scholarly journals Bilateral polysegmentary pneumonia caused by SARS-CoV-2 in a transplanted liver recipient

2020 ◽  
Vol 11 (2) ◽  
pp. 101-106
Author(s):  
Roman V. Ishenko ◽  
Sergei V. Golovincki ◽  
Artur R. Akhmedianov ◽  
Sergei E. Voskanyan ◽  
Ilya Yu. Kolyshev
Keyword(s):  
Infectious Disease ◽  
Clinical Case ◽  
Organ Transplant ◽  
Immunosuppressive Drugs ◽  
Right Lobe ◽  
Coronavirus Infection ◽  
Disease Hospital ◽  
The Right ◽  
Liver Recipient

Background. In December 2019, the humanity met a previously unknown infectious disease (COVID-19) caused by a new coronavirus called SARS-CoV-2. An important role in the treatment of COVID-19 belongs to anti-inflammatory and immunosuppressive drugs. In this regard, the cases of the disease in patients undergoing long-term immunosuppressive therapy, for example, organ transplant recipients, are of particular interest. We present our clinical observation of COVID-19 in a liver recipient patient, which, apparently, is the first in the Russian Federation. Clinical case description A 54-year-old man, 10 years ago at the A.I. Burnazyan Center underwent transplantation of the right lobe of the liver after resection of hepatocellular carcinoma, T2N0M0, and due to liver cirrhosis as a result of НСV hepatitis. At the time of hospitalization, he had been constantly receiving immunosuppressive monotherapy with everolimus. The patient was transferred to an infectious disease hospital due to a positive PCR test for SARS-CoV-2 RNA. No signs of respiratory failure were found upon admission. Subsequently, a mild course of COVID-19 was observed, without signs of an acute inflammatory reaction, with normal CRP values and a slight increase of ferritin. 7 days after the treatment, the patient was discharged for outpatient observation. Conclusion. This clinical case is of interest not only by the success of the treatment of the new coronavirus infection COVID-19 in an immunocompromised patient a recipient of a liver transplant, but also by the fact that the disease manifested itself primarily as a transient increase in hepatic aminotransferases, which can be attributed to the gastrointestinal manifestations of COVID-19.

scholarly journals Modern views on the problem of sepsis

2020 ◽  
pp. 18-26
Author(s):  
V.S. Kopcha
Keyword(s):  
Infectious Disease ◽  
Inflammatory Response ◽  
Clinical Case ◽  
Conservative Therapy ◽  
Medical Community ◽  
Etiological Factors ◽  
Systemic Reactions ◽  
Almost All ◽  
Increased Activity

BACKGROUND. By defining the cornerstone of sepsis as the “systemic” of the inflammatory response in the form of cytokine violations, the authors of the corresponding concept are forced to recognize the etiological factors almost all pathogens of infectious diseases, which naturally go with the increased activity of cytokines in serum. Without diminishing the importance of these components of inflammation, one should pay attention to the postulate that not only viruses and protozoa never cause sepsis, but also all non-bacterial pathogens are not etiological factors of this disease, although they lead to severe systemic reactions accompanied by an increase in the level of proinflammatory cytokines. OBJECTIVE. The purpose of the work is to draw the attention of physicians to the discrepancy between the new notions about sepsis imposed on the medical community and accepted not only by anesthetists, resuscitative surgeons and surgeons, but also by many infectionists. MATERIALS AND METHODS. A detailed analysis of the clinical case of sepsis in a young woman is presented, which, due to adequate surgical and long-term conservative therapy, has safely recovered. CONCLUSIONS. Sepsis is a generalized acyclic infectious disease of the bacterial and/or fungal etiology that develops in an immunodeficient organism with characteristic pathomorphological and pathologist changes in organs and tissues.

scholarly journals Development of Rhabdomyolysis in the Long-term Period of Previous New Coronavirus Infection COVID-19 (Clinical Case Report)

2021 ◽  
Vol 10 (3) ◽  
pp. 452-459
Author(s):  
G. A. Berdnikov ◽  
N. Y. Kudryashova ◽  
E. V. Migunova ◽  
S. I. Rey ◽  
E. V. Gurok ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Kidney Injury ◽  
Infusion Therapy ◽  
Dynamic Observation ◽  
Three Phase ◽  
One Step ◽  
Coronavirus Infection ◽  
The Right

Relevance. Rhabdomyolysis is one of the complications of the new coronavirus infection COVID-19, which may cause acute kidney injury (AKI). The reason for the development of rhabdomyolysis in our observation in a patient after suffering COVID-19 in the long-term period was an increased muscle load.Aim of study. Presentation of a case of rhabdomyolysis with AKI in a patient after COVID-19 in the long-term period.Material and methods. In clinical observation, a 25-year-old patient L. is presented, who was being treated in the Department for the Treatment of Acute Endotoxicosis of the N.V. Sklifosovsky Research Institute for Emergency Medicine. In 2020, he developed COVID-19, complicated by rhabdomyolysis and AKI in the long term period.Results. Examination revealed an increase in creatinine phosphokinase (CPK) — 106,000.0 U/L, alanine aminotransferase (ALT) — 553.0 U/L, aspartate aminotransferase (AST) — 1582.0 U/L, lactate dehydrogenase (LDH) — 2809.0 U/L, levels of serum creatinine 164 μmol/L and myoglobin — 201 ng/ml. Virological research: IgM — 0.27 units per ml; IgG — 7.28 units per ml. 3 Three-phase scintigraphy with 99mTc-pyrfotech revealed signs of necrotic changes in the muscles of the upper half of the back, muscles of the chest (mainly on the right), muscles of the shoulder and upper half of the forearm on both sides. Kidneys: decreased perfusion of the right kidney (relative to the left), moderate slowdown of urodynamics at the level of the calyx-pelvis complex on both sides.Conclusions. The reason for the development of rhabdomyolysis in the long-term period in the patient after suffering from COVID-19 was an increased muscle load. Targeted research and medical history can help identify signs of rhabdomyolysis. The use of the radionuclide diagnostic method makes it possible to identify areas of soft tissue damage with a one-step assessment of renal function in rhabdomyolysis in the acute period of the disease, as well as to evaluate the effectiveness of treatment with dynamic observation. When rhabdomyolysis is confirmed, it is necessary to carry out detoxification and infusion therapy, to monitor renal function in order to detect acute kidney injury, and in case of deterioration of renal function and intoxication, renal replacement therapy is indicated.

scholarly journals A clinical case of arrhythmogenic right ventricular dysplasia

2021 ◽  
Vol 2 (1) ◽  
pp. 109-114
Author(s):  
E. V. Solovyoval ◽  
N. A. Popova ◽  
T. V. Vlasoval ◽  
M. L. Gorbunova ◽  
L. N. Antsygina
Keyword(s):  
Right Ventricular ◽  
Clinical Case ◽  
Ventricular Myocardium ◽  
Arrhythmogenic Right Ventricular Dysplasia ◽  
Myocardial Diseases ◽  
Conduction Disorders ◽  
Right Ventricular Dysplasia ◽  
Common Causes ◽  
The Right

Arhythmogenic right ventricular dysplasia (ADP) refers to hereditary myocardial diseases, in which there are structural and functional disorders in the right ventricular myocardium, causing rhythm and conduction disorders, including fatal ventricular arrhythmias. ADP is considered one of the most common causes of sudden cardiac death in young people and people who are engaged in sports. However, in practice, there are cases of this disease in people of an older age category. Diagnosis of ADP is still difficult due to the possible long-term asymptomatic course of the disease. The article describes a clinical case of ADP in a 48-year-old man.

scholarly journals Long-term consequences of Lyell's syndrome suffered in childhood

2021 ◽  
pp. 79-82
Author(s):  
O.M. Okhotnikova ◽  
◽  
T.M. Tkachоva ◽  
A.S. Andriyko ◽  
I.O. Kurian ◽  
...  
Keyword(s):  
Clinical Case ◽  
Chronic Sinusitis ◽  
Treatment Strategies ◽  
Chronic Obstructive ◽  
Long Term Consequences ◽  
Lyell’S Syndrome ◽  
The Right ◽  
Chronic Conjunctivitis ◽  
Lyell's Syndrome

The article provides a review of literature on the long-term consequences of Lyell's syndrome (one of the forms of toxic epidermal necrolysis). Among them: chronic eczema with xerosis and itching, skin depigmentation, hypertrophic and keloid scars, nail lesions, eyes, including dry eye syndrome and chronic conjunctivitis with/without obliteration of the nasolacrimal canal, kidney disease, lung disease, Sjogren's syndrome, Hashimoto's thyroiditis and others. Clinical case. The authors present their clinical case of an 11-year-old girl who suffered from Lyell's syndrome at the age of 8 and has been observed for the past three years, share their clinical and laboratory-instrumental observations and treatment strategies. In particular, they report about the revision of the clinical diagnosis with which the girl was admitted to the OHMADYT hospital, from BA to chronic secondary obstructive bronchitis, the detection of chronic conjunctivitis with obliteration of the nasolacrimal canals, chronic sinusitis, secondary immune deficiency, keloid skin scars. Conclusions. Despite constant rehabilitation therapy and a significant improvement in the general condition of the girl, it was not possible to fully restore the function of mucociliary transport, as a result ventilation of small bronchi gradually deteriorates, bronchiectasis is observed in the basal segments of the right lung, a polyserial strain S. aureus is formed, which is constantly sown from the child's sputum; it was not possible to fully restore the patency of the nasolacrimal canals and achieve a stable remission of chronic sinusitis. The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: Lyell's syndrome, children, Long-term consequences, chronic obstructive bronchitis, obesity, treatment.

Balance of private and public interests in the field of entrepreneurial activity during the period of taking measures to ensure the sanitary and epidemiological welfare of the population

2020 ◽  
pp. 495-502
Author(s):  
Anton Bibarov-Gosudarev
Keyword(s):  
State Regulation ◽  
The State ◽  
Entrepreneurial Activity ◽  
Public Interests ◽  
Counter Measures ◽  
Balance Of Interests ◽  
Private And Public ◽  
Coronavirus Infection ◽  
The Right

The work is devoted to the issue of determining the balance of interests of the entrepreneurial community, society and state. We conduct a fairly detailed analysis of the reasons for the restrictions imposed due to the spread of new coronavirus infection COVID-19. We work on the concepts of “public interest” and “private interest”, we investigate the limits of restric-tions that the state has the right to impose in terms of entrepreneurial activity regulation. We substantiate the conclusions that the tasks of entrepreneur-ship’s state regulation indicate that state regulation is necessary not only for the state, but also for entrepreneurs themselves. And the introduction of re-strictions, despite all their painfulness, was beneficial in the long term for en-trepreneurs. We also emphasize that these restrictions are not always propor-tionate and adequate to the current conditions. In the course of the study, we conclude that the restrictions should be thoughtful, understandable and justi-fied, while the state should think about counter measures of support, since in fact, in the current situation, the entrepreneurial community shared with the state all the risks and severity of consequences from the complication of the sanitary and epidemiological situation in the country.

scholarly journals Long-term consequences of Lyell's syndrome suffered in childhood

2021 ◽  
pp. 69-78
Author(s):  
O.M. Okhotnikova ◽  
◽  
T.M. Tkachоva 0000-0001-8951-7767 ◽  
A.S. Andriyko ◽  
I.O. Kurian ◽  
...  
Keyword(s):  
Clinical Case ◽  
Chronic Sinusitis ◽  
Treatment Strategies ◽  
Chronic Obstructive ◽  
Long Term Consequences ◽  
Lyell’S Syndrome ◽  
The Right ◽  
Chronic Conjunctivitis ◽  
Lyell's Syndrome

The article provides a review of literature on the long-term consequences of Lyell's syndrome (one of the forms of toxic epidermal necrolysis). Among them: chronic eczema with xerosis and itching, skin depigmentation, hypertrophic and keloid scars, nail lesions, eyes, including dry eye syndrome and chronic conjunctivitis with/without obliteration of the nasolacrimal canal, kidney disease, lung disease, Sjogren's syndrome, Hashimoto's thyroiditis and others. Clinical case. The authors present their clinical case of an 11-year-old girl who suffered from Lyell's syndrome at the age of 8 and has been observed for the past three years, share their clinical and laboratory-instrumental observations and treatment strategies. In particular, they report about the revision of the clinical diagnosis with which the girl was admitted to the OHMADYT hospital, from BA to chronic secondary obstructive bronchitis, the detection of chronic conjunctivitis with obliteration of the nasolacrimal canals, chronic sinusitis, secondary immune deficiency, keloid skin scars. Conclusions. Despite constant rehabilitation therapy and a significant improvement in the general condition of the girl, it was not possible to fully restore the function of mucociliary transport, as a result ventilation of small bronchi gradually deteriorates, bronchiectasis is observed in the basal segments of the right lung, a polyserial strain S. aureus is formed, which is constantly sown from the child's sputum; it was not possible to fully restore the patency of the nasolacrimal canals and achieve a stable remission of chronic sinusitis. The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: Lyell's syndrome, children, Long-term consequences, chronic obstructive bronchitis, obesity, treatment.

A clinical case of treatment of traction retinal detachment in a patient with proliferative diabetic retinopathy on the background of Sweet s syndrome after a coronavirus infection

2021 ◽  
pp. 202-205
Author(s):  
D.O. Shkvorchenko ◽  
◽  
S.A. Kakunina ◽  
K.S. Norman ◽  
M.G. Polin ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Retinal Detachment ◽  
Proliferative Diabetic Retinopathy ◽  
Clinical Case ◽  
The Body ◽  
Angle Closure ◽  
Traction Retinal Detachment ◽  
Results Of Treatment ◽  
Coronavirus Infection ◽  
The Right

Purpose. To evaluate the clinical and functional visual results of treatment of traction retinal detachment in a patient with proliferative diabetic retinopathy on the background of Sweet's syndrome after a coronavirus infection. Material and methods. Under observation was a 65-year-old patient with a diagnosis in the right eye: traction retinal detachment, hemophthalmos, proliferative diabetic retinopathy, artifacia and in the left eye: angle-closure glaucoma, proliferative diabetic retinopathy, complicated cataract. In the anamnesis of patient E., there was a tendency for complaints of decreased visual acuity, discomfort and redness of the right eye against the background of coronavirus infection. Results. Patient E. on the right eye underwent microinvasive subtotal vitrectomy, removal of the epiretinal membrane, endolasercoagulation of the retina, and silicone tamponade. When visualizing the fundus of the right eye, atypical changes were found for the fundus. Conclusion. This clinical case is interesting for the variability of the virus ' effect on the body and requires further confirmation of this effect on the posterior segment of the eye and its study. Key words: traction retinal detachment, coronavirus infection, retina, optic disc.

scholarly journals Clinical case of multisystem inflammatory syndrome development in a child with new coronavirus infection

2021 ◽  
Vol 20 (2) ◽  
pp. 60-63
Author(s):  
Yu. B. Belan ◽  
E. A. Gashina ◽  
E. F. Lobova ◽  
E. P. Shefer
Keyword(s):  
Infectious Diseases ◽  
Clinical Case ◽  
Maculopapular Rash ◽  
Present Patient ◽  
Clinical Hospital ◽  
Nasal Swabs ◽  
Coronavirus Infection ◽  
Inflammatory Syndrome

Objective: The article deals with a clinical case of new coronavirus infection in a 1 5-year-old child who was receiving treatment in an infectious diseases hospital of City Children's Clinical Hospital №3 during the period from 1 0 October to 1 December 2020.Materials and methods. The diagnosis was confirmed through nasal swabs examination for the presence of SARS-CoV-2 RNA using PCR and SARS-CoV-2 IgM detection through ELISA.Results. The main feature of the infection course in the present patient was multisystem inflammatory syndrome development with long-term fever, maculopapular rash and multisystemic lesions including bilateral pneumonia, acute carditis and polyserositis.

scholarly journals Right lobo-isthmic agenesis of the thyroid: A case report

2021 ◽  
pp. 18-22
Author(s):  
Sylvain Diembi ◽  
F Itere-Odzili ◽  
Boris Otouana ◽  
GC Gouoni ◽  
Donatien Moukassa ◽  
...  
Keyword(s):  
Congenital Anomaly ◽  
Case Report ◽  
Clinical Case ◽  
Left Lobe ◽  
Volume Ultrasound ◽  
Right Lobe ◽  
The Right

The authors report the observation of a 36-year-old woman with right lobo-isthmic agenesis complicated by an adenoma developed at the expense of the left lobe. The patient presented for many years a presumed cystic nodule developed at the expense of the left lobe, having recently increased in volume. Ultrasound and scannographic studies suggested that the right lobe and isthmus were absent. At cervicotomy, it was a hypoplasia of the right lobe and isthmus. Keywords: Congenital Anomaly; Thyroid; Lobar Agenesis; Clinical Case

scholarly journals CLINICAL CASE OF PERFORMING A TWO-ST AGE LOVER RESECTION BY TYPE ALPPS IN PATIENT WHO PREVIOUSLY UNDERWENT ANATOMIC RESECTION OF THE RIGHT LOBE OF THE LIVER

2015 ◽  
Vol 2 (3) ◽  
pp. 93-97 ◽  
Author(s):  
D. V. Sidorov ◽  
M. V. Lozhkin ◽  
L. O. Petrov ◽  
N. A. Grishin ◽  
A. A. Troitskiy ◽  
...  
Keyword(s):  
Clinical Case ◽  
Anatomic Resection ◽  
Right Lobe ◽  
The Right
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