IDENTIFICATION OF PATIENTS WITH "INTESTINAL FORM" WITH NEW CORONAVIRAL INFECTION IN PATIENTS WITH A SURGICAL PROFILE AT THE LEVEL OF THE ADMISSION UNIT OF A MULTIDISCIPLINE HOSPITAL

2021 ◽  
pp. 86-95
Author(s):  
Дмитрий Валериевич Судаков ◽  
Олег Валериевич Судаков ◽  
Артём Николаевич Шевцов ◽  
Евгений Владимирович Белов
Keyword(s):  
Differential Diagnosis ◽  
Blood Test ◽  
Clinical Symptoms ◽  
Pain Syndrome ◽  
Pathological Process ◽  
Surgical Patients ◽  
Primary Data ◽  
Patient Complaints ◽  
Coronavirus Infection ◽  
Leading Symptom

В статье рассматриваются некоторые особенности выявления больных с «кишечной формой» новой коронавирусной инфекцией у пациентов хирургического профиля на уровне приемного отделения многопрофильного стационара. Данная тематика является весьма актуальной, так как после начала пандемии Covid-19 в 2020 году, было выявлено несколько отличающихся течением, форм заболевания, одной из которых и стала, так называемая «кишечная форма». Большой интерес обусловлен тем, что при данном виде течения патологического процесса практически отсутствуют характерные для Covid-19 симптомы - болезнь, зачастую, маскируется под клинику «острого живота», в виду чего в ряде случаев диагностика ложиться на плечи врачей хирургического профиля. Данная работа стала результатом попытки выявить основные закономерности развития и особенности «течения» у пациентов данной патологии, с выявлением основных клинических симптомов, которые могли бы своевременно помочь с адекватной дифференциальной диагностикой. Объектами исследования послужило 150 пациентов, мужчин и женщин, в возрасте от 19 до 79 лет, мужчин (n=91) и женщин (n=59). Все больные были разделены на 3 группы по 50 человек. В первую группу вошли больные, у которых была выявлена одна из существующих острых хирургических патологий. Вторую группу составили пациенты, у которых была диагностирована «кишечная форма» новой коронавирусной инфекции. В третью группу вошли пациенты, которые ранее уже перенесли Covid-19. В основу исследования лег подробное изучение всех жалоб пациентов. Так были установлены определенные различия между рядом жалоб у пациентов различных групп. Однако ведущим симптомом, заставившем всех больных обратиться в стационар, был болевой синдром. В дальнейшем в работе проведен комплексный анализ боли, ее характер и особенности локализации в зависимости от группы. Важной частью исследования стало также изучение общего анализа крови и биохимического анализа крови, с выделением основных показателей, способных оказать помощь в дифференциальной диагностике. В завершении исследования проводилось изучение данных УЗИ и методов специфической диагностики новой коронавирусной инфекции, позволяющих получить первичные данные о процессе формирования иммунитета после перенесенного Covid-19. Статья интересна прежде всего врачам, занимающимся первичным приемом пациентов в стационарах и поликлиниках The article discusses some of the features of identifying patients with "intestinal form" of new coronavirus infection in surgical patients at the level of the admission department of a multidisciplinary hospital. This topic is very relevant, since after the start of the Covid-19 pandemic in 2020, several different forms of the disease were identified, one of which became the so-called "intestinal form". The great interest is due to the fact that with this type of pathological process, there are practically no symptoms characteristic of Covid-19 - the disease is often disguised as an acute abdomen clinic, which means that in some cases, the diagnosis falls on the shoulders of surgical doctors. This work was the result of an attempt to identify the main patterns of development and features of the "course" in patients with this pathology, with the identification of the main clinical symptoms that could promptly help with adequate differential diagnosis. The objects of the study were 150 patients, men and women, aged 19 to 79, men (n = 91) and women (n = 59). All patients were divided into 3 groups of 50 people each. The first group included patients who had one of the existing acute surgical pathologies. The second group consisted of patients who were diagnosed with the "intestinal form" of a new coronavirus infection. The third group included patients who had previously suffered from Covid-19. The study was based on a detailed study of all patient complaints. Thus, certain differences were established between a number of complaints in patients of different groups. However, the leading symptom that made all patients go to the hospital was pain syndrome. In the future, a comprehensive analysis of pain, its nature and localization characteristics depending on the group was carried out. An important part of the study was also the study of a general blood test and a biochemical blood test, with the identification of the main indicators that can help in differential diagnosis. At the end of the study, the study of ultrasound data and methods of specific diagnostics of a new coronavirus infection was carried out, which make it possible to obtain primary data on the formation of immunity after the transferred Covid-19. The article is of interest primarily to doctors engaged in the primary admission of patients in hospitals and clinics

scholarly journals Pulmonary lesions in visceral toxocariasis in children in the phthisiatric practice (clinical case)

2021 ◽  
Vol 16 (3) ◽  
pp. 245-250
Author(s):  
O.M. Raznatovska ◽  
Yu.V. Mironchuk
Keyword(s):  
Differential Diagnosis ◽  
Blood Test ◽  
Clinical Case ◽  
Clinical Symptoms ◽  
Correct Diagnosis ◽  
White Blood Cells ◽  
Left Lung ◽  
Lung Lesion ◽  
Pediatric Tuberculosis ◽  
Tuberculin Tests

Background. The clinical and radiological picture of pulmonary tuberculosis has many common features with a large number of diseases. Therefore, differential diagnosis is very important when detecting tuberculosis. The purpose of the work: on the example of a clinical case to present the complexity of the differential diagnosis between pulmonary lesion in visceral toxocariasis and tuberculosis in children. Results. The child was diagnosed with an infiltrate in the third segment of the left lung with lesions of the intrathoracic lymph nodes, which is characteristic of the primary tuberculosis. The volatility of the infiltrate was not determined. All general blood test hadn’t shown an increase in eosinophils and white blood cells. According to the literature data, the appearance of persistent and prolonged eosinophilia with the development of eosinophilic leukemoid reactions of the blood, an increase in the level of leukocytes are the main and one of the constant manifestations of toxocariasis. The child was diagnosed with moderate hepatomegaly, which is cha­racteristic for both diseases. The patient was registered at a pediatric tuberculosis clinic due to a shift in tuberculin tests. At the time of hospitalization, there were not reasons to suspect visceral toxocariasis. Due to the examination data, first of all the absence of bacterial excretion and negative tuberculin tests, and the pre­sence in the child’s house of the dogs and cats, it was decided to recommend the consultation of the infectionist to exclude any parasitic disease. At the end, the correct diagnosis was established in this child at time and the necessary treatment was prescribed. Conclusions. This clinical case demonstrates the difficulties of differential diagnosis of visceral toxocariasis in lung lesion and tuberculosis. First of all, this is due to the asymptomatic clinical picture of toxocariasis, the diagnosis of which was established by X-ray data, blood test for IgG antibodies to Toxocara and epidemiological history. Given the fact that toxocariasis includes a large spectrum of masks of various diseases, and children who are infected by Toxocara do not have specific clinical symptoms, doctors should remember to prescribe the additional examination for the presence of parasitic diseases, including toxocariasis, especially if pets live in the child’s home.

scholarly journals Differential diagnosis of bilateral lungs opacities in the hospital for admission of community-acquired pneumonia – not only COVID-19

2020 ◽  
Vol 24 (2) ◽  
pp. 78-95
Author(s):  
A. S. Vinokurov ◽  
O. I. Belenkaya ◽  
E. A. Zolotova ◽  
S. V. Michurina ◽  
O. O. Vinokurova ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Clinical Laboratory ◽  
Clinical Symptoms ◽  
Community Acquired Pneumonia ◽  
Lung Damage ◽  
Ground Glass ◽  
Small Areas ◽  
Radiological Data ◽  
Coronavirus Infection ◽  
To Receive

Due to the current epidemiological situation caused by the spread of the new SARS-CoV-2 coronavirus, in March 2020 several Moscow hospitals were completely or partially redesigned to receive patients with community- acquired pneumonia.Purpose. The aim of the survey is to analyze clinical, laboratory and radiological data in patients with coronavirus infection at the early stages of its spread in Russia, and to clarify diseases for differential diagnosis mainly based on CT evidence.Materials and methods. We studied data from 21 patients with verified coronavirus infection admitted to the hospital for community-acquired pneumonia. Clinical symptoms, laboratory and physical indicators, as well as typical lung changes on the CT were evaluated.Results. Major clinical symptoms in coronavirus patients are fever (100%), cough (90.5%), shortness of breath (76.1%). Laboratory indicators showed increases in CRP (85.7%), leukocytosis (66.6%), and LDG (84.6%). According to CT, 95.2% of lung changes involved both sides, and 66.7% occurred in all lung fields. The sign of “ground glass” was observed in a 100% of the cases, its combination with the “paving stone” – in 61,9%, “ground glass” coupled with small areas of consolidations were detected in 33,3% of the cases. Changes such as nodules, cavities and massive areas of consolidation were not identified.Conclusion. On the basis of our own data we confirmed the main trends of diagnostics and clinical features, which were identified by authors from Asia and Europe, who faced this infection earlier, and also considered important CT characteristics useful for differential diagnosis of coronavirus lung damage and other lung diseases.

scholarly journals FEATURES OF DIFFERENTIAL DIAGNOSIS OF URGENT SURGICAL ABDOMINAL PATHOLOGY DURING A PANDEMIC OF CORONAVIRUS INFECTION

2021 ◽  
pp. 5-8
Author(s):  
V. V. Lesnoy ◽  
A. S. Lesna ◽  
V. A. Filonenko
Keyword(s):  
Differential Diagnosis ◽  
Clinical Symptoms ◽  
Diagnostic Algorithm ◽  
Surgical Pathology ◽  
Sonographic Examination ◽  
Advantages And Disadvantages ◽  
Abdominal Organs ◽  
Rapid Tests ◽  
Coronavirus Infection ◽  
Instrumental Methods

Summary. Aim. To analyze the features of differential diagnosis of urgent surgical pathology during a coronavirus infection pandemic. Materials and methods. The work is based on the analysis of the results of additional examination of 28 patients at the admission department, who sought medical help in an urgent manner. Results. The advantages and disadvantages of using instrumental methods for detecting atypical forms of coronavirus infection and acute abdominal pathology are analyzed. Based on this, a diagnostic algorithm was developed using express tests for the determination of COVID-19 and urgent ultrasound protocols, which made it possible to identify lung lesions without clinical symptoms in 8 (28.6 %) patients, and to confirm acute surgical pathology in 5 (17.9 %) patients. Conclusion. Еxamining patients with suspected acute abdominal pathology for the purpose of differential diagnosis with the gastrointestinal form of COVID-19, it is necessary to use rapid tests for detecting antibodies to coronavirus infection and sonographic examination of the abdominal organs (FAST protocol), chest organs (BLUE protocol).

scholarly journals EXPERIENCE WITH TRANSVAGINAL APPLICATION OF ELECTROPHORESIS IN THE COMPLEX THERAPY OF PATIENTS WITH CHRONIC SALPINGOOPHORITIS

2017 ◽  
Vol 16 (5) ◽  
pp. 261-264
Author(s):  
T. M Medoeva ◽  
Madina Zautdinovna Dugieva ◽  
N. B Korchazhkina
Keyword(s):  
Quality Of Life ◽  
High Efficiency ◽  
Clinical Symptoms ◽  
Pain Syndrome ◽  
Pathological Process ◽  
Symptom Scale ◽  
Gynecological Diseases ◽  
Negative Effect ◽  
Clinical Conditions

Chronic salpingooophoritis occupies one of the leading places in the structure of gynecological diseases (60-70%) with a tendency to generalization and chronicization of the inflammatory process, the development of serious pathophysiological and pathomorphological changes in affected tissues, involvement of the reproductive system in the pathological process and a significant negative effect on the quality of life. In clinical conditions, 25 patients (mean age 29.9 ± 3.6 years) with a verified diagnosis of chronic salpingooophoritis were examined and treated. Treatment included transvaginal electrophoresis of the complex of collagenases (15 procedures for a course, 3-4 times a week). Efficacy was assessed taking into account the indices of the scale of symptoms, degree of pain syndrome and quality of life. Transvaginal electrophoresis with collagenase preparations has a high efficiency for all clinical symptoms of chronic salpingooophoritis, which is confirmed by the dynamics of the index of the symptom scale, the reduction of which was 74.9%, while the global therapeutic effectiveness of the method was 80%. The developed method is highly effective in terms of relief of pain, which significantly contributes to improving the quality of life of this category of patients.

scholarly journals DIAGNOSIS AND EMERGENCY SURGICAL TREATMENT OF GIANT LEFT ATRIAL SARCOMA: CLINICAL CASES

2019 ◽  
Vol 34 (1) ◽  
pp. 130-136
Author(s):  
G. E. Gogin ◽  
N. V. Eremina ◽  
A. V. Molochkov ◽  
M. N. Alekhin
Keyword(s):  
Differential Diagnosis ◽  
Surgical Treatment ◽  
Left Atrium ◽  
Left Atrial ◽  
Surgical Intervention ◽  
Clinical Symptoms ◽  
Primary Diagnosis ◽  
Pathological Process ◽  
Emergency Surgical Intervention ◽  
Clinical Cases

We present two clinical cases of the late primary diagnosis of cardiac sarcoma with an unusual intracavitary growth in the left atrium with the left atrioventricular orifice obstruction requiring an emergency surgical intervention. A variety of concomitant clinical symptoms that mask the underlying pathological process and impede differential diagnosis has been described.

scholarly journals DIAGNOSIS AND EMERGENCY SURGICAL TREATMENT OF GIANT LEFT ATRIAL SARCOMA: CLINICAL CASES

2019 ◽  
Vol 34 (1) ◽  
pp. 130-136
Author(s):  
G. E. Gogin ◽  
N. V. Eremina ◽  
A. V. Molochkov ◽  
M. N. Alekhin
Keyword(s):  
Differential Diagnosis ◽  
Surgical Treatment ◽  
Left Atrium ◽  
Left Atrial ◽  
Surgical Intervention ◽  
Clinical Symptoms ◽  
Primary Diagnosis ◽  
Pathological Process ◽  
Emergency Surgical Intervention ◽  
Clinical Cases

We present two clinical cases of the late primary diagnosis of cardiac sarcoma with an unusual intracavitary growth in the left atrium with the left atrioventricular orifice obstruction requiring an emergency surgical intervention. A variety of concomitant clinical symptoms that mask the underlying pathological process and impede differential diagnosis has been described.

scholarly journals New Aspects in the Differential Diagnosis and Therapy of Bladder Pain Syndrome/Interstitial Cystitis

2011 ◽  
Vol 2011 ◽  
pp. 1-9 ◽  
Author(s):  
Jochen Neuhaus ◽  
Thilo Schwalenberg ◽  
Lars-Christian Horn ◽  
Henry Alexander ◽  
Jens-Uwe Stolzenburg
Keyword(s):  
Differential Diagnosis ◽  
Interstitial Cystitis ◽  
Clinical Symptoms ◽  
Pain Syndrome ◽  
Bladder Pain Syndrome ◽  
Clinical Diagnostics ◽  
Receptor Expression ◽  
Case Scenario ◽  
Worst Case ◽  
Bladder Pain

Diagnosis of bladder pain syndrome/interstitial cystitis (BPS/IC) is presently based on mainly clinical symptoms. BPS/IC can be considered as a worst-case scenario of bladder overactivity of unknown origin, including bladder pain. Usually, patients are partially or completely resistant to anticholinergic therapy, and therapeutical options are especially restricted in case of BPS/IC. Therefore, early detection of patients prone to develop BPS/IC symptoms is essential for successful therapy. We propose extended diagnostics including molecular markers. Differential diagnosis should be based on three diagnostical “columns”: (i) clinical diagnostics, (ii) histopathology, and (iii) molecular diagnostics. Analysis of molecular alterations of receptor expression in detrusor smooth muscle cells and urothelial integrity is necessary to develop patient-tailored therapeutical concepts. Although more research is needed to elucidate the pathomechanisms involved, extended BPS/IC diagnostics could already be integrated into routine patient care, allowing evidence-based pharmacotherapy of patients with idiopathic bladder overactivity and BPS/IC.

A Historical Review of Complex Regional Pain Syndrome in the “Guides Library”

2009 ◽  
Vol 14 (6) ◽  
pp. 1-9
Author(s):  
Robert J. Barth
Keyword(s):  
Differential Diagnosis ◽  
Complex Regional Pain Syndrome ◽  
Reflex Sympathetic Dystrophy ◽  
International Association ◽  
Historical Review ◽  
Pain Syndrome ◽  
Sixth Edition

Abstract Complex regional pain syndrome (CRPS) is a controversial, ambiguous, unreliable, and unvalidated concept that, for these very reasons, has been justifiably ignored in the “AMA Guides Library” that includes the AMAGuides to the Evaluation of Permanent Impairment (AMA Guides), the AMA Guides Newsletter, and other publications in this suite. But because of the surge of CRPS-related medicolegal claims and the mission of the AMA Guides to assist those who adjudicate such claims, a discussion of CRPS is warranted, especially because of what some believe to be confusing recommendations regarding causation. In 1994, the International Association for the Study of Pain (IASP) introduced a newly invented concept, CRPS, to replace the concepts of reflex sympathetic dystrophy (replaced by CRPS I) and causalgia (replaced by CRPS II). An article in the November/December 1997 issue of The Guides Newsletter introduced CRPS and presciently recommended that evaluators avoid the IASP protocol in favor of extensive differential diagnosis based on objective findings. A series of articles in The Guides Newsletter in 2006 extensively discussed the shortcomings of CRPS. The AMA Guides, Sixth Edition, notes that the inherent lack of injury-relatedness for the nonvalidated concept of CRPS creates a dilemma for impairment evaluators. Focusing on impairment evaluation and not on injury-relatedness would greatly simplify use of the AMA Guides.

DISORDERS OF PERIPHERAL CIRCULATION AMID CHRONIC OSTEOCHONDROSIS OF THE LUMBAR SPINE

Vestnik ◽  
2021 ◽  
pp. 24-28
Author(s):  
Р.С. Бегимбетова ◽  
Н.О. Бейсембинова ◽  
А.К. Кадырали ◽  
Г.М. Жолдасова ◽  
А. Бауржанкызы ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Informed Consent ◽  
Clinical Symptoms ◽  
Personal Data ◽  
Pain Syndrome ◽  
Peripheral Circulation ◽  
Research Protocol ◽  
Initial Visit ◽  
Continue Research ◽  
Inhibitory Reflex

Проведен анализ состояния периферического кровообращения у 28 мужчин, больных остеохондрозом поясничного отдела позвоночника, сопровождающегося люмбалгией с клинической симптоматикой нарушения периферического кровообращения нижних конечностей. Все больные, принимавшие участие в нашем исследовании, подписали информированное согласие на участие в программе и соглашение о неразглашении личных данных и протокола исследований. Критериями для анализа являлись изменения клинической симптоматики остеохондроза поясничного отдела позвоночника, обусловленной им люмбалгии и показателей оксиметрического исследования, которые были зафиксированы при первичном обращении и через 7 суток на фоне проводимого лечения и регрессии болевого синдрома. Таким образом, полученные результаты свидетельствовали о рефлекторном нарушении периферического кровообращения за счет развития патологического спинально-вазального тормозного рефлекса, обусловленного люмбалгией, которые восстанавливаются на фоне регрессии патологической импульсации в поясничном отделе позвоночника. Целесообразно продолжить исследования в этом направлении. The state of peripheral circulation in 28 men were analyzed, patients with osteochondrosis of the lumbar spine, accompanied by lumbodynia with clinical symptoms of impaired peripheral circulation of the lower extremities was carried out. All patients who took part in our study signed an informed consent to participate in the program and a non-disclosure agreement of personal data and research protocol. The criteria for the analysis were clinical symptoms of osteochondrosis of the lumbar spine caused by lumbodynia and indicators of oximetry studies, which were recorded during the initial visit and after 7 days amid treatment and regression of pain syndrome. Thus, the results indicated a reflex disorder of the peripheral circulation due to the development of a pathological spinal-vasal inhibitory reflex caused by lumbodynia, which is restored amid regression of pathological impulses in the lumbar spine. It is advisable to continue research in this direction.

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