The aim is to identify age, gender, clinical and morphological features of seborrheic keratosis. Material and methods: The study used biopsy material from 196 patients with a clinical diagnosis of “Seborrheic keratosis”. In all cases, when studying directions for pathohistological examination, the authors analyzed gender and age characteristics, as well as localization of seborrheic keratosis. The resulting material was fixed in a 10% solution of neutral formalin (ph 7.4) for 24-48 hours. The procedure was carried out according to the generally accepted technique and the material was embedded in paraffin. Sections of 4–5×10–6m thick were made from paraffin blocks for staining with hematoxylin and eosin. The microspecimens were examined using an Olympus BX-41 microscope (Japan). Results: The study revealed a modern feature of seborrheic keratosis –”rejuvenation” of this tumor, as evidenced by its predominant development in patients aged 31 to 50 years. Seborrheic keratosis is more common in men, and is localized mainly on the skin of the face, scalp, neck and back. When diagnosing seborrheic keratosis, the author notes a significant discrepancy between clinical and morphological diagnoses, which actualizes the problem of improving the available clinical research methods and emphasizes the importance of morphological research. Hyperkeratotic and acanthotic histological variants of seborrheic keratosis are the most common. The case of seborrheic keratosis with malignancy and transformation into squamous cell carcinoma, identified by the author, should develop oncological alertness in doctors and patients. Conclusions: The study revealed age, gender, clinical and morphological features of seborrheic keratosis, which will contribute to a better understanding of this pathology by the doctors of various specialties, and improve the treatment and diagnostic process.
The aim is to identify the etiology, clinical and morphological features of rhinosinusitis in patients in post-COVID-19 period. Materials and methods: In the present study, it was carried out the analysis of 11 cases of rhinosinusitis, which developed after COVID-19 infection. The diagnosis of rhi¬nosinusitis was established on the basis of anamnesis, clinical and laboratory examination, specialized instrumental examination (rhinoendoscopy, X-ray, magnetic resonance imaging, spiral and 3D computed tomography). All patients underwent endoscopic sanitation of the nasal cavity, expansion of the maxillary anastomosis, maxillary sinusotomy, sanitation of the maxillary sinuses and removal of pathologically altered tissues. Microbiological examination of the swab from the nasal cavity was carried out in all patients. Histological and morphometric research methods were used during the morphological study of surgical material. The nonparametric Mann-Whitney U test was used to compare the means in the groups. Results: The conducted comprehensive study made it possible to identify chronic atrophic rhinosinusitis at the stage of exacerbation caused by associations of bacteria and fungi in patients in post-COVID-19 period. Among bacteria, the authors most often noted Staphylococcus aureus, Staphylococcus epidermidis, Klebsiella pneumonia, Streptococcus pneumonia and Enterococcus faecalis. Among fungi, there were Aspergillus, Candida, Mucor and Coccidioides. Fungal infection was characterized by invasion into the mucous membrane of the nose and paranasal sinuses. In patients in post-COVID-19 period the invasive bacterial-fungal chronic atrophic rhinosinusitis at the stage of exacerbation was predominantly bilateral, characterized by the involvement of several or all paranasal sinuses in the process. Patients with such pathology complained of periodic fever, headaches and malaise; nasal congestion and constant difficulty in nasal breathing; yellowish-greenish-reddish discharge from the nasal cavity, sometimes with a fetid odor; discomfort and pain in the area of paranasal sinuses; immobility of the eyeball, hyposmia or anosmia; reduction or complete loss of vision. Frequent risk factors for the development of invasive bacterial-fungal chronic atrophic rhinosinusitis at the stage of exacerbation in patients in post-COVID-19 period were the information about moderate or severe course of this infection in anamnesis; comorbidities (predominantly diabetes mellitus, hypertensive disease and ischemic heart disease). Conclusions: The study conducted by the authors made it possible to identify the etiological, clinical and morphological features, as well as risk factors of rhinosinusitis in patients in post-COVID-19 period. This information will contribute to a better understanding of such pathology by the doctors and improve the diagnostic and treatment process.
Today, Babesia is recognized as one of the most common blood parasites in the world, which in terms of the number of cases of invasion is second only to trypanosomes (the causative agent of African trypanosomiasis and Chagas’ disease). These microorganisms can cause parasitism in erythrocytes and hematopoietic organs. They cause an infectious process, the clinical course of which can vary from asymptomatic, subclinical, mild or moderate influenza-like forms – to severe progressive disease (fulminant form) with fatal outcome. Thus, the latter determines the significant burden of babesia for the leading branches of medicine, veterinary medicine and the economy as a whole. The presented work is devoted to the study of the prospects for verification of babesiosis causative agents by the polymerase chain reaction (PCR) method. Blood, erythrocyte suspension, homogenized tick-carriers of babesiosis, culture of Babesia spp. were used as research material (samples). In order to obtain an objective assessment, the PCR-diagnostics method was used in two formats – standard and multiplex (multi-primer). Multiple PCR testing of multiplex format using primers in model samples containing cells of different species of Babesia (B. microti, B. divergens, B. bovis, B. canis), allowed us to establish the level of reproducibility of the results of such studies, which ranged 94.6–96.4%, to determine the level of PCR sensitivity of the multiplex format for detection/identification of human pathogenic babesia (B. microti, B. divergens and B. venatorum). It is established that the advantages of the PCR-diagnostic method of babesiosis pathogens in the samples of the studied biomaterial were: speed of research (2–4 hours); high sensitivity, specificity, reproducibility of Babesia detection results, prospects of species identification, differentiation with apicomplex spores (Plasmodium falciparum, Toxoplasma). In view of the above, the PCR method is recommended for use in cases of persistent suspicion of babesiosis infection (in cases of negative results of microscopic/cytological studies, to identify asymptomatic, subclinical and chronic forms of babesiosis, verification of active invasion in seropositive individuals and for Babesia species and their differentiation).
Introduction: Ovarian tumours are an actual problem of present-day medicine, being one of the most difficult sections of modern oncology. The majority of ovarian tumours are of epithelial origin. The ovarian Brenner tumour represents a rare epithelial ovarian neoplasm and accounts for 1-2% of all ovarian neoplasms. The aim of the study is to identify clinical and morphological features of ovarian Brenner tumour. Materials and methods: The material was 5 cases of Brenner ovarian tumour, diagnosed in the study of 4 cases of operational material and 1 case of autopsy observation for the period from 2007 to 2019. Histological and immunohistochemical staining methods were used. The microspecimens were examined on an Olympus BX-41 microscope (Japan). Results: Ovarian Brenner tumour is a rather rare pathology, the histogenesis of which is debatable. Morphological examination is the main method for its diagnosing. Ovarian Brenner tumours developed in women of middle and old age (the average age was 51.8 years). Women with a malignant ovarian Brenner tumour were older than women with a benign variant (the average age in women with a malignant variant was 55.8 years, with a benign variant – 49.3 years). Benign ovarian Brenner tumour occurred more frequently compared with a malignant one. Malignant and benign variants of ovarian Brenner tumour were characterized by a one-sided nature of the lesion with frequent involvement in the pathological process of the left ovary. Clinically, in patients with a benign variant of the Brenner tumour in all cases an abdominal pain syndrome was determined, combined in one case with metrorrhagia. A malignant ovarian Brenner tumour was clinically manifested by severe abdominal pain syndrome, combined in one case with complaints of an increase in the size of the abdomen, and in another case with intoxication syndrome and a clinic of small bowel obstruction. In all cases a malignant ovarian Brenner tumour metastasized to the omentum and in one case also to the small intestine wall. Macroscopically the ovarian Brenner tumour had the form of a node, the dimensions of which were significantly larger for the malignant variant compared with a benign, dense or soft consistency, on the cross section of a whitish-gray or brown color with cysts. A damaged ovary with a malignant variant of Brenner tumour significantly increased in size, while with a benign one, its size did not change or increased slightly. In all cases the malignant and benign variants of ovarian Brenner tumour were combined with various reproductive system organs pathologies (mucinous papillary cystadenoma of the ovary, serous ovarian cyst, ovarian endometriosis, endometrial hyperplasia, cervical nabothian cysts, uterine leiomyoma). Conclusions: A study conducted by the authors revealed clinical and morphological features of a rare ovarian tumour – Brenner tumour, which will contribute to a better understanding of this pathology by the doctors of various specialties, and improve the treatment and diagnostic process.
The aim is to establish a unified version of the biological method for babesiosis detection in vivo. Materials and methods: samples (n=257) of biological material of different origin were examined. These included: blood samples from patients (n=6) and cattle (n=15); salivary gland homogenates (n=28) from 147 imagoes of ticks of the family Ixodidae, 32 imagoes of Ixodes ricinus and 115 imagoes of Dermacentor reticulates; spleen homogenates (n=63) from mouse-like rodents (Muridae) of the genera Myodes, Microtus, Apodemus and Sylvaemus. In order to cultivate in vivo Babesiae of the species B. microti, Syrian hamsters were infected with spleen homogenates from mouse-like rodents; for cultivating the B. divergens species Mongolian gerbils and nonlinear white mices were infected with blood samples from patients and cattle and salivary gland homogenates from ixodic ticks. The technology of modeling was based on the group specificity (differences in susceptibility to parasites and in parameters of morbidity) of the animals, involved in the experiment (Syrian hamsters, Mongolian gerbils, nonlinear white mices). Results: Experimental animals were contaminated by means of intraperitoneal inoculation of 0.3 ml samples of biological material (infected with Babesiae). The animals were infected next day following a day of their preinoculation preparation. The marker parameters for the functional state of experimental animals were as follows: preterm death; appearance and development of clinical-laboratory signs of disease (hypo- or adynamia, loss of appetite, inertness/absence of reactogenicity to tactile/acoustical stimulation, postural changes, wetting of fur, pronounced lameness, flatulence, loss of ≥ 25% of body mass) in them; parasitaemia, histodestruction, cellular detritis. Parasitaemia was detected every two days (beginning with day 8 from the moment of inoculation) by reserves of light and luminescent microscopy. In case of the positive result (revealing of haemoparasites with Babesia spp.-like morphological and tinctorial signs) the verification of Babesiae with their more precise specific identification was performed using the technique of polymerase chain reaction (PCR). Preliminary detection of morbidity parameters in each experimental animal with the artificially created immunocompromised state became an obligatory moment of the described experiment. Conclusions: The biological method for detecting Babesia spp. in vivo was improved by the author. This result was achieved by using a double reservoir (Syrian hamsters, Mongolian gerbils and nonlinear white mices with an increased level of susceptibility to parasites) followed by the immunocompromise formation. The use of the improved version of biological method increased the total rate of revealing of Babesiae, therewith creating an objective basis for optimizing the available ways of detection and study of Babesiae in vivo.
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