Clinical case of papulo-pustular rosacea

The article presents a clinical case of papulopustular rosacea from our own practice. First of all, the patient's anamnesis is extremely interesting: family history (his brother has episodes of reddening of the face), the onset of rosacea against the background of a stressful situation, the presence of gastric diseases, the connection with nutritional factors. One of the first mentions of rosacea belongs to Avicenna, who in his writings described the clinical picture of rhinophyma ("badschenan", later renamed "abedsamen"). The pineal nose, dotted with "serpentine" vessels, has traditionally been associated with excessive drinking. Currently, the role of alcohol as an etiological factor is not paramount, but its aggravating effect has been proven. Despite the typical picture of rosacea, our patient has been receiving therapy for seborrheic dermatitis and other diseases several times over the course of several years. Probably, the specialists had doubts about the possible diagnosis of rosacea in a male patient under the age of 30.

A case of chronic progressive chorea

Patient T., whom I have the honor to present to the Society, suffers from the form of the disease that, according to a typical picture, can be defined as chorea chronica progressiva. The first to emerge from chronic progressive chorea as a separate nosological unit was the American neuropathologist Huntington, in honor of whom chronic chorea was called Huntingtons chorea for a long time, in contrast to chorea minor, first described by Sydenham; the latter is a more common form of Witta's dog and carries on itself all the signs of an acute infectious disease.

CT patterns in the differential diagnosis of the etiology of liver abscesses

Invasive fungal infections (IFIs) have become the leading cause of morbidity and mortality in oncohematological patients and hematopoietic stem-cell transplant recipients (HSCT). But at the same time, fungal infections are less than 2 % of the causes of liver abscesses in patients without onco-hematological diseases. Doctors from hospitals with onco-hematology departments encounter this more often and know the typical picture of fungal liver abscesses, but for others doctors, who do not have sufficient experience, this finding may not seem like something familiar. This is why knowing the typical patterns of fungal liver disease is so important. We have studied the typical patterns of abscesses in patients with hematological oncology and present a clinical case of patient D, 48 years old. Differential diagnosis of the etiological agent of the abscess is difficult, but in some cases the picture is specific: in the described case, the multiplicity and small size of the foci made it possible at an early stage to effectively identify the fungal nature of the disease and begin the right treatment.

Ukrainian Nationalists in Omsk: Prosecuted and Vindicated

The article reviews actions of Omsk Region Office of Ministry of State Security (MSS) towards politically active Ukrainian nationalists among deportees from the Dragobychsky region of Western Ukraine and assesses their vindication in the Russian Federation. This study is based on archival documents from legal prosecutions of Ukrainian deportees stored in the Records Office of Omsk Region of Federal Security Service and recently opened for scholarly review, as well as exhibits from the History section of the Omsk Office of the FSB. Legal prosecutions documents were analysed using a prosopographic method to reconstruct a typical picture of young Ukrainian deportees who continued to believe in the values of Ukrainian nationalism and kept connections with the Organization of Ukrainian Nationalists (OUN)/Ukrainian Insurgent Army (UPA). All prosecuted Ukrainians were driven to nationalism by conditions of their upbringing. The young men were deportees from Western Ukraine and of peasant origin. The OUN/UPA were widely supported by the rural population in this region. They were deported to Siberia as family members of UPA militias fighting against the Soviet army. Having nationalist views, all prosecuted young men sincerely supported the creation of an independent Ukrainian state and did not accept Soviet authority that did not allow this creation, and so they were deported from their homeland. Omsk MSS agents, together with their Ukrainian colleagues, identified young radical nationalists. Some of those were active members of underground militant groups and during World War II carried out intelligence requests for OUN/UPA and provided information for its members. The author concludes that the nationalistic activities of these Ukrainian youth were are a real threat to security of the Soviet state and as such the fact of their vindication in the Russian Federation is not well-grounded from historical point of view.

Pituitary Apoplexy, an Endocrinological Emergency: Case Report

Pituitary apoplexy is a rare endocrine emergency that can occur due to bleeding or ischemia in the pituitary gland. Its incidence can vary between 0.6% and 16.8% in the general population (2-7% in pituitary adenomas). We herein report an unusual case of a 50-year-old female patient who presented to the emergency with complaints of left hemicranial headache, cervicalgia, shoulder pain and dizziness for 1 year worsened in the last three days. Her prolactin levels were high, and the first imaging exam suggested a silent apoplexy, since the clinical picture of the patient did not indicate such condition. In the second one, the patient presented a typical picture of apoplexy, including intense headache and nausea. Her temporal evolution suggested a macroprolactinoma with hemorrhagic degeneration or apoplexy. As she did not present signs of indication for transsphenoidal emergency surgery, conservative treatment was chosen. In this case, due to history of repeated apoplexy, nausea and intense headache, it is important to keep close monitoring for an eventual urgent surgical intervention in case of new bleeding, visual alterations and/or reduced level of consciousness, since these are indicative signs for transsphenoidal emergency surgery.

ROGUE WAVE ASYMMETRY IN THE DIRECT NUMERICAL SIMULATIONS OF DIRECTIONAL JONSWAP WAVES

The asymmetry between the troughs from the rear and front sides of rogue waves is the particular object of the present study. In our previous simulations of unidirectional waves the typical picture of a rogue waves possesses the trend that most of the rogue waves where characterized by deeper rear troughs. In the present work we broaden the discussion of the rogue wave front-to-crest asymmetry to the directional case. The direct numerical simulation of primitive water equations is an affordable alternative to the in-situ or laboratory measurements, in particularly when the interest is focused on the long-term evolution or on the detailed consideration of the water wave movement in space and time. In this work we simulate irregular surface waves in the hydrodynamic equations using the High-Order Spectral Method, and focus on the so-called rogue waves.Recorded Presentation from the vICCE (YouTube Link): https://youtu.be/plseXdjpE6c

SARS-Cov-2 Infection (COVID-19) Revealed by Persistent Hiccups: Case Report

Hiccups are a ventilatory mechanism involuntarily involving the inspiratory muscles and the glottis, Its physiological interest has not been demonstrated until today. Acute or chronic hiccups have a wide variety of etiologies. We report the case of a 50-year-old patient with a history of iterative sinusitis, who consulted a gastroenterologist for persistent hiccups. The patient's clinical examination was normal. Chest x-ray showing an abnormal mediastinal image leads to a chest CT scan showing a typical picture of COVID-19 virus infection: bilateral and peripheral frosted glass opacities. A nasal swab RT-PCR test confirmed the diagnosis. Admitted to an isolation unit, the patient received treatment with clinical and biological monitoring. The hiccups disappeared around the 3rd day of hospitalization, the negativation of the RT-PCR occurring after 14 days with a favorable evolution of the symptoms. To our knowledge, this is the 2nd global case of persistent hiccups that has revealed infection with the COVID-19 virus.

Intracranial Intradural Vascular Injury during Endoscopic Endonasal Transsphenoidal Surgery: A Case Report and Literature Review

Background Transsphenoidal surgery (TSS) is a procedure for sellar or midline masses in the skull base. Among the reported complications are iatrogenic vascular injuries; that are rare, yet they carry devastating outcomes, with an incidence of injury between 0.34 and 2.6%. The cavernous internal carotid artery is the most commonly injured. However, intradural arterial injuries are much less reported with challenging management. We report a rare incident of intradural arterial injury during TSS, and we compared our management to the summarized few cases reported in the literature Case Report We report a 43-year-old female who had a recurrent planum sphenoidal meningioma. She underwent trans-nasal transsphenoidal endoscopic resection that was complicated with intraoperative bleeding due to an injury to the anterior communicating artery that was challenging to control, resulted in a bilateral loss of flow in A1 segments of anterior cerebral artery and required endovascular management. The patient had a good recovery postoperatively without the typical picture of ACA syndrome. Conclusion Intradural arterial injury is exceedingly rare in TSS, with no clear standard of care for the management. Collateral blood supply allows definitive management with minimal morbidity. Identifying the risk factors beforehand, as well as performing such cases in a well-resourced center, are crucial elements of safety.

COVID-19 Infection Leading to Lethal Spondylodiscitis with Spinal Abscess

Background and Importance: Secondary complications after SARS-CoV-2 virus infection including cardiovascular and neurological pose additional morbidity and mortality. The data on spondylodiscitis with spinal abscess after COVID-19 infection is very limited. Case Presentation: A 71-year-old man presented with tachypnea and cough since 24 hours before admission. He was febrile and his chest CT showed typical picture of bilateral covid-19 pneumonia. Nasopharyngeal swabs showed a positive PCR for COVID-19. The patient was admitted to the intensive care unit (ICU) due to low oxygen saturation. Forty-eight hours after admission, the patient started to develop paraparesis which rapidly progressed to paraplegia within a few hours. In MRI scan, multilevel spondylodiscitis and epidural abscess in the thoracic spine were observed. Urgent surgery was performed and the patient was treated medically with hydroxychloroquine and Favipiravir for COVID-19. Calculated antibiotic treatment with meropenem and vancomycin. No COVID-19 was detected in the abscess samples. The patient passed away later due to multiorgan failure. Conclusion: Spondylodiscitis with spinal abscess secondary to COVID-19 infection is a severe condition and might be a consequence of dysbalanced immune response with immunodepression after COVID-19 infection.

COVID-19 pandemic: An intensivist’s perspective

We present a case of COVID-19 patient, who had multiple comorbidities, including diabetes mellitus, bronchial asthma, morbid obesity (BMI:48) and obstructive sleep apnea. She had good compliance with CPAP treatment. After a vacation, she developed typical symptoms of COVID-19, including fever, cough with blood tinged sputum and shortness of breath. She had to be treated with polypharmacy for all of her concurrent diseases. Her hypoxia responded well to oxygen therapy. Laboratory reports and chest x-rays presented a typical picture of COVID-19, including lymphopenia and lung infiltrates. Patient received inj. ceftriaxone, inj. azithromycin and hydroxychloroquine, to which her response was quite satisfactory and after two weeks, she was discharged and shifted to home.