Multi-organ Lesions Research Articles

Depth-Aware Networks for Multi-Organ Lesion Detection in Chest CT Scans.

Computer tomography (CT) scans' capabilities in detecting lesions have been increasing remarkably in the past decades. In this paper, we propose a multi-organ lesion detection (MOLD) approach to better address real-life chest-related clinical needs. MOLD is a challenging task, especially within a large, high resolution image volume, due to various types of background information interference and large differences in lesion sizes. Furthermore, the appearance similarity between lesions and other normal tissues demands more discriminative features. In order to overcome these challenges, we introduce depth-aware (DA) and skipped-layer hierarchical training (SHT) mechanisms with the novel Dense 3D context enhanced (Dense 3DCE) lesion detection model. The novel Dense 3DCE framework considers the shallow, medium, and deep-level features together comprehensively. In addition, equipped with our SHT scheme, the backpropagation process can now be supervised under precise control, while the DA scheme can effectively incorporate depth domain knowledge into the scheme. Extensive experiments have been carried out on a publicly available, widely used DeepLesion dataset, and the results prove the effectiveness of our DA-SHT Dense 3DCE network in the MOLD task.

Autoantibodies against Endophilin A2 as a novel biomarker are beneficial to early diagnosis of breast cancer

BackgroundDue to the lack of early symptoms, breast cancer is frequently overlooked, leading to distant metastases and multi-organ lesions that directly threaten patients’ lives. We have identified a novel tumor marker, antibodies to endophilin A2 (EA2), to improve early diagnosis of breast cancer. MethodsAntibody levels of EA2 were analyzed in sera of patients with cancers of different origins and stages by indirect enzyme-linked immunosorbent assay (ELISA). Diagnostic accuracy and reference range were determined by the area under the receiver operating curve and distribution curve. The levels of EA2 antigen in sera were determined by sandwich ELISA. ResultsThe levels of antibodies against EA2 were higher in sera of patients with breast cancer (P < 0.0001), liver cancer (P = 0.0005), gastric cancer (P = 0.0026), and colon cancer (P = 0.0349) than those in healthy controls, but not in patients with rectal cancer (P = 0.1151), leukemia (P = 0.7508), or lung cancer (P = 0.2247). The highest diagnostic value was for breast cancer, particularly in early cases (AUC = 0.8014) and those with distant metastases (AUC = 0.7885). The titers of EA2 antibodies in sera were correlated with levels of EA2 antigen in breast cancer patients. ConclusionAntibodies to EA2 are novel blood biomarkers for early diagnosis of breast cancer that warrants further study in larger-scale cohort studies.

Limited usefulness of the IS6110 touchdown-PCR in blood for tuberculin skin test false-negative cattle with serological response to Mycobacterium bovis.

Ante-mortem diagnosis of bovine tuberculosis (bTB) is based mainly on the tuberculin skin test (TST) and the ɣ-IFN release assay (IGRA). Some infected animals escape screening tests, thus, limit herd sanitation. Previous reports have suggested a predominant pattern of multi-organ lesions attributable to Mycobacterium bovis (the causative agent of bTB) bacteraemia. A case-control study was conducted to investigate blood PCR as an alternative tool for improving ante-mortem detection of TST false-negative bovines. Cases comprised 70 TST false-negative bovines (cases), which were serology positive, and controls included 81 TST positive bovines; all of them confirmed as infected with M. bovis. Detection of the IS6110 target through touchdown blood-PCR (IS6110 TD-PCR) was performed. The positivity of the blood-PCR was 27.2% in the control group. This performance was similar to the 15% obtained among cases (p = 0.134). Most cases identified by the IS6110 TD-PCR exhibited focalized lesions (p = 0.002). Results demonstrated that blood-PCR could detect TST false-negative cattle, even if they are negative for IGRA. Considering that cases exhibited humoral response to M. bovis, further studies conducted in a pre-serological stage could provide evidence about the real contribution of the technique in herds.

Generalized Varicella Zoster infection in a patient with lymphogranulomatosis after bone marrow transplantation: clinical and laboratory characteristics and virus genotyping

A description of a laboratory confirmed clinical case of generalized Varicella Zoster infection in a patient with lymphogranulomatosis after bone marrow transplantation is presented.Detection of the Varicella Zoster virus in biological material was carried out by real-time PCR using the RealBest DNA VZV test system manufactured by Vector-BEST, Russian Federation. Isolation of viral DNA from biological material was performed using the ArtRNA MiniSpin kit (ArtBioTech, Belarus) or QIAamp DNA mini kit (QIAGEN, Germany).The disease had an atypically severe course with a multiorgan lesion, represented not only by lesions of the skin and mucous membranes, but also by the development of encephalitis, myocarditis, and pneumonia. The disease was characterized by an acute onset, with a pronounced intoxication syndrome, signs of pancreatitis with the appearance of a widespread vesicular rash on the trunk and extremities, prone to fusion, located, including on the scalp, on the feet and palms. The disease was complicated by a secondary bacterial infection, in connection with which the patient received both antiviral treatment and broad-spectrum antibiotic therapy.The virus was assigned to clade 3 (or E2 genotype according to the old classification), the same genotype as the viruses circulating in Minsk. This case is the first described case of generalized VZV infection in the Republic of Belarus, confirmed by laboratory using molecular genetic methods.

N-acetylcysteine ameliorates erectile dysfunction in rats with hyperlipidemia by inhibiting oxidative stress and corpus cavernosum smooth muscle cells phenotypic modulation.

Hyperlipidemia is a major risk factor for erectile dysfunction (ED). Oxidative stress and phenotypic modulation of corpus cavernosum smooth muscle cells (CCSMCs) are the key pathological factors of ED. N-acetylcysteine (NAC) can inhibit oxidative stress; however, whether NAC can alleviate pathological variations in the corpus cavernosum and promote erectile function recovery in hyperlipidemic rats remains unclear. A hyperlipidemia model was established using 27 eight-week-old male Sprague-Dawley (SD) rats fed a high-fat and high-cholesterol diet (hyperlipidemic rats, HR). In addition, 9 male SD rats were fed a normal diet to serve as controls (NC). HR rats were divided into three groups: HR, HR+normal saline (NS), and HR+NAC (n = 9 for each group; NS or NAC intraperitoneal injections were administered daily for 16 weeks). Subsequently, the lipid profiles, erectile function, oxidative stress, phenotypic modulation markers of CCSMCs, and tissue histology were analyzed. The experimental results revealed that erectile function was significantly impaired in the HR and HR + NS groups, but enhanced in the HR + NAC group. Abnormal lipid levels, over-activated oxidative stress, and multi-organ lesions observed in the HR and HR + NS groups were improved in the HR + NAC group. Moreover, the HR group showed significant phenotypic modulation of CCSMCs, which was also inhibited by NAC treatment. This report focuses on the therapeutic effect of NAC in restoring erectile function using a hyperlipidemic rat model by preventing CCSMC phenotypic modulation and attenuating oxidative stress.

Generalized HIV-associated kaposi's sarcoma with multiorgan lesion in a comorbid patient

Generalized HIV-associated kaposi's sarcoma with multiorgan lesion in a comorbid patient

Features of the course of pneumonia in children with coronavirus infection

BACKGROUND:The most frequent complication of coronavirus infection (COVID-19) in young children is severe viral pneumonia.&#x0D; AIM:To reveal the features of the course of coronavirus pneumonia in children.&#x0D; MATERIALS AND METHODS:A retrospective analysis of 54 case histories of children with coronavirus pneumonia, aged 1 month to 15 years, who received inpatient treatment in the Department of Pulmonology was performed.&#x0D; RESULTS:The disease was most often registered in children of the first three years of life (66,7%). 49 (90,7%) children turned out to be from family foci of coronavirus infection. The majority of children (4481.5%) had signs of respiratory failure of I-II degree. Polymerase chain reaction (PCR) for the presence of coronavirus was positive in 37 (68.5%) children. Radiologically, bilateral infiltrates were detected predominantly in the middle and lower parts of the lungs. The multisystem inflammatory syndrome associated with SARS-CoV-2 was characterized by persistent fever, multiple organ damage and clinical and laboratory shifts.&#x0D; The vast majority of cases involved transmission from adult patients. The disease most often developed in children under 3 years of age. The course of the disease is accompanied by the development of grade III respiratory failure and intoxication. PCR for the presence of coronavirus may be negative due to late admission of patients to the hospital. Radiological changes were characterized by extensive bilateral lesions mainly in the lower and middle lobes of the lungs. Persistent fever, multiorgan lesions, clinical and laboratory shifts in coronavirus pneumonia in children indicate the development of multisystem inflammatory syndrome associated with SARS-CoV-2.&#x0D; CONCLUSIONS:Pneumonia in most cases proceeded with the development of respiratory failure, symptoms of gastrointestinal tract damage, a pronounced intoxication syndrome. At the same time, there was revealed inconsistency of radiologically extensive lung lesions with more scanty auscultatory data.

The role of neutrophil extracellular traps (NETs) in the immunopathogenesis of severe COVID-19: potential immunotherapeutic strategies regulating NET formation and activity

The role of neutrophil granulocytes (NG) in the pathogenesis of COVID-19 is associated with the NG recruitment into inflammatory foci, activation of their functions and enhanced formation of neutrophil extracellular networks (NETs). In this review, we analyzed a large body of scientific literature devoted to the features of developing NETs, their role in the COVID-19 pathogenesis, a role in emerging immunothrombosis, vasculitis, acute respiratory distress syndrome, cytokine storm syndrome, and multi-organ lesions. Convincing data are presented clearly indicating about a profound role of NETs in the COVID-19 immunopathogenesis and associated severe complications resulting from intensified inflammation process, which is a key for the course of SARS-CoV-2 virus infection. The presented role of NGs and NETs, along with that of other immune system cells and pro-inflammatory cytokines, is extremely important in understanding development of overactive immune response in severe COVID-19. The scientific results obtained available now allow to identify an opportunity of regulatory effects on hyperactivated NGs, NETosis at various stages and on limiting a negative impact of pre-formed NETs on various tissues and organs. All the aforementioned data should help in creating new, specialized immunotherapy strategies designed to increase the odds of survival, reduce severity of clinical manifestations in COVID-19 patients as well as markedly reduce mortality rates. Currently, it is possible to use existing drugs, while a number of new drugs are being developed, the action of which can regulate NG quantity, positively affect NG functions and limit intensity of NETosis. Continuing research on the role of hyperactive NG and NETosis as well as understanding the mechanisms of regulating NET formation and restriction in severe COVID-19, apparently, are of high priority, because in the future the new data obtained could pave the basis for development of targeted approaches not only for immunotherapy aimed at limiting education and blocking negative effects already formed NETs in severe COVID-19, but also for immunotherapy, which could be used in combination treatment of other netopathies, primarily autoimmune diseases, auto-inflammatory syndromes, severe purulent-inflammatory processes, including bacterial sepsis and hematogenous osteomyelitis.

Clinical and immunological features of COVID-19 at different stages of the course of the disease

A retrospective analysis of clinical and immunological manifestations of COVID-19 was performed in 419 patients (women n=167 (39.8 %) men n= 252 (60.2 %)) aged 20 to 80 years. Mild stage I (early infection) in patients was mainly manifested by symptoms characteristic of other acute respiratory infections. Distinctive features were the loss (distortion) of smell and taste. The clinical manifestations of stage II (pulmonary) were determined by lung damage in the form of pneumonitis. Stage III (hyperinflammatory response) it was characterized by severe lung damage, involvement of other organs in the pathological process as a consequence of a hyperimmune reaction. The determination of cellular and humoral immunity indicators reflected the severity of damage to the body's immune system, and, accordingly, the severity of the course of coronavirus infection. The variety of clinical manifestations and examination results confirms that COVID-19 is a systemic disease with a multi-organ lesion that requires in-depth study of its clinical and immunological features.

Clinical features of the course of cystic fibrosis during pregnancy and childbirth

Cystic fibrosis is one of the urgent medical and social problems of health care systems in most countries due to fairly high prevalence, development of multi-organ lesions, and poor outcomes.Due to modern advances in the diagnosis and treatment of cystic fibrosis, not only has the average life expectancy of patients increased, but their quality of life has also improved, and it has become possible to maintain pregnancy and childbearing. Since cystic fibrosis can adversely affect the course of pregnancy, childbirth, and health of both mother and child, proper management of women with cystic fibrosis during pregnancy and childbirth is of particular relevance. The presented clinical case is an example of competent supervision at all stages of monitoring of a patient with cystic fibrosis during pregnancy and childbirth.

Current approaches in the treatment and rehabilitation of patients with neurological diseases after COVID-19. Resolution of the International Experts Forum

Despite the significant shift in global attention away from the pandemic, the problem of a new coronavirus infection remains important in the medical community. Almost 3 years after the start of the COVID-19 pandemic the issues of rehabilitation and management of delayed manifestations and sequelae of the disease are especially important. According to numerous available data, the new coronavirus infection is characterized by multiorgan lesions. Respiratory dysfunction, clotting disorders, myocardial dysfunction and various arrhythmias, acute coronary syndrome, acute renal failure, GI disorders, hepatocellular damage, hyperglycemia and ketosis, dermatological complications, ophthalmological symptoms and neurological disorders may be found. Significant prevalence of the latter in the post-coronavirus period necessitated this International Expert Forum to develop unified approaches to the management of patients with neurological complications and sequelae of new coronavirus infection based on practical experience and considering the scientific information available on COVID-19. The expert council developed a resolution formulating the tactics for the management of patients with neurological manifestations of COVID-19.

Sars-Cov2 Induced Biochemical Mechanisms in Liver Damage and Intestinal Lesions.

The online version contains supplementary material available at 10.1007/s12291-022-01089-x.

STD-Related sexual and gynaecological issues, including lesions of the genital organs and oral cavity

Abstract Human sexual life takes place at the biological, mental and social levels. Sexually transmitted diseases are an important issue associated particularly with the biological sphere, and have been on the rise in recent years. The wide spectrum of symptoms and consequences depends on aetiology and advancement, accompanying symptoms and/or their absence, as well as local, generalised and multiorgan lesions. They can also be present in the oral cavity. The prevention and treatment of these diseases is a special sphere of healthcare. In the context of sexual health, healthcare can be understood as integration of the biological, emotional, intellectual and social aspects of sexual life, being also important for the positive development of personality, communication and love.

Systemic manifestations of IgG4-associated disease

The article presents general data on IgG4-associated disease, as well as its classification and universal diagnostic criteria. Attention is focused on the possibility of multi-organ lesions, which complicates diagnosis and treatment. A clinical case of an IgG4-associated disease involving the retroperitoneal space (retroperitoneal fibrosis), lungs (bilateral interstitial pneumonia, diffuse and focal fibroid lung), intestines (chronic colitis) in a middle-aged man is described. Sequential administration of glucocorticoids and monoclonal antibodies made it possible to bring a patient into remission, however, the recurrence of the disease required the resumption of hormone therapy at a reduced dose with a positive effect.

PD18-04 HAZARD OF DEATH IN VON HIPPEL-LINDAU DISEASE PATIENTS DEPENDS ON GENOTYPE AND ONSET AGE AS WELL AS FIRST AFFECTED LESION

You have accessJournal of UrologyCME1 May 2022PD18-04 HAZARD OF DEATH IN VON HIPPEL-LINDAU DISEASE PATIENTS DEPENDS ON GENOTYPE AND ONSET AGE AS WELL AS FIRST AFFECTED LESION Kaifang Ma, Lin Cai, and Kan Ging Kaifang MaKaifang Ma More articles by this author , Lin CaiLin Cai More articles by this author , and Kan GingKan Ging More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002556.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Historically, von Hippel-Lindau disease (vHL) is characterized by poor survival resulting from multi-organ lesions and higher morbidity. The present study sought to determine the effect of various genetic and clinical factors on survival in patients with vHL. METHODS: In this cohort study, we recruited 768 VHL mutation carriers from 299 vHL families who were retrospectively followed for a total of 30636 person-years. Cox regression models and Kaplan-Meier plot were used to evaluate the effect of genotype, gender, onset age, family history, birth order and first affected lesion on survival. RESULTS: The predicted mean life expectancy for vHL patients was 60 years, and 205 patients died in the study subjects. Individuals with truncated mutation genotype, earlier-onset age and CNS tumour as the first affected lesion had a significantly higher risk of all-cause death, vHL-related death and central nervous system hemangioblastoma-specific death. Male patients had a mortality hazard from renal cell carcinoma that was twice as high as female patients (HR = 1.96, 95%CI: 1.245-3.099, P = 0.005). CONCLUSIONS: The vHL survival study indicated that genotype, onset age, first affected lesion, as well as gender have significant effects on survival. These findings provide a basis for genetic counseling and development of guidelines for vHL surveillance. Source of Funding: This work was financially supported by the National Natural Science Foundation of China (No. 82172617; 82172665; 81872081), the Fundamental Research Funds for the Central Universities (No. BMU2018JI002), and Beijing Key Laboratory of Urogenital diseases (male) molecular diagnosis and treatment center © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e343 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kaifang Ma More articles by this author Lin Cai More articles by this author Kan Ging More articles by this author Expand All Advertisement PDF DownloadLoading ...

Complicated urinary tract infection in a patient with severe COVID-19

Introduction. At the end of 2019, the world faced a pandemic of infection caused by the SARS-CoV-2 coronavirus. The disease caused by this virus is referred to as COVID-19, and is characterized by multiorgan lesion. The leading syndrome is the syndrome of immune response disregulation or the «cytokine storm». According to the studies, which were used as the basis of patient management clinical protocols, antiinterleukin-6 agents, and glucocorticosteroids, are the most effective in stopping the «cytokine storm». At the same time, the use of immunosuppressive drugs increases the risk of secondary infectious complications not associated with the COVID-19 viral infection.The aim of the study was to present a successful case of treating a secondary bacterial infection in a patient with a severe new coronavirus infection in the context of a limited choice of antimicrobial therapy.Materials and methods. The report presents a clinical case of a complicated urinary tract infection associated with an extremely resistant Kl.pneumoniae strain in a 58-year-old patient hospitalized with severe COVID-19. Due to comorbidity, combined with long-term hospitalization, the need in immunosuppressive therapy, and long-term catheterization of the urinary tract, the patient got affected by Kl.pneumoniae. This pathogen demonstrated microbiological and clinical resistance to all studied classes of antibiotics, including carbapenems, aminoglycosides and polymyxins. The patient developed an abscess of the prostate, and orchiepididymitis, which required repeated surgical interventions.Results and Discussion. The multidisciplinary approach to patient treatment, as well as the use of local and regional epidemiological data made it possible to choose the most effective drug therapy. The combination of adequate surgical debridement and combined antibiotic therapy (ceftazidime/avibactam and aztreonam) led to regression of the complicated urinary tract infection manifestations and clinical recovery.Conclusions. The use of ceftazidime/avibactam and aztreonam combination is a promising therapeutic option for the treatment of infections caused by extremely resistant strains of Enterobacterales, in which the combined production of serine proteases and metallobetalactamases is expected.

Novel Recurrent Mutations in Eldheim-Chester Disease Patients Identified By Whole Exome Sequencing and Whole Genome Sequencing

▪Background: Erdheim-Chester disease (ECD) is a type of systemic, non-Langerhans histiocytic disorder characterized by diffuse organ damage with infiltration of CD68-positive, CD163-positive, and CD1a-negative histiocytes. Although most patients have mutations associated with the hyperactivation of the MAPK pathway, including BRAF, MAP2K1, and NRAS, the remaining have no known driver mutations. So far, there is no specific target of treatment for them. To elucidate novel driver mutations and establish new treatment strategies in these patients, we performed whole-exome sequencing (WES) and whole-genome sequencing (WGS) using patient samples with ECD. In addition, we performed WES with multi-organ lesions in a patient with ECD to reveal the mutational profiles of each organ lesion.Methods: We performed a nationwide survey and collected clinical samples of ECD in Japan. We collected 22 samples of ECD lesions from 15 adult patients. All cases were pathologically proved. Twenty of 22 samples were formalin-fixed and paraffin-embedded tissue (FFPE) and were examined by WES. For WGS, DNA was extracted from 2 raw samples of ECD lesions. In addition, we collected multi-organ lesions in 3 patients. One patient developed myelodysplastic syndrome (MDS) and subsequent acute myeloid leukemia (AML). Therefore, we also performed WES with each bone marrow (BM) sample to reveal the relationship between ECD and these myeloid malignancies. We used 6 samples of peripheral blood, 1 BM sample, 1 skin sample, and 1 oral mucosa sample as normal controls.Result: We detected known driver mutations in seven of 15 cases (47%). Among them, BRAF V600E was detected in 5 cases (8 samples), MAP2K1 C121S in 1 case (1 sample), and NRAS Q61R in 1 case (2 samples) by WES and WGS. A mean of 69 nonsynonymous mutations per patient was identified in normal-tumor analysis (range, 2-491) and 188 in tumor-only analysis (range, 17-3598) of WES, and 3134 in normal-tumor analysis (range, 2588-3680) of WGS. The median variant allele frequency (VAF) for the 11 samples with known activating kinase mutations identified by WES and WGS was 14.4% (range, 6.3-34.7). We could not detect known driver mutations in the other 8 cases (53%). Therefore, to reveal novel driver mutations, we focused on these 8 cases. Notably, EPHA2 P786L, MYBPC3 D798N, TDRD5 P115L, and TCEAL4 F17L mutations are recurrently found in 2 out of the 8 cases, suggesting new driver mutations are contained in these. The VAFs of EPHA2 P786L were 9.1% and 9.3%, MYBPC3 D798N 5.5% and 11.9%, TDRD5 P115L 10.2% and 18.7%, and TCEAL4 F17L 7.5% and 9.0% in each case. We also analyzed multiple organ samples of a case with BRAF V600E mutation (5 samples of ECD lesions, BM with MDS, BM with AML, and skin as normal control). Interestingly, BRAF V600E mutation was identified in 3 samples (bone lesion, heart, and intestine) but was not in other samples (kidney lesion, dura matter, BM tumor, BM with MDS, and BM with AML), suggesting mutational profiles are different depending on the organ of the lesion.Conclusion: Our nation-wide analysis revealed that no well-known driver mutations were found in more than half of the ECD cases. We identified EPHA2 P786L, MYBPC3 D798N, TDRD5 P115L, and TCEAL4 F17L mutations as candidates of novel driver mutations in ECD. To elucidate the role of these mutations in pathogenesis of ECD, further functional analyses are warranted. In addition, we revealed heterogeneity of mutational profile of multi lesions in an ECD patient with BRAF V600E mutation. It is noteworthy that mutational profiles might be different depending on the organ of the lesion. DisclosuresHonda: Chugai Pharmaceutical: Other: Lecture fee; Ono Pharmaceutical: Other: Lecture fee; Nippon Shinyaku: Other: Lecture fee; Takeda Pharmaceutical: Other: Lecture fee; Otsuka Pharmaceutical: Other: Lecture fee; Jansen Pharmaceutical: Other: Lecture fee. Matsuda: Kyowa Kirin: Other: Lecture fee; Ono Pharmaceutical: Other: Lecture fee. Taoka: ONO PHARMACEUTICAL CO., LTD.: Other; Chugai Pharmaceutical Company: Other. Kurokawa: Teijin Limited: Research Funding, Speakers Bureau; Chugai Pharmaceutical Company: Research Funding, Speakers Bureau; Takeda Pharmaceutical Company Limited.: Research Funding, Speakers Bureau; ONO PHARMACEUTICAL CO., LTD.: Research Funding, Speakers Bureau; Otsuka Pharmaceutical Co., Ltd.: Research Funding, Speakers Bureau; Eisai Co., Ltd.: Research Funding, Speakers Bureau; Astellas Pharma Inc.: Research Funding, Speakers Bureau; MSD K.K.: Research Funding, Speakers Bureau; Nippon Shinyaku Co., Ltd.: Research Funding, Speakers Bureau; Daiichi Sankyo Company.: Research Funding, Speakers Bureau; Sumitomo Dainippon Pharma Co., Ltd.: Research Funding, Speakers Bureau; Kyowa Hakko Kirin Co., Ltd.: Research Funding, Speakers Bureau; AbbVie GK: Research Funding, Speakers Bureau; Pfizer Japan Inc.: Research Funding, Speakers Bureau.

External and Internal Validation of a Computer Assisted Diagnostic Model for Detecting Multi-Organ Mass Lesions in CT images

External and Internal Validation of a Computer Assisted Diagnostic Model for Detecting Multi-Organ Mass Lesions in CT images

Possi bilities and perspectives of colchicine application in complex therapy in patients with COVID-19

The new coronavirus infection, which has become a pandemic, is greatly increasing interest in the search for new pharmacological drugs with antiviral and anti-infl ammatory properties. Colchicine, which has been used in medicine for centuries and has been mainly known as arthrifuge, has come to be unexpectedly considered as a drug aff ecting the cumulative endpoint in outpatients, including death and hospitalization requirement in a recent large, well-planned, randomized controlled trial. The article provides data on the pharmacodynamics of the drug, which consists in blockade of infl ammasome activation in patients with COVID-19, and an eff ective impact on the mechanisms of “cytokine storm” — a predictor of acute respiratory distress syndrome and sepsis as a major cause of multi-organ lesions and death. The information that its spectrum of anti-infl ammatory activity may explain the vasoprotective eff ects in patients with coronary heart disease (CHD) who underwent acute infarction in the COLCOT study, is particularly attractive from the point of view of the perspectives for the oral colchicine application in COVID-19. High tolerability of the drug, the absence of severe adverse reactions, simple dosing regimen, low cost of colchicine, the absence of signifi cant drug interactions are additional advantages. The authors of this article believe that this information is suffi cient for planning a study of the eff ectiveness of colchicine as an element of complex therapy in hospitalized patients with COVID-19 in combination with acute coronary syndrome, including the need for percutaneous coronary intervention. Early anti-infl ammatory therapy in patients with COVID-19 is still not recommended, despi te th e fact t h at there comes an understanding of its necessity. And in this situation, colchicine has the potential to challenge.

Gastrointestinal symptoms in SARS-CoV‑2 infected: emphasis on increased mucosal permeability

The article presents data on the prevalence of gastrointestinal symptoms in patients with COVID‑19, the mechanisms of its development, the impact on the course of the disease and the tactics of drug therapy. It is noted that the persistence of the SARS-CoV‑2 virus in the intestine may be responsible for an increase in the duration of the disease and the development of multi-organ lesions, since the intestine, on the one hand, is the site of penetration and replication of the SARS-CoV‑2 virus, and on the other, is a potential source of virus spread due to increased intestinal permeability against the background of infection and disturbed microbiocenosis. Based on this, it seems pathogenetically justified to use drugs in the complex therapy of patients that contribute to the normalization of intestinal microbiocenosis and intestinal permeability.