Medicinskij alʹâns最新文献

{"title":"Using MRI for pulmonary tuberculomas evaluation","authors":"","doi":"10.36422/23076348-2023-11-3-93-102","DOIUrl":"https://doi.org/10.36422/23076348-2023-11-3-93-102","url":null,"abstract":"SummaryPulmonary tuberculomas have a high probability of the infectious process reactivation during the first four years since their formation, it is also specifically difficult to define the inflammation activity in case of a stable clinical and radiological picture, hence difficult to select the treatment tactics. Aim of study. To develop and test the MRI technique in case of pathological pulmonary formations in order to check the MRI capabilities as an additional tool for the diagnostics of pulmonary tuberculomas’ activity. Маterials and methods. The MRI technique for checking the lungs of patients with verified pulmonary tuberculomas of various degree of activity was proposed and tested. Results. Radial patterns of pulmonary tuberculomas were identified and demonstrated in standard pulse sequences, radial features of tuberculomas of various degree of activity were established. Non-active tuberculoma is characterized by higher signal on diffusion weighted MRI images and hypointense signal on ADC maps. In dynamic contrast enhanced MRI, low active tuberculomas were slowly accumulating the contrast, while the active ones did this fast and intensely in the capsule with further reaching the plateau, at the same time the central part accumulated the contrast at a slower pace. Conclusion. Using MRI may be promising for the pulmonary tuberculomas’ activity evaluation. The MRI technique for pulmonary tuberculoma evaluation has to include a protocol with standard pulse sequences: Т2, Т1 WI, STIR WI in coronal and axial planes; DWI with maximum b-factor 800 s/mm2and ADC maps; dynamic contrast enhancement.","PeriodicalId":489032,"journal":{"name":"Medicinskij alʹâns","volume":"95 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135010555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative volumetric and density CT-characteristics of lungs in children: what is to be the norm (preliminary results of a pilot study)","authors":"","doi":"10.36422/23076348-2023-11-3-13-20","DOIUrl":"https://doi.org/10.36422/23076348-2023-11-3-13-20","url":null,"abstract":"SummaryFunctional and radiation methods of respiratory or-gans’ examination make it possible to obtain quantitative summarised characteristics of the lung tissue. In some cases, it may be advisable to differentially study the right and left lungs in children, especially at an early age when it is impossible to correctly perform functional examina-tion methods. The objective of the study: to evaluate the possibility of non-invasive differentiated analysis of the volumes of the right and left lungs in children with no chest pathologies. Materials and methods. A retro-spective analysis of volumetric CT of the chest organs was carried out in 100 children aged 5 months to 18 years (divided into standard age groups) with no established diseases of the chest organs or identified radiological pa-thology. Post-processing manipulation of CT scans was performed with the calculation of the absolute values of the volume of the right and left lungs, total lung volume and tissue density for each lung, with further structural distribution (as a percentage of the total volume). Exclu-sion criteria included the presence of respiratory diseas-es, or any changes in the lung structure according to the results of CT, incl. breath artifacts. Results. The CT-volu-metry method was used to obtain the average values of the volumes of the right, left and total volume of both lungs. The absolute values of the volume of the right lung dominated over the left. In the process of growth, these differences change unidirectionally, with a decrease in the asymmetry coefficient from 1.23 to 1.1. The total co-efficient of volume gain for the left lung, in comparison with the right one, turns out to be larger both in limiting and average values. Conclusion. The conducted study of normal volume characteristics of the lung parenchyma using CT volumetry is one of the few demonstrations of lung volume in children of various age groups. The data obtained are the basic quantitative indicators of normal lung parenchyma in children, and can be used in compar-ison with studies of changes in lung volumes in various pathological conditions, including deformities of the spi-nal-rib complex","PeriodicalId":489032,"journal":{"name":"Medicinskij alʹâns","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135008172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Algorithm for differential diagnosis of cough by primary care physician","authors":"","doi":"10.36422/23076348-2023-11-3-6-12","DOIUrl":"https://doi.org/10.36422/23076348-2023-11-3-6-12","url":null,"abstract":"SummaryCough is a common symptom that occurs in diseases of many organs and systems: respiratory, cardiovascular, digestive, endocrine, nose/ ear/ throat pathology, as well as mental disorders. Cough is an unconditioned reflex that occurs in response to direct irritation of specific cough receptors in diseases or when the cough center is stimulated. The causes of acute, subacute, and chronic cough are various but not always obvious. To determine them, one needs appropriate knowledge, thorough clinical examination, including medical history and complaints, and the necessary lab tests. The greatest attention should be paid to the diagnosis of chronic cough and the exclusion of those causes of cough that are life-threatening. Alarming symptoms are hemoptysis, prolonged persistent cough, which appears for the first time and does not stop, prolonged intoxication syndrome, resistance to ongoing therapy, weight loss, nocturnal cough, etc. For more in-depth diagnosis, additional examination methods are carried out, such as computed tomography of the chest, magnetic resonance tomography and bronchoscopy. The appointment of a general practitioner is strictly time-limited, which does not allow for a full diagnosis and determination of true cause of the cough. As a result, the patient is prescribed therapy aimed at suppressing the cough, and not at eliminating it. Algorithms and differential diagnosis schemes can help the doctor quickly determine the cause of the cough and prescribe the correct treatment.","PeriodicalId":489032,"journal":{"name":"Medicinskij alʹâns","volume":"123 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135009518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}