Difficulties in diagnosing tuberculous spondylitis against the background of liver echinococcosis

MedAlliance ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 88-92
Keyword(s):  
Neurological Disorders ◽  
Soft Tissues ◽  
Correct Diagnosis ◽  
Molecular Genetic ◽  
Treatment Algorithm ◽  
Definite Diagnosis ◽  
Tuberculous Spondylitis ◽  
Treat Ment ◽  
Appropriate Treatment ◽  
Logical Study

Difficulties in diagnosing tuberculous spondylitis are caused by the rarity of the pathology, and blurred clinical and laboratory presentation. The correct diagnosis can take several months, since pain is often interpreted as a degenerative process. Spondylitis should be assumed in patients with back pain resistant to conservative treat-ment methods, it may be accompanied by neurological disorders, fever, and increased laboratory indicators of inflammation. Radiodiagnostic methods can reveal the presence of destruction, its localization, distribution, and the degree of involvement of the surrounding soft tissues. To confirm the etiology of the process, morpho-logical study of the biopsy or surgical samples is needed, as well as pathogen verification by bacteriological and/or molecular genetic methods. Only after making a definite diagnosis, it is possible to choose the most appropriate treatment algorithm for the patient

scholarly journals Reactive Lesions of Oro-Maxillofacial Region

2021 ◽  
pp. 599-614
Author(s):  
Raja Sekhar Gali
Keyword(s):  
Soft Tissues ◽  
Correct Diagnosis ◽  
Low Grade ◽  
Maxillofacial Region ◽  
Diagnostic Dilemma ◽  
Hormonal Influence ◽  
Facial Region ◽  
Appropriate Treatment ◽  
The Common ◽  
Low Grade Inflammation

AbstractA plethora of pathologies occurs in the skeletal and soft tissues of the oro-facial region that are reactive. These arise as a result of chronic low-grade inflammation, trauma, hormonal influence and other causes. Varied types of clinical, radiological and histological presentations are often associated with these lesions that pose a diagnostic dilemma to the clinician. This chapter describes in detail the common reactive lesions of the maxillofacial region with an emphasis on correlating the clinical and investigational findings to arrive at the correct diagnosis and provide appropriate treatment.

scholarly journals Genetic Approaches Using Zebrafish to Study the Microbiota–Gut–Brain Axis in Neurological Disorders

Cells ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 566
Author(s):  
Jae-Geun Lee ◽  
Hyun-Ju Cho ◽  
Yun-Mi Jeong ◽  
Jeong-Soo Lee
Keyword(s):  
Neurological Disorders ◽  
Genetic Model ◽  
Molecular Genetic ◽  
Autism Spectrum ◽  
Behavioral Abnormalities ◽  
Bidirectional Signaling ◽  
Intestinal Dysbiosis ◽  
The Central Nervous System ◽  
The Brain

The microbiota–gut–brain axis (MGBA) is a bidirectional signaling pathway mediating the interaction of the microbiota, the intestine, and the central nervous system. While the MGBA plays a pivotal role in normal development and physiology of the nervous and gastrointestinal system of the host, its dysfunction has been strongly implicated in neurological disorders, where intestinal dysbiosis and derived metabolites cause barrier permeability defects and elicit local inflammation of the gastrointestinal tract, concomitant with increased pro-inflammatory cytokines, mobilization and infiltration of immune cells into the brain, and the dysregulated activation of the vagus nerve, culminating in neuroinflammation and neuronal dysfunction of the brain and behavioral abnormalities. In this topical review, we summarize recent findings in human and animal models regarding the roles of the MGBA in physiological and neuropathological conditions, and discuss the molecular, genetic, and neurobehavioral characteristics of zebrafish as an animal model to study the MGBA. The exploitation of zebrafish as an amenable genetic model combined with in vivo imaging capabilities and gnotobiotic approaches at the whole organism level may reveal novel mechanistic insights into microbiota–gut–brain interactions, especially in the context of neurological disorders such as autism spectrum disorder and Alzheimer’s disease.

scholarly journals An intrasellar germinoma with normal tumor marker concentrations mimicking primary lymphocytic hypophysitis

2013 ◽  
Vol 57 (7) ◽  
pp. 566-570 ◽  
Author(s):  
Mariana F. Guzzo ◽  
Cristina B. Formiga Bueno ◽  
Thiago T. Amancio ◽  
Sergio Rosemberg ◽  
Cleonice Bueno ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
Correct Diagnosis ◽  
Careful Analysis ◽  
Malignant Neoplasms ◽  
Pituitary Hormone ◽  
Appropriate Treatment ◽  
Suprasellar Region ◽  
Neoplastic Lesions ◽  
Posterior Pituitary Hormone ◽  
Pituitary Stalk Thickening

Intracranial germinomas (GE) are malignant neoplasms most commonly found in the suprasellar region, which may cause anterior and particularly posterior pituitary hormone deficits with central diabetes insipidus (DI). Differential diagnosis of pituitary stalk thickening includes granulomatous, inflammatory, infectious, and neoplastic lesions. Although careful analysis of clinical, laboratory, and imaging findings may facilitate the diagnosis, transsphenoidal biopsy is indicated to confirm the disease, as the correct diagnosis directs the appropriate treatment.

scholarly journals Recurrent leiomyomatosis peritonealis disseminate: a case report

2021 ◽  
Vol 55 (2) ◽  
pp. 160-164
Author(s):  
Yaw B. Mensah ◽  
Lawrence Buadi ◽  
Afua Abrahams ◽  
Andrea A. Y. Appau ◽  
Kwadwo Mensah
Keyword(s):  
Correct Diagnosis ◽  
Reproductive Age ◽  
Gnrh Analogue ◽  
Ultrasound Guided ◽  
Pelvic Ultrasound ◽  
Women Of Reproductive Age ◽  
Unusual Condition ◽  
Appropriate Treatment ◽  
Leiomyomatosis Peritonealis Disseminata ◽  
Histopathologic Analysis

Leiomyomatosis peritonealis disseminata (LPD), a rare and unusual condition affecting mainly women of reproductive age, causes peritoneal and subperitoneal nodules formed by smooth muscle. Very few cases have been diagnosed since the disease was first described. We present a 42year old female who was managed for infertility and uterine myomata at a Municipal hospital in Ghana. Following a pelvic ultrasound diagnosis of multiple uterine myomata the patient was booked for myomectomy. At surgery to remove her myomata, the patient was found to have several peritoneal nodules some of which were attached to peritoneum, omentum and the surface of bowel loops in addition to a uterine myoma. The disease has since recurred twice after two laparotomies. The diagnosis was made by histopathology of ultrasound-guided biopsy of the nodules, and she has since been on GnRH analogue treatment. LPD simulates peritoneal carcinomatosis; thus, a good history, clinical evaluation, radiological imaging, and histopathologic analysis must be accurately diagnosed. Surgeons’ and Radiologists’ knowledge of the condition is fundamental to ensuring correct diagnosis and appropriate treatment and to minimising the probability of malignant transformation.

scholarly journals A Reliable Surgical Procedure for Sinus Floor Augmentation with Antral Pseudocysts

2021 ◽  
Vol 9 (10) ◽  
pp. 122
Author(s):  
Yasuhiro Nosaka ◽  
Hitomi Nosaka ◽  
Yasushi Nakajima ◽  
Tadasuke Tanioka ◽  
Daniele Botticelli ◽  
...  
Keyword(s):  
Soft Tissues ◽  
Correct Diagnosis ◽  
Inflammatory Cells ◽  
Histological Evaluation ◽  
Histopathological Diagnosis ◽  
Cystic Lesions ◽  
Two Stage ◽  
Asymptomatic Patients ◽  
Sinus Floor Augmentation ◽  
Sinus Floor

An antral pseudocyst (AP) is a common well-defined ‘dome-shaped’ faintly radiopaque lesion of the maxillary sinus, and usually does not require treatment in asymptomatic patients. However, when sinus floor augmentation is required to increase bone volume for implant installation, the elevation of the sinus mucosa might drive the AP against the ostium. This might cause its obstruction and, as possible consequence, sinusitis. The purpose of this study was to investigate the clinical and tomographic conditions of APs to identify a predictable cyst removal that might allow a safety sinus floor augmentation. A total of 52 maxillary sinuses in 46 patients (mean age 55.1 years) presenting AP were examined by cone beam computed tomographies (CBCTs). A two-stage approach was applied. At the first surgery, the cystic lesions were further inspected by an endoscope through the antrostomy, and histopathological diagnosis of the removed tissues was carried out. After the confirmation of decrease of the swelling of sinus membrane by CBCT, the sinus floor augmentation was performed, at least four months after cyst removal. The color and transparency of the 86 cystic lesions were classified into 4 types. The whitish transparent cysts were 34 (39.5%), the yellowish transparent cysts were 18 (20.9%), the dark purple transparent cysts were 8 (9.3%) and the milky-white opaque cysts were 26 (30.2%). The contents of the 60 (69.8%) transparent cysts were serous fluid, but those of milky-white cysts were composed of viscous or elastic soft tissues, and the aspiration of the contents was unsuccessful. The analysis of the preoperative CBCT did not provide certainty on the contents of the cystic lesions. All cystic lesions were diagnosed as AP, and an infection was identified in one AP, presenting marked infiltration of the inflammatory cells. Considering the difficulties of performing a correct diagnosis of the AP content by a CBCT analysis, the risk of failure of the surgery that creates severe afflictions to the patients, and the necessity of a histological evaluation of the cyst, a two-stage surgery appeared to be the most reliable procedure.

scholarly journals Importance of Laparoscopy to Solve the Diagnostic Dilemma of Abdominal Tuberculosis

KYAMC Journal ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 14-17
Author(s):  
Md Saiful Islam ◽  
Md Masudar Rahman ◽  
M Fardil Hossain Faisal ◽  
Md Alamgir Jalil Pramanik ◽  
Muhammad Abdur Rouf
Keyword(s):  
Minimally Invasive ◽  
Diagnostic Laparoscopy ◽  
Abdominal Cavity ◽  
Correct Diagnosis ◽  
Abdominal Tuberculosis ◽  
Diagnostic Dilemma ◽  
Peritoneal Tissue ◽  
Appropriate Treatment ◽  
Liver Surface ◽  
Minimally Invasive Access

Background: Diagnosis of abdominal tuberculosis as well as histopathological confirmation is difficult because of suboptimal access to the intraperitoneal pathology. Laparoscopy provides minimally invasive access to the peritoneal cavity and materials can be collected for confirmation of diagnosis. Objectives: To study the importance of laparoscopy as a tool for the diagnosis of abdominal tuberculosis and initiation of appropriate treatment without delay. Materials & Methods: In this study 25 patients with suspected abdominal tuberculosis were selected within the period of May, 2014 to October, 2014. Diagnostic laparoscopy performed on all patients with biopsy of tissue from accessible sites. Results: Diagnostic laparoscopy with biopsy confirmed the diagnosis in 24 (96%) patients, 23 of these patients (96%) had nodules at different site of abdominal cavity and 19 of these patients (76%) had ascites. In two cases there were nodules over liver surface; biopsy was taken also from both liver nodules. One nodule revealed fibrosis and another nodule revealed tuberculosis. Conclusion: Imaging and culture of ascitic fluid may fail to confirm or exclude abdominal tuberculosis in clinically suspected cases. Laparoscopy with peritoneal tissue biopsy provided rapid and correct diagnosis of abdominal tuberculosis and should be performed early in suspected cases. KYAMC Journal.2021;12(01): 14-17

scholarly journals Mitochondrial Strokes: Diagnostic Challenges and Chameleons

Genes ◽  
2021 ◽  
Vol 12 (10) ◽  
pp. 1643
Author(s):  
Chiara Pizzamiglio ◽  
Enrico Bugiardini ◽  
William L. Macken ◽  
Cathy E. Woodward ◽  
Michael G. Hanna ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Neurological Disorders ◽  
Clinical Laboratory ◽  
Positive Family History ◽  
Autoimmune Encephalitis ◽  
Brain Regions ◽  
Imaging Features ◽  
Cns Vasculitis ◽  
Appropriate Treatment ◽  
Mitochondrial Pathology

Mitochondrial stroke-like episodes (SLEs) are a hallmark of mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS). They should be suspected in anyone with an acute/subacute onset of focal neurological symptoms at any age and are usually driven by seizures. Suggestive features of an underlying mitochondrial pathology include evolving MRI lesions, often originating within the posterior brain regions, the presence of multisystemic involvement, including diabetes, deafness, or cardiomyopathy, and a positive family history. The diagnosis of MELAS has important implications for those affected and their relatives, given it enables early initiation of appropriate treatment and genetic counselling. However, the diagnosis is frequently challenging, particularly during the acute phase of an event. We describe four cases of mitochondrial strokes to highlight the considerable overlap that exists with other neurological disorders, including viral and autoimmune encephalitis, ischemic stroke, and central nervous system (CNS) vasculitis, and discuss the clinical, laboratory, and imaging features that can help distinguish MELAS from these differential diagnoses.

scholarly journals Rare Renal Disease in Macedonia – An Update

PRILOZI ◽  
2017 ◽  
Vol 38 (3) ◽  
pp. 63-69
Author(s):  
Velibor Tasic ◽  
Zoran Gucev ◽  
Momir Polenakovic
Keyword(s):  
New England ◽  
Health Professionals ◽  
Molecular Genetic ◽  
Current Status ◽  
Renal Diseases ◽  
Treatment Interventions ◽  
New Genes ◽  
Appropriate Treatment ◽  
Genetic Techniques ◽  
Unites States

Abstract Rare renal diseases (RRD) are an important category of rare disease (RD) as they can do great damage to the patients, families and society. The patient may undergo years even decades of numerous investigations including invasive procedures and yet not have definitive and precise diagnose and therefore, no opportunity for appropriate treatment. The great progress in molecular genetic techniques characterized many Mendelian diseases on molecular level. This gave the possibility for appropriate prevention and treatment interventions, genetic counseling and prenatal diagnosis. Herein, we summarize the current status of RRD in Macedonia. The research interest of Macedonian clinicians and scientists is focused on the genetics of congenital anomalies of the kidney and urinary tract (CAKUT), steroid resistant nephrotic syndrome, nephrolithiasis and nephrocalcinosis, cystic diseases and cilliopathies with collaborations with eminent laboratories in Unites States and Europe. This collaboration resulted in detection of new genes and pathophysiological pathways published in The New England Journal of Medicine and in other high impact journals. Macedonian health professionals have knowledge and equipment for diagnosis of RRD. Unfortunately the lack of finances is great obstacle for early and appropriate diagnosis. Participation in the international registries, studies and trials should be encouraged. This would result in significant benefit for the patients, health professionals and science.

scholarly journals Difficulties of radiological diagnosis оf small breast cancers

2021 ◽  
Vol 20 (2) ◽  
pp. 49-53
Author(s):  
Т. N. Leikht ◽  
G. I. Bratnikova ◽  
Р. S. Gomina ◽  
N. S. Kosolapova ◽  
К. A. Tihaya ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Soft Tissues ◽  
Correct Diagnosis ◽  
Screening Mammography ◽  
Diagnostic Methods ◽  
Benign Tumors ◽  
Breast Cancers ◽  
Vertical Orientation ◽  
Small Breast ◽  
Ultrasound Scanner

Introduction. Breast cancer in the structure of malignancies in women takes the 1st place. There has been an annual increase in morbidity, including due to improvements in diagnostic interventions and screening. Mammography and ultrasound of the breasts is mandatory when diagnosing breast cancer. The difficulties of diagnosis are revealed in small tumors.Methods. Breast ultrasounds were performed on the ultrasound machines of the expert class TOSHIBA APLIO 500, PHILIPS EPIQ 5 and PHILIPS EPIQ 7. Mammography and tomosynthesis were performed on mammogram MAMMOMAT INSPITATION PRIME. Core-biopsia under ultrasound control was carried out on the Logiq9 ultrasound scanner. Eighty women were selected with suspected cancer after breast core-biopsy with the category BI-RADS 3, 4 and 5. The size of the node according to ultrasound data was 6-10 mm.Results. According to core-biopsia has been identified cancer, histologically and immunohystochemically confirmed in 50 cases. In 30 women benign tumors were identified. The most informative mammograms of breast cancer were high tumor density, ray of radiibility and local deformity of soft tissues. Among the characteristic ultrasonic signs of the cancer more often noted vertical orientation, reduced echogenicity, uneven contour, other signs were not so character for the cancer.Conclusion. You can't focus on a separate sign of education! Only a combination of traits, different diagnostic methods contribute to the correct diagnosis.

INTERDISCIPLINARY APPROACH TO THE TREATMENT OF INFANT HEMANGIOMA

2021 ◽  
Vol 100 (3) ◽  
pp. 174-182
Author(s):  
N.P. Kotlukova ◽  
◽  
T.S. Belysheva ◽  
T.T. Valiev ◽  
N.K. Konstantinova ◽  
...  
Keyword(s):  
Laser Therapy ◽  
Soft Tissues ◽  
Treatment Algorithm ◽  
Clinical Manifestations ◽  
Local Therapy ◽  
Interdisciplinary Approach ◽  
Premature Baby ◽  
Maximum Effect ◽  
Ultrasound Diagnostics ◽  
The Right

The aim of the study is to find the best approaches to the treatment of infantile hemangiomas (IH). Materials and methods of research: the experience of treatment of pediatric patients with IH of various localization is presented, which was carried out according to the protocol elaborated by the authors. Systemic therapy with propranolol, local therapy, laser therapy were used in the complex of treatment. The age of patients at the beginning of therapy ranged from 1 month up to 4,5 years. Results: in all cases, patients with propranolol treatment showed a quick and stable effect. Even at the time of the selection of the dose of the drug, IH patients began to involute, became paler, less tense. The thickness of the soft tissues in the IH area decreased by 65% compared to the baseline, the number of functioning vessels decreased by 86%. The maximum effect was achieved within the first 6 months from the start of therapy. Clinical case report – a 2,5-year-old child with extensive hemangioma of the right buttock. There was a complex treatment with propranolol, local therapy, laser therapy. The general course of treatment with propranolol was 2 years 8 months. The total number of laser interventions was 6 with the overall effect in the form of maximum regression of residual clinical manifestations of IH. A positive clinical and ultrasound picture was noted, indicating a pronounced involution of IH, and a gradual withdrawal of propranolol was started. Conclusion: the effectiveness of a comprehensive interdisciplinary approach to the treatment of extensive complicated IH was demonstrated with the participation of specialists of various disciplines: pediatricians, cardiologists, surgeons, specialists in functional and ultrasound diagnostics, specialists in laser therapy, endocrinologists in a severe premature baby with a large number of somatic problems. The clinical treatment algorithm developed and implemented for patients with IH makes it possible to avoid more aggressive methods of treatment of this pathology and to improve the quality of life of this category of patients. On the basis on the results obtained, indications for laser therapy with a selective pulsed laser were formulated.

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