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1.
Ter Arkh ; 95(11): 970-975, 2023 Dec 22.
Article in Russian | MEDLINE | ID: mdl-38158954

ABSTRACT

The differential diagnosis of neoplasms of various localizations is the primary task in clinical practice of all physicians. We present a description of the case of invasion with Dirofilaria repens in the lung of a 68-year-old patient. In 2016 the patient was diagnosed with cancer of the left kidney and underwent a left-sided nephrectomy. During the dynamic observation in 2019, a lump was found in the left lung, which was regarded as a metastasis. An atypical SIX resection of the left lung was performed. Microscopy of the removed lump revealed the presence of a nematode of the genus Dirofilaria, presumably D. repens. The species identity of D. repens was confirmed by polymerase chain reaction using species-specific primers. It is known that the morphological identification of parasites up to the species in the surgical material presents certain difficulties and requires high professional training of the researcher. Therefore, the diagnosis of dirofilariasis in atypical localizations of nematodes in the human body is of great importance in the differentiation of malignant and benign formations, and the use of the polymerase chain reaction method can significantly increase the accuracy in establishing the final diagnosis.


Subject(s)
Dirofilaria repens , Dirofilariasis , Animals , Humans , Aged , Dirofilariasis/diagnosis , Dirofilariasis/surgery , Dirofilaria repens/genetics , Polymerase Chain Reaction , Lung/pathology , Diagnosis, Differential
2.
Ter Arkh ; 94(1): 57-63, 2022 Jan 15.
Article in Russian | MEDLINE | ID: mdl-36286920

ABSTRACT

INTRODUCTION: Currently, a significant number of patients with COVID-19 require inpatient treatment. At the same time, predictors of hospitalization are still stable, including in persons with concomitant pathology. AIM: Assessment of factors affecting the probability of hospitalization of COVID-19 patients with concomitant pathology and the development of a prognostic model based on them. MATERIALS AND METHODS: An observational retrospective cohort study of 74 314 patients with COVID-19 with various comorbidities was carried out in the period from March to November 2020 in the Russian Federation. RESULTS: Based on 16 factors, including age, gender, place of diagnosis, fever, rhinitis, loss of taste, shortness of breath, concomitant diseases of the cardiovascular, bronchopulmonary system, oncological, endocrine diseases in patients included in the study, a prognostic model was developed. The need for inpatient treatment of patients with COVID-19 and comorbidities was determined. CONCLUSION: The constructed predictive model has demonstrated sufficient efficiency to assess the likelihood of hospitalization of patients with COVID-19 by medical specialists.


Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , COVID-19/therapy , SARS-CoV-2 , Prognosis , Retrospective Studies , Hospitalization , Risk Factors
3.
Ter Arkh ; 94(11): 1315-1319, 2022 Dec 26.
Article in Russian | MEDLINE | ID: mdl-37167171

ABSTRACT

Two clinical cases of perforation of a previously undiagnosed colon diverticulum in patients with coronavirus infection caused by the SARS-CoV-2 virus treated at the Hospital №1 of Nalchik. Both patients were elderly, overweight, had a lot of chronic concomitant diseases. Patients received hormone therapy and were targeted: the first patient twice (tocilizumab on the first day of hospitalization and olokizumab on the 7th day of inpatient treatment). The second patient received levilimab on the 3rd day of his stay in the hospital. A short time after targeting, both patients developed acute diffuse abdominal pain, the patients were transferred to the surgical department and operated on. During the operation, both patients were found to have previously undiagnosed diverticular disease, complicated by diverticular perforation and peritonitis on the background of immunosuppression. Both patients died. Thus, when using targeted therapy for patients with COVID-19, it is necessary to take into account that they may have previously undiagnosed chronic diseases that can cause fatal complications against the background of immunosuppression.


Subject(s)
COVID-19 , Diverticulitis, Colonic , Diverticulitis , Peritonitis , Humans , Aged , COVID-19/complications , SARS-CoV-2 , Diverticulitis/complications , Diverticulitis/surgery , Hospitalization , Peritonitis/complications , Peritonitis/surgery , Diverticulitis, Colonic/complications , Diverticulitis, Colonic/diagnosis , Diverticulitis, Colonic/therapy
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