Репозиторий Университета

© 2018 Ima-Press Publishing House. All rights reserved. Idiopathic lobular panniculitis (ILP) (synonym: Weber-Christian panniculitis) is the least studied disease in the group of systemic connective tissue lesions and characterized by systemic damage to subcutaneous adipose tissue (SAT). There is no unified concept of the etiology and pathogenesis of ILP now. The literature contains almost no data on the diagnostic value of laboratory studies and therapeutic approaches, which served as the basis for this investigation. Objective: to investigate the relationship between the clinical presentation of ILP and immune inflammatory parameters in patients with this disease. Subjects and methods. Examinations were made in 67 patients (9 men and 58 women) aged 20 to 76 years with a verified diagnosis of ILP (median duration, 78.91 [48; 540] months), who were followed up at the V.A. Nasonova Research Institute of Rheumatology for the period 2007 to 2017. The determination of α1-antitrypsin titer, liver fractions, amylase, lipase, trypsin, ferritin, creatine phosphokinase, leptin, and tumor necrosis factor-α (TNFα), chest computed tomography, and induration morphological examination were done in addition to physical examination. Results and discussion. The disease was found in all age groups, but it accounted for more than half (57%) of cases at the most able-bodied age (45–60 years). Analysis of the clinical manifestations of ILP could identify its four types: nodular (n=30), plaque (n=10), infiltrative (n= 5), and mesenteric (n=12), which were characterized by typical clinical features. The observed group showed a significant increase in erythrocyte sedimentation rate (ESR) (p=0.01) and C-reactive protein (CRP) level (p < 0.0001). ESR correlated with tenderness on the visual analogue scale (VAS) (p<0.05; r=0.29), induration area (p<0.05; r=0.50), and rises in body temperature (p<0.05; r=0.68) and CRP level (p<0.05; r=0.68). The concentration of CRP correlated with tenderness on visual analog scale (p<0.05; r=0.46), induration area (p<0.05; r=0.61), node stage (p<0.05; r=0.41), and TNF-α concentrations (p<0.05; r=0.32). The latter showed a direct correlation with node stage (p<0.05; r=0.41) and leptin levels (p<0.05; r=0.28) and an inverse correlation with the number of nodes (p<0.05; r=-0.24). Leptin levels were increased in 35 (52.23%) patients and displayed a direct correlation with body mass index (p<0.05; r=0.46), induration area (p<0.05; r=0.31), CRP level (p<0.05; r=0.36) and an inverse correlation with the number of nodes (p≤0.05; r=-0.33). Morphological examination of skin and SAT biopsy specimens was performed in 65 (97.01%) patients. Pre- and retroperitoneal adipose tissues were biopsied in three of five patients without skin and SAT lesions; this was not done in the remaining patients because of access difficulties. ILP was verified in all cases. Therapy was performed using the essential drugs adopted in rheumatology practice. Their therapeutic effects were noted in 62.68% of cases; inefficiency and health deterioration were detected in 12 (17.91%) patients, which necessitated an increase in the dose of disease-modifying antirheumatic drugs. Seven patients were given the following biological agents: abatacept (n=2), adalimum-ab (n = 3), etanercept (n=1), and rituximab (n=1). Conclusion. There is an obvious need to expand knowledge about this pathology amongst physicians and to conduct further investigation in order to timely diagnose and search for the most effective treatment options for ILP.

© 2018 Media Sfera. All rights reserved. The article reviews development mechanisms of different refractive errors accompanied by marked defocus of light rays reaching the retina. Terminology used for such ametropias includes terms extreme, ultra-high and complicated. Justification of their usage for primary ametropias, whose symptom complex is based on changes in axial eye length, is an ongoing discussion. To comply with thesaurus definitions of «diagnosis» and «pathogenesis», to characterize refractive and anatomical-functional disorders in patients with primary ametropias it is proposed to use the terms «hyperaxial and hypoaxial syndromes» with elaboration of specific symptoms instead of such expressions as extreme (ultra-high) myopia and hypermetropia.

Scleromyxedema is regarded as a rare cutaneous mucinosis from a group of lichen myxedematosus characterized by diffuse mucin deposition, sclerosis, and lichenoid eruptions in the absence of thyroid disease. The paper discusses the pathogenesis of the disease and histological changes in tissues. It underlines the need for using histochemical tests to identify acidic and neutral glycosaminoglycans and gives a differential diagnosis of this disease.

© 2018 Izdatel'stvo Meditsina. All rights reserved. The main objective of laboratory diagnosis of a diphtheria is identification of the causative agent by means of the minimum quantity of diagnostic tests for obtaining the authentic answer in the most short time. One of the major stages is capture and delivery of pathological material on which the efficiency of carrying out and timeliness of issue of the final answer depends. Considering emergence in the market of commercial liquid transport mediums, assessment of their efficiency for diagnosis of diphtheria is advisable. In the real work the pilot studies allowing to predict efficiency of use of the commercial transport liquid medium £-Transwab® with the liquid medium of Ames in two systems - with the standard applicator (system 1) and with the thin extended tampon for sampling from narrow cavities - urethral and nazofarengialny are conducted (system 2). In a research used a control toxigenic strain of Corynebacterium diphtheriae of a biovar of gravis No. 665. In an experiment "imitated" operating conditions of the medical organizations for storage of tampons with pathological material on diphtheria before their transportation in laboratory - on a table at the room temperature (6 and 20 hours), in the refrigerator (6 and 20 hours), in the thermostat (6 and 20 hours). After an incubation all tampons sowed the environment for primary crops ofpathological material on a blood tellurite agar.. Accounting of results was carried out in 24 and 48 hours of growth. It is established that the commercial transport liquid medium ofAmes can be usedfor capture of pathological material on diphtheria in the second half of the working day at storage in the conditions of the refrigerator. At the same time, it is necessary to consider a tampon form as the best results on a identification of the causative agent of diphtheria have been received when using a universal tampon.

THE PURPOSE OF THE STUDY: determination of the optimal parameters of the action of various types of current, which have the most pronounced irritating effect on the receptor apparatus of the tooth pulp. The study involved 102 volunteers aged 19 to 72 years (53 females and 49 males). The study was conducted on 217 teeth: 86 molars, 25 premolars, 19 canines and 98 incisors. 137 (63%) teeth were intact, in 48 (22%) teeth caries were found, in 32 (15%) teeth there was pulpitis or teeth were depulpated. Electroexcitability of the teeth was determined with the help of various types of electric current: an impulse variable, an impulse constant and a sinusoidal variable. The optimal current for carrying out an electroodontodiagnosis proved to be sinusoidal variable current with a frequency of 50 Hz. This current does not cause polarization of tissues, it is easy to dose, it causes a clear, but not painful sensation, gives the smallest spread of the indicators during repeated studies. The obtained results allowed formulating requirements for electroodontodiagnosis devices.

© Ima-Press Publishing House. All rights reserved. Peripheral nervous system involvement may be a main manifestation of systemic amyloidosis or occur in the later stages of the disease in the presence of multiple organ pathology. Focal, multiple mononeuropathy, radiculopathy, polyneuropathy, autonomic nervous system dysfunction, and myopathy develop depending on the localization of amyloid deposits in the peripheral nervous system. The most characteristic symptom in systemic amyloidosis is sensorimotor polyneuropathy accompanied in most cases by the involvement of autonomic nerve fibers in the pathological process. In cases of systemic amyloidosis, peripheral nervous system involvement is progressive, leading to disability, which makes the early diagnosis of the disease and its neurological manifestations and subsequent pathogenetic therapy relevant.

© 2018 Media Sphera Publishing Group. All rights reserved. Ascites and hydrothorax may be the symptoms of congestive heart failure and do not always reflects presense of the decompensated liver cirrhosis. Clinical examination of patient with chronic hepatitis C which cyanosis of the lips, cervival veins pulsation, a triple heart rhythm indicated on pathology of the heart (constrictive pericarditis), which was confirmed by instrumental methods. Congestive heart failure has lead to the congestive liver in a young female patient. Regression of all the symptoms of heart failure occurred after surgical treatment (pericardectomy).

© 2018 Ima-Press Publishing House. All rights reserved. We have considered it appropriate to publish this case due to the rarity of progressive myoclonus epilepsy; diagnostic difficulties, particularly in the early stages of the disease (the female patient has been long followed up for diagnosed juvenile myoclonic epilepsy); the relative role of a genetic study because it has not brought results in this case, and, finally, a problem with therapy, and a significant contribution to the achievement of certain success of currently available antiepileptic drugs, levetiracetam in particular.

© 2018 Media Sphera Publishing Group. All rights reserved. This article presents current views on the classification, diagnosis, treatment, and prevention of drug dependence caused by the co-use of several psychoactive substances (PASs). It describes the fundamental regularities of the development and course of the disease, the patterns of consumption, and the issues of laboratory diagnosis. Particular attention is paid to the clinical diagnosis of the most common patterns of use of various PASs. In order to make and propose the reader the most complete basis for evidencebased strategies for the treatment of various variants of polydrug abuse, the authors studied the results of investigations that enrolled patients using more than one PAS at least 1 month before the start of treatment. The section on therapy is presented as clinical recommendations, taking into account the levels of evidence and the grades of recommendations.

© 2018 Ima-Press Publishing House. All Rights Reserved. What factors negatively influence the accuracy of topical diagnosis of spinal nerve root lesion during neurological examination has not been solved until now. Objective: to identify the nature of the relationship between the accuracy of topical diagnosis of spinal nerve lesion from neurological symptoms in patients with cervical disk herniation and the peculiarities of their emotional status and quality of life. Patients and methods: Forty-eight patients with cervical disc herniation were examined. At first, the level of spinal nerve root lesion established during neurological examination was compared with the results of magnetic resonance imaging or computed tomography and surgical intervention. Thereafter, the importance of emotional factors in determining the accuracy of topical diagnosis is studied in these patients. Results and discussion: If there was a divergence between preliminary neurological and final diagnoses, personality traits, such as hysteria, psychasthenia, alexithymia, and trait anxiety were most significant. The most substantial differences were found in the index of alexithymia. The accuracy of topical diagnosis was influenced not only by the psychological profile of patients with cervical disc herniation, but also by their quality-of-life indicators. These are persons who are anxious and suspicious and are characterized by anxiety, fearfulness, indecision, and constant doubt. They use the symptoms of a somatic disease as a means to avoid responsibility. These patients solve all their problems, by escaping into disease, which causes social maladjustment. Conclusion: The features of an individual's psychological profile as increased anxiety, hysteria, and psychasthenia reduce the accuracy of topical diagnosis of the lesion by 25.6%. Patients with cervical disk herniation, low quality-of-life indicators, and high scale scores for hypochondria, depression, psychasthenia, and trait anxiety need their emotional status to be corrected.

© 2018, ABV-Press Publishing House. Attention deficit hyperactivity disorder (ADHD) is the most common cause of behavioral disorders and learning difficulties in preschool and school-age children. Patients with ADHD are often diagnosed with concomitant diseases, which creates additional diagnostic and therapeutic challenges and leads to a more significant reduction in the quality of life. ADHD is often associated with epilepsy: ADHD manifestations are more common in individuals with epilepsy, and vice versa, patients with ADHD are more likely to have epilepsy. The estimated prevalence of ADHD in children is 7-9 %, whereas in children with epilepsy, it reaches 20-50 %. Epilepsy is also one of the most common diseases in children (affecting approximately 1 % of the pediatric population), which is often aggravated by concomitant diseases, including cognitive, behavioral and emotional disorders. Various factors, such as characteristics of epileptic process and lesions in particular portions of the brain, can underlie the development of ADHD in epilepsy. Epileptiform activity and adverse effects of antiepileptic drugs can also play an important etiological role. Some antiepileptic drugs (such as barbiturates) may cause symptoms similar to those in ADHD (in this case, inattentiveness and hyperactivity shall be considered as adverse events that can be reduced or eliminated after cessation of the drug) or exacerbate ADHD symptoms in patients with these disorders. Therefore, the drugs with no negative impact on concomitant diseases or with a positive therapeutic effect for both diseases are preferable in these cases. High prevalence of the ADHD/epilepsy combination leads to a greater reduction in the quality of life, suggesting high relevance of this problem and requiring a revision of therapeutic approaches.

© 2019, Privolzhsky Research Medical University. All rights reserved. The aim of the study was to assess the efficiency of the method for registration of video fluorescence of 5-ALA-induced protoporphyrin IX in stomach and esophagus diseases, to adapt it for clinical conditions, i.e. for conducting differential diagnosis and detecting precancer conditions, and to formulate recommendations on the best photosensitizer doses and time of application in order to make the diagnostic procedure for these diseases more accurate. Materials and Methods. Registration of fluorescence for diagnostic purposes was performed on 57 patients with gastropathology (mainly with stomach cancer) with the help of single-channel (n=50) and dual-channel (n=7) laser video fluorescence registration systems. The study was performed using 5-aminolevulinic acid (5-ALA) (Alasens). 39 endoscopic, 18 intraoperative/laparoscopic investigations, and 7 studies on the macropreparation have been performed. Results. When both systems were used, no fluorescence was registered in cases of stomach ulcer, chronic gastritis, massive tumor necrosis and blood admixture in the stomach as well as in the patient with subcompensated stenosis and a stented output section of the stomach without serous membrane invasion and low 5-ALA concentration. In all other cases, a distinct fluorescence was recorded, the data of which may be used for establishing exact diagnosis and choosing further treatment tactics. Conclusion. Laser video fluorescence technique is a promising method for differential diagnosing and definition of the tumor extension process in the stomach and esophagus which can be used as an express method in diagnostically complex cases.

© 2018 Russian Electronic Journal of Radiology.All right reserved. Purpose: To investigate the prevalence of anatomic and pathologic findings in the maxillary sinus detected through cone-beam computed tomography (CBCT) in the routine of Stomatology. Materials and methods: The sample consisted of 954 CBCT scans from male (n: 330) and female (n: 624) patients aged between 2 and 86 years (mean age: 33 years). CBCT scans were taken from each patient for dental and maxillofacial diagnosis and treatment planning. The iCAT CBCT device and the inherent VisionQ software package (Imaging Science International, Hatfield, PA, USA) were used. X2 test was used to associate the anatomic and pathologic findings with patients' sex and age. Results: In both males and females, the most prevalent anatomic and pathologic findings in the maxillary sinus were, respectively, the sinus septa (21.2%) and thickening of the sinus mucosa (62.3%). Higher prevalence of maxillary sinus findings were detected within patients in the age range from 12 and 18 years (p<0.05). CBCT exams showed a high prevalence of anatomic and pathologic findings in the maxillary sinus that may have a significant clinical relevance. Conclusions: Stomatologists, Maxillofacial Surgeons and Physicians must properly interpret CBCT exams and must be aware of the occurrence of anatomic and pathologic findings prior to procedures that involve the maxillary sinus.

© 2018 Russian Photodynamic Association. All rights reserved. A comparative experimental study of the specific activity of drugs based on 5-aminolevulinic acid (5-ALA) and its hexyl ester (5-ALA HE) was carried out. Their ability to induce the synthesis of photoactive protoporphyrin IX in the healthy tissues of the rabbit bladder when instilling the drug solutions at various concentrations has been estimated. It was shown that 5-ALA HE results in the induction and accumulation of PPIX in the rabbit bladder epithelium at much lower concentrations than 5-ALA. Thus, a significant increase in the fluorescence intensity in comparison with the control was achieved by instillation of 5-ALA HE solution in the rabbit' bladder at a concentration of only 0.0001% (fluorescence intensity 2.20±0.60 a.u.), and for 5-ALA - only when using a solution at a concentration of 0.3% (fluorescence intensity 2.60±1.02 a.u.).

© 2018 Media Sphera Publishing Group. All rights reserved. Scleromyxedema is a rare mucinosis with a primary skin lesion due to diffuse mucin deposition, sclerosis, and lichenoid eruptions in the absence of hypothyroidism. The paper describes scleromyxedema cases and gives recommendations for the histological diagnosis of the disease by histochemical reactions to detect acid and neutral glycosaminoglycans.

© 2018 Russian Electronic Journal of Radiology.All right reserved. Purpose: To study peculiarities of clinico-radiological and anatomico-topographic relationship of sciatic nerve and acetabulum. Materials and Methods: Two stages experimental research was conducted in vitro on 20 human corpses, died due to various reasons. Clinico-radiological study was carried out in vivo on 41 patients with injuries of sciatic nerve and acetabulum. Results: Research data can confidently state that topographic proximity of sciatic nerve to acetabulum especially to its posterior-upper edge determines high risk of nerve lesion at acetabulum fractures due to influence of bone fragments, formed hematoma, forming scars. Conclusion: Acetabulum fractures are potentially dangerous for possibility of simultaneous injury of sciatic nerve; in this case a patient has to be subjected to special examination with the purpose of his sciatic nerve status evaluation.

© 2018, Media Sphera Publishing Group. All Rights Reserved. The careful differential diagnosis is very important in pediatric cases of multiple sclerosis (MS). It has special difficulties if MS started in patients with residual neurological pathology. Two cases of development of MS in children with cerebral palsy (CP) are presented. The clinical features and diagnostic difficulties in such comorbid situations are discussed.

© 2018 Ima-Press Publishing House. All rights reservbed. The examination of a patient with acute low back pain (LBP) includes the clarification of complaints and history data, brief physical and neurological examinations, and an assessment of danger symptoms. The diagnosis of acute nonspecific (musculoskeletal) LBP is based on the exclusion of a specific cause of pain (a potentially dangerous disease), discogenic radiculopathy, and lumbar spinal stenosis. If there is typical musculoskeletal pain and no danger symptoms, radiography, X-ray computed tomography, and magnetic resonance imaging are not recommended in the first 4 weeks of disease. Whether it is expedient to perform these techniques is considered when LBP persists over this time period. A patient with acute nonspecific (musculoskeletal) LBP should be informed about the favorable outcome of the disease and the need to maintain physical and social activities, to avoid bed rest, and, if possible, to continue professional activities. The lowest effective dose of nonsteroidal anti-inflammatory drugs for short-term duration, as well as muscle relaxants (the medium level of evidence) can be used to relieve pain. It is recommended that one should use an educational program (to prevent over-exercising and prolonged standing or sitting in static and awkward positions; to lift weights properly; etc.) to prevent recurrent LBP, as well as therapeutic exercises during a non-exacerbation period.

© COPYRIGHT SPIE. Downloading of the abstract is permitted for personal use only. We have performed the in vitro terahertz (THz) spectroscopy of human brain tumors. In order to fix tissues for the THz measurements, we have applied the gelatin embedding. It allows for preserving tissues from hydration/dehydration and sustaining their THz response similar to that of the freshly-excised tissues for a long time after resection. We have assembled an experimental setup for the reflection-mode measurements of human brain tissues based on the THz pulsed spectrometer. We have used this setup to study in vitro the refractive index and the amplitude absorption coefficient of 2 samples of malignant glioma (grade IV), 1 sample of meningioma (grade I), and samples of intact tissues. We have observed significant differences between the THz responses of normal and pathological tissues of the brain. The results of this paper highlight the potential of the THz technology in the intraoperative neurodiagnosis of tumors relying on the endogenous labels of tumorous tissues.