FEATURES OF THERAPY FOR ACUTE POISONING WITH JELLYFISH POISON (CLINICAL OBSERVATION)

2020 ◽  
pp. 38-42
Author(s):  
V. V. Shilov ◽  
V. A. Lukin ◽  
L. P. Pivovarova ◽  
M. I. Gromov
Keyword(s):  
Clinical Observation ◽  
Health And Safety ◽  
Pain Syndrome ◽  
Antiplatelet Agents ◽  
Acute Poisoning ◽  
Marine Fauna ◽  
Soft Tissue Necrosis ◽  
Therapeutic Measures ◽  
The Right ◽  
Therapeutic Doses

Jellyfish, as representatives of marine fauna, contain toxic chemicals in their bodies and, if they come into contact with humans, can pose a threat to their health and safety. The article describes a clinical observation of a patient who received a chemical injury as a result of contact of the right upper limb with a venomous jellyfish (Medusa kornerot) and was hospitalized for 35 days with acute poisoning with animal toxin, chemical burns, toxic-allergic dermatitis, epidermolysis, soft tissue necrosis and compression-ischemic neuropathy. Laboratory results confirmed the presence of an inflammatory process, but without allergic and autoimmune components (leukocytosis 16,7 x 109/l, acceleration of ESR to 21 mm/h), revealed an increase in the level of transaminases upon admission: alanine aminotransferase 138.3 u/l (norm 0-31 u/l), aspartate aminotransferase 94,8 u/l (norm 0-31 u/l), gamma-glutamyltransferase 97 u/l (norm 0-32 units/l). Previous drug therapy, including the introduction of tetanus serum (once), antihistamines (chloropyramine), hormonal (prednisone), anticoagulants (heparin sodium), antispasmodics (Metamizole sodium, pitofenone hydrochloride, fenpiverinium bromide), antiplatelet agents (pentoxifylline, nicotinic acid), calcium gluconate, multivitamins in therapeutic doses, the application of bandages «gelonet», «fibrotul Argentum», was not effective enough. Complex therapy with cellular metabolism regulators, antihypoxants, cholinesterase inhibitors using hyperbaric oxygenation and membrane plasmapheresis allowed to achieve a lasting effect: to stop the pain syndrome, normalize the disturbed functions of internal organs and the affected limb, avoid surgery, and fully restore working capacity. This complex of therapeutic measures should be used in the treatment of patients with this pathology

scholarly journals Martorell’s ulcer: a literature review and own clinical observation

2021 ◽  
Vol 18 (1) ◽  
pp. 55-70
Author(s):  
B. V. Boldin ◽  
P. Yu. Golosnitskiy ◽  
V. Yu. Bogachev ◽  
S. V. Rodionov ◽  
I. M. Dizengof
Keyword(s):  
Clinical Observation ◽  
Treatment Options ◽  
Local Treatment ◽  
Local Therapy ◽  
Pain Syndrome ◽  
Definitive Treatment ◽  
Outpatient Basis ◽  
Narcotic Analgesics ◽  
Wide Range ◽  
The Right

Introduction. Martorell’s ulcer is a rather rare pathology that occurs exclusively in patients with long-term and poorly controlled arterial hypertension and continues to be one of the poorly studied areas of modern surgery. There are few reports on the occurrence of this pathology in the medical literature and, as a rule, describe extremely rare clinical cases. The issues of etiology, pathogenesis and differential diagnosis of this disease continue to cause debate. The article provides a review of the literature on this rare surgical pathology, presents its own clinical observation, discusses the issues of diagnosis and treatment options for this disease.Clinical case. A 56-year-old patient was admitted with complaints of a non-healing trophic ulcer on the lateral surface in the lower third of the right leg since one year ago with severe pain syndrome not adequately controlled with non-narcotic analgesics. he received treatment in an outpatient department and in the hospital, underwent courses of rheological therapy to the ulcer region as a local therapy, used a wide range of dressings of domestic and foreign origin. No positive effect was reported on the top of already administered combination therapy, the ulcer continued to increase in size. A Martorell’s ulcer was diagnosed, and a decision was made to provide a course of presurgical conservative rheological therapy with PGE1 (VAP 20 mg), antibiotic therapy, and local therapy aimed at maximal ulcer necrotic tissue clearance before the forthcoming planned surgical treatment. The patient underwent the surgery – autodermatoplasty of the trophic ulcer of the right leg with a mesh graft, continued local treatment of the ulcer using dressings with peruvian balsam and other medications on an outpatient basis without chemical and biological components from the antiseptics and healing stimulants group. Two months after the surgery, the patient had no complaints, the pain syndrome in the ulcer region completely regressed, no edema occurred in the lower operated leg, the right let ulcer completely healed with the formation of a permanent scar.Conclusion. Surgical management is the final and definitive treatment for Martorell’s chronic hypertensive ulcer and should be carried out promptly to minimize the spread of the ulcer and minimize a pain syndrome.

scholarly journals Venipuncture Induced Complex Regional Pain Syndrome Presenting as Inflammatory Arthritis

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Punit Pruthi ◽  
Pramod Arora ◽  
Manoj Mittal ◽  
Anugrah Nair ◽  
Waqia Sultana
Keyword(s):  
Complex Regional Pain Syndrome ◽  
Inflammatory Arthritis ◽  
Young Male ◽  
Pain Syndrome ◽  
Poor Response ◽  
History Of ◽  
Diagnostic Modalities ◽  
Musculoskeletal Ultrasonography ◽  
The Right

Venipuncture is one of the most commonly done medical procedures. We report a unique case of a 23-year-old young male who presented with features suggestive of inflammatory arthritis. The symptoms, which initially started on the right side, also involved the other side after a few weeks. Although the patient’s symptoms and signs were simulating inflammatory arthritis, he had atypical features like poor response to anti-inflammatory medicines and normal laboratory parameters. His musculoskeletal ultrasonography was also not suggestive of arthritis. His history was reviewed and on direct questioning he revealed a history of venipuncture for blood sample withdrawal, done from right antecubital region for routine health check on the day prior to the onset of symptoms. Complex regional pain syndrome was suspected and triple-phase radioisotope bone scan was done which was highly suggestive of this diagnosis. The patient was managed with multidimensional approach and responded very well to the treatment. Complex regional pain syndrome is usually not thought of in the initial differential diagnosis of inflammatory arthritis. In this report we highlight the need to elicit the often overlooked history of trivial trauma like venipuncture, especially in atypical cases of arthritis. Also the role of newer diagnostic modalities in such cases is emphasized.

Recurrent Chronic Subdural Hematoma: Clinical and Imaging Risk Factors

2018 ◽  
Vol 15 (01) ◽  
pp. 008-015 ◽  
Author(s):  
Benaissa Abdennebi ◽  
Maher Al Shamiri
Keyword(s):  
Risk Factors ◽  
Subdural Hematoma ◽  
Heart Diseases ◽  
Chronic Subdural Hematoma ◽  
Antiplatelet Agents ◽  
The Elderly ◽  
Imaging Data ◽  
Anticoagulation Agents ◽  
The Right ◽  
Recurrence Group

Abstract Background Chronic subdural hematoma (CSDH) is a major cause of neurosurgical emergencies in the elderly. Despite the use of routine surgical practices, recurrence of this condition is expected. This study was conducted to identify the risk factors (RF) for recurrent CSDH. Methods Between January 2016 and July 2017, 103 consecutive patients suffering from CSDH were admitted to our department. The no-recurrence group (NRG) consisted of 91 patients, and the recurrence group (RG) consisted of 12 patients. To identify the RF involved in recurrent CSDH, we analyzed multiple factors, including patient comorbidities and imaging data. Results Between the two groups, there were no statistical differences (p > 0.05) for head trauma, diabetes mellitus (DM), high blood pressure, heart diseases, anticoagulation agents, or seizures; however, DM was associated with one of the above-mentioned factors. In contrast, there were significant differences for antiplatelet agents (APA) (p < 10–6) and the right side of the hematoma location (p = 0.03). Conclusion Although the literature highlights the controversy regarding RF for CSDH, we detected APA and the right side as RF, whereas DM alone or associated with another comorbidity does not affect the CSDH outcome.

scholarly journals Treatment of Type 1 Complex Regional Pain Syndrome in 14 Years Old Child

2014 ◽  
Vol 21 (4) ◽  
pp. 79-82
Author(s):  
V. N Merkulov ◽  
A. I Dorokhin ◽  
A. I Krupatkin ◽  
M. V Merkulov ◽  
M. A Avakova
Keyword(s):  
Complex Regional Pain Syndrome ◽  
Pain Syndrome ◽  
Hand Injury ◽  
Psychological Status ◽  
Interventional Treatment ◽  
Bolus Administration ◽  
Right Hand ◽  
Foot Injury ◽  
The Right

Case report on 14 years old girl with type 1 complex regional pain syndrome (CRPS) is presented. At first admission in 5.5 months after right hand injury and development of type 1 CRPS, paravasal sympathectomy on the right upper extremity was performed. Complete elimination of pain syndrome and restoration of the extremity function was achieved. Five and a half months after discharge the left foot and in 3 weeks later the right hand were injured. In both cases injuries were accompanied by pronounced CRPS clinical picture. At second admission in 6 weeks after foot injury interventional treatment with placement of catheters next to nerve trunks and bolus administration of antibiotics was performed for 1 week and enabled to achieve remission of the disease. It was noted that not only hypersymphaticotony but also psychological status of a patient were important for the disease development.

scholarly journals Pain Assessment: Subjectivity, Objectivity, and the Use of Neurotechnology Part One: Practical and Ethical Issues

2010 ◽  
Vol 4;13 (4;7) ◽  
pp. 305-315 ◽  
Author(s):  
James Giordano
Keyword(s):  
Pain Assessment ◽  
Subjective Experience ◽  
Ethical Issues ◽  
Social Issues ◽  
Clinical Care ◽  
Pain Syndrome ◽  
Objective Evaluation ◽  
Pain Patient ◽  
Key Words Pain ◽  
The Right

The pain clinician is confronted with the formidable task of objectifying the subjective phenomenon of pain so as to determine the right treatments for both the pain syndrome and the patient in whom the pathology is expressed. However, the experience of pain — and its expression — remains enigmatic. Can currently available evaluative tools, questionnaires, and scales actually provide adequately objective information about the experiential dimensions of pain? Can, or will, current and future iterations of biotechnology — whether used singularly or in combination (with other technologies as well as observational-behavioral methods) — afford objective validation of pain? And what of the clinical, ethical, legal and social issues that arise in and from the use — and potential misuse — of these approaches? Subsequent trajectories of clinical care depend upon the findings gained through the use of these techniques and their inappropriate employment – or misinterpretation of the results they provide — can lead to misdiagnoses and incorrect treatment. This essay is the first of a two-part series that explicates how the intellectual tasks of knowing about pain and the assessment of its experience and expression in the pain patient are constituent to the moral responsibility of pain medicine. Herein, we discuss the problem of pain and its expression, and those methods, techniques, and technologies available to bridge the gap between subjective experience and objective evaluation. We address how these assessment approaches are fundamental to apprehend both pain as an objective, neurological event, and its impact upon the subjective experience, existence, and expectations of the person in pain. In this way, we argue that the right use of technology — together with inter-subjectivity, compassion, and insight — can sustain the good of pain care as both a therapeutic and moral enterprise. Key words: pain, assessment, neurotechnology, biotechnology, neuroethics, medicine

scholarly journals Stridor in infant caused by subglottic hemangiome: case report

2020 ◽  
Vol 10 (3) ◽  
Author(s):  
Raquel Lot ◽  
Caroline Rosa ◽  
Camila Freitas ◽  
Gracinda Adnet ◽  
Luisa Costa ◽  
...  
Keyword(s):  
Beta Agonist ◽  
First Year ◽  
Vascular Neoplasms ◽  
Threatening Condition ◽  
Life Threatening ◽  
Diagnostic Hypothesis ◽  
Therapeutic Measures ◽  
The Right ◽  
First Year Of Life ◽  
Age Range

Subglottic hemagioma is a rare cause of stridor, but it is one of the most common vascular neoplasms of the airways in childhood. If the treatment is not promptly instituted, it becomes a life-threatening condition. The diagnosis should be suspected when infants outside the age range for acute laryngitis present with stridor associated with severe respiratory effort, without viral prodromes, with a condition that is not responsive to initial therapeutic measures considering the main diagnostic hypothesis. Infantile hemangiomas begin to proliferate during the first year of life (between the 1st and 2nd month of life). Involution usually occurs between 6 months and 12 months of life (most involution until 4 years). The case is a 5-month-old female infant, with sudden stridor associated with respiratory distress without viral prodromes or fever, with little response to inhaled short-acting beta-agonist, inhaled adrenaline, as well as corticosteroids inhalation/parenteral. Bronchoscopy showed a bulging of the submucosa to the right of the subglottis with slight vascularization, suggestive of subglottic hemangioma. Treatment with propranolol was initiated orally with the aim of regressing the hemangioma and after clinical stability, the infant was discharged with outpatient follow-up.

scholarly journals Attending Weak Signals: The Prevention of Work-related Illnesses

2017 ◽  
Vol 7 (2) ◽  
Author(s):  
Roy Liff ◽  
Ann-Charlotte Eriksson ◽  
Ewa Wikström
Keyword(s):  
Health Care ◽  
Occupational Health ◽  
Health And Safety ◽  
Occupational Health Care ◽  
Weak Signals ◽  
Work Related ◽  
Safety Work ◽  
Informal Information ◽  
Group Interviews ◽  
The Right

This article examines the characteristics of communication among managers, human resource (HR) experts, and occupational health care specialists, as they deal with such informal information as weak signals in the prevention of work-related illnesses, using a theoretical framework in which the prevention of work-related illness is analogous to theory on crisis management. This is a qualitative study in which individual and focus-group interviews were conducted in a Swedish context with occupational health care specialists, managers, and HR experts. The results suggest that organizational solutions have failed and continue to fail at controlling workers’ health problems, although the main difficulty is not in identifying the ‘right’ individually oriented weak signals. Rather, it is upper management’s reliance on formal information (e.g., statistics and surveys) – because of the difficulty in supplementing it with informal information (e.g., rumors and gossip) – that makes it difficult to improve traditional health and safety work

Guidelines for treating depressive illness with antidepressants: A statement from the British Association for Psychopharmacology

1993 ◽  
Vol 7 (1_suppl) ◽  
pp. 19-23 ◽  
Author(s):  
Stuart A. Montgomery ◽  
P. Bebbington ◽  
P. Cowen ◽  
W. Deakin ◽  
P. Freeling ◽  
...  
Keyword(s):  
Side Effects ◽  
Depressed Mood ◽  
Antidepressant Treatment ◽  
Depressive Illness ◽  
Social Impairment ◽  
Self Blame ◽  
The Core ◽  
The Right ◽  
Therapeutic Doses ◽  
Core Symptoms

Depression is a common illness which affects some 3% of the population per year. At least 25% of those with marked depression do not consult their general practitioner and in half of those who do the illness is not detected. Depression is easy to recognize when four or five of the core symptoms have been present for 2 weeks which often coincides with some occupational and social impairment. The core symptoms are depressed mood, loss of interest or pleasure, loss of energy or fatigue, concentration difficulties, appetite disturbance, sleep disturbance, agitation or retardation, worthlessness or self blame and suicidal thoughts. A diagnosis of depression is made when five of these core symptoms, one of which should be depressed mood or loss of interest or pleasure, have been present for 2 weeks. Four core symptoms are probably sufficient. Response to antidepressants is good in those with more than mild symptoms. When there are only few or very mild depressive symptoms evidence of response to antidepressants is more uncertain. Antidepressants are effective, they are not addictive and do not lose efficacy with prolonged use. The newer antidepressants have fewer side effects than the older tricyclics, they are better tolerated and lead to less withdrawals from treatment. They are less cardiotoxic and are safer in overdose. Antidepressants should be used at full therapeutic doses. Treatment failure is often due to too low a dose being used in general practice. It may be difficult to reach the right dose with the older tricyclics because of side effects. To consolidate response, treatment should be continued for at least 4 months after the patient is apparently well. Stopping the treatment before this is ill-advised as the partially treated depression frequently returns. Most depression is recurrent. Long-term antidepressant treatment is effective in reducing the risk of new episodes of depression and should be continued to keep the patient well.

A case of successful surgical treatment of patient with adrenal cyst using 3-d modeling

2020 ◽  
Vol 28 (4) ◽  
pp. 530-535
Author(s):  
Ivan Andreev ◽  
Alexander Kolsanov ◽  
Sergey Katorkin ◽  
Evgeniy Shestakov ◽  
Leonid Lichman
Keyword(s):  
Surgical Treatment ◽  
Surgical Resection ◽  
3D Modeling ◽  
Clinical Observation ◽  
Preoperative Planning ◽  
Clinical Presentation ◽  
Surgical Intervention ◽  
Adrenal Cyst ◽  
The Right ◽  
Medical University

Aim. Demonstration of potentials of preoperative planning and implementation of surgical resection in patients with adrenal cysts. A clinical observation of a successful surgical treatment of a rare pathology cyst of the right adrenal is presented. The choice of surgical treatment tactics is determined by the size of tumor and clinical presentation of the disease. The surgical treatment was accomplished laparoscopically which permitted to reduce the time of recovery and rehabilitation of the patient. In this clinical observation, the benefit of using 3D-modeling of the surgical area was shown for visualization of topographic and anatomic peculiarities and facilitation of the intraoperative navigation with the help of Avtoplan program developed by Samara State Medical University. Conclusion. Preoperative 3D-modeling permits to prepare to surgical intervention taking into account individual anatomic peculiarities of a patient, and to determine the optimal volume of the operation.

ISOLATED HYPOPLASIA OF THE RIGHT CORONARY ARTERY IN A YOUNG ATHLETE: A CASE REPORT AND LITERATURE REVIEW

2021 ◽  
Vol 100 (5) ◽  
pp. 175-180
Author(s):  
A.S. Sharykin ◽  
◽  
E.V. Karelina ◽  
N.K. Konstantinova ◽  
V.A. Badtieva ◽  
...  
Keyword(s):  
Case Report ◽  
Coronary Artery ◽  
Right Coronary Artery ◽  
Clinical Observation ◽  
Young Athlete ◽  
Stress Tests ◽  
Professional Athlete ◽  
Young Professional ◽  
Modern Methods ◽  
The Right

A unique clinical observation of the intravital diagnosis of hypoplasia of the right coronary artery in the young professional athlete is presented. This observation demonstrates the importance of carrying out stress tests during the dispensary examination of athletes, as well as modern methods of diagnosis of pathology of coronary arteries.

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