[Recovery of consciousness under therapy with benzodiazepines. A case report and literature review]. / Vosstanovlenie yasnogo soznaniya na fone priema benzodiazepinov. Opisanie sluchaya i obzor literatury.

BACKGROUND: Treatment of patients with prolonged and permanent disturbance of consciousness is still an extremely difficult problem. Nowadays, management is based on pathophysiological and molecular mechanisms of impaired consciousness. Several electrophysiological and pharmacological methods were proposed to restore consciousness in appropriate patients. OBJECTIVE: We present recovery of clear consciousness under therapy with phenazepam and literature review devoted to therapy of these disorders. RESULTS AND CONCLUSION: This case confirms available data on drug neuromodulation in complex treatment of patients with prolonged impairment of consciousness and substantiates the need for individual multimodal assessment of structural and functional disorders in prolonged and chronic impairment of consciousness for adequate therapy.

[A favorable outcome of surgical treatment and intensive care in a child admitted in a severe condition in the setting of aneurysmal subarachnoid hemorrhage (a clinical case and literature review)]. / Blagopriiatnyi iskhod khirurgicheskogo lecheniia i intensivnoi terapii u rebenka, postupivshego v tiazhelom sostoianii na fone anevrizmaticheskogo subarakhnoidal'nogo krovoizliianiia (klinicheskoe nabliudenie i obzor literatury).

Treatment of children in the acute stage of hemorrhage from cerebral aneurysms is based on clinical cases reported in the literature and descriptions of small series of observations. There are no studies that enable the development of evidence-based approaches to intensive care in treatment of children with aSAH. We present a clinical case with a favorable outcome of complex treatment in a child admitted to the Burdenko Neurosurgical Institute at an extremely severe condition. The efficacy of treatment was based on a timely urgent neurosurgical intervention and adequate intensive therapy in the form of extended neuromonitoring with continuous measurement of intracranial pressure, which enabled using the whole complex of measures for timely management of intracranial hypertension. A favorable outcome (a GOS score IV) after this severe aneurysmal SAH indicates that there are no absolute contraindications for neurosurgical treatment of children with cerebral aneurysms.

[Somatostatin receptor expression in the ileal mucosa of patients with inflammatory bowel disease].

AIM: to investigate the specific features of somatostatin receptor expression in the ileal mucosa of patients with inflammatory bowel disease (IBD). MATERIAL AND METHODS: Ileal biopsy specimens from 42 patients aged 22 to 55 years, including 16 patients with Crohn's disease (CD), 14 with indeterminate colitis of IBD unclassified (IBDU), and 12 with the unchanged ileal mucosa (a comparison group). Immunohistochemical examination was performed using anti-somatostatin receptor type 2 (SSTR-2) antibodies (Epitomics, USA). SSTR2-positively stained cells were counted per 100 epitheliocytes. RESULTS: There were three receptor expression types: predominantly membranous, cytoplasmic, and mixed (membranous-cytoplasmic). Calculation of cells with membranous expression indicated that the median was 1 in the patients with Crohn's disease (interquartile range (IQR) 0.5), 3 in those with IBDU (IQR 2.5), and 2 (IQR 2) in the comparison group. These indicators were 1 (IQR 2), 3 (IQR 2), and 2 (IQR 1) for cytoplasmic expression and 5 (IQR 4), 2 (IQR 3), and 3 (IQR 2) for membranous-cytoplasmic one. CONCLUSION: The number of SSTR-2-expressing cells was significantly smaller in the patients with Crohn's disease than that in those with the unchanged mucosa and in those with indeterminate (unclassified) colitis. There were three SSTR2 staining types: predominantly membranous, cytoplasmic, and mixed (membranous-cytoplasmic). The cells with membranous staining appeared to be neuroendocrine, those with cytoplasmic expression were intraepithelial T lymphocytes, and those with membranous-cytoplasmic expression were both neuroendocrine and epithelial.

[Adrenocortical oncocytoma].

The paper characterizes adrenocortical oncocytoma, a rare adrenal tumor, accompanied by Cushing's syndrome and estrogen and androgen production and provides histological and immunohistochemical features. The authors describe their observation of a 33-year-old female woman. It is shown that estimation of the malignant potential of adrenocortical oncocytomas requires a special approach and must be done using the Lin-Weiss-Bisceglia criteria.

[Primary thyroid extranodal marginal zone lymphoma].

The paper gives the data available in the literature on the clinical and morphological features of thyroid lymphomas and on their diagnostic principles. The authors' observation details the histological and immunohistochemical characteristics of primary thyroid extranodal marginal zone lymphoma. The specific feature of the observation is total thyroid tissue substitution for tumor cells so the characteristic sign of chronic autoimmune thyroiditis were undetectable, but found only immunohistochemically from the remaining thyroid tissue follicle-like structures, which bears out the relationship between the development of lymphoma and autoimmune thyroiditis.