scholarly journals Peculiarities of pathogenesis, diagnostics and treatment of erectile dysfunction in patients presenting with hypogonadism

2010 ◽  
Vol 56 (5) ◽  
pp. 33-42
Author(s):  
S I Gamidov ◽  
O Kh Tazhetdinov ◽  
A A Pavlovichev ◽  
A Iu Popova ◽  
R A Tkhagapsoeva
Keyword(s):  
Erectile Dysfunction ◽  
Clinical Symptoms ◽  
Combined Therapy ◽  
Smooth Muscles ◽  
Clinical Manifestations ◽  
Digital Rectal Examination ◽  
Plasma Testosterone ◽  
Androgen Deficiency ◽  
Substitution Therapy ◽  
Testosterone Substitution

Different authors estimate the prevalence of hypogonadism and erectile dysfunction at 1.7% to 35%. The contribution of androgens playing an important role in regulation of erection remains the subject of extensive investigations. To date, experimental and clinical studies have demonstrated that androgen deficiency leads to degeneration and apoptosis of smooth muscle cells followed by fibrosis of cavernous bodies, impaired expression of endothelial and neuronal NO synthase, decreased arterial inflow and increased venous drainage of the cavernous bodies, enhanced sensitivity to mediators of vasoconstriction, impaired NO-mediated relaxation of smooth muscles in response to sexual stimulation, reduced expression of type 5 phosphodiesterase (PDE-5). Moreover, hypogonadism and erectile dysfunction are frequently associated with cardiovascular disorders, diabetes mellitus, metabolic syndrome, dyslipidemia, hypercholesterolemia, hypertriglyceridemia, and obesity. The main purpose of hormonal substitution therapy is to maximally normalize the physiological concentration of plasma testosterone and to eliminate clinical manifestations of androgen deficiency. The treatment with testosterone-containing preparations is indicated only for patients with clinical symptoms and laboratory findings suggestive of hypogonadism. The testosterone-based preparations for intramuscular administration currently find wide application for this purpose. Testosterone substitution therapy enhances libido, increases the frequency of morning erection, and improves sexual quality of life at large. It is worthy of note that treatment with these preparations is well tolerated by the patients. Control over hormonal substitution therapy with testosterone preparations implies evaluation of the clinical response and achievement of the target testosterone level in blood plasma. Also. it is necessary to measure PSA, perform digital rectal examination, and determine the hematocrit level prior to the initiation of the treatment, 3 and 6 months after its termination, and every 6 months thereafter. To conclude, androgens are natural stimulators maintaining sexual function in men. Patients with hypogonadism and erectile dysfunction should be managed by combined therapy with androgens and PDE-5 inhibitors.

"CLARITHROMYCIN-MB" CLINICAL EFFICACY IN COMBINED THERAPY OF PATIENTS WITH COMMUNITY-ACQUIRED PNEUMONIA

2020 ◽  
pp. 66-69
Author(s):  
O. V. Volobuieva ◽  
N. V. Shepylieva ◽  
V. V. Pavlov ◽  
T. V. Sevastianova ◽  
O. O. Shevchenko ◽  
...  
Keyword(s):  
Clinical Efficacy ◽  
Inflammatory Process ◽  
Clinical Symptoms ◽  
Combined Therapy ◽  
Clinical Manifestations ◽  
Temperature Response ◽  
Clinical Effectiveness ◽  
Modern Medicine ◽  
Community Acquired Pneumonia ◽  
Antibacterial Drug

The problem of rational antibiotic therapy of pneumonia is one of the most relevant in modern medicine. So far, a large number of the factors have been identified that determine the optimal quality of antimicrobial therapy: the maximum effectiveness with the lowest toxicity of drugs should be combined with their proper cost. In order to study the clinical efficacy and therapeutic tolerability of the drug class of macrolides, clarithromycin for parenteral use in the treatment of patients with community−acquired pneumonia, 20 patients were examined. All the patients had clinical symptoms of severe infectious lesions of the lower respiratory tract. The complex therapy (detoxification, mucolytic drugs, multivitamins, metabolites) included "Clarithromycin−MB", which was administered intravenously for 60 minutes at a dose of 500 mg 2 times a day for 7−10 days. The clinical effectiveness of antibacterial therapy was assessed by the dynamics of the activity of the inflammatory process in the lungs. For this purpose, the following clinical and laboratory parameters characterizing the activity of the inflammatory process (temperature response, tachycardia, respiratory rate, leukocytosis, number of immature granulocytes, change in erythrocyte sedimentation rate), severity of pain, radiological changes in the lungs were determined. Macrolide "Clarithromycin−MB" in a parenteral form is a highly effective antibacterial drug for the treatment of community−acquired pneumonia with severe course. Positive dynamics of clinical manifestations of the disease was observed on the third day from the beginning of therapy. "Clarithromycin−MB" has good therapeutic tolerability, the dosage regimen allows to maintain the required concentration in the site of inflammation, which affects the clinical and bacteriological efficacy of treatment of the patients with community−acquired pneumonia. Key words: community−acquired pneumonia, macrolides, "Clarithromycin−MB".

Etiology and clinical features of epididymo-orchitis: A single-center study in Tehran, Iran

2020 ◽  
Vol 20 ◽  
Author(s):  
Sara Abolghasemi ◽  
Mohammad Alizadeh ◽  
Ali Hashemi ◽  
Shabnam Tehrani
Keyword(s):  
Chlamydia Trachomatis ◽  
Clinical Symptoms ◽  
Urine Culture ◽  
Clinical Manifestations ◽  
Urinary Frequency ◽  
Serological Tests ◽  
Duration Of Symptoms ◽  
Two Samples ◽  
History Of ◽  
Tract Infections

Introduction: Epididymo-orchitis is a common urological disease among men. Little is known about the clinical and epidemiological aspects of the disease in Iran. Thus, the present study was aimed to investigate the etiology, clinical sequelae and risk factors of patients with epididymo-orchitis in Tehran, Iran. Materials and Methods: Patients presenting with epididymo-orchitis were prospectively analyzed in order to study the etiology and pattern of the disease. Bacteriological, molecular and serological tests were undertaken to look for Chlamydia trachomatis, Neisseria gonorrhoeae, Brucella spp., Mycoplasma spp, and other bacteria. Results: Fifty patients with epididymo-orchitis were evaluated according to their clinical symptoms, duration of symptoms, physical examination, and laboratory studies. The mean age of the patients was 53 years. Fever, dysuria, pain in the flanks, urinary frequency and discharges occurred in 58.0%, 50.0%, 50.0%, 28.0% and 6.0%, respectively. Bacterial pathogen was identified in 26% (13/50) of patients by urine culture. Escherichia coli was the etiological agent in 11/13 patients (84.6%). Two out of 50 patients (4.0%) were also positive for Chlamydia trachomatis. Two samples were serologically positive for Brucella spp. High Mean age, fever, urinary frequency, history of the underlying disease and history of urinary tract infections were found to have a significant association with the positive bacteriologic urine culture (P<0.05). Conclusions: The most common clinical manifestations were fever, dysuria, and abdominal pain. E. coli and C. trachomatis were the major causative agents. Use of a set of diagnostic approaches including clinical symptoms, urine culture and more precise techniques such as PCR should be taken into consideration for the definitive diagnosis.

Scrub typhus (Orientia tsutsugamushi), A rapidly spreading epidemic in Chennai - A standalone lab experience

2016 ◽  
Vol 5 (09) ◽  
pp. 4896
Author(s):  
Sripriya C.S.* ◽  
Shanthi B. ◽  
Arockia Doss S. ◽  
Antonie Raj I. ◽  
Mohana Priya
Keyword(s):  
Scrub Typhus ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Febrile Illness ◽  
Orientia Tsutsugamushi ◽  
The Past ◽  
Igm Elisa ◽  
The Mean ◽  
Specific Symptoms ◽  
Symptoms And Signs

Scrub typhus (Orientia tsutsugamushi), is a strict intracellular bacterium which is reported to be a recent threat to parts of southern India. There is re-emergence of scrub typhus during the past few years in Chennai. Scrub typhus is an acute febrile illness which generally causes non-specific symptoms and signs. The clinical manifestations of this disease range from sub-clinical disease to organ failure to fatal disease. This study documents our laboratory experience in diagnosis of scrub typhus in patients with fever and suspected clinical symptoms of scrub typhus infection for a period of two years from April 2014 to April 2016 using immunochromatography and IgM ELISA methods. The study was conducted on 648 patients out of whom 188 patients were found to be positive for scrub typhus. Results also showed that pediatric (0 -12 years) and young adults (20 – 39 years) were more exposed to scrub typhus infection and female patients were more infected compared to male. The study also showed that the rate of infection was higher between September to February which also suggested that the infection rate is proportional to the climatic condition. Statistical analysis showed that the mean age of the patients in this study was 37.6, standard deviation was 18.97, CV % was 50.45. 

scholarly journals Pediatric COVID-19 and the Factors That May Mitigate Its Clinical Course

2020 ◽  
Vol 10 (01) ◽  
pp. e137-e140
Author(s):  
Mosaad Abdel-Aziz ◽  
Nada M. Abdel-Aziz ◽  
Dina M. Abdel-Aziz ◽  
Noha Azab
Keyword(s):  
Clinical Features ◽  
Clinical Symptoms ◽  
Clinical Course ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Angiotensin Converting Enzyme 2 ◽  
Compulsory Vaccination ◽  
Specific Factors ◽  
Novel Coronavirus ◽  
Radiographic Data

AbstractThe clinical manifestations of novel coronavirus disease 2019 (COVID-19) vary from mild flu-like symptoms to severe fatal pneumonia. However, children with COVID-19 may be asymptomatic or may have mild clinical symptoms. The aim of this study was to investigate clinical features of pediatric COVID-19 and to search for the factors that may mitigate the disease course. We reviewed the literature to realize the clinical features, laboratory, and radiographic data that may be diagnostic for COVID-19 among children. Also, we studied the factors that may affect the clinical course of the disease. Fever, dry cough, and fatigue are the main symptoms of pediatric COVID-19, sometimes flu-like symptoms and/or gastrointestinal symptoms may be present. Although some infected children may be asymptomatic, a recent unusual hyperinflammatory reaction with overlapping features of Kawasaki's disease and toxic shock syndrome in pediatric COVID-19 has been occasionally reported. Severe acute respiratory syndrome-coronvirus-2 (SARS-CoV-2) nucleic acid testing is the corner-stone method for the diagnosis of COVID-19. Lymphocyte count and other inflammatory markers are not essentially diagnostic; however, chest computed tomography is highly specific. Factors that may mitigate the severity of pediatric COVID-19 are home confinement with limited children activity, trained immunity caused by compulsory vaccination, the response of the angiotensin-converting enzyme 2 receptors in children is not the same as in adults, and that children are less likely to have comorbidities. As infected children may be asymptomatic or may have only mild respiratory and/or gastrointestinal symptoms that might be missed, all children for families who have a member diagnosed with COVID-19 should be investigated.

scholarly journals Gastric amyloidosis presenting as acute upper gastrointestinal bleeding: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rachael Chan ◽  
Stephanie Carpentier
Keyword(s):  
Multiple Myeloma ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Left Gastric Artery ◽  
Bleeding Complications ◽  
Al Amyloidosis ◽  
Gi Bleeding ◽  
Reduced Ejection Fraction ◽  
Repeat Endoscopy ◽  
Tertiary Center

Abstract Background Amyloidosis is characterized by extracellular tissue deposition of fibrils, composed of insoluble low-molecular-weight protein subunits. The type, location, and extent of fibril deposition generates variable clinical manifestations. Gastrointestinal (GI) bleeding due to amyloid deposition is infrequent. Previous literature describes upper GI bleeding (UGIB) in patients with known amyloid disease. Here, we describe a case of recurrent UGIB that ultimately led to a diagnosis of GI amyloidosis and multiple myeloma in a patient with no history of either. Case presentation A 76-year-old male presented to the emergency department with frank hematemesis, melena, and a decreased level of consciousness. Management required intensive care unit (ICU) admission with transfusion, intubation, and hemodynamic support. Upper endoscopy revealed gastritis with erosions and nodularity in the gastric cardia and antrum. Hemostasis of a suspected bleeding fundic varix could not be achieved. Subsequently, the patient underwent computerized tomography (CT) angiography and an interventional radiologist completed embolization of the left gastric artery to address potentially life-threatening bleeding. Complications included development of bilateral pleural effusions and subsegmental pulmonary emboli. Pleural fluid was negative for malignancy. He was transferred to a peripheral hospital for continued care and rehabilitation. Unfortunately, he began re-bleeding and was transferred back to our tertiary center, requiring re-admission to the ICU and repeat endoscopy. Repeat biopsy of the gastric cardial nodularity was reported as active chronic gastritis and ulceration. However, based on the unusual endoscopic appearance, clinical suspicion for malignancy remained high. He exhibited symptoms of congestive heart failure following standard resuscitation. Transthoracic echocardiogram (TTE) demonstrated a reduced ejection fraction of 35–40% and a strain pattern with apical sparing. Following discussions between the treating gastroenterologist, consulting cardiologist, and pathologist, Congo Red staining was performed, revealing submucosal amyloid deposits. Hematology was consulted and investigations led to diagnosis of multiple myeloma (MM) and immunoglobulin light-chain (AL) amyloidosis. The patient was treated for MM for four months prior to cessation of therapy due to functional and cognitive decline. Conclusions GI amyloidosis can present with various non-specific clinical symptoms and endoscopic findings, rendering diagnosis a challenge. This case illustrates GI amyloidosis as a potential—albeit rare—etiology of UGIB.

scholarly journals CD4+ CD25+ Foxp3+ Regulatory T Cells, Dendritic Cells, and Circulating Cytokines in Uncomplicated Malaria: Do Different Parasite Species Elicit Similar Host Responses?

2010 ◽  
Vol 78 (11) ◽  
pp. 4763-4772 ◽  
Author(s):  
Raquel M. Gonçalves ◽  
Karina C. Salmazi ◽  
Bianca A. N. Santos ◽  
Melissa S. Bastos ◽  
Sandra C. Rocha ◽  
...  
Keyword(s):  
Dendritic Cells ◽  
Parasite Species ◽  
Inflammatory Responses ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Surface Expression ◽  
Interleukin 10 ◽  
Treg Cells ◽  
Experimental Models ◽  
Necrosis Factor Alpha

ABSTRACT Clearing blood-stage malaria parasites without inducing major host pathology requires a finely tuned balance between pro- and anti-inflammatory responses. The interplay between regulatory T (Treg) cells and dendritic cells (DCs) is one of the key determinants of this balance. Although experimental models have revealed various patterns of Treg cell expansion, DC maturation, and cytokine production according to the infecting malaria parasite species, no studies have compared all of these parameters in human infections with Plasmodium falciparum and P. vivax in the same setting of endemicity. Here we show that during uncomplicated acute malaria, both species induced a significant expansion of CD4+ CD25+ Foxp3+ Treg cells expressing the key immunomodulatory molecule CTLA-4 and a significant increase in the proportion of DCs that were plasmacytoid (CD123+), with a decrease in the myeloid/plasmacytoid DC ratio. These changes were proportional to parasite loads but correlated neither with the intensity of clinical symptoms nor with circulating cytokine levels. One-third of P. vivax-infected patients, but no P. falciparum-infected subjects, showed impaired maturation of circulating DCs, with low surface expression of CD86. Although vivax malaria patients overall had a less inflammatory cytokine response, with a higher interleukin-10 (IL-10)/tumor necrosis factor alpha (TNF-α) ratio, this finding did not translate to milder clinical manifestations than those of falciparum malaria patients. We discuss the potential implications of these findings for species-specific pathogenesis and long-lasting protective immunity to malaria.

CLINIC AND COMPLICATIONS OF COVID-19 CORONAVIRUS DISEASE WITH PATHOGENESIS ELEMENTS

2020 ◽  
pp. 72-79
Author(s):  
I. V. Аndrusovich
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Tract ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Clinical Symptoms ◽  
Clinical Course ◽  
Clinical Manifestations ◽  
Second Phase ◽  
Upper Respiratory Tract

The longer the COVID−19 coronavirus pandemic lasts, the more information about its clinical manifestations is accumulated. The incubation period of COVID−19 ranges from 2 to 14 days, rarely up to 3 weeks, but in a significant number of cases an infection is not accompanied with the appearance of clinical symptoms. Currently, the following variants of the clinical course of COVID−19 can be identified as follows: viral load; subclinical; slight; uncomplicated with damage to only the upper respiratory tract; mild pneumonia, severe pneumonia, acute respiratory distress syndrome, etc. The clinical course of COVID−19 depends on the severity, the criteria of which are the intoxication manifestation, the degree of fever and the dominant syndrome. Mild / moderate forms are manifested by frequent increase in body temperature up to 38 ° C, respiratory symptoms, headache, myalgias, palpitations and general malaise. Patients stop distinguishing smells and feel the taste of food. Approximately from the 7th to the 9th days of the disease there are problems with breathing, which indicates the impairment of the lower respiratory tract and the beginning of the second phase of the disease, and its course is regarded as severe. Severe forms of the disease can also be manifested by impaired coordination of movements, slurred speech. In 1 to 4 % of patients there is developed the psychosis in the form of hallucinations. In the elderly, COVID−19 may be accompanied by delirium, lowering blood pressure. The risks of adverse disease are associated with somatic diseases: cardiovascular and nervous systems, respiratory tract, hormonal disorders, etc. Otitis, sinusitis, sepsis, bronchopulmonary infection, thrombosis, myocarditis etc. can be the complications of COVID−19. Computer tomography is an instrumental test that demonstrates the damage of lungs with coronavirus and allows to assess its severity. Key words: coronavirus infection, COVID−19, clinical variants, severity, pneumonia, acute respiratory distress syndrome.

scholarly journals Chronic venous insufficiency after COVID-19: management of edema and pain syndromes

2021 ◽  
Vol 18 (2) ◽  
pp. 151-153
Author(s):  
F. Kh. Nizamov
Keyword(s):  
Chronic Diseases ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Clinical Symptoms ◽  
Varicose Veins ◽  
Clinical Manifestations ◽  
Pain Syndrome ◽  
Venous Stasis ◽  
Vein Wall ◽  
Vas Scores

Introduction. COVID-19 infection raises many questions regarding the health condition of patients after they have had COVID-19. The aim of this study is to examine the characteristic symptoms of chronic venous insufficiency in the postcovid period.Materials and methods. The materials that were used for work included the results of studying the medical aid appealability, characteristic symptoms, diagnosis and treatment of symptoms of chronic venous insufficiency in persons who have had the coronavirus infection. 47 patients presented with complaints about deterioration of their condition after they had had COVID-19 over March to September 2021 period. Methods: general clinical examiniation, ultrasound angioscanning of veins of the lower extremities, laboratory coagulation tests.Results and discussion. Before deterioration, calf circumference was measured 22–24 cm at a typical measurement site in most patients (89%), after covid infection it reached 26–27 cm. Varicose veins remained soft, without intravascular formations, edema was often bilateral, asymmetric, pain was described as constant (5–6 VAS scores), patients had prominent signs of lymphostasis. 35 out of 47 people received diosmin-based venotonic drug of Russian manufacture at a dose of 1000 mg/day (one tablet twice a day), the course of treatment lasted one to two months. After that period, the edema subsided in 85% of patients, the severity of pain syndrome significantly reduced (up to 2–3 VAS scores). With regard to chronic venous insufficiency in patients with chronic diseases of lower extremity veins (mostly varicose and post-thrombotic diseases), the significant progress of disease was observed in almost 94% of follow-up cases. Diosmin is the main drug that is prescribed to treat chronic venous insufficiency. The drug has an angioprotective and venotonic effect, reduces the vein wall elasticity, increases venous tone, and decreases venous stasis, reduces capillary permeability and fragility, and increases their resistance, improves microcirculation and lymphatic drainage.Сonclusions. In the postcovid period, clinical symptoms of some chronic diseases occur/worsen, including clinical manifestations of chronic venous insufficiency. The use of Russian diosmin-based drug for the management of edema and pain syndrome is very promising.

scholarly journals A de novo variant in CASK gene causing intellectual disability and brain hypoplasia: A Case Report and Literature Review

2021 ◽  
Author(s):  
Ying Zhang ◽  
Yanyan Nie ◽  
Yu Mu ◽  
Jie Zheng ◽  
Xiaowei Xu ◽  
...  
Keyword(s):  
Intellectual Disability ◽  
Mental Disorders ◽  
De Novo ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
De Novo Mutation ◽  
Loss Of Function ◽  
Bioinformatics Analyses ◽  
Whole Exome ◽  
De Novo Variant

Abstract Background：The pathogenic variation of CASK gene can cause CASK related mental disorders. The main clinical manifestations are microcephaly with pontine and cerebellar hypoplasia, X-linked mental disorders with or without nystagmus and FG syndrome. The main pathogenic mechanism is the loss of function of related protein caused by mutation. We reported a Chinese male newborn with a de novo variant in CASK gene. Case presentation：We present an 18-day-old baby with intellectual disability and brain hypoplasia. Whole-exome sequencing was performed, which detected a hemizygous missense mutation c.764G>A of CASK gene. The mutation changed the 255th amino acid from Arg to His. Software based bioinformatics analyses were conducted to infer its functional effect.Conclusions：In this paper, a de novo mutation of CASK gene was reported. Moreover, a detailed description of all the cases described in the literature is reported.CASK mutations cause a variety of clinical phenotypes. Its diagnosis is difficult due to the lack of typical clinical symptoms. Genetic testing should be performed as early as possible if this disease is suspected. This case provides an important reference for the diagnosis and treatment of future cases.

scholarly journals Clinical Characteristics and CT Manifestations of 143 Patients With 2019 Novel Coronavirus Disease (COVID-19) in Taizhou City, Zhejiang, China

2020 ◽  
Author(s):  
Yani Kuang ◽  
Susu He ◽  
Shuangxiang Lin ◽  
Rui Zhu ◽  
Rongzhen Zhou ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Protein A ◽  
Clinical Manifestations ◽  
Imaging Features ◽  
First Case ◽  
Severe Group ◽  
Laboratory Examinations ◽  
The Difference ◽  
Severity Of The Disease ◽  
Novel Coronavirus

Abstract Background: In December 2019, the first case of pneumonia associated with the SARS-CoV-2 was found in Wuhan and rapidly spread throughout China, so data are needed on the affected patients. The purpose of our study was to find the clinical manifestations and CT features of COVID-19.Methods: All patients with COVID-19 in Taizhou city were retrospectively included and divided into non-severe group and severe group according to the severity of the disease. The clinical manifestations, laboratory examinations and imaging features of COVID-19 patients were analyzed, and the differences between the two groups were compared.Results: A total of 143 laboratory-confirmed cases were included in the study, including 110 non-severe patients and 33 severe patients. The median age of patients was 47 (range 4–86 years). Fever (73.4%) and cough (63.6%) were the most common initial clinical symptoms. Between two groups of cases, the results of aspartate transaminase, creatine kinase and lactate dehydrogenase, serum albumin, CR, glomerular filtration rate, amyloid protein A, fibrinogen, calcitonin level and oxygen partial pressure, IL – 10, absolute value of CD3, CD4, CD8 were different, and the difference was statistically significant (P < 0.05). Therefore, these quantitative indicators can be used to help assess the severity. On admission, the CT showed that the lesions were mostly distributed in the periphery of the lung or subpleural (135 cases (98%)), and most of lesions presented as patchy (81%), mixed density (63%) shadow. Consolidation (68% vs 41%), bronchial inflation signs (59% vs 41%), and bronchiectasis (71% vs 39%) were more common in the severe group.Conclusions: Most of the cases of COVID-19 in Taizhou have mild symptoms and no death. In addition to clinical symptoms, some laboratory tests (such as absolute values of CD4 and CD8) and CT findings can be used to assess the severity of the disease.

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