Not every hypochromic anemia is an iron deficiency anemia. Case study

Case study of female patient with hypochromic anemia, who has been treated with iron preparations for iron deficiency anemia for a long time, is reported. A hemoglobin electrophoresis test has been performed due to treatment failure, and β-thalassemia (thalassemia minor) has been diagnosed. The data on β-thalassemia and approaches to differential diagnosis of hypochromic anemias are summarized.

Risk management of micro- and macrovascular complications of diabetes mellitus: the importance of glycemic self-control

As the incidence of obesity, unhealthy lifestyles and an aging population increases, the global prevalence of diabetes mellitus (DM) is projected to rise sharply in the coming decades. A significant part of the burden of DM is associated with the development of micro- and macrovascular complications, which are the cause of a deterioration in the quality of life, disability and premature death of patients with DM. Cardiovascular disease (CVD) is the leading cause of death in patients with DM, especially those with type 2 DM The risk of CVD in people with DM is 2–4 times higher than in people without DM, and this risk increases with the deterioration of glycemic control. Disorders of the glycemic profile such as hyperglycemia, hypoglycemia and high variability of glycemia negatively affect the prognosis of patients with DM. Self-monitoring of blood glucose is an effective tool for managing DM, which allows not only achieving the target level of glycated hemoglobin and minimizing glycemic variability, but predicting the risk of severe hypoglycemia.

A clinical case of diagnosis and endoscopic removal of a rare Vanek tumor (inflammatory fibrous polyp) of the antrum of the stomach

Inflammatory fibrous polyp is a rare benign lesion arising from the submucosa of the gastrointestinal tract. It usually manifests itself as an isolated benign lesion, most often located in the stomach. Its origin is debatable. The clinical picture varies depending on its location; the most common symptoms are pain, vomiting, heaviness in the epigastrium (localization in the stomach), invagination and obstruction (localization in the small intestine). This article discusses a clinical case of endoscopic removal of an inflammatory fibrous polyp of the antrum of the stomach. The final diagnosis of inflammatory fibrous polyp was established by histological examination.

Topical issues of differential diagnosis and treatment of cough during the pandemic

A cough is observed by medical practitioners of various specialties, and is among the most common symptoms of the broad range of disorders. The cause of coughing remains unclear in more than half of adults, who visit physicians with complaints of respiratory symptoms. The paper reports the principles of the cough differential diagnosis and treatment in patients with respiratory disorders, including during the pandemic; the cough features, characteristic of pulmonary fibrosis and COVID-19, are discussed. The clinical case of the 47-year-old patient, illustrating the need to use CT not only at onset, during the acute period of the disease, but also during the recovery period in patients with a lingering cough, is discussed as an example of the cough differential diagnosis.

Syndrome of increased epithelial permeability, non-alcoholic fatty liver disease and cardiovascular diseases: what is the association and what can be done about it?

Syndrome of increased epithelial permeability occurs due to a decrease in the barrier function of the gastrointestinal mucosa due to impaired intercellular interactions, resulting in bacterial translocation (i. e. penetration of bacteria and toxins from the gastrointestinal lumen into the bloodstream), which can initiate an inflammatory process in various diseases. Syndrome of increased epithelial permeability plays an important role in the pathogenesis of many chronic diseases, including cardiovascular and non-alcoholic fatty liver disease (NAFLD). In turn, the presence of NAFLD is associated with an increase in cardiovascular morbidity and mortality. The use of ursodeoxycholic acid in NAFLD allows reducing both hepatological and cardiovascular risks. Gastro- and enteroprotector rebamipide not only eliminates increased epithelial permeability and acts at all three levels of protection of the mucosepithelial barrier, but also has multiple pleiotropic effects, which opens up wide prospects for its use in cardiovascular diseases and NAFLD. The hepatoprotective and anti-sclerotic effects of rebamipide identified in experimental studies need further study in clinical trials in NAFLD patients.

Vestibular disorders in elderly people (conference proceedings)

The causes and clinical manifestations of vestibulopathies in elderly people are extremely diverse. The experts of CON-MED.RU, the professional information resource for healthcare specialists, the expert on gerontology Elen A. Mkhitaryan (PhD, head of the laboratory of neurogeriatrics and cognitive impairment under the Science section, Pirogov Russian National Research Medical University, Russian Clinical and Research Center of Gerontology), and one of the most recognized Russian neurologists, the expert on vertigo Maxim V. Zamergrad (D. Sci. (Med.), professor at the Department of Neurology with the course of reflexology and manual therapy, Russian Medical Academy of Continuous Professional Education), clarified this issue, which was difficult for clinicians.

Oral candidiasis as a consequence of the systemic disease or its drug therapy

The emergence, development and treatment of systemic diseases could go along with activation of saprophytic fungal flora, including in the oral mucosa. In such cases, the patients complain of discomfort and soreness in response to irritants. Local treatment is used for mild forms. Generalized candidiasis requires prescribing systemic therapy, which is provided by the general practitioner (primary care physician). The dentist provides topical treatment.

Morphological substrate and clinical manifestations of neurosurgical conditions

Frequent dissociations between morphological substrate and clinical manifestations of the disorder were analyzed. Noninvasive neuroimaging techniques created the opportunity for the life-time verification of incidental findings, which resulted in development of the new area, preventive neurosurgery. Systematization, diagnosis, and criteria for the surgical treatment of incidental findings in neurosurgery are reported. It had been emphasized that while the brain and spinal cord disorder recognition during the preclinical period can only be accomplished based on imaging data, the decision on the management and treatment strategy in apparently healthy individuals has to be clinical-philosophical, and has to be made in view of the subsequent quality of life.

Who are you, Doctor Bianchon? On Honoré de Balzac's illness and death

The paper explores clinical manifestations and the course of the disease in Honoré Balzac, the famous French writer. Interpretation of possible causes and the disease treatment is analyzed. The various diagnostic hypotheses, the cause of Balzac's death, and the treatment methods for his disorder, used in the 19th century French medicine, are discussed. The analysis of Balzac's medical history makes it possible to reconstitute the clinical features in terms of modern medicine. Particular attention is paid to the Balzac's attitude to the doctors, represented within the covers of his books, dowered with many valuable human qualities.