In recent years, there has been an increase in publications on rare cases of combined myasthenia gravis and idiopathic inflammatory myopathies, including polymyositis. Such cases complicate the differential diagnosis and worsen patients' prognosis. This article presents a rare case of a patient with two serious autoimmune diseases: myasthenia gravis and polymyositis. A clinical case of the ocular form of myasthenia gravis in a 60-year-old woman with a long history of polymyositis is presented, with a detailed discussion of diagnostic and treatment stages. Clinically, polymyositis was manifested by proximal tetraparesis and confirmed by electromyography and biopsy data, and a good response to glucocorticoid therapy. Decrement test results were within acceptable limits. An increase in creatine phosphokinase up to 1630 U/L was observed. Ocular myasthenia gravis was diagnosed based on clinical criteria, with a positive pharmacological fatigue test (positive proserin test). Literature reviews on this topic are presented, emphasizing the importance of early diagnosis and adequate pathogenetic therapy to improve the prognosis for both polymyositis and myasthenia gravis.
The purpose of the research is to characterize histopathological changes in the cecal wall of horses naturally infected with cyathostomes (small strongyles).Materials and methods. An observational cross-sectional study was conducted on material from three 12-month-old meet horses naturally infected with cyathostomes. After slaughter, a partial dissection was performed with visual assessment and cecal tissue sampling. The number of encysted larvae per 1 cm² of the mucosa was counted. Histological sections stained with hematoxylin and eosin were examined using light microscopy with a morphometric analysis of cysts, inflammatory infiltrate, and fibrotic changes.Results and discussion. Larvae form cysts (on average, 6 specimens/cm²) in the submucosa and mucosa of the cecum. A histological examination of the cecal samples revealed a wide range of tissue reactions ranging from acute inflammatory changes to severe chronic remodeling. Early lesions included swollen mucosa, epithelial desquamation, and eosinophiliclymphocytic infiltration around thin-walled mucosal cysts. Chronic changes were characterized by formed dense fibrous capsules (up to 335.9 μm), proliferated fibroblasts, increased angiogenesis, and lymphoid follicle hyperplasia, which reflects a prolonged antigen stimulation. The heterogeneity of the cyst structure indicates the simultaneous presence of acute and chronic lesions within a single section of the cecal wall. The obtained data can be used in a comprehensive assessment of inflammatory, fibrotic, and vascular changes to understand the pathogenesis of the disease, improve diagnostic criteria, and evaluate the efficacy of antiparasitic therapy.
The distal radial access (DRA) in the anatomical snuffbox area is considered as a modification of the transradial access (TRA), potentially reducing the incidence of radial artery occlusion (RAO) and local complications, while preserving the proximal radial artery (RA) segment for future interventions. Aim : To evaluate the efficacy and safety of DRA compared with conventional TRA for endovascular procedures based on current randomized clinical trials (RCTs) and meta-analyses (2022–2026), with a focused quantitative synthesis of randomized evidence and a narrative overview of other procedural setting. Methods . PubMed/MEDLINE, Web of Science Core Collection, Google Scholar, and eLIBRARY (including manual search of reference lists) were searched using PRISMA 2020 from January 1, 2022, to February 1, 2026. Only meta-analyses and prospective RCTs were included; Retrospective studies, case-control designs, and clinical cases were excluded. The primary outcome was RAO (by assessment time), secondary outcomes were technical access success, access change (crossover), local complications, hemostasis time, operator radiation exposure, and ergonomics. A sensitivity analysis was performed at ≤ 48 hours (at discharge) and 30–90 days. Results . Nine RCTs (only coronary procedures) were included in the quantitative synthesis of RAO. In the subgroup of comparable timing (48 hours / 30 days / 60 days / 1 month / 3 months; k = 6), DRA reduced the risk of LA: RR = 0.37 (95% CI 0.25–0.54), I² = 0%. A risk reduction was also found for RAO at 24 hours ( k = 1). 12-month data are presented in the TENDERA RCT. Sensitivity analysis stratified by the time of RAO assessment showed consistent results. Conclusions . According to RCTs and meta-analyses, DRA is associated with a reduction in RAO and several local complication/ hemostasis benefits in 2022–2026. However, it often requires crossover and longer cannulation times during the development phase. The “protective effect” of DRA on the radial artery remains stable over different observation periods. Practical implications: DRA is appropriate for patients where preserving the proximal radial artery is important (repeated interventions, potential bypass/fistula), provided experience and patent hemostasis and/or ultrasound-guided protocols are available.
Early detection of tumors is a significant priority in modern medical practice. Advances in diagnostics and treatment of cancer patients have led to an increase in the proportion of younger patients and in life expectancy after treatment. In addition to other side effects, chemotherapy has a negative impact on the reproductive system, which is especially relevant for women of childbearing age. Furthermore, the recent trend toward later motherhood makes the issue of fertility relevant for a wider range of cancer patients. Understanding the risks helps health professionals choose the optimal treatment strategy for young oncohematologic female patients and increases the chances of their fertility preservation. Also, the study of mechanisms by which chemotherapy affects reproductive function allows for the development and implementation of methods that can reduce the gonadotoxic effect of anticancer therapy without compromising its effectiveness.
Objective : To analyze the treatment outcomes for acute surgical conditions of the abdominal organs in the Amur Region from 2020 to 2024. Materials and methods . Data from the surgical service of the Amur Region for 2020–2024 were used, covering 15,920 patients with acute appendicitis, acute cholecystitis, acute pancreatitis, acute intestinal obstruction, peptic ulcer bleeding, perforated peptic ulcer, and incarcerated hernia. Results . From 2020 to 2024, 28.01% of cases were acute appendicitis, 24.59% were acute pancreatitis, 18.62% for acute cholecystitis, 12.87% for acute intestinal obstruction, 7.61% for peptic bleeding, 3.9% for perforated ulcers, and 4.4% for incarcerated hernias out of the total number of patients (15,920). In 2024, acute pancreatitis (28.14%) was the leading cause of hospitalization among admitted patients (3,572), followed by acute appendicitis (22.56%) in the second place and acute cholecystitis (18.73%) in the third place. Surgery was most commonly performed for appendicitis (46.95%). The highest mortality rates were observed in cases of perforated ulcers (15.78%), peptic bleeding (10.9%), and acute intestinal obstruction (10.3%). Among patients, 48.16% were admitted more than 24 hours after the onset of symptoms, and the mortality rate doubled. Laparoscopic surgeries accounted for 27.44% of all procedures. Conclusion . Therefore, to integrate theoretical knowledge with practical application more effectively, it is advisable to schedule the study The incidence of acute surgical conditions of the abdominal organs in the Amur Region aligns with rates observed in the Far Eastern Federal District and the Russian Federation. Delayed hospitalization of patients, defined as more than 24 hours, is associated with complications and increased mortality. Proposed organizational measures aim to improve the provision of emergency surgical care.
