Diagnosing Conjunctivitis

2021 ◽  
pp. 71-74
Author(s):  
A.E. Babushkin ◽  
Keyword(s):  
Clinical Picture ◽  
Clinical Symptoms ◽  
Specific Treatment ◽  
Mucosal Inflammation ◽  
Laboratory Diagnostics ◽  
Medical Specialties ◽  
Follicular Hyperplasia ◽  
Gender And Age ◽  
Symptom Complex ◽  
Acute Conjunctivitis

Conjunctivitis accounts for a significant share in the structure of eye disease. The reasons for their occurrence are very diverse. At first glance, it seems that such a disease as conjunctivitis does not cause difficulties in making a diagnosis. However the wide variety of its clinical forms and the need for strictly specific treatment in some cases, in addition to modern laboratory diagnostics, requires careful collection of anamnesis, sufficient clinical experience, and knowledge of related medical specialties. In this case the probable etiology, mainly of acute conjunctivitis, can be established by anamnesis, a set of clinical symptoms observed in the dynamics of its development. In other words, each of the acute infectious or allergic lesions of the eyelid mucosa is characterized by its own symptom complex, while the effective treatment in such cases is specific therapy (antibacterial, antiviral, anti-allergic, etc.). Differentiation of various forms of conjunctivitis is usually based on the assessment of the nature of the discharge, the localization of follicular hyperplasia, and lymphadenopathy. At the same time, the patient's gender and age, living and working conditions, concomitant diseases, contact with an infectious patient, etc. are taken into account. As for chronic forms of mucosal inflammation, in contrast to acute conjunctivitis, they are characterized more by subjective complaints of patients than by objective changes. Since it is often not possible to establish their etiology from the biomicroscopic picture and other data due to the erased clinical picture, it is often necessary to resort to laboratory diagnostics to verify chronic conjunctival ophthalmic infections. Key words: conjunctivitis, clinical picture, diagnosis.

scholarly journals Clinicobiochemical correlations in patients with the predominance of high-molecular prolactin in the blood serum

1995 ◽  
Vol 41 (1) ◽  
pp. 19-22
Author(s):  
Ye. Ye. Makarovskaya ◽  
I. A. Ilovaiskaya ◽  
A. V. Martynov ◽  
Ye. I. Marova ◽  
G. A. Melnichenko ◽  
...  
Keyword(s):  
Blood Serum ◽  
Molecular Mass ◽  
Clinical Picture ◽  
Clinical Symptoms ◽  
Disease Course ◽  
Typical Symptom ◽  
Blood Disease ◽  
Symptom Complex ◽  
Large Groups

A new rapid method for assesment of the ratio of immunoreactive prolactin forms with high and low molecular mass has been developed, which permits screening of large groups of patients. It was used in examinations of 44 women with hyperprolactinemea of various origin and with normoprolactinemic galactorrhea. High-molecular immunoreactive prolactin predominated in the blood serum of 25% of patients. This predominance did not depend on the origin of hyperprolactinemia, clinical picture of the disease, or level of total immunoreactive prolactin in the blood. Heterogenous clinical symptoms of the disease were characteristic of these patients: a typical symptom complex was absent in moderate hyperprolactinemia, whereas in patients with manifest hyperprolactinemia of a tumorous origin a classical clinical picture of persistent galactorrhea-amenorrhea was observed. A follow-up showed the predominance of high-molecular prolactin irrespective of the changes in the level of total immunoreactive prolactin in the blood, disease course, onset of pregnancy and labor.

scholarly journals Az alacsony alkalikusfoszfatáz-aktivitás klinikai értékelése és differenciáldiagnosztikája

2017 ◽  
Vol 158 (26) ◽  
pp. 1003-1007 ◽  
Author(s):  
Anna Fodor ◽  
Éva Kenesei ◽  
J. Attila Szabó
Keyword(s):  
Alkaline Phosphatase ◽  
Differential Diagnosis ◽  
Clinical Picture ◽  
Normal Values ◽  
Daily Practice ◽  
Laboratory Diagnostics ◽  
Test Results ◽  
Age Related ◽  
Gender And Age ◽  
Low Serum

Abstract: Laboratory diagnostics is especially important in the diagnosis of certain diseases. We compared manual measurements results to laboratory normal values. In some cases, these values depend on the gender and age as well. In the case of alkaline phosphatase, it is rarely considered that reference values change over life periods. Unfortunately, during the daily practice we do not always take into account of the changes with aging. This is especially true if the laboratory does not specify the age related normal values. Another problem that we mostly focus on the results exceeding the normal values, and do not pay enough attention to the low values. Of course, these results should be put in the context of the clinical picture and other diagnostic test results. We would like to draw attention to the measuring of alkaline phosphatase and the differential diagnosis for low serum activity. Orv Hetil. 2017; 158(26): 1003–1007.

scholarly journals Some Predictors of Depressive Disorders in the Context of Clinical Patomorphosis

2021 ◽  
Vol 6 (4) ◽  
pp. 77-82
Author(s):  
O. O. Belov ◽  
Keyword(s):  
Cognitive Impairment ◽  
Clinical Picture ◽  
Depressive Disorders ◽  
Clinical Symptoms ◽  
Emotional Lability ◽  
Obsessive Compulsive ◽  
Diagnostic Strategies ◽  
Low Mood ◽  
Self Blame ◽  
Initial Stage

The purpose of the study was to study the clinical and psychopathological phenomenology of the initial stage of depressive disorders in the context of clinical pathomorphosis. Materials and methods. Features of clinical symptoms of the initial stage of depressive disorders in the comparative aspect in the context of clinical pathomorphosis based on the analysis of medical records of 236 patients who were treated for depressive disorders in 1971-1995 (ICD-9 codes 296.1, 296.3) and clinical examination of 245 patients with depressive disorders in 2015-2019 (ICD-10 codes F 31.3, F 31.4, F 32.0, F 32.1, F 32.2, F 33.0, F 33.1, F 33.2) are considered. Results and discussion. It was established that there is a predominance in the clinical picture of modern depressive disorders of low mood (in general in 91.4% of patients, 91.6% of men and 91.3% of women, p>0.05), dyssomnia (93.1%, 92.5% and 93.5%, respectively, p>0.05), anxiety, fear (84.5%, 78.5%, 89.1%, respectively, p<0.01), asthenia (82.4%, 77.6% and 86.2%, respectively, p>0.05), somatic vegetative symptoms (82.9%, 77.6% and 87.0%, respectively, p<0.01), apathy (78.8%, 69.2% and 86.2%, respectively, p<0.01) and ideas of self-humiliation and self-blame (69.8%, 72.9% and 67.4%, respectively, p<0.01), and the relatively low prevalence of obsessive symptoms (55.1%, 54.2% and 55.8%, respectively, p<0.05), emotional lability (51.0%, 54.2% and 48.6%, respectively, p<0.01) and cognitive impairment (45.3%, 43.9% and 46.4%, respectively, p<0.05) with a predominance of emotional lability and ideas of self-humiliation and self-blame in men, and manifestations of anxiety, fear, apathy, cognitive impairment, obsessive and somatic vegetative symptoms in women, which gives grounds to consider that the main predictors of depressive disorder at the initial stage of low mood are dyssomnia, anxiety fear, asthenia and somatic vegetative symptoms. The revealed features suggest the presence of a clinical pathomorphosis of depressive disorders. The clinical pathomorphosis of the initial stage of depressive disorders is in a significant reduction in the clinical picture of low mood, ideas of self-abasement and self-blame, emotional lability and cognitive impairment, and an increase in anxiety, fear, asthenia, apathy, obsessive symptoms and obsessive-compulsive symptoms, with significantly greater gender differentiation of clinical symptoms of depression. Conclusion. The identified patterns are embedded in the general trend towards polymorphism and clinical undifferentiation of modern depressive disorders, significant involvement of patients with sleep disorders, asthenic, apathetic and somatic vegetative symptoms, which requires revision of diagnostic strategies and individualization of diagnosis. The identified patterns can be used for early diagnosis of depressive disorders and prevention of depression

scholarly journals Ichthyosis (concept, pathohistology, clinical picture, treatment)

2021 ◽  
Vol 97 (3) ◽  
pp. 6-13
Author(s):  
Tatyana Gennadyevna Takhtarova ◽  
Zarema Rimovna Khismatullina ◽  
Lyudmila Dmitrievna Panova ◽  
Anastasia Nikolaevna Panova
Keyword(s):  
Clinical Picture ◽  
Specific Treatment ◽  
Electron Microscopic Examination ◽  
Allergic Diseases ◽  
Electron Microscopic ◽  
Lamellar Ichthyosis ◽  
Congenital Ichthyosis ◽  
Age Related ◽  
Epidermolytic Hyperkeratosis ◽  
Definition Of

Ichthyosis is a skin disease that is hereditary, has pronounced symptoms in the form of a violation of the skin, and the presence of formations resembling fish scales. It is possible to distinguish different approaches to the definition of ichthyosis, based on the modern study of this issue. Ichthyosis is classified by type: congenital and acquired. Congenital ichthyosis has its own classification depending on the manifestation of changes in the skin, the course of the disease, concomitant pathologies. Congenital ichthyosis is divided into ordinary (vulgar autosomal dominant, simple) ichthyosis, lamellar ichthyosis (dry ichthyosiform erythroderma, "collodion child", lamellar ichthyosis), X-linked ichthyosis (ichthyosis associated with the X chromosome, blackening ichthyosis), congenital bullous ichthyosiform erythroderma (erythroderma Broca's disease, ichthyosiform epidermolytic hyperkeratosis), fetal ichthyosis (intrauterine ichthyosis, universal hyperkeratosis, "Harlequin fetus", congenital keratosis), other congenital ichthyosis. Ichthyosiform conditions (the so-called acquired ichthyosis) are divided into symptomatic, age-related (senile), discoid ichthyosis. The causes of acquired ichthyosis can be various diseases, taking medications, improper skin care, unbalanced nutrition. Each form of ichthyosis differs by the type of inheritance, prevalence in the population, clinical picture, verified by histological examination of skin biopsies and electron microscopic examination of the skin. It may be accompanied by seasonality of exacerbation of the clinical picture, association with other diseases (allergic, diseases of the gastrointestinal tract, congenital malformations). There is no specific treatment for ichthyosis. In systemic therapy, derivatives of vitamin A are used, keratolytics, as well as moisturizing and emollient agents are used for external treatment. The use of therapeutic baths, general ultraviolet irradiation is effective.

Cutaneous manifestations in systemic scleroderma

2021 ◽  
pp. 58-63
Author(s):  
Olga Alekseevna Petrishcheva
Keyword(s):  
Gastrointestinal Tract ◽  
Clinical Picture ◽  
Laboratory Data ◽  
Joint Damage ◽  
Specific Treatment ◽  
Systemic Scleroderma ◽  
Lower Gastrointestinal Tract ◽  
Internal Organs ◽  
Cutaneous Manifestations ◽  
Therapeutic Measures

Systemic scleroderma is a chronic disease, the etiology of which is not fully understood. In systemic scleroderma, there is a diffuse change in the skin with the development of fibrosis, as well as with damage to internal organs (in particular, the esophagus, lower gastrointestinal tract, heart, liver and kidneys). The disease can proceed in a generalized and focal form; it is also possible to develop a variant of scleroderma without affecting the skin. A typical clinical picture of the disease is characterized by damage to the skin, the occurrence of multiple joint damage, the development of dysphagia, and the appearance of heartburn, general swelling and the formation of digital contractures. In women, the disease occurs 4 times more often than in men, while it is very rare in children. The onset of the disease is usually observed between the ages of 30 and 50. The diagnosis is established on the basis of the clinical picture, taking into account laboratory data. There is no specific treatment; therapeutic measures are usually aimed at combating complications.

scholarly journals Current and Future Treatments in Alzheimer Disease: An Update

2020 ◽  
Vol 12 ◽  
pp. 117957352090739 ◽  
Author(s):  
Konstantina G Yiannopoulou ◽  
Sokratis G Papageorgiou
Keyword(s):  
Alzheimer Disease ◽  
Clinical Symptoms ◽  
Neurofibrillary Tangle ◽  
Treatment Strategies ◽  
Specific Treatment ◽  
Amyloid Β ◽  
Cell Therapies ◽  
Novel Biomarkers ◽  
Disease Modifying ◽  
Underlying Mechanisms

Disease-modifying treatment strategies for Alzheimer disease (AD) are still under extensive research. Nowadays, only symptomatic treatments exist for this disease, all trying to counterbalance the neurotransmitter disturbance: 3 cholinesterase inhibitors and memantine. To block the progression of the disease, therapeutic agents are supposed to interfere with the pathogenic steps responsible for the clinical symptoms, classically including the deposition of extracellular amyloid β plaques and intracellular neurofibrillary tangle formation. Other underlying mechanisms are targeted by neuroprotective, anti-inflammatory, growth factor promotive, metabolic efficacious agents and stem cell therapies. Recent therapies have integrated multiple new features such as novel biomarkers, new neuropsychological outcomes, enrollment of earlier populations in the course of the disease, and innovative trial designs. In the near future different specific agents for every patient might be used in a “precision medicine” context, where aberrant biomarkers accompanied with a particular pattern of neuropsychological and neuroimaging findings could determine a specific treatment regimen within a customized therapeutic framework. In this review, we discuss potential disease-modifying therapies that are currently being studied and potential individualized therapeutic frameworks that can be proved beneficial for patients with AD.

scholarly journals DOP20 Can lifestyle and psychosocial factors predict flares of IBD; an exploratory study using telemedicine

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S059-S060
Author(s):  
R C A Lalisang ◽  
G Adriaans ◽  
M de Jong ◽  
A van der Meulen-de Jong ◽  
M Romberg-Camps ◽  
...  
Keyword(s):  
Disease Activity ◽  
Exploratory Study ◽  
Clinical Symptoms ◽  
Lifestyle Factors ◽  
Information Criteria ◽  
Mucosal Inflammation ◽  
Study Cohort ◽  
Telemedicine System ◽  
Targeted Interventions

Abstract Background Tight control of mucosal inflammation and prevention of disease flares are emerging treatment goals to prevent disease progression in inflammatory bowel disease (IBD). The state of the art clinical classification only marginally predict flare occurrence. Mounting evidence shows that psychosocial and lifestyle factors are associated with flares. Longitudinal monitoring of these factors has been made possible by implementing a web-based telemedicine tool, called myIBDcoach. This study is an exploration on the potential additive predictive value of data captured in a telemedicine system to predict flares. Methods Consecutive IBD patients (n = 393) were recruited from the prospective myIBDcoach telemedicine study cohort (ClinicalTrials.gov, NCT02173002). During a one-year follow-up, every 1–3 months, participants reported information on all variables displayed in Figure 1 via myIBDcoach. Variables were subdivided into two main categories; Baseline and myIBDcoach. The myIBDcoach variables were once again subdivided (Figure 1). The outcome of interest, a flare during follow-up, was defined as having clinical symptoms of disease activity (using the Monitor IBD At Home questionnaire) combined with either a faecal calprotectin &gt; 250g/g, disease activity on endoscopy, MRI or CT. Stepwise group-Lasso logistic regression (G-LASSO) was used to estimate associations between flares and individual variables, as well as between flares and the different variable categories (Figure 1). G-LASSO performs variable selection, resulting in models that contain only the most relevant explanatory variables. Results Seven G-LASSO regressions were estimated and evaluated using the Akaike information criteria (AIC), the area under the curve (AUC) and stepwise importance using 10-fold cross-validated penalty parameter. Figure 2 shows that the overall model performance increased when consecutively adding extra variable categories, the largest increase occurred for psychosocial and lifestyle factors. All telemedicine variable categories were found to be more important compared with the baseline variable category, as shown in Figure 3. Results shown in Figure 4 indicate that the information from myIBDcoach was found to be more important than the baseline variables. Conclusion In this exploratory study, psychosocial and lifestyle factors monitored via telemedicine are of superior value to predict flares in IBD patients compared with clinical stratification. Holistic monitoring, including psychosocial and lifestyle factors, and targeted interventions are of interest for future trials and are a promising strategy to prevent flares and improve the outcome of IBD.

scholarly journals Avian Paramyxovirus Serotype-1: A Review of Disease Distribution, Clinical Symptoms, and Laboratory Diagnostics

2012 ◽  
Vol 2012 ◽  
pp. 1-17 ◽  
Author(s):  
Nichole L. Hines ◽  
Cathy L. Miller
Keyword(s):  
Cleavage Site ◽  
Clinical Symptoms ◽  
Fusion Gene ◽  
Classification Systems ◽  
Laboratory Diagnostics ◽  
Avian Paramyxovirus ◽  
Genetic Composition ◽  
Species Classification ◽  
Wide Range ◽  
Serotype 1

Avian paramyxovirus serotype-1 (APMV-1) is capable of infecting a wide range of avian species leading to a broad range of clinical symptoms. Ease of transmission has allowed the virus to spread worldwide with varying degrees of virulence depending on the virus strain and host species. Classification systems have been designed to group isolates based on their genetic composition. The genetic composition of the fusion gene cleavage site plays an important role in virulence. Presence of multiple basic amino acids at the cleavage site allows enzymatic cleavage of the fusion protein enabling virulent viruses to spread systemically. Diagnostic tests, including virus isolation, real-time reverse-transcription PCR, and sequencing, are used to characterize the virus and identify virulent strains. Genetic diversity within APMV-1 demonstrates the need for continual monitoring for changes that may arise requiring modifications to the molecular assays to maintain their usefulness for diagnostic testing.

Inflammatory cytokine biomarkers of asymptomatic sexually transmitted infections and vaginal dysbiosis: a multicentre validation study

2018 ◽  
Vol 95 (1) ◽  
pp. 5-12 ◽  
Author(s):  
Lindi Masson ◽  
Shaun Barnabas ◽  
Jennifer Deese ◽  
Katie Lennard ◽  
Smritee Dabee ◽  
...  
Keyword(s):  
16S Rrna ◽  
Clinical Symptoms ◽  
Point Of Care ◽  
Specific Treatment ◽  
Interferon Γ ◽  
Vaginal Wall ◽  
16S Rrna Sequencing ◽  
African Women ◽  
Sexually Transmitted ◽  
Rrna Sequencing

ObjectivesVaginal dysbiosis and STIs are important drivers of the HIV epidemic and reproductive complications. These conditions remain prevalent, partly because most cases are asymptomatic. We have shown that inflammatory cytokines interleukin (IL)-1α, IL-1β and interferon-γ-induced protein (IP)-10 are biomarkers for detecting asymptomatic STIs and vaginal dysbiosis (bacterial vaginosis (BV) or intermediate microbiota). This study aimed to validate the performance of these biomarkers in African women recruited regardless of symptoms.MethodsIL-1α, IL-1β and IP-10 were measured in menstrual cup secretions, endocervical, lateral vaginal wall and vulvovaginal swabs from 550 women from Pretoria, Soweto and Cape Town, South Africa and Bondo, Kenya using Luminex and ELISA. STIs were assessed by PCR, BV by Nugent scoring and vaginal microbiota by 16S rRNA sequencing.ResultsAcross four study populations and four types of genital specimens, the performance of IL-1α, IL-1β and IP-10 for identification of women with STIs, BV or intermediate microbiota was consistent. Of the genital samples assessed, biomarkers measured in lateral vaginal wall swabs performed best, correctly classifying 76%(95% CI 70% to 81%) of women according to STI, BV or intermediate microbiota status (sensitivity 77%, specificity 71%) and were more accurate than clinical symptoms (sensitivity 41%, specificity 57%) (p=0.0003). Women incorrectly classified as STI/BV positive using the biomarkers had more abundant dysbiosis-associated bacteria, including Prevotella bivia and Gardnerella sp, detected by 16S rRNA sequencing, but not Nugent scoring. Including vaginal pH with the cytokine biomarkers improved the accuracy of the test (82% (95% CI 75% to 88%) correctly classified), although pH alone had poor specificity (61%).ConclusionsAn inexpensive, point-of-care screening test including IL-1α, IL-1β and IP-10 (and potentially pH) could be used in resource-limited settings to identify women with asymptomatic STIs and dysbiosis. These women could then be referred for aetiological testing, followed by specific treatment.

scholarly journals Management of pulmonary arterial hypertension in patients aged over 65 years

2019 ◽  
Vol 21 (Supplement_K) ◽  
pp. K29-K36 ◽  
Author(s):  
Olivier Sitbon ◽  
Luke Howard
Keyword(s):  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Older Patients ◽  
Clinical Symptoms ◽  
Survival Rates ◽  
Specific Treatment ◽  
Younger Patients ◽  
Expert Opinions ◽  
Literature Searches ◽  
Pulmonary Arterial

Abstract Historically, pulmonary arterial hypertension (PAH) has been considered a disease of young adults, but over the last three decades, the average age at diagnosis has increased, presenting clinicians with some unique challenges. Clinical symptoms of PAH, including shortness of breath and reduced functional capacity, are not specific for the disease and may be present in older patients because of their age or as a result of comorbid conditions. Eliminating other causes for these symptoms can delay PAH diagnosis and initiation of PAH-specific treatment compared with younger patients. Currently, there are no specific guidelines relating to PAH in older patients and existing guidelines for identifying patients at potential risk of PAH may not be appropriate for patients aged over 65 years. Even though older patients tend to be diagnosed with more advanced symptoms, and evidence suggests that they are less responsive to PAH-specific therapies, treatment is often less aggressive than in younger patients. Even after adjusting for age, survival rates remain disproportionately lower in the older vs. younger PAH populations. Specific guidelines for diagnosis and treatment of older patients with PAH are needed to improve care and outcomes in this growing population. This review aims to assess the challenges associated with diagnosing and managing PAH in older patients, based on literature searches, authors’ experiences, and expert opinions.

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