Нейроэндокринная опухоль — параганглиома, симулирующая зоб

This paper presents two rare case reports with one common feature. Patients with thyroid nodules, who had undergone a comprehensive clinical evaluation based on standard algorithms according to their preoperative diagnosis of “Multinodular goiter, grade II”, were scheduled for surgical treatment (thyroidectomy). Postoperative morphological examination revealed, however, the extremely rare neuroendocrine tumor paraganglioma that simulated multinodular goiter with tracheal compression. Our analysis of these clinical cases showed common systematic mistakes that were committed during conventional, standardized preoperative examination, resulting in certain difficulties in the treatment of these patients.В данной статье представлены два редких клинических наблюдения, имеющих один объединяющий их признак. Пациентам с узловыми образованиями в щитовидной железе, обследованным в полном объеме согласно стандартным алгоритмам, с установленным до операции диагнозом «многоузловой зоб II степени», планировалось хирургическое лечение в объеме тиреоидэктомии. Однако после выполненных операций было установлено, что за многоузловой зоб с компрессией трахеи была ошибочно принята крайне редко встречающаяся нейроэндокринная опухоль — параганглиома, имитировавшая зоб с признаками компрессии органов шеи. При анализе клинических случаев нами были выявлены общие систематические ошибки, допущенные при обследовании с соблюдением общепринятых стандартизированных подходов, что привело к определенным сложностям в лечении этих пациентов

Роль радионуклидной диагностики в комплексном обследовании ВИЧ-инфицированных пациентов с ишемической болезнью сердца

Cardiovascular disease is one of the most frequent cause of death globally. The greatest part is occupied by ischemic heart disease. HIV patients are composed to a higher risk of coronary heart disease.The purpose of this work is to evaluate the possibility of using molecular imaging methods in a comprehensive examination of patients with HIV infection and ischemic heart disease.Materials and methods. The survey group includes 32 patients with HIV infection. The comparison group consists of 25 age-matched patients with coronary heart disease and without HIV Infection. All patients were underwent myocardial perfusion scintigraphy using single photon emission computed tomography. Positron emission tomography with FDG were performed if necessary to assess the viability of the myocardium. The patients of the main group undergo diagnostic coronary angiography and standard set of laboratory and institutional diagnostic methods.Results. The results of which confirm the high efficiency of radionuclide diagnostic methods for detecting perfusion disorders, contractility and myocardial viability in patients with HIV infection even at an early stage. They can be recommended for using in a comprehensive examination of patients with HIV infection.Наиболее частой причиной смертности во всем мире являются сердечно-сосудистые заболевания, среди которых ведущее место занимает ишемическая болезнь сердца (ИБС). В группу с наиболее высоким риском развития ИБС входят пациенты с ВИЧ-инфекцией.Цель исследования: оценка возможности применения методов молекулярной визуализации в комплексном обследовании пациентов с ВИЧ-инфекцией и ИБС.Материал и методы. В группу обследования включено 32 пациента с ВИЧ-инфекцией, группу сравнения составили 25 сопоставимых по возрасту пациентов без ВИЧ-инфекции с ИБС. Всем пациентам проведена перфузионная сцинтиграфия миокарда (с помощью ОФЭКТ), ПЭТ/КТ сердца с ФДГ проводилась при необходимости оценки жизнеспособности миокарда в комплексе с диагностической коронароангиографией и стандартным набором лабораторно-инструментальных методов диагностики.Результаты. Полученные результаты подтверждают высокую эффективностью методов радионуклидной диагностики для выявления нарушений перфузии, сократимости и жизнеспособности миокарда у пациентов с ВИЧ-инфекцией даже на ранней стадии и могут быть рекомендованы к использованию в комплексном обследовании пациентов с ВИЧ-инфекцией

THE FIRST EXPERIENCE OF TRANSORAL ROBOT-ASSISTED SURGERY IN A PATIENT WITH OROPHARYNGEAL CANCER (CLINICAL OBSERVATION)

Multiple approaches are currently available for treatment of oropharyngeal cancer. Particular attention is usually paid to preservation of the normal shape of the organ and maintenance of the quality of life in patients. Early-stage oropharyngeal cancer can be treated by both radiotherapy and surgery, including transoral laser microsurgery and robot-assisted surgery.Early diagnosis and the use of modern technological approaches allow to conduct adequate surgical treatment without significant injury of the surrounding soft tissues and bone structures, which in turn promotes both aesthetic and functional rehabilitation of the patient. The case of robot-assisted surgical treatment of the oropharyngeal tumor described in this article is a good example of this rehabilitation

VISUAL EVOKED POTENTIALS OF SICK INFANTS WITH EPILEPSY

Summary: 39 patients aged from 3 months to 3 years have been examined. The first group consisted of 19 sick infants with symptomatic epilepsy, the second – 10 infants with motor defect without epilepsy, the third – 10 healthy infants. The maximum delay of latency (37,4 ± 30 мс) of component Р100 of the visual evoked potentials and consequently more expressed disturbances of carrying out of impulses on visual ways, are taped in group sick of a symptomatic epilepsy of early age. The given changes had statistically significant differences (P <0,001) with those at children without a pathology of nervous system. At patients with impellent disturbances delay of latency and decrease of amplitude have been less expressed, than at patients with a symptomatic epilepsy, but differences of indicators of amplitude were doubtful. 32% of patients with symptomatic epilepsy have been diagnosed to have сortical visual impairments with disturbance of behavioural visual reactions, 67 ± 14,2 ms accurate delay of latency, 4,6 ± 3,0 mcv decrease of amplitude of the main visual evoked potentials component P100 and optic nerve hypoplasia. Delay of latency and decrease of amplitude of the main visual evoked potentials component are criterions’ of severity of sick infants’ symptomatic epilepsy course

Effects of longJterm lisinopril therapy on central and peripheral hemodynamics in patients with dilated cardiomyopathy

The study was aimed at investigating the effects of a second?generation ACE inhibitor, lisinopril (Diroton), on central and peripheral hemodynamics in patients with dilated cardiomyopathy (DCMP). In total, 39 persons with DCMP and chronic heart failure (CHF), aged 35–55 years, were examined. Diroton dose was titrated from low (2,5 mg/d) to high (10 mg/d). The treatment lasted for 12 months. Longterm Diroton therapy, as a part of complex pharmaceutical treatment, was associated with significant improvement in total and regional hemodynamics in DCMP patients: left ventricular ejection fraction increased, dilated myocardium volumes and sizes reduced, together with reduction in temporal rheography parameters and increase in velocity ones. Diroton therapy also improved clinical course of CHF and circadian blood pressure profile