scholarly journals Criteria for differential diagnostics of the bronchopulmonary pathology in employees exposed to occupational air pollutants

2020 ◽  
Vol 99 (8) ◽  
pp. 803-808
Author(s):  
Elena A. Beigel ◽  
Elena V. Katamanova ◽  
Oleg L. Lakhman
Keyword(s):  
Differential Diagnosis ◽  
Clinical Manifestations ◽  
Forced Expiratory Volume ◽  
Individual Characteristics ◽  
The Body ◽  
Differential Diagnostics ◽  
Body Plethysmography ◽  
Airborne Pollutants ◽  
Volumetric Rate ◽  
Group 2

Introduction. In recent years the nature of the developing professional pathology of the respiratory system and the features of clinical manifestations have been proved to be determined not only by harmful factors of the working environment but also by individual characteristics of the body, such as age, state of the immune system, etc. In some cases, the differential diagnosis of various forms of bronchopulmonary pathology to date causes certain difficulties.Aim. To establish the criteria for differential diagnosis of the nosological form of the pathology of the bronchopulmonary system from the effects of occupational airborne pollutants using fluorine compounds as an example at different times of diagnosis.Material and methods. 130 patients with an established diagnosis of occupational pathology of the broncho-pulmonary system were examined. All patients were divided into 2 groups: 1 - patients with professional bronchopulmonary pathology, in whom the disease was associated with the occupation during initial hospitalization, during the continuation of work in aluminum production or no later than a year after termination of work); Group 2 - persons with occupational bronchopulmonary pathology, who were diagnosed with respiratory pathology during the period of work, and the connection of the disease with the occupation more than 1 year after termination of work. Patients underwent spirometry, body plethysmography, a 6-minute walk test, questionnaires using the COPD Assessment Test (CAT) questionnaire, and respiratory symptoms were assessed using a 4-point mMRS scale. Statistical analysis methods were performed using the STATISTICA software package - version 6 of Stat Soft Inc. (USA). Intergroup comparison of quantitative indices was carried out using the nonparametric Mann-Whitney test. Values are presented as mean and mean error. To establish the criteria for differential diagnosis, a discriminant analysis was performed.Results. The CAT score (strong COPD influence on the patient’s life) was statistically significantly worse (25.91 points) in group 2 (versus 21.85 points in group 1), as well as spirometry indices: FVC, 68.30% of due values against 79.90% and FEV1 - 62.15% against 70.88%. (p <0.05). As a result of discriminant analyzes, informative criteria for the differential diagnosis of occupational bronchopulmonary pathology were established: the severity of shortness of breath on the CAT questionnaire, the total score on the CAT questionnaire; the ratio of the forced vital capacity of the lungs to the forced expiratory volume in 1 minute (FVC /FEV1), the instantaneous volumetric rate after expiration is 25% FVC (MOS25), the instantaneous volumetric rate after expiration is 50% FVC (MOS50, forced expiratory volume per 1 minute (FEV1); total bronchial resistance according to body plethysmography (sRtotal), residual lung volume according to body plethysmography (RLV). The results indicate the progression of clinical manifestations of bronchopulmonary pathology even after stopping work in aluminum new production.Conclusion. The criteria for differential diagnosis of bronchopulmonary pathology from the effects of occupational airborne pollutants taking into account the individual characteristics of the body are established.

Hepatic Encephalopathy

2017 ◽  
Author(s):  
Allison R Schulman ◽  
Nikroo Hashemi
Keyword(s):  
Differential Diagnosis ◽  
Liver Disease ◽  
Hepatic Encephalopathy ◽  
Chronic Liver Disease ◽  
Wide Spectrum ◽  
Clinical Manifestations ◽  
Minimal Hepatic Encephalopathy ◽  
The Body ◽  
Chronic Liver ◽  
Intrahepatic Portosystemic Shunt

Hepatic encephalopathy (HE) is one of the most debilitating manifestations of acute or chronic liver disease and/or portosystemic shunting. The clinical manifestations of HE span a wide spectrum of neurologic or psychiatric abnormalities, ranging from subclinical neuropsychological disturbances to coma. HE severely affects the lives of patients and their caregivers and results in the use of more health care resources in adults than other manifestations of hepatic dysfunction. To date, there are insufficient clinical studies and standardized definitions, making the diagnosis, classification, and treatment of HE challenging. This review covers the epidemiology, pathophysiology and pathogenesis, diagnosis, differential diagnosis, treatment, and follow-up of HE. Figures show the numerous processes and mechanisms involved in the pathogenesis of HE and ammonia trafficking and metabolism within the body. Tables list the four factors that dictate categorization and grading of HE, differential diagnosis of HE, summary of testing used for minimal HE and covert HE with associated advantages and/or disadvantages, and precipitating causes of HE in patients with cirrhosis. This review contains 2 highly rendered figures, 4 tables, and 77 references. Key words: chronic liver disease; covert hepatic encephalopathy; hepatic encephalopathy; minimal hepatic encephalopathy; overt hepatic encephalopathy; transjugular intrahepatic portosystemic shunt 

scholarly journals A 28-Year-Old Woman with Fever, Weight Loss, Pancytopenia, and Multiple Hepatosplenic and Bone Lesions

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Fereshte Sheybani ◽  
Bezat Amiri ◽  
HamidReza Naderi ◽  
Mohammad Reza Sarvghad
Keyword(s):  
Weight Loss ◽  
Differential Diagnosis ◽  
Broad Spectrum ◽  
Clinical Manifestations ◽  
Febrile Illness ◽  
The Body ◽  
Bone Lesions ◽  
Zoonotic Infection ◽  
Rare Presentation ◽  
Multifocal Osteomyelitis

Brucellosis is a systemic zoonotic infection that can involve any organ or system in the body. It may present with a broad spectrum of clinical manifestations. Considering such myriad presentations, brucellosis should always be considered in the differential diagnosis of any febrile illness in a compatible epidemiological context. Here, we report a rare presentation of acute brucellosis with multifocal osteomyelitis and hepatosplenic lesions.

Clinical, morphological and biochemical signs of polymycotoxicosis in highly productive cows

2020 ◽  
pp. 14-17
Author(s):  
Irina A. Shkuratova ◽  
◽  
Lyudmila I. Drozdova ◽  
Aleksander I. Belousov ◽  
Keyword(s):  
Metabolic Disorders ◽  
Hepatorenal Syndrome ◽  
Morphological Changes ◽  
Clinical Manifestations ◽  
The Body ◽  
Feed Mixture ◽  
Milk Productivity ◽  
Structural Disorders ◽  
Increased Sensitivity ◽  
Penicillium Spp

Mycotoxicological monitoring of forages shows that the problem of mycotoxicosis has been relevant for several decades. Minimal doses of mycotoxins in feed lead to a decrease in milk productivity, increased sensitivity to infectious and non-infectious diseases. When several mycotoxins enter the body simultaneously, a synergistic effect develops, causing a significant increase in toxicity. Feed contaminated with several types of fungi and their toxins is dangerous for dairy cattle. It was found that the feed mixture contained the types of associations of Aspergillus spp. fungi + Fusarium; Aspergillus spp. + Penicillium spp. + Mucor spp; Fusarium + Penicillium; Mucor spp. + Fusarium + Ustilaginales. Pathogenetic features of metabolic and morphological changes in highly productive cows with polymycotoxicosis were studied. Feeding food contaminated with various metabolites of mold fungi leads to the development of signs of chronic toxemia in animals. Clinical manifestations are the development of diarrhea and dehydration, with a decrease in milk productivity. Metabolic disorders feature the development of an inflammatory process, metabolic acidosis, hyperfermentonemia, with an increase in the amount of creatinine and urea in the blood serum. Metabolic signs indicate the development of hepatorenal syndrome due to structural disorders of the liver and kidneys. Histological signs of polymicotoxicosis are intracapillary and hemorrhagic glomerulonephritis, hepatocyte micronecrosis, and proliferation of connective tissue stroma cells, which leads to the development of atrophic cirrhosis in the interstitial and circular phases.

HISTOLOGICAL CHANGES IN THE INTESTINES OF POULTRY DURING FODDER INTOXICATION

2020 ◽  
Author(s):  
E.P. Dolgov ◽  
◽  
A.A. Abramov ◽  
E.V. Kuzminova ◽  
E.V. Rogaleva ◽  
...  
Keyword(s):  
Body Weight ◽  
Histological Examination ◽  
Aflatoxin B1 ◽  
Structural Changes ◽  
Clinical Manifestations ◽  
Feed Additives ◽  
The Body ◽  
Histological Changes ◽  
Beet Pulp

The article presents the data on the study of the influence of mycotoxins combination (T-2 toxin at the concentration of 0.095 mg/kg and aflatoxin B1 in the concentration of 0.019 mg/kg) on the body of quails and the results of pharmacocorrection of toxicosis with a complex consisting of beet pulp and lecithin. Structural changes in the intestines of quais at fodder mycotoxicosis are described. The use of antitoxic feed additives in poultry led to a weakening of the action of xenobiotics, which was confirmed by an increase in the safety of poultry and increase in body weight of quails, a decrease in the clinical manifestations of intoxication, as well as in positive changes in the structure of the intestine of the poultry during histological examination.

Efficacy evaluation of the CEUS-LI-RADS-v2017 system in differential diagnosis of liver tumors

2019 ◽  
pp. 57-67
Author(s):  
A. N. Katrich ◽  
V. A. Porkhanov ◽  
N. S. Ryabin
Keyword(s):  
Risk Factors ◽  
Differential Diagnosis ◽  
Liver Tumors ◽  
Morphological Data ◽  
Malignant Neoplasms ◽  
Diagnostic Efficiency ◽  
Efficacy Evaluation ◽  
General Group ◽  
Group 2 ◽  
Group 1

Objective: efficacy evaluation of the CEUS LI RADS v2017® system for differential diagnosis of liver tumors in patients with and without cirrhosis.Materials and methods. Retrospective analysis of diagnostic results of the 165 patients with liver tumors (177 nodules) was done. All patients underwent CEUS with results interpretation in accordance to the CEUS LIRADSv2017 ® criteria. Patients were divided into 2 groups based on clinical and morphological data. Group 1 included 62 patients with cirrhosis and/or CVH. Group 2 included 110 patients without risk factors for HCC.Results. Diagnostic efficiency of CEUS LI RADS v2017® for HCC identification was: group 1 – Se – 100%, Sp – 88%, Ac – 95.5%; group 2 – Se – 100%, Sp – 68.8%, Ac – 72.7%; general group Se – 100%, Sp – 72.2%, Ac – 81.4%. In the 2nd group, 21 out of 22 neoplasms, confirmed morphologically as FNH, we classified as LR 4. By applying benign character and specific contrasting patterns of FNG, they were transferred from LR 4 to LR 3. This allowed to increase sensitivity and specificity of differential diagnosis in group 2 (Se – 100%, Sp – 90.6%, Ac – 91.8%) and in general group (Se – 100%, Sp – 90.1%, Ac – 93.2%). Diagnostic efficiency of the criteria for non hepatocellular malignant neoplasms (LR M) was: group 1 – Se – 77.8%, Sp – 100%, Ac – 97%; group 2 – Se – 90%, Sp – 96.7%, Ac – 93.6%; general group- Se – 88.1%, Sp – 98.3%, Ac – 94.9%.Conclusion. Our study confirmed high accuracy of the CEUS LI RADS v2017® system in the differential diagnosis of focal liver tumors. Modification of the system (in particular, transfer of typical FNG forms from the LR 4 category) will make it possible to increase the accuracy of diagnostics by 20%. It will allow to use the LI RADS v2017® system for interpretation CEUS not only among patients with liver cirrhosis, but also in a general group without risk factors of GCC.

Ultrasonic differential diagnostics of cyst and cystic tumors of the spleen

2020 ◽  
Vol 24 (3) ◽  
pp. 63-75
Author(s):  
Yu. A. Stepanova ◽  
M. Z. Alimurzaeva ◽  
D. A. Ionkin
Keyword(s):  
Differential Diagnosis ◽  
Cancer Metastasis ◽  
Malignant Tumors ◽  
Dynamic Control ◽  
Differential Diagnostics ◽  
Epithelial Lining ◽  
Focal Lesions ◽  
Morphological Form ◽  
Cystic Tumors ◽  
Number Of Patients

The incidence of focal lesions in the spleen is 3.2–4.2% per 100,000 population. Spleen cysts are rare (incidence 0.75 per 100,000). These are single or multiple, thin- and smooth-walled cavities filled with a transparent liquid. Distinguish between primary (or true) cysts, lined with epithelium, and secondary (or false), devoid of epithelial lining. Among the primary cysts, there are congenital cysts formed in the embryonic period due to the migration of peritoneal cells into the spleen tissue, dermoid and epidermoid cysts. A special group of primary cysts are parasitic cysts. Cystic tumors of the spleen include lymphangioma and lymphoma.The main difficulties in the diagnosis and differential diagnosis of cysts and cystic tumors of the spleen are associated with the rarity of this pathology and, as a consequence, a small number of works, including a significant number of the cases. However, in those works where a large number of the cases are described, most often this is one morphological form and an analysis of its various characteristics.Purpose. Based on the analysis of our own examination data of a significant number of patients with cysts and cystic tumors of the spleen, to assess the possibility of differential diagnosis of individual morphological forms according to ultrasound data.Materials and methods. 323 patients with cysts and cystic tumors of the spleen from 15 to 77 years old (men – 105 (32.5%); women – 218 (67.5%) were treated at A.V. Vishnevsky National Medical Research Center of Surgery for the period from 1980 to 2020. All patients underwent ultrasound during examination. Surgical treatment was carried out in various ways – (85.1%), when making a preoperative diagnosis of an uncomplicated spleen cyst of small size, dynamic observation was carried out (verification by puncture biopsy data).Results. Morphological verification of cysts and cystic tumors of the spleen was presented as follows (taking into account possible difficulties in identifying the epithelial lining): true cyst – 182 (56.4%); dermoid cyst – 3 (0.9%) (malignant – in 1 case); pseudocyst – 16 (5.0%); pancreatogenic – 34 (10.5%); echinococcus – 52 (16.1%); lymphangioma – 24 (7.4%); lymphoma – 10 (3.1%); ovarian cancer metastasis – 2 (0.6%). The article describes the ultrasound signs of the above forms of the lesions with an emphasis on the complexity of diagnosis.Conclusions. Primary and parasitic spleen cysts are well differentiated according to ultrasound; false cysts of the spleen, depending on the cause of their occurrence, can create difficulties in their identification and differentiation (they require careful dynamic control); cystic tumors of the spleen should be differentiated from malignant tumors and metastases of a cystic structure, as a result of which such vigilance should always be present when they are detected.

Defensive activity of Hesperidin against Ciprofloxacin induced hepatic injury in rabbits.

2019 ◽  
Vol 10 (03) ◽  
Author(s):  
Hawraa M. Murad ◽  
Tamadhur Hani Hussein ◽  
Audai Sulaiman Khudhair ◽  
Manal Muhi Murad ◽  
Jawad Kadhim Faris
Keyword(s):  
Body Weight ◽  
Bacterial Infections ◽  
Hepatoprotective Activity ◽  
The Body ◽  
Local Breed ◽  
Group 4 ◽  
Group 3 ◽  
Group 2 ◽  
Defensive Activity ◽  
Antioxidant Effects

This study was conducted to find out hepatoprotective activity of hesperidin (HES) 100mg/kg body weight (b.w.) against ciprofloxacin (CPX) 100 mg/kg induced hepatotoxicity in local breed rabbits .CPX is a broad spectrum antibiotic used for treatment of many bacterial infections. Twenty four male rabbits were divided into four groups ,group1: control, (1 ml/kg Saline orally) group 2: CPX (100 mg/kg orally) for (14) consecutive days , group 3: HES (100 mg//kg) orally for (14) consecutive days group 4: CPX (100 mg/kg orally) plus HES (100 mg//kg orally ) for (14) consecutive days. All the rabbits were killed on the (15) day of the experiment, and then the blood, and livers samples were taken. CPX induced hepatotoxicity was proved by a significant (p less than 0.01) reduction in the body weight ,and a significant (p less than 0.01) increased serum aspartate transaminase (AST), alanine transaminase (ALT) , Malonaldehyde enzyme (MAD) and histopathological changes. Protective hepatic toxicity effect and oxidative damage caused by CPX significantly (p less than 0.01) increasing in body weight and significantly (p less than 0.01) decreasing AST , ALT, MAD and improving tissue morphology in HES (100 mg//kg) . These results assure that HES (100 mg//kg) antioxidant effects can protect CPX-induced hepatotoxicity in rabbits.

A glance on dystonias, how to recognize and handle them

2019 ◽  
pp. 22-29
Author(s):  
F. N. Mercan ◽  
E. Bayram ◽  
M. C. Akbostanci
Keyword(s):  
Differential Diagnosis ◽  
Movement Disorder ◽  
Age Of Onset ◽  
Clinical Manifestations ◽  
Body Part ◽  
Classification Model ◽  
Treatment Choices ◽  
Muscle Groups

Dystonia refers to an involuntary, repetitive, sustained, painful and twisting movements of the affected body part. This movement disorder was first described in 1911 by Hermain Oppenheim, and many studies have been conducted to understand the mechanism, the diagnosis and the treatment of dystonia ever since. However, there are still many unexplained aspects of this phenomenon. Dystonia is diagnosed by clinical manifestations, and various classifications are recommended for the diagnosis and the treatment. Anatomic classification, which is based on the muscle groups involved, is the most helpful classification model to plan the course of the treatment. Dystonias can also be classified based on the age of onset and the cause. These dystonic syndromes can be present without an identified etiology or they can be clinical manifestations of a neurodegenerative or neurometabolic disease. In this review we summarized the differential diagnosis, definition, classifications, possible mechanisms and treatment choices of dystonia.

Experience in the use of double broncholytic therapy in occupational practice

2019 ◽  
pp. 303-307
Author(s):  
Elena A. Beigel ◽  
Natalya G. Kuptsova ◽  
Elena V. Katamanova ◽  
Oksana V. Ushakova ◽  
Oleg L. Lakhman
Keyword(s):  
Quality Of Life ◽  
Personal Data ◽  
The Body ◽  
Step Test ◽  
Aluminum Production ◽  
Chronic Obstructive ◽  
Body Plethysmography ◽  
Occupational Copd ◽  
The Impact

Introduction. Occupational chronic obstructive pulmonary disease (COPD) is one of the leading nosological forms of occupational respiratory disease. Numerous studies have shown high effectiveness of the combination of indacaterol/glycopyrronium (Ultibro®breezhaler®) on the impact on clinical and functional indicators in the treatment of COPD in General practice.The aim of the investigation the case of occupational COPD with the analysis of the dynamics of functional indicators, tolerance to physical load and evaluation of the quality of life of workers engaged in aluminum production by using combination of indacaterol/glycopyrronium.Materials and methods. The random sampling method included 20 men, workers of aluminum production, with the established diagnosis of professional COPD at the age of 40 to 60 years. The survey was conducted (Borg scale, medical Research Council scale (mMRC) and COPD Assessment Test (CAT). Functional methods of studies were conducted: spirometry, body plethysmography, electrocardiography (ECG) and the six-minute stepper test (6-MST).Results. Against the background of 8 weeks of therapy, the volume of forced exhalation for 1 minute (FEV1) increased by 14.7% and amounted to 67.90% of the due values, the forced vital capacity of the lungs (FVC) increased by 11.3% and amounted to 76.95% of the due. According to the body plethysmography (BPG) is set to decrease in residual lung volume on average by 13.4% and static hyperinflation, confirmed by the decrease in functional residual volume (FRV) of 18.8%. During the study period increased physical activity of patients. The average difference between the distance traveled in the six-minute step test before and after treatment was 58.8 m. The analysis of personal data showed that the quality of life of patients improved, the total score in the questionnaire CAT at the beginning of the study was 16.9 points, and after 8 weeks decreased by 63% and amounted to 10.7 points.Conclusions: The Results indicate a positive effect of combination therapy with indacaterol/glycopyrronium on the course and progression of occupational COPD.

DIAGNOSTICS AND TREATMENT OF POISONING WITH THALLIUM

2018 ◽  
pp. 9-15 ◽  
Author(s):  
L. B. Zavaliy ◽  
A. Yu. Simonova ◽  
M. M. Potskhveriya ◽  
Yu. N. Ostapenko ◽  
M. G. Gadzhieva ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Clinical Picture ◽  
Clinical Guidelines ◽  
The Body ◽  
Biological Media ◽  
Pathophysiological Mechanisms ◽  
Thallium Poisoning ◽  
The World

Cases of thallium poisonings are regularly reported in media. In the present work, the world experience in diagnostics and treatment of victims with thallium poisoning has been compiled and summarized, search for clinical guidelines for the diagnostics, treatment and rehabilitation of patients has been carried out. The toxicokinetics and toxicodynamics, as well as pathophysiological mechanisms of thallium influence on the body are described in detail. Toxic and lethal concentrations of poison in biological media, as well as its tropicity to various tissues and body systems were determined. The clinical picture depending on the timing of poisoning and the dose of poison is described in detail. Difficulties of the differential diagnosis are defined. The most interesting cases of criminal and household poisonings with various terms of establishment of the diagnosis, doses of poisoning and outcomes are presented.

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