In this paper, we present a rare case of pulmonary cyst echinococcosis, in which the patient presented with no symptoms and was misdiagnosed as having pulmonary tuberculosis. Our case is a prime example of why echinococcosis should be part of the differential when dealing with an immigrant population.
Background: Chronic obstructive pulmonary disease (COPD) may frequently be complicated by sleep disorders, which worse quality of life and lead to other adverse consequences. The objective of the study was to analyze clinical course of the disease and quality of life in elderly patients with both COPD and sleep disorders. Methods and Results: The study included 50 patients with moderate and severe COPD in age from 60 to 75 years (mean age, 66.12 ± 0.76 years). Patients were divided into 2 groups randomly. For patients in Group 1, 3 mg of melatonin was prescribed orally 30–40 minutes before bedtime for 14 days on the background of standard COPD therapy. Patients of Group 2 received only standard COPD therapy. After 12 months of follow-up, the number of exacerbations and hospitalizations for COPD significantly decreased in Group 1: from 3.74±0.19 to 1.91±0.20 times a year (P=0.0000) and from 2.08±0.18 to 1.35±0.18 (P=0.0046). In Group 2, the dynamics of these parameters was not statistically significant. In addition, along with the improvement of sleep quality in COPD patients during treatment with melatonin, both state and trait anxiety scores and depression level improved. In Group 1, SF-36 scores (PF, RP, BP, and GH) have also significantly improved. Conclusion: Correction of sleep disorders by melatonin in elderly patients with COPD improved the effectiveness of COPD treatment, and reduced the frequency and duration of exacerbations and the number of outpatient visits and hospitalizations.
Background: Liposomes have been shown to be an effective targeted drug delivery system used to decrease side effects of glucocorticosteroids in the treatment of rheumatoid arthritis. Materials and Results: Experimental arthritis was induced in rabbits by a single intra-articular administration into the knee joint of poly-D-lysine (molecular weight, 175 kDa) and hyaluronic acid (7.5 mg per administration). To determine temperature readings over the joint a standard radiator was used with a temperature of 320C. Large oligolamellar liposomes from different phospholipidsand and cholesterol containing hydrocortisone acetate in lipid phase and prednisolone hemisuccinate in water phase were used. Conclusion: Intra-articular administration of the water-soluble prednisolone hemisuccinate (0.125 mg) and the lipid-soluble hydrocortisone acetate (0.125 mg) into the knee joint in the aqueous and lipid phases of large oligolamellar TSL (DPPC + 20 mole % cholesterol) prolongs the anti-inflammatory effect produced by glucocorticoids by 7–8 days compared to 1 day for free glucocorticosteroids at a total dose of 2.5 mg and 2 days for phosphatidylcholine-cholesterol liposomes at a total dose of 0.25 mg in rabbits with aseptic arthritis.
The aim of this study was to develop anthropometrical reference data for women of Uzbek nationality. In total, 1413 women of Uzbek nationality aged ≥35 years were studied. BMI was calculated for 411 women. The reference values of BMI for Uzbek women vary from 19.4 to 24.8kg/m2; BMI 22.7kg/m2 corresponds to the 50th percentile. These results correspond to the WHO criteria for European populations. The reference values of WC vary from 65.0 to 90.0cm. The conventional cut-off for normal WC (80cm) corresponded to the 75th percentile of the analysis among women of Uzbek nationality without any carbohydrate metabolism disorders and with normal BMI. WC equal to 76cm corresponds to the 50th percentile. Thus, the cut-off of WC for Uzbek women is 90.0cm, which is a mismatch to the European criteria. Average value of WHR was 0.80±0.07. Reference values of WHR vary of 0.69 to 0.93. WHR 0.8 corresponds to the 80th percentile. The obtained reference ranges are recommended to reveal the prevalence of MS and its components at the stage of revealing of risk groups in Uzbek women.
The aim of this study was to assess complaints about sleep quality and to investigate circadian rhythms of melatonin secretion in peri- and postmenopausal women. Material and Methods: A total of 146 climacteric women were examined. All patients were divided into 2 groups: Group1 included 72 perimenopausal women and Group 2 included 74 postmenopausal women. Women were surveyed with special questionnaires: PSQI, FFS, ESS, Daytime Feeling and Functioning Scale. Insomnia Severity Index was calculated. Salivary melatonin content was determined (4 times a day) by immunoassay using Microplate Reader EL×808 (USA). Results: Perimenopausal women often complained about difficulties falling asleep (more than 20 minutes from the moment the light was turned off) and difficulties awakening in the morning, while postmenopausal women often complained about snoring and frequent awakenings during sleep(≥2 times). ISI was 21.3±0.54 in Group 1 and 24.8±0.31 in Group 2, which corresponded to insomnia. Daily melatonin secretion in perimenopausal patients with insomnia was altered – the maximal level was registered in the morning hours. The circadian rhythms of melatonin secretion in the group of postmenopausal women did not correlate to the occurrence of insomnia. Conclusion: We can recommend administration of melatonin in the evening time and light therapy in the early morning hours in the complex treatment of SDs in perimenopausal women for normalizing and shifting the chronobiological rhythms of melatonin secretion, and specific therapy is aimed to eliminate snoring for postmenopausal women.
An optical barrier (OB) may eliminate the entrance of aerosol generated by clinical procedures in sterilization devices. The OB is a new alternative for sterilizing medical and dental instruments. The objective of the study was to evaluate the action of the OB on the entrance of bacteria into an autoclaving system and to correlate the time and distance of exposure. To test the configuration of the device, we used Escherichia coli. A lamp utilized in this instrument was low pressure with a wavelength around 254nm. A homogenous distribution of light around the door was observed by the Inventor 2015 software. Microbiological tests showed efficient bacterial elimination at a distance of 8cm from OB. The results show that the use of the OB radiation for 30 minutes guarantees the non-entry of microorganisms into the sterilized environment. The use of the OB may be recommended to maintain the surface of sterile materials for long periods of time.
The main purpose of this study was to investigate the features of within-visit blood pressure variability (BPV) in patients with arterial hypertension (AH) and to assess the relationship of those features to impaired renal filtration. Material and Methods: The study included 120 patients with AH Stages I and II (ESH/ESC, 2013): 58(48.3%) men and 62(51.7%) women aged from 22 to 73 years (mean age 58.7±15 years). Average duration of AH was 15.0±6.7 years. BP was measured three times during visit. BP was measured three times at 2-minute intervals during one visit. Within-visit BPV was evaluated by the presence of an absolute difference (AD) between any two readings of three SBP measurements of more than 5mmHg. All patients underwent a comprehensive examination, which included blood and urine tests, kidney ultrasound, assessment of blood levels of creatinine and TnT, and calculation of GFR. Results: Depending on the response of BP to repeated measurements, three types of BPV were identified. A prognostically unfavorable type of BPV, which is characterized by SBP-AD >5mmHg between the third and first measurements, was identified. Patients of this group had the lowest eGFR value that indicates more pronounced renal damage, and, as a consequence, worse prognosis. Also in these patients, there was an increase in TnT level, which is a predictor of the development of adverse cardiovascular complications.
Background: Since Langer’s first foray into studying cutaneous lines, although people have studied skin lines across the body, there has not been a study that elucidates changes to skin structure of elastin and collagen at different load levels. This study set out to look at whether incisional lines and excisional lines have different biodynamics and have to be considered differently. Materials and Methods: For this study, we used a two-photon microscopic camera using optimal wavelengths to detect collagen and elastin. Measurements were taken in 5 patients at the center of the excisional wound (high-load) and at the ends of the wound (tapered end of the ellipse) where effectively the wound is an incisional wound. Results: Wounds were observed after they were surgically closed. When incisional wounds were observed, where there was minimal tension (< 1.5 N force) we found that, in each case, elastin stretched and collagen buckled, revealing mostly elastin. Where larger defects were created after excisions (as in the figure where a skin cancer had been removed, where forces to close wounds were typically greater than 2N), we noted that the image revealed mostly collagen, suggesting that the reverse had occurred (i.e. collagen stretched and elastin buckled). Conclusion: This difference between tension loads on skin and the interplay between collagen and elastin has never before been elucidated for incisional and excisional wounds, and in the author’s view has great research interest for a cutaneous surgeon seeking to identify the best skin lines to utilize to minimize scarring.
Background: The improvement of asthma treatment is still one of the urgent issues of modern medicine. The objective of this study was to evaluate the dynamics of lipid peroxidation parameters in patients with asthma receiving complex therapy with ceruloplasmin (Cp). Methods and Results: The study included 92 patients with severe uncontrolled asthma. Patients were divided into 2 groups. The case group consisted of 45 patients, whose treatment was conventional therapy combined with Cp produced by “MICROGEN” (Russia). Cp 100 mg was administered intravenously once daily for 7 days. The control group consisted of 47 patients who received conventional treatment: inhaled and systemic corticosteroids, bronchodilators, and, if necessary, antibiotics and oxygen therapy. All participants underwent a comprehensive examination, including clinical investigation, chest radiography, assessment of spirometry parameters (VC, FVC, FEV1, FEV1/FVC ratio, PEFR, FEF 25-75), and determination of MDA, metHB, HbCO, total sulfhydryl groups, and SOD activity in blood plasma. Patients of the case group showed a statistically significant decrease in elevated rates of MDA and HbCO, an increase in SOD activity and the content of sulfhydryl groups. Conclusion: Cp in complex treatment of patients with asthma allows eliminating the imbalance in the prooxidant-antioxidant system and providing an obviously positive clinical effect.
Background: Lung cancer is one of the most common cancers in the world. The main objective of our study was to analyze the results of the surgical treatment of non-small cell lung cancer (NSCLC) in patients of different age groups. Methods and Results: We examined 280 patients (262/93.6% men and 18/6.4% women) aged from 39 to 75 years with NSCLC who underwent surgical treatment in the Ulyanovsk Regional Oncology Center in the period from 2010 to 2016. The mean age of patients was 64.9±10.1 years. Concomitant diseases were identified in 256(91.4%) patients: cardiovascular diseases in 170(60.7%), COPD in 147 (52.5%), lower extremity peripheral artery disease (stages II and III chronic ischemia) in 49(17.5%), a combination of concomitant pathology in 110(39.3%) patients. A total of 85(30.4%) pneumonectomies were performed, 56 of them in patients of young and middle age. Among early postoperative complications, the most frequent complications were purulent-inflammatory complications of the soft tissues of wounds (38.5%) and bronchopleural fistula (31.1%). The most severe complications, such as myocardial infarction, acute stroke, and acute limb ischemia, developed in patients with concomitant cardiovascular diseases, which caused the postoperative mortality of 4.6%. Conclusion: There were no statistically significant differences in the structure of complications depending on sex and age.