Peculiarities of radiological and laboratory values in patients with community-acquired pneumonia during COVID-19 pandemic

Literature and personal data on community-acquired pneumonia during the epidemic of a new coronavirus infection COVID-19 are presented. It was found that men and patients with moderately to severe form were treated for community-acquired pneumonia more often. The most common localizations were as follows (in descending frequency): bilateral multisegmental, right-sided lower lobe, left-sided lower lobe. Men as compared to women more often had the following localization of pneumonia: right-sided lower lobe pneumonia at the age of 20–30, 51–60; right-sided multisegmental in all age groups; left-sided lower lobe pneumonia at the age of 51–60, left-sided upper lobe pneumonia at the age of 20–50; left-sided multisegmental pneumonia in all age groups; slightly more frequent bilateral lower lobe pneumonia in different age groups; bilateral multisegmental pneumonia at the age of 20–30 and over 60. Conversely, the most common localization in women was as follows: right-sided lower lobe pneumonia at the age 31–50, right-sided upper lobe pneumonia at the age 20–30, left-sided lower lobe pneumonia at the age 20–50 and over 60, left-sided upper lobe pneumonia at the age over 60, bilateral lower lobe pneumonia at the age 31–40, bilateral multisegmental pneumonia at the age 41–60. Right-sided lower lobe pneumonia was equally often registered irrespective of gender in persons older than 60 years old. Right-sided upper lobe pneumonia was not registered in patients aged 31–40 and 41–50 years, and over 60 years old. The most frequent localization of pneumonia in mild form was left-sided lower lobe (35.3 %), right-si­ded lower lobe (20.6 %), and bilateral lower lobe (14.7 %). The least frequent were upper lobe localization of pneumonia in the right, left, and both lungs (2.94 % each), and left multisegmental pneumonia was not observed at all. The most frequent localization of pneumonia in the moderate form was the lower lobes of the right lung (29.4 %), left lung (18.3 %), and multisegmental in both lungs (28.8 %). It was least frequently registered in the upper lobe of the right lung (2.6 %), left lung (3.9 %) but was not registered in the upper lobes of both lungs. The most frequent localization of pneumonia in severe form was bilateral multisegmental (37.5 %). Right-sided multisegmental, left-sided lower lung and bilateral lower lung were the least common — 12.5 % for each. Subfebrile fever was registered more frequently in almost all localizations. More often normal or subfebrile temperature was registered in all localizations, except for right-sided upper lobe pneumonia, in which higher (febrile, pyretic) temperature was registered more often. In all localizations within three days after hospitalization most patients had normal leukocyte count, leukopenia was slightly more frequent in left-sided lower lobe pneumonia, leukocytosis — in the bilateral upper lobe, bilateral lower lobe, and right-sided upper lobe. In general, leukocytosis in community-acquired pneumonia was registered in 38.8 % of patients. In the first three days after hospitalization, a normal amount of lymphocytes was registered in the majority of patients, lymphopenia was observed in one-third of patients with right-sided upper and left-sided lower lobe localization.

MALT Stomach Lymphomas: Aspects of Diagnosis and Treatment

Marginal zone lymphoma (LMZ) accounts for 5–15% of all NHL in Europe. This option includes splenic (0.7%), nodal (2.4%) and extranodal (MALT-Mucosa-Associated Limphoid-Tissue) LMZ −5%. Extranodal variants of MALT lymphomas can occur in any organ due to chronic antigenic stimulation. The most frequent localization associated with Helicobacter pylori (HP) infection is the stomach - 30%. The gastrobiopsy material of 115 patients with lymphoid cell infiltrates in the gastric mucosa was studied, a complex of morphological diagnostic criteria for MALT gastric lymphoma for gastrobiopsy was developed based on a combination of histological and immunohistochemical characteristics of tumor cells, the nature of their growth. It is known that the mandatory initial therapy for local stages of HP-positive MALT lymphoma of the stomach is the eradication of HP. 68 patients with stages I – II of gastric MALT lymphomas were observed. Anti HP therapy resulted in 87.8% of complete remissions, with a median duration of 51 months. The median time to the onset of HP- eradication was 3 months, and the median time to the implementation of the antitumor process was 5.5 months. With a median follow-up of 58 months, the median overall and relapse-free survival was not achieved: 10-year OS - 100%, 10-year RFS - 92. 3%.

Characteristics of bodily injuries of the pelvic girdle and lower extremities in car trauma

Background. Fractures of the pelvic girdle and lower extremities as a result of a road traffic accident are the most frequent localization of injuries in victims, however, the structure of pedestrian and intra-salon injuries has not been sufficiently studied. Objective - to study the nature of injuries in victims of a car injury to the pelvic girdle and lower extremities. Methods. Research material - 170 acts of primary forensic medical examinations of victims with fractures of the pelvic bones and long bones of the lower extremities, received as a result of a non-lethal automobile injury. An expert assessment of the nature of bodily injuries was carried out at the Kharkiv Regional Bureau of Forensic Medicine (KRBSFM) within a period of no more than 1 month after injury. Acts of primary forensic medical examinations were selected at random for the period February - June 2018. Research methods - retrospective analysis, descriptive statistics. Results. Among the injured as a result of a car injury - 129 (75.9%) pedestrians, 23 (13.5%) drivers, 14 (8.2%) front seat passengers and 4 (2.4%) rear seat passengers. Thus, pedestrians and car drivers are the most vulnerable to road traffic injuries; the most protected rear seat passengers. Men predominated among the drivers; in the remaining groups of victims, the gender distribution was generally even. Among the participants in the accident were mainly people of working age. Injuries to the chest (26.5%), head (25.9%), abdomen (16.5%) prevailed among the associated injuries. Conclusion. A distinctive feature of injuries sustained as a result of a collision of a pedestrian or a car with another car with a relatively low speed of movement was an isolated injury to the bones of the pelvic girdle or lower extremities, both during pedestrian and intra-salon trauma. All the victims had injuries of the integumentary system of various localization in the form of subcutaneous hematomas and abrasions (158; 92.9%), bruised lacerations (96; 56.5%), stamp injuries (62; 36.5%). The main mechanism of pedestrian injury is the direct impact of the traumatic force with the formation of primary injuries in the form of bumper fractures of the shin bones (35.9%), hip (22.4%) and pelvis (10%).

Clinical and Pathological Significance of Cellular Atypia in Endometriosis

Objective: To highlight the most frequent localization of ovarian endometriosis, the presence of atypical endometriosis, and recurrences. Retrospective review of 259 patients diagnosed with ovarian endometriosis treated at Tîrgu-Mures Emergency County Hospital, Obstetric Gynecology Clinic, between January 2014 and December 2018. Methods: Data were collected and analyzed for demographics, size of ovarian endometriotic cyst, and recurrences. Results: Out of 259 patients, 51 patients presented atypia, 20 on the right, 24 on the left, and seven patients were diagnosed with endometriosis with bilateral atypia. Higher susceptibility for left localization was noted. Thirty-nine patients (15.1%) presented recurrence. A statistically significant correlation (p = 0.006) was noted between patients with recurrence and atypia compared with those without atypia and endometriotic cysts larger than 7 cm. Patients with relapse under the age of 40 were noted to have mainly atypia with localization on the right (p = 0.025, OD = 4.107). Conclusion: The presence of endometrioma was not statistically significant correlated with left or right sided localization; recurrent endometriomas larger than 7 cm represents a risk for atypical endometriosis development. Recurrence and atypia appear more often in patients under the age of 40 and are right-sided. The total removal of the endometriomas can prevent the recurrence and subsequently the appearance of atypia and secondary neoplastic conditions.

Giant dermoid cyst of the brain: a clinical case and literature review

The study objective to present a clinical case of patient with a giant brain dermoid cyst, as well as to analyze the literature data about this problem. Clinical case. The patient, 48 years old, with a giant dermoid cyst, complaints of headache, oculomotor disorders, underwent total microsurgical excision. In the long-term period after surgery, a complete resolution of neurological disorders was achieved, with a control MRI after 9 months, no recurrence of the disease was detected. Literature analysis. The analysis of the literature data was published during the thirty years from 1977 to 2017 revealed descriptions of intracranial dermoid cysts in 69 patients, determined the most frequent localization of cysts, the clinical status of the disease, outcomes of surgical treatment and prognosis of the disease. Results. The work demonstrates the results of surgical treatment of a dermoid cyst of the brain and a systematic analysis of the scientific medical literature data on this disease.

Incidence of Horner syndrome associated with neuroblastic disease

Purpose Horner syndrome (HS) manifests in unilateral ptosis, miosis, enophthalmos, and anhedonia. It is most commonly caused by trauma or surgical procedures, but can also occur in pediatric patients as a result of tumors, especially neuroblastoma (NBL). The objective of this study was to analyze the incidence of HS in patients diagnosed with NBL. Methods A retrospective analysis of data collected at the Department of Pediatric Oncology, Hematology, and Transplantology from 2004 to 2019 was performed. The study group included 119 patients younger than 18 years old, with 62 girls and 57 boys. All of them were diagnosed with a neuroblastic tumor. Results Among the 119 patients, eight children (6.72%) were diagnosed with HS associated with NBL. Three of these patients presented to the clinic with HS, whereas HS developed after the surgical procedure to remove the tumor in four patients. The adrenal gland was the most frequent localization of the tumor. However, HS occurred more frequently in patients with mediastinum tumors. As a presenting symptom, HS occurred in 2 of 11 cases (18.18%) with mediastinum localization. All of the patients with HS were younger than 2 years old. Conclusion Investigation of the cause of isolated HS is crucial because it can be the first symptom of NBL. However, the surgical procedure itself increases the risk of HS as a complication of NBL treatment.

Masa a nivel de íleon distal

GIST is the most common mesenchymal tumour in the digestive tract. One of the most frequent localization is at the small bowel (30%), and one of its unusual forms of presentation is as a bowel obstruction. The purpose of this article is to report a case of bowel obstruction secondary to a GIST and the adopted conduct.

MONO- AND BISEGMENTAL COMMUNITY-ACQUIRED PNEUMONIA IN YOUNG MEN (TOPICAL AND CLINICAL ASPECTS)

Localization of community-acquired pneumonia (CAP) is its independent clinical sign which has not received proper coverage in the medical literature. The aim of the study is to compare the topical and clinical characteristics of unilateral lobar and segmental CAP in young men. Materials and methods: topical and clinical features of lobar, bi- and monosegmental CAP were studied in 6332 young military men. It was found out that monosegmental CAPs (mCAP) are more variable in their clinical and laboratory manifestations than their bisegamental and lobar variants not identified at the segmental level. The frequency of occurrence of mCAP of a specific localization directly correlates with the frequency of sputum expectoration, the severity of systemic and local neutrophilic inflammation. The 5th and 10th segments of both lungs are the zones of the most frequent localization of mCAP associated with a relatively high severity of systemic neutrophil reaction, and the 6th and 8th segments are the zones of a relatively longer course of mCAP and the predominance of signs of local inflammation. In bisegmental CAP, there is a general trend of a more pronounced systemic inflammatory response to the criterion of blood neutrophils level than in mCAP. The revealed regularities can contribute to a more accurate prediction of the mCAP course in the population of young men.

THE CLINICAL CASE OF THE SURGICAL TREATMENT OF CYSTIC LYMPHANGIOMA OF THE COMPLEX ANATOMICAL LOCALIZATION IN CHILD AGED OF 1 YEAR 7 MONTHS

Lymphangiomas are non-specific formations developing from the lymphatic vessels, occupying an intermediate position between the tumor and the developmental malformation. The most frequent localization of the pathology is the face and neck area (75%) and the axillary region (20%), less than 1% of cases are located in the mediastinum. According to the literature data, the only radical treatment is surgical, but there is a high prevalence rate of relapses (25%). This article is devoted to the analysis of the clinical case of the treatment of lymphangioma of the complex anatomical localization, reflecting the complexity of the diagnosis and radical relapse-free treatment of this pathology.