scholarly journals Errors in the diagnosis of syphilitic infection

2020 ◽  
Vol 24 (4) ◽  
pp. 679-683
Author(s):  
S. A. Bondar ◽  
A. A. Nalizhitiy ◽  
L. L. Garmash ◽  
O. M. Pichkur ◽  
S. O. Kachula
Keyword(s):  
Clinical Manifestations ◽  
Specific Treatment ◽  
Diagnostic Errors ◽  
Prevention Measures ◽  
Internal Organs ◽  
Sexually Transmitted ◽  
Treatment And Prevention ◽  
Health Authorities ◽  
Spread Of Infection ◽  
Medical University

Annotation. Syphilis remains one of the infections of particular concern worldwide, being one of the most important medical and social problems. Scientists' reports and WHO data show an increase in the incidence of sexually transmitted diseases. Syphilitic infection is still a pressing problem in Ukraine. Because syphilis facilitates the transmission of HIV and STIs, a comprehensive model for the prevention of HIV, STIs, and syphilis at the same time is needed. This requires the health authorities to strengthen treatment and prevention measures, among which an important role is to improve the skills of doctors in modern clinics and early diagnosis of luteal infection. Mistakes made by doctors are one of the reasons for the spread of infection, the development of severe, often disabling lesions of the patient’s internal organs and nervous system. The purpose of the work is to improve the diagnosis of syphilitic infection, which contributes to the effective fight against the spread of syphilis in Ukraine. 4 cases of syphilis in patients who applied to the Vinnytsia Regional Clinical Dermatological and Venereological Dispensary and were consulted by the staff of the Department of Dermatology and Venereal Diseases of National Pirogov Memorial Medical University, Vinnytsya, they were verified the diagnosis of syphilis and received specific treatment. During the examination of patients with syphilis with clinical manifestations of infection by doctors of various profiles in 14% of patients, the true disease remained undiagnosed. The analysis of diagnostic errors of syphilis in the primary period, when patients with classic manifestations of syphilitic infection visited 4–6 doctors of different profiles. The errors made by doctors were divided as follows: dermatovenereologists – 21%, surgeons – 26%, obstetricians and gynecologists – 22%, physicians – 19%, oncologists, dentists and other specialists – 12%. Thus, timely diagnosis of syphilitic infection is one of the most important points in a set of national measures to combat this infection.

scholarly journals INDIVIDUAL APPROACH TO THE EXAMINATION OF PATIENTS AND THE CHOICE OF TREATMENT METHODS TOOTH SENSITIVITY

2020 ◽  
Vol 75 (3) ◽  
pp. 60-64
Author(s):  
N.F. Aleshina ◽  
◽  
N.V. Piterskaya ◽  
I.V. Starikova ◽  
◽  
...  
Keyword(s):  
Rational Choice ◽  
Clinical Manifestations ◽  
Dental Status ◽  
Prevention Measures ◽  
Treatment Methods ◽  
Individual Approach ◽  
Treatment And Prevention ◽  
Choice Of Treatment ◽  
The Individual

52 patients aged 26 to 54 years (39 women and 13 men) with hypersensitivity of the teeth were examined. Taking into account the individual approach to the examination of patients, the dental status was determined, etiological factors, body features, the presence of somatic pathology, clinical manifestations of hypersensitivity of the teeth were determined, with the determination of the degree, prevalence and intensity of hyperesthesia. The study made it possible to make a rational choice of treatment and prevention measures, taking into account individual General and local manifestations of this pathology.

scholarly journals CHRONIC CEREBROVASCULAR DISORDERS IN YOUNG PEOPLE: CLINICAL, DIAGNOSTIC, ETIOLOGICAL, PATHOGENETIC, TREATMENT AND PROPHYLACTIC ASPECTS

2020 ◽  
Vol 4 (14) ◽  
pp. 97-104
Author(s):  
O.E. Kovalenko ◽  
B.G. Gavryshchuk
Keyword(s):  
Young People ◽  
Preventive Measures ◽  
Cerebrovascular Disorders ◽  
Clinical Manifestations ◽  
Cerebrovascular Diseases ◽  
Comprehensive Analysis ◽  
Individual Treatment ◽  
Prevention Measures ◽  
Treatment And Prevention

Cerebrovascular diseases remain among the world`s most pressing problems due to the high mortality, disability, reduced quality of life, development of dementia and a high risk of recurrence of cerebral circulatory disorders. Over the last 15 years, there has been a tendency to increase the number of cerebrovascular diseases among young people. The clinical manifestations of the initial cerebrovascular disorders are nonspecific and require additional examination and development of individual treatment and prevention measures. This review of chronic cerebrovascular disorders in young people is based on the analysis of local and foreign literature. The article presents a comprehensive analysis of the problem of the initial manifestations of cerebral circulatory failure in young people: etiology, pathogenesis, clinical features, diagnosis, treatment and preventive measures.

Phagedenic ulcer of the chancre in young woman

2016 ◽  
Vol 19 (6) ◽  
pp. 378-380
Author(s):  
A. O Olisov ◽  
V. V Vladimirov
Keyword(s):  
Young Woman ◽  
Clinical Observation ◽  
Clinical Manifestations ◽  
Specific Treatment ◽  
Diagnostic Errors ◽  
Primary Syphilis ◽  
Acute Reaction ◽  
Benzylpenicillin Sodium

The literature data on such severe and rare complications of chancre in primary syphilis as gangrene and phagedenic ulcer, that developing normally in the background of immunodeficiency patients, especially in alcoholics, are presented. Infection and the development of chancre significantly change the clinical manifestations of primary syphilis, which can lead to diagnostic errors. The clinical observation of the patient suffering from alcoholism, which had a diagnosis ofprimary syphilis chancre on the basis of complicated phagedenic ulcer, regional lymphadenitis, positive serological reactions, acute reaction to the beginning of specific treatment, is presented. The treatment with Benzylpenicillin sodium was performed and led to the scarring of the chancre.

A CLINICAL CASE OF PRIMARY HYPERPARATHYROIDISM OF THE OSTEO-VISCERAL FORM

2020 ◽  
pp. 155-161
Author(s):  
Poselyugina O.B. ◽  
Kulish A.S. ◽  
Vasiliev D.F.
Keyword(s):  
Primary Hyperparathyroidism ◽  
Clinical Case ◽  
Early Stage ◽  
Diagnostic Errors ◽  
Epidemiological Studies ◽  
Medical Documentation ◽  
Screening Methods ◽  
Internal Organs ◽  
Blood Calcium ◽  
Slow Development

Introduction. Primary hyperparathyroidism is an endocrine disease resulting from a primary pathology of the parathyroid gland, characterized by increased secretion of parathyroid hormone and increased blood calcium levels. Among the endocrine diseases, primary hyperparathyroidism is the third most common after diabetes mellitus and thyroid disease. In Russia, according to epidemiological studies, primary hyperparathyroidism is found in 1% of the population, women suffer 2-3 times more often than men do, and the average age of diagnosis is 54-59 years. In the absence of a timely diagnosis, primary hyperparathyroidism causes systemic damage to internal organs: renal impairment, nephrolithiasis, esophageal affection, cardiovascular and nervous system involvement, and it leads to a violation of bone tissue integrity. The aim is to demonstrate a clinical case of a patient with primary hyperparathyroidism and to analyze the stages of diagnosis of the disease and treatment. Material and methods. The review of medical literature on the problem of diagnostics and treatment of primary hyperparathyroidism was performed, as well as an analysis of the patient’s medical documentation with this pathology. Results and discussion. A variant of complicated course of primary hyperparathyroidism of bone and visceral form is considered. About 15 years passed from the moment of appearance of the first symptoms of the disease to the development of complications of renal and bone system. Despite the slow development of the disease and availability of screening methods, hyperparathyroidism was detected at the stage of complications. This article provides a detailed analysis of the primary hyperparathyroidism history, as well as analyzes the possibilities of diagnosis, treatment and prevention of this pathology. The efficacy of the therapy has been assessed, and ways of correction have been outlined. The analysis of the reasons that made it difficult to diagnose this pathology at an early stage, before the development of serious complications of internal organs, has been carried out. Conclusions: It can be assumed that the presented clinical case will increase the awareness of physicians, especially therapists, about the primary manifestations of this pathology and the peculiarities of its detection and routing the patient, which will allow avoiding many diagnostic errors.

scholarly journals A New Multiplatform Model for Outpatient Prenatal and Postpartum Care in a Cohort of COVID-19-Affected Obstetric Patients

2021 ◽  
Vol 18 (10) ◽  
pp. 5144
Author(s):  
Mar Muñoz-Chápuli Gutiérrez ◽  
Ana Durán-Vila ◽  
Javier Ruiz-Labarta ◽  
Pilar Payá-Martínez ◽  
Pilar Pintado Recarte ◽  
...  
Keyword(s):  
Clinical Manifestations ◽  
Specific Treatment ◽  
Rt Pcr ◽  
Good Adherence ◽  
Major Morbidity ◽  
Reference Hospital ◽  
The Mean ◽  
Discharge From Hospital ◽  
Over Time

Spain was one of the epicenters of the first wave of the COVID-19 pandemic. We describe in this article the design and results of a new telephone-and-telematic multiplatform model of systematic prenatal and postpartum follow-up for COVID-19-affected women implemented in a tertiary reference hospital in Madrid. We included patients with RT-PCR-confirmed COVID-19 during pregnancy or delivery from 10 March 2020 to 15 December 2020. We had a total of 211 obstetric patients: 148 (70.1%) were tested at the onset of suspicious clinical manifestations and 62 (29.4%) were tested in the context of routine screening. Of all the patients, 60 women (28.4%) were asymptomatic and 97 (46%) presented mild symptoms. Fifty-one women (24.2%) were admitted to our hospital for specific treatment because of moderate or severe symptoms. We had no missed cases and a good adherence. The mean number of calls per patient was 2.3. We performed 55 in-person visits. We analyzed the complexity of our program over time, showing a two-wave-like pattern. One patient was identified as needing hospitalization and we did not record major morbidity. Telemedicine programs are a strong and reproducible tool to reach to pregnant population affected by COVID-19, to assess its symptoms and severity, and to record for pregnancy-related symptoms both in an outpatient regime and after discharge from hospital.

scholarly journals Clinical Management of Hypertension, Inflammation and Thrombosis in Hospitalized COVID-19 Patients: Impact on Survival and Concerns

2021 ◽  
Vol 10 (5) ◽  
pp. 1073
Author(s):  
Patricia Martínez-Botía ◽  
Ángel Bernardo ◽  
Andrea Acebes-Huerta ◽  
Alberto Caro ◽  
Blanca Leoz ◽  
...  
Keyword(s):  
Arterial Hypertension ◽  
Clinical Management ◽  
Cox Regression ◽  
Angiotensin Receptor Blockers ◽  
Treatment Options ◽  
Clinical Manifestations ◽  
Specific Treatment ◽  
Hospitalized Patients ◽  
Thrombosis Prophylaxis ◽  
The Impact

The most severe clinical manifestations of the Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), are due to an unbalanced immune response and a pro-thrombotic hemostatic disturbance, with arterial hypertension or diabetes as acknowledged risk factors. While waiting for a specific treatment, the clinical management of hospitalized patients is still a matter of debate, and the effectiveness of treatments to manage clinical manifestations and comorbidities has been questioned. In this study, we aim to assess the impact of the clinical management of arterial hypertension, inflammation and thrombosis on the survival of COVID-19 patients. The Spanish cohorts included in this observational retrospective study are from HM Hospitales (2035 patients) and from Hospital Universitario Central de Asturias (72 patients). Kaplan Meier survival curves, Cox regression and propensity score matching analyses were employed, considering demographic variables, comorbidities and treatment arms (when opportune) as covariates. The management of arterial hypertension with angiotensin-converting enzyme 2 (ACE2) inhibitors or angiotensin receptor blockers is not detrimental, as was initially reported, and neither was the use of non-steroidal anti-inflammatory drugs (NSAIDs). On the contrary, our analysis shows that the use on itself of corticosteroids is not beneficial. Importantly, the management of COVID-19 patients with low molecular weight heparin (LMWH) as an anticoagulant significantly improves the survival of hospitalized patients. These results delineate the current treatment options under debate, supporting the effectiveness of thrombosis prophylaxis on COVID-19 patients as a first-line treatment without the need for compromising the treatment of comorbidities, while suggesting cautiousness when administering corticosteroids.

scholarly journals Patient health engagement model: explaining citizens noncompliance and maladaptive behaviors

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
G Graffigna ◽  
S Barello ◽  
L Palamenghi ◽  
M Savarese ◽  
G Castellini
Keyword(s):  
Healthcare Services ◽  
Cross Sectional Study ◽  
Health Prevention ◽  
Prevention Measures ◽  
Cross Sectional ◽  
Health Authorities ◽  
Patient Health ◽  
Public Health Authorities ◽  
High Level ◽  
Restrictive Measures

Abstract Background At the end of February 2020 a new case was diagnosed with COVID-19 in north Italy, suddenly followed by new cases. Italian health authorities decided to enforce restrictive measures. Northern areas of Italy were identified as “red areas” to slow down the epidemic and its impact on the healthcare system. From this perspective, the COVID-19 epidemic in Italy constitutes a testing ground for the assessment of the ability of consumers to cope with this health risk. Methods A cross-sectional study on a representative sample of 1000 Italian citizens was conducted over the period 27 February- 5 March exploring the following hypotheses: 1) less engaged individuals are more concerned for the health emergency and feel more vulnerable; 2) less engaged have higher probability to develop negative attitudes and dysfunctional behaviors. Results only the 16% the interviewees presented a high level of engagement. Lower levels of engagement were measured in the southern parts of Italy (not yet touched by the epidemics at the time of data collection). People with lowers levels of engagement reported higher fears for the contagion and sense of vulnerability. Furthermore, they showed the lower levels of trust in the Public Health Authorities, in medical research and in vaccines. Finally, they appeared more dismissive in their preventive behaviors and more disorganized in the fruition of the healthcare services. Conclusions A psychological analysis of processes of attitudinal and role change in the direction of becoming more engaged in health prevention is worthy in order to forecast potential dysfunctional reactions to restrictive health prevention measures and to orient personalized education initiatives to consumers with different level of engagement. Key messages Profiling based on the levels of health engagement is important in order to plan more effective healthcare measures during epidemics. Targeted educational initiatives should take into account citizens' engagement profiles.

Management of Plantar Keratodermas

2017 ◽  
Vol 107 (5) ◽  
pp. 428-435 ◽  
Author(s):  
Rebecca M. Porter ◽  
Albert A. Bravo ◽  
Frances J.D. Smith
Keyword(s):  
Gene Therapy ◽  
Salicylic Acid ◽  
Alternative Treatment ◽  
Autosomal Dominant ◽  
Treatment Options ◽  
Clinical Manifestations ◽  
Specific Treatment ◽  
Inherited Mutations ◽  
Pachyonychia Congenita

Plantar keratodermas can arise due to a variety of genetically inherited mutations. The need to distinguish between different plantar keratoderma disorders is becoming increasingly apparent because there is evidence that they do not respond identically to treatment. Diagnosis can be aided by observation of other clinical manifestations, such as palmar keratoderma, more widespread hyperkeratosis of the epidermis, hair and nail dystrophies, or erythroderma. However, there are frequent cases of plantar keratoderma that occur in isolation. This review focuses on the rare autosomal dominant keratin disorder pachyonychia congenita, which presents with particularly painful plantar keratoderma for which there is no specific treatment. Typically, patients regularly trim/pare/file/grind their calluses and file/grind/clip their nails. Topical agents, including keratolytics (eg, salicylic acid, urea) and moisturizers, can provide limited benefit by softening the skin. For some patients, retinoids help to thin calluses but may lead to increased pain. This finding has stimulated a drive for alternative treatment options, from gene therapy to alternative nongenetic methods that focus on novel findings regarding the pathogenesis of pachyonychia congenita and the function of the underlying genes.

SPECIAL ARTICLE

PEDIATRICS ◽  
1955 ◽  
Vol 15 (5) ◽  
pp. 642-646
Keyword(s):  
General Population ◽  
Rheumatic Fever ◽  
Streptococcal Infection ◽  
Acute Otitis Media ◽  
Clinical Manifestations ◽  
Diagnostic Errors ◽  
White Blood Count ◽  
Streptococcal Infections ◽  
Laboratory Findings ◽  
Adequate Treatment

RHEUMAT1C fever is a recurrent disease which in most instances can be prevented. Since both the initial and recurrent attacks of the disease are precipitated by infections with beta hemolytic streptococci, prevention of rheumatic fever and rheumatic heart disease depends upon the control of streptococcal infections. This may be accomplished by (1) early and adequate treatment of streptococcal infections in all individuals and (2) prevention of streptococcal infections in rheumatic subjects. TREATMENT OF STREPTOCOCCAL INFECTIONS IN THE GENERAL POPULATION In the general population about 3 per cent of untreated streptococcal infections are followed by rheumatic fever. Adequate and early penicillin treatment, however, will eliminate streptococci from the throat and prevent most attacks of rheumatic fever. Diagnosis of Streptococcal Infection In many instances streptococcal infections can be recognized by their clinical manifestations. In some patients, however, it is difficult or impossible to determine the streptococcal nature of a respiratory infection without obtaining throat cultures. The following section on diagnosis has been included in order to reduce diagnostic errors and to assist physicians in avoiding unnecessary therapy. The accurate recognition of individual streptococcal infections, their adequate treatment and the control of epidemics in the community presently offer the best means of preventing initial and recurrent rheumatic fever. Common Symptoms Sore Throat—sudden onset, pain on swallowing. Headache—common. Fever—variable, but generally from 101° to 104°F. Abdominal Pain—common, especially in children; less common in adults. Nausea and Vomiting—common, especially in children. Common Signs Red Throat. Exudate—usually present. Glands—swollen, tender lymph nodes at angle of jaw. Rash—scarlatiniform. Acute Otitis Media and Acute Sinusitis —frequently due to the streptococcus. In the absence of the common symptoms and signs occurrence of any of the following symptoms is usually not associated with a streptococcal infection : simple coryza; hoarseness; cough. Laboratory Findings White Blood Count—generally over 12,000. Throat Culture—positive culture for hemolytic streptococci is almost always diagnostic.

scholarly journals Larva of greater wax moth Galleria mellonella is a suitable alternative host for the fish pathogen Francisella noatunensis subsp. orientalis

2019 ◽  
Author(s):  
Winarti Achmad Sarmin Djainal ◽  
Khalid Shahin ◽  
Alexandra Adams ◽  
Andrew Desbois
Keyword(s):  
Galleria Mellonella ◽  
Dependent Manner ◽  
Alternative Host ◽  
Prevention Measures ◽  
Suitable Alternative ◽  
Treatment And Prevention ◽  
Greater Wax Moth ◽  
Important Food Source ◽  
Dose Dependent ◽  
Lethal Doses

Abstract Background Francisella noatunensis subsp. orientalis (Fno) is the etiological agent of francisellosis in cultured warm water fish, such as tilapia. Antibiotics are administered to treat the disease but a better understanding of Fno infection biology will inform improved treatment and prevention measures. However, studies with native hosts are costly and considerable benefits would derive from access to a practical alternative host. Here, larvae of Galleria mellonella were assessed for suitability to study Fno virulence. Results Larvae were killed by Fno in a dose-dependent manner but the insects could be rescued from lethal doses of bacteria by antibiotic therapy. Infection progression was assessed by histopathology (haematoxylin and eosin staining, Gram Twort and immunohistochemistry) and enumeration of bacteria recovered from the larval haemolymph on selective agar. Fno was phagocytosed and could survive intracellularly, which is consistent with observations in fish. Virulence of five Fno isolates showed strong agreement between G. mellonella and red Nile tilapia hosts. Conclusions This study shows that an alternative host, G. mellonella, can be applied to understand Fno infections, which will assist efforts to identify solutions to piscine francisellosis thus securing the livelihoods of tilapia farmers worldwide and ensuring the production of this important food source.

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