scholarly journals Experience of Chita the program of the Scientific Society of Gastroenterologists of Russia and Russian Scientific Medical Society of Internal Medicine “Physicians without helicobacteriosis”

2020 ◽  
pp. 34-46
Author(s):  
E. V. Luzina ◽  
L. B. Lazebnik ◽  
N. V. Lareva ◽  
N. N. Chartorizhskaya ◽  
A. A. Dutova ◽  
...  
Keyword(s):  
Histological Examination ◽  
Morphological Changes ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Statistical Processing ◽  
Medical Society ◽  
Genotypic Resistance ◽  
Biopsy Material ◽  
Genetic Method ◽  
History Of

Objective. To determine the prevalence of Helicobacter pylori (HP) in doctors in Chita, to identify clinical manifestations of infection, endoscopic, ultrasound and morphological changes in the stomach, to conduct eradication treatment with an assessment of its effectiveness, to determine the resistance of HP to clarithromycin and to develop treatment tactics for HP-associated diseases in the region.Material and methods. 70 doctors of Chita were examined, including 55 women and 15 men, average age 47.04±12.76 years (20 persons were 39 years and younger, 33 persons were 40–59 years, 17 people were 60 years and older; 27 persons were gastroenterologists, 17 — therapists, 11 — pediatricians, 5 — surgeons and 10 persons were doctors of other specialties). All doctors underwent antigen (AH) of HP determination in feces, a survey on the original questionnaire to assess clinical manifestations. Ultrasound examination of the stomach was performed in 47 doctors. Endoscopy of the upper gastrointestinal tract (GI) was performed in 35 persons. During endoscopy, in 29 doctors biopsy material of the mucous membrane from 5 points of the stomach were taken. A histological examination of biopsy samples was performed with an assessment using the OLGA system. The resistance of HP to clarithromycin was determined by the molecular genetic method in biopsy samples of gastric biopsy. 44 doctors conducted eradication with different schemes. Adverse events (AE) and treatment tolerance were evaluated. Control of eradication was carried out 6–8 weeks after the end of therapy by determining AH of HP in the feces. Statistical processing was carried out using the method of descriptive statistics, criterion of Student and criterion x2 (Biostatprogramm).Results. A positive AH of HP in feces was registered in 71.4% of the doctors examined: 73.3% of men and 70.9% of women, 75% of people under the age of 39 years, 72.7% of those aged 40–59 years and 64.7% are over 60 years old. Gastroenterologists were infected in 63%, therapists in 70.6%, pediatricians in 72.7%, surgeons in 80%, another specialists in 90% of cases. In the presence of HP, 81.6% of the examined showed symptoms from the digestive organs, 3 times more often a hereditary history of stomach cancer was determined. The wall thickness of the stomach during ultrasound in the infected was recorded 0.21–0.18 mm more than in the group of HP-negative individuals. A histological examination of III–IV degree of activity of inflammation in the stomach was diagnosed in 86.1%, stage III atrophy and colonic metaplasia in 20.7% of the examined doctors. The desire to conduct eradication treatment was expressed by 78% of doctors, 44 people completed the therapy. Non-compliance with the eradication regimen was noted in 9 people. AE were registered in 76.6% of cases. The efficacy of all regimens was 71.4%: when using the regimen with clarithromycin — 73%, with josamycin — 100%, with tetracycline and metronidazole — 33%, with levofloxacin — 100%. HP DNA was detected in 27 samples of gastric. In 10 cases, mutations A2142G and A2143G in the HP genome were detected, providing resistance to clarithromycin, which amounted to 37%.Conclusion1. 71.4% of doctors in Chita are infected with HP, among which the bacterium is most often detected at a young age (39 years and younger).2. Infected doctors are more likely to have gastrointestinal symptoms, a history of gastric damage, and hereditary gastric cancer.3. In 20.7% of doctors, histological examination revealed colonic metaplasia and dysplasia, which confirms the need for treatment and requires further observation.4. Only 78% of Chita doctors expressed their readiness to eradicate HP, and 20.4% of those who started treatment did not comply with the treatment regimen. This fact requires further educational activities.5. The efficacy of eradication by all schemes was 71.4%. Genotypic resistance of HP to clarithromycin was found in 37% of doctors. Further studies are needed to identify the characteristics of the macro- and microorganism (genetic polymorphism of enzymes, HP mutations) in groups, both among doctors and other categories of patients who do not have professional contacts with microorganisms and antibiotics in order to develop recommendations on the use of HP eradication schemes in region.

scholarly journals Retrospective analysis of clinical characteristics of 405 patients with COVID-19

2020 ◽  
Vol 48 (8) ◽  
pp. 030006052094903 ◽  
Author(s):  
Ting Zhan ◽  
Meng Liu ◽  
Yalin Tang ◽  
Zheng Han ◽  
Xueting Cheng ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Severe Disease ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Circulatory System ◽  
Respiratory Illnesses ◽  
Reactive Protein ◽  
Circulatory System Diseases ◽  
History Of ◽  
Abnormal Lymphocyte

Objective This study was performed to investigate the clinical characteristics of patients with coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods We analyzed the electronic medical records of 405 hospitalized patients with laboratory-confirmed COVID-19 in the Third Hospital of Wuhan. Results The patients’ median age was 56 years, 54.1% were female, 11.4% had a history of smoking, and 10.6% had a history of drinking. All cases of COVID-19 were community-acquired. Fever (76.8%) and cough (53.3%) were the most common clinical manifestations, and circulatory system diseases were the most common comorbidities. Gastrointestinal symptoms were present in 61.2% of the patients, and 2.9% of the patients were asymptomatic. Computed tomography showed ground-glass opacities in most patients (72.6%) and consolidation in 30.9%. Lymphopenia (72.3%) and hypoproteinemia (71.6%) were observed in most patients. About 20% of patients had abnormal liver function. Patients with severe disease had significantly more prominent laboratory abnormalities, including an abnormal lymphocyte count and abnormal C-reactive protein, procalcitonin, alanine aminotransferase, aspartate aminotransferase, D-dimer, and albumin levels. Conclusion SARS-CoV-2 causes a variety of severe respiratory illnesses similar to those caused by SARS-CoV-1. Older age, chronic comorbidities, and laboratory abnormalities are associated with disease severity.

scholarly journals Erythema Nodosum: A Manifestation of Salmonella Infection

2019 ◽  
Vol 13 (3) ◽  
pp. 456-461
Author(s):  
Ali Hassan ◽  
Amna Alsaihati ◽  
Malak Al Shammari ◽  
Mohammed Sharroufna ◽  
Haitham Alaithan ◽  
...  
Keyword(s):  
Erythema Nodosum ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Punch Biopsy ◽  
Stool Culture ◽  
Delayed Type Hypersensitivity ◽  
Breast Abscess ◽  
Salmonella Infection ◽  
Cutaneous Lesions ◽  
History Of

Erythema nodosum is a delayed-type hypersensitivity reaction with an unknown trigger in the majority of cases. It is characterized by the development of erythematous tender nodules on the shins. Septal panniculitis without vasculitis is a characteristic histopathological finding. We report the case of a 26-year-old woman who presented with a four-day history of an erythematous swollen left lower limb. She was treated with intravenous clindamycin for suspected cellulitis. However, her symptoms persisted. Punch biopsy revealed findings consistent with erythema nodosum. Two days later, she developed colicky abdominal pain associated with non-bloody diarrhea. Stool culture yielded Salmonella enterica serotype enteritidis. Two days after discharge, she presented again with a right breast abscess for which she underwent incision and drainage along with antibiotic therapy. After discharge, she was symptom-free with complete resolution of the cutaneous lesions. The presented case is unique as it had multiple clinical manifestations of Salmonella infection including erythema nodosum, diarrhea, and presumably a breast abscess. It should be kept in mind that gastrointestinal symptoms are not necessarily the initial presentations of Salmonella infection.

scholarly journals mNGS helped diagnose scrub typhus presenting as a urinary tract infection with high D-dimer levels: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mei-fang Liu ◽  
Yong Liu ◽  
De-rong Xu ◽  
La-gen Wan ◽  
Rui Zhao
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Scrub Typhus ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Kidney Injury ◽  
History Of ◽  
D Dimer

Abstract Background Scrub typhus is caused by O. tsutsugamushi and spreads through mite larvae biting the skin. Classic symptoms of the disease are eschar and lymphadenopathy. Previous reports have revealed clinical manifestations of scrub typhus, including gastrointestinal symptoms, meningoencephalitis, ocular flutter, pneumonitis, acute respiratory distress syndrome, and acute kidney injury. However, cases of scrub typhus presenting as a urinary tract infection (UTI) with high D-dimer levels could be easily misdiagnosed when clinical attention is insufficient, resulting in difficulty in making a timely diagnosis of the infection. Metagenomics next-generation sequencing (mNGS) is a revolutionary and highly sensitive method that may help in diagnosing atypical cases, even when trace amounts of pathogens are present. Case presentation A 52-year-old female presented with a 10-day history of fever, chills, headache and myalgia. She was initially diagnosed with influenza at a local clinic. Various antibacterials were used on the 2nd–12th day onwards; however, her symptoms persisted and were followed by increased urination duration, frequency, urgency and dysuria for 2 days. Orientia tsutsugamushi was confirmed as the pathogen responsible for the infection through mNGS analysis of her blood samples from Day 13 onwards. The patient’s temperature changed remarkably 24 h after the initiation of doxycycline. Over the next 48 h (i.e., Day 15 onwards), the patient showed clinical improvement. She recovered and was discharged from the hospital. Conclusions Scrub typhus can present atypical clinical symptoms, such as UTIs, in a febrile patient. mNGS may be a useful method for identifying O. tsutsugamushi infection in patients with atypical clinical manifestations.

Finding at dermatologist’s appointment: linear porokeratosis

2021 ◽  
pp. 45-48
Author(s):  
N. E. Manturova ◽  
A. L. Rodina
Keyword(s):  
Histological Examination ◽  
Skin Disease ◽  
Medical Records ◽  
Clinical Case ◽  
Correct Diagnosis ◽  
Clinical Manifestations ◽  
Trigger Factors ◽  
Biopsy Material ◽  
Wide Range ◽  
Clinical Variants

The article deals with the epidemiology, pathomorphological picture, trigger factors of development, clinical manifestations and forms, diagnosis, and peculiarities of treatment of linear porokeratosis. A clinical case is presented.Purpose of the article. To consider the clinical manifestations and peculiarities of the course of porokeratosis, paying special attention to linear porokeratosis and its management tactics.Material and methods. The article presents a clinical case of linear porokeratosis. The analysis of medical records was carried out. The forms of porokeratosis, clinical manifestations, peculiarities of diagnosis and approaches to the treatment of porokeratosis in modern conditions are considered.Results. This clinical case demonstrates the difficulty of making a diagnosis of linear porokeratosis. The diagnosis was made based on the results of histological examination of biopsy material. A tactic for the management of the patient was developed.Conclusions. Porokeratosis is a rare skin disease with a wide range of clinical variants, which is important for clinicians to know in order to make a correct diagnosis and avoid errors in diagnosis. The clinical manifestations of the disease are varied, with localized, disseminated, and rash forms.

Myeloid Sarcoma of the Hepatobiliary System: A Case Series and Review of the Literature

2016 ◽  
Vol 135 (4) ◽  
pp. 241-251 ◽  
Author(s):  
Kelly J. Norsworthy ◽  
Bhavana Bhatnagar ◽  
Zeba N. Singh ◽  
Ivana Gojo
Keyword(s):  
Hematologic Malignancy ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Case Series ◽  
Biliary Tree ◽  
Myeloid Sarcoma ◽  
Review Of The Literature ◽  
System A ◽  
Hepatobiliary System ◽  
History Of

Myeloid sarcoma (MS) is a rare extramedullary presentation of myeloid malignancies, most commonly seen in association with acute myeloid leukemia (AML). Although MS can develop in any organ, the involvement of the hepatobiliary system is rare. With clinical manifestations of jaundice, abdominal pain and other gastrointestinal symptoms, MS presenting at this location can be a challenge to diagnose, particularly in patients with no known history of hematologic malignancy. This may cause delay in proper management. Here we report 3 cases from a single institution and a review of the literature concerning the epidemiology, clinical presentation, treatment and outcomes in patients with MS of the liver, biliary tree and pancreas.

scholarly journals Morphological changes of muscles of the crus and prevention of postoperative complications at patients with the diabetes mellitus at critical ischemia of the lower extremity

2019 ◽  
Vol 3 ◽  
Author(s):  
Bakhodir Barnoyevich Safoyev ◽  
Azizzhon Yakhyoevich Rakhimov ◽  
Razhabboy Isroilovich Isroilov
Keyword(s):  
Diabetes Mellitus ◽  
Muscle Tissue ◽  
Morphological Changes ◽  
High Growth ◽  
Limb Ischemia ◽  
Medical Institute ◽  
Clinical Database ◽  
Critical Ischemia ◽  
Biopsy Material ◽  
History Of

The case history of 57 patients with critical lower limb ischemia in diabetes mellitus in the clinical database of the Bukhara State Medical Institute was studied. All examined patients were taken during surgery 2 grams of muscle tissue from m. soleus and m. gastrocnemius from one anatomical zone from the side of the amputated limb. Biopsy material was studied to determine the microflora and to predict the course of the wound process, and therefore the qualitative and quantitative content of the microbial bodies of the material was determined by bacteriological examination. The morphology of the soleus and biceps muscles was also studied. The results of the study showed a high growth of microbial bodies from the soleus muscle, the reason for this is necrosis of the muscle tissue, which was confirmed by the morphological study.

scholarly journals The Natural History of Severe Acute Respiratory Syndrome Coronavirus 2–Related Multisystem Inflammatory Syndrome in Children: A Systematic Review

2020 ◽  
Author(s):  
Stephen C Aronoff ◽  
Ashleigh Hall ◽  
Michael T Del Vecchio
Keyword(s):  
Systematic Review ◽  
Natural History ◽  
Severe Acute Respiratory Syndrome ◽  
Myocardial Dysfunction ◽  
Case Reports ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Case Series ◽  
History Of ◽  
Inflammatory Syndrome

Abstract Background The clinical manifestations and natural history of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)–related multisystem inflammatory syndrome in children (MIS-C) are poorly defined. Using a systematic review of individual cases and case series and collating elements of the clinical course, the objective of this study was to provide a detailed clinical description and natural history of MIS-C. Methods Case reports and series of MIS-C were recovered from repeated MEDLINE searches, a single EMBASE search, and table of contents reviews of major general medicine and pediatric journals performed between June 3 and July 23, 2020. Fever, evidence of inflammation, and evidence of organ dysfunction were required for inclusion. Results MEDLINE and EMBASE searches produced 129 articles, and 10 articles were identified from journal contents or article bibliographies; 16 reports describing 505 children with MIS-C comprise this review. Thirty-two children (14.7%) had negative results for SARS-CoV-2 by nucleic acid and/or antibody testing. The weighted median age was 9 years (6 months to 20 years). Clinical findings included fever (100%), gastrointestinal symptoms (88.0%), rash (59.2%), conjunctivitis (50.0%), cheilitis/ “strawberry tongue” (55.7%), or extremity edema/erythema (47.5%). Median serum C-reactive protein, ferritin, fibrinogen, and D-dimer concentrations were above the normal range. Intravenous gammaglobulin (78.1%) and methylprednisolone/prednisone (57.6%) were the most common therapeutic interventions; immunomodulation was used in 24.3% of cases. Myocardial dysfunction requiring ionotropic support (57.4%) plus extracorporeal membrane oxygenation (5.3%), respiratory distress requiring mechanical ventilation (26.1%), and acute kidney injury (11.9%) were the major complications; anticoagulation was used commonly (54.4%), but thrombotic events occurred rarely (3.5%). Seven (1.4%) children died. Conclusions MIS-C following SARS-CoV-2 infection frequently presents with gastrointestinal complaints and/or rash; conjunctivitis, cheilitis, and/or extremity changes also occur frequently. Serious complications occur frequently and respond to aggressive supportive therapy.

Clinical, morphological and biochemical signs of polymycotoxicosis in highly productive cows

2020 ◽  
pp. 14-17
Author(s):  
Irina A. Shkuratova ◽  
◽  
Lyudmila I. Drozdova ◽  
Aleksander I. Belousov ◽  
Keyword(s):  
Metabolic Disorders ◽  
Hepatorenal Syndrome ◽  
Morphological Changes ◽  
Clinical Manifestations ◽  
The Body ◽  
Feed Mixture ◽  
Milk Productivity ◽  
Structural Disorders ◽  
Increased Sensitivity ◽  
Penicillium Spp

Mycotoxicological monitoring of forages shows that the problem of mycotoxicosis has been relevant for several decades. Minimal doses of mycotoxins in feed lead to a decrease in milk productivity, increased sensitivity to infectious and non-infectious diseases. When several mycotoxins enter the body simultaneously, a synergistic effect develops, causing a significant increase in toxicity. Feed contaminated with several types of fungi and their toxins is dangerous for dairy cattle. It was found that the feed mixture contained the types of associations of Aspergillus spp. fungi + Fusarium; Aspergillus spp. + Penicillium spp. + Mucor spp; Fusarium + Penicillium; Mucor spp. + Fusarium + Ustilaginales. Pathogenetic features of metabolic and morphological changes in highly productive cows with polymycotoxicosis were studied. Feeding food contaminated with various metabolites of mold fungi leads to the development of signs of chronic toxemia in animals. Clinical manifestations are the development of diarrhea and dehydration, with a decrease in milk productivity. Metabolic disorders feature the development of an inflammatory process, metabolic acidosis, hyperfermentonemia, with an increase in the amount of creatinine and urea in the blood serum. Metabolic signs indicate the development of hepatorenal syndrome due to structural disorders of the liver and kidneys. Histological signs of polymicotoxicosis are intracapillary and hemorrhagic glomerulonephritis, hepatocyte micronecrosis, and proliferation of connective tissue stroma cells, which leads to the development of atrophic cirrhosis in the interstitial and circular phases.

HISTOLOGICAL CHANGES IN THE INTESTINES OF POULTRY DURING FODDER INTOXICATION

2020 ◽  
Author(s):  
E.P. Dolgov ◽  
◽  
A.A. Abramov ◽  
E.V. Kuzminova ◽  
E.V. Rogaleva ◽  
...  
Keyword(s):  
Body Weight ◽  
Histological Examination ◽  
Aflatoxin B1 ◽  
Structural Changes ◽  
Clinical Manifestations ◽  
Feed Additives ◽  
The Body ◽  
Histological Changes ◽  
Beet Pulp

The article presents the data on the study of the influence of mycotoxins combination (T-2 toxin at the concentration of 0.095 mg/kg and aflatoxin B1 in the concentration of 0.019 mg/kg) on the body of quails and the results of pharmacocorrection of toxicosis with a complex consisting of beet pulp and lecithin. Structural changes in the intestines of quais at fodder mycotoxicosis are described. The use of antitoxic feed additives in poultry led to a weakening of the action of xenobiotics, which was confirmed by an increase in the safety of poultry and increase in body weight of quails, a decrease in the clinical manifestations of intoxication, as well as in positive changes in the structure of the intestine of the poultry during histological examination.

Celiac Disease in Kosovar Albanian Children: Evaluation of Clinical Features and Diagnosis

2020 ◽  
Vol 16 (3) ◽  
pp. 241-247
Author(s):  
Atifete Ramosaj-Morina ◽  
Alije Keka-Sylaj ◽  
Arbana Baloku Zejnullahu ◽  
Lidvana Spahiu ◽  
Virgjina Hasbahta ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Disease Onset ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Dominant Mode ◽  
Primary School Children ◽  
Cross Sectional ◽  
Classical Form ◽  
Wide Range ◽  
The Mean

Background: Celiac disease is an immune-mediated disorder characterized by variable clinical manifestations, specific antibodies, HLA-DQ2/DQ8 haplotypes, and enteropathy. Objectives: The aim of this study was to present the clinical spectrum and patterns of celiac disease in Kosovar Albanian children. Methods: A cross-sectional retrospective study was performed with Albanian children aged 0-18 years, treated for celiac disease in the Pediatric Clinic, University Clinical Center of Kosovo from 2005 to 2016. Results: During the study period, 63 children were treated for celiac disease. The mean age at diagnosis was 5.5 years (SD ± 3.31). The mean age at celiac disease onset was 3.3 years (SD ± 2.02), while the mean delay from the first symptoms indicative of celiac disease to diagnosis was 2.2 years (SD ± 2.09). More than 70% of the patients were diagnosed in the first 7 years of life, mainly presented with gastrointestinal symptoms, while primary school children and adolescents mostly showed atypical symptoms (p<0.001). The classical form of celiac disease occurred in 78% of the cases. Sixty (95%) patients carried HLA-DQ2.5, DQ2.2 and/or HLA-DQ8 heterodimers, and only three of them tested negative. Conclusions: Kosovo, as the majority of developing countries, is still facing the classical form of celiac disease as the dominant mode of presentation; as a result, most children with other forms of the celiac disease remain undiagnosed. : Physicians should be aware of the wide range of clinical presentations and utilize low testing thresholds in order to prevent potential long-term problems associated with untreated celiac disease.

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