scholarly journals A CLINICAL CASE OF PROGRESSIVE COURSE OF SARCOIDOSIS OF THE RESPIRATORY ORGANS

2021 ◽  
Vol 19 (3) ◽  
pp. 324-330
Author(s):  
S. N. Demidik ◽  
◽  
S. B. Volf ◽  
Keyword(s):  
Clinical Case ◽  
Alternative Therapy ◽  
Organ Damage ◽  
Unknown Etiology ◽  
Respiratory Organ ◽  
Systemic Inflammatory Disease ◽  
Active Observation ◽  
Noncaseating Granulomas ◽  
Progressive Course

Sarcoidosis is a systemic inflammatory disease of unknown etiology, characterized by the formation of noncaseating granulomas and multiple system organ damage. Sarcoidosis therapy is aimed at prevention and reducing inflammation as well as improving patient’s symptoms and quality of life. Active observation is preferred for patients with morphologically confirmed diagnosis in the absence of a lifethreatening condition, organ and system dysfunction as well as disease progression. Alternative therapy may include alphatocopherol and/or pentoxifylline. Treatment with glucocorticosteroids is used for a long period of time (12-24 months) only when clinically indicated. The presented clinical case of progressive course of respiratory organ sarcoidosis is intended to draw the attention of doctors to the peculiarities of examination, treatment and observation of such patients. The case is discussed from the perspective of personalized medicine and modern clinical guidelines.

scholarly journals Listeriosis: the review of a problem, presentation of a clinical case of listeria sepsis in a 4-month child

2021 ◽  
Vol 9 (4) ◽  
pp. 39-42
Author(s):  
L.P. Shostakovych-Koretskaya ◽  
I.V. Budayeva ◽  
M.A. Nikolaichuk
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Clinical Case ◽  
Clinical Manifestations ◽  
Organ Damage ◽  
Multiple Organ ◽  
High Rate ◽  
Problem Presentation ◽  
The Central Nervous System ◽  
Progressive Course

Listeriosis is an infectious disease caused by Listeria monocytogenes microorganisms. A human can catch an infection through fecal-oral, aerogenous, or transplacental route. The listeriosis incidence in Ukraine is sporadic, single cases are not related to each other. Listeriosis is characterized by a high rate of mortality and polymorphism of clinical manifestations. The symptoms of the disease are multiple-organ: damage to the central nervous system, septic symptoms, aborts, mastitis; listeriosis can also be subclinical. The disorders of the central nervous system are associated with meningitis, meningoencephalitis, or brain abscess. The importance of the problem of diagnosis and treatment of listeriosis derived from the disease sporadicity, polymorphism of its manifestations, difficulties in etiological verification of the diagnosis. The case described is specific due to the diagnostic mistake: a child was not diagnosed with sepsis. Listeriosis in this child had a progressive course with sepsis development. Listeriosis is a rare infection, therefore it was difficult to suggest this particular infection intra vitam.

Clinical case of a comorbid patient with arterial hypertension

2020 ◽  
pp. 31-39
Author(s):  
Ella Polozova ◽  
Vsevolod Skvortsov ◽  
Olga Radaykina ◽  
Mariya Narvatkina ◽  
Anastasiya Seskina ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Arterial Hypertension ◽  
Clinical Picture ◽  
Clinical Case ◽  
Diagnosis And Treatment ◽  
The Moment

The widespread prevalence of comorbid pathology determines the relevance of this problem. Comorbid pathology due to the interaction of diseases, drug pathomorphism, age characteristics of the patient, significantly changes clinical picture and course of the main nosology, affects severity of complications and their nature, significantly affects quality of life and prognosis of patients. Diagnosis and treatment of many diseases is complicated in the conditions of comorbidity. The article presents a clinical case of a comorbid patient with arterial hypertension from the moment of exposure to risk factors and ending with the formation of many concomitant diseases, as an example of trans-nosological comorbidity.

An Ayurvedic Visual Rehabilitation In Lebers Congenital Amaurosis - Prospective Case Study

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Dr. Vidhyasri M ◽  
Dr. S. M. Pasha
Keyword(s):  
Marked Improvement ◽  
Clinical Case ◽  
Treatment Plan ◽  
Visual Disability ◽  
Visual Rehabilitation ◽  
Potential Risks ◽  
The Subject ◽  
Slow Frequency

Introduction: This is the case report of child who was diagnosed with LCA reported with complaints of large-amplitude, slow-frequency, roving nystagmus, frequent tendency to press on his eyes, enopthalmos, with completely normal ophthalmoscopic examination with normal appearing optic nerve and retina and has a non recordable ERG; considering this condition under the lines of Vataja Nanatmaja Vyadhi treatment was structured to render effective visual rehabilitation which showed marked results. Methods: 4 years old male child who was diagnosed with lebers congenital amaurosis was brought by his parents to Eye OPD, GAMC, Bengaluru. The presentation of this case includes bibliographic review of the subject, presentation of a clinical case and description of the importance of Ayurvedic prespective of handling of these patients. Results: The child showed improvement in fixing for light and also nystagmus showed marked improvement and there were considerable behavioural changes observed. Discussion: It is important to deepen the environment of the disease to know the possible implications in Ayurvedic management, recognize the magnitude of visual disability that our patient presents for the establishment of the treatment plan and provide an integral care of excellence in an interdisciplinary way in favor of visual rehabilitation of our patients and also help to restore quality of life with no potential risks of side effects.

scholarly journals The Attention of Caregiver. An Intersdisciplinary Vision

2011 ◽  
Vol 1 (3) ◽  
pp. 105-118
Author(s):  
Esther Secanilla ◽  
María Bonjoch ◽  
Margarida Galindo ◽  
Laura Gros
Keyword(s):  
Quality Of Life ◽  
Emotional Wellbeing ◽  
Educational Training ◽  
Social And Emotional ◽  
Validated Questionnaire ◽  
People With Dementia ◽  
Active Observation ◽  
Admission Interviews ◽  
Social And Emotional Wellbeing

In a global approach to the attention of carers of older people with dementia living at the elder’s home, it is essential to promote their personal, social and emotional wellbeing as well as provide them with tools that improve their quality of life. With this goal we present the experience of CDD and Residencia de Horta, Barcelona. A documentary review of the file was made, covering the period between 2004 and 2010 to define the sample. For the analysis of the semistructured admission interviews, monitoring and mentoring, a research was made through the daily records. Other strategies used were fulfilment questionnaires as well as the validated questionnaire of caregiver’s burden (Zarit and Zarit, 1982). Likewise, there was a systematic active observation of the GAM group. The interviews were made to the caregivers who attended the GAM. It is proven that actions of prevention and monitoring as well as psycho-educational training designed for carers promotes the user’s staying at their home, improves their quality of life and their caregiver’s.

scholarly journals A Comprehensive Review Evaluating the Impact of Protein Source (Vegetarian vs. Meat Based) in Hepatic Encephalopathy

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 370
Author(s):  
Umair Iqbal ◽  
Ravirajsinh N. Jadeja ◽  
Harshit S. Khara ◽  
Sandeep Khurana
Keyword(s):  
Hepatic Encephalopathy ◽  
Protein Intake ◽  
Alternative Therapy ◽  
Case Series ◽  
Current Evidence ◽  
Branch Chain Amino ◽  
The Impact ◽  
Protein Diets

Hepatic encephalopathy (HE) is a common neurological consequence in patients with cirrhosis and has a healthcare burden of USD 5370 to 50,120 per patient annually. HE significantly hampers the quality of life and is a major cause of morbidity and mortality. Patients with cirrhosis are at a high risk for protein-calorie malnutrition due to altered metabolism. Current evidence has changed the old belief of protein restriction in patients with cirrhosis and now 1.2 to 1.5 g/kg/day protein intake is recommended. Case series and studies with small numbers of participants showed that a vegetarian protein diet decreases the symptoms of HE when compared to a meat-based diet, but the evidence is limited and requires further larger randomized controlled trials. However, vegetable or milk-based protein diets are good substitutes for patients averse to meat intake. Branch chain amino acids (BCAA) (leucine, isoleucine and valine) have also been shown to be effective in alleviating symptoms of HE and are recommended as an alternative therapy in patients with cirrhosis for the treatment of HE. In this review, we provide an overview of current literature evaluating the role of protein intake in the management of HE in cirrhosis.

scholarly journals SAT0232 PERCEPTION OF THE DISEASE IN PATIENTS WITH EARLY SYSTEMIC LUPUS ERYTHEMATOSUS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1059.3-1059
Author(s):  
M. Garabajiu ◽  
L. Mazur-Nicorici ◽  
T. Rotaru ◽  
V. Salaru ◽  
S. B. Victoria ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Disease Duration ◽  
Activity Index ◽  
Damage Index ◽  
Organ Damage ◽  
Systemic Lupus

Background:Systemic lupus erythematosus is an autoimmune disease with a major impact on patient’s quality of life.Objectives:To evaluate patient’s attitude toward early disease and factors that influence it.Methods:Performed case-control study included SLE patients that fulfilled SLICC, 2012 classification criteria. The research included two groups of patients: early SLE – 1stgroup (disease duration ≤24 months) and non-early SLE – 2ndgroup control (disease duration >24 months). The pattern of the disease activity was assessed by patient global assessment (PGA), Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) and Systemic Lupus Activity Measure (SLAM), for SLE activity, SLICC/ACR Damage Index (DI) for disease irreversible changes and SF-8 for the Quality of Life (QoL).Results:A total of 101 SLE patients with 34 in the 1stgroup (early SLE) and 67 in the 2ndgroup (non-early SLE) was analyzed. The disease activity showed high disease activity in both groups by SLEDAI (7,02±4,16 and 6,26±4,43 points, p>0,05) and SLAM (7,47±4,40 and 7,31±4,10 points, p>0,05) such as (46,97±19,39 vs 47,98±22,41 points). The QoL was appreciated as low, by both components (mental and physical), in groups. The damage index was higher in the 2nd group (0,23±0,43 and 1,07±1,29, p<0,001), which can be explained by the development of irreversible changes with the increase of disease duration.The PGA in early SLE was influenced by subjective symptoms contained in SLAM index (r=0,48, p<0,05), such as fatigue and depression, and the level of the quality of life (r=0,65, p<0,001). Meantime, PGA in patients with longer disease duration (>2 years), was influenced by the presence of organ damage by SLICC/ACR DI (0,23, p<0,05) and objective findings of the disease activity contained in SLEDAI (r=0,33, p<0,005) and SLAM (0,44, p<0,001).Conclusion:The disease recognition in patients with early SLE was determined by subjective and psycho-emotional signs, while in patients with longer disease duration it was influenced by organ damage and complications.References:no referencesDisclosure of Interests:None declared

CLINICAL CASE: STEROID-RESISTANT NEPHROTIC SYNDROME

2021 ◽  
pp. 13-17
Author(s):  
А.Е. Турсын
Keyword(s):  
Quality Of Life ◽  
Nephrotic Syndrome ◽  
Arterial Hypertension ◽  
Clinical Case ◽  
Steroid Resistant ◽  
Steroid Resistant Nephrotic Syndrome ◽  
Moderate Severity ◽  
Syndrome Diagnosis ◽  
Pathogenetic Therapy

Описан клинический случай пациент с нефротическим синдромом, стероид резистентный вариант, с артериальной гипертензией, осложненный полисерозитом (гидроторакс, асцит, плеврит). Пациент поступил в клинику в состоянии средней степени тяжести, с массивными отеками, полисерозитом, артериальной гипертензией и выраженным нефротическим синдромом. Диагноз: Гломерулярная болезнь. Нефротический синдром, стероид резистентный вариант. Функция почек снижена (СКФ- 84мл/мин по Шварцу). Двухсторонний экссудативный плеврит. Гидроторакс. Полисерозит (в рамках нефротического синдрома) был установлен на основании выраженного нефротического синдрома. Пациенту была проведена патогенетическая терапия. Отмечено улучшение состояния больного, в виде снижения отеков, нормализаций артериального давления, что в свою очередь поспособствовало сохранению и улучшению качества жизни пациента. A clinical case of a patient with nephrotic syndrome, steroidresistant variant, with arterial hypertension complicated by polyserositis (hydrothorax, ascites, pleurisy) is described. The patient was admitted to the clinic in a state of moderate severity, with massive edema, polyserositis, arterial hypertension, and severe nephrotic syndrome. Diagnosis: Glomerular disease. Nephrotic syndrome, steroidresistant variant. The kidney function is reduced (GFR - 84 ml/min according to Schwartz). Bilateral exudative pleurisy. Hydrothorax. Polyserositis (within the framework of nephrotic syndrome) was established based on the severe nephrotic syndrome. The patient underwent pathogenetic therapy. An improvement in the patient's condition was noted, in the form of a decrease in edema, normalization of blood pressure, which in turn contributed to the preservation and improvement of the patient's quality of life.

FRI0168 ASSOCIATION OF OVERWEIGHT/OBESITY WITH IMPAIRED HEALTH-RELATED QUALITY OF LIFE IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 668-669
Author(s):  
A. Gomez ◽  
F. H. Butrus ◽  
P. Johansson ◽  
E. Åkerström ◽  
S. Soukka ◽  
...  
Keyword(s):  
Lupus Erythematosus ◽  
Linear Regression Analysis ◽  
Organ Damage ◽  
Health Related Quality ◽  
Systemic Lupus ◽  
Sf 36 ◽  
Related Quality ◽  
Health Related ◽  
Impaired Health

Background:Patients with systemic lupus erythematosus (SLE) experience a considerably impaired health-related quality of life (HRQoL) compared with the general population. Previous literature has implied an association between high body mass index (BMI) and HRQoL diminutions. However, data are scarce and further exploration in large study populations and, importantly, with regard to the clinical significance of this association is needed.Objectives:The aim of this study was to determine whether overweight and/or obesity were associated with impaired physical and/or mental HRQoL aspects in the SLE population of two large clinical trials.Methods:We utilised pooled baseline data from the BLISS-52 (NCT00424476) and BLISS-76 (NCT00410384) clinical trials of belimumab (N=1684). Access to data was granted by GlaxoSmithKline. The patients were stratified into four groups based on their body mass index (BMI), according to WHO guidelines. We conducted comparisons between non-overweight versus overweight, and non-obese versus obese SLE patients. HRQoL was self-reported using the Medical Outcomes Study (MOS) short form 36 (SF-36) health survey, the functional assessment of chronic illness therapy (FACIT)-Fatigue scale and the three-level EuroQol- 5 Dimension (EQ-5D) questionnaire. We explored whether the differences in scores were clinically meaningful using previously determined thresholds for minimal clinically important differences (MCIDs). The non-parametric Mann-Whitney U test was used for comparisons between different BMI groups. Linear regression analysis was next applied to test independence in multivariable models, adjusting for age, sex, ethnicity, disease duration, disease activity, organ damage and standard of care treatment.Results:Forty-four per cent (44%) of the patients had a BMI score over the normal range, and 18% were obese. The overweight group performed worse than the non-overweight with regard to FACIT-Fatigue scores (mean ± standard deviation: 27.7 ± 12.1 vs 32.0 ± 11.3; P<0.001), EQ-5D score (0.70 ± 0.19 vs 0.76 ± 0.18; P<0.001) and all SF-36 subscales and component summaries. The differences were greater than the MCIDs for physical component summary (PCS) scores (36.9 ± 9.3 vs 40.8 ± 9.6; P<0.001), physical functioning (53.3 ± 25.1 vs 63.6 ± 25-1; P<0.001), role physical (48.0 ± 27.1 vs 55.6 ± 26.9; P<0.001), bodily pain (43.8 ± 22.4 vs 52.5 ± 25.1; P<0.001), vitality (39.6 ± 21.7 vs 46.6 ± 21.3; P<0.001), and social functioning scores (55.8 ± 25.2 vs 62.6 ± 25.2; P<0.001). Likewise, obese patients reported worse FACIT-Fatigue scores (25.7 ± 11.9 vs 31.1 ± 11.6; P<0.001), EQ-5D scores (0.68 ± 0.20 vs 0.75 ± 0.18; P<0.001) and clinically important diminutions of HRQoL in all SF-36 items, except for the mental component summary (MCS), role emotional and mental health.In multivariable linear regression analysis, the overweight and obese group showed worse PCS scores (standardised coefficient: β=-0.09; P<0.001 and β=-0.13; P<0.001, respectively) and FACIT-Fatigue scores (β=-0.11; P<0.001 and β=-0.10; P<0.001, respectively), and overweight patients had significantly impaired MCS scores (β=-0.05; P=0.039), irrespective of other factors. High disease activity and organ damage were associated with impaired HRQoL in all aspects, while Asian patients reported better PCS scores (and β=0.29; P=0.007) and FACIT-Fatigue scores (β=0.33; P=0.002).Conclusion:BMI above normal was highly associated with HRQoL impairment, especially in physical aspects. Further survey to examine causality is warranted to support structured weight control strategies as an intervention towards a more favourable HRQoL.Disclosure of Interests:None declared

scholarly journals Prosthodontic Rehabilitation of a Patient with Subtotal Maxillectomy using a Hollow Bulb Obturator

2012 ◽  
Vol 2 (1) ◽  
pp. 24-28 ◽  
Author(s):  
Gita Rani ◽  
Amarjeet Gambhir
Keyword(s):  
Quality Of Life ◽  
Case Report ◽  
Clinical Case ◽  
Soft Tissues ◽  
Prosthetic Reconstruction ◽  
Maxillary Defect ◽  
Hollow Bulb Obturator

ABSTRACT Successful prosthetic reconstruction of hemimaxillectomy defects is a challenging procedure that requires multidisciplinary expertize to achieve acceptable function, speech and esthetics. Rehabilitation of an acquired maxillary defect improves the quality of life for the patient as close to normal as possible. Obturation of the defect depends on its volume and position of remaining hard and soft tissues, to be utilized for retention, stability and support for the prosthesis. The prosthesis should be simple to handle, easy to maintain, biocompatible, light in weight and convenient for future adjustments. This case report describes a clinical case of subtotal maxillectomy, which was successfully rehabilitated with a hollow bulb obturator. How to cite this article Rani G, Gambhir A. Prosthodontic Rehabilitation of a Patient with Subtotal Maxillectomy using a Hollow Bulb Obturator. Int J Prosthodont Restor Dent 2012; 2(1):24-28.

scholarly journals Transarterial Chemoembolization (TACE) with Lipiodol� in HCC PatientsTechnical, clinical and imagistic aspects

2019 ◽  
Vol 56 (1) ◽  
pp. 194-187
Author(s):  
Decebal Fodor ◽  
Bogdan Andrei Suciu ◽  
Ioan Jung ◽  
Simona Gurzu ◽  
Tamas-Csaba Sipos ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Alternative Therapy ◽  
Life Quality ◽  
Case Series ◽  
Hepatic Tumors ◽  
Hepatic Transplantation ◽  
Therapeutic Attitude ◽  
Control Tumor ◽  
Prolongation Of Life

Hepatocellurar carcinoma (HCC) is the most frequent primary hepatic tumor, the vast majority of patients have less than a 12 month survival rate. The aim of this study was to evaluate the efficacy of TACE in patients with HCC, based on a case series and literature review. The study included 12 consecutive patients with HCC who underwent surgical treatment (resection, liver transplantation � resection) at the Department of Transplantation and Surgery, Semmelweis University, Budapest, during 2009-2015. All the patients received at least one TACE session. Patients with BCLC B-stage who benefit from TACE and another alternative therapy (eg, RFA) may be associated with or exhibit tumor stagnation, or tumor necrosis in most cases. In C BCLC stages, desperate cases - the two patients to whom TACE was the last therapeutic attitude, despite the predicted prognosis, TACE assured the prolongation of life and increased life quality. In the majority of patients in this study, stage A BCLC, chemoembolization was a therapeutic attitude that allowed subsequent liver transplantation (when it was not feasible initially due to tumor size) or liver resection in apparently inoperable cases. The arterial chemotherapy is the unanimously accepted indication in patients with stage B, BCLC. The data presented encourages us to opt for TACE with the intention of destaging BCLC and giving an operability character to the hepatic tumors (resection � hepatic transplantation). In stage C BCLC, TACE can be a last attempt to improve the quality of life and to control tumor progression.

Sign in / Sign up

Export Citation Format

Share Document