The special role of CXCL13 in Lyme neuroborreliosis: a case report

The diagnosis of chronic lyme neuroborreliosis can be a challenge even for experienced neurologists. The clinical picture may be multifaceted, including polyradiculitis to cranial nerve palsies, meningitis, encephalomyelitis, encephalopathy and peripheral neuropathy. We report on a patient presenting with basal leptomeningoencephalitis associated with vasculopathy where the chemokine CXCL13 in cerebrospinal fluid played an important diagnostic role.

Wolfram Syndrome Type 2: A Systematic Review of a Not Easily Identifiable Clinical Spectrum

Background: Wolfram syndrome (WS) is a rare autosomal recessive disorder that is characterized by the presence of diabetes mellitus, optic atrophy and hearing loss, all of which are crucial elements for the diagnosis. WS is variably associated with diabetes insipidus, neurological disorders, urinary tract anomalies, endocrine dysfunctions and many other systemic manifestations. Since Wolfram and Wagener first described WS in 1938, new phenotypic/genotypic variants of the syndrome have been observed and the clinical picture has been significantly enriched. To date, two main subtypes of WS that associated with two different mutations are known: WS type 1 (WS1), caused by the mutation of the wolframine gene (WS1; 606201), and WS type 2 (WS2), caused by the mutation of the CISD2 gene (WS2; 604928). Methods: A systematic review of the literature was describe the phenotypic characteristics of WS2 in order to highlight the key elements that differentiate it from the classic form. Conclusion: WS2 is the rarest and most recently identified subtype of WS; its clinical picture is partially overlapping with that of WS1, from which it traditionally differs by the absence of diabetes insipidus and the presence of greater bleeding tendency and peptic ulcers.

Necrolytic erythema migrans in celiac disease

Erythema migrans necrolytica is a red, blistering rash that spreads over the skin. It particularly affects the skin around the mouth and distal extremities, but can also be found on the lower abdomen, buttocks, perineum and groin. It is strongly associated with glucagonoma, a glucagon-producing tumor of the pancreas, but is also seen in a number of other conditions, including liver disease and intestinal malabsorption such as celiac disease. We present a case of a patient with a history of poorly followed celiac disease presenting with a clinical picture of ENM. This rare case adds to our understanding of the clinical presentation of NME, as well as highlights the importance of acting in a timely manner to avoid the most redoubtful complications.

The Cases of COVID-19 and Measles Co-Infection in Children

Relevance. The rapid spread of new pathogens inevitably leads to the occurrence of joint circulation with already known infectious agents, leading to the development of mixed infections. The simultaneous circulation of the pandemic coronavirus SARS-CoV-2 with a highly contagious measles virus leads to the development of mixed infections in people who have not been sick or vaccinated against measles. Aims. Review cases of co-infection with measles and COVID-19 in Moscow. Material and methods. A retrospective study of cases of measles and COVID-19 co-infection in three children with a description of the epidemiological and clinical picture of the disease. Results. In all observed children, the manifestation of the disease was typical for measles, the diagnosis of COVID-19 was established based on a laboratory study carried out in a hospital, which gave reason to count. That the infection with SARSCoV-2 occurred after the infection of children with measles. Conclusions. Different incubation periods can lead to several options for the development of co-infection. The similarity of clinical symptoms at the onset of the disease does not allow excluding a certain infection clinically, without laboratory verification.

Steroid glaucoma

Glucocorticosteroids are widely used in clinical and ophthalmic practice, but their unjustifi ed and uncontrollable use is unacceptable. Prescription of steroids has to be controlled strictly and the level of intraocular pressure must be diagnosed, because one of the signifi cant side eff ect of steroids is increased intraocular pressure level and, as a result, the development of glaucomatous optic neuropathy. This review deals with the pathogenesis of an increase in the level of intraocular pressure against various forms of glucocorticosteroids intake, describes the time and duration of their ocular-hypertensive eff ect. The available data on the features of the clinical picture of steroid glaucoma, depending on the routes of their entry, have been studied in detail. The tactics of treating patients with ocular hypertension or a proven case of steroid glaucoma are described.

CLINICAL AND MORPHOLOGICAL CHARACTERISTICS OF H. PYLORI-ASSOCIATED GASTRODUODENAL ZONE DISEASES: AGE-RELATED ASPECTS

The aim of the paper is to study the clinical and morphological characteristics of H. pylori-associated gastroduodenal zone diseases, depending on patients’ age. Materials and Methods. Three groups of patients of various ages with H. pylori-associated gastroduodenal zone diseases were formed in the course of a prospective clinical study. We studied the clinical picture, and morphological characteristics of the gastroduodenal zone before and after eradication therapy. Average length of the observation period was 172 days. All patients underwent esophagogastroduodenoscopy with biopsy. Results. Severe dyspeptic disorders were diagnosed in all young patients belonging to group 1 (100 %). The dyspeptic index corresponded to a high degree of severity. Morphological changes in the gastric mucosa were more significant in patients with a less pronounced clinical picture (Groups 2 and 3). In group 3, atrophic transformations of the gastric corpus were found in 30.5 %, atrophic transformations of the pylorus – in 11 %, and intestinal metaplasia – in 2.8 % of patients. Unlike young and middle-aged patients with pronounced dyspeptic syndrome, elderly patients were characterized by a low-symptom clinical picture, which was accompanied by morphological gastroduodenal zone transformations with the possible progression. Conclusions. Effective eradication therapy contributes to clinical, endoscopic and morphological remission of the gastroduodenal zone and prevents the progression of the inflammatory cascade. Key words: Helicobacter pylori, gastroduodenal diseases, eradication therapy, age characteristics. Цель исследования – изучить клинико-морфологические особенности H. рylori-ассоциированных заболеваний гастродуоденальной зоны в зависимости от возраста пациентов. Материалы и методы. В процессе проспективного клинического исследования были сформированы три группы пациентов разного возраста, имеющих H. pylori-ассоциированные заболевания гастродуоденальной зоны. Изучали клиническую картину, морфологические особенности гастродуоденальной зоны до и после эрадикационной терапии. Период наблюдения больных составил в среднем 172 дня. Всем пациентам выполнялась ззофагогастродуоденоскопия с биопсией. Результаты. У 100 % пациентов молодого возраста (I группа) установлены выраженные диспепсические расстройства. Диспепсический индекс соответствовал высокой степени тяжести. Для пациентов II и Ш групп при менее выраженной клинической картине морфологические изменения слизистой оболочки желудка оказались более существенны. В старшей группе (Ш группа) атрофические преобразования тела желудка выявлены у 30,5 % пациентов, привратника желудка – у 11 %, кишечная метаплазия – у 2,8 %. В отличие от пациентов молодого и среднего возраста, имеющих выраженный диспепсический синдром, для пациентов пожилого возраста характерна малосимптомная клиническая картина, которая сопровождалась морфологическими преобразованиями гастродуоденальной зоны с возможностью прогрессирования. Выводы. Эффективная эрадикационная терапия способствует достижению клинико-эндоскопической и морфологической ремиссии состояния гастродуоденальной зоны и создает условия для предотвращения прогрессирования воспалительного каскада. Ключевые слова: Helicobacter pylori, заболевания гастродуоденальной зоны, эрадикационная терапия, возрастные особенности.

Hirayama disease. Clinical cases

Hirayama disease, or monomelic amyotrophy, is a rare neurological pathology manifested by unilateral or bilateral asymmetric paresis with atrophy of the distal upper extremities. The development of this disease is associated with the forward displacement of the posterior dural sac during neck flexion, which leads to compression of the spinal cord and venous stasis. The diagnosis of monomelic amyotrophy is based on the clinical picture and the results of magnetic resonance imaging of the cervical spine with flexion, showing segmental atrophy of the anterior horns of the spinal cord at C7 — Th1, detachment of the posterior dura mater and venous stasis. Most of the cases described in the literature are from India and Japan, with isolated cases diagnosed in North America and Europe. This article presents two clinical cases of progressive hand weakness in young men. The clinical picture of the disease and the results of additional examination methods are presented, which is necessary to establish a diagnosis of Hirayama’s disease.

THE FEATURES OF THE CLINIC AND DIAGNOSIS OF INTRAUTERINE PNEUMONIA IN NEWBORNS (LITERATURE REVIEW)

This article focuses on the variety of clinical manifestations of intrauterine pneumonia in newborns, including premature infants. The clinical picture of early and late intrauterine pneumonia is presented. The features of the methods of examination of the respiratory organs, such as percussion and auscultation in newborns, are given. The article presents the material of the course of pneumonia which is based on etiological factors and manifested by specific clinical features. The main methods of diagnosis of intrauterine pneumonia such as instrumental and laboratory which is used in newborns are indicated

Symptomatic nucleus of homeopathic remedies: remedies derived from carbon as case-study.

Homeopathic clinical practice requires both accuracy and agility in diagnosis and prescription of treatment during real-time consultations. Several approaches have been attempted to facilitate this process including different criteria to group homeopathic remedies. This study sought to establish whether classification according to the chemical composition of substances used as basis of homeopathic remedies have correspondence in the experimental homeopathic materia medica. Methods: The homeopathic remedies derived from carbon were selected as case-study. The experimental symptoms of these remedies were compared and a nucleus of symptoms common to all could be found. This nucleus was then compared to similarly obtained nuclei of experimental symptoms of homeopathic remedies derived from sulfur and phosphor to test qualitative specificity and finally to the traditionally described clinical picture of the so-called homeopathic carbonic constitution to establish whether the latter has homeopathic experimental grounds. Results: a nucleus of experimental symptoms common to homeopathic remedies derived from carbon was found, qualitatively different from the symptomatic nuclei of homeopathic remedies derived from sulfur and phosphor; no correlation was found, however, with the clinical image of so-called carbonic constitution. Keywords: Homeopathy; Materia Medica; Remedies; Classes; Carbon.  Núcleo sintomático dos medicamentos homeopáticos derivados do Carbono Resumo A prática homeopática exige simultaneamente, rapidez e exatidão no diagnóstico e a prescrição do tratamento nas consultas, em tempo real. Para isso, diversas estratégias tem sido implementadas para facilitar tal processo, incluindo critérios para agrupar os medicamentos homeopáticos. Este estudo se propôs a verificar se classificações baseadas na composição química das substâncias utilizadas nos medicamentos homeopáticos tem correlação com a materia médica homeopática experimental. Métodos: Como estudo de caso, foram selecionados os medicamentos homeopáticos derivados de carbono. Os sintomas experimentais destes medicamentos foram comparados de maneira a definir um núcleo de síntomas comuns ao grupo. Este núcleo foi comparado aos outros núcleos correspondentes a sintomas experimentais de medicamentos homeopáticos derivados de Enxofre e Fósforo, com o propósito de determinar a especificidade qualitativa do núcleo carbônico em estudo. Finalmente, comparamos o núcleo proposto com o quadro tradicional atribuído àchamada constituição carbônica homeopática, com o objetivo de verificar se esta tem alguma fundamentação experimental. Resultados: foi encontrado um núcleo sintomático comum aos medicamentos derivados de carbono, qualitativamente diferente dos núcleos sintomáticos dos medicamentos derivados do Enxofre e Fósforo. No entanto, não foi encontrada correlação entre este núcleo e o quadro clínico do grupo chamado de constituição carbônica. Palavras-chave: Homeopatia; Materia Medica; Remédios; Classes; Carbono.  Nucleo sintomático de los medicamentos homeopaticos derivados de carbono Resumen La praxis homeopática exige simultáneamente rapidez y precisión en el diagnóstico y prescripción del tratamiento en consultas en tiempo real. Por eso, diversas estrategias han sido buscadas para facilitar este proceso, incluyendo criterios para agrupar los medicamentos homeopáticos. El presente estudio se propuso establecer si clasificaciones basadas en la composición química de las sustancias utilizadas como base de los medicamentos homeopáticos tienen correlación con la materia médica homeopática experimental. Métodos: como estudio de caso, fueron seleccionados los medicamentos homeopáticos derivados de carbono; los síntomas experimentales de estos medicamentos fueron comparado de manera a definir un núcleo de síntomas común al grupo; este núcleo fue comparado a los correspondientes a los síntomas experimentales de los medicamentos homeopáticos derivados de azufre y fósforo, con el propósito de determinar la especificidad cualitativa del núcleo carbónico propuesto; finalmente, el núcleo propuesto fue comparado con el cuadro tradicional atribuido a la así llamada constitución carbónica homeopática, con el propósito de establecer si ésta última tiene fundamentos experimentales. Resultados: fue encontrado efectivamente un núcleo sintomático común a los medicamentos homeopáticos derivados de carbono, cualitativamente diferente de los núcleos sintomáticos de los medicamentos homeopáticos derivados de azufre y fósforo; no fue detectada correlación entre este núcleo y el cuadro clínico de la así llamada constitución carbónica. Palabras-clave: Homeopatia; Materia Medica; Remédios; Classes; Carbono.  Correspondence author: Luciana Costa Lima Thomaz, [email protected] How to cite this article: Symptomatic nuclei of homeopathic remedies: remedies derived from carbon as case-study. Int J High Dilution Res. [online]. 2009 [cited YYYY Month dd]; 8 (26): 15-25. Available from: http://journal.giri-society.org/index.php/ijhdr/article/view/330/381. ÂÂÂ