Навчально-науковий медичний інститут (НН МІ)
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Item Meningo-encephalitis in a middle-aged woman hospitalized for COVID-19(ALUNA Publishing, 2021) Dyachenko, P.A.; Сміянова, Ольга Іванівна; Smiianova, Olha Ivanivna; Дьяченко, Анатолій Григорович; Diachenko, Anatolii HryhorovychThe aim: To pay attention of clinicians to possible lesions of the central nervous system (encephalitis) in patients with COVID-19. Case presentation: A 44-year-old woman was admitted to our clinic because of 2-month-history of mild fever, bilateral lower lobe pneumonia, respiratory failure, generalized weakness, and some neurologic symptoms. SARS-CoV-2 RNA was detected in nasopharyngeal swab. Chest CT demonstrated bilateral pulmonary poly segmental consolidations in the mid and lower zones. Focal hyper intensive abnormalities in various parts of the left hemisphere were found at MR brain imaging in T2WI, and T2 FLAIR mode. Cerebrospinal fluid (CSF) examination showed a white cell count of 31/uL (normal <5/uL), protein 0.73 g/L (0.15-0.45), and glucose 1.4 mmole/L (2.2-3.9). Standard CSF neuroviral PCR panel and PCR for SARS-CoV-2 were negative. She was treated with ganciclovir, and dexamethasone. Due to suspected tuberculosis meningitis (cytosis, decreased level of protein and glucose), she also received ex juvantibus a course of anti-TB therapy (isoniazid, kanamycin, and levofloxacin) and made a steady improvement. Conclusion: This case shows that SARS-CoV-2 in association with other pathogens may cause various lesions of the CNS accompanied by severe neurological manifestations in adults.Item Algorithm of adenoiditis treatment in adults, depending on the pharyngeal tonsil hypertrophy stage(ALUNA, 2018) Сміянов, Євген Владиславович; Смиянов, Евгений Владиславович; Smiianov, Yevhen Vladyslavovych; Сміянов, Владислав Анатолійович; Смиянов, Владислав Анатольевич; Smiianov, Vladyslav Anatoliiovych; Sniehirova, I.O.; Сміянова, Ольга Іванівна; Смиянова, Ольга Ивановна; Smiianova, Olha IvanivnaIntroduction: Implementation of the endoscopic technologies while the upper airways diseases gave opportunity to diagnose the adenoid vegetation in adults. The aim: Тo offer effective algorithm of curing adults for adenoiditis, depending on the degree of pharyngeal tonsil hypertrophy. Materials and methods: 43 patients aged 18-55 with hypertrophy of pharyngeal tonsil were examined. Depending on the degree of hypertrophy three clinical groups of patients was created: the first one receiving only conservative treatment, the second one receiving conservative therapy and radiowaveradiation coagulation with the apparatus “SURGITRON” and the third one receiving the endoscopic shave adenotomy. Statistical processing of the received data was made in the programs «Exсel» and «STATISTICA 6.0». Data rows were checked for the normality with the help of Shapiro-Wilk statistical criteria (small sample) and Kolmohorov-Smirnov (large sample). Checking of the dispersion uniformity was done by Leneva criteria. During the comparison of the rows criteria of Student and Wilkokson for the non-paired, Kolmogorov-Smirnov were used. Results: During the re-examination of patients who received only conservative therapy treatment in a month endoscopic signs adenoiditis were distinguished and a year later percentage of relapse was higher than in patients with complex treatment. After shave adenotomy adenoiditis recurrence was not observed. Conclusions: While treatment of the patients with the pharyngeal tonsil hypertrophy of the 1 and 2 degree conservative therapy is possible. Addition into the scheme of conservative treatment RWCAV actually reduces quantity of adenoiditis recurrence and allows fast recovery. Treatment of patients with the pharyngeal tonsil hypertrophy of 3 degree, in context of contraindication absence requires surgical treatment (adenotomy) in 100% of cases.