Variation in the Clinical Manifestation of Rheumatoid Arthritis Based on the Residence Areas

The study included rheumatoid arthritis patients from three regions of Uzbekistan, viz., Tashkent city - zone I (n=144), Khorezm region – zone II (n=112) and the Namangan region – zone III (n=104). Comparative clinical and laboratory analyses showed the clear evidence of aggressive joint syndrome dominance in zone II (71.4%), which was higher than those of the patients in zone III (P<0.05), as well as the development of severe destructive lesions of the joints, even up to the joints ankylosing. Also, zone II was dominated by the visceral forms of the disease, up to 52.7%, whereas in zone I this value was 31.3%, while zone III was characterized by the low rates of extra-articular manifestations, at 11.5% (P<0.05). Moreover, the zone II patients in comparison with zone I patients more frequently required hospitalization and ambulant therapy (P<0.05). A retrospective study of the genetic aspects of rheumatoid arthritis patients had established the fact that in zone I, 52.14% of the patients’ family history was burdened with rheumatoid arthritis (28.6% in zone II and 24.1% in zone III); while in zone II - there was an upward trend in the incidence of the disease among the descendants of the rheumatoid arthritis patients, at 55.4% (27.8% in zone I and 23.1% in zone III). Thus, a comparative analysis demonstrated that the clinical and epidemiological parameters of rheumatoid arthritis were different in all the three areas of Uzbekistan, which did not exclude the probability of the influence of climatic and geographical factors on the course of the rheumatoid arthritis

Literature review and clinical observation of acquired idiopathic hemophilia with a new missense mutation in the factor VIII gene (His2026Arg)

The article provides review of possible mechanisms of inhibitor coagulopathies, in particular of acquired hemophilia A. This pathology is an extremely rare disease occurring in 1-2 cases in 1 million per year. In the present study we provide data for two clinical cases of hemophilia A in women. These cases had different development mechanisms, although both women have a newly discovered missense mutation His2026Arg in the VIII factor gene. The matter of main interest is the description of the disease development in the patient with an acquired idiopathic hemophilia A with a possible disease occurrence due to an asymmetric X-chromosome inactivation (lyonization). In this particular case lyonization led to the late manifestation of the hemophilia A carrier’s state and development of severe form of the inhibitor-associated acquired hemophilia A. We also discuss therapeutic approaches to these forms of the disease, considering there are no concise protocols for case management due to an extreme rarity of the pathology. Acquainting the clinical personnel working it the different areas of medicine with suchlike inhibitor coagulopathies has a major practical importance

Difficulties in diagnosing intestinal T-cell lymphoma. Case report

The article describes a rare diagnosis of monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL), due to its veiled by a number of so-called masks of enteropathies. A detailed analysis of all clinical, morphological and immunohistochemical data made it possible to establish the correct diagnosis. The revealed pathology is extremely rare in practice, even among specialists in hematology. The article demonstrates the main stages of both a complex diagnosis and an attempt at therapy for this aggressive form of intestinal lymphoma

Плоскоклеточная карцинома яичка и паратестикулярных тканей

Testicular tumors occur in 1–1.5 % of cases in the structure of the general oncological morbidity among men and constitute 5 % among tumors of the urogenital tract. In Western Europe, 3–6 new cases are recorded a year per 100 thousand male population. Nevertheless, in relation to young men, this particular type of neoplasm is not only the most common oncological pathology (up to 60 % of all neoplasms), but also the main cause of cancer mortality. Risk factors for developing ovarian cancer include a family history, previous development of a tumor in the contralateral testicle, and components of testicular dysgenesis syndrome (cryptorchidism, hypospadias, spermatogenesis disorders leading to infertility). Tumors of paratesticular tissues are much less common and most of them are benign. Squamous cell carcinoma rarely develops as a primary tumor of the testis and / or paratesticular tissue, isolated cases have been described in the English literature. Secondary damage to the scrotum organs is more frequent, but such situations are usually found in patients of an older age group. This article presents the clinical case and the final results of treatment of a patient with squamous cell carcinoma of paratesticular tissue.Опухоли яичка встречаются в 1–1,5 % случаев в структуре общей онкологической заболеваемости у мужчин и составляют 5 % среди опухолей урогенитального тракта. В Западной Европе регистрируется 3–6 новых случаев в год на 100 тыс. мужского населения. При этом у мужчин молодого возраста этот тип новообразований является не только наиболее распространенной онкологической патологией (до 60 % всех новообразований), но и основной причиной смертности от рака. Факторы риска развития рака яичников включают семейный анамнез, предшествующее развитие опухоли в контралатеральном яичке и компоненты синдрома дисгенеза яичка (крипторхизм, гипоспадия, нарушения сперматогенеза, приводящие к бесплодию). Опухоли паратестикулярных тканей встречаются значительно реже, и большинство из них доброкачественные. Плоскоклеточный рак редко развивается как первичная опухоль яичка и / или паратестикулярной ткани, отдельные случаи были описаны в английской литературе. Вторичное повреждение органов мошонки происходит чаще, но такие ситуации обычно встречаются у пациентов старшей возрастной группы. В данной статье представлены клинический случай и окончательные результаты лечения пациента с диагнозом плоскоклеточного рака паратестикулярных тканей

Characteristics of Early-Onset vs Late-Onset Colorectal Cancer: A Review.

The incidence of early-onset colorectal cancer (younger than 50 years) is rising globally, the reasons for which are unclear. It appears to represent a unique disease process with different clinical, pathological, and molecular characteristics compared with late-onset colorectal cancer. Data on oncological outcomes are limited, and sensitivity to conventional neoadjuvant and adjuvant therapy regimens appear to be unknown. The purpose of this review is to summarize the available literature on early-onset colorectal cancer. Within the next decade, it is estimated that 1 in 10 colon cancers and 1 in 4 rectal cancers will be diagnosed in adults younger than 50 years. Potential risk factors include a Westernized diet, obesity, antibiotic usage, and alterations in the gut microbiome. Although genetic predisposition plays a role, most cases are sporadic. The full spectrum of germline and somatic sequence variations implicated remains unknown. Younger patients typically present with descending colonic or rectal cancer, advanced disease stage, and unfavorable histopathological features. Despite being more likely to receive neoadjuvant and adjuvant therapy, patients with early-onset disease demonstrate comparable oncological outcomes with their older counterparts. The clinicopathological features, underlying molecular profiles, and drivers of early-onset colorectal cancer differ from those of late-onset disease. Standardized, age-specific preventive, screening, diagnostic, and therapeutic strategies are required to optimize outcomes

Post-Operative Functional Outcomes in Early Age Onset Rectal Cancer

Background: Impairment of bowel, urogenital and fertility-related function in patients treated for rectal cancer is common. While the rate of rectal cancer in the young (&lt;50 years) is rising, there is little data on functional outcomes in this group. Methods: The REACCT international collaborative database was reviewed and data on eligible patients analysed. Inclusion criteria comprised patients with a histologically confirmed rectal cancer, &lt;50 years of age at time of diagnosis and with documented follow-up including functional outcomes. Results: A total of 1428 (n=1428) patients met the eligibility criteria and were included in the final analysis. Metastatic disease was present at diagnosis in 13%. Of these, 40% received neoadjuvant therapy and 50% adjuvant chemotherapy. The incidence of post-operative major morbidity was 10%. A defunctioning stoma was placed for 621 patients (43%); 534 of these proceeded to elective restoration of bowel continuity. The median follow-up time was 42 months. Of this cohort, a total of 415 (29%) reported persistent impairment of functional outcomes, the most frequent of which was bowel dysfunction (16%), followed by bladder dysfunction (7%), sexual dysfunction (4.5%) and infertility (1%). Conclusion: A substantial proportion of patients with early-onset rectal cancer who undergo surgery report persistent impairment of functional status. Patients should be involved in the discussion regarding their treatment options and potential impact on quality of life. Functional outcomes should be routinely recorded as part of follow up alongside oncological parameters

Issues of using local energy systems with hydraulic energy storage in the power system of the republic of Uzbekistan

The method of determining the main energy parameters of a local energy system based on renewable sources with hydraulic accumulation of part of the generated energy is considered. The example shows the economic efficiency of hydraulic energy storage in comparison with lithium-ion batteries

Cardiac involvement in lymphomas. Review of literature and case report of the clinical course of B-large-cell lymphoma

Clinical case of successful chemotherapy of patient with cardiac involvement in lymphoma, one of manifestations of which was the heart rhythm and conduction disorder, is presented as illustration. The data on the epidemiology of cardiac involvement in hematologic diseases, particularly in lymphomas and their clinical manifestations, modern diagnostic and treatment are presented. Clinical case of successful chemotherapy of patient with cardiac involvement in lymphoma, one of manifestations of which was the heart rhythm and conduction disorder, is presented as illustration.</p

Squamous cell carcinoma of the testis and paratesticular tissue

Testicular tumors occur in 1–1.5 % of cases in the structure of the general oncological morbidity among men and constitute 5 % among tumors of the urogenital tract. In Western Europe, 3–6 new cases are recorded a year per 100 thousand male population. Nevertheless, in relation to young men, this particular type of neoplasm is not only the most common oncological pathology (up to 60 % of all neoplasms), but also the main cause of cancer mortality. Risk factors for developing ovarian cancer include a family history, previous development of a tumor in the contralateral testicle, and components of testicular dysgenesis syndrome (cryptorchidism, hypospadias, spermatogenesis disorders leading to infertility). Tumors of paratesticular tissues are much less common and most of them are benign. Squamous cell carcinoma rarely develops as a primary tumor of the testis and / or paratesticular tissue, isolated cases have been described in the English literature. Secondary damage to the scrotum organs is more frequent, but such situations are usually found in patients of an older age group. This article presents the clinical case and the final results of treatment of a patient with squamous cell carcinoma of paratesticular tissue