Emergency Splenectomy in a Patient with Splenic Marginal Zone Lymphoma, Acute Portal Vein Thrombosis, and Chronic Viral Hepatitis B.

Splenic marginal zone lymphoma (SMZL) is a type of non-Hodgkin's lymphoma (NL) that occurs in 2 out of 100 cases and is more common in women aged >60 years. A sluggish, asymptomatic course of the disease does not exclude transformation into a malignant form that occurs in 25% of patients with SMZL. Another equally important sign of an NL is thrombosis that occurs in 3.

[Liver and COVID-19: possible mechanisms of damage].

The global epidemic of a new coronavirus infection caused by SARS-CoV-2 is a major threat to human health. In the clinical picture, along with acute respiratory distress syndrome, liver lesions are also noted. The following mechanisms are currently being considered: direct damaging effects of SARS-CoV-2, immuno-mediated inflammation, hypoxia, drug exposure, and reactivation of pre-existing liver disease.

[Esophageal disorders in patients with irritable bowel syndrome].

Aim: To study the whole range of esophageal disorders in patients with irritable bowel syndrome (IBS) using high-tech methods.

Materials And Methods: 102 IBS patients (47 males, mean age 40.8, diagnosis of IBS was established according to Rome III criteria) with esophageal symptoms (heartburn, belching, globus sensation and noncardiac chest pain) were examined in gastroenterology department.

[NERVOUS SYSTEM LESIONS ASSOCIATED WITH RELAPSING POLYCHONDRITIS: ANALYSIS OF ORIGINAL OBSERVATIONS].

Three clinical cases are described including two of relapsing polychondritis with lesions in the central and peripheral nervous system (one of long-standing aseptic lymphocytic meningitis and one of cranial neuropathy of 2, 5, 7, and 8 pairs) and the third case of the optic nerve lesion with amblyopia. The two former cases were successfully treated with high doses of corticosteroids, the third one with moderate doses of the same medications. The data from the current literature concerning variants of clinical manifestations, methods for diagnostics and treatment of neurologic manifestations of relapsing polychondritis are discussed.

[Emotional and personality features of patients with irritable bowel syndrome and bowel inflammatory diseases].

Objective: To conduct a comparative analysis of the emotional and personality characteristics of patients with irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) in remission with IBS-like symptoms.

Patients And Methods: This study carried out based at a specialized gastroenterology clinic in the period from 2010 to 2015 included 125 patients with IBS (IBS-D - 46, IBS-C - 20, IBS-M - 59) and 37 patients with IBD in remission: Crohn's disease (CD) - 11 and ulcerative colitis (UC) -26 patients. The levels of depression (Beck questionnaire), urgent and personal anxiety (Spielberger questionnaire), the degree of alexithymia (Toronto scale) as well as the severity of psychopathology and behavioral symptoms (PBS) were estimated.

[Case report of a combination of periodic disease and irritable bowel syndrome].

The article reports a case of atypical picture of a combination of periodic disease and irritable bowel syndrome in a 52 year old patient.

[Functional disorders: pathogenesis and systematic of clinical presentation].

Functional disorders hold a prominent place in the clinical practice of physicians of different specialties. The difficulties in the diagnosis of functional disorders need expensive examinations, and standard treatment is, as a rule, is not effective. Currently, the pathogenesis of these disorders is considered in the frames of the biopsychosocial model.

[Relapsing polychondritis].

Relapsing polychondritis (RP) is a systemic inflammatory condition leading to irreversible structural changes in cartilaginous tissue as a result of generalized proteoglycane decomposition. Auricular and nasal cartilage is usually the first to be affected at the onset of the disease which leads to episcleritis. At the later stages, the larynx and trachea become involved, vasculitis develops affecting the organs of hearing, coronary arteries, kidneys, meninges, and other organs.

[24-hour combined pH-impedance measurement in differential diagnosis of non-erosive reflux disease and functional gastroesophageal disorders].

Aim Of Investigation: To study potentials of 24-hour combined pH-impedance measurement in differential diagnosis of nonerosive reflux disease and functional gastroesophageal disorders.

Materials And Methods: Overall 60 patients with heartburn, belch and epigastric discomfort were investigated. All patients underwent esophagogastroduodenoscopy (EGDS), X-ray examination of upper gastrointestinal tract, 13C-urea breath test, 24-hour combined pH-impedance measurement.

[Familial transthyretin amyloidosis].

A case of familial transthyretin amyloidosis with TTR Cys 114 gene polymorphism is described (first in Russia and third in the world). The clinical picture of the proband was dominated by symptoms of autonomous polyneuropathy (orthostatic hypotension, erectile dysfunction, diarrhea, tachycardia, foot dyshydrosis) and of somatic nerve lesions (dumbness, impaired surface and deep sensitivity in the limbs). The patient presented with vitreous body opacity, disturbed eye movements, lateralized sensory symptoms, and difficulty of speech (baryphonia).

[Debatable aspects of pathogenesis and diagnostics of irritable bowel syndrome (IBS) and inflammatory bowel diseases with IBS-like diseases].

Aim Of Review: To analyze current publications devoted to controversial issues of pathogenesis, diagnosis and differential diagnosis of irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) in remission with IBS-like symptoms.

Key Points: There are three main hypotheses discussed in the literature: 1) IBS as a prodrome, pre-stage of the IBD; 2) IBS and IBD are different variants of inflammatory disorder which is common to both diseases; 3) The onset of IBS-like symptoms in IBD patients in remission.

Conclusion: It is shown that modern literature data on this issue is contradictory and ambiguous.

[Psycho-autonomic aspects in patients with gastroesophageal reflux disease, and functional esophageal disorders].

The subjects of the study were 79 patients (35 with functional esophageal disorders (FED), 24 with nonerosive reflux disease (NERD), and 20 with erosive reflux disease (ERD), who were selected on the basis of clinical complaints, 24-hour ph-study, and esophagogastroduodenoscopy. All the subjects were evaluated by means of clinical questionnaires and psychological tests: Beck depression test, Spielberg State-Trait Anxiety inventory (STAI), and Toronto alexithymia test (TAS). In FED and NERD patients vs.

[Psychophysiologic disorders in patients with functional disorders of upper sections of the gastrointestinal tract and with gastroesophageal reflux disease].

The features of the psychovegetative status in patients with functional disorders of the esophagus and stomach (FD) and gastroesophageal reflux disease (GERD) are investigated. The methods included clinical, instrumental and psychometric examination. The patients of both groups had similar vegetative abnormalities and a tendency towards the growth of depression and anxiety parameters, did not differ in psychosocial factors, and had a wide range of psychovegetative abnormalities (PA).

[Results of simultaneous 24 hour pH and ECG monitoring in patients with cardialgias].

Simultaneous 24-hour pH and ECG monitoring is suggested as a method for differential diagnosis of cardialgias. Fifty-four patients were examined, complaining of retrosternal and precardial pain, retrosternal burning, heartburn, and belching of unknown origin. Four groups were distinguished.

[Clinical, diagnostic and therapeutic features of tricuspid infectious endocarditis].

From 1987 to 1998, examination and treatment were conducted of 12 patients with infectious endocarditis of the tricuspid valve (TIE). 11 of them were operated. TIE was clinically characterized by lesser circulation thromboembolism and marked right ventricular failure.

[Active computer systems for medical education: approach and implementation].

The methodological bases and ways of building and using the new type of the educational computer-aided systems for physicians, the Diagnostic trainer, are discussed in the paper. The user's work on the Diagnostic Trainer proceeds in the form of a game during which the system stimulates clinical cases while the user analyzes them. The Diagnostic Trainer uses its knowledge base for simulations and requires no clinical cases to be prepared beforehand.