[Is this iatrogenic pathology or rare disease?] / Yatrogennaya patologiya ili redkaya bolezn'?

The article is devoted to the problem of diagnosis and treatment strategy of Buerger's disease rarely found in the expert and clinical practice, that is inflammatory disease of unknown etiology, affecting mainly small and medium arteries and veins of limbs. Vascular surgeons around the world have been solving this problem for many years, both in terms of timely diagnosis of this disease and its proper pathogenic treatment. The authors of the article described an expert case of Buerger's disease larvated course in 15-years-old girl, which primarily was mistakenly assessed by specialists as iatrogenic pathology of right forearm vessels in injecting aminazin solution that, according to the clinicians' opinion, led to dry gangrene formation of right wrist and its subsequent amputation. The results of the forensic histological study and retrospective analysis of all child's medical documents allowed to correctly diagnose this rare pathology but only on the stage of commission forensic medical examination in the framework of the initiated criminal proceeding against several leading medical organizations in Saint-Petersburg with a pediatric profile. The authors noted the role of routine medical manipulation in manifestation of larvated pathologic process in a teenage girl in addition to full health and well-being. The objective of present article is devoted to understanding this problem.

[Lung pathology in children with a long-term novel coronavirus infection COVID-19]. / Patologiya legkikh u detei pri dlitel'no tekushchei novoi koronavirusnoi infektsii COVID-19.

New coronavirus infection is registered less frequently in children than in adults. Among all patients with COVID-19, the share of children is 8.6%. Clinical practice shows that in children, COVID-19 can be severe and even fatal. Articles have been published reflecting the clinical manifestations of Long Covid in children, while data on pathomorphological examination of the lungs during long-term COVID-19 in children are not available in the literature. On the basis of the Department of Pathological Anatomy with a course of Forensic Medicine and the Pathological-Anatomical Department of the Clinic of St. Petersburg State Pediatric Medical University, an analysis of medical documentation was carried out, autopsy materials were selected from 3 observations of the death of children from COVID-19. The selection criterion was the duration of the disease. A histological examination using standard methods and IHC analysis using antibodies to the nucleocapsid of SARS-Cov-2, CD95, CD31 were carried out on the lung tissue of 3 children aged 2 months to 2 years who died from a new coronavirus infection. Microscopically, all three patients showed microvessels damage, their thrombosis, angiogenesis, as well as signs of diffuse alveolar damage The combination of expression of the SARS-CoV-2 nucleocapsid and the apoptosis marker on the vascular endothelium of the MCR is of interest. CONCLUSION: The data obtained indicate infection with coronavirus and death of endothelial cells due to apoptosis. Endothelial damage in the microvessels of the lungs is the initiating factor in the development of capillary-alveolar block, tissue hypoxia, and disseminated intravascular coagulation syndrome, leading in some cases to respiratory/multiple organ failure and death.

[To the 90th anniversary of the department of pathological anatomy with a course of forensic medicine named after professor D.D.Lokhov of Saint Petersburg State Pediatric Medical University]. / K 90-letiyu kafedry patologicheskoi anatomii s kursom sudebnoi meditsiny im. professora D.D. Lokhova Sankt-Peterburgskogo gosudarstvennogo pediatricheskogo meditsinskogo universiteta.

The article is devoted to the history of Professor D.D. Lokhov Department of Pathological Anatomy with a course of forensic medicine of the St. Petersburg State Pediatric Medical University of the Ministry of Health of Russia, founded by one of founders of the national pathological anatomy of childhood and adolescence, Professor D.D. Lokhov, whose name has been awarded to the Department since 2022. The updated advances of the Department in research, teaching and diagnostic activity are presented.

A rare case of diagnosed absent aortic valve and severely hypoplastic pulmonary valve with double outlet right ventricle: A case report.

Agenesis of the aortic and pulmonary valves is a very rare congenital malformation of the semilunar valves. The literature describes no more than thirty cases of such anomaly in combination with congenital heart disease. Most descriptions include aplasia of either the aortic or pulmonic valve. The combination of such defect in both valves has been described in a much smaller number of scientific papers. In this article, we present a clinical case of the treatment of a patient with agenesis of aortic valve and severely hypoplastic pulmonary valve. As a result circulatory arrest occurred immediately after birth, which required the implementation of cardiopulmonary resuscitation. The child was resuscitated and transferred to the intensive care unit for further examination and treatment.

[Arterial fibromuscular dysplasia as a factor in sudden cardiac death in young adults]. / Fibromuskulyarnaya displaziya arterii ­ odin iz faktorov vnezapnoi serdechnoi smerti lits molodogo vozrasta.

The objective of the study is to consider the problem of diagnostics of a rare vasculopathy, fibromuscular dysplasia of coronary arteries, by the case study of a 19-year-old serviceman, an athlete with sudden death occurred during slight physical exertion. After repeated histological examination as part of the forensic medical examination, the diagnosis was made: «multifocal fibromuscular dysplasia of the coronary arteries and ascending aortic arch, complicated by acute left ventricular failure.¼ This disease often manifests with the acute coronary syndrome in people of young age. Therefore, special attention was given to the macroscopic and histological features of fibromuscular dysplasia of arteries.

[Study cytoflavin dose-dependent effect in the treatment of acute ischemic stroke]. / Izuchenie dozozavisimogo effekta tsitoflavina v terapii ostrogo perioda ishemicheskogo insul'ta.

AIM: To compare the efficacy of cytoflavin in doses of 10 and 20 ml/day in the complex pharmacological therapy of patients with acute ischemic stroke. MATERIAL AND METHODS: Eighty-six patients, aged from 43 to 85 years, were examined. Patient's status was assessed using the NIHSS, the Rankin scale, the Barthel index and the Rivermead mobility index. Patients were stratified into 3 groups: patients of group 1 received standard treatment, patients of group 2 received cytoflavin in dose of 10 ml/day in addition to standard treatment and patients of group 3 were treated with cytoflavin in dose of 20 ml/day in addition to standard treatment. RESULTS AND CONCLUSION: Cytoflavin in doses of 10 and 20 ml/day significantly promotes the regression of neurological deficit, improves day-to-day activity, and therefore, improves functional independence in daily life. The dose-dependent effect of the drug was shown. The use of cytoflavin in dose of 20 ml/day resulted in the more rapid regress of neurological symptoms during inpatient treatment and higher indices of daily activities and functional independence of patients that was important for the further rehabilitation.

[Morphological study of ANCA-associated glomerulonephritis in children].

The paper presents the results of a morphological study of ANCA-associated glomerulonephritis in children with different ANCA titers in the blood. Cellular and fibrotic crescents and tubulointerstitial fibrosis were noted when the blood ANCA values were low. On the contrary, destructive changes were prevalent in the glomerular loop and tubular walls when the blood ANCA values were high.

[Intrauterine mycoplasmosis in late miscarriage]. / Vnutriutrobnyi mikoplazmoz u pozdnikh vykidyshei.

118 late abortions were investigated at week 18-28 of pregnancy with the use of light and immunofluorescent microscopy. Intrauterine infections were found in 86 cases including 44 observations of mycoplasmosis, 16-M. hominis, 18-M. pneumoniae, 10-U. urealyticum. Histologically similar changes were found in the form of vacuolar degeneration of the amnion, trophoblast of the basal lamina and foetal coats, inner foetal organs and neuroepithelial cells in the central nervous system. Apart from this, focal leucocytic-lymphocytic infiltration was observed. Marked myeloid hematopoiesis was found in the liver. Maximum changes were found in the placenta and foetal organs in chronic placental deficiency.