Instrumental diagnosis of cholesterol polyps of the gallbladder

Author(s):  
Dmitriy Vladimirovich Nikolaev ◽  
◽  
Aleksandra Sergeevna Gavrilova ◽  
Elena Olegovna Grozina ◽  
◽  
...  

Gallbladder polyposis is a common pathology, the detection of which has increased significantly in recent years. The dominant form of this disease is cholesterol pseudopolyps, mainly found inwomen. Clinical manifestations of gallbladder cholesterol polyps are nonspecific,which presents certain difficulties in diagnosis.Ultrasonography is one of themost informative and accessible instrumental diagnostic methods.

2021 ◽  
Vol 26 (2) ◽  
pp. 163-169
Author(s):  
V. A. Gordeeva ◽  
I. V. Kulik ◽  
E. A. Khromova ◽  
A. L. Rubezhov ◽  
M. V. Gordeeva

Relevance. The paper demonstrates the need to implement modern diagnostic techniques for diagnosis of precancerous and cancerous lesions at early or preclinical stages. Additional diagnostic methods are necessary, e.g. tissue autofluorescence, which allows revealing insidious pathological risk zones, particularly precancerous and cancerous lesions, to evaluate the condition of the oral tissues in patients with chronic oral mucosa disorders, especially caused by trauma. Purpose – to assess trauma-specific effectiveness of autofluorescence spectroscopy (AFS) in risk group patients with chronic trauma of the oral mucosa to reveal early malignization signs.Materials and methods. 25 subjects were selected for the study and divided into 2 groups: main group – 20 patients with different manifestations of chronic oral mucosa trauma; control group – 5 subjects without visible clinical manifestations and without oral trauma factors. Autofluorescence spectroscopy was performed in both groups using AFS-400 stomatoscope.Results. The received data demonstrated that the change in autofluorescence doesn’t allow drawing final conclusions on the presence or absence of chronic oral trauma malignization signs.Conclusion. AFS-400 stomatoscope may be effective in differentiating between healthy and damaged tissues, but there is no solid evidence that the change in fluorescence shade can help differentiate between various types of damaged tissues. Autofluorescence spectroscopy should be considered as an additional method for examination of patients with chronic oral mucosa trauma to reveal early malignization signs.


2018 ◽  
Author(s):  
Andres Cardenas ◽  
Isabel Graupera ◽  
Elsa Sola ◽  
Pere Ginès

Cirrhosis is the most advanced stage of all the different types of chronic liver diseases. It is defined as a diffuse disorganization of normal hepatic structure by extensive fibrosis associated with regenerative nodules. Hepatic fibrosis is potentially reversible if the causative agent is removed. However, advanced cirrhosis leads to major alterations in the hepatic vascular bed and is usually irreversible. Cirrhosis is a progressive and severe clinical condition associated with considerable morbidity and high mortality. It leads to a wide spectrum of characteristic clinical manifestations, mainly attributable to hepatic insufficiency and portal hypertension. Major complications of portal hypertension include ascites, gastrointestinal (GI) variceal bleeding, hepatic encephalopathy (HE), renal failure, and bacterial infections. In recent years, major advances in the understanding of the natural history and pathophysiology of cirrhosis and the treatment of its complications have led to improved management, quality of life, and life expectancy of patients with this disease. Cirrhosis is also a risk factor for developing hepatocellular carcinoma (HCC). Decompensated cirrhosis carries a poor short-term prognosis; thus, orthotopic liver transplantation (OLT) should always be considered in suitable candidates. This chapter describes the epidemiology, etiology and genetic factors, pathogenesis, diagnosis, general management, and treatment of cirrhosis. Complications of cirrhosis are discussed, including ascites, spontaneous bacterial peritonitis, dilutional hyponatremia, hepatorenal syndrome, variceal bleeding, hepatopulmonary syndrome and postpulmonary hypertension, HE, and HCC. Indications and contraindications for liver transplantation are described. Figures show liver biopsy results and ultrasound images in cirrhosis from hepatitis C, a patient with tense ascites, transjugular intrahepatic portosystemic shunting (TIPS), large esophageal varices with red spots, and HCC. Tables outline the main causes of cirrhosis and the diagnostic methods for identifying them, the Child-Pugh score, diagnostic criteria for hepatorenal syndrome, grades of HE, and indications for liver transplantation.This chapter contains 6 highly rendered figures, 8 tables, 73 references.


Author(s):  
Badri V. Sigua ◽  
Vyacheslav P. Zemlyanoy ◽  
Elguja L. Lataria ◽  
Alexey A. Kurkov ◽  
Vyacheslav A. Melnikov ◽  
...  

The mucocele of the appendix is the expansion of the appendix with the accumulation of a large amount of mucus. The mechanism and causes of mucocele are not fully understood. According to some authors, such changes in the appendix can occur due to cicatricial narrowing of the lumen of the appendix, compression or blockage of its base. Other authors believe that the mucocele of the appendix is a benign tumor that develops from the remnants of primitive mesenchyme and is sometimes prone to malignancy. Clinical manifestations of mucocele of the appendix are nonspecific. In a number of patients, this disease causes pain in the right abdomen, more often pulling, intermittent. However, the disease is often asymptomatic. In this regard, diagnosis is established only during performing an operation, most often, regarding acute appendicitis. Nevertheless, instrumental diagnostic methods such as ultrasound and computed tomography of the abdominal and pelvic organs make it possible to suspect mucocele. Despite the frequent asymptomatic, non-aggressive course, a number of life-threatening complications can become the outcome of the mucocele of the vermiform appendix. The most formidable complication is the rupture of the appendix with mucus entering free abdominal cavity, followed by the development of peritoneal pseudomyxoma due to implantation of mucus-forming cells. The only option for radical treatment of the mucocele of the appendix is a surgical intervention. A presented clinical case demonstrates the difficulties of diagnosis, as well as the features of surgical treatment of a patient with a mucocele of the appendix.


2019 ◽  
Vol 21 (1) ◽  
pp. 54-59
Author(s):  
M. G. Bashlachev ◽  
G. Yu. Evzikov ◽  
V. A. Parfenov ◽  
N. B. Vuitsyk ◽  
F. V. Grebenev

The study objective is to report a case of dynamic neuropathy of the common peroneal nerve at the level of the fibular head and to discuss diagnostic methods and neurosurgical treatment. Materials and methods. We report a case of dynamic neuropathy of the common peroneal nerve at the level of the fibular head in a female patient. The patient was treated in the Neurology Clinic of I.M. Sechenov First Moscow State Medical University. We analyzed clinical manifestations and compared them with the data described in research literature. Results. Upon admission, the patient complained of pain in the anterolateral surface of the right shin and in the dorsum of the foot during walking. At rest, the patient experienced no pain. We observed no motor or sensory disorders typical of nerve root disorders at the level of L5. Lasegue’s test was negative. The patient had a positive Tinel’s sign in the area of the right fibular head. In order to clarify the diagnosis, we performed a repeated extension test in the right ankle joint and it was positive. The patient underwent surgery that included peroneal nerve decompression and neurolysis at the level of the fibular head. In the postoperative period, the patient had complete pain relief. Conclusion. Due to the difficulties in the diagnostics of dynamic neuropathy of the common peroneal nerve, this disease is often mistaken for radiculopathy at the level of L5. Thorough clinical examination, testing for Tinel’s sign in the area of the fibular head, and repeated extension test in the ankle joint ensure the correct diagnosis and reduce the frequency of ineffective surgeries on the lumbar spine. Surgical decompression of the common peroneal nerve at the level of the fibular head with obligatory opening of the entrance to the nerve canal is an effective method of treatment in such patients.


2019 ◽  
Vol 13 (4) ◽  
pp. 41-47 ◽  
Author(s):  
E. M. Agafonova ◽  
T. V. Dubinina ◽  
D. G. Rumyantseva ◽  
A. B. Demina ◽  
A. V. Smirnov ◽  
...  

In Russia, coxitis is one of the most common extra-axial manifestations of ankylosing spondylitis (AS). However, many issues regarding its early diagnosis remain unresolved.Objective: to compare the clinical manifestations of coxitis with the data from an instrumental examination of CoRSAR cohort (Cohort of Early Axial Spondyloarthritis) patients.Patients and methods. Examinations were made in 175 patients (mean age, 28.2±5.7 years) diagnosed as having axial spondyloarthritis (axSpA) with inflammatory back pain lasting up to 5 years, which occurred at the age of ≤45 years. There was non-radiographic axSpA (nraxSpA) in 69 patients and AS in 106 patients. 87% of patients were HLA-B27-positive. The median disease duration was 23.8 [1–60] months; BASDAI was 3.3±1.94. Regardless of complaints, all the patients underwent hip X-ray and ultrasound studies and 54 more patients had magnetic resonance imaging (MRI).Results and discussion. The clinical signs of coxitis were present in 95 (54%) patients, of them 60% were diagnosed with AS and 40% had nraxSpA. According to the numerical pain rating scale (NPRS), the median hip joint pain was 4 [3; 7]. Limited joint movement was observed in 6 (3.4%) patients. The level of hip joint pain correlated with BASDAI (r=0.53) and ASDAS (r=0.30). The ultrasound signs of coxitis were detected in 42 (24%) patients; of them 26 (62%) had the clinical manifestations of hip joint injury, and such changes were absent in 16 patients. The patients with ultrasound signs of coxitis were noted to have a higher disease activity; peripheral arthritis and enthesitis were more common. According to MRI, coxitis was diagnosed in 39 (72%) of the 54 examinees, while the disease was asymptomatic in 10%.Conclusion. Different diagnostic methods used in patients with early axSpA could reveal coxitis in 33% of cases. The patients with coxitis show higher laboratory disease activity than those without hip joint injury. It is necessary to include MRI and ultrasound in the mandatory examination of patients with axSpA.


2018 ◽  
Vol 14 (4) ◽  
pp. 14-18 ◽  
Author(s):  
Владимир Базарный ◽  
Vladimir Bazarnyy ◽  
Лариса Полушина ◽  
Larisa Polushina ◽  
Арина Максимова ◽  
...  

Introduction. A variety of concepts and approaches to the analysis of the etiology and pathogenesis of temporomandibular joint dysfunctions, results in increased interest in the search for highly informative diagnostic methods, especially at the stage of pre-clinical manifestations. Objectives. The aim of the study was to analyze the possibilities of modern technologies in diagnostics of temporomandibular joint dysfunctions. Materials and methods. We studied original papers on the diagnostics of temporomandibular joint dysfunctions from several databases: Russian State Library, eLibrary, PubMed, The Cochrane Library, Google Scholar. Results. The review presents both generally accepted and alternative approaches to the diagnostics of different clinical manifestations in temporomandibular joint dysfunctions. We described the diagnostic value of occlusal disorders analysis in universal articulators, virtual articulators, T-scan system. Capabilities of teleroentgenography, axiography, electromyography, computed and magnetic resonance imaging were estimated as well. Conclusions. The literature review on the problem of diagnosing the temporomandibular joint dysfunctions showed a scientifically based spectrum of diagnostic capabilities of modern dentistry, a trend in the development of highly informative digital diagnostic technologies. Due to the diversity of the etiology and pathogenesis of the temporomandibular joint dysfunctions further in-depth studies of this issue are required.


2018 ◽  
Vol 47 (1) ◽  
pp. 159-172 ◽  
Author(s):  
Alexandra Stoica ◽  
Victoriţa Şorodoc ◽  
Cătălina Lionte ◽  
Irina M. Jaba ◽  
Irina Costache ◽  
...  

Objective This study was performed to determine whether a dual-biomarker approach using N-terminal prohormone of brain natriuretic peptide (NT-proBNP) and galectin-3 optimizes the diagnosis and risk stratification of acute cardiac dyspnea. Atypical clinical manifestations and overlapping pathologies require objective and effective diagnostic methods to avoid treatment delays. Methods This prospective observational study included 208 patients who presented to the emergency department for acute dyspnea. NT-proBNP and galectin-3 were measured upon admission. The patients were divided into two groups according to the etiology of their clinical manifestations: cardiac and non-cardiac dyspnea. The patients’ New York Heart Association functional class, left ventricular ejection fraction, and discharge status were assessed. Results Diagnostic criteria for acute heart failure were fulfilled in 61.1% of the patients. NT-proBNP and galectin-3 were strongly and significantly correlated. Receiver operating characteristic analysis revealed similar areas under the curve for both markers in the entire group of patients as well as in the high-risk subsets of patients. Conclusions The diagnostic performance of NT-proBNP and galectin-3 is comparable for both the total population and high-risk subsets. Galectin-3 adds diagnostic value to the conventional NT-proBNP in patients with acute cardiac dyspnea, and its utility is of major interest in uncertain clinical situations.


Author(s):  
Rita Cruz ◽  
Carmen Vasconcelos-Nobrega ◽  
Fernando Esteves ◽  
Catarina Coelho ◽  
Ana Sofia Ferreira ◽  
...  

Q fever, a widespread zoonotic disease caused by Coxiella burnetiid, produces a complex and polymorphic disease in humans. As a zoonotic disease, control in animals will influence the level of disease seen in humans, thus resulting in interesting one health perspectives for disease control. Here the authors describe the clinical manifestations in animals and humans, as well as the current diagnostic methods available and the strategies for disease control. A review on the published information regarding Q fever as a disease with impact for veterinary public health and public health is presented.


2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Emilija Jonaitytė ◽  
Martynas Judickas ◽  
Eglė Tamulevičienė ◽  
Milda Šeškutė

Alveolar echinococcosis (AE) is an infectious zoonotic disease that is caused by Echinococcus multilocularis. The disease is generally identified accidentally because of the long asymptomatic period, has a malignant behaviour, and mainly occurs in the liver. Usually it is diagnosed in adults and is very rare in pediatric patients. We report two cases of AE and 1 differential case between AE and cystic echinococcosis (CE) in children: two of them had lesions in the liver and one had rare extrahepatic presentation of a cyst in the spleen. All our patients received chemotherapy with albendazole because surgical treatment was not recommended. The children were followed-up from 10 to 30 months and no significant improvement was seen. In this report we discuss the difficulties we faced in the treatment and follow-up of these patients. We also review the main clinical manifestations, general diagnostic methods, and treatment options of AE according to the current literature.


2020 ◽  
Vol 6 (2) ◽  
pp. 20190051
Author(s):  
Miguel Ángel Carrillo-Martínez ◽  
German Alfonso Garza García ◽  
Juan Manuel Leal Jacinto

Vertebral artery pseudoaneurysm usually occurs after major trauma, but it can arise spontaneously after trivial injury. Clinical manifestations are often related to alterations in the posterior brain circulation. CT and angiography are usually the diagnostic methods of choice. We present a case of a pseudoaneurysm of the left vertebral artery caused by a lesion during a cervical spine surgery and treated with endovascular approach with a covered stent.


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