Wernicke encephalopathy after sleeve gastrectomy

The article describes the case of a patient with Wernicke encephalopathy, which developed 3 months after the sleeve gastrectomy. An MRI of the brain was performed to verify the diagnosis, which revealed a symmetrical non-uniform increase in the MR signal on T2-WI and Tirm from the medial part of the thalamus, mastoid bodies and gray matter around the aqueduct of Sylvius. Thiamine infusion was promptly initiated as therapy. During treatment, acute neurological symptoms almost regressed, the patient was discharged in a satisfactory condition with preservation of vertical nystagmus under the supervision of specialists at the place of residence. Wernicke–Korsakoff syndrome more often occurs as a complication of alcoholism and arising from thiamine deficiency. However, the fact that this condition also occurs under the influence of other etiopathogenetic factors is often ignored by clinicians. In the management of patients after bariatric interventions, this condition is much more common in malabsorptive operations. However, a combination of certain factors can be described in patients after restrictive types of bariatric surgeries

Mathematical model of the competition life cycle under limited resources conditions: Problem statement for business community

Present study is devoted to the development of competition life cycle mathematical model in the closed business community with limited resources. Growth of each agent is determined by the balance of input and output resource flows: input (cash) flow W is covering the variable V and constant C costs and growth dA/dt of the agent's assets A. Value of V is proportional to assets A that allows us to write down a first order non-stationary differential equation of the agent growth. Model includes the number of such equations due to the number of agents. The amount of resources that is available for agents vary in time. The balances of their input and output flows are changing correspondingly to the different stages of the competition life cycle. According to the theory of systems, the most complete description of any object or process is the model of its life cycle. Such a model describes all stages of its development: from the appearance ("birth") through development ("growth") to extinction ("death"). The model of the evolution of an individual firm, not contradicting the economic meaning of events actually observed in the market, is the desired result from modern AVMs for applied use. With a correct description of the market, rules for participants' actions, restrictions, forecasts can be obtained, which modern mathematics and the economy can not give. © 2017 Author(s).15-06-04863Present study was carried out under financial support of the Russian Fund of Fundamental Research grant № 15-06-04863 "Mathematical models of local payment system lifecycles"

Clinical case of chronic supraventricular tachycardia and arrhythmogenic left ventricular myocardial dysfunction of a 3-year-old patient

The aim of the study - to demonstrate a clinical case of a 3-year-old patient diagnosed with chronic SVT, arrhythmogenic left ventricular (LV) myocardial dysfunction.Цель исследования - демонстрация клинического случая 3-летнего пациента с диагнозом: хроническая СВТ, аритмогенная дисфункция миокарда левого желудочка (ЛЖ)

Comparative Analysis of Clinical, Hormonal and Morphological Studies in Patients with Neuroendocrine ACTH-Producing Tumours

This paper highlights the problem of neuroendocrine tumours (NETs) with clinical symptoms of hypercorticism caused by hypersecretion of adrenocorticotropic hormone (ACTH) by tumour cells. In most cases (85%), the tumours were localized in the pituitary gland (Cushing's disease); 15% of the patients had an extrapituitary tumour that manifest as an ectopic ACTH secretion (EAS). Comparative analysis of clinical, hormonal, histological, and immunohistochemical characteristics of pituitary and extrapituitary ACTH-secreting NET was performed. It included 46 patients with CD and 38 ones exhibiting ectopic ACTH secretion (EAS). Results of the study suggest differences between CD and EAS in terms of the severity of clinical manifestations and duration of the disease. Hormonal studies showed that EAS unlike CD was associated with high plasma ACTH and cortisol levels, late-evening salivary cortisol and daily urinary free cortisol, the absence of a 60% or greater reduction of cortisol in the HDDST test, and the presence of a low (less than 2) ACTH gradient in response to desmopressin administration with catheterization of cavernous sinuses. The study of morphofunctional characteristics of the removed NET demonstrated the ability of both pituitary and extrapituitary NETs to express ACTH as well as GH, PRL, LH, and FSH. The angiogenic markers (CD31 and VEGF) were detected with equal frequency regardless of the NET localization. The histological structure of all corticotropinomas suggested their benign origin, but extrapituitary NETs were represented by different morphological types with varying malignancy, invasiveness, and metastatic properties. A higher cell proliferation potential (Ki-67) was documented for NET in patients presenting with an ectopic ACTH secretion compared to those having corticotropinomas

System-dynamic modeling of the development of universities in the conditions of informatization

The work is devoted to the selection of key performance indicators (KPI) of universities, as well as the development of the concept of using these indicators in assessing the effectiveness of universities in the scientific and innovative sector of Russia. The study used a combination of descriptive and deductive methods, as well as experiment. There were analyzed the data on financing, the number of publications indexed in the Web of Science, as well as the number of employees of 14 Russian universities that have been participating since 2013 in the state program "Project 5-100". This program is aimed at the adaptation of Russian universities to international standards and incorporating them into international education environment. A system-dynamic model is constructed that allows, on the basis of the key performance indicators, to find new approaches and ways to achieve the goals set and to build an effective university development strategy in the transition to a digital economy. © 2020 American Institute of Physics Inc.. All rights reserved

Anthropogenic- and natural sources of dust in peatland during the Anthropocene

As human impact have been increasing strongly over the last decades, it is crucial to distinguish human-induced dust sources from natural ones in order to define the boundary of a newly proposed epoch - the Anthropocene. Here, we track anthropogenic signatures and natural geochemical anomalies in the Mukhrino peatland, Western Siberia. Human activity was recorded there from cal AD 1958 (±6). Anthropogenic spheroidal aluminosilicates clearly identify the beginning of industrial development and are proposed as a new indicator of the Anthropocene. In cal AD 1963 (±5), greatly elevated dust deposition and an increase in REE serve to show that the geochemistry of elements in the peat can be evidence of nuclear weapon testing; such constituted an enormous force blowing soil dust into the atmosphere. Among the natural dust sources, minor signals of dryness and of the Tunguska cosmic body (TCB) impact were noted. The TCB impact was indirectly confirmed by an unusual occurrence of mullite in the pea

Difficulties in diagnosis of adenomas with mixed prolactin and growth hormone secretion: case presentation

Hyperpolactinemia is a persistent excess of prolactin in the blood serum. The symptom complex of hyperprolactinemia primarily consists of disturbances in function of the reproductive system. The secretion of prolactin is under complex neuroendocrine control, which involves factors of different nature: neurotransmitters, hormones of the peripheral endocrine glands. In most cases, prolactin is secreted by pituitary cells - lactotrophs, but in some cases, hypersecretion of prolactin is combined with an excess production of growth hormone, which is typical for tumors originating from the line of progenitor cells of lactotrophs and somatotrophs of the pituitary gland, mammosomatotrophs. In this case, the symptom complex of hyperprolactinemia is accompanied by clinical manifestations of acromegaly. In patients with acromegaly, the cause of hyperprolactinemia may be pituitary stalk compression or mixed secretion of prolactin and growth hormone. Differentiation of lactotropic and somatotropic pituitary cells is determined by transcription factor Pit-1. These cell lineages are closely connected,  and this may be one of the reasons for formation of tumors with mixed secretion. Reports of late presentation of acromegaly in patients previously diagnosed with prolactinomas have also been described in literature.Clinical manifestations of hyperprolactinemia can cause the patient to seek doctor’s attention before acromegalic changes in appearance develop. Careful attention is needed both to the primary diagnosis and to the clinical course of the disease in patients with hyperprolactinemia and pituitary adenoma: full assessment of hormonal status with mandatory evaluation of IGF-1 is crucial at initial examination, during further observation it may be advised to consider periodic evaluation of IGF-1 in addition to assessment of prolactin and the size of adenoma.  Pituitary adenomas with mixed secretion may have a poorer prognosis

Long-term follow-up of a female patient with Weber–Christian panniculitis

Weber–Christian disease is a rare form of lobular panniculitis characterized by painful subcutaneous nodules on the trunk and limbs commonly concurrent with systemic manifestations and a tendency to relapse. Known are only sporadic cases of a long-term (more than 5-year) followup of patients with Weber–Christian disease. For this reason, there are neither prognostic criteria for the disease no proven conventional treatment option now. The paper describes a clinical case of a female patient with a verified diagnosis of Weber–Christian disease who has a sustained subclinical remission due to low-dose prednisone use and basic antirecurrent therapy