scholarly journals DERMOID AND EPIDERMOID CYSTS OF THE MAXILLOFACIAL AREA AND THE NECK AMONG CHILDREN

2020 ◽  
pp. 25-30
Author(s):  
P.I. Tkachenko ◽  
I.I. Starchenko ◽  
S.O. Bilokon ◽  
Y.V. Popelo ◽  
N.P. Bilokon ◽  
...  

It is generally accepted that dermoid and epidermoid cysts are the result of malformation of the ectoderm. The asymptomatic course, absence of pathognomonic symptoms and similarity of clinical manifestations at separate stages of growth, despite nosological form and place of occurrence, give this pathology of particular relevance in the practice of pediatric maxillofacial surgery. However, if there are no significant issues regarding the etiology and pathogenesis of dermoids and epidermoids, there is a problem of constant monitoring of their prevalence and structure for the formation of administrative organizational measures for the planning of specialized care for this category of patients. Special attention should also be given to the development of new, minimally invasive surgical interventions, given the increasing aesthetic demands and requirements of patients. The aim of the study is to study in a comparative aspect their own experience on the clinical and morphological features and principles of treatment of dermoid and epidermoid cysts of the maxillofacial area and neck in children with the results of scientific studies, covered in literature. A thorough analysis of fundamental scientific works and publications in periodicals devoted to the scientific development of various directions in relation to these issues is carried out. The clinical section of the work concerns 15 children with dermoids and 8 children with epidermoids who have been treated for 8 years in the surgical ward of the children's clinical hospital in Poltava. General clinical, additional, and specific examination methods were used to establish clinical diagnosis, including diagnostic puncture, ultrasound, and MRI examination, which was performed in complex and questionable cases. If it is necessary, the patients are consulted by doctors of related specialties. The microscopic structure of the postoperative material was studied on preparations made by conventional methods. An objective study found that the clinical picture of the dermoid and epidermoid cysts is similar, differing only in slight subjective sensations on palpation. Comparison of clinical diagnosis and results of postoperative morphological verification of removed soft tissue bones showed that in 23.9% of patients the clinical diagnosis did not coincide with pathohistological. The difference in dermoids was the largest (75.0%), which confirms the need for expanded use of additional examination methods both at the pre-hospital stage and under inpatient conditions immediately before surgery. In general, the obtained morphological picture of the postoperative material coincided with the literature data on the classical structure of the dermoid and epidermoid cysts of the soft tissues of the maxillofacial area. Thus, the dermoid and epidermoid cysts of the maxillofacial area in children, having a dysontogenic origin, are most often diagnosed at younger and older school age. Despite their classic clinical picture, a considerable number of discrepancies between clinical and pathohistological diagnoses are traced , requiring a careful examination at both the hospital and hospital stages using modern, informative supplementary and special methods of investigation in complex and doubtful cases of cases and complex cases. These materials may be the basis for further in-depth scientific studies on immunohistochemical structural features dermoids and epidermoids to determine immunocompetence layers cystic membranes and determine their probable role in causing acute inflammation depending on the type of formation.

2020 ◽  
pp. 67-73
Author(s):  
P.I. Tkachenko ◽  
I.I. Starchenko ◽  
S.O. Bilokon ◽  
N.V. Lokhmatova ◽  
N.P. Bilokon ◽  
...  

The great diversity of the jaw cysts makes the issues of their diagnosis, differential diagnosis, and treatment quite important, always requiring an individual approach, given the features of each clinical case. Although the jaw cysts were first mentioned by Scultetus in 1654, the researchers still have different views on the semiotics and classifying individual nosological forms and, consequently, on choosing treatment methods, preventing possible complications and recurrences, and making prognosis. Asymptomatic clinical course and absence of characteristic clear clinical manifestations of the jaw cysts and similarity of their signs at separate developmental stages regardless of the nosological form and origin site make this pathology relevant in the practice of maxillofacial surgery. Traumatic and aneurysmal pseudocysts are common in the nomenclature of tumor-like formations of the jaws. The paper is concerned with the etiology and pathogenesis, clinical morphological features, and modes of treatment of traumatic and aneurysmal jaw cysts, based on the generalization of the findings of the scientific researches, to emphasize the above nosological forms to the medical community. The study encompasses a thorough analysis of the fundamental scientific works and publications in periodicals on the above issues. The clinical part of the study concerned a comprehensive examination of 46 children with traumatic and aneurysmal jaw cysts who received treatment at the surgical unit of the Poltava Municipal Children’s Clinical Hospital during the period of 5 years. In addition, 8 adult patients with traumatic cysts were examined and received outpatient treatment at the Department’s clinic. Common clinical and additional examination methods, diagnostic puncture, EOD, radiography, CT, and MRI were used to make the clinical diagnosis in serious cases. The microscopic structure of the specimens made from the postoperative material using conventional techniques was studied. During 2014-2019, 46 children with non-odontogenic jaw cysts (NJC) were treated at the Department of Children’s Oral Surgery, including 24 patients (52.2%) with traumatic cysts (TC) and 15 patients (32.6%) with aneurysmal cysts (AC). That is, TC and AC accounted for 39 cases (84.8%) of NJC. At the same time, while the general age of patients with NJC ranged from 5 to 15 years, TC and AC were most common in children aged 10-15 years, which is consistent with other researchers’ data, who observed the highest incidence in puberty. 25 (64,1%) boys and 14 girls (35.9%) have been involved in the study. Generalized statistical analysis revealed that traumatic cysts accounted for 52.2% of children, 32.6% for aneurysmal and 15.2% for other types of non-odontogenic jaw cysts. The patients were predominantly males, and even trauma in the past medical history did not always correspond to and confirm the type of cystic formation. The presented material suggests a rather unclear diagnostic “boundary” between traumatic and aneurysmal cysts, when, in fact, the main differential diagnostic criterion is a carefully gathered anamnesis, even at the prehospital stage. The given material can be the basis for further in-depth scientific and practical studies on immunohistochemical structural features of traumatic and aneurysmal jaw cysts.


2019 ◽  
Vol 15 (2) ◽  
pp. 11-16
Author(s):  
Антон Султанов ◽  
Anton Sultanov ◽  
Юрий Первов ◽  
Yury Pervov ◽  
Анна Яценко ◽  
...  

Introduction. The tissues surrounding the implant, which have common features with periodontal tissues, but still possessing a certain specificity are the actual topic of the study. A considerable amount of textbooks has been written on this topic, but so far it has remained little studied. Purpose ― to summarize all knowledge of the structural features of the tissues surrounding the implant, etiology, pathogenesis, clinical picture, differential diagnosis of the pathologies of these tissues. Results. This review is devoted to the analysis of the modern understanding of the influence of the structural features of the soft tissues surrounding the implant and the nonspecific protection factors of the oral mucosa on the potentiation of inflammatory processes and their relationship with the biodegradation of the material. The work of scientists on the criteria for choosing an implantable material depending on the resistance to aggressive environments of the oral cavity, as well as biocompatibility with the tissues of the oral cavity. The risks of complications are considered depending on the implantable material. The etiopathogenesis of such diseases as implantation mucositis and dental periimplantitis is also considered. The clinical picture of these diseases is described, a correlation is made with the materials used for the manufacture of suprastructures. The prevention of complications arising from prosthetics on dental implants is considered.


2020 ◽  
pp. 27-34
Author(s):  
A. Nikitina ◽  
A. Rusanova ◽  
A. Zhilenkova

HIV infection is a significant problem in the modern world, because there are more and more infected people every year. This article will consider: the clinical picture, diagnosis and treatment of this disease in different countries. Based on these data, the following conclusions will be made to help doctors in their future practice correctly approach the diagnosis and treatment of patients with this disease.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1284.1-1285
Author(s):  
A. S. Lundberg ◽  
B. A. Esbensen ◽  
E. M. Hauge ◽  
A. De Thurah

Background:Early treatment, before three months from symptom onset of rheumatoid arthritis (RA), is essential to increase the likelihood of remission and to prevent permanent joint damage (1). However, it has been shown that only 20% of the patients are seen within the first three months, and the median delay in general practice has been estimated to 4 months (range 2–9) (2).Objectives:To explore the barriers in diagnosing RA from the general practitioners’ (GPs) perspective.Methods:We conducted a qualitative study based on focus group interviews. We recorded the interviews digitally and transcribed verbatim. The transcribed interviews were analyzed based on content analysis (3), by using Nivo 12. Sample size was determined by thematic saturation.Results:In total ten GPs participated in three different focus groups. 40 % were female, mean age was 53 years (range 37-64), and mean year since specialist authorization as GP was 16 years (range 5-23). 60 % of the GPs worked in a practice located within the referral area of a university hospital; the remaining within the referral area of a regional hospital.Four themes emerged in the analysis: 1) When the patient is not a text book example, referring to the difficulty of identifying relevant symptoms among all clinical manifestations from the joints as described by the patients, 2)The importance of maintaining the gatekeeper function, referring to the societal perspective, and the GPs responsibility to refer the right patients to secondary care, 3)Difficulties in referral of patients to the rheumatologist,referring to perceived differences in the collaboration with rheumatologists. The GPs experienced that it was sometimes difficult to be assisted by rheumatologists, especially when the clinical picture was not ‘clear cut’. Finally, (4)Para-clinical testing, can it be trusted?referring to challenges on the evaluation of especially biomarkers.The overarching theme was:Like finding a needle in a haystack, covering the GPs difficulties in detecting RA among the many patients in general practice who appear to be well and at the same time have symptoms very similar to RA.Conclusion:The GPs experienced that RA was a difficult diagnosis to make. The immediate challenge was that RA patient’s initial symptoms often resembled those of more common and less serious conditions, and that investigative findings such as biomarkers can be negative at the early state of the disease. At the same time, the collaboration with rheumatologists was sometimes seen as a hurdle, when the clinical picture was not ‘clear cut’.In order to facilitate earlier diagnosis of RA in general practice, the GPs and rheumatologists need to focus on these barriers by strengthening mutual information and collaboration.Physicians should remain vigilant to patients who have conditions that do not resolve as expected with treatment, who have symptoms that persist, or who do not look well despite negative investigative findings.References:[1]Aletaha D, et al. JAMA, Oct 2018.[2]Kiely P, et al. Rheumatology, Jan 2009.[3]Braun V. Qualitative research in psychology. 2006, 3(2), 77-101Disclosure of Interests:Anne Sofie Lundberg: None declared, Bente Appel Esbensen: None declared, Ellen-Margrethe Hauge Speakers bureau: Fees for speaking/consulting: MSD, AbbVie, UCB and Sobi; research funding to Aarhus University Hospital: Roche and Novartis (not related to the submitted work)., Annette de Thurah Grant/research support from: Novartis (not relevant for the present study)., Speakers bureau: Lily (not relevant for the present study).


Molecules ◽  
2021 ◽  
Vol 26 (9) ◽  
pp. 2618
Author(s):  
Tatyana A. Kuznetsova ◽  
Boris G. Andryukov ◽  
Ilona D. Makarenkova ◽  
Tatyana S. Zaporozhets ◽  
Natalya N. Besednova ◽  
...  

Hemostasis disorders play an important role in the pathogenesis, clinical manifestations, and outcome of COVID-19. First of all, the hemostasis system suffers due to a complicated and severe course of COVID-19. A significant number of COVID-19 patients develop signs of hypercoagulability, thrombocytopenia, and hyperfibrinolysis. Patients with severe COVID-19 have a tendency toward thrombotic complications in the venous and arterial systems, which is the leading cause of death in this disease. Despite the success achieved in the treatment of SARS-CoV-2, the search for new effective anticoagulants, thrombolytics, and fibrinolytics, as well as their optimal dose strategies, continues to be relevant. The wide therapeutic potential of seaweed sulfated polysaccharides (PSs), including anticoagulant, thrombolytic, and fibrinolytic activities, opens up new possibilities for their study in experimental and clinical trials. These natural compounds can be important complementary drugs for the recovery from hemostasis disorders due to their natural origin, safety, and low cost compared to synthetic drugs. In this review, the authors analyze possible pathophysiological mechanisms involved in the hemostasis disorders observed in the pathological progression of COVID-19, and also focus the attention of researchers on seaweed PSs as potential drugs aimed to correction these disorders in COVID-19 patients. Modern literature data on the anticoagulant, antithrombotic, and fibrinolytic activities of seaweed PSs are presented, depending on their structural features (content and position of sulfate groups on the main chain of PSs, molecular weight, monosaccharide composition and type of glycosidic bonds, the degree of PS chain branching, etc.). The mechanisms of PS action on the hemostasis system and the issues of oral bioavailability of PSs, important for their clinical use as oral anticoagulant and antithrombotic agents, are considered. The combination of the anticoagulant, thrombolytic, and fibrinolytic properties, along with low toxicity and relative cheapness of production, open up prospects for the clinical use of PSs as alternative sources of new anticoagulant and antithrombotic compounds. However, further investigation and clinical trials are needed to confirm their efficacy.


PEDIATRICS ◽  
1951 ◽  
Vol 7 (4) ◽  
pp. 537-549
Author(s):  
ELLEN P. MACKENZIE

Thirteen cases of pneumatosis intestinalis are reported, 12 of them in infants between 12 days and 12 months of age, one in a boy of 6 years. Review of these cases and of 32 reported cases falling within the pediatric age range discloses that the disease occurs most frequently in patients whose general condition is poor, that it is very often associated with congenital or acquired disease of the intestine, and that respiratory disease, usually infectious, frequently co-exists. The presence of pneumatosis in pediatric patients has so far been discovered only at autopsy, but clinical diagnosis, with the aid of the typical roentgenologic findings, is feasible and may be accomplished when the disease is more widely known. The clinical picture and roentgenographic findings in adults are reviewed. The most acceptable theories concerning the pathogenesis are discussed, with their possible relation to infantile diarrhea.


Author(s):  
Igor Sergeevich Trifonov ◽  
Mikhail Vladimirovich Sinkin ◽  
Elena Vladimirovna Grigoryeva ◽  
Rashid Abdurakhmanovich Navruzov

Surgical treatment of bilateral temporal lobe pharmacoresistant epilepsy is associated with some difficulties: particularly, the lack of stereotypical clinical picture in the same patient and controversial data on modern methods of diagnostics — all these statements make identifying epileptogenic zone more difficult and lack of clear criteria for the selection of patients for surgical treatment. In this review, issues of aetiology, pathogenesis, clinical manifestations and criteria for the selection for surgical treatment suggested by different authors are presented.


Author(s):  
Maksim Vladimirovich Shpagin ◽  
Anton Viktorovich Yarikov ◽  
Denis Nikolaevich Nikitin ◽  
Igor Anatolievich Lobanov ◽  
Ivan Aleksandrovich Laganin ◽  
...  

The article is devoted to rare brain pathology, i.e. epidermoid cysts. The histological picture of the tumor is described; the classification is given. On the basis of our own clinical observations and a literature review, the features of the clinical manifestations of cholesteatoma of the cerebellopontine angle, modern approaches to the diagnosis and tactics of complex treatment are presented.


PEDIATRICS ◽  
1958 ◽  
Vol 22 (5) ◽  
pp. 972-990
Author(s):  
Niels L. Low ◽  
Julia Schneider ◽  
Sidney Carter

Polyneuritis in children is becoming more common. The clinical picture is variable; it may be manifested by motor and sensory findings, or by a combination of peripheral and cranial nerve signs and symptoms. The etiology is usually obscure. The pathologic picture varies with the severity of the disease and differs according to the stage at which the patient dies, but all fatal cases show the same main characteristic changes. Clinical records of 30 cases, 17 boys and 13 girls from 17 months to 16 years of age, are reviewed. The clinical manifestations, course and treatment are described.


2018 ◽  
Vol 9 (4) ◽  
pp. 62 ◽  
Author(s):  
Gianluca Turco ◽  
Davide Porrelli ◽  
Eleonora Marsich ◽  
Federica Vecchies ◽  
Teresa Lombardi ◽  
...  

Background: Bone substitutes, either from human (autografts and allografts) or animal (xenografts) sources, suffer from inherent drawbacks including limited availability or potential infectivity to name a few. In the last decade, synthetic biomaterials have emerged as a valid alternative for biomedical applications in the field of orthopedic and maxillofacial surgery. In particular, phosphate-based bone substitution materials have exhibited a high biocompatibility due to their chemical similitude with natural hydroxyapatite. Besides the nature of the biomaterial, its porous and interconnected architecture is essential for a correct osseointegration. This performance could be predicted with an extensive characterization of the biomaterial in vitro. Methods: In this study, we compared the biological, chemical, and structural features of four different commercially available bone substitutes derived from an animal or a synthetic source. To this end, µ-CT and SEM were used to describe the biomaterials structure. Both FTIR and EDS analyses were carried out to provide a chemical characterization. The results obtained by these techniques were correlated with cell adhesion and proliferation of the osteosarcoma MG-63 human cell line cultured in vitro. Results: The findings reported in this paper indicate a significant influence of both the nature and the structure of the biomaterials in cell adhesion and proliferation, which ultimately could affect the clinical performance of the biomaterials. Conclusions: The four commercially available bone substitutes investigated in this work significantly differed in terms of structural features, which ultimately influenced in vitro cell proliferation and may so affect the clinical performance of the biomaterials.


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