ABSTRACT
The aim of this work was to study the incidence, diagnostics and clinical features of interstitial lung diseases (ILD) in the practical work of pulmonological and rheumatological departments of a multifield hospital Theanalysis included 565 case histories of the patients admitted to these departments in 2008-2012. The structure of ILD was elucidated along with the frequency of major clinical symptoms ofsarcoidosis and rheumatic diseases, the occurrence of clinico-morphological variants of ILD. Difficulties encountered in diagnostics of ILD and systemic scleroderma as well as their causes are discussed Resultsof the 5 year followup of 40 patients are presented.
Subject(s)
Diagnostic Errors/prevention & control , Lung Diseases, Interstitial , Rheumatic Diseases , Adult , Diagnosis, Differential , Diagnostic Techniques, Respiratory System , Disease Management , Female , Follow-Up Studies , Humans , Incidence , Lung Diseases, Interstitial/diagnosis , Lung Diseases, Interstitial/epidemiology , Lung Diseases, Interstitial/etiology , Lung Diseases, Interstitial/physiopathology , Lung Diseases, Interstitial/therapy , Male , Middle Aged , Prognosis , Rheumatic Diseases/complications , Rheumatic Diseases/diagnosis , Russia/epidemiologyABSTRACT
Pulmonary disseminations are frequently encountered in the practical work of a multi-disciplinary hospital and require differential diagnostics by join efforts of specialists in different fields of medicine. The aim of this study was to estimate the frequency and clinical picture of these conditions. We analysed clinical records of 154 patients admitted to the department of pulmonology and intensive therapy. Most patients in need of intensive therapy (n=54) presented with disseminations of infectious origin, such as disseminated tuberculosis (32%), pulmonary problems associated with sepsis and infectious endocarditis (14%), HIV-associated disseminations (23%). Canceromatosis and idiopathic interstitial pneumonia occurred in 18 and 13% of the cases respectively. Patients in the department of pulmonology had pulmonary dissemination syndrome of unclear origin or no overt clinical symptoms (n=100). The leading cause of their disease was sarcoidosis (60%) and idiopathic interstitial pneumonia (20%). 27 patients had this syndrome associated with HIV/AIDS. Clinical examples and difficulties of early diagnostics of pulmonary dissemination syndrome are discussed with reference to underlying diseases (sepsis, infectious endocarditis, HIV/AIDS, Goodpasture's syndrome). Special attention is given to the management of this condition based at a multidisciplinary hospital.
Subject(s)
Lung Diseases/diagnosis , Lung Diseases/etiology , Adult , Aged , Diagnosis, Differential , Endocarditis, Bacterial/complications , Endocarditis, Bacterial/diagnosis , Female , HIV Infections/complications , HIV Infections/diagnosis , Humans , Lung Diseases, Interstitial/diagnosis , Lung Diseases, Interstitial/etiology , Male , Middle Aged , Retrospective Studies , Sarcoidosis/complications , Sarcoidosis/diagnosis , Sepsis/complications , Sepsis/diagnosis , Syndrome , Young AdultABSTRACT
AIM: To review current course of infectious endocarditis (IE), time and quality of the diagnosis, results of hospital treatment. MATERIAL AND METHODS: 30 cases of IE have been analysed (17 males, 13 females, mean age 37.6 +/- 2.3 years. The patients were admitted to hospital in 1997-1998. RESULTS: Late diagnosis registered in many IE cases is explained by low quality of history data and of heart auscultation responsible for late start of conservative treatment. Some specific features of the disease course, visceral lesions, efficacy of the treatment are outlined. CONCLUSION: IE morbidity is still high and prognosis in many cases if unfavourable.