ABSTRACT
The paper describes a 56-year-old female patient who in December 2015 lost her appetite and 20 kg of weight, had diarrhea, rapidly increasing weakness, dizziness, joint pains, fever, swelling of the feet, and convulsions. Blood tests revealed anemia, elevated erythrocyte sedimentation rate, and hypoproteinemia. Computed tomography showed enlarged mesenteric and retroperitoneal lymph nodes. The doctor suspected lymphoma and referred her to the Moscow Clinical Research Center. The diagnosis of Whipple's disease was established by carrying out a small intestinal (duodenal) mucosal biopsy with the PAS reaction. A fat-free diet and antibiotic therapy with co-trimoxazole 2.0 g/day and ciprolen 0.3 g/day were prescribed for the patient. Fever and diarrhea disappeared, appetite appeared, weight gained, and blood counts normalized over 1 month of treatment. The patient was discharged with a recommendation to continue antibiotic treatment until the histopathological signs of the disease ceased.
Subject(s)
Whipple Disease/diagnosis , Anti-Bacterial Agents/therapeutic use , Diet, Fat-Restricted , Female , Humans , Middle Aged , Whipple Disease/diet therapy , Whipple Disease/drug therapyABSTRACT
The number of medical errors is increasing. Medical errors have negative impact on the professional activities of physicians. Analysis of the causes and incidence of medical errors and conflicts in clinical practice of foreign and domestic doctors is presented based on the author's observations and didactic materials recommended for training doctors to prevent conflict situations in their professional work and for developing a common strategy for the prevention of medical errors.
Subject(s)
Medical Errors/psychology , Pediatrics/standards , Physician-Patient Relations , Humans , Medical Errors/prevention & controlABSTRACT
The authors present materials of the elaboration of a method of obtaining stable erythrocytic diagnostic agents from semipurified preparations of type-specific antigens of the hemolytic streptococcus of the 1st, 4th, 12th and 18th serotypes. Adequate specificity and high sensitivity of the passive hemagglutination test was shown in examination of the sera of experimental animals. In the sera of healthy children the type-specific antibodies were revealed with a different frequency at various seasons of the year; this was in inverse correlation with the level of scarlet fever morbidity.
