Своевременная диагностика паразитарных заболеваний опорно-двигательного аппарата представляет определенные сложности, обусловленные редкостью данной патологии. В статье представлено клиническое наблюдение-случай дирофиляриоза влагалища разгибателя пальца кисти у 49-летней женщины, госпитализированной с диагнозом «гигрома тыльной поверхности кисти». правильный диагноз заболевания был поставлен только после извл ечения паразита во время операции. Обсуждены проблемы дифференциальной диагностики данного заболевания и гигромы тыла кисти. Для уточнения диагноза предложено использовать предоперационное узИ мягких тканей кисти.
Relevance: world studies showed that egg allergy is one of the main causes of IgE-mediated food allergies in children. The aim of our study was analyzing the frequency and rate of sensitization to white egg of the Russian population's children, depending on the gender and age. Materials and methods: allergen-specific IgE levels were measured in children with food allergy (4981 patients aged 6 months-18 years). The frequency and degree of sensitization in various age groups were analyzed. Results: 29.5% of children had an anti-egg IgE antibodies. Among all positive responses, the low (31.6%, IgE=0.35-0.69 kU/l) and moderate (40.2%, IgE=0.70-3.5 kU/l) sensitization were most common. An extremely high level of anti-egg antibodies (IgE50.0 kU/l) was observed in 6.2% of patients. The highest frequency of sensitization was revealed in patients under the age of one year (39%). Decreasing of the positive responses frequency was noted in patients of older age groups. The dependence of the sensitization frequencies on sex was found in children over 12 years old. Frequencies of egg sensitization in girls aged 12-14 and 14-18 were statistically significantly lower compared to those in boys of the same age. The dependence of the response severity on the patient's age was also noted: a decrease in the frequency of highly positive responses and an increase in proportion of patients with medium or low IgE levels in older children were found. There was a decrease in the severity of the IgE-response by the age of 12 years in girls and by the age of 14 years in boys. Conclusion: the frequency and severity of positive IgE-responses to white egg allergens extract is the highest in children of the first year of life. These parameters decrease in older children, After 12 years of age the response severity and frequency are associated with the patient's gender. The marked tendency towards a decrease in the number of patients who have a positive response to a white egg allergens extract and the degree of its severity by adolescence may be evidence of the development of tolerance to this food product with the age.
Introduction. Inherited epidermolysis bullosa belongs to the group of severe rare hereditary mechanobullous diseases. Often, the skin pathological process is difficult to treat, which leads to a decrease in the quality of life of such patients. The mechanism of development of transcutaneous sensitization in this category of patients is not excluded. This issue remains a very relevant area for study, given the characteristic nutritional deficiency and the difficulties that arise in the formation of the diet.The aim: to assess the frequency of occurrence and characteristics of food sensitization in children with epidermolysis bullosa.Materials and methods: the group included 164 children with epidermolysis bullosa (45 with rapid detection and 119 with dystrophic). For all patients, an assessment of the risk of an allergic history, determination of the total level of IgE and specific IgE of blood serum to the most significant food allergens (UniCAP system, Thermo Fisher Scientific). Results: food sensitization was detected in 34.1 % of children with epidermolysis bullosa (in 38.7 % of cases with dystrophic and in 24.4 % with a simple form of epidermolysis bullosa). Among the manifestations of food allergy in both groups, skin symptoms were more common. The most common etiological factors were products containing cow’s milk protein, eggs, and cereals. In the group of children with comorbid food allergies and epidermolysis bullosa, high and extremely high levels of total IgE were most common.Conclusion: a high frequency of food sensitization in patients with epidermolysis bullosa, was shown, which is important not only from a scientific, but also from a practical point of view. Given the nutritional deficiency characteristic of this disease, the complexity of nutritional support, the presence of comorbid food allergies should be taken into account when recommending nutrition and selecting therapeutic products for this category of patients.
Relevance of topic. The course of atopic dermatitis complicated by food allergies, as well as the use of an elimination diet, can significantly worsen patient’s quality of life and affect his eating behavior.Aim of the study was to assess indicators of the quality of life and eating behavior in children with severe atopic dermatitis and food allergies.Methods. This study included children of age 4–13 years 11 months, hospitalized in Dermatology with the Laser Surgery department in the National Medical Research Center of Children’s Health from September 2021 to May 2022. Anthropometric indices, the index of the influence of atopic dermatitis on the quality of life, eating behavior parameters, bioimpedance analysis of body composition and analysis of the chemical composition of the diet were assessed in all children.Results. A total of 92 children were included in the study. The course of atopic dermatitis had a very strong and strong impact on the quality of life – in 25.6 % and 39.0 % of children, respectively. Itching in 83.6 % of children and sleep disturbance in 86.6 % of children had the greatest impact on the quality of life. When assessing the eating behavior, there was an increase in the indicators of «emotional undereating», «slowness in eating» and «desire to drink» and a decrease in the «enjoyment of food». When analyzing anthropometric indicators, a correlation was established between BAZ, an indicator of quality of life (r= –0.44, p=0.01) and the indicator «enjoyment of food» (r=0.19, p=0.01). A positive correlation was also found between the quality of life index, disease duration (r=0.57, p=0.01) and the number of food groups excluded from the diet (r=0.51, p=0.03). A negative correlation was found between the indicators of quality of life, «food responsiveness» (r= –0.49, p=0.04) and «enjoyment of food» (r= –0.57, p=0.01).Conclusions. Elimination diet has a significant impact on the quality of life and eating behavior of children with severe atopic dermatitis and food allergies. This suggests that the diet must be strictly justified both in terms of the set of excluded foods and in terms of its duration.
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