Pulmonary actinomycosis: cytomorphological features

Pulmonary actinomycosis is an uncommon infectious disease. Although the gold standard for diagnosis is histological examination with bacterial culture of lung tissue, cytology samples offer a fast and low-cost alternate diagnostic procedure. The cytology literature on this topic is limited to mostly case reports. Therefore, the aim of this study was to review cytological material in a series of patients with a diagnosis of pulmonary actinomycosis to characterize the main cytomorphological findings. Different cytological respiratory samples including sputum smears, bronchoalveolar lavages (BALs), transthoracic or endobronchial fine needle aspiration cytology (FNAC) and cell block preparations were used for retrospective examination. For all cases patient age, gender, symptoms, and radiological chest findings were recorded. A total of 26 cytological respiratory samples (14 sputum smears, 9 FNAC, two BALs) including direct smears and 6 cell blocks from 9 patients were examined. In sputum smears the most remarkable findings were the presence of dark cotton ball masses with projections like spider legs and/or mouse tails (75% of the samples). Sulfur granules were observed in 4 (40%) of the sputum smears and within FNAC cases. Various respiratory cytology samples including sputum smears, FNAC and BALs can reveal cytomorphological findings diagnostic of pulmonary actinomycosis. Characteristic cytological findings compatible with a diagnosis of this infection include cotton ball masses and less frequently sulfur granules.

Possibilities of modern methods of laboratory diagnostics in the study of viral hepatitis A.

It is generally accepted that the course of viral hepatitis A is accompanied by short-term viremia, and the disease itself does not have serious consequences for the person who has recovered. The article describes a clinical case of a protracted course of viral hepatitis A with long-term persistence of the virus. Against the background of the therapy, the patient's condition improved, and by the time of discharge from the hospital on the 38th day of illness and later, with a retrospective examination on the 68th day from the onset of the disease by the method of reverse transcription PCR (RT-PCR in real time), the presence of RNA of the hepatitis A virus was confirmed in feces, which indicated a long persistence of the virus in the body. This observation indicates the need for long-term dispensary observation of patients who have undergone viral hepatitis A.

A Retrospective Examination of Home PCA Use and Parental Satisfaction With Pediatric Palliative Care Patients

Introduction: Home Patient-Controlled Analgesia (PCA) is an effective and often preferred therapy for the treatment of chronic pain symptoms in the pediatric palliative care patient. There is little previous research of patient experience with Home PCA. The purpose of this study was to investigate use of home PCA devices in pediatric patients to inform palliative care providers considering an alternative management option for the treatment of end-of-life or chronic pain. Methods: A chart review was performed of patients prescribed home PCA. Surveys were sent to patients’ guardians/caregivers. Questions referred to caregiver impression/satisfaction with information provided regarding use of the PCA machine, the medication used, the benefits and risks of PCA, monitoring of patient pain level and alertness, machine efficacy, and fears and concerns. Results: Thirty-four patients met inclusion criteria, and 18 patient families completed surveys. Demographic data showed that the majority were Caucasian and had a cancer diagnosis. Patient age and duration of home PCA use varied greatly. Overall, participants were satisfied with information received and felt positively about home PCA, albeit expressing concerns. The majority described the machine as easy to use and were satisfied with their child’s pain management and level of alertness. Conclusion: Responses indicated that home PCA is a manageable and effective alternative to traditional analgesic medications for management of chronic pain in the pediatric patient.

Diagnostic conundrum: an elusive bleeding source in patient with recurrent gastrointestinal bleeding

Over a 6-month period, a 69-year-old woman presented with recurrent symptomatic anaemia, melaena and haematochezia. Extensive investigations were carried out, including CT of the abdomen and pelvis, oesophagogastroduodenoscopy, colonoscopy, two capsule endoscopies and two CT angiograms. The lack of active bleeding at the time of both CT angiograms meant a diagnosis was only made following retrospective examination of images by interventional radiology once fresh ampullary bleeding was identified on capsule endoscopy. The unifying diagnosis was haemosuccus pancreaticus given the combination of the left gastric artery pseudoaneurysm, fresh bleeding identified from ampulla and the patient’s history of chronic alcohol-related pancreatitis. Subsequent coil embolisation was performed to an optimal result with no recurrence of symptoms to date.

Neglected intrauterine bilateral congenital knee dislocation

Bilateral congenital knee dislocation is a rare deformity which may present with other musculoskeletal abnormalities. In the early period, conservative treatment options have a high chance of success. However, in later stages, surgical treatment is indicated in neglected or unresponsive cases to manipulation in the early period. Herein, we present a rare case of bilateral congenital knee dislocation which was diagnosed after birth. Retrospective examination revealed that it occurred in the antenatal period and neglected.

Is punk not dead?: retrospective analysis of the Russian subcultures

The object of this research is the punk subcultures, while the subject is the genesis of punk subcultures. The goal lies in retrospective analysis of punk subcultures for compiling an objective image of subcultural space and advancing the hypotheses for further development of the spiritual and material elements of subcultures. Methodological framework consists of the genesis of punk culture, taking into account the currently observed changes observed today over time to the period of its emergence in the cultural space. Retrospective analysis allows determining all changes in the qualitative and quantitative state for certain time periods, particularly since the origin of subcultures in the second half of the XX century until the preset for tracing the dynamics of the development of subcultures. The article carries out a retrospective examination of the genesis of punk subcultures in Russia; compares the ideas advanced by the subcultures with the achieved results. The use of reliable sociological methods in the modern conditions when subcultures mostly exists in the Internet streams, and restrictive measures due to the outbreak of coronavirus pandemic, seems extremely difficult and even impossible. The article describes the gradual commercialization of the counter- and sub- cultures in the early XX century, their partial integration into popular culture by the producers and managers, departure from the anarchic philosophical tradition, and withering away of nihilistic tends. The consideration of experience allows optimizing the sociocultural processes and managing the risks of sociocultural development in the future.