The article presents a clinical case of intensive care of a child with the main diagnosis: Bronchiectasis, surgical sepsis (>10 points on the p SOFA scale); with complications: HDN 2 degrees, CSHF 2B degrees, protein-energy deficiency, hypercatabolism-hypermetabolism syndrome, toxic infectious encephalopathy, purulent fibrous endobronchitis; with concomitant Ehlers-Danlos syndrome. Upon admission to the intensive care unit, the child was diagnosed with BDL pulmonary form, bacterial sepsis, respiratory failure of the 2nd degree. The diagnosis was confirmed on the basis of instrumental research methods. Complex intensive therapy was carried out: respiratory and nutritional support, antibacterial and infusion therapy, sanitation bronchoscopy. Due to the defeat of more than 11 segments of the lungs - in carrying out surgical treatment was refused. A good example of the outcome of late diagnosis of bronchiectasis, which led to systemic irreversible processes, is presented.
BACKGROUND: Sepsis is one of the leading causes of hospital mortality in children. a decisive role in improving the results of treatment of this group of patients belongs to early diagnosis and pathogenetic therapy. AIM: this study optimizes the diagnosis and intensive care of surgical sepsis in children based on clinical and laboratory criteria and bacteriological monitoring.
MATERIALS AND METHODS: the study period is 2018–2020. the study subjects were children (n = 73) with surgical pathology (diffuse purulent peritonitis, bacterial destruction of the lungs, post-traumatic brain hematomas, injuries of the abdominal organs, and others). clinical and laboratory parameters were analyzed, and microbiological monitoring was performed to determine antibiotic sensitivity.
RESULTS: Patients who developed sepsis had a pronounced hypermetabolic syndrome, which was manifested by tachycardia and tachypnea, hyperthermia, low levels of albumin, and total protein in the blood. Protein catabolism in patients was accompanied by a decrease in globulins (IgG) synthesis and the development of a secondary immunodeficiency state. Both gram-positive and gram-negative microorganisms were involved in developing surgical sepsis in children, increasing the proportion of the latter. Given the high proportion of multi-resistant flora, empirical combined de-escalation antibiotic therapy (aBt) with broad-spectrum antibiotics was prescribed. this was followed by its revision based on microbiological monitoring and clinical and laboratory data of the patient with sepsis. Studies have shown the effectiveness of complex intensive care in 86.3% of cases. Mortality occurred in 13.7% of cases. Patients with severe surgical pathology died: fecal, generalized peritonitis, severe traumatic brain injury + coma with irreversible neurological disorders, and urosepsis against the background of chronic renal failure after repeated surgical interventions.
CONCLUSIONS: early diagnosis of sepsis, rational aBt under the control of microbiological monitoring, non-aggressive infusion therapy, and active sanitation of the surgical infection focus contributed to a decrease in mortality in this category of patients.
In this review, the authors performed an overview of the literature on early diagnosis, treatment and methods for predicting the outcomes of the disease. According to regional endocrinological dispensaries, for 2020 registered SD for RUZ 277 926., Of these, type 1 type 18178, SD 2 type 259,748 patients. At the same time, the number of patients with DR was 2020 g of 83,632 persons, of which 73690 persons with di type 2. The real number of patients exceeds a registered 10 times, over the past 18 years, the number of patients with a rope in Uzbekistan increased by 2.4 times (according to the Ministry of Health of RUZ).
The prevalence of others among patients of the CD is 10-90%, according to some specialists, up to 97-98.5%. For example, the frequency of development dr in India is lower than among Europeans and Americans, and among the black population more frequent than among the white. According to the WHO research group, it was revealed that the highest frequency of DR was detected in Oklahoma (76.4%), Zagreb (73.1%) and Hong Kong (58.1%). The lowest frequency was observed in Tokyo (29.7%). The prevalence of DR in patients in China amounted to 47.4%, and the frequency of DR in Poland was 31.4%.
Pedagogical diagnosis provides a scientific approach to the organization of methodical work with teachers, their professional and mutual development. Therefore, it plays an important role in the methodological, educational processes and in the school management process. The pedagogical diagnosis obtained as a system of studying the level of professional development of a teacher serves as a basis for identifying difficulties in the work, encouraging the search for alternative ways to overcome them. At the same time, it allows to identify the strengths of the teacher, to strengthen them and to identify specific ways and means of developing individualized methods of pedagogical activity and teaching model.
This article describes the work carried out to improve the educational system and content of differential diagnosis of children with complex defects, a brief analysis of the educational opportunities of children with complex defects. Information about the work of medical workers and various specialists, educators is also provided.
Subject of research: 128 patients with acute, subacute, secondary-chronic and primary-chronic types of Rock fever.
Aim of research: early diagnosis of audio and vestibular disturbances on patients undergo Rock fever and against background of usage of ototoxic medicines by applying of modem complex tools of audio research and impcdanccmctry.
Tools of research: general clinical research, special inquiries: examination of otolaryngologic organs, acoumctcring, tone threshold audiomctcring, voice audiometery, impcdanccmctry, detection of audio sensitivity to ultrasound under methodology of В. M. Sagalovich, vestibulometery, clcctronistagmography, reenccphalography.
Results received and their novelty: different types of audio disturbances were first time discovered from patients with Rock fever infection during a complex inquiry of audio and vestibular organs status: in acute and subacute types of Rock fever there dominate the audio disturbances on sound conductivity, in chronic type - the mixed or advantageously ncurosensoric character. There was applied an impcdanccmetry to define a character and level of injury of audio organ.
A scheme of complex conservative therapy included the mounts that influence on hemodynamics; adjuvants; the mounts that influence on tissue interchange; antyhypoxantincs that improve microcirculation of internal car; enzyme mounts that eliminate cicatrical and soldering processes in medium ear.
Practical value of dissertation: a qualified method of diagnosis of different types audio disturbances was proposed to practical public health. The methods of early diagnosis allow asserting a necessity of usage of early complex inquiries of audio and vestibular analyzers to make a prevention and development of further abnormalities (hard hearing and surdity).
A level of introduction: received results were introduced to the work of Otolaryngologic department of Second Tashkent State Medical Institute and clinical infectious hospital of Scientific Research Institute of Epidemiology, Microbiology of Infection Diseases of Republic of Uzbekistan.
Fields of applying: otolaryngology, infection diseases.
This paper explores the pivotal role of spectroscopy in cancer screening and diagnosis, shedding light on its significance in early detection and accurate characterization of cancerous tissues. Spectroscopic techniques offer unique capabilities for non-invasive and real-time analysis of tissue composition, providing valuable insights into biochemical and structural alterations associated with cancer development. By leveraging the inherent molecular signatures of tissues, spectroscopy enables clinicians to identify abnormal changes indicative of cancer presence, facilitating timely intervention and improved patient outcomes. This review examines the principles, methodologies, and applications of spectroscopy in cancer detection across various modalities, including Raman spectroscopy, fluorescence spectroscopy, and infrared spectroscopy. Additionally, it discusses recent advancements, challenges, and future directions in harnessing spectroscopic technologies for enhanced cancer screening and diagnosis.
Diagnosis and management of pregnant women with cervical cancer is a difficult problem for clinicians. There is still no consensus on the need for a biopsy or conization in pregnant women, especially with suspected CIN III and cancer in situ. The issues of diagnosis, treatment, delivery and monitoring in pregnant women with cervical cancer are practically not covered in textbooks and scientific and practical publications. This article analyzes the recommendations of the international scientific community and the results of large-scale clinical studies on the management of pregnant women with abnormal cytological smears during pregnancy. Summarized current knowledge about the diagnosis and treatment of CIN during pregnancy. Also reviewed and analyzed more than 40 works of domestic and foreign authors on this issue