  
Epidemiological Studies ◽  
Therapeutic Interventions ◽  
Venous Disease ◽  
Clinical Classification ◽  
Age Related

Objective: To highlight gaps in knowledge concerning the epidemiology of chronic venous insufficiency and to indicate what future studies are required. Methods: Existing classifications are compared. Limitations of epidemiological studies are defined. Data from published series and from the Edinburgh Vein Study are presented. Synthesis: The Basle 1978 classification of chronic venous insufficiency (CVI) is a purely clinical classification in which the earliest grade is corona phlebectatica. The Porter 1988 classification of CVI attempted to correlate clinical grades with sites of venous incompe-tence. However, a consistent relationship does not exist. The CEAP classification separates the clinical grades (which do not include corona phlebectasia) from the anatomical segments. The CEAP clinical classification covers a range of venous manifestations but is not consistent. There is a need for further consideration of classifications. Published selected series of patients show that the frequency of incompetence in both deep and superficial systems increases in proportion to the severity of the clinical manifestations of venous disease. To understand the significance of these data we need to know the patterns of venous incompetence in the general population. Data from 1566 subjects between the ages of 18 and 64 years in the Edinburgh Vein Study, a randomly selected cross-section of members of the Edinburgh population, showed that the prevalence of CVI was age-related and was present in 9.2% of men and 6.6% of women. Men had a significantly higher frequency of reflux in the deep system than women. In order to direct therapeutic interventions where they are most appropriate we need to know which patients with the early stages of varicose veins progress to CVI and which patients with early CVI progress to the serious skin complications. Conclusions: Key information concerning the natural history of venous disease and its evolution in relation to haemodynamic abnormalities awaits the findings of longitudinal-cohort epidemiological studies which include the duplex scanning of large populations.

scholarly journals Symptom-based clinical profiles in the classification of post-traumatic headache

Neurology ◽  
2018 ◽  
Vol 91 (23 Supplement 1) ◽  
pp. S28.2-S28
Author(s):  
Andrew H Ahn ◽  
Sylvia M Lucas
Keyword(s):  
Unmet Need ◽  
Clinical Manifestations ◽  
Primary Headache ◽  
Current Data ◽  
Headache Disorders ◽  
Primary Headache Disorders ◽  
Specific Outcome ◽  
Post Traumatic ◽  
Definition Of

There are currently no established therapies for post-traumatic headache (PTH). One key obstacle standing in the way of meeting this unmet need is the fundamental gap in our understanding of the clinical course and functional impact of PTH. In this presentation we examine the existing schema used to characterize the clinical characteristics of PTH, including the International Classification of Headache Disorders (ICHD), and find that they leave major unresolved questions about the diagnosis, classification, and measurement of the clinical impact of PTH. Specifically, current data suggest that the ICHD classification, which is based on the extent of brain injury and the duration of condition, have limited prognostic and treatment implications. There are several challenges to the classification of PTH, as the clinical manifestations of PTH do not map well to the primary headache disorders, and the definition of the continuous and chronic daily headache require further study. Importantly, the existing classification do not provide or imply specific outcome measures for PTH, again a fundamental roadblock to testing therapeutic hypotheses for PTH. We hypothesize that a symptom-based classification is needed to begin an examination of these unresolved questions, and to establish clinically relevant endpoints for research and clinical trials for effective therapies.

Clinical Classification of Acquired Concomitant Esotropia

2021 ◽  
Vol 238 (04) ◽  
pp. 482-487
Author(s):  
Sara Gisselbaek ◽  
Nicole Hoeckele ◽  
Georges Klainguti ◽  
Pierre-François Kaeser
Keyword(s):  
Large Angle ◽  
The Elderly ◽  
Ophthalmological Examination ◽  
Clinical Classification ◽  
Adolescents And Adults ◽  
Long Term Follow Up ◽  
Retinal Correspondence

Abstract Background Classification and management of acquired concomitant esotropia is controversial. We sought to establish a simple clinical classification in order to determine in which cases further investigations in search of underlying pathologies are necessary. Patients and Methods Observational retrospective study of the files of 175 consecutive patients examined in our unit between 2009 and 2018 for acute convergent strabismus. One hundred and nine patients were selected, after exclusion of infantile, incomitant, or mechanical esotropias, residual esotropias, and patients examined on a single occasion. All patients received a complete orthoptic and ophthalmological examination. We grouped the patients according to their common characteristics. Results We established the following categories: 1. Acute esotropia of large angle (20 to 45 prism diopters [PD]), accompanied by mild hyperopia (mean 1.2 D) in children (n = 16) and moderate myopia (mean 3.7 D) in adolescents and adults (n = 13). 2. Decompensated micro-esotropia, which is distinguished from the other categories by the presence of abnormal retinal correspondence (n = 33). 3. Decompensated esophoria, with intermittent deviations of 5 to 30 PD, esotropia being compensated part of the time (n = 25). 4. Esotropia present only at a distance in patients over 50 years of age (n = 20). 5. Small-angle esotropia (< 15 PD) greater at a distance, associated with oculomotor cerebellar syndrome (n = 2). Complementary examinations (MRI or CT scan) were performed on 21 patients, leading to the discovery of a posterior fossa astrocytoma in a 4-year-old boy. Conclusions The recognition of decompensated micro-esotropia and esophoria, as well as distance esotropia of the elderly, avoids unnecessary additional investigations, which are indicated in any type of acute comitant strabismus if associated with any neurological sign or symptom (e.g., headaches, nausea, vertigo, imbalance, poor coordination, nystagmus, or papilledema). In the absence of neurological findings, there is no consensus about the indication of neuroimaging in large-angle acquired concomitant esotropia, but long-term follow-up of patients that do not undergo neuroimaging is strongly recommended in order to identify later occurring intracranial diseases. This is of particular importance with children.

scholarly journals Deep Learning on Oral Squamous Cell Carcinoma Ex Vivo Fluorescent Confocal Microscopy Data: A Feasibility Study

2021 ◽  
Vol 10 (22) ◽  
pp. 5326
Author(s):  
Veronika Shavlokhova ◽  
Sameena Sandhu ◽  
Christa Flechtenmacher ◽  
Istvan Koveshazi ◽  
Florian Neumeier ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Confocal Microscopy ◽  
Oral Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Ex Vivo ◽  
Diagnostic Methods ◽  
Automated Classification ◽  
Cancerous Tissue

Background: Ex vivo fluorescent confocal microscopy (FCM) is a novel and effective method for a fast-automatized histological tissue examination. In contrast, conventional diagnostic methods are primarily based on the skills of the histopathologist. In this study, we investigated the potential of convolutional neural networks (CNNs) for automatized classification of oral squamous cell carcinoma via ex vivo FCM imaging for the first time. Material and Methods: Tissue samples from 20 patients were collected, scanned with an ex vivo confocal microscope immediately after resection, and investigated histopathologically. A CNN architecture (MobileNet) was trained and tested for accuracy. Results: The model achieved a sensitivity of 0.47 and specificity of 0.96 in the automated classification of cancerous tissue in our study. Conclusion: In this preliminary work, we trained a CNN model on a limited number of ex vivo FCM images and obtained promising results in the automated classification of cancerous tissue. Further studies using large sample sizes are warranted to introduce this technology into clinics.

scholarly journals Post-COVID Syndrome: An Insight on Its Pathogenesis

Vaccines ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 497
Author(s):  
Helena C. Maltezou ◽  
Androula Pavli ◽  
Athanasios Tsakris
Keyword(s):  
Vascular Dysfunction ◽  
Clinical Manifestations ◽  
Neurological Complications ◽  
Good Prognosis ◽  
Current Data ◽  
Term Outcome ◽  
Long Term Outcome ◽  
History Of ◽  
Inflammatory Syndrome

Post-COVID syndrome is increasingly recognized as a new clinical entity in the context of SARS-CoV-2 infection. Symptoms persisting for more than three weeks after the diagnosis of COVID-19 characterize the post-COVID syndrome. Its incidence ranges from 10% to 35%, however, rates as high as 85% have been reported among patients with a history of hospitalization. Currently, there is no consensus on the classification of post-COVID syndrome. We reviewed the published information on post-COVID syndrome, putting emphasis on its pathogenesis. The pathogenesis of post-COVID syndrome is multi-factorial and more than one mechanism may be implicated in several clinical manifestations. Prolonged inflammation has a key role in its pathogenesis and may account for some neurological complications, cognitive dysfunction, and several other symptoms. A multisystem inflammatory syndrome in adults (MIS-A) of all ages has been also described recently, similarly to multisystem inflammatory syndrome in children (MIS-C). The post-infectious inflammatory pathogenetic mechanism of MIS-A is supported by the fact that its diagnosis is established through serology in up to one third of cases. Other pathogenetic mechanisms that are implicated in post-COVID syndrome include immune-mediated vascular dysfunction, thromboembolism, and nervous system dysfunction. Although the current data are indicating that the overwhelming majority of patients with post-COVID syndrome have a good prognosis, registries to actively follow them are needed in order to define the full clinical spectrum and its long-term outcome. A consensus-based classification of post-COVID syndrome is essential to guide clinical, diagnostic, and therapeutic management. Further research is also imperative to elucidate the pathogenesis of post-COVID syndrome.

Neurofibromatosis-associated pulmonary hypertension: an ominous duo

2020 ◽  
Vol 13 (7) ◽  
pp. e234976
Author(s):  
Sónia Gomes Coelho ◽  
Maria José Loureiro
Keyword(s):  
Pulmonary Hypertension ◽  
Clinical Case ◽  
Neurofibromatosis Type ◽  
Rapid Progression ◽  
Clinical Classification ◽  
Group 5 ◽  
Long Term Prognosis

The authors report a rare clinical case of a patient with neurofibromatosis type 1 (NF1) complicated by pulmonary hypertension (PH), which presents with rapid progression. An exhaustive investigation was performed to identify the main aetiology of the PH. It was concluded that the PH could be associated with NF1, and so belonged in group 5 of the clinical classification of PH. In general, such patients have a poor long-term prognosis due to the inexistence of proven, effective treatment. Further studies are needed to better understand the mechanisms of NF1-associated PH.

Spinal lumbar stenosis (analysis of the literature and own results)

2021 ◽  
pp. 594-613
Author(s):  
Anton Viktorovich Yarikov ◽  
Maksim Vladimirovich Shpagin ◽  
Amir Muratovich Meredzhi ◽  
Olga Aleksandrovna Perlmutter ◽  
Aleksandr Petrovich Fraerman
Keyword(s):  
Surgical Treatment ◽  
Lumbar Spine ◽  
Spinal Stenosis ◽  
Clinical Manifestations ◽  
Long Term Results ◽  
Lumbar Stenosis ◽  
Detailed Classification ◽  
Surgical Methods

The article is devoted to the issues of etiology, pathophysiology and clinical manifestations of spinal stenosis of the lumbar spine. The possibilities of modern instrumental diagnostics of the disease are described, the differential clinical diagnosis of lumbar stenosis is presented. The paper presents a detailed classification of spinal stenosis. The modern therapeutic tactics of the disease are described, indications for the surgical treatment of the disease are given. Modern methods of surgical treatment of stenosis are briefly and schematically described: decompression (microsurgical and endoscopic), interspinous fixation, stabilization (dorsal and ventral) and epidural stimulation of the spinal cord. The data on the immediate and long-term results of surgical methods of treatment are presented. The authors also presented their experience in the treatment of spinal stenosis of the lumbar spine. The use of differentiated surgical treatment tactics in 85–90 % of cases provides good and excellent results in the treatment of lumbar stenosis.

Use of photodynamic therapy for photodamage skin (review of literature)

2019 ◽  
Vol 1 (7) ◽  
pp. 19-23
Author(s):  
S. I. Surkichin ◽  
N. V. Gryazeva ◽  
L. S. Kholupova ◽  
N. V. Bochkova
Keyword(s):  
Photodynamic Therapy ◽  
Comparative Evaluation ◽  
Clinical Manifestations ◽  
Light Sources ◽  
Review Of Literature ◽  
Photosensitizing Agents ◽  
Selection Of

The article provides an overview of the use of photodynamic therapy for photodamage of the skin. The causes, pathogenesis and clinical manifestations of skin photodamage are considered. The definition, principle of action of photodynamic therapy, including the sources of light used, the classification of photosensitizers and their main characteristics are given. Analyzed studies that show the effectiveness and comparative evaluation in the selection of various light sources and photosensitizing agents for photodynamic therapy in patients with clinical manifestations of photodamage.

Modern methods of treating rosacea

2019 ◽  
Vol 1 (7) ◽  
pp. 65-71
Author(s):  
O. A. Egorova ◽  
K. A. Novikov
Keyword(s):  
Clinical Manifestations ◽  
Treatment Method ◽  
Current Data ◽  
Trigger Factors ◽  
Laser Technology ◽  
Individual Approach ◽  
Modern Methods ◽  
Methods Of Treatment ◽  
Choice Of Therapy

Presented current data on the etiology of rosacea, the main aspects of pathogenesis, clinical forms of the disease. Reflects trigger factors leading to rosacea, as well as complicating its course. Modern methods of treatment are described, including the use of new safe preparations of ivermectin and brimonidine, providing a good, lasting effect of clinical manifestations of rosacea. The role of laser technology, actively occupying a leading place in the choice of physiotherapeutic treatment method, is noted. The need for an individual approach in the choice of therapy for each patient with rosacea is emphasized.

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