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The article presents analyzis of the data of the clinical course of Covid-19 and probable pathogenetic mechanisms of lesions, which are presented in foreign and domestic literature The hypothesis about the hematotoxic effect of the SARS-CoV-2 virus is considered, which may cause its multi-system action An analogy is made of the pathogenesis of multiple organ lesions in case of viral infection and in acute poisoning with hemolytic poisons and iron preparations, in which the development of metabolic acidosis, toxic hemolysis, and an increase in free hemoglobin and iron ions in the blood plasma are the central link The article proposes to use a set of diagnostic measures aimed at confirming the hematotoxic component during SARS-CoV-2 infection and methods for assessing the severity of the condition, adopted in clinical toxicology Taking into account the experience of treating acute poisoning with hemolytic poisons, attention is focused on the importance of using alkalizing therapy in order to remove the products of hemoglobin breakdown and prevent acute nephritic failure When confirming the presence of a toxic factor, methods aimed at eliminating toxic products of hemolysis can be used - antidote therapy and methods of surgical detoxification This complex of therapeutic measures in clinical toxicology is effective, aimed at the prevention of acute renal failure and toxic coagulopathy The authors believe that the hypothesis of a hematotoxic factor in the pathogenesis of Covid-19 requires a targeted therapeutic strategy and targeted study В статье проанализированы данные клинического течения Covid-19 и вероятные патогенетические механизмы поражений, которые представлены в зарубежной и отечественной литературе Рассматривается гипотеза о гематотоксическом свойстве вируса SARS-CoV-2, которое возможно объясняет его мультисистемное действие Проведена аналогия патогенеза полиорганных поражений при вирусной инфекции и при острых отравлениях гемолитическими ядами и препаратами железа, в которых центральным звеном являются развитие метаболического ацидоза, токсический гемолиз, повышение свободного гемоглобина и ионов железа в плазме крови В статье предложены к использованию комплекс диагностических мероприятий, направленных на подтверждение гематотоксического компонента при инфицировании SARS-CoV-2 и методы оценки тяжести состояния, принятые в клинической токсикологии Учитывая опыт лечения острых отравлений гемолитическими ядами, акцентируется внимание на важность применения ощелачивающей терапии с целью выведения продуктов распада гемоглобина и профилактики острой почечной недостаточности При подтверждении наличия токсического фактора могут быть использованы методы, направленные на элиминацию токсических продуктов гемолиза - антидотная терапия и методы хирургической детоксикации Данный комплекс лечебных мероприятий в клинической токсикологии является эффективным, направленным на профилактику острой почечной недостаточности и токсической коагулопатии Авторы считают, что гипотеза гематотоксического фактора в патогенезе Covid-19 требует целевой терапевтической стратегии и целенаправленного изучения

Hematomas in the extremities can present clinically as a soft tissue mass. Hematomas can usually be distinguished from neoplasia on MR by the signal patterns of hemoglobin breakdown products, which are dependent on the chemical bonding and oxidation state of hemoglobin iron. Beginning with a discussion of relevant atomic electronic structure, this review will examine how oxyhemoglobin, deoxyhemoglobin, methemoglobin, and hemosiderin, the principal iron compounds occurring in the various stages of a hematoma, affect its appearance on MRI.

A 46-year-old woman presented with bilateral adnexal masses on pelvic sonography, a complex cystic mass on the right, and a homogeneously hypoechoic, solid-appearing mass on the left. Pelvic MRI showed a T1 hypointense, T2 hyperintense, nonenhancing mass in the right ovary and a homogeneously T1 hyperintense lesion with mixed T2 signal in the left ovary. Fat-saturated T1-weighted sequences showed the left ovarian lesion to be an endometrioma containing a high concentration of hemoglobin breakdown products and revealed other endometriotic implants in the right ovary, broad ligament, and cul-de-sac. Follow-up pelvic sonography 9 weeks later showed resolution of the right complex cystic ovarian mass, indicating that it was a physiologic hemorrhagic cyst.Imaging features of benign and malignant ovarian masses overlap. If imaging is inconclusive in characterizing an adnexal mass as benign, the mass will be resected rather than followed up because of the concern for a rapidly growing ovarian cancer. Thus, the goal of imaging is to identify unequivocally the benign lesions that can be left untreated. Pelvic MRI provides a powerful adjunct to pelvic sonography in characterizing adnexal masses as benign.

Purpose: To present an unusual case of a preretinal mass that simulated a retained metallic foreign body. Method: Case report. Results: A 30–year–old man presented with unilateral iridocyclitis and an ipsilateral preretinal mass with ultrasonographic and computed tomographic characteristics of a metallic foreign body. Histologic examination of the mass disclosed a central concentration of iron-containing hemoglobin breakdown products surrounded by a cocoon of fibrous tissue. Conclusion: Blood breakdown products surrounded by a fibrous capsule can present with the characteristics of an intraocular metallic foreign body.

Giving public water authorities another tool to monitor and measure levels of human waste contamination of waters simply and rapidly would enhance public protection. Most of the methods used today detect such contamination by quantifying microbes occurring in feces in high enough densities that they can be measured easily. However, most of these microbes, for example E. coli, do not serve as specific markers for any one host species and many can have origins other than feces. As an alternative, chemicals shed in feces and urine might be used to detect human waste contamination of environmental waters. One potential chemical marker of human waste is the compound urobilin. Urobilin is one of the final by-products of hemoglobin breakdown. Urobilin is excreted in both the urine and feces from many mammals, particularly humans. Source waters from 21 sites in New England, Nevada, and Michigan were extracted using hydrophilic-lipophilic balance (HLB) cartridges and then analyzed by high performance liquid chromatography-electrospray mass spectrometry (HPLC-ES-MS). As a marker of human waste, urobilin was detected in many of the source waters at concentrations ranging from not detectable to 300 ng L(-1). Besides urobilin, azithromycin, an antibiotic widely prescribed for human use only in the US, was also detected in many of these waters, with concentrations ranging from not detectable to 77 ng L(-1). This methodology, using both urobilin and azithromycin (or any other human-use pharmaceutical) could be used to give public water authorities a definitive method for tracing the sources of human waste contamination. The analysis and detection of urobilin in surface waters by HPLC-ES-MS has not been previously reported in the peer-reviewed literature.

In substantiating a diagnosis of intracranial hemorrhage, the most important laboratory findings are RBCs, free hemoglobin, or hemoglobin breakdown products in the CSF. When the Gram stain is negative and results of bacterial, viral, and fungal cultures are pending. CSF WBC and differential counts and glucose and lactic acid levels may provide clues to the cause of meningitis. In addition, counterimmuno-electrophoresis and other immunologic techniques that facilitate the diagnosis of meningitis are now becoming more widely available.

Five bovine livers were isolated and perfused with DDT [2,2-bis ( p -chlorophenyl)-1,1,1-trichloroethane] to study the ability of liver to detoxify chlorinated hydrocarbons. A perfusion apparatus was designed and constructed so as to minimize contact of perfusate or tissue vrith metal or plastic. Within fifteen minutes after dosing there was a measurable decrease of DDT in the perfusate and a significant increase in DDD [2,2-bis ( p -chlorophenyl) 1,1-dichloroethane]. Levels of DDE (2,2-bis ( p -chlorophenyl) 1,1-dichloroethylene] were low at the beginning and increased only slightly during the experiment. It was demonstrated that isolated perfused bovine liver was capable of dehalogenating DDT to its less toxic analog, DDD. Production of DDE was probably due to catalytic action caused by hemoglobin breakdown. At the end of each two-hour perfusion experiment the livers still had a natural appearance and probably could have been used longer had it been necessary.

An interesting monograph has appeared in which the various aspects of bile pigment are discussed in regard to their clinical applications. As part of the "Living Chemistry Series," this volume stresses the close relationship between chemistry and medicine so that a better understanding of heme breakdown can be achieved. Sections under discussion include the chemistry of the bile pigments with emphasis on the chemical makeup, classification, the bilatrienes, the biladienes, the bilenes, the bilanes, oxidation products, reactions, potical activity, prototopy, and nomenclature. Other chapters are centered around hemoglobin breakdown, urobilinoid pigments, bile pigment in the blood and the van den Bergh reaction, bile pigments in the body fluids and tissues, biosynthesis, conjugates, clinical jaundice including retention jaundice, regurgitation jaundice, jaundice in infancy, and hemolytic disease of the newborn, and lastly, clinical methods and interpretation. I was particularly interested in learning that Virchow in 1847 first noted the relationship between the