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Clinical Case of Lymphomatoid Papulosis
Get PDFLymphomatoid papulosis is a rare skin disease. The incidence averages 1.5 cases per 1 million population. It is the most common in adults around the age of 40. It was previously considered as paraneoplastic dermatosis, but recent studies have confirmed that lymphomatoid papulosis is a primary CD30 + T-lymphoma of the skin. Despite the aggressive morphological features, it is benign. The disease is characterized by a tendency to spontaneous regression. Typically, skin lesions last 3-12 weeks, although in some severe cases they may last longer. Skin lesions may disappear or recur over decades. Patients require observation because a second lymphoproliferative disease develops in 10-40% of patients.
A case of lymphomatoid papulosis in a patient with diffuse astrocytoma is presented. The patient was treated with systemic retinoids. The results of differential diagnosis and additional research methods, including dermoscopy, are given. Although the use of dermoscopy was not crucial, the results of the research showed microscopic visual differences between the elements of the rash, depending on the stage of the disease. The picture was mostly typical, however, spots formed by the areas of central erythema on the background of light brown areas, with a predominance of the reticular vessels pattern were also noted in addition to the rash elements on the hairy skull. Clarification of this feature requires further study.
The purpose of our report is to draw the attention of dermatologists and family doctors to cases of rare dermatoses. The rareness of the disease, lack of knowledge on the clinical findings lead to diagnostic errors, “inadequate treatment”
Prognostic Value of Serum Interleukin-6 Level in Hypertensive Patients with COVID-19-Associated Pneumonia
Get PDFBackground. An interleukin-6 (IL-6) is a proinflammatory cytokine which plays an important role in COVID-19-associated hyperinflammation.
Aim. This study aimed to assess the predictive ability of serum IL-6 levels for the development of severe/critical clinical conditions, a hypoxemic state requiring supplemental oxygen, and lethal outcomes in patients with COVID-19-associated pneumonia and arterial hypertension (AH).
Materials and Methods. One hundred and thirty-five unvaccinated patients hospitalized for COVID-19-associated pneumonia were enrolled in the study. AH was diagnosed in 78.5% of cases. Pneumonia was confirmed radiologically. SARS-COV-2 as an etiological factor was confirmed by either PCR or ELISA. In addition to conventional laboratory tests, IL-6, ferritin, and soluble interleukin-2 levels were measured.
Results. Among AH patients, the median levels of IL-6 were higher in non-survivors (95.1 [37.8 - 158.8] pg/mL) as compared to survivors (39.5 [13.6 - 81.1] pg/mL) (p=0.04). Among AH patients, the median serum level of IL-6 was 98.3 [37.8 - 158.8] pg/mL in critically ill patients, 41.7 [11.8 - 83.4] pg/mL in severely ill patients, 37.8 [13.6 - 74.4] pg/mL in moderately ill patients (p=0.051). The median serum level of IL-6 was lower at the time of discharge (6.5 [2.0 - 21.5] pg/mL) as compared to that on admission (43.2 [16.1 - 92.0] pg/mL) (p< 0.001). IL-6 level failed to predict severe/critical condition (AUC=0.59, p=0.13) and the need for supplemental oxygen (AUC=0.61, p=0.06); however, it might be used for the prediction of the lethal outcome (AUC=0.69, p=0.03). The cut-off value of IL-6 level for lethal outcome prediction of 91.0 pg/mL showed a sensitivity of 58.3% and a specificity of 78.7%. Patients with IL-6 levels > 91.0 pg/mL on admission had higher odds of lethal outcomes (OR = 4.87 [1.40 - 16.92], p=0.01).
Conclusions. Serum IL-6 level on admission did not show significant predictive ability for severe/critical conditions and hypoxemic states requiring supplemental oxygen in AH patients. However, serum IL-6 levels on admission were higher in non-survivors and might be used for the prediction of lethal outcomes with a cut-off value of 91.0 pg/mL in AH patients
Influence of Chronic Ethanol Intoxication on Hemodynamics in Testicles and Spermatogenesis in Middle-Aged Males
Get PDFDiseases of testicles are an important social problem because according to WHO data, the male factor is about 45% in the structure of sterile marriage. Among many pathogenic factors distorting spermatogenic and endocrine function of testicles, acute and chronic circulatory disorders in them play a great role. Recent studies showed that one of the causes of male infertility is chronic ethanol intoxication causing distorted hemomicrocirculation in testicles, so determining the character of cytologic changes in them in these circumstances remains relevant.
Objects and methods. In the study, we used 14 histological micropreparations from testicular biopsy specimens from middle-aged infertile males (22-35 years) with chronic alcoholism in anamnesis,. In some biopsy specimens, ultrastructural changes in testicles were studied under the electronic microscope, testicular hemodynamics in infertile males was examined with ultrasound.
Results. In middle-aged infertile males with chronic alcoholism, the volume of testicles decreases compared to normal. The arterial blood flow rate in them decreases significantly. The diameter of tortuous looped seminiferous tubules decreases compared to normal. Their membrane is thickened; the layers of spermatogenic epithelial cells are reduced. The volume of interstitial endocrinocytes decreases compared to normal. Testosterone level in blood decreases too.
Ultrastructural changes in testicles are manifested with irregular thickness and curving of spermatogenic epithelial basal membrane, vacuolization of myoid cellular, supporting epitheliocytes, and interstitial endocrinocyte cytoplasm with reduced mitochondrial cristae and tubules in the endoplasmic reticulum. In ejaculate of infertile males, sperm concentration decreases to (30.65±1.70) million/ml compared to (75.80±4.20) million/ml, the number of pathologic forms of spermatozoids increases twice, the number of spermatozoids with progressive movement decreases
Pyramidal Lobe Variations of the Thyroid Gland and Its Clinical Implications: A Short Review and Case Report
Get PDFThe thyroid gland is characterized by significant anatomical variability, which may lead to difficulties in diagnostic and treatment outcomes. The pyramidal lobe is the most common variation present in up to 30% of the population. Literature has witnessed research on different variations of the pyramidal lobe, preference for the lobe from which it arises, gender preference, etc. Understanding such variations is essential for successful treatment outcomes for thyroid diseases. This short review was aimed to highlight embryological aspects of the thyroid gland, variation of its pyramidal lobe and present a rare case of demarcated left lobe, pyramidal lobe, and an associated cyst
Therapeutic Doctors` Competency during the Providing Emergency Medical Care at the Scene
No full textDuring the last years it has been observed the worldwide trend in regular creation, upgrading and implementation of emergency care protocols at the prehospital stage in the medical practice. The huge role is given to the methods of doctors` simulation preparedness in case of the emergency care at the scene. Modern doctors` preparedness requires practicing of the resuscitation in the simulation centers on the specific dummies or devices without the risk of making any harm to the patient, developing the ability to make quick and correct decision and conduct all necessary manipulations and interferences without any mistake. According to the professional literature, it is usually observed the lack of practical skills concerning the emergency care at the scene of an accident among therapeutic doctors`. Nowadays, one of the most important task undergraduate and postgraduate medical educations is the creation of simulation centers for quality training of highly qualified specialists, including emergency medical care.
The aim of given investigation is the evaluation of the professional therapeutic doctors` competency in providing emergency medical care at the scene in accordance to the latest recommendations of the European Resuscitation Council (2021) and American Heart Association (2020). According to tests conducted in the 2017-2018s among therapeutic doctors about their abilities of the resuscitation conducting, it was revealed that only 52% were able to diagnose the state of clinical death; 63% - were able to perform chest compression; 15% were able to provide opening of airways; extremely low was the numbers of those who were able to use AED and ventilation – 5% and 9% correspondently. Therefore, one of the key tasks of the modern medical simulative education is to prepare therapeutic doctors to be able to perform emergency resuscitation at the scene.
Key words. Simulative medicine, emergency medical care, the scene of an accident, therapeutic doctors
Зміни Орального Мікробіоценозу в Процесі Користування Різними Адгезивними Засобами для Фіксації Повних Знімних Пластинкових Протезів
Get PDFThe use of adhesives to improve the fixation of complete removable laminar dentures, along with numerous benefits for the patient, creates additional risks of imbalance in some representatives of the oral microflora and, consequently, may cause or maintain the development of prosthetic stomatitis and worsen oral hygiene. Therefore, it is important to study the prevention of disorders of the normobiocenosis of the oral cavity due to the differentiated choice of adhesives based on their antimicrobial activity. The study represents the peculiarities of changes in the oral normomicrobiocenosis in the process of the prescribed adhesives’ use for fixing complete removable laminar dentures.
The aim of the study – is to study the changes in the oral microbiocenosis in the process of adhesives use for fixing complete removable laminar dentures and to assess the effectiveness of their choice based on the results.
Materials and methods of the study. There were examined 120 people, who used full removable laminar dentures, 90 of them used adhesive means prescribed by a dentist for three weeks to improve fixation. All patients were sampled for bacteriological examination. Based on the analysis of culture results for microorganisms in each Group, the constancy index was determined – sowing frequency in percent and population level – colonization mass in lg CFU/ml.
Results of the study. In comparison with persons who did not use adhesives to improve the fixation of removable dentures and data before the study it was determined that the adhesive “Corega” had a preservative effect on the normoflora, reduced the population level of pathogenic coccal microflora, yeasts; adhesive “Laсalut” had an inhibitive effect on all representatives of the normal microflora, reduced sowing frequency and population level of β-hemolytic streptococci, but did not affect the pathogenic activity of Staphylococcus aureus, yeasts and gram-negative bacteria; adhesive “Protefix” had a suppressive effect on the normoflora, did not affect the population level of pathogenic microorganisms and even increased the massiveness of colonization by gram-negative bacteria.
Conclusions. Taking into account the determined changes in the oral microbiocenosis in persons who used adhesives to improve the fixation of complete removable laminar dentures, we can talk about the effectiveness of the adhesive “Сorega” for long-term use in the absence of complications in prosthetic bed tissues and with proper hygienic care of the oral cavity; adhesives “Laсalut” and “Protefix” in patients with existing dysbiotic disorders and with subsequent control of the impact on the resident microflora of the oral cavity.Використання адгезивних засобів для покращення фіксації повних знімних пластинкових протезів поряд із численними перевагами для пацієнта створює додаткові ризики у порушенні балансу між окремими представниками мікрофлори ротової порожнини та як наслідок, може спричинювати чи підтримувати розвиток протезних стоматитів, погіршувати гігієну ротової порожнини. Тому важливими є дослідження щодо попередження порушень нормобіоценозу ротової порожнини через диференційований вибір адгезивних засобів з огляду на їхню протимікробну активність. У дослідженні представлено особливості зміни орального нормомікробіоценозу в процесі користування призначеними адгезивними засобами для фіксації повних знімних пластинкових протезів.
Мета дослідження - вивчити зміни орального мікробіоценозу в процесі користування адгезивними засобами для фіксації ПЗПП та на основі отриманих результатів оцінити ефективність їхнього вибору.
Матеріали та методи дослідження: обстежено 120 осіб, які користувалися повними знімними пластинковими протезами, 90 з яких – для покращення фіксації три тижні використовували призначені лікарем-стоматологом адгезивні засоби. У всіх пацієнтів проводили забір матеріалу для бактеріологічного дослідження. На основі аналізу результатів посівів для мікроорганізмів кожної групи визначали індекс постійності – частоту висівання у відсотках та популяційний рівень – масивність колонізації у lg КУО/мл.
Результати дослідження та обговорення. У порівнянні з особами, які не використовували адгезивні засоби для покращення фіксації знімних протезів та даними до початку дослідження встановлено, що адгезив «Корега» мав зберігачу дію на нормофлору, зменшував популяційний рівень представників патогенної кокової мікрофлори, дріжджоподібних грибів; адгезив «Лакалут» мав пригнічуючий вплив на усіх представників нормальної мікрофлори, зменшував частоту висівання та популяційний рівень β-гемолітичних стрептококів, але не впливав на патогенну активність золотистого стафілококу, дріжджоподібних грибів і грам-негативних бактерій; адгезив «Протефікс» мав пригнічуючий вплив на нормофлору, не впливав на популяційний рівень патогенних мікроорганізмів і навіть збільшував масивність колонізації грам-негативними бактеріями.
Висновки. З огляду на встановлені зміни орального мікробіоценозу в осіб, які для покращення фіксації ПЗПП використовували адгезивні засоби, можемо стверджувати про ефективність призначення адгезиву «Корега» для тривалого використання за відсутності ускладнень зі сторони тканин протезного ложа та за умови належного гігієнічного догляду за ротовою порожниною; адгезивів «Лакалут» і «Протефікс» пацієнтам, із наявними дизбіотичними порушеннями та з послідуючим контролем впливу на резидентну мікрофлори ротової порожнини
Risk Factors Associated with Treatment Default Among Tuberculosis Patients in Adamawa State, Nigeria
Get PDFBackground. Tuberculosis is an infectious disease caused by bacteria called Mycobacterium tuberculosis. The treatment of drug-resistant tuberculosis is complex, costly, and usually has poor outcomes. Treatment default is well known as a very significant factor associated with drug-resistant tuberculosis.
The aim of this study was to investigate the hazard ratios associated with treatment default among tuberculosis patients in Adamawa State, Nigeria.
Materials and Methods. The Cox proportional hazards regression was used to determine the hazard ratios associated with tuberculosis patient treatment default in Adamawa State, Nigeria. The Kaplan-Meier method was used to analyze time-to-event data. The study assessed the survival status and treatment outcomes of tuberculosis patients over a six-month period (January 2019 to June 2019). Data analysis was done using R - Programming Software and the statistical significance was considered at p < 0.05.
Results. Out of the 197 (124 males and 73 females) tuberculosis patients, 148 (75.1%) individuals were diagnosed with pulmonary tuberculosis and 49 (24.9%) individuals were diagnosed with extrapulmonary tuberculosis. The treatment outcomes were as follows: 33 (16.8%) patients were cured; 36 (18.3%) individuals completed their treatment; 3 (1.5%) patients died during treatment; 105 (53.3%) subjects defaulted; 8 (4.1%) patients were lost to follow-up; the remaining 12 (6.1%) individuals were still on treatment at the end of the study. According to the Cox proportional hazards analysis, HIV-positive status (p < 0.05, 95% CI [0.361 - 0.879]), primary education level (p < 0.01, 95% CI [1.248 - 3.354]), poor quality of life (p < 0.01, 95% CI [1.239 - 3.511]) and age over 60 years old (p < 0.05, 95% CI [0.569 - 2.206]) were significant hazard ratios to experience the event (treatment default) in the study area.
Conclusions. This study revealed that HIV-positive tuberculosis patients, older patients, patients with primary education, and those with poor quality of life are significant risk factors to experience treatment default in the study area. Therefore, it is recommended that stakeholders managing the treatment and care of tuberculosis patients should be dedicated and intentional in the provision of psychosocial therapy to patients with poor quality of life
COVID-19 Through the Eyes of a Physiatrist: Back Pain Can Be a Symptom and May Predict Pneumonia in COVID-19
Get PDFThe study aimed to determine whether back pain is a clinical manifestation in patients with COVID-19 and whether several demographic and disease characteristics could be an effective indicator of back pain.
Materials and Methods. A total of 99 patients with COVID-19 were recruited from the Department of Infectious Diseases of the Kirikkale High Specialized Hospital in Turkey and divided into two groups depending on the presence (n=50) or absence of back pain (n=49). The primary outcomes included were demographic and disease characteristics, the Nord-Trøndelag Health Study Physical Activity Level for Work (HUNT), and the 6-minute walking test.
Results. The most common symptom was fatigue (n=63, 63.6%), followed by back pain (n=50, 50.5%). In the back pain group, the number of patients with sedentary lifestyle, oxygen requirement, pneumonia, and typical pneumonia pattern were significantly higher (p=0.009, p=0.026, p=0.001, p=0.001, respectively), while aerobic capacity was lower (p=0.001). In a logistic regression analysis, back pain was found to be associated with pneumonia presence.
Conclusions. Back pain may be associated with the presence of COVID-19 pneumonia and should be evaluated as its early warning symptom
Curcumin Attenuates Lipopolysaccharide-Induced Neuroinflammation and Memory Deficiency by Inhibiting Microglia Activation in Mice Hippocampus
Get PDFBackground. Curcumin has a variety of properties, including antioxidant and anti-inflammatory ones, and has demonstrated some protective prospects on neurological conditions.
Aim: This study explored the neuroprotective ability of curcumin in lipopolysaccharide-induced neuroinflammation in an animal model.
Methods. A total of thirty-two adult male mice were randomly assigned to four groups (A, B, C, and D, n=8): Group A (Control) received distilled water; Group B was administered lipopolysaccharide (LPS) only to induce neuroinflammation for seven days; Group C was treated with both LPS and curcumin simultaneously for fourteen days; Group D received only curcumin for fourteen days. After appropriate exposure to the mice, their cognitive abilities were assessed using the Y-maze and novel object recognition tests. At the termination of the administration period, the mice were sacrificed, and the hippocampi were dissected for histology and immunostaining using GFAP and Iba1. Statistical analysis for the data generated was done with GraphPad prism. Tests of significance were with one-way ANOVA and Tukey tests for post-hoc.
Results. Curcumin significantly (p < 0.05) increased object recognition, mean alternation, and markedly restored neuronal distortion caused by LPS toxicity in the CA3 region and the dentate gyrus of the hippocampus of Group C animals as compared to Group B. In addition, curcumin significantly down-regulated Iba1 expression and GFAP cell activities of both the CA3 region and the dentate gyrus.
Conclusions. Curcumin showed a promising role in attenuating LPS-induced neuroinflammation in the brain by inhibiting microglial activation and improving memory of neurotoxic mice
Theoretical Justification of the Dermatoglyphics Use As Basic Identification Method
Get PDFThe article analyzes the main literature sources providing a holistic view of the state and issues of studying the issue related to the possibility of using the dermatoglyphic research method for identification purpose; it is about external recognition, behavioral, psychological identification. The main directions of application of the dermatoglyphic method, providing the study of this issue, are highlighted. Problematic issues related to the areas of application of the dermatoglyphic method have been studied and further prospects for its study have been outlined