Polymorphism Of Symptoms Research Articles

Pathogenesis and clinical forms of human listeriosis

Listeriosis is a saprozoonotic infection caused in humans mainly by the species Listeria monocytogenes. Its source can be objects of the external environment (soil and water of open reservoirs with a high content of organic compounds, plants) and more than 90 species of animals. The high metabolic activity of listeria and resistance to adverse factors create the possibility of an easy transition from a saprophytic to a parasitic type of metabolism when ingested by the host. A variety of transmission routes and "entrance gates" cause the emergence of a variety of primary localized forms of infection, the most common of which is gastrointestinal. Invasive forms of listeriosis develop mainly in people with immunological insufficiency. "Risk groups" are pregnant women, newborns, people with comorbid conditions, over 60 years old, drug addicts, etc. They are characterized by polymorphism of symptoms, the absence of specific manifestations. Pathogenicity factors of L. are important in the pathogenesis of infection. monocytogenes, providing their incomplete phagocytosis, intracellular parasitism, high rate of colonization of neighboring healthy cells, the formation of antibiotic resistance. The pathological expression of changes caused by listeria in cells is the formation of small granulomas — listeriomas. The "diversity" of listeriosis, the high mortality rate (up to 50% or more) and the low alertness of doctors regarding this infection create difficulties in making a diagnosis, and therefore the improvement of microbiological diagnostic methods is of particular importance.

A clinical case of maxillofacial dirofilariasis in a child

The article presents a clinical case of surgical treatment of dirofilariasis in the maxillofacial region in a child. Diagnosis is difficult due to the complex mechanism of transmission, long incubation period and polymorphism of symptoms. The method of ultrasonic diagnosis allows the most accurate and clear verification of the diagnosis (the presence of a dense capsule, in the lumen of which linear hyperechogenic moving structures are determined). Treatment of dirofilariasis is only surgical - excision of the capsule with the helminth within healthy tissues with subsequent pathomorphologic examination and clarifying of the etiology of the parasite.

Application of a diagnostic algorithm for differential diagnosis in a patient with recurrent abdominal pain

Introduction Among the diseases of urgent pathology the leading place belongs to acute pancreatitis, which is second only to acute appendicitis and acute cholecystitis. Moreover, a significant share is occupied by mild forms, which account for 85%. In the Clinical Recommendations for Acute pancreatitis in the section “Prevention and dispensary monitoring”, the authors recommend regular dispensary monitoring by a gastroenterologist and a surgeon. However, this nosology according to the Order of the Ministry of Health of the Russian Federation from 03.15.2022 No 168N is not included in the dispensary observation. In this regard, patients remain without proper attention of doctors when they are discharged from hospitals, or when they refuse hospitalization after examination in the emergency room.The aim of the work – is to present the result of applying the diagnostic algorithm of differential diagnosis of diseases and detection of gastrointestinal tract pathology on the clinical example of a patient with recurrent abdominal pain syndrome.Materials and methods The analysis of medical records of a 59-year-old patient who repeatedly applied to the network of polyclinics and hospitals providing emergency specialized medical care for recurrent abdominal syndrome was carried out.Results and discussion In this clinical observation of recurrent abdominal syndrome in a patient, the biliary mask of acute pancreatitis was revealed. In outpatient conditions using the developed diagnostic algorithm, choledocholithiasis, juxtapapillary diverticulum of the duodenum and hernia of the esophageal aperture of the diaphragm were detected. The diagnosis made it possible to perform the treatment competently and lead to the patient's recovery. Thanks to the dispensary observation and additional methods of investigation according to the developed algorithm, the following were detected: juxtapapillary diverticulum of the duodenum, which may not be visualized at video esophagogastroduodenoscopy with direct optics, as well as ductal stones, which are not always visualized at transabdominal ultrasound and are detected at endoscopic retrograde cholangiopancreatography or endoscopic ultrasonography. Difficulties may arise in the diagnosis of gastrointestinal diseases due to the variability of the clinical course and polymorphism of symptoms in this category of patients. Such a course of diseases causes difficulties at the stage of patients' admission to the emergency room of clinics, can lead to diagnostic errors that lead to incorrect treatment tactics.Conclusion The application of an algorithm based on the assessment of clinical criteria in conjunction with instrumental imaging methods and laboratory tests allowed to optimize the diagnostic process and facilitated the choice of optimal therapy and surgical tactics for the treatment of the patient with recurrent abdominal pain syndrome.

Brait–Fahn–Schwarz disease (result of two-year clinical follow-up)

The article presents the result of a two-year follow-up of a patient with a combination of parkinsonism syndromes and amyotrophic lateral sclerosis, a rare form of a neurodegenerative disease of the central nervous system called “Bright–Fan–Schwarz disease”. The diversity and polymorphism of symptoms in this disease can lead to diffi culties in diagnosis and therapy. The data of the patient’s anamnesis, the dynamics of the clinical picture during the stay in the hospital, the diagnostic and therapeutic measures taken, and the subsequent follow-up are given. In conclusion, a generalization of the features of the clinical picture and the progression of the disease in question is presented.

CLINICAL AND ANAMNESTIC FEATURES OF THE DYNAMICS AND TRANSFORMATION OF IRON-DEFICIENCY ANEMIA IN ADOLESCENT GIRLS

Annotation: According to the World Health Organization, in any population, for every person suffering from IDA, there are three with iron deficiency (IAD). The risk group for the development of anemia includes children, women of reproductive age and the elderly. A special group among them are girls of pubertal age, who have a high potential for the formation of various organ dysfunctions. The purpose of this work was to study the clinical and anamnestic features of the dynamics and transformation of iron deficiency anemia in adolescent girls. Object and methods of the study: adolescent girls aged 12-14 years (n=177) of the Uzbek population, respectively, with LAD (45), mild IDA (56) and moderate (25), and the control group (51). For the study, whole blood and serum of adolescent girls with IDA were used. General clinical, instrumental, biochemical and statistical methods were used. Results: From the data of our material it follows that the clinical picture of IDA in schoolgirls was somewhat transformed and among them the syndrome of decreased immunological resistance of the body and gastrointestinal syndrome began to prevail, their frequency increased by more than 2-5 times compared to the above authors. The clinical picture of iron deficiency anemia in adolescent girls is characterized by polymorphism of symptoms and syndromes, which indicates the involvement of many organs and systems in the pathological process. It is concluded that it is necessary to update data on the clinical symptoms of ID in adolescent girls, depending on age, gender and regions of residence.

Clinical and anamnestic features of the dynamics and transformation of iron-deficiency anemia in adolescent girls

According to the World Health Organization, in any population, for every person suffering from IDA, there are three with iron deficiency (ID). The risk group for the anemia development includes children, women of reproductive age and the elderly. A special group among them are girls of pubertal age, who have a high potential for the formation of various organ dysfunctions. The purpose of this work was to study the clinical and anamnestic features of the dynamics and transformation of iron deficiency anemia in adolescent girls. Object and methods of the study: adolescent girls aged 12-14 years (n=177) of the Uzbek population, respectively, with LID (45), mild IDA (56) and moderate IDA (25), and the control group (51). For the study, whole blood and serum of adolescent girls with IDA were used. General clinical, instrumental, biochemical and statistical methods were used. From the data of our material, it follows that the clinical picture of IDA in schoolgirls was somewhat transformed and among them the syndrome of decreased immunological resistance of the body and gastrointestinal syndrome began to prevail, their frequency increased by more than 2-5 times compared to the above authors. The clinical picture of iron deficiency anemia in adolescent girls is characterized by polymorphism of symptoms and syndromes, which indicates the involvement of many organs and systems in the pathological process. We’ve concluded that it is necessary to update data on the ID clinical symptoms in adolescent girls, depending on age, gender and regions of residence.

Severe diseases of the anterior segment of the eye accompanied by somatic pathology and COVID-19: clinical cases under the pandemic

The article presents three clinical cases of severe pathologies of the anterior segment of the eye, which developed in patients with serious concomitant somatic diseases and COVID-19 under the pandemic. Our observations show that the SARS-CoV-2 virus can contribute to the onset of severe keratitis and keratouveitis, characterized by a long torpid course, relapses, and a poorly predicted outcome. In patients with coronavirus and severe somatic pathology, these diseases have atypical symptoms that complicate the diagnosis, are resistant to treatment, and require an extended period of convalescence. This can be explained by pronounced vascular inflammatory reactions, a possible invasion of eye tissue by viral particles, disruption of tear production, a decrease in local immune defense factors of the eye and systemic immunity, and a violation of the hemato-ophthalmic barrier. Local and general drug treatment brought weakly positive changes. The course of the disease took an undulating character. The description of the clinical cases reflects the polymorphism of symptoms and the multiorganic character of damages associated with COVID-19.

Clinical-Dynamical Features of Alcohol Use Disorder and Mood Disorders Considering the Chronology of Their Comorbidity Formation

Background. The comorbid course of Mood Disorders (MD) and Alcohol Use Disorder (AUD) is a problem actively discussed by national and foreign researchers. Scientists pay close attention to clinical and pathodynamic polymorphism of symptoms in their works. Objective of the study: to compare the Clinical-Dynamical characteristics of AUD and MD, taking into account the formation chronology of their comorbidity, in a clinical sample of the specialized psychiatric hospital. Patients and methods: the study enrolled 56 patients under treatment in Department of Affective Disorders or Addictive Disorders of Mental Health Research Institute Clinics with a comorbid diagnosis of AUD (F10.2 according to ICD-10) and MD (F31–F34.1 according to ICD10). The Clinical-Dynamic, Psychometric and Statistical Methods were used in work. Results: according to statistical analysis in the case of the primary onset of AUD a relatively later formation of the comorbidity was shown (p = 0.001, Mann–Whitney test) and a higher frequency of Dysthymia as a Secondary MD (p = 0.043, chi-square test). Inspite of relatively shorter Duration of the Disease (p = 0.001, Mann–Whitney test), Secondary AUD characterized by rapid evolution of clinical and dynamic traits: the Alcohol Tolerance and Duration of Withdrawal Symptoms are comparable to the Primary AUD (p = 0.739, Mann–Whitney test; p = 0.359, Mann–Whitney test), and slightly shorter Duration of Light Gaps (p = 0.087, Mann–Whitney test) and Heavy Drinking Days (p = 0.034, Mann–Whitney test). A Psychometric study of the severity of symptoms of Depression, Anxiety and Craving for alcohol in the dynamics of psychopharmacotherapy demonstrate their comparability both at the beginning of treatment and by the 28th day of therapy (p > 0.05, Mann–Whitney test). Thereby, AUD developed in the background of a formed MD characterized by a prognostically unfavorable course of Disease.

Intoxication syndrome in the practice of internist

Background. Intoxication syndrome (IS) is one of the most common syndromes in the medical practice, but its exact scientific outline has not yet been established. This is due to a variety of toxic factors, a large polymorphism of symptoms, and complex interactions between the processes of toxin production and detoxification.
 Objective. To describe the main features of IS and its treatment.
 Materials and methods. Analysis of literature sources on this issue.
 Results and discussion. The morphological basis of IS is the subcellular interaction between the toxin and the receptor. IS develops if the toxins’ entry or formation outweigh their elimination. Intoxications are divided into exogenous and endogenous. The diagnostic criteria for exogenous intoxications are the contact of the patient with the substance that caused the intoxication and the corresponding damage to the organs. Exogenous intoxications have a clear clinical picture, and the introduction of specific antidotes or antitoxins is the best treatment. In turn, endogenous IS is mediated by the accumulation of bacterial endotoxins, excess amounts of physiological metabolic products, biologically active substances and mediators. Natural ways of detoxification include metabolism, excretion and immune mechanisms. Infusion detoxification (IDT) with a significant load by crystalloids and multicomponent drugs is a mandatory treatment for both exogenous and endogenous IP. In most cases, the volume of infusion should be 25-35 ml/kg body weight. Requirements for the ideal drug for detoxification include hypervolemia, improving microcirculation and rheological properties of blood, correction of electrolyte disorders and disorders of acid-base balance, increase of diuresis and peristalsis. All these effects are typical for Reosorbilact (“Yuria-Pharm”). In general, the IDT program may include classical and balanced crystalloids (800-1500 ml), Reosorbilact (600-800 ml), specialized solutions (100-200 ml), and symptomatic drugs. The optimal duration of treatment with Reosorbilact is 7 days.
 Conclusions. 1. Exact scientific characteristics of IS are still missing. 2. IDT is the mandatory method of treatment of exogenous and endogenous IS. 3. Reosorbilact is the main component of IDT in any IP, as it affects the main links of the pathogenesis of the latter.

Primary hypertrophic osteoarthropathy

The article presents information about a rare hereditary disease – primary hypertrophic osteoarthropathy with autosomal dominant and autosomal recessive inheritance. Genetic heterogeneity is responsible for the clinical polymorphism of symptoms that appear in childhood and adolescence. Differential diagnosis should be carried out with secondary hypertrophic osteoarthropathy, which occurs in 90% of cases and is associated with malignant neoplasms, rheumatic diseases and other diseases. X-ray signs are of great importance to clarify the localization, extent and nature of bone lesions. There is no specific treatment for the disease.

The structure of psychopathological manifestations in internally displaced persons

In order to study the spectrum of psychopathology in internally displaced persons (IDPs) who asked for help, 68 IDPs with three categories of diseases were examined: organic mental disorders (F06.3, F06.4); aff ective disorders (F32.1, F33.1, F34.0); neurotic disorders (F40—48). It was established that among the surveyed IDPs, young people of working age prevail (from 40 to 49 years old — 41.18 %, from 30 to 39 years old — 23.52 % and from 18 to 29 — 20.59 %); with the presence of signifi - cant unsolved problems in the sphere of employment (52.94 % of the surveyed did not work). The clinical picture of the disease, regardless of the disorder, was characterized by polymorphism of symptoms and included a violation of the emotional spectrum, vegetative-somatic and cognitive impairment. In the structure of psychopathological manifestations in all mental disorders, there were isolated symptoms of posttraumatic disorder in the form of obsessive anxious memories of past events, fear that the situation with military actions would repeat, with dreams, accompanied by pictures of experienced events. Personal characteristics were manifested in passivity, inertia, emotional lability, reduced life satisfaction and inadequate self-esteem. All of the above should be considered when making a diagnosis, identifying specifi c targets in the development of therapeutic and rehabilitation measures. Keywords: internally displaced persons, mental disorders, personality traits, diagnosis and treatment

ERRORS IN THE DIAGNOSTICS OF TESTICLE TORSION IN CHILDREN

Introduction. Testicular torsion is an emergency condition requiring emergency medical care. Polymorphism of symptoms in testicular torsion makes diagnostics not easy and leads to late treatment what can results in irreversible damages to the testicle. Early diagnostics is a key point to organ preservation. Material and methods. The authors describe two clinical cases of testicular torsion in adolescents with errors in diagnostics. Clinical, laboratory findings and instrumental examination (MRI, ultrasound) were used for diagnostics. Results. A diagnostic error resulted in orchectomy which was made to one patient. In the other patient - despite a diagnostic error- testiclular detorsion and urgent surgical intervention resulted in patient’s complete recovery. Discussion. These examples illustrate how important is to carefully study the patient’s case-history - onset and nature of pain, associated vegetative symptoms - nausea and vomiting - which are not characteristic for other acute testicular diseases. Conventional tactics of urgent surgical intervention for all acute testicular diseases in children does not insure against diagnostic errors in case of testicular torsion with atypical symptoms. Ultrasound examination is of irreplaceable value, but one cannot be guided only by its findings in excluding testicular torsion. Conclusion. Any of the symptoms of testicular torsion - whether it is acute onset or severe pain, or a combination with vomiting, or severe pain on palpation, or ultrasound findings - is a reason to suspect testicular torsion and, it is an absolute indication for urgent surgery. The protocol for diagnostics and treatment of acute testicular diseases developed by us includes these diagnostic peculiarities and allows to choose an effective treatment modality.

CEREBRAL AUTOSOMAL DOMINANT ARTERIOPATHY WITH SUBCORTICAL INFARCTS AND LEUKOENCEPHALOPATHY (CADASIL ): a case report and literature review

The article presents literature review dedicated to the modern aspects of a rare hereditary disease – cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). Data concerning genetic features, pathogenesis, symptoms, methods of diagnosis of the disease, clinical screening of patients for further genetic testing are reviewed. Ethnic and gender characteristics of CADASIL are presented. Challengers in diagnosis are associated with subclinical course of CADASIL up to 40 years, polymorphism of symptoms, and its similarity to other vascular diseases. Pathogenetic treatment that slows the progression of the disease currently is not available.

Primary septicopemia complicated by parietal embolic endocarditis

"Medical Newspaper". 1902, No. 52.Rare cases of primary septicopemia disease, developed by Leube and Bisenom, due to the polymorphism of symptoms, are often confused with various acute infections.