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Introduction. Most acute respiratory infections are accompanied by a cough. Therefore, it is important to promptly determine whether the cough is a symptom of inflammatory diseases of the upper or lower respiratory tract or has a different origin, which will allow for the selection of an appropriate diagnostic and treatment plan. The article focuses on the issues of symptomatic treatment of cough in children using a modern herbal preparation with complex action in the standard treatment regimen. Aim. To study the possibilities of rational cough therapy using a herbal preparation Gedelix based on ivy in children. Materials and methods. The study included 62 patients of both sexes from 2 to 6 years, who were in the children’s hospital of the Central City Clinical Hospital No. 18 in Kazan, with a symptom of cough that was nonproductive at the time of screening/ unproductive nature, against the background of acute bronchitis without concomitant somatic diseases. Results and discussion. The analysis of the conducted study showed high clinical efficacy of the studied herbal medicine based on ivy. The drug is included in the standard of treatment. The results of the recommended treatment option were analyzed. During the study, the drug demonstrated high efficacy in reducing inflammation, liquefying and facilitating sputum discharge, restoring mucociliary clearance and stimulating the regeneration of the respiratory mucosa. The absence of adverse drug reactions showed safety and good tolerability. Conclusions. The herbal preparation has shown its effectiveness and safety, which allows us to recommend it as the drug of choice for the symptomatic treatment of cough in children from infancy as part of standard treatment.
PurposeCarotid-cavernous fistulas (CCFs) are abnormal connections between the carotid artery and cavernous sinus, often causing ocular symptoms like chemosis, proptosis, and diplopia. Endovascular embolization is the preferred treatment, typically performed via the transfemoral transvenous route through the inferior petrosal sinus (IPS). However, we present a case and a systematic review of indirect CCF treated through deep orbital puncture of the superior ophthalmic vein (SOV) for embolization.MethodsWe systematically revised the current literature on PubMed, Web of Science, and Embase, based on PRISMA guideline, concerning the deep orbital puncture of the SOV for embolization of indirect CCFs.ResultsOur systematic review identified only eight eligible studies encompassing 17 patients, ranging in age from 34 to 82 years, underscoring the rarity of this specific approach. The most frequently used trajectory directed the needle along the floor of the orbit towards the superior orbital fissure or orbital apex, and a variety of embolization materials were used in the studies. While the technique has been mentioned in the literature, our analysis indicates that it remains infrequently reported, with many cases lacking consistent procedural details. Furthermore, we present a case of a 63-year-old woman with imaging suggesting a CCF and compatible symptoms. A transorbital puncture of the SOV was performed. Embolization was successfully achieved with ethylene vinyl alcohol copolymer. The follow-up confirmed the resolution of the CCF without new neurological deficits and no new symptoms.ConclusionThis case highlights transorbital SOV puncture as a feasible and minimally invasive alternative for treating CCFs when conventional access is unsuccessful.
Scolopendrae represent the best-known genus of centipedes. They are the largest centipedes. There were several reported cases of scolopendra venom poisoning around the world. We report a clinical case of an unusual reaction to a scolopendra bite in Crimea, accompanied by severe acute neurological and articular manifestations and hard-to-diagnose delayed sequela. Despite the full range of medical care provided and active management strategy, the female patient developed allergic and subsequently autoimmune pathologies due to individual immune characteristics, including genetic ones caused by the presence of previously undiagnosed connective tissue dysplasia. The retrospective observation showed how the female patient’s congenital imbalance between humoral and cellular components of the immune system contributed to the more aggravated clinical picture that developed as reaction to the arthropod bite, and it was its venom that initially acted as an allergic, and subsequently as an autoimmune trigger. A review of modern Russian and foreign literature on cases of scolopendra bites was performed. This review highlighted possible complications associated with the effects of the venom. Recommendations on the management strategies for such patients are provided to primary care physicians.
Despite widespread elderly population, these patients are underrepresented in clinical trials. Considering the Russian prospective registry REGION-IM, the authors analyzed anamnestic, demographic and clinical characteristics of patients with acute MI over ≥ 75 years old, treatment features and in-hospital mortality. The results were compared with the data of Russian and foreign ACS registries. Patients with MI ≥75 years old in the Russian Federation are characterized by severe comorbidities, less frequent invasive treatment and prescription of necessary drugs. Elderly patients have longer patient-associated reperfusion delay, symptom-to-diagnosis and symptom-to-hospitalization time, which may be explained by atypical symptoms, mental problems and social factors. In-hospital mortality is much higher in patients ≥75 years old. Elderly patients with MI represent a high-risk group that dictates the need for active and balanced approach at all stages of treatment.
