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В статті наведені тези науково-практичної конференції «Актуальні інфекційні захворювання. Клініка. Діагностика. Лікування та профілактика», яка відбулася 26–27 листопада 2015 року у Києві.

В статье представлены тезисы Научно-Практической конференции с международным участием "Инфекционные заболевания у детей. Современный взгляд на диагностику, лечение и профилактику.", которая состоялась 24 марта 2016 года в Киеве.

У статті представлені тези Республіканської науково-практичної конференції з міжнародною участю «Сучасні аспекти патогенезу, клініки, діагностики, лікування та профілактики паразитарних захворювань», яка відбулася 28 жовтня 2016 р.у м. Вітебськ (Білорусь).

Aim: The importance of managing fetal arrhythmia has increased with advances in fetal echocardiography. We aimed to describe the incidence, types, clinical characteristics, treatments, and follow-ups of patients diagnosed with fetal arrhythmia in our center. Materials and Methods: Fetal echocardiographic examinations performed in our units between January 2016 and September 2019 were retrospectively evaluated. Fetal arrhythmias and their subtypes were identified using M-mode and Doppler echocardiography in all patients. Maternal age, gestational age, history of maternal or gestational pathology, diagnoses, and medications were recorded. Fetal arrhythmias were categorized into three main groups: 1) Irregular heart rhythm (ectopic beats), 2) Bradyarrhythmias: a ventricular rate less than 110 bpm; and 3) Tachyarrhythmias: a ventricular rate exceeding 180 bpm. Results: A total of 60 patients were diagnosed with fetal arrhythmia, corresponding to an overall incidence of 0.5%. The mean maternal and gestational age of those patients with fetal arrhythmia were 28.35 +/- 4.88 years and 31.03 +/- 5.94 weeks. One patient had maternal systemic disease, and four had concurrent congenital cardiac disease. Fetal tachycardia, bradycardia, and irregular heart rhythm were detected in 10 (16.6%), 8 (13.3%), and 42 (70%) patients, respectively. Conclusion: Fetal echocardiography represents the main diagnostic tool for prenatal evaluation of fetal arrhythmias, which have a variable prognosis depending on the type of arrhythmia. The most common fetal arrhythmia, the irregular heart rhythm, generally does not necessitate any treatment and resolves spontaneously. The treatment plan in patients should be based on etiology and fetal conditions.

A. Kawai43, K. Kopeckova44, D. A. Krakorova45, A. Le Cesne46, F. Le Grange1, E. Legius47, A. Leithner48, A. Lopez Pousa49, J. Martin-Broto36, O. Merimsky50, C. Messiou51, A. B. Miah52, O. Mir53, M. Montemurro54, B. Morland55, C. Morosi56, E. Palmerini57, M. A. Pantaleo58, R. Piana59, S. Piperno-Neumann60, P. Reichardt61, P. Rutkowski62, A. A. Safwat63, C. Sangalli64, M. Sbaraglia19, S. Scheipl48, P. Schoffski65, S. Sleijfer66, D. Strauss67, K. Sundby Hall13, A. Trama68, M. Unk69, M. A. J. van de Sande70, W. T. A. van der Graaf66,71, W. J. van Houdt72, T. Frebourg73x, R. Ladenstein41z, P. G. Casali2,74z &

Contains fulltext : 244686.pdf (Publisher’s version ) (Open Access) Cloacal malformations are among the most complex types of anorectal malformation and are characterized by the urological, genital, and intestinal tracts opening through a single common channel in the perineum. Long-term outcome is affected by multiple factors, which include anatomical variants of the malformation itself, associated anomalies, and the surgical approach. Reconsidering these variables and their influence on "patient important" function might lead to strategies that are more outcome-driven than focused on the creation of normal anatomy. Key outcomes reflect function in each of the involved tracts and the follow-up needed should therefore not only include the classical fields of colorectal surgery and urology but also focus on items such as gynecology, sexuality, family-building, and quality of life as well as other psychological aspects. Involving patients and families in determining optimal treatment strategies and outcome measures could lead to improved outcomes for the individual patient. A strategy to support delivery of personalized care for patients with cloacal malformations by aiming to define the best functional outcomes achievable for any individual, then select the treatment pathway most likely deliver that, with the minimum morbidity and cost, would be attractive. Combining the current therapies with ongoing technological advances such as tissue expansion might be a way to achieve this.

Background Hepatocellular carcinoma (HCC) incidence, management and survival across England were examined to determine if geographical inequalities exist. Method 15,468 HCC cases diagnosed 2010–2016 were included. Age-standardised incidence rates, net survival and proportions receiving potentially curative treatment and presenting through each route to diagnosis adjusted for age at diagnosis, sex and area-based deprivation quintile, were calculated overall and by Cancer Alliance. Results HCC incidence rates increased in men from 6.2 per 100,000 in 2010 to 8.8 in 2016, and in women from 1.5 to 2.2. The highest incidence rates, found in parts of the North of England and London, were nearly double the lowest. The adjusted proportion presenting as an emergency ranged 27–41% across Cancer Alliances. Odds increased with increasing deprivation quintile and age. Only one in five patients received potentially curative treatment (range 15–28%) and odds decreased with increasing deprivation and age. One-year survival in 2013–2016 ranged 38–53%. Conclusion This population-based, nationwide analysis demonstrates clear differences in HCC incidence, management and survival across England. It highlights socioeconomic-associated variation and the need for improvement in early diagnosis and curative treatment of HCC. This research should assist policymakers, service providers and clinicians to identify regions where additional training, services and resources would be best directed.

Гидроцефалия является одним из наиболее распространенных мозговых расстройств. Каждый год в мире возникает почти 400 000 новых случаев гидроцефалии у детей. Согласно данным международной рабочей группы по изучению гидроцефалии, распространенность детской гидроцефалии колеблется от 1 до 32 случаев на 10 000 новорожденных. Частота гидроцефалии в Украине, по данным разных авторов, составляет 1–4 случая на 1000 родившихся живыми/год. При этом нередко спутником гидроцефалии является эпилепсия. Распространенность эпилепсии среди пациентов с гидроцефалией составляет от 12 до 50 % по данным разных авторов. Причины гидроцефалии, ее лечение и осложнения лечения являются потенциальными причинами эпилепсии. При этом эпилепсия может быть и следствием хирургического лечения гидроцефалии. В данной ситуации вопрос диагностики, назначения антиконвульсантов, хирургического лечения и прогнозирования течения эпилепсии остается дискутабельным. Целью нашего исследования был обзор литературы по диагностике, лечению и прогнозированию эпилепсии у детей с гидроцефалией на современном этапе развития медицинской науки. Проведен поиск научных публикаций с помощью электронных баз данных PubMed, Google Scholar по ключевым словам «гидроцефалия», «эпилепсия», «вентрикуло-перитонеальном шунтирование». В общем найдено 47 публикаций, среди них 25 уникальных исследований. Метaaнализ исследований по указанным критериям не проводился.

[English] Due to continuous aging of population and increase in the number of elderly people, osteoporosis became socially significant disease leading to disability, increasing mortality and thereby putting an additional burden on the public healthcare system. Screening to identify groups with a high probability of fracture is recommended using the FRAX® Tool for all postmenopausal women and men over 50 years old (А1). In the presense of major pathological fractures (hip, spine, multiple fractures) it is recommended to diagnose osteoporosis and prescribe treatment regardless of the results of spine and hip double X-ray absorptiometry (DXA) or FRAX® (B2). It is recommended to evaluate C-terminal telopeptide when prescribing antiresorptive therapy and procollagen type 1 N-terminal propeptide (P1NP) when prescribing anabolic therapy to patients receiving osteoporosis treatment at baseline and 3 months after the start of therapy in order to assess the effectiveness of treatment early and adherence to the therapy (А2). It is recommended to diagnose osteoporosis and prescribe treatment to patients with high individual 10-year probability of major pathological fractures (FRAX®) regardless of the results of spine and hip DXA (В3). It is recommended to diagnose osteoporosis and prescribe treatment with a decrease in BMD, measured by DXA, by 2.5 or more T-score standard deviations in femoral neck, and/or in total hip, and/or in lumbar vertebrae, in postmenopausal women and men over 50 years old (А2). It is recommended to prescribe bisphosphonates, denosumab or teriparatide to prevent pathological fractures and increase BMD in patients with postmenopausal osteoporosis, osteoporosis in men, glucocorticoid-induced osteoporosis (А2). When the clinical effect of therapy in osteoporotic patients without pathological fractures is achieved (BMD T-score > -2.0 SD in femoral neck and absence of new fractures), it is recommended to interrupt bisphosphonates therapy for 1-2 years with subsequent follow-up (B2). In patients with vertebral fractures, hip fractures or multiple fractures, it is recommended to continue ceaseless long-term treatment of osteoporosis (В3). All drugs for the treatment of osteoporosis are recommended to be prescribed in combination with calcium and cholecalciferol (А2). In order to reduce the risk of recurrent fractures by prescribing osteoporosis therapy timely and maintaining long-term follow-up of patients over 50 years old with pathological fractures, it is recommended to create Fracture Liaison Services (В2). [Русский] В связи с непрерывным старением населения и увеличением количества лиц старшего и пожилого возраста остеопороз стал социально значимым заболеванием, приводя к инвалидности, повышая уровень смертности и создавая тем самым дополнительную нагрузку на систему здравоохранения. Скрининг для выявления групп с высокой вероятностью переломов рекомендован с использованием Алгоритма FRAX® среди всех женщин в постменопаузе и мужчин старше 50 лет (А1). При наличии патологических переломов крупных костей скелета (бедренной кости, тел(а) позвонков(-а), множественных переломов) в анамнезе рекомендовано устанавливать диагноз остеопороза и назначать лечение независимо от результатов рентгеноденситометрии поясничного отдела позвоночника и проксимального отдела бедренной кости или FRAX® (B2). Рекомендуется определение С-концевого телопептида при назначении антирезорбтивной терапии и исследование уровня N-терминального пропептида проколлагена 1-го типа (P1NP) при назначении анаболической терапии пациентам, получающим лечение остеопороза, исходно и через 3 месяца от начала терапии с целью ранней оценки эффективности лечения и приверженности к терапии (А2). Рекомендовано устанавливать диагноз остеопороза и назначать лечение пациентам c высокой индивидуальной 10-летней вероятностью основных патологических переломов (FRAX®) независимо от показателя рентгеноденситометрии поясничного отдела позвоночника и проксимального отдела бедренной кости (В3). Рекомендовано устанавливать диагноз «остеопороз» и назначать терапию при снижении МПК, измеренной при DXA, на 2,5 и более стандартных отклонения по Т-критерию в шейке бедренной кости, и/или в целом в проксимальном отделе бедренной кости, и/или в поясничных позвонках у женщин в постменопаузе и у мужчин старше 50 лет (А2). Для предупреждения патологических переломов и повышения МПК у пациентов с постменопаузальным остеопорозом, остеопорозом у мужчин, глюкокортикоидным остеопорозом рекомендуется прием бисфосфонатов, деносумаба или терипаратида (А2). Пациентам с остеопорозом без патологических переломов при достижении клинического эффекта терапии (МПК до -2,0 SD по Т-критерию в шейке бедренной кости и отсутствие новых переломов) рекомендовано на 1-2 года прекратить терапию бисфосфонатами с последующим динамическим наблюдением (B2). Пациентам с переломами тел позвонков, бедренной кости или множественными переломами в анамнезе рекомендуется продолжать непрерывное длительное лечение остеопороза (В3). Все препараты для лечения остеопороза рекомендуется назначать в сочетании с препаратами кальция и колекальциферола (А2). С целью своевременного назначения терапии остеопороза и обеспечения длительного наблюдения за пациентами в возрасте 50 лет и старше с патологическими переломами для снижения риска повторных переломов рекомендуется создавать Службы профилактики повторных переломов (В2).

Objective: Influenza virus is common in children, especially in winter, causing hospitalization, admission to the intensive care unit, or even death. There are few studies on the attitudes or knowledge of influenza diagnosis, treatment, and vaccination among pediatricians. This study was planned to determine pediatric residents' attitudes and behaviors about recognizing the influenza virus, making treatment decisions, prophylaxis, and immunization. Material and Methods: This descriptive cross-sectional study was performed from 31 July-1 December 2019 among pediatric residents working in six different hospitals in the Aegean Region by an online survey. Twenty-seven questions were asked regarding articipant's demographic characteristics, recognition of the influenza symptoms, treatment, prophylaxis, and immunization. Results: Two hundred and four (58.5%) of 349 pediatric residents were included in the study, who answered the questionnaire. Among the participants, 72.5% were females, and their mean age was 27.9 +/- 2.1 years, and 59.3% worked as a pediatric residents for less than two years. When the symptoms of influenza were evaluated, the most known symptoms were fever (94.1%), myalgia (81.9%), tiredness (77.0%), headache (70.1%), and cough (68.6%). When oseltamivir treatment indications were questioned, most pediatric residents (82.2%) answered the questions. It was observed that 21.1% of the pediatric residents had the flu vaccine in the current season. According to the state of having chronic diseases, the rate of vaccination in participants was not statistically significant (p= 0.136). Conclusion: In this study, it was determined that pediatric residents' knowledge about influenza awareness, treatment, and immunization was insufficient. It may be beneficial to train pediatric residents about the influenza virus and vaccine before each influenza season.

Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum (T. Palladium). Human Immunodeficiency Virus (HIV) is a virus that attacks the body's immune system, decreased the number of CD4 cells that makes the immune system decrease, and facilitates syphilis infection. Syphilis increased the risk of spreading HIV infection with skin barrier destruction. The diagnosis of syphilis is made based on a complete history, including sexual history, clinical manifestations, and examination. The treatment of syphilis with HIV and without HIV similar, penicillin is still the gold standard for syphilis treatment with HIV. Prevention of syphilis with HIV are educated, screening for syphilis and other sexually transmitted infections, as well as early detection and therapy of partners. The prognosis for syphilis in HIV is worse than for syphilis without HIV.

BACKGROUND: In recent years, low back pain (LBP) is a growing major health issue around the world and mostly addressed in primary healthcare settings. This may be due to changing work environment including the nature of long sitting work hours, especially in the booming information and technology (IT) and Business Process Outsourcing (BPO) industry. LBP is normally considered as a combination of various types of pain and its related conditions, which eventually lead to disabilities. AIM: In this article, the aim is to discuss the current and future perspectives of LBP mainly on diagnosis and therapeutic front of LBP. METHODS: A search was performed using electronic databases, which include PubMed Central and Google Scholar, using the related key words “back pain and low back pain.” All related peer reviewed published articles were included regardless of the language, region, or the publication date. RESULTS: Although the management of LBP both in terms of diagnosis as well as in the therapeutic options has witnessed considerable progress but challenges are still exist not only within countries but also in the regions and continents among various medical professionals. However, in the past few years, a huge array of coordinated but randomized multi-center clinical studies were performed and various detailed insight investigations have been done, and substantial clinical guidelines have become available. Hence, a new view on evidence-based management approach for LBP has significantly improved recently and discussed here. CONCLUSION: Based on the available evidence and literature, this comprehensive review discusses the present and future perspectives of LBP mainly on diagnosis and therapeutic front for LBP. In addition, current intervention and prevention plans have failed to lessen the considerable burden of LBP and hence several areas which require more details, which deserves additional discussion to augment us through an understanding of this very important topic on improvements of multi tasked outcomes to benefit the affected patients.

Introduction COVID-19 epidemic has had different effects on many diseases, including gastric cancer. Due to COVID-19 epidemic the importance of knowing the effects of the epidemic in patients to deal with it, the present study aimed to investigate the effect of COVID-19 on the diagnosis, treatment, concerns, problems, and mental health of patients with gastric cancer. Methods The present study was a systematic review by searching the PubMed, Scopus, and Web of Science databases with the keywords of COVID-19 and gastric cancer. The articles that addressed any aspect of COVID-19 epidemic on diagnosis, treatment, problems, and mental health in patients with gastric cancer were included; the data were qualitatively summarized and presented in related tables. Results A total 22 articles were included. The effects of COVID-19 on gastric cancer were divided into four categories of the effects of COVID-19 on the diagnosis, treatment and follow-up, concerns, and problems and mental health of patients with gastric cancer. The COVID-19 epidemic has reduced the number of screenings, altered treatment, and delayed or discontinued treatment, which caused problems and concerns such as sleep disturbances and stress. Conclusion Considering the effects of COVID-19 epidemic on gastric cancer and on the other hand, the continuation of the epidemic in the society, it is necessary for the officials and experts of the health system to design and implement necessary interventions to minimize the negative effects of epidemic on patients with gastric cancer.

В гіпоталамусі знаходяться ядра нейронів як вегетативної нервової, так і ендокринної системи, а також життєво важливі центри — голоду, насичення, терморегуляції, сну й бадьорості. Під впливом черепно-мозкових травм, нейроінфекцій і отруєнь така складна інтегральна система часто порушується, спричиняючи розвиток дисфункції гіпоталамуса. В підготовлених методичних рекомендаціях розглядаються питання етіології, патогенезу, клініки, діагностики та лікування дисфункції гіпоталамуса. В плані лікування основний акцент ставиться на фізіологічних підходах до нормалізації гіпоталамічних порушень. Особлива увага звертається на формування діагнозу відповідно до вимог Міжнародної класифікації хвороб 10-го перегляду, що має важливе значення для впорядкування статистичної звітності. Методичні рекомендації призначені для лікарів — ендокринологів, невропатологів, кардіологів, загальної практики, сімейних.

Aim. To analyze the recurrence of endometriosis after surgical treatment of patients with deep endometriosis. Materials and methods. The case histories of 90 patients aged 19 to 45 years were retrospectively analyzed. The study group consisted of 70 endometriosis patients: 20 with peritoneal endometriosis and 50 with deep infiltrative endometriosis (DIЕ). The comparison group included 20 women without endometriosis. There was an in-depth study of anamnestic data in the cohort of patients under study. The results of preoperative laboratory tests, including serum levels of the CA-125 and CA 19-9 oncomarkers, were processed. Results. Analysis of the obtained data showed that about half of the DIE patients (54%) in the main group had a history of surgical interventions for endometriosis. The number of operations was significantly higher in patients compared to the peritoneal endometriosis group (68% vs 20%, respectively; р=0.0012). Two subgroups were formed from the group of women with DIE: patients who had no history of previous surgical treatment for endometriosis and those hospitalized for repeated surgical treatment of endometriosis (patients with recurrent endometriosis). Patients with recurrent endometriosis had a significantly higher incidence of heavy menstruation, pregnancy terminations (abortions), and a high proportion of gastrointestinal diseases. Analysis of the hormonal therapy received in patients with DIE showed that every second patient with relapses (18/53%) after surgical treatment and every third patient without a prior history of surgery (5/31%) received hormonal therapy. Examination of the preoperative serum levels of CA-125 and CA 19-9 serum markers in patients with DIE showed an increase in their serum levels and a correlation with the frequency of endometriosis recurrence and the size of DIE foci. Conclusion. Despite the conservative and surgical treatment of DIE patients, the recurrence rate is still high. At present, there is no satisfactory therapy for all endometriosis patients. Therefore, the development of therapy for the conservative treatment of the disease remains an urgent task.

The worldwide pandemic of coronavirus disease 2019 (COVID-19) presents us with a serious public health crisis. To combat the virus and slow its spread, wider testing is essential. There is a need for more sensitive, specific, and convenient detection methods of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Advanced detection can greatly improve the ability and accuracy of the clinical diagnosis of COVID-19, which is conducive to the early suitable treatment and supports precise prophylaxis. In this article, we combine and present the latest laboratory diagnostic technologies and methods for SARS-CoV-2 to identify the technical characteristics, considerations, biosafety requirements, common problems with testing and interpretation of results, and coping strategies of commonly used testing methods. We highlight the gaps in current diagnostic capacity and propose potential solutions to provide cutting-edge technical support to achieve a more precise diagnosis, treatment, and prevention of COVID-19 and to overcome the difficulties with the normalization of epidemic prevention and control.

Patients with rare diseases are a major challenge for healthcare systems. These patients face three major obstacles: late diagnosis and misdiagnosis, lack of proper response to therapies, and absence of valid monitoring tools. We reviewed the relevant literature on first-generation artificial intelligence (AI) algorithms which were designed to improve the management of chronic diseases. The shortage of big data resources and the inability to provide patients with clinical value limit the use of these AI platforms by patients and physicians. In the present study, we reviewed the relevant literature on the obstacles encountered in the management of patients with rare diseases. Examples of currently available AI platforms are presented. The use of second-generation AI-based systems that are patient-tailored is presented. The system provides a means for early diagnosis and a method for improving the response to therapies based on clinically meaningful outcome parameters. The system may offer a patient-tailored monitoring tool that is based on parameters that are relevant to patients and caregivers and provides a clinically meaningful tool for follow-up. The system can provide an inclusive solution for patients with rare diseases and ensures adherence based on clinical responses. It has the potential advantage of not being dependent on large datasets and is a dynamic system that adapts to ongoing changes in patients' disease and response to therapy.

Purpose. To study the possibilities of a new method of CMRR treatment in the prevention of irreversible blindness. Material and methods. 74 patients with cytomegalovirus retinitis, frolicking after hematopoietic stem cell transplantation. The first group (9 people, 15 eyes) consisted of children, whose treatment was carried out under ophthalmoscopic control. The second group (65 people, 114 eyes) consisted of children in whom the control of the effectiveness of treatment was carried out using PCR of aqueous humor in real time. Results. In the first group, retinal detachment was diagnosed in three out of fifteen eyes, accounting for 20%. In the second group, the incidence of retinal detachment was 3.5% of 114 eyes. Among patients receiving treatment under ophthalmoscopic control, CMRR relapses were detected in 5 cases, which amounted to 33.3%. In children, whose treatment was controlled by intraocular fluid PCR, relapses were diagnosed in 22 cases, which amounted to 19.29%. Conclusions. Intravitreal administration of antiviral drugs under the control of polymerase chain reaction is a more effective method of treating cytomegalovirus retinitis than intravitreal administration under ophthalmoscopic control. Key words: cytomegalovirus retinitis, intraocular fluid polymerase chain reaction.

Objective: Molluscum contagiosum (molluscum) is considered benign and self-limiting. However, the caregiver and patient experience largely remains a mystery. This online survey aimed to collect caregivers’ views on their experiences with molluscum infection in their children, including diagnosis, treatment, and the impact of the virus on the caregivers’ and their child’s life. Methods: Parents, caregivers, and/or legal guardians (ages 18+, 20% male and 80% female) of children diagnosed with molluscum in the past 4 years (ages 3-16 years of age) answered a 15-minute paid online survey with questions about their experience with molluscum. Results: Caregivers (n=150) were mostly Caucasian (85%), 25-44 years of age (87%) and had at least one child with active molluscum (75%) at the time of the survey. The average number of health care providers (HCPs) consulted for molluscum was 1.95 and diagnosis was made by a variety of HCP types. The spread of molluscum to ≥ 1 child in the household was reported by 60% of caregivers in multi-child households. The average number of treatments used were 2.36 including HCP-administered treatments and consumer products. Caregivers reported moderate to major impact on their lives (62%) or their child’s life (74%) due to molluscum. Limitations: Questions were not validated, recall time was up to 4 years. Conclusions: Molluscum patients may receive a diagnosis from many sources. Caregivers may utilize more than one treatment modality to help clear the infection including consumer products. Molluscum can cause an impact on quality of life for affected children and their caregivers.

Lateral x-rays in the weight bearing position assume special significance in correction of foot deformities of congenital or acquired nature. There are limited references in the literatures for taking lateral weight bearing Xrays and these too by using diverse equipment, because its importance has not been fully realized. Amanda Er, et al [1] (Figure: 1) used wooden blocks for placing the cassette. Evans Danial [2] (Figure: 2) used special sloted table for this. Thapa et al also used special gadget for such exposure and similarly others, using their own ways [3-5].

No abstract available

Background Thallium poisoning is rare and difficult to recognize. Early diagnosis and treatment of thallium-poisoned patients are essential to prevent morbidity and mortality. Aim To evaluate the efficacy of treatments and outcomes of five patients with early diagnosis of acute thallium poisoning. Methods Five patients who consumed a thallium-contaminated meal were hospitalized in succession, and underwent clinical examinations such as blood tests and electromyography tests. Urine and blood tests confirmed the diagnosis of thallotoxicosis, revealing the occurrence of food poisoning. All patients underwent detoxification treatment, including hemoperfusion (HP) and treatment with Prussian blue (PB). A 24-mo follow-up was performed to evaluate the long-term outcomes on the patients after discharge. Results Initially, the patients presented with symptoms of acute thallium poisoning including hyperalgesia of the limbs and abdominalgia, which may differ from common peripheral neuropathy. Accompanying symptoms such as hepatic damage and alopecia were observed in all the patients, which further confirmed the diagnosis of poisoning. Treatment with chelating agents was ineffective, while HP and treatment with PB drastically decreased the thallium concentration in the urine and blood. With early diagnosis and intervention, four patients had a good prognosis and no permanent sequelae. One patient developed blindness and disability during the 24-mo follow-up period. Conclusion Identification of incident cluster and characteristic symptoms is extremely important for early diagnosis of acute thallium poisoning. HP plus PB is essential to improve the prognosis of thallium-poisoned patients.

The SARS-CoV-2 episode began in Wuhan City, China, in December 2019. It is currently a worldwide pandemic, with 7,820,023 affirmed cases, 430,694 deaths, and 3,729,054 recuperations (starting at 14 June 2020). The infection has the potential for fast and broad spread among individuals and nations. There is a great deal of misdirecting data and information holes on the recently risen SARS-CoV-2. Hence, we checked on the most recent updates about various angles including the study of disease transmission, wellspring of contamination, transmission elements, zoonotic potential, infection attributes, and revelation of novel methodologies for ailment control to keep away from overflow of disease later on. Bats assume a significant job in the transmission of the disease to people. Corona viruses are hereditarily assorted and have a high propensity towards visit hereditary changes and quality recombination, which expands the danger of interspecies transmission. Data about the brooding time frame can help in setting up a powerful isolate for asymptomatic bearers, subsequently forestalling the infection spread. From our points of view and dependent on the at present accessible data about the infection and it’s the study of disease transmission, the control of the SARS-CoV-2 requires a powerful and worldwide sickness coordination exertion including multidisciplinary research endeavours (One-Wellbeing approach) through joint effort between governments, disease transmission specialists, virologists, wellbeing specialists, veterinarians, and doctors. At this phase of the ailment flare-up, creating antibodies is vital to constrain the spread of the disease.

Diagnosis, treatment planning & management of patient undergoing orthodontic therapy with blunderbuss canal’s in relation to one or multiple tooth requires a precise scientific approach based on sound principles. Interdisciplinary therapy integrates individual disciplines to function as a comprehensive unit providing consistent and predictable treatment results. A thorough logical diagnostic approach and treatment planning must be executed by each member of endodontic-orthodontic team when an esthetic and healthy makeover of a patient’s dentition is planned. Precise communication is important to provide patients with desired results. This case report presents one such approach for diagnosis, treatment planning & management of patient undergoing orthodontic therapy with blunderbuss canal’s in relation to one or multiple tooth. After careful clinical and radiographic evaluation, the patient was diagnosed with Angle’s Class I malocclusion with spacing in maxillary and mandibular arch, and blunderbuss canal’s irt 35&45. The treatment consisted of initial endodontic approach by starting treatment irt 35 and 45, followed by fixed orthodontic approach using passive self-ligating bracket system and by-passing the endodontically treated tooth. Regular followup to observe apexogenesis and continuous evaluation of the case is being done. Keywords : Blunderbuss Canal,Apexogenesis,Endodontic therapy,Platelet­rich fibrin,Bone regeneration,MTA,Self ligation

This article reviews the current literature on osteoarthritis in pet and laboratory guinea pigs. The associated clinical signs, diagnosis and treatment of osteoarthritis in pet guinea pigs will be discussed, with options for analgesia detailed. This condition is thought to be common in pet guinea pigs, even from an early age in some genetic lines, although osteoarthritis often goes undiagnosed in this species until advanced disease is present, posing a major welfare concern. Increasing awareness of this condition in veterinary practitioners should aid early diagnosis in pets and help improve their quality of life. Prevention may be possible using oral protective nutritional supplements to slow down the progression of this disease at an early stage. Lifestyle changes are also discussed for the management of this condition in pet guinea pigs.

In this nonsystematic review, the complementary diagnosis, treatment, prevention, and control of human papillomavirus are discussed. The histopathology is addressed regarding its indications, main findings and limitations, as a complementary diagnostic method largely used by dermatologists. Electron microscopy is briefly reviewed, along with its contribution to the accumulated knowledge on HPV, as well as the relevance of research in using this technology for future advances in diagnosis and treatment. Molecular information about the virus is continuously increasing, and the practical applications of HPV serology, molecular identification and genotyping are discussed. Vaccines are a valuable tool in primary HPV infection prevention and are now available in many countries; their composition, indications, and adverse effects are revisited. Local and systemic treatment options are reviewed and off-label prescriptions are discussed. Finally, health education focusing on HPV infection as a sexually transmitted infection of worldwide relevance and the many barriers to improve primary and secondary prevention are addressed.

Congenital cytomegalovirus (CMV) infection is the most common nongenetic cause of sensorineural hearing loss and a major cause of visual, intellectual, and neurodevelopmental impairment worldwide. The seroprevalence of CMV among women of childbearing age in developing countries reaches almost 100%, and the incidence of CMV infection in neonates is 1%–2%. Approximately 87% of the infected neonates are asymptomatic at birth and 13% of them have permanent sequelae. The burden of congenital malformations due to congenital CMV infection is higher than that due to Down syndrome, fetal alcohol syndrome, and spina bifida. Nevertheless, there is little knowledge regarding congenital CMV pathogenesis, diagnosis, treatment, and prevention. In this study, we report a case that showed sequential changes of fetal brain following CMV infection in pregnancy. Additionally, we reviewed the latest information on the diagnosis, treatment, and prevention of congenital CMV infection.

This ESMO-EURACAN Clinical Practice Guideline provides key recommendations for managing nasopharyngeal cancer (NPC). It covers screening, clinical and pathological diagnosis, staging and risk assessment, treatment and follow-up. Treatment algorithms for locoregional and recurrent/metastatic NPC are provided. Recommendations were compiled by the authors based on available scientific data and the authors' collective expert opinion.

Erysipelas is an infectious disease seen mainly in growing pigs and characterized clinically by fever, arthritis, skin lesions and sudden death. The disease may be acute, subacute, or chronic. Swine erysipelas is a disease caused by a specific micro organ Erysipelothrix rhusiopathiae whic h is a zoonotic ubiquitous gram-positive bacterium that causes erysipelas in swine, mammals, birds and erysipeloid in humans. People in contact with animals, animal products or animal wastes are at greatest risk. The acute form of swine erysipelas may have been confused for other diseases in pigs which are characterized by acute symptoms such as sudden death (for example, African swine fever). It can be diagnosed by its clinical signs, necropsy findings, bacteriology, antimicrobial response, molecular and serological examinations. It is recommended to increase awareness of the disease among animal and human practitioners as treatment is easy and available and vaccination is possible. However, the disease is still unknown to local veterinarians, clinical doctors, meat inspectors, butchers and laboratory personnel. Proper hygiene, regular pork inspection, use of protective wear among people working/ in contact with animals should be promoted. The disease causes high economic loss in pig rearing areas and influences the public health being a severe zoonotic disease. So the objective of this review is to create a better understanding of the disease for proper control and prevention of the disease

ispartof: HEMASPHERE vol:5 issue:2 ispartof: location:United States status: published

Coronavirus 2019 (COVID-19), as an emerging infectious disease, has caused significant mortality and morbidity along with socioeconomic impact. No effective treatment or vaccine has been approved yet for this pandemic disease. Cutting-edge tools, especially nanotechnology, should be strongly considered to tackle this virus. This review aims to propose several strategies to design and fabricate effective diagnostic and therapeutic agents against COVID-19 by the aid of nanotechnology. Polymeric, inorganic self-assembling materials and peptide-based nanoparticles are promising tools for battling COVID-19 as well as its rapid diagnosis. This review summarizes all of the exciting advances nanomaterials are making toward COVID-19 prevention, diagnosis and therapy., Lay abstract The emergence of the new coronavirus 2019 (COVID-19) has affected millions of people around the world and has become a serious threat to human life. To date, nanotechnology-based tools have been effective in preclinical studies against a variety of pathogens, including respiratory viruses, herpes virus, human papillomavirus and HIV. Nanoparticles, particles smaller than a micrometer, have drawn particular interest in the management of COVID-19 disease due to their unique properties (easy preparation, low cost, easy modification, appropriate size, etc). Nanotechnology-based strategies for COVID-19 disease management include the development of tools for rapid, accurate and sensitive diagnosis, production of effective disinfectants, delivery of mRNA vaccines into human cells and delivery of antiviral agents into the body.

Breast cancer in young females is a relatively common disease in China. Young breast cancer has aggressive clinical and pathological features. During the treatment of young females with breast cancer, issues involving the choice of surgical methods, early amenorrhea, and fertility protection may have physical, psychological, and social impacts. Thus, a multidisciplinary model of diagnosis and treatment is indispensable. The breast cancer expert committee of the National Cancer Quality Control Center organized experts in related fields in China to compile this consensus as to provide scientific and feasible solutions for rational diagnosis, treatment, and fertility management for young females with breast cancer. This consensus is based on the literature data, the views of relevant international guidelines, and the clinical practice experience of experts in different fields.

Objectives Although tick-borne diseases account for a large number of health care visits in the United States, clinical practices for tick bite and Lyme disease treatment and prevention are not well understood. The objective of this study was to better understand factors associated with clinical practices related to tick bites and Lyme disease. Methods In 2013-2015, questions about tick-bite evaluation, Lyme disease diagnosis and treatment, appropriate use of Lyme disease testing, and tick-bite prevention were included in Porter Novelli’s DocStyles survey, a nationally representative annual web-based survey of health care providers. We performed analyses of responses by provider license type and state-level incidence (high or low) of Lyme disease in 2019. Results A total of 4517 providers were surveyed across the 3 study years. Overall, 80.9% of providers reported that they had evaluated at least 1 patient for a tick bite, 47.6% had diagnosed at least 1 patient with Lyme disease, and 61.9% had treated at least 1 patient for Lyme disease in the previous year. Providers from states with a high incidence of Lyme disease saw more patients for tick bites and Lyme disease than providers from states with a low incidence of Lyme disease. Few providers correctly chose Lyme disease testing as clinically useful in the hypothetical case of a patient from a state with a high incidence of Lyme disease with an arthritic knee (36.0%) or with new-onset atrioventricular block (39.5%), and respondents across all provider types incorrectly chose testing when not clinically indicated. Most providers (69.7%) reported routinely recommending tick-bite prevention methods to patients. Conclusions Many providers evaluate patients for tick bites and treat patients for Lyme disease, but knowledge about appropriate testing is low. Providers may benefit from tailored education about appropriate Lyme disease diagnosis, testing, and effective tick-bite prevention.

Theranostics, the combination of diagnosis and therapy, has long held promise as a means to achieving personalised precision cancer treatments. However, despite its potential, theranostics has yet to realise significant clinical translation, largely due the complexity and overriding toxicity concerns of existing theranostic nanoparticle strategies. Methods: Here, we present an alternative nanoparticle-free theranostic approach based on simultaneous Raman spectroscopy and photodynamic therapy (PDT) in an integrated clinical platform for cancer theranostics. Results: We detail the compatibility of Raman spectroscopy and PDT for cancer theranostics, whereby Raman spectroscopic diagnosis can be performed on PDT photosensitiser-positive cells and tissues without inadvertent photosensitiser activation/photobleaching or impaired diagnostic capacity. We further demonstrate that our theranostic platform enables in vivo tumour diagnosis, treatment, and post-treatment molecular monitoring in real-time. Conclusion: This system thus achieves effective theranostic performance, providing a promising new avenue towards the clinical realisation of theranostics.

Gastroesophageal reflux disease (GERD) remains a major problem in gastroenterology. GERD phenotypes have recently been identified, but a key mechanism of pathogenesis is the effect of acidic stomach contents on the esophageal mucosa due to reflux. The role of alginates in GERD is expanding in terms of diagnosis, improvement of treatment outcomes, and prevention of relapse.

BACKGROUND Focal intrahepatic strictures (FIHS) refer to local strictures of the small and medium intrahepatic bile ducts. FIHS are easily misdiagnosed due to their rare incidence, and few studies have focused on the diagnosis and treatment approaches. AIM To propose a new classification for FIHS in order to guide its diagnosis and treatment. METHODS The symptoms, biochemistry results, imaging results, endoscopic examination results and initial and final diagnoses of 6 patients with FIHS admitted between January 2010 and December 2019 were retrospectively analyzed. RESULTS The 6 patients were diagnosed with intratubular growth-type intrahepatic cholangiocarcinoma (IG-ICC), recurrent multiple hepatocellular carcinoma (rmHCC) with bile duct tumor thrombus (BDTT), adenosquamous carcinoma (ASC), hepatolithiasis, small duct primary sclerosing cholangitis (SD-PSC) and autoimmune hepatitis (AIH). The initial and final diagnoses were not consistent in 4 patients. Hepatectomy was performed in patients with IG-ICC, ASC and hepatolithiasis according to the locations of their FIHS. Patients with rmHCC with BDTT received lenvatinib/sintilimab, while patients with SD-PSC and AIH received UDCA. We proposed the following classification system for FIHS: type I: FIHS located within one segment of the liver; type II: FIHS located at the confluence of the bile ducts of one segment or two adjacent segments; type III: FIHS connected to the left or right hepatic duct; and type IV: Multiple FIHS located in both lobes of the liver. CONCLUSION Our proposed classification system might help to guide the diagnosis and treatment of FIHS. Hepatectomy should be performed not only for malignant FIHS but also for benign strictures with severe secondary damage that cannot be improved by nonsurgical methods.

The presence of monoclonal proteins is common, with a prevalence in the United States around 5% that increases with age. Although most patients are asymptomatic, most cases are caused by a clonal plasma cell disorder. Monoclonal gammopathy of undetermined significance (MGUS) and smoldering multiple myeloma (SMM) are asymptomatic precursor conditions with variable risk of progression to multiple myeloma. In recent years, significant progress has been made to better understand the factors that lead to the development of symptoms and progression to myeloma. This review summarizes the current diagnosis treatment guidelines for MGUS and SMM and highlights recent advances that underscore a shifting paradigm in the evaluation and management of plasma cell precursor conditions.

Background Diagnostic and treatment strategies for chronic obstructive pulmonary disease (COPD) vary greatly. Despite international efforts to standardize the management of COPD, two-thirds of primary care patients are not diagnosed, treated, or managed according to current evidence-based guidelines, probably because of the difficulty of applying these in routine practice. The aim of this study was to develop a simplified algorithm for diagnosing, treating, and managing COPD in primary care whose consistency, scientific relevance, and applicability to routine clinical practice met approval bct 3y family doctors (FDs) and pulmonologists. Methods The algorithm was developed in a series of sequential phases, consisting of a preliminary meeting among group coordinators to design the initial structure, an input meeting with FDs and pulmonologists to refine and validate the proposal, an algorithm design stage, and a Delphi survey in which FDs and pulmonologists evaluated and approved the final version. A target of 75% or more was established for each of the 20 items in the Delphi survey in the FDs group as well as the pulmonologists group. It was estimated that at least two Delphi rounds would be needed to reach consensus. Results In total, 118 physicians (75 FDs and 43 pulmonologists) participated in the Delphi process. Fourteen of the 20 items (70%) were approved in the first round. In the second round (in which 74 FDs and 42 pulmonologists participated), the remaining six items, which had been reformulated based on feedback from the first round, were approved, together with an additional question on the face validity of the algorithm as a whole. Dyspnea was positioned as the main determinant of treatment decisions in the new algorithm. Conclusion According to the experts consulted, this new simplified algorithm for the diagnosis, treatment, and management of COPD in primary care is a clear, functional, and useful tool for routine practice and meets the requirements for the correct management of this condition.

People over the age of 65 and those suffering from chronic diseases, such as asthma, are part of the risk group for severe acute respiratory syndrome-COV-2 (SARS-CoV-2) infection. In the past, a connection between viral infections and asthma has been presented. Patients with asthma appear to be at risk of contracting viral infections, and also viruses can cause asthma exacerbations. Another concern during this period was about the chronic administration of corticosteroids in asthmatic patients, because of the consideration that corticosteroid therapy would decrease the immunity of these patients, thus increasing the risk of infections, including the infection with SARS-CoV-2. Thus, several questions have emerged about the role of corticosteroid therapy in the development of COVID-19 in patients undergoing corticosteroid treatment. Most guidelines recommend continuing the administration of chronic treatment to this category of patients. At the same time, the health system had to adapt to the situation caused by the COVID-19 pandemic and deviate from the standard methods of managing most chronic diseases and these changes had an impact on these category of patients.