Describtion of clinical case of mesenterial lymphadenitis of yersiniosis ethiology

The article presents a clinical case of abdominal form of yersiniosis with mesenteric lymphadenitis, which imitated the symptoms of acute appendicitis. We described the key aspects of epidemiology, clinical manifestations and diagnostics of intestinal yersiniosis.В статье представлен клинический случай абдоминальной формы иерсиниоза с вариантом течения – мезентериальный лимфаденит, который имитировал симптоматику острого аппендицита. Описаны ключевые аспекты эпидемиологии, клинической картины и диагностики кишечного иерсиниоза

Problems of parvovirus b19 infection in the modern society

The article discusses the modern aspects of epidemiology, pathogenesis, clinical manifestations of parvovirus B19 infection. Particular attention is directed to the diagnostics of this disease.В статье рассмотрены современные аспекты эпидемиологии,патогенеза, клинических проявлений парвовирусной В19 инфекции. Особое внимание уделено вопросам диагностики данного заболевани

Прогностическая значимость моторных вызванных потенциалов при оперативных вмешательствах по поводу устранения спинального стеноза на цервикальном уровне

Introduction. Transcranial electrical stimulation is a neurophysiological method that is used intraoperatively for evaluating the conduct of a nerve impulse through the cortical-spinal tract. However, the results obtained during registration of this modality do not always correlate with the neurological status of the patient after surgery. The purpose of the study is to determine the prognostic significance of motor evoked potentials in surgical interventions for the elimination of spinal stenosis at the cervical level. Materials and methods. The study analyzed the results of 20 microsurgical root decompressions at the cervical level by eliminating spinal stenosis. Surgical interventions were performed in the neurosurgical Department of National medical and surgical center named after N.I. Pirogov from august 2018 to march 2019. Intraoperatively there were used the following modalities: motor evoked potentials, 3-channel registration of somatosensory evoked potentials from the median nerves, 8-channel electroencephalography, and train-of-four monitoring. The patients were divided into 2 groups: in the 1st group was used inhalant anesthetics, in the 2nd the anesthesia was conducted according to the protocol “Total intravenous anesthesia”. Results. Within each group, in a number of cases, there was a decrease in the response amplitude (by 80 % or more), as well as a loss of motor evoked potentials. In the “Total intravenous anesthesia” group, the current stimulation forces used to obtain motor evoked potentials did not exceed 150 mA, while in the group of inhaled anesthetics, the maximum value was 300 mA, and the average value was 170 mA. In the “Total intravenous anesthesia” group, in 2 cases, a loss of response from one myotome at the decompression phase was registered without recovery during intraoperation monitoring, in 2 cases there was the amplitude loss by 80 % or more with subsequent recovery. In the “Total intravenous anesthesia” group, the results were comparable. Conclusion. During neurophysiological monitoring in surgeries at the cervical level, the loss of motor evoked potentials from one myotome, as well as a decrease the response amplitude by 80 % or more are doubtful as a criteria for predicting neurological deficit.Введение. Транскраниальная электростимуляция – нейрофизиологический метод, который применяется интраоперационно и необходим для оценки проведения нервного импульса по кортико-спинальному тракту. Однако полученные результаты при регистрации этой модальности не всегда коррелируют с неврологическим статусом пациента при пробуждении. Цель исследования – определить прогностическую значимость моторных вызванных потенциалов при оперативных вмешательствах по поводу устранения спинального стеноза на цервикальном уровне. Материалы и методы. В исследовании проанализированы результаты 20 операций по микрохирургической декомпрессии корешков на цервикальном уровне путем устранения спинального стеноза. Оперативные вмешательства были проведены в нейрохирургическом отделении ФГБУ «Национальный медико-хирургический центр им. Н.И. Пирогова» с августа 2018 по март 2019 г. Интраоперационно использованы следующие модальности: моторные вызванные потенциалы, 3-канальная регистрация соматосенсорных вызванных потенциалов со срединных нервов, 8-канальная электроэнцефалография, контроль Train-of-four. По виду анестезиологического пособия пациенты разделены на 2 группы: в 1-й применялись ингаляционные анестетики, во 2-й – анестезиологическое пособие проводилось по протоколу Total intravenous anesthesia. Результаты. Внутри каждой группы в ряде случаев зафиксировано снижение амплитуды ответов (на 80 % и более), а также выпадение моторных вызванных потенциалов. В группе Total intravenous anesthesia применяемые для получения моторных вызванных потенциалов силы тока не превышали 150 мA, в то время как в группе ингаляционных анестетиков максимальное значение было 300 мA, среднее – 170 мA. В группе Total intravenous anesthesia в 2 случаях было зарегистрировано выпадение ответа с 1 миотома на этапе декомпрессии без восстановления за время мониторинга, в 2 случаях – падение амплитуды ответов на 80 % и более с последующим восстановлением. В группе десфлюрана результаты оказались сопоставимыми. Заключение. При проведении нейрофизиологического мониторинга при оперативных вмешательствах на цервикальном уровне выпадение моторных вызванных потенциалов с 1 миотома, а также снижение амплитуды ответа на величину 80 % и более сомнительны как предиктор неврологического дефицита

Prognostic significance of motor evoked potentials in surgical interventions to eliminate spinal stenosis at the cervical level

Introduction. Transcranial electrical stimulation is a neurophysiological method that is used intraoperatively for evaluating the conduct of a nerve impulse through the cortical-spinal tract. However, the results obtained during registration of this modality do not always correlate with the neurological status of the patient after surgery. The purpose of the study is to determine the prognostic significance of motor evoked potentials in surgical interventions for the elimination of spinal stenosis at the cervical level. Materials and methods. The study analyzed the results of 20 microsurgical root decompressions at the cervical level by eliminating spinal stenosis. Surgical interventions were performed in the neurosurgical Department of National medical and surgical center named after N.I. Pirogov from august 2018 to march 2019. Intraoperatively there were used the following modalities: motor evoked potentials, 3-channel registration of somatosensory evoked potentials from the median nerves, 8-channel electroencephalography, and train-of-four monitoring. The patients were divided into 2 groups: in the 1st group was used inhalant anesthetics, in the 2nd the anesthesia was conducted according to the protocol “Total intravenous anesthesia”. Results. Within each group, in a number of cases, there was a decrease in the response amplitude (by 80 % or more), as well as a loss of motor evoked potentials. In the “Total intravenous anesthesia” group, the current stimulation forces used to obtain motor evoked potentials did not exceed 150 mA, while in the group of inhaled anesthetics, the maximum value was 300 mA, and the average value was 170 mA. In the “Total intravenous anesthesia” group, in 2 cases, a loss of response from one myotome at the decompression phase was registered without recovery during intraoperation monitoring, in 2 cases there was the amplitude loss by 80 % or more with subsequent recovery. In the “Total intravenous anesthesia” group, the results were comparable. Conclusion. During neurophysiological monitoring in surgeries at the cervical level, the loss of motor evoked potentials from one myotome, as well as a decrease the response amplitude by 80 % or more are doubtful as a criteria for predicting neurological deficit

Pregnancy and Zika virus

Zika virus (ZIKV) is an arthropod-borne virus (arbovirus) in the genus Flavivirus and the Flaviviridae family. In 1947 and 1948 ZIKV was first isolated from a nonhuman primate as well as from mosquitoes in Africa, respectively. For half a century, ZIKV infections in human were sporadic prior to 2015–2016 pandemic spreading. Transmission of ZIKV from mother to fetus can occur in any trimester of pregnancy, even if mother was an asymptomatic carrier. The clinical signs of ZIKV infection are nonspecific and can be misdiagnosed as some other infectious diseases, especially those caused by arboviruses such as Dengue and Chikungunya. ZIKV infection was solely associated with mild illness prior to the large French Polynesian and Brazil outbreaks, when severe neurological complications, Guillain–Barre syndrome and dramatically increased rate of severe congenital malformations (including microcephaly) were reported. The adaptation of ZIKV to an urban cycle in endemic areas suggests that the incidence of ZIKV infections may be underestimated. The pandemic of novel coronavirus infection (COVID-19) demonstrates that lessons from ZIKV pandemic propagation has not been learned properly