Anamnesis Of Life Research Articles

Features of fibromyalgia in patients with rheumatoid arthritis

To determine the features of fibromyalgia (FM) in patients with rheumatoid arthritis (RA). Seventy-six patients participated in the study. The patients were divided into 2 groups: RA+FM (n=55), FM (n=21). Anamnesis of life and disease was carefully collected in all patients. The intensity (according to VAS) and phenotype (Pain DETECT, DN4) of pain syndrome (PS), the presence of symptoms of central sensitization (CSI), fatigue (FSS), signs of anxiety and depression (HADS), sleep quality (PSQI), cognitive functions (DSST) and quality of life (QoL) (EQ-5D, FIQR) were also evaluated. The average age of patients in the FM group was significantly lower (42 [35; 53] vs. 50 [42.5; 59], p=0.042). Patients with «pure» FM without RA were more often divorced and had no children (p=0.045 and p=0.02, respectively). The duration of PS in the groups did not differ (11 [7; 17] vs. 8 [5; 13] years, p=0.429), however, patients with «pure» FM waited longer for diagnosis (115 [40; 198] vs. 20 [5.5; 59] months, p<0.001), and they also were less likely to be recognized as disabled (p=0.003). Patients of both groups had equally severe fatigue, anxiety, depression, sleep disorders and cognitive functions compared to the norms. Patients of the FM group noted a lower QoL (according to EQ-5D, p=0.041) then in RA+FM group, despite the comparable severity of FM and the intensity of the PS in both groups. FM in patients with RA develops at a later age compared to «pure» FM. The clinical picture of FM with and without RA does not differ in the main manifestations, however, the QoL of patients with «pure» FM is lower. Accounting for fibromyalgia in the treatment of rheumatoid diseases can significantly improve the QoL of patients.

A clinical case of drug-induced arterial hypertension caused by glycyrrhizic acid

Background: In clinical practice, drug-induced arterial hypertension (AH) often remains undiagnosed, since the identification of an ethical disease in this form of AH avoids the initiation of antihypertensive therapy. A critical part in the differential diagnosis of hypertension and planning of long-term strategies for managing a patient requires a thorough study of the properties of the drugs taken and the pathophysiological mechanisms that depend on the increase in high blood pressure against the background of taking one or another substance. Clinical case description: Assumption of pregnancy in a random 57-year-old Caucasian female patient with AH syndrome and history of AD crisis during the year. Against the background of two-component antihypertensive therapy, indapamide 2.5 mg + telmisartan 80 mg, increased blood pressure. From the anamnesis of life, it is noteworthy that the patient should keep records with a hepatologist; with a diagnosis of chronic viral hepatitis C with moderate activity, she takes Phosphogliv. Physical examination confirmed the presence of grade 2 hypertension; no signs of target organ detection were found. Laboratory and instrumental research showed cytolytic syndrome of minimal activity (AST, 74.8 U/l; ALT, 60.5 U/l), hypokalemia (K+ 2.1 mmol/l), unknown etiology, aldosterone within the normal range, metanephrine (80.4 pg/ml at a rate of 64 pg/ml), and normetanephrine (276 pg/ml at a rate of 176 pg/ml) in blood plasma are increased. MSCT of the kidneys and adrenal glands revealed no enlarged formations. Drug-induced arterial hypertension was clinically diagnosed. Concomitant diseases: Chronic viral hepatitis C, moderate activity. Varicose veins, venous infection of the extremities. Dynamics and outcome. After the abolition of glycyrrhizic acid, blood pressure and potassium levels in the blood plasma returned to normal, which is not recommended to take antihypertensive drugs. Conclusion: An exceptional clinical situation is a pronounced manifestation of a rare side effect of glycyrrhizic acid in the form of drug-induced hypertension.

Case of acute recurrent myocardial infarction in a child

Information on the essential aspects of prevalence, etiology and pathogenesis of coronary heart disease, which is the leading cause of death in the world, is given in this article. It is emphasized that the incidence of ischemic coronary events is the result of a complex sequence of pathogenetic links, which involves the formation of atherosclerotic lesions and destabilization as the primary provoking factor. Purpose - the attraction of the medical community attention to the problem of ischemic heart disease in children. A clinical case of recurrent myocardial infarction in a child who was examined and treated at the MNPE «Ivano-Frankivsk Regional Children’s Clinical Hospital of the Ivano-Frankivsk Regional Council», is described here. The key points of the patient’s complaints, anamnesis of life and this disease are described, the data of the objective condition at the hospitalization and during dynamic observation of the child, which showed the signs of left ventricular overload, coronary blood flow disorder, dilatation of the left heart ventricles, decreased left ventricular contractility. The data of the main indices of laboratory and instrumental methods of research, including X-ray diagnostic methods, performed not only on the basis of the department, but also in the Scientific-Practical Medical Center of Pediatric Cardiology and Cardiac Surgery of the Ministry of Health of Ukraine (Kyiv). The treatment of this clinical case in the child is described in this article. The data of dynamic observation are given. The discussion and conclusions emphasize the problem of coronary insufficiency in pediatrics, which requires clinical understanding, the choice of the correct diagnostic algorithm and qualified medical care. The study was performed in accordance with the principles of the Declaration of Helsinki. Informed consent of the child’s parents was obtained for the research conduction. No conflict of interests was declared by the authors.

A clinical case of postinfaction aneurysm development, in a patient after COVID-19

There is no data in the literature on the course of myocardial infarction in patients after COVID-19. Purpose to use a clinical example to present a case of postinfarction left ventricular aneurysm in a patient after undergoing COVID-19. Materials and methods: Patient T., 49 years old, was admitted to the federal state budgetary institution Federal Center of Cardiovascular Surgery of the Ministry of Health of the Russian Federation (Astrakhan) with complaints of pain in the heart with irradiation in the left shoulder and lower jaw. Considers himself ill for 7 days. It is known from anamnesis of life that the patient suffered COVID-19 two weeks ago. He has been suffering from arterial hypertension for a year. Results: A clinical example demonstrates that COVID-19 affects course of myocardial infarction: it is a risk factor for the development of post infarction aneurysm of the left ventricle in the early stages after a myocardial infarction. Myocardial infarction was accompanied by the formation of pathological Q waves, impaired conduction of the right leg of the Gis bundle a decrease in the ejection fraction of the left ventricle, acute occlusion of the right coronary artery. Postinfarction aneurysm of the left ventricle had an anterior-septal apical localization. In addition, the study of highly sensitive troponin T and N-terminal fragment of the pro-brain natriuretic peptide type B in patients with myocardial infarction complicated by postinfarction aneurysm of the left ventricle after COVID-19 is also important for determining the stages of development of pathological processes in this pathology, evaluating the effectiveness of therapy and the outcome of this pathology.

Clinical case of severe COVID-19 in a child with morbid obesity

The pandemic of coronavirus infection is characterized by a low percentage of complications and severe forms in sick children compared to the adult population. However, there have been described cases of severe clinical course of COVID-19 in children with comorbidities among which is obesity. The aim of this study was to analyze the severe course of a new coronavirus infection paralleled with morbid obesity in a pediatric patient. Materials and methods. All accompanying patient medical documentation was examined. Results and discussion. From the anamnesis of life it is known that the patient was long time complained of intensively increased body weight, on which she repeatedly underwent examinations. In 2018, hypothalamic pubertal syndrome was diagnosed for the first time, for which the patient received hypoglycemic and antihypertensive drugs, hepatoprotectors on an ongoing basis. In the epidemiological anamnesis, the intrafamilial COVID-19 contact with mother was established. The main disease began acutely with a rise in body temperature up to 3939.5C, cough and weakness. During the first week of illness, the patient did not seek medical help and receive self-treatment, but the positive effect was not achieved. Saturation measurement showed low oxygen level (SpO2 71%). In this regard, the patient underwent chest computed tomography, which revealed a bilateral interstitial polysegmental lung lesion with signs of consolidation. After emergency hospitalization, the patient was prescribed empiric antibiotic therapy, anti-inflammatory and antithrombotic treatment, as well as respiratory support. A positive PCR result of a throat and nasal swab for SARS-CoV-2 was obtained in the hospital. Due to a poor response to therapy, the patient was transferred to a respiratory hospital. At the time of hospitalization, the condition was considered severe due to severe respiratory failure and premorbidity. The range of treatments included oxygenotherapy, antibacterial and anticoagulation therapy, as well as surfactant and the nucleoside analogue Remdesivir. During treatment, the clinical picture gained a positive trend, and after 6 days of hospitalization the patient no longer needed respiratory support. According to the results of repeated computed tomography, bilateral interstitial polysegmental pneumonia was diagnosed with damage to the lung tissue up to 95%. The patient remained stable and showed no signs of respiratory failure during the following days of hospitalization. On the 20th day of ilness, the patient was discharged from hospital with full clinical recovery. Conclusion. This clinical case demonstrates the role of premorbid background in aggravating the clinical picture of a new coronavirus infection in a child. Careful study of anamnestic characteristics is necessary in patients of any age, even with an uncomplicated disease course.

FEATURES OF OBSTRUCTIVE BRONCHITIS AND BRONCHOPNEUMONIA IN CHILDREN

This article examines the clinical features of obstructive bronchitis and bronchopneumonia in children under 2 years of age. Examinations were conducted in the Department of Infectious Diseases of Children's Clinical Hospital No. 1 of Gomel Region. Medical records of 47 hospitalized patients are analyzed. The child's life anamnesis, duration of illness, clinical symptoms, concomitant diseases and a number of laboratory analyzes were evaluated.

PULMONARY DISEASE DIAGNOSTIC AND REHABILITATION TREATMENT FOR PATIENTS WITH OVERLAP ASTHMA AND CHRONIC OBSTRUCTIVE PULMONARY DISEASES.

Aim: To analyze the effectiveness of rehabilitation treatment in the conditions of halo aerosol therapy and when using different groups of fixed-dose aerosol inhalers in patients with asthma, chronic obstructive pulmonary diseases and asthma-chronic obstructive pulmonary diseases overlap. Materials and Methods: A total 112 patients with asthma, chronic obstructive pulmonary diseases and asthma-chronic obstructive pulmonary diseases overlap. All patients carefully collected allergic history, anamnesis of life, and disease. The study includes assessment of resting anthropometric data, physical activity habits, blood pressure, structure and quality of nutrition, family and economic data. Result: After a course of rehabilitation treatment, lung ventilation improved in all groups of patients compared to controls. The dynamics of FER indicators after the rehabilitation treatment had some differences for each group of patients in relation to the control groups. If in all A groups (control) the increase in FER indicators was insignificant, then in all B groups of patients it was significant, and differed from 14,6% up to 36%. Conclusions: Thus, a differentiated approach to the use of fixed-dose aerosol inhalers increases the effectiveness of rehabilitation treatment under conditions of halo aerosol therapy in patients with various genesis of bronchi-obstructive syndrome.

SARS-COVID-19 TRIGGERED WERNICKE'S ENCEPHALOPATHY (CLINICAL CASE).

Patient P., born in 1956, was found by relatives in a state of confused consciousness, an act of involuntary urination and defecation, numbness and weakening of the strength of both lower limbs were recorded. He was taken by ambulance to the reception room of the Regional Clinical Center of Neurosurgery and Neurology. The following concomitant diseases are known from the life anamnesis: Atrial fibrillation, gout, hypertension and type II non-insulin-dependent diabetes mellitus. Objective status: general condition of medium severity, tophuses of small joints of hands and feet, knee and elbow joints. Pronounced deformity of hands and feet due to gouty lesions. Heart tones are weakened. Breath sounds are weakened. The abdomen is soft, not painful on palpation. Glasgow coma scale 14-15 points. Consciousness is confused, disoriented in time, space and own person. To clarify the diagnosis, clinical and laboratory and instrumental diagnostic methods were used. Neurological complications, in particular, acute encephalopathy, on the background of coronavirus infection, may develop in patients with the presence of such risk factors as advanced age, cardiovascular diseases, hypertension, diabetes, gout. Most of the neurological complications in COVID-19 are probably not related to the direct penetration of the virus into the CNS, but are a trigger for the development of the pathology. Neuroimaging in such cases does not reveal pathological changes or reflects non-specific disorders.

The period of manifestation of type 1 diabetes mellitus in children and adolescents living on the territory of ZATO (Closed administrative-territorial entity)

Type 1 diabetes mellitus (T1DM) in children and adolescents remains one of the urgent problems of pediatric endocrinology. There is a constant increase in disease rates, both worldwide and Russia. The occurrence of pathology in childhood leads to a decrease in the quality of life of patients and their parents, the early development of chronic complications and disability, which makes type 1 diabetes a social problem in society. Despite numerous scientific works devoted to the study of the factors of manifestation of the disease, the causes of the occurrence are still unclear and ambiguous. The purpose of the study: is to identify and study possible clinical and laboratory features of the onset of type 1 diabetes in children and adolescents permanently residing in the territory of closed administrative-territorial entities (ZATO). Materials and methods: a continuous cohort retrospective study of children with type 1 DM was conducted for the period from 2009-2019, permanently residing in the ZATO territory to obtain data related to the period of manifestation of the disease. The study group included 55 children from 0 - 18 years of age suffering from type 1 diabetes. Results: Data on the anamnesis of life and disease, and indicators of clinical and laboratory studies (fasting glycemia, postprandial glycemia, average daily glycemia, average amplitude of glycemia fluctuations and glycated hemoglobin) at the time of disease manifestation are presented. A comparative analysis was carried out with the indicators of the Krasnoyarsk Territory, Russia, the obtained features were described.

Constructive approaches to creating an adaptive environment for student youth with vision problems

Introduction. The article deals with a topical issue on the peculiarities of adaptation of students with problematic vision and studying in the inclusive educational space of the university. To develop an individual program of support in the educational space of the university, it is very important to collect and analyze data from the anamnesis of life and an individual program for the rehabilitation and habilitation of a special student. University teachers do not always take into account the ability of these students to master the educational material in a timely manner, since an adapted form of perception is often not provided.Purpose setting. The purpose of the study is to analyze the created inclusive conditions for the adaptation of blind and visually impaired students studying at ZabGU.Methodology and methods of the study. Technique and methodology of research. The basis of the sociological study was interviewing respondents to identify adaptation problems in social, educational and leisure aspects.Results. The results of the adaptive capabilities of students with different levels of visual impairment are described. The obstacles hindering the improvement of the educational process are revealed. Only 46.6 % of those surveyed are fully satisfied with the quality of inclusive education. The forms of interaction and socialization of student youth through active involvement in participation in leisure activities are shown. Participation in integrated student projects allowed students with limited educational needs, in a short time and with minimal losses, to adapt to the intensive regime of student life.Conclusions. Thus, the administration of the university needs to provide for the improvement of systematically organized work on the adaptation and support of students with visual impairment in the educational space, taking into account the existing individual capabilities of all sensory systems, which will be a support in the acquisition and deepening of adaptive, cognitive and communication capabilities.

The suicidal activity and comorbid mental pathology in persons with gender dystrophia

According to foreign publications, 58% of patients with gender disorders had additional psychiatric diagnosis, 39.3% had at least one suicide attempt. The data of suicidal activity and mental comorbidity in Russian population of transgenders are absent.Purpose of the study is to assess suicidal activity and mental comorbidity in persons with gender disorders.The retrospective analysis of records of patients applied with complains on gender disorders from January 2014 to April 2021 was applied. The demographic characteristics, life anamnesis, comorbid mental pathology at time of appliance, frequency of suicidal attempts, suicidal thoughts and auto-aggressive behavior were examined. The data of 926 patients with gender disorders were included: FtM 515 (55.7%), MtF 411 (44.3%). The median age of patients applied for care appliance was 24 years (13-65 years). In group of transgender patients 75.2% had no mental illness, except gender disorders. At that, there was high prevalence of comorbid mental pathology (24.8% on average). Usually, it was background mental illnesses and reversible mental disorders, which were not causes of gender disorders. The suicide rate in transgender group was 12.5%. For 1 patient with suicidal experience, there were 1.3 suicidal attempts (from 1 to 5). The significant dependence of increased suicidal activity, depression, auto-aggressive behavior and rate of comorbid mental pathology on age of debut of gender disorders was established. The transgender patients with debut of gender dysphoria in puberty age are most vulnerable to development of any mental pathology. The suicidal activity of patients with gender disorders depends on both social causes and presence of comorbid mental pathology. A number of modifiable risk factors for suicidal behavior were identified: support of relatives, external correspondence to associated gender, early steps to "change gender", earlier apply for medical care, background compensated mental illnesses.

НЕВУС КЕННОНА: ФАКТОРЫ РИСКА, КЛИНИЧЕСКАЯ КАРТИНА, ДИАГНОСТИКА

Abstract. Diseases of the oral mucosa are quite common, but their differential diagnosis is very difficult. One of the types of diseases of the oral mucosa are diseases accompanied by a violation of keratinization - the so-called "white manifestations" on the oral mucosa, some of which can lead to the development of cancer. Cannon’s spongy nevus is a disease whose main symptom is parakeratosis, which is a violation of the keratinization of the oral mucosa. The purpose of the study was to study the clinical picture of Cannon's spongy nevus, to identify differential diagnostic criteria and risk factors for exacerbation of this disease. Materials and methods: 23 patients aged 18-44 years of both sexes with a diagnosis of Cannon's spongy nevus were under our supervision. Patients underwent a survey (including a detailed collection of complaints, anamnesis of life and disease), a daily objective examination for three weeks, fluorescent diagnostics using a Wood's lamp, a biochemical blood test for vitamin D and A. Results and discussion: it was found that the course of Cannon's spongy nevus is cyclic, periods of exacerbation and remission replace each other within 10-14 days. The results of luminescent diagnostics turned out to be non-specific - the mucous membrane of the oral cavity under ultraviolet rays is gray-white in color, which is typical for hyperkeratosis. Vitamin D in the blood of patients with Cannon's spongy nevus is reduced, and vitamin A is within the normal range. Conclusions: a cyclical course, similar symptoms in relatives under 30 years old, young age, low vitamin D in the blood are diagnostic criteria for Cannon's spongy nevus, and the frequency of exacerbations increases with nervous tension.

Differential diagnosis of secondary parkinsonism in a complex clinical case in the city of Vladikavkaz

This article describes the differential diagnosis of secondary parkinsonism in a complex clinical example. Information about the patient was collected at a neurologist's appointment by collecting complaints, an anamnesis of life and disease, conducting a thorough general and neurological examination, and conducting additional diagnostic methods. After studying the obtained clinical data of the patient, a differential diagnosis was made between vascular and drug-induced parkinsonism. The factors and influencing each of these diagnoses are determined. The most likely diagnosis was successfully made, followed by appropriate therapy. This article also shows clinical experience on secondary types of parkinsonism, which will be very useful for neurologists at all levels of medical care.

Targeted therapy of bronchial asthma in children

Objective: to evaluate the clinical efficacy of targeted therapy with omalizumab in children with moderate to severe uncontrolled bronchial asthma. Materials and methods: 7 children receiving omalizumab therapy in a hospital and polyclinic of the Ufa City Children’s Clinical Hospital No. 17 were under observation. In accordance with the instructions for use, the monoclonal antibody drug omalizumab was administered subcutaneously every 2-4 weeks. The dosage of the drug was determined based on the child’s body weight and the initial level of serum IgE. The anamnesis of life and disease, the results of instrumental and laboratory research methods, the results of AST and c-AST tests were studied in all the children studied. Results: against the background of therapy with omalizumab in children, there was a significant decrease in the frequency of daytime symptoms (p=0.0179), a decrease in the frequency of night symptoms (p=0.0233), increased physical activity (p=0.0179), a decrease in the need for bronchodilators (p=0.0179), an increase in FEV1 according to spirography (p=0.0431), a decrease in the volume of basic anti-inflammatory therapy with a decrease in the dose of IGCS in 71.43% of patients (p=0.0425), a significant increase in the number of AST and c–AST test scores: before treatment 12 [10; 13] points, against the background of treatment - 23 [20; 25] points, (p=0.0277). During the follow-up period of therapy with omalizumab, no serious adverse reactions were detected. Conclusion: thus, targeted therapy using omalizumab is clinically effective in children with moderate to severe uncontrolled bronchial asthma.

First study of the RuPatient health information system with optical character recognition of medical records based on machine learning

RuPatient health information system (HIS) is a computer program consisting of a doctor-patient web user interface, which includes algorithms for recognizing medical record text and entering it into the corresponding fields of the system.Aim. To evaluate the effectiveness of RuPatient HIS in actual clinical practice.Material and methods. The study involved 10 cardiologists and intensivists of the department of cardiology and сardiovascular intensive care unit of the L. A. Vorokhobov City Clinical Hospital 67 We analyzed images (scanned copies, photos) of discharge reports from patients admitted to the relevant departments in 2021. The following fields of medical documentation was recognized: Name, Complaints, Anamnesis of life and illness, Examination, Recommendations. The correctness and accuracy of recognition of entered information were analyzed. We compared the recognition quality of RuPatient HIS and a popular optical character recognition application (FineReader for Mac).Results. The study included 77 pages of discharge reports of patients from various hospitals in Russia from 50 patients (men, 52%). The mean age of patients was 57,7±7,9 years. The number of reports with correctly recognized fields in various categories using the program algorithms was distributed as follows: Name — 14 (28%), Diagnosis — 13 (26%), Complaints — 40 (80%), Anamnesis — 14 (28%), Examination — 24 (48%), Recommendations — 46 (92%). Data that was not included in the category was also recognized and entered in the comments field. The number of recognized words was 549±174,9 vs 522,4±215,6 (p=0,5), critical errors in words — 2,1±1,6 vs 4,4±2,8 (p&lt;0,001), non-critical errors — 10,3±4,3 vs 5,6±3,3 (p&lt;0,001) for RuPatient HIS and optical character recognition application for a personal computer, respectively.Conclusion. The developed RuPatient HIS, which includes a module for recognizing medical records and entering data into the corresponding fields, significantly increases the document management efficiency with high quality of optical character recognition based on neural network technologies and the automation of filling process.

Clinical picture and ultrasound manifestations of secondary lymphedema of the maxillofacial region

The aim of the study is to determine the main clinical symptoms and ultrasound manifestations of secondary lymphedema of the maxillofacial region. This study is based on the study of a comprehensive examination and the effectiveness of treatment of 15 patients diagnosed with lymphedema of the maxillofacial region, who are on outpatient treatment at the Federal State Budgetary Institution "National Medical Research Centre for Dental and Maxillofacial Surgery" of the Ministry of Health of the Russian Federation from 2020-2021 at the age of 18 to 70 years. The examination of patients included the study of complaints, anamnesis of life, anamnesis of the disease, external examination and examination of the oral cavity, palpation of soft tissues of the maxillofacial region, X-ray examination (if necessary). All patients underwent ultrasound examination of the soft tissues of the maxillofacial area. When examining patients, it was revealed that the main clinical symptoms of lymphedema of the maxillofacial region are the presence of edema, a feeling of heaviness and stiffness of movements in the area of edema and the absence of symptoms of inflammation such as fever, hyperemia and pain. 100% of patients had the following ultrasound manifestations in the area of lymphatic drainage disorders: an increase in tissue thickness, impaired tissue differentiation into layers, a diffuse increase in tissue echogenicity, and the presence of dilated lymphatic vessels. Lymphedema of the maxillofacial region is a polyetiological disease that is difficult to diagnose, requiring a thorough examination of the patient, including basic examination methods, radiography, and mandatory ultrasound examination of soft tissues.

Острый тромбоз бедренно-подколенного сегмента, осложнившийся ТЭЛА. Описание клинического случая

Deep vein thrombosis (DVT) and PE are classified as venous thromboembolic complications (VTEO), they remain an important problem in clinical medicine and affect the professional sphere of doctors of all specialties, since their pathogenesis is based on hypercoagulation caused by various causes, in particular, genetic defects of blood clotting factors, diseases of the cardiovascular system, severe injuries and subsequent immobilization, iatrogenic lesions, etc. The article describes a clinical case of treatment, observation and treatment of a patient diagnosed with Subacute phlebothrombosis of the left lower limb. Popliteal-femoral segment. VN II. Non-massive bilateral pulmonary embolism. DN 0-1. Arterial hypertension 2 stages, 2 degrees, risk 3.CHF 1. The study was conducted on the basis of the Regional Clinical Hospital No. 2 in Tyumen. Aim. Description of the identified case, subcute thrombosis of the femoral-popliteal segment, complicated by PE, for a more complete understanding of the problem due to the high prevalence of this pathology in the structure of vascular diseases; analysis of the possibility of early diagnosis and treatment on the example of a specific case. Material and methods. A retrospective analysis of the patient’s medical history was carried out and an example from the practice of the admission department of the Regional Clinical Hospital No. 2 in Tyumen of clinical observation of a patient diagnosed with subacute thrombosis of the femoral-popliteal segment, complicated by PE. Anamnesis of life and disease, clinical, laboratory and instrumental data were evaluated. Conclusion. The most realistic prevention of threatening PE is the effective treatment of acute venous thrombosis. It is very important to timely and adequately assess the risk of thrombosis in each individual case. The consequences of the lack of prevention of thrombosis lead to an increased risk of repeated episodes of venous thromboembolism, the development of post-thrombotic disease, and can also lead to death from PE. It should be noted that it is necessary to monitor CT scans – angiopulmonography – to control the development of pulmonary embolism as a complication against the background of newly formed thrombosis of the femoral-popliteal segment. Sanitary and educational work, active tactics, timely treatment and hospitalization of patients with acute deep vein thrombosis BPS will contribute to improving the quality of life of this category of patients, reducing the percentage of PE and deaths.

The general condition of patients requiring the alveolar bone crest reconstruction

Objectives: To present the survey questionnaire used for the medical assessment of patients requiring alveolar ridge reconstruction as well as the study of concomitant pathologies and their influence on the healing process. Material and methods: The study involved 173 patients aged between 18 and 69 years. All patients have been assessed according to the survey questionnaire developed to determine the patient’s general condition, life anamnesis, and medical history. Results: Out of the total of 173 patients, 72 (41.6%) had no concomitant pathologies, 8 patients (4.6%) had concomitant pathologies that did not interfere with the operation, 40 (23.1%) had pathologies that might affect the outcome of alveolar ridge reconstruction but still were admitted to surgery, and 53 patients (30.6%) had pathologies that could affect the outcome of the reconstruction procedure and were not admitted to bone grafting. Conclusions: Assessment of patients with alveolar ridge defects during preparation and planning of preimplantation bone reconstruction identified a number of concomitant pathologies, more or less noticed by the patient, which may remain unclear due to superficial study of the patient’s condition that is able to influence the surgical treatment outcome. These issues can be both intraoperative and postoperative and lead to failure of surgical treatment and further reoperation.

Клинические проявления расстройств моторной функции верхнего отдела пищеварительного тракта у детей с вегетативной дисфункцией

Было обследовано 109 детей с синдромом вегетативной дисфункции в возрасте 6–16 лет, которые были распределены на 2 группы. Основная группа — 87 детей с синдромом вегетативной дисфункции и нарушениями моторной функции верхнего отдела пищеварительного канала и группа сравнения — 22 ребенка с синдромом вегетативной дисфункции без нарушений моторной функции верхнего отдела пищеварительного тракта. По разработанной нами схеме обследования у детей, находившихся под наблюдением, нами был проведен анализ жалоб, анамнеза жизни и болезни, объективное обследование с использованием клинических, инструментальных и лабораторных методов исследования. Была изучена следующая информация: возраст, пол, течение беременности и родов у матери, заболевания в раннем детском возрасте, наличие хронических и функциональных заболеваний органов пищеварения у родителей, наличие у родителей ребенка вегетативной дисфункции, характер питания в грудном и школьном возрасте, наличие пищевой аллергии и влияния психогенных факторов, продолжительность жалоб, частота обострений, сопутствующая патология. Для оценки клинического течения вегетативной дисфункции и моторных нарушений верхнего отдела пищеварительного тракта была изучена симптоматика заболеваний с учетом физикальных данных, результатов общего клинического исследования крови и мочи, биохимического исследования крови, исследование кала на яйца гельминтов, данных электрокардиографии, консультаций врачей-специалистов (лор, невролог, офтальмолог), ультразвукового исследования органов брюшной полости. Состояние слизистой оболочки желудка, двенадцатиперстной кишки и наличие моторно-эвакуаторной нарушений в виде рефлюкса нами оценивались по данным фиброэзофагогастродуоденоскопии, которую проводили с помощью фиброскопов Richard Wolf 2163 (Германия) и Оlympus CLE 10 (Япония) с последующим взятием биопсии по общепринятой методике.

Hydatid cysts in the outpatient practice of a surgeon

Introduction. The hydatid form of echinococcal disease of EB is a rather urgent problem and over time the degree of its significance does not decrease. The main target organ is the liver, according to various authors, it accounts for up to 84% of all clinical observations. The probability of lung tissue involvement in the pathological process is 15%. Echinococcosis of other organs and tissues, as well as a combined lesion occurs in 25% of cases. Lesion of echinococcosis of muscle tissue is observed in 0.7–0.9% of all cases. The main method of treatment at present is surgery with its various options such as echinococcectomy, pericystectomy, resection.Objective. To demonstrate on the available clinical example the feasibility of using surgical treatment of EB of rare localization in the area on the anterior abdominal wall.Materials and methods. The result of treatment of a patient with echinococcosis of rare localization on the anterior abdominal wall is presented. The diagnosis is established in accordance with the available clinical recommendations. The examination was carried out using a standard set of clinical metols, and included: collection, analysis of complaints, as well as an anamnesis of life and disease. Standard clinical and biochemical studies were performed.Results. The hydatid form of echinococcosis with localization on the anterior abdominal wall is a rather rare pathology. However, treatment issues and diagnostic difficulties are quite relevant for doctors of various specialties. As a result of this clinical observation and the treatment, the patient recovered; after 17 months there was no data for a relapse of the disease.Conclusion. 1. Timely diagnosis of hydatid echinococcosis of any localization is fundamental in improving the results of treatment of this category of patients. 2. A multidisciplinary approach in the selection of therapeutic tactics, namely the appointment of chemotherapeutic effects before and after surgery, an active surgical one, allows to achieve a good therapeutic result.