DETECTION OF PATIENTS WITH NEW CORONOVIRAL INFECTION IN PATIENTS AT THE LEVEL OF THE ADMISSION UNIT OF A MULTIDISCIPLINE HOSPITAL ON THE BASIS OF ANALYSIS OF CLINICAL MANIFESTATIONS AND RESULTS OF LABORATORY DIAGNOSIS

Author(s):  
Дмитрий Валериевич Судаков ◽  
Елена Анатольевна Фурсова ◽  
Олег Валериевич Судаков ◽  
Наталья Владимировна Якушева ◽  
Артём Николаевич Шевцов

Статья посвящена особенностям выявления новой коронавирусной инфекции у пациентов хирургического профиля (с различной патологией) на уровне приемного отделения БУЗ ВО ВОКБ №1. Данная тематика является весьма актуальной, так как в 2020 году весь мир, в том числе и Россия, столкнулись с новой эпидемиологической угрозой - угрозой новой коронавирусной инфекции. Данная вирусная инфекция показала свою высокую контагиозность и тяжесть течения, обусловленную быстрым развитием целого ряда осложнений. Своевременное выявление пациентов с подобной инфекцией стало одной из первоочередных задач, так как ее выполнение способно помочь сохранить здоровье и жизни медицинского персонала. Интерес к выявлению больных коронавирусной инфекцией в приемном отделении многопрофильного стационара на основании лишь клинических проявлений и результатов лабораторной диагностики обусловлен еще и внутренним регламентом лечебного учреждения и особенностью работы кабинетов компьютерной томографии. Объектами исследования послужило 150 пациентов, мужчин и женщин, поступающих в приемное отделение БУЗ ВО ВОКБ №1 с различной хирургической патологией. В зависимости от последующего обследования все пациентки были разделены на 3 группы по 50 человек. В первую группу вошли пациенты, диагноз которым подтверждался ПЦР-диагностикой; во вторую группу вошли 50 человек, диагноз которым подтверждался наличием антител; третью группу составили пациенты, диагноз новой коронавирусной инфекции у которых не был подтвержден ни при инструментальных, ни при лабораторных методах диагностики. Подробно собирался анамнез, в том числе и эпидемиологический, проводился подробный анализ основных клинических проявлений и результатов лабораторной диагностики (включая ОАК, Б/Х крови, специфические исследования на новую коронавирусную инфекцию). Были установлены основные клинические проявления новой вирусной инфекции, среди которых, наиболее часто встречаемыми стали повышенная температура тела, кашель, слабость и утомляемость. Среди лабораторных показателей крови ведущее место заняли исследование лейкоцитоза при лимфоцитопении, увеличение СОЭ, D-димера и С - реактивного белка. Данная статья представляет интерес для практикующих врачей большинства специальностей, работающих в приемных отделениях многопрофильных стационаров и в поликлиниках. По результатам работы планируется продолжение исследования с большей выборкой пациентов и более узкой патологией The article is devoted to the peculiarities of detecting a new coronavirus infection in surgical patients (with various pathologies) at the level of the admission department of BUZ VO VOKB № 1. This topic is very relevant, since in 2020 the whole world, including Russia, faced a new epidemiological threat - the threat of a new coronavirus infection. This viral infection has shown its high contagiousness and severity of the course, due to the rapid development of a number of complications. Timely identification of patients with such an infection has become one of the priority tasks, since its implementation can help preserve the health and lives of medical personnel. The interest in identifying patients with coronavirus infection in the admission department of a multidisciplinary hospital based only on clinical manifestations and the results of laboratory diagnostics is also due to the internal regulations of the medical institution and the peculiarity of the work of computed tomography rooms. The objects of the study were 150 patients, men and women admitted to the admission department of BUZ VO VOKB № 1 with various surgical pathologies. Depending on the subsequent examination, all patients were divided into 3 groups of 50 people each. The first group included patients whose diagnosis was confirmed by PCR-diagnostics; the second group included 50 people whose diagnosis was confirmed by the presence of antibodies; the third group consisted of patients whose diagnosis of a new coronavirus infection was not confirmed either by instrumental or laboratory diagnostic methods. Anamnesis was collected in detail, including an epidemiological one, a detailed analysis of the main clinical manifestations and results of laboratory diagnostics (including CBC, B / C blood, specific studies for a new coronavirus infection) was carried out. The main clinical manifestations of a new viral infection were established, among which, the most common were fever, cough, weakness and fatigue. Among laboratory blood parameters, the leading place was taken by the study of leukocytosis in lymphocytopenia, an increase in ESR, D-dimer and C - reactive protein. This article is of interest to practicing doctors of most specialties working in the admissions departments of multidisciplinary hospitals and polyclinics. Based on the results of the work, it is planned to continue the study with a larger sample of patients and a narrower pathology

2022 ◽  
pp. 15-21
Author(s):  
Oksana Anatolievna Gizinger ◽  
◽  
Irina Yurievna Lepina ◽  
Marina Nikolaevna Bagdasaryan ◽  
◽  
...  

The article presents an analysis of current information on the etiology, pathogenesis, laboratory diagnosis of human papillomavirus. It is shown that at the current stage of development of laboratory diagnostics there is a reliable screening test — cytological examination of smears taken from the ecto- and endocervix. To diagnose HPV, a combination of microscopic (cytological studies) and molecular genetic (PCR) diagnostic methods is used.


Author(s):  
D. I. Sadykova ◽  
S. V. Khaliullina ◽  
V. A. Anokhin ◽  
A. I. Ziatdinov ◽  
S. A. Senek ◽  
...  

Objective. To describe clinical and laboratory features of COVID-19 in children admitted to the hospital.Children characteristics and research methods. The authors carried out a retrospective observational study, which included 204 children admitted to the Kazan hospital with a diagnosis of “new coronavirus infection” in the period from May 1 to October 30, 2020.Results. It was revealed that all hospitalized children had RNA of the SARS-CoV-2 virus (100%) in a smear from the nasopharynx and oropharynx detected by PCR and only 50% of patients were diagnosed with lung tissue lesions by computed tomography. The clinical picture of COVID-19 in children most often corresponds to the classic manifestations of a respiratory viral infection. Risk factors for the development of severe forms, described in adults, were recorded only in isolated cases in our study.Conclusion. The clinical picture of COVID-19 in children most often corresponds to the classic manifestations of a respiratory viral infection. Risk factors for the development of severe forms, described in adults, were recorded in isolated cases in our study.


Author(s):  
Oksana Anatolievna Gizinger

Тhe article presents an analysis of current information on the etiology, pathogenesis, and laboratory diagnosis of the human papillomavirus (HPV). HPV is a trigger factor in the pathogenesis of proliferative and inflammatory diseases. HPV-associated cervical cancer is one of the few forms of malignant tumors that can be detected at the precancerous stage or at the earliest stage of cancer: the disease is widespread, has a recognizable preclinical phase, a long period of development, there is a reliable screening test - cytological examination of smears taken from ecto- and endocervix and HPV-testing. Laboratory diagnostics is based on a combination of microscopic (cytological studies) and molecular genetic (PCR) diagnostic methods.


2021 ◽  
Vol 34 (2) ◽  
Author(s):  
John A. Branda ◽  
Allen C. Steere

SUMMARY Lyme borreliosis is caused by a growing list of related, yet distinct, spirochetes with complex biology and sophisticated immune evasion mechanisms. It may result in a range of clinical manifestations involving different organ systems, and can lead to persistent sequelae in a subset of cases. The pathogenesis of Lyme borreliosis is incompletely understood, and laboratory diagnosis, the focus of this review, requires considerable understanding to interpret the results correctly. Direct detection of the infectious agent is usually not possible or practical, necessitating a continued reliance on serologic testing. Still, some important advances have been made in the area of diagnostics, and there are many promising ideas for future assay development. This review summarizes the state of the art in laboratory diagnostics for Lyme borreliosis, provides guidance in test selection and interpretation, and highlights future directions.


Author(s):  
T.F. Stepanova ◽  
◽  
M.I. Belyaeva ◽  
K.B. Stepanova ◽  
A.M. Baranova ◽  
...  

The article presents data on 7 deaths of patients with malaria (Plasmodium falciparum) in 2020 in the Russian Federation, errors in the epidemiological, clinical and laboratory diagnostics of malaria. The use of preventive measures and effective drugs, adherence to the Protocol for the treatment of patients with malaria of various types, improving the knowledge of medical personnel of medical and preventive medical organizations are especially necessary during a pandemic of a new coronavirus infection for the timely differential diagnosis of diseases. Key words: malaria, clinical diagnostics, treatment, deaths.


Author(s):  
O. Yu. Zolnikova ◽  
N. L. Dzhakhaya ◽  
N. D. Potskherashvili ◽  
K. B. Puzakov ◽  
O. Yu. Кiseleva ◽  
...  

Aim. Analysis of clinical manifestations, laboratory and instrumental examination data in SARS-CoV-2 patients with taking into account the disease severity and outcome.Materials and methods. The study included 92 patients with confirmed coronavirus infection, including 15 lethal cases, hospitalised at the Vasilenko Clinic of Internal Disease Propaedeutics, Gastroenterology and Hepatology of the Sechenov University in April 2020. The analysis included demographic data, the presence of concomitant diseases, chest computed tomography (CT) results, laboratory tests (including SARS-CoV-2-diagnostic PCR, general and metabolic blood panels, coagulogram) and the duration of disease.Results. Patients infected with SARS-CoV-2 usually exhibit lymphopenia (p ≤ 0.001), leucocytosis, the elevated neutrophils (p ≤ 0.05), neutrophil-lymphocyte ratio (p ≤0,05), C-reactive protein (p ≤ 0.05), ferritin (p ≤ 0.05), D-dimer (p ≤ 0.05) and fibrinogen (p ≤ 0.05), altered prothrombin time (p ≤ 0.05) and INR (p ≤ 0.05). In a critical coronavirus infection, the pulmonary lesion exceeds 50% (corresponds to CT3 — CT4). The risk of critical SARS-CoV-2 infection increases with elder age (p ≤ 0.001), associates with the male gender and presence of concomitant diseases, such as obesity (p < 0.01), diabetes mellitus (p < 0.001), hypertension (p ≤ 0.001), CHD (p ≤ 0.001) and atrial fibrillation (p <0.05).Conclusion. The risk of severe and adverse coronavirus infection is significantly higher in elder comorbid patients.


2021 ◽  
pp. 44-49
Author(s):  
Natalya Yu. Timofeeva ◽  
Olga Yu. Kostrova ◽  
Irina S. Stomenskaya ◽  
Natalia V. Bubnova

In 2020 the pandemic of a new coronavirus infection spread in almost all countries of the world. The danger of this infection lies in the damage to the lungs, which can lead to fatal outcomes. The success of treatment is largely determined by the early diagnosis of the disease and its timely treatment. In order to find the ways of early laboratory diagnosis of coronavirus infection, we studied changes in peripheral blood indicators, coagulograms and C-reactive protein in 56 outpatient patients with mild course of coronavirus infection, whose average age was 49±2 years (among them, 23.2% were men and 66.8% were women). In all patients, coronavirus infection was confirmed by the detection of SARS-CoV-2 RNA by polymerase chain reaction (PCR) in nasopharyngeal or oropharyngeal smears. Signs of lung damage were detected in 66% of patients according to computed tomography findings. The number of red blood cells and the level of hemoglobin in all patients were normal. In 7% of patients, thrombocytopenia was detected, in 5.3% of patients – thrombocytosis. The most pronounced changes are foundin the leucoformula and indicators of the blood coagulation system. In 12.5% of patients without signs of viral pneumonia, leukocytosis was detected. All cases of leukopenia were noted only against the background of lung damage, at this, in 16% lymphopenia was found, 43% had relative lymphocytosis. The coagulogram of more than half of the patients with pneumonia showed shortening of blood clotting in the activated partial thromboplastin time (APTT) test, an increase in prothrombin index(PI) and the content of fibrinogen. The level of C-reactive protein was increased in only a quarter of patients with mild lung damage. Thus, changes in the leucoformula against the background of a tendency to hypercoagulation in blood clotting indicators should cause doctors' apprehensive attitude when treating a patient with clinical symptoms similar to COVID-19.


10.14341/8156 ◽  
2017 ◽  
Vol 20 (3) ◽  
pp. 185-193 ◽  
Author(s):  
Kirill A. Popov ◽  
Alla Y. Tokmakova ◽  
Irina Z. Bondarenko

Diabetic cardiovascular autonomic neuropathy (DCAN) is a diabetic complication characterised by early dissemination of sympathetic and parasympathetic, small-fibre neuronal degeneration. DCAN is the most dangerous and insidious complication that influences the clinical course and mortality rate of diabetes; however, it is often underestimated and not recognised by practitioners. Medical history and a physical examination are not sufficient for diagnosing DCAN. Laboratory diagnosis and the instrumental methods used to evaluate DCAN are time-consuming and not always available. Early detection of DCAN in diabetic patients is important for the early implementation of therapy. Today, there is no uniform diagnostic algorithm for DCAN in patients with various disorders of carbohydrate metabolism. This is due to the insufficient number of clinical trials and limitations of current protocols. This review presents an overview of the clinical and experimental studies of DCAN. The epidemiology, clinical manifestations, risk factors and underlying pathogenesis of DCAN are considered. The advantages and disadvantages of conventional and new diagnostic methods are discussed.


2003 ◽  
Vol 16 (1) ◽  
pp. 37-64 ◽  
Author(s):  
Christopher D. Paddock ◽  
James E. Childs

SUMMARY Ehrlichia chaffeensis is an obligately intracellular, tick-transmitted bacterium that is maintained in nature in a cycle involving at least one and perhaps several vertebrate reservoir hosts. The moderate to severe disease caused by E. chaffeensis in humans, first identified in 1986 and reported for more than 1,000 patients through 2000, represents a prototypical “emerging infection.” Knowledge of the biology and natural history of E. chaffeensis, and of the epidemiology, clinical features, and laboratory diagnosis of the zoonotic disease it causes (commonly referred to as human monocytic ehrlichiosis [HME]) has expanded considerably in the period since its discovery. In this review, we summarize briefly the current understanding of the microbiology, pathogenesis, and clinical manifestations associated with this pathogen but focus primarily on discussing various ecological factors responsible for the recent recognition of this important and potentially life-threatening tick-borne disease. Perhaps the most pivotal element in the emergence of HME has been the staggering increases in white-tailed deer populations in the eastern United States during the 20th century. This animal serves as a keystone host for all life stages of the principal tick vector (Amblyomma americanum) and is perhaps the most important vertebrate reservoir host for E. chaffeensis. The contributions of other components, including expansion of susceptible human populations, growth and broadening geographical distributions of other potential reservoir species and A. americanum, and improvements in confirmatory diagnostic methods, are also explored.


1996 ◽  
Vol 7 (5) ◽  
pp. 321-325 ◽  
Author(s):  
Renuka Bhatt ◽  
Mary Abraham ◽  
Dino Petrin ◽  
Gary E Garber

Trichomonas vaginalisinfection is the most commonly encountered sexually transmitted disease. There is a need for more accurate and rapid laboratory diagnostic methods, leading to better control and treatment strategies. Various virulence factors such as adherence, contact-independent factors, hemolysis and acquisition of host macromolecules have been shown to play a role in the pathogenesis of this infection. Detection of the factors that are only present in the pathogenic isolates of trichomonads will lead to a better understanding of the epidemiology of this pathogen. Culture technique is highly specific compared with microscopic techniques, but it is time consuming. Immunological techniques lack proper correlation with clinical manifestations. The application of monoclonal antibodies, either singly or in a group that recognizes a common antigen, along with methods such as detection of common DNA fragment from clinical specimens, may have a promising future in the laboratory diagnosis of trichomoniasis.


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