Thyrotoxic hepatitis during pregnancy (clinical case)

A rare clinical case of thyrotoxic hepatitis detected in a pregnant woman is presented. A diagnostic search was carried out to clarify the cause of hepatitis, during which the pathology of the thyroid gland was revealed. The patient was prescribed adequate therapy with a thyrostatic drug, which in a short time allowed to achieve a significant decrease in the activity of the hepatic pathological process, which made it possible to prolong pregnancy.

DRESS/DIHS syndrome induced by sulfasalazine

Among the manifestations of drug hypersensitivity, DRESS/DIHS syndrome is of particular importance. The clinical manifestations include rash, enlarged lymph nodes, fever, hepatitis, leukocytosis with eosinophilia, as well as the involvement of other organs and systems. The most common causative agents include anticonvulsants, antidepressants, sulfanilamides, non-steroidal anti-inflammatory drugs, and allopurinol, but the list is constantly expanding. The exact pathogenesis of DRESS/DIHS syndrome is currently unclear. Timely diagnosis and adequate therapy can improve prognosis of this disease. In our clinical case, DRESS syndrome developed after the patient was administered sulfasalazine for erosive proctosigmoiditis. In order to ensure adequate prevention, early diagnosis, and proper management of DRESS syndrome, it is necessary to raise awareness of practitioners of different specialties about the possibility of developing this undesirable reaction to pharmacotherapy.

Violation of hemostasis in coronavirus infection

Hemostatic disorders in COVID-19 play an important role in the pathogenesis and clinical implications of the disease. The ability to identify factors and risk of developing thrombotic complications, to interpret the peripheral blood and coagulation dynamics, knowledge of diagnostic criteria possible of hemostatic disorders (DIC, sepsis-induced coagulopathy, antiphospholipid, hemophagocytic, hypercoagulation syndromes, etc.) are necessary to determine the scope of the survey, differentiated prescription of adequate therapy (including anticoagulants, blood components, plasmapheresis), which determines a greater efficiency of complex treatment and prognosis of patients with COVID-19.

BACKGROUND OF THE CCHF PATHOGEN CIRCULATION IN THE SOUTHERN REGION OF KAZAKHSTAN AND LABORATORY DIAGNOSTICS OF THE CONGO-CRIMEAN HEMORRHAGIC FEVER

Своевременная диагностика ККГЛ, прогнозирование геморрагического синдрома и адекватная терапия часто определяют благоприятный исход заболевания. Лабораторная оценка клинических проявлений ККГЛ проводится гематологическими, биохимическими, гемостазиологическими лабораторными испытаниями. Подтверждение диагноза осуществляется иммунологическими, молекулярно-генетическими и вирусологическими методами. Timely diagnosis of CCHF, prognosis of hemorrhagic syndrome and adequate therapy often determine a favorable outcome of the disease. Laboratory evaluation of clinical manifestations of CCHF is carried out by hematological, biochemical, and hemostasiological laboratory tests. Confirmation of the diagnosis is carried out by immunological, molecular-genetic and virological methods.

Two original observations concerning bacterial infections in COVID-19 patients hospitalized in intensive care units during the first wave of the epidemic in France

Among 197 COVID-19 patients hospitalized in ICU, 88 (44.7%) experienced at least one bacterial infection, with pneumonia (39.1%) and bloodstream infections (15,7%) being the most frequent. Unusual findings include frequent suspicion of bacterial translocations originating from the digestive tract as well as bacterial persistence in the lungs despite adequate therapy.

Characteristics Of Articulate Syndrome In Patients With Reactive Arthritis

In many countries and in our country reactive arthritis (RA) is a topical rheumatologic problem requiring early and individual therapy. Recently in the diagnostics of RA there is an active search of early biomarkers (BM) of articulate structures damage, which provide revealing of the symptoms of lesion of articulate soft tissues elements at the early stages of the disease. It can also help to assess the stage of lesion and prognosis of the disease. Later it will assist to prescribe adequate therapy according to the stage of the pathological process and perform monitoring of the therapy [1].

Two original observations concerning bacterial infections in COVID-19 patients hospitalized in intensive care units during the first wave of the epidemic in France

Among 197 COVID-19 patients hospitalized in ICU, 88 (44.7%) experienced at least one bacterial infection, with pneumonia (39.1%) and bloodstream infections (15,7%) being the most frequent. Unusual findings include frequent suspicion of bacterial translocations originating from the digestive tract as well as bacterial persistence in the lungs despite adequate therapy.

Diagnosis and treatment of otodectes in cats

Ticks of the genus Otodectes are often found in domestic animals. This disease has an all-season character in urban conditions. Since the transmission of the tick occurs by contact with an animal infected with otodectosis, it was recom-mended to exclude contact with strays and animals that have characteristic clinical signs in order to prevent the spread of this disease. Timely diagnosis and adequate therapy make it possible to identify and suppress the further development of this tick in animals in a short time. This paper presents the results of a study on the diagnosis and treatment of otodectosis in cats in the city of Irkutsk.

Coagulopathy at intoxication with rodenticides – antagonists of vitamin K

The review is devoted to poisoning with rodenticides containing indirect anticoagulants – vitamin K antagonists (VKA). The work describes the main groups of anticoagulants that are used in such preparations, describes the mechanism of their action. The authors analyzed a significant number of foreign and local literary sources on the poisoning of the rodenticides of this group. It was concluded that VKA intoxication occurs much less frequently than other rodenticides; it is mainly the occasional intake of drugs, most of the victims are children. The use of rodenticides-VKA by psychiatric patients and criminal cases are not common. Analysis of the literature has shown that the overwhelming number of poisonings occurs when using VKA, which are contained in ready-made rodent-control baits available to the majority of the population. Intoxication with modern rodenticides-VKA – superwarfarins is possible with oral, dermal exposure and contact with the mucous membranes of the eye; they have a cumulative effect. The main clinical manifestation of superwarfarin poisoning is hemorrhagic syndrome. The clinical signs of coagulopathy are much more pronounced in case of deliberate poisoning than in case of accidental poisoning, since for the appearance of hemorrhagic syndrome, a large amount of the substance contained in the finished bait is required. The principles and features of diagnosis, differential diagnosis and treatment of coagulopathy of this genesis are described. All patients have changes in the coagulogram, characteristic of vitamin K-dependent coagulopathy: an increase in the international normalized ratio, prothrombin time and activated partial thromboplastin time, a decrease in the levels of II, VII, IX and X blood coagulation factors, physiological anticoagulants – proteins C and S. Determine the concentration of superwarfarin in the blood using high performance liquid chromatography is not possible in every medical institution. In the clinical diagnosis of coagulopathy and the identification in the coagulogram of changes characteristic of vitamin K deficiency, even if its etiological cause has not been established, it is immediately necessary to prescribe adequate therapy: the introduction of fresh frozen plasma and/or concentrates of prothrombin complex factors, prescription of vitamin K preparations, symptomatic therapy. Taking into consideration the long half-life of superwarfarins, coagulopathy can persist for several months, during which treatment should be continued. With timely diagnosis and the appointment of adequate therapy, the prognosis in most cases is favorable. The mortality rate among people with superwarfarin poisoning is not high. As an illustration, the authors cite two clinical cases from personal practice.

Recurrent Mycobacterium chelonae Skin Infection Unmasked as Factitious Disorder Using Bacterial Whole Genome Sequence Analysis

Mycobacterium chelonae infections usually resolve with adequate therapy. We report the case of an adolescent with a chronic and progressive M chelonae infection refractory to combined antimicrobial and surgical therapy. Whole genome sequence analysis of consecutive isolates distinguished reinfection from recurrence and contributed to the diagnosis of a factitious disorder.