Тяжелое поражение легких у больной с недиагностированной системной красной волчанкой

Systemic lupus erythematosus (SLE) is one of the most complex rheumatic diseases, which is due to the variety of its clinical forms and manifestations. The article describes a case of severe lung injury (LI) in a female patient with previously undiagnosed and untreated SLE, which led to a fatal outcome. A 33-year-old female patient diagnosed with pneumonia was delivered by an ambulance team to City Clinical Hospital Thirteen. Her leading complaints were dyspnea, joint pain, fever, and abdominal pain. During examination of the patient and analysis of her medical documents, attention was focused on a long history of articular syndrome, recurrent pneumonia with progressive pulmonary hypertension, general trophic, hematological changes, and the presence of autoantibodies, which was in aggregate the basis for the diagnosis of SLE with LI. This clinical case demonstrates the importance of the timely diagnosis and treatment initiation of SLE with LI. The diagnosis of SLE requires special attention to the patient's history and clinical and laboratory parameters. Specific immunological studies were conducted in doubtful cases. Rheumatological alertness is necessary, especially in relation to young women.Системная красная волчанка (СКВ) – одно из самых сложных ревматических заболеваний, что обусловлено разнообразием его клинических форм и проявлений. В статье описан случай тяжелого поражения легких (ПЛ) у больной с ранее не диагностированной и не леченной СКВ, что привело к фатальному исходу. В Городскую клиническую больницу № 13 бригадой скорой медицинской помощи с диагнозом «пневмония» была доставлена больная 33 лет. Ведущими жалобами были: одышка, боль в суставах, лихорадка, боль в животе. В процессе обследования и анализа медицинских документов было обращено внимание на длительный анамнез суставного синдрома, рецидивирующие пневмонии с нарастанием легочной гипертензии, общетрофические, гематологические изменения, наличие аутоантител, что в совокупности явилось основанием для установления диагноза СКВ с ПЛ. Данное клиническое наблюдение демонстрирует важность своевременной диагностики и начала лечения СКВ с ПЛ. Диагностика СКВ требует особого внимания к анамнезу пациента, клинико-лабораторным показателям. В сомнительных случаях проводят специфические иммунологические исследования. Необходима «ревматологическая» настороженность, особенно по отношению к женщинам молодого возраста

Severe lung involvement in a female patient with undiagnosed systemic lupus erythematosus

Systemic lupus erythematosus (SLE) is one of the most complex rheumatic diseases, which is due to the variety of its clinical forms and manifestations. The article describes a case of severe lung injury (LI) in a female patient with previously undiagnosed and untreated SLE, which led to a fatal outcome. A 33-year-old female patient diagnosed with pneumonia was delivered by an ambulance team to City Clinical Hospital Thirteen. Her leading complaints were dyspnea, joint pain, fever, and abdominal pain. During examination of the patient and analysis of her medical documents, attention was focused on a long history of articular syndrome, recurrent pneumonia with progressive pulmonary hypertension, general trophic, hematological changes, and the presence of autoantibodies, which was in aggregate the basis for the diagnosis of SLE with LI. This clinical case demonstrates the importance of the timely diagnosis and treatment initiation of SLE with LI. The diagnosis of SLE requires special attention to the patient's history and clinical and laboratory parameters. Specific immunological studies were conducted in doubtful cases. Rheumatological alertness is necessary, especially in relation to young women

Possibilities of a Course of Geometry of Teacher Training University in the Decision of a Problem of Formation of Intellectual Abilities of Students

Авторами на примере специально разработанных графических заданий рассматриваются дидактические возможности курса геометрии педагогического вуза в решении задачи формирования интеллектуальных умений будущих учителей математики.Authors on an example of specially developed graphic tasks consider didactic possibilities of a course of geometry of pedagogical high school in the decision of a problem of formation of intellectual abilities of the future mathematics teachers

ELECTROCARDIOGRAPHIC ASPECTS OF SECONDARY CARDIOMYOPATHY IN HEPATIC PARENCHYMAL DISEASE, AND THEIR ASSOCIATION WITH THE LEADING HEPATIC SYNDROME

In 68 patients with clinical, anamnestic, laboratory, and ultrasound evidence of chronic hepatic parenchymal disease and secondary cardiomyopathy, a range of electrocardiographic parameters was investigated, in accordance with the leading hepatic syndrome. Among the individuals with hepatic secondary cardiomyopathy, the most informative parameters, determining the severity and prognosis of the disease, were the following: the number of supraventricular and ventricular extrasystoles; myocardial ischemia duration; segment ST depression/elevation area; QT interval dispersion; and temporal parameters of heart rate variability. These parameters were more disturbed in patients with the leading syndromes of cytolysis and cholestasis, in comparison to the participants with the leading syndromes of hepato-cellular failure

ALLOTRANSPLANTATION OF MACROENCAPSULATED PARATHYROID CELLS IN SEVERE POSTSURGICAL HYPOPARATHYROIDISM: A CASE REPORT

The last therapeutic alternative in severe postsurgical hypoparathyroidism is allotransplantation of macroen- capsulated parathyroid cells. With this technique, it is possible to implant cells or tissue of parathyroid origin to replace them in such patients, without immusupression. We report an allotransplant of parathyroid cells in a patient with continous endovenous requirement of calcium to survive. The macroencapsulation was carried out with a polyvinylidine difluoride (PVDF). We implant ~100 000 parathyroid cells in the deep femoral artery. In this article, we show functionality of the graft for at least 3 months without requirement of endovenous calcium. We report this procedure as a therapeutical alternative in severe hypoparathyroidism