Ovarian cancer is the most common cause of death among women with malignant tumors of the reproductive system. Due to the absence of pronounced clinical symptoms, in 70% of cases the disease is not diagnosed until it has progressed to advanced stage. This article describes a clinical case of a giant tumor of the right ovary complicated by plastic peritonitis and bilateral compression of the ureters with impaired passage of urine in a 51-year-old woman. For several months, the patient was disturbed by pain in the right iliac region, enlargement of the abdomen, weight loss, weakness, impaired urination and defecation. Based on complaints and examination data, the patient was diagnosed with cancer of the right ovary and a combined cytoreductive surgery was recommended, during which the cystic tumor, right and left fallopian tubes and ovaries, the greater omentumwas removed, and a biopsy of the mesenteric lymphatic catches and parietal peritoneum was performed.
In the article, the authors present the result of a pharmaco-economic analysis (based on the calculation of the CER indicator of cost-Aeffectiveness ratio) of complex therapy for psoriasis patients, including cortexin, which demonstrates the advantage of standard therapy in terms of stopping the clinical symptoms of the progressive stage of psoriasis and the number of subsequent relapses.
This article describes the case of development of secondary polycystic ovary syndrome with high activity of adrenal cortex. Young woman (19 years old) had preventive examination in private clinic. The patient revealed late menarche, 18-month amenorrhea, late development of secondary sex characteristics, but also early development of pubic and axillary hair growth and low BMI in pre-puberty years. After the first medical examination on amenorrhea patient was diagnosed with polycystic ovary syndrome. She was prescribed the combined oral contraceptive pill "Yarina". The data of the anamnesis (both vitae and morbi) and diagnostics results led to the conclusion of abnormal pre-puberty development with early thelarche. Excess adrenal activity that occurred in the period of reproductive maturing have formed the vicious circle which led to the polycystic ovary syndrome development. This case demonstrates role of non-associated with hypothalamic-hypophyseal-ovarian axis endocrine activity in female reproductive function maturation.
In this clinical case, the pathology of the development of the genitourinary system is described, in the context of the peculiarities of pregnancy management, the clinical variant of one of the combined anomalies in the development of the urinary and reproductive system in women. It also demonstrated an example of successful clinical management of a patient with a combination of developmental anomalies in obstetric practice.
In the modern world, more and more attention is paid to pathologies related to the human psyche. The formation of an understanding of the causes and mechanisms of the development of mental diseases will allow the most effective search for treatment methods and conduct therapy. It is in this light that rare cases of psychiatric practice allow us to form the most complete picture of the conditions of development and the course of the disease. In this paper, we consider a clinical case of induced delusional disorder in members of the same family who are a married couple.
Most often in children's practice, among cases of children handling foreign GI bodies, there are trichobezoars, which can be formed by animal hair, patient hair, wool of clothes or blankets, hair of dolls and other toys. This paper presents a clinical case that clearly demonstrates the complexities of diagnosis and the severity of the condition of such patients.
There are for today a large number of publications on the topic of COVID-19 infection, dedicated to lung damage, less often-neurological and gastrointestinal disorders. Much less attention is paid to the lesion of the visual organ. Considering themechanism of pathogenesis of coronavirus infection, the eye is defined as the entrance gate of infection. However, the anatomical and immunological characteristics of theeye allow us to talk about the defeat of the visual organin particular as a target organ. To enter cells, SARS-CoV-2 uses the angiotensinconverting enzyme 2 receptor, which is also expressed in the retina. This paper presents an analysis of modern sources of literature on this topic and provides a clinical example of an acute circulatory disorder in the central retinal artery on the background of COVID-19 with an outcome in optic nerve atrophy.
The "rigid spine" syndrome is a rare disease of neurological origin, the etiology and pathogenesis of which have not yet been fully studied. The "rigid spine" syndrome in children is accompanied by non-rough postural disorders that resemble the "flexor pose" in patients with parkinsonism. As a result of the pathological influence, the patient's motor activity sharply decreases. To confirm the final diagnosis of the child, doctors conduct a study of the existing clinical picture and the results of electrophysiological research methods. The clinical case presented by us clearly demonstrates the importance of personalized medicine for establishing such complex diagnoses as rigid spine syndrome.
A clinical case of successful diagnosis and treating of a perforated giant duodenal ulcer of 88-year-old patient who was staying in a surgical hospital for 3 days with a closed fracture of the right femoral neck is described.The patient had a mild abdominal pain syndrome, but there was no ulcerative history, percussion signs of free gas in the abdominal cavity, pronounced tension of the abdominal muscles, signs of irritation of the peritoneum.Diagnostics was hampered by the presence of senile layers and a number of concomitant somatic diseases of the heart, blood vessels, and metabolism.Hollow organ perforation was diagnosed by plain radiography in the patient's half-sitting position and in lateroposition.The operation revealed perforation of a giant ulcer of the anterior wall of the duodenum with pyloroduodenal stenosis.Despite the maximally high degree of operational risk, due to the impossibility of suturing (excising) the perforation, 2/3 of the stomach was resected according to Balfour.The case demonstrates the need for a personalized approach to the choice of surgical tactics in complex emergency clinical situations that go beyond the standard scope of clinical guidelines and instructions.
Sarcoidosis has now ceased to be a rare pathology. The incidence can reach nine per ten thousand people. The absence of pathognomonic clinical manifestations of sarcoidosis makes it difficult to diagnose the disease and leads to a lung biopsy. Generalized sarcoidosis is less common than local forms, but can become a source of diagnostic errors. It is characterized by the prevalence of clinical symptoms and the possible presence of biomarkers of the disease. Generalized sarcoidosis can pose a significant diagnostic problem, since differential diagnosis has to exclude diseases of neoplastic, parasitic, infectious etiology. A feature of the clinical case given in the article is the presence of diffuse subcutaneous nodular formations. On the example of a clinical case, this publication demonstrated the features of clinical symptoms and identified biomarkers of generalized sarcoidosis.
History of heart transplantation in combination with immunosuppressive therapy and acute viral respiratory infection overlay makes the patient difficult to manage. In case of COVID-19, the setting is complicated by unknown pathogenesis, including its effect on blood, coagulation system, and lung tissue. Current case report discusses the 60-year-old patient with a COVID-19 infection occurred in the immediate postoperative period after heart transplantation.
Oncological and cardiovascular diseases are the leading causes of morbidity and mortality in the Russian population. Surgical treatment of patients with severe cardiovascular diseases requires a thorough assessment of cardiovascular risk. The article describes the experience of risk stratification in a patient with severe heart failure. A thorough assessment of the functional status of the patient showed that, despite the extremely low level of the cardiac output fraction, the patient's chronic heart failure is at the stage of compensation, and, therefore, surgical treatment is possible. Further observation confirmed the previously assessed risks. The patient successfully underwent three surgical operations, which allowed him to achieve remission of cancer.
Mental disorders associated with eating disorders are becoming very common these days, but questions of diagnosis and treatment of such diseases are still open. This article is devoted to the global problem of 21st century society - anorexia nervosa. Here, this pathology is considered taking into account current knowledge and clinical guidelines for anorexia nervosa. The article presents modern statistical data, criteria for risk factors and diagnostics, as well as current methods of treatment. A clinical case was analyzed in patient M.
Тhe article presents the results of studies of the features of the course of a new coronavirus infection in young people. According to the data obtained, in young patients, the course of a new coronavirus infection is more often mild. Bad habits, the presence of concomitant diseases of the respiratory and cardiovascular systems negatively affect the course of COVID-19. Young people are most often faced with such symptoms of a new coronavirus infection as a decrease in smell and taste, an increased body temperature within 37-38.5 ° C, a feeling of chest congestion, nasal congestion, sore throat, dry cough, shortness of breath, fatigue.
Sexually transmitted infections (STIs) are the most important problem in the modern world. Their negative influence on the course of pregnancy, as well as on the development of congenital diseases and fetal malformations has been proven for a long time. However, this problem has not lost its relevance, despite all attempts to conduct educational work among different segments of the population about the prevention of STIs. The aim of this study is to establish the relationship between the presence of sexually transmitted infections in women, both in history and those transferred during pregnancy, and complications of the early neonatal period.
