Lymph node infarction – a rare complication associated with disseminated intra vascular coagulation in a case of dengue fever

Background  

Lymph node infarction is known to occur in association with many non-neoplastic and neoplastic conditions however its occurrence in association with DIC is not reported hitherto in the literature.     

Role of Chlamydia, mycoplasma and cytomegalovirus infection in the development of coronary artery disease

AIM: To assess relationship between some infection factors and presence of coronary heart disease. MATERIAL: Patients with myocardial infarction (n=56), unstable angina (n=50), stable angina (n=50) and age - matched controls (n=49). METHODS: Levels of IgG, IgM, IgA antibodies to Chlamydia pneumonia, Chlamydia trachomatis, Chlamydia psittaci, IgG, IgM antibodies to Cytomegalovirus, and also of antibodies and antigen to Mycoplasma pneumoniae were measured in blood serum. RESULTS: Compared with controls patients with coronary heart disease had higher frequency of seropositivity to Chlamydia pneumonia, Mycoplasma pneumonia and Cytomegalovirus (p< 0.05 ) and similar levels of seropositivity to Chlamydia trachomatis and Chlamydia psittaci. Infectious burden (quantity of antibodies per one patient) was significantly higher in patients with myocardial infarction, unstable and stable angina than in controls (1.58, 1.42, 1.41 and 0.95, respectively). CONCLUSION: Our results confirm presence of association between infection and coronary heart disease.     

Eleven novel mutations in the factor VIII gene from Brazilian hemophilia A patients

The molecular characterization of the mutations in hemophilia A patients is hampered by the large size of the factor VIII gene and the great heterogeneity of mutations. In this study, we have performed a protocol involving multiplex polymerase chain reaction in which 19 exons were amplified in four different combinations followed by nonradioactive single-strand conformational polymorphism (SSCP) to screen for mutations. Southern blotting was used to detect inversion of the factor VIII gene resulting from recombination between copies of the gene A (F8A) located in intron 22 of the factor VIII gene and two copies close telomeric region of X chromosome. Forty-two hemophilia A patients (21 with severe and 21 with mild-to-moderate disease) were studied. The inversion of factor VIII occurred in 13 of 21 patients affected by severe hemophilia A. One patient showed a large extra band in addition to the three bands observed after Southern blotting with the F8A probe. An abnormal electrophoretic pattern of SSCP was detected in 85% and 50% of the patients affected by mild-to-moderate and severe disease, respectively. Sixteen different mutations were identified. Eleven mutations were novel and comprised 9 point mutations and 2 small deletions. This study shows that the methodology used is safe and rapid and has potential for detecting almost all of the genetic defects of the studied hemophilia A patients.     

Selective screening of patients with associated somatic diseases as a method of early detection of acromegaly

BackgraundBackgraund: Acromegaly is a multi-organ disabling disease, the effectiveness of treatment of which directly depends on timely diagnosis. Latent course and delayed diagnosis increase the exposure of pathological hypersecretion of growth hormone and insulin-like growth factor-1, contributing to the development of irreversible systemic and metabolic changes in the body that negatively affect survival.AimsAims: The aim of the study was to clinically test a comprehensive diagnostic approach using selective screening to detect cases of acromegaly in patients with combined somatic diseases.Materials and methodsMaterials and methods: The diagnostic search algorithm included a 2-stage questionnaire, expert assessment of the clinical status, laboratory and instrumental examination. The inpatient examination included the use of additional laboratory and instrumental methods and expert evaluation of the results obtained by filling out a doctor’s questionnaire. When the score was higher than 18 points, a more specific examination was performed: double determination of the insulin-like growth factor-1 level, oral glucose tolerance test with determination of the nadir of growth hormone value, and MRI of the brain with contrast enhancement. The diagnosis of acromegaly was made on the basis of personal data, expert assessment of the clinical status, results of laboratory and instrumental examinations.ResultsResults: A survey of 1249 patients with combined systemic and metabolic disorders conducted using the point system allowed us to suspect acromegaly in 367 patients (29.4%), who were offered further examination. The majority of patients were previously seen by specialists for diabetes mellitus (79.3%) or thyroid pathology (10%). In the result of inpatient ­examination of 329 patients, 35 (10.6%) patients showed an increase in the blood level of IGF-I. In 19 patients, a persistent increase in the level of IGF-I was combined with the absence of GH suppression of less than 0.4 ng/ml against the background of glucose load. During MRI in 9 patients, pituitary adenoma was detected (in 2 — microadenoma and 7 — ­macroadenoma).ConclusionsConclusions: As a result of the study, among the group of 1249 patients (mean age 58±13 years) with the presence of concomitant diseases, 9 newly identified patients with acromegaly were found who were prescribed adequate treatment. The introduction of selective screening technology into the practice of an endocrinologist will improve the effectiveness of diagnostic search for patients with acromegaly, more accurately assess the prevalence of the disease in Russia and the need for specialized medical care.     

Dissolved ozone treatment-induced change in the resistance of multi-resistant mycobacterial strain to isoniazid and rifampicin

For 60 minutes, a mycobacterial (MBT) clinical strain resistant to streptomycin (S), rifampicin (R), isoniazid (I) was treated with dissolved ozone (PO3) at the concentration used for intravenous injection in the clinic. Then the strain was added to the L?wenstein-Jesen solid medium containing different concentrations of antituberculous agents. Following 3 weeks, drug sensitivity was determined by the number of grown colonies. Then MBT were retreated with PO3 in the same fashion, by repeating the cycle three times. At week 3, a growth of over 100 colonies was recorded in all control cultures. After each PO3 treatment of the strain, there was a reduction in its resistance to I and R. After triple treatment, MBT sensitivity to I completely recovered. In the R-containing media, there was also decrease in drug resistance, but the latter remained high (640 mu/ml). S resistance substantially lowered after the second PO3 treatment, but it restored after the third one. A mechanism responsible for lower MBT resistance to I and R under the action of "therapeutical" concentrations of PO3 is analyzed. The paper discusses whether MBT resistance can be changes at the phenotypic level rather that at the genetic one.     

Action of acyclovir on cytomegalovirus in tissue culture and in chronic infection in women

Acyclovir was capable to delay for some time the development of the cytopathic effect in cell cultures. When acyclovir was added to the infected tube cultures in a concentration of 250 micrograms/ml, virus reproduction was inhibited for 6 days. Then foci of lesions were observed, and by the 12-13th days the intensity of involvement of the cell layer was 80-90% and did not differ from that in control tubes infected with cytomegalovirus (CMV). No significant differences were observed in the inhibiting effect of acyclovir on the freshly isolated strains or the reference Ad-169 strain. A course of therapy with acyclovir showed the inhibiting effect of this drug on CMV reproduction in women with the CMV infection to be of short duration. The temporary improvement observed on the first day after treatment was accompanied by reduced virus excretion with both the urine and saliva. Antibody titres remained the same before and after treatment. After 1-2 months virus excretion was observed practically in all the women similarly to that before the treatment.