Fundamentals of differential diagnosis of hemorrhagic vasculitis

2021 ◽  
pp. 44-49
Author(s):  
Vladimir Anatolievich Klimov
Keyword(s):  
Abdominal Pain ◽  
Pathological Condition ◽  
Family Doctor ◽  
Pain Syndrome ◽  
Scientific Work ◽  
Intestinal Wall ◽  
The Body ◽  
Upper Respiratory Tract ◽  
Mucous Membranes ◽  
Bowel Disorders

It is quite rare, but in the practice of a family doctor, a condition may occur when, after an upper respiratory tract infection, flu or tonsillitis, the patient develops petechial rashes, hemorrhages in the mucous membranes, articular syndrome develops and abdominal pain appears. The first elements of the rash appear symmetrically first on the lower extremities, and then spread throughout the body. Joint lesions are characterized by severe pain syndrome and swelling; changes usually affect large joints – knee and ankle, but sometimes smaller articular surfaces are affected. Hemorrhages in the intestinal wall and mesentery are the cause of abdominal pain, flatulence, bowel disorders; nausea and vomiting are possible, sometimes mixed with blood. All these signs are characteristic of hemorrhagic vasculitis, which is also called Henoch–Schonlein purpura, capillary toxicosis or allergic purpura. For the first time, a description of several cases of purpura associated with arthritis was given by a German doctor Johann Schonlein in 1937, and a few decades later this nosology was described in detail by Eduard Henoch in his scientific work. In this pathological condition, autoimmune damage to small arteries is observed, as a result of which they become fragile, their permeability increases, resulting in the development of microthrombosis and multiple small hemorrhages in the skin, mucous membranes and internal organs. The disease most often occurs in children and adolescents, however, cases of diagnosis of hemorrhagic vasculitis have been described in adults as well [7].

Lactic acidosis in diabetes mellitus in the practice of a family doctor

2020 ◽  
pp. 37-43
Author(s):  
Vsevolod Skvortsov ◽  
Ekaterina Skvortsova ◽  
Georgiy Malyakin ◽  
Elina Goliyeva
Keyword(s):  
Diabetes Mellitus ◽  
Lactic Acid ◽  
Metabolic Acidosis ◽  
Lactic Acidosis ◽  
Chronic Hypoxia ◽  
Pathological Condition ◽  
Family Doctor ◽  
The Body ◽  
Anion Gap ◽  
The Moment

Lactic acidosis is a metabolic acidosis with a large anion gap (> 10 mmol/L) and a level of lactic acid in the blood > 4 mmol/L (according to some definitions, more than 2 mmol/L). This is a critical pathological condition of the body, accompanied by acute or chronic hypoxia, and even coma. The prognosis for the development of this condition is always severe, mortality is 50–80 %. Clear criteria for the diagnosis and treatment of this pathological condition are defined at the moment. This article focuses on the main issues that endocrinologists and resuscitators may encounter when identifying this complex of symptoms.

The Clinical Course of Irritable Bowel Syndrome in Young Patients with Neurocirculatory Dystonia

2016 ◽  
pp. 104-105
Author(s):  
Olena Suprun
Keyword(s):  
Irritable Bowel Syndrome ◽  
Abdominal Pain ◽  
Clinical Course ◽  
Family Doctor ◽  
Young Patients ◽  
Pain Syndrome ◽  
Comorbid Conditions ◽  
The Family ◽  
Irritable Bowel

The clinical picture of the combined course of irritable bowel syndrome (IBS) and neurocirculatory dystonia (NCD) in young patients has been described in the article. Features of abdominal pain syndrome and disorders of defecation, depending on the type of NCD (hypertonic or hypotonic) were shown. The conditions under which the exacerbation of IBS occurred in these patients were reviewed. The role of the family doctor in monitoring of the comorbid conditions was shown.

scholarly journals HEMATOLOGICAL AND BACTERIOLOGICAL PREDICTORS OF OCCUPATIONALLY AND INDUSTRIAL CONDITIONED DISEASES IN MEDICAL WORKERS

2020 ◽  
Vol 99 (1) ◽  
pp. 125-128
Author(s):  
L. M. Karamova ◽  
Natalya V. Vlasova ◽  
L. G. Gizatullina ◽  
L. M. Masyagutova
Keyword(s):  
Respiratory Tract ◽  
Allergic Diseases ◽  
The Body ◽  
Hospital Environment ◽  
Upper Respiratory Tract ◽  
Hemoglobin Content ◽  
Hematological Indices ◽  
Mucous Membranes ◽  
Upper Respiratory ◽  
Medical Examinations

Introduction. Medical workers in the process of labor are exposed to a complex of adverse factors: neuro-emotional, physical stress of a chemical, physical and biological nature. A long stay in a hospital environment with medical workers can lead to the formation of various diseases of microbiological etiology or the carriage of pathogenic and conditionally pathogenic flora and the development of dysbiosis. Objective. Give hematological and bacteriological characteristics of the health status of medical workers. Material and methods. The results of laboratory studies of blood and mucous membranes of the upper respiratory tract of medical workers performed during the performing occupational medical examinations are analyzed. Results. Hematological indices were found to be characterized by an increased hemoglobin content in one-fourth of the examined workers, as well as lymphocytosis, eosinophilia, cholesterolemia. The microflora of the mucosa of the upper respiratory tract is mainly represented by Staphylococcus aureus, Candida albicans, Streptococcus pyogenes in 65.2% of the workers; the remaining 34.8% were revealed to have a resident microflora. With the experience of work, the frequency of insemination increases and doubles by 10 years of the work. The structure of microflora is also changing. In the nosological form of occupational morbidity, allergic diseases prevail and account for 60.8%, tuberculosis - 26.0%, and hepatitis - 8,6%. Conclusion. All these changes in the body are the basis of pathogenetic manifestations in the formation of allergic and pathogenic pathologies, which make up to 70.0% of all occupational morbidity.

Abdominal pain: finding the cause and selecting tactics

2021 ◽  
pp. 26-32
Author(s):  
Roman Petrovich Stepchenkov
Keyword(s):  
Abdominal Pain ◽  
Digestive System ◽  
Correct Diagnosis ◽  
Family Doctor ◽  
Pain Syndrome ◽  
Lower Abdomen ◽  
Family Doctors ◽  
Genitourinary System ◽  
The Family ◽  
The Right

Abdominal pain is one of the most common symptoms that family doctors have to deal with in their practice. In the vast majority of cases, the patient considers abdominal pain to be the sign of a disturbance in the digestive system; however, in fact, any organ — the spleen, bladder, organs of the genitourinary system, and sometimes even the heart — can be the «culprit» causing the pain syndrome. Therefore, the family doctor is often faced with a rather difficult task — to carry out a differential diagnosis of abdominal pain and choose the right tactics for further treatment. By its nature, the pain can be acute and chronic, associated or not associated with food intake, arising periodically, having a cramping character or constant. Depending on the localization, it is divided into pain in the epigastric region, pain in the middle and lower abdomen. Often it is the localization of pain that helps to make the correct diagnosis.

scholarly journals Features of correction of a pathological condition of small animals at the diabetes mellitus with obesity

2021 ◽  
Vol 23 (101) ◽  
pp. 50-54
Author(s):  
T. P. Lokes-Krupka ◽  
M. I. Tsvilichovsky ◽  
A. U. Karasenko
Keyword(s):  
Diabetes Mellitus ◽  
Weight Loss ◽  
General Condition ◽  
Pathological Condition ◽  
The Body ◽  
Portion Size ◽  
Veterinary Drug ◽  
Small Animals ◽  
Domestic Cats ◽  
Mucous Membranes

 The article presents the results of clinical studies of domestic cats and dogs with diabetes mellitus on the background of obesity at the beginning and for a month of treatment. Domestic cats with diabetes were prescribed active exercise and industrial diet Royal Canin Diabetic Feline, dogs – Royal Canin Diabetic DS37. The portion size was determined according to the manufacturer's recommendations. Treatment of small animals for obesity, both alimentary and endocrine, preferably involves feeding food in limited quantities to cause controlled weight loss, as well as increased physical activity, which can provide additional energy expenditure. Successful weight loss can reduce the effects of comorbidities associated with obesity, such as improved mobility in osteoarthritis, increased insulin sensitivity and the reversal of other metabolic disorders, and improved quality of life. The main pathogenetic therapy for animals with diabetes for both domestic cats and dogs is the mandatory use of insulin. Researching the market of drugs in Ukraine, we chose the most affordable and effective veterinary drug – Caninsulin. The dose of insulin was selected individually for each animal by plotting a curve of blood glucose concentration over three days. At the beginning of treatment and at the end of the course, we conducted a comprehensive study of animals of both species. In cats, the general condition significantly improved as a result of treatment: only one animal remained depressed, the number of cases of hyporexia decreased, only 25.0 % of animals remained pale mucous membranes; temperature within the physiological norm; vomiting and bradycardia were not reported. A decrease in the rate of shortness of breath and drowsiness also indicates an improvement in the condition of cats with obesity due to diabetes. The improvement of the general condition of domestic dogs is evidenced by the restoration of the condition of the coat (about 4 times), the restoration of appetite in 66.7 %. Only one dog had anemia of the mucous membranes. Anxiety, bradycardia, hypothermia and itching disappeared completely. Within one month, there was a tendency to decrease the body weight of animals of both groups, but due to the insufficient duration of treatment, their fatness still remained excessive. Which indicates the need for further correction of the pathological condition.

A MANAGEMENT OF YAKRIT VRIDDHI (HEPATOMEGALY) BY SHODHANA CHIKITSA (VIRECHANA) FOLLOWED BY SHAMAN CHIKITSA (ARKA MAKOI): A CASE STUDY

2021 ◽  
Vol 12 (4) ◽  
pp. 19-23
Author(s):  
Rakesh Mishra ◽  
Ankita Mishra ◽  
IB Kotturshetti
Keyword(s):  
Abdominal Pain ◽  
Palliative Treatment ◽  
Pathological Condition ◽  
Solanum Nigrum ◽  
The Body ◽  
Routine Examination ◽  
Poor Appetite ◽  
Size And Shape ◽  
Complete Procedure

A 39-year-old man with clinical sign and symptoms of poor appetite, nausea, fatigue, distend abdomen, increased abdominal size and shape, abdominal pain, indigestion, vomiting sensation diagnosed as Yakrit Vriddhi or Yakrit-dalodar (Hepatomegaly). As per Ayurveda Samhita Shodhana Chikitsa is more effective in such type of patient. In this case after the routine examination i.e., History, Palpation, Blood Investigation (LFT), and Ultrasonography patient was treated by Panchakarma treatment. (Bio-purification therapy) In this Poorva Karma (Snehan- Bahya/Abhyantara) and Pradhana Karma (Abhayadimodak - Virechana Karma) in which vitiated doshas were expelled through Adhomarga (Anal route). After the Virechana Karma for restoration of the body Sansarjana Karma (Ayurvedic Dietary & Behavior regimen) was also done. The patient was on purgation 26 times (Vegas). At the end of the virechana karma Kapha was presented in the stool (Kaphant-Virechana). After the complete procedure followed by palliative treatment with Arka Makoi (Solanum nigrum) patient felt remarkable relief from above cited symptoms i.e., poor appetite, nausea, fatigue, distend abdomen, increased abdominal size and shape, abdominal pain, indigestion, vomiting sensation. The therapeutic purgation is safe and effective Panchakarma protocol to eliminate the morbid Pitta Dosha in the body either by pathological condition or diet and behavioral mismanagement.

Toxic epidermal necrolysis in the practice of a family doctor

2020 ◽  
pp. 61-67
Author(s):  
Esed Esedov ◽  
Fariza Akhmedova ◽  
Dina Akbiyeva
Keyword(s):  
Allergic Reaction ◽  
Toxic Epidermal Necrolysis ◽  
Family Doctor ◽  
Favorable Outcome ◽  
Rational Treatment ◽  
Systemic Allergic Reaction ◽  
Timely Diagnosis ◽  
First Case ◽  
Mucous Membranes

Toxic epidermal necrolysis is a severe delayed-type systemic allergic reaction, in which there is a combined lesion of the skin and mucous membranes. 2 cases of toxic epidermal necrolysis from the practice of a family doctor are described in the article. Timely diagnosis and rational treatment of the disease in the first case led to a favorable outcome, in the second case, the outcome of the disease was unfavorable.

ASSESSMENT OF THE TOXICITY AND HAZARD OF SODIUM LAURYL SULFATE AT DIFFERENT EXPOSURE ROUTES

2020 ◽  
pp. 56-59
Author(s):  
M. V. Bidevkina ◽  
M. I. Golubeva ◽  
A. V. Limantsev ◽  
I. N. Razumnaya ◽  
T. N. Potapova ◽  
...  
Keyword(s):  
Sodium Lauryl Sulfate ◽  
Exposure Level ◽  
Hazardous Substance ◽  
Lauryl Sulfate ◽  
Upper Respiratory Tract ◽  
Mucous Membranes ◽  
Chloroprene Rubber ◽  
Upper Respiratory ◽  
Exposure Routes ◽  
Number Of Cells

Sodium lauryl sulfate is the most common surfactant used in the production of detergents, chloroprene rubber, plastics, artificial furs and in pharmaceutical industry. Sodium lauryl sulfate is a moderately hazardous substance when introduced into the stomach (DL50 for white mice and rats is in the range of 2086-2700 mg/kg), has a pronounced local irritant effect on the skin and mucous membranes of the eyes, has a skin-resorptive, sensitizing and pronounced cumulative effects. The threshold for acute inhalation action is set at 15,3 mg/m3 for changes in the function of the nervous system and irritating effects on the mucous membranes of the upper respiratory tract (an increase in the total number of cells in the nasal flushes).Recommended for approval tentative safe exposure level of sodium lauryl sulfate in the air of the working area is 0.2+ mg/m3 (aerosol).

scholarly journals Evaluation of the short-term efficacy of local analgesic (lidocaine) and opioid analgesic (sufentanil) on patients with centrally mediated abdominal pain syndrome: a randomized controlled trial

2021 ◽  
Vol 14 ◽  
pp. 175628482110217
Author(s):  
Hang Yang ◽  
Honglin Chen ◽  
Bing Hu
Keyword(s):  
Randomized Controlled Trial ◽  
Abdominal Pain ◽  
Rating Scales ◽  
Rating Scale ◽  
Controlled Trial ◽  
Opioid Analgesic ◽  
Pain Syndrome ◽  
Short Term ◽  
Randomized Controlled ◽  
Term Efficacy

Background: Centrally mediated abdominal pain syndrome (CAPS) is characterized by continuous or frequently recurring abdominal pain and can result in functional loss across several life domains. The efficacy of the present management methods has not been established yet. We performed a prospective randomized controlled trial to explore the short-term efficacy of local analgesic (lidocaine) and opioid analgesic (sufentanil) in patients with CAPS. Methods: We consecutively enrolled 130 patients who met the Rome IV CAPS criteria and divided them into the sufentanil + lidocaine (S + L) group and sufentanil (S) group. Patients completed the pain rating scales, including the numeric rating scale (NRS) and verbal rating scale (VRS), 60 min before colonoscopy. All the patients were initially administered sufentanil. In the S + L group, we sprayed a 5 ml solution of lidocaine on the surface of ascending, transverse, descending, and sigmoid colon during colonoscope withdrawal, while 5 ml saline was sprayed in the S group. Follow up was performed 1 day, 3 days, 1 week, 2 weeks, 1 month, and 3 months after colonoscopy, to complete the pain scaling. Results: A comparison of the NRS and VRS showed that there were no significant differences between the S + L and S groups and within each group ( p > 0.05). Conclusions: Local analgesic lidocaine and opioid analgesic sufentanil showed negative efficacy during short-term observation. The opioid receptor blocker sufentanil did not worsen symptoms in patients with CAPS after colonoscopy under general anesthesia in the short term. [chictr.org.cn, Chinese Clinical Trial Identifier, ChiCTR-IOR-16008187]

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