Репозиторий Университета

Research objective was assessment of a possibility of primary diagnosis of viruses Epstein-Burr, a cytomegalovirus, a virus of herpes of the 6th type in oral liquid and also influences of herpes infection on development and the clinical course of precancer diseases of the oral mucosa and the red border of lips (RBL). Profound clinic-immunological examination is conducted to 60 patients: the first group are have made 20 patients with an erosive and ulcer form of the lichen planus, the second - 20 people with an erosive form of a leukoplakia, a third - 20 people without diseases of the oral mucosa. As a result of work detection herpes infection is revealed high (90%). The combined infection with a virus Epstein-Burr and a virus of herpes of the 6th type was observed more than at a half of patients. The imbalance of factors of local immunity of the oral cavity in the form of increase in the IgG profile, decrease in concentration of IGA, lysozyme, and increase in an indicator of Ksb three times in comparison with norm and also substantial increase of level of pro-inflammatory cytokin IL 1β and FNO-α is found in patients with precancer diseases of the oral mucosa. Characteristic clinical feature of the precancer diseases associated with latent herpes infection is the long, recidivous current, persistent to traditional therapy. The research of oral liquid and blood on herpes viruses and consultation of the infectiologist is recommended to all patients with precancer diseases.

© 2018 Interregional public organization Association of infectious disease specialists of Saint-Petersburg and Leningrad region (IPO AIDSSPbR). All rights reserved. The development of mesenteric lymphadenitis is typical for patients with HIV infection at the stage of secondary diseases. The purpose of our study is to decipher the etiology of lymphadenitis in patients with HIV infection at the stage of secondary diseases. The analysis of disease histories of 113 HIV infection patients at the stage of secondary diseases with the use of statistical processing was carried out. The article presents examples that characterize the polymorphism of clinical variants of the development of mesadenitis in HIV-infected patients with stage 4B, which has developed as a result of the influence of various etiological factors.

© 2018, Dynasty Publishing House. All rights reserved. The objective. To offer a clinical and laboratory characteristic of coronavirus infection in hospitalised children. Patients and methods. The group of study included 50 children, who were diagnosed with coronavirus infection by polymerase chain reaction (PCR). Mono-coronavirus infection was found in 40 children (80%), mixed virus infection conditioned by a combination of two or three viruses - in 10 children (20%). Results. In all examined children with coronavirus infection disease had an acute onset and took a mild or moderate course. In general, the clinical picture of disease was manifested by cough, signs of rhinitis (stuffy nose, mucus discharge from the nose), febrile fever (in 52.5% of patients with mono-infection and in 80% of children with mixed infection), laryngotracheitis with laryngeal stenosis grade 1 (in 52.5% with mono-infection and in 80% with mixed infection). In 10% of children with monoinfection and in 50% of children with mixed infection gastrointestinal dysfunction was noted in the form of repeated vomiting to 2-6 times, diarrhoea to 1-4 times daily without pathological admixtures. Haematological parameters did not show any characteristic specificities in any child in both mono-infection and mixed infection. Cclusionon. Catarrhal inflammation is the leading clinical syndrome in mono- and mixed coronavirus infection; disease was manifested by cough, often - elevated body temperature, signs of stenosing laryngitis; part of children developed gastrointestinal dysfunction.

© 2018 Dynasty Publishing House. All rights reserved. The objective: To establish the character of haemodynamic disorders in the fetoplacental complex taking into account blood rheological properties, severity of systemic inflammatory response syndrome and to offer a pathogenetic rationale for terms that would be optimal for treatment of placental dysfunction in pregnant women with influenza. Patients and methods: 114 pregnant women with influenza were examined, of them 35 with moderate, 79 with severe flu. In order to rule out the variability of parameters reflecting the state of the fetoplacental complex all women were at comparable terms of gestation (20-30 wks). Results: We have found a relation between the severity of influenza, increased blood viscosity and the development of haemodynamic disorders in the fetoplacental complex. In moderate flu, fetoplacental blood circulation practically does not suffer. Resistivity index (RI), pulsatility index (PI) and systolic/diastolic (S/D) ratio remain within control values. In severe influenza, blood viscosity significantly increases and uteroplacental blood flow exhibits significant impairment. Against the background of increased blood viscosity on the average by 15-20%, taking into account the shear rate, RI, PI and S/D ratio values increase by 25-30%, which is indicative of the signs of impaired blood circulation. In increased blood viscosity at low shear rates it is uteroplacental blood flow that suffers predominantly, without involving fetoplacental one. Conclusion: In severe influenza, the contingency of placental hemodynamics on the maternal and fetal sides is impaired, and increased blood viscosity is to a great extent the cause of these disorders.

© 2018 Dynasty Publishing House. All rights reserved. The objective: The purpose of the study is to establish the role of infection with herpes simplex viruses type I and II in the pathogenesis of urogenital infection in pregnant women. Patients and methods: 89 patients of I, II trimester gestation, aged 18 to 35 years (average age of 27.5 ± 5.6 years) were examined. The design of the research and the methodology of verification of the UGI pathogens of pregnant women are presented in previously published materials. The establishment of character of pregnancy course (urgent delivery, premature birth, termination of pregnancy and mis-carriage), the presence or absence of infection and/or clinical manifestations of infectious and inflam-matory diseases, as well as evaluating the gene expression of TLR-2, TLR-3, TLR-4, TLR-8 (in relative units - RU) was conducted according to manuals. Results: It is established, that in UGI in pregnant combined viral-bacterial infection is registered. Viral component of UGI pathogens in pregnant women is presented by the association of viruses from the Herpesviridae family - herpes simplex viruses, Cytomega-lovirus, Epstein-Bar virus. Against the background of polyfactorial mechanisms of the pathogenesis of abortion, extra maximum activation of gene expression of TLR (22-23 RU or more) additional external factors, for example, infections can be an aggravating pathogenetic factor of miscarriage. Reduced expression of genes of TLR2, TLR4, TLR3 and TLR8 in the mucous membrane of the cervical canal in UGI of pregnant women in infection with herpes simplex virus due to the oppressive effect of pregnancy on the reaction of TLR, combined with the immunodepressive effect of the virus itself. With the violation of cellular part of immuno-logical reactivity of the body under the influence of adverse endogenous and exogenous factors on the process of pregnancy is activated the infectious process caused by the bacte-rial-viral pathogens association, which is accompanied by hyper reaction and increased reaction from the expression of genes of TLR, determines the pathological development of pregnancy. It is established that in the UGI of pregnant gene expression levels of TLR2-21.2 and above, TLR4-23.0 and above, TLR8 - 26.0 and above (the level of gene expression of TLR8 above 28 is the predictor of the onset of abortion and miscarriage) testify to the acute infectious process with the clinical manifestations of the UGI, and also indicates the possible interruption of pregnancy and miscarriage; levels of gene expression of TLR2 below 21.2, TLR4 below 23.0, TLR8 below 26.0, in-dicated a decrease in the severity of the infectious process and its chronicity, as well as the possibility of direct microbial damage to the tissues of UGT, placenta, and fetus. Conclusion: Verified in preg-nant women in 61% of cases clinical manifestations of the infectious process are necessarily associated with the verification of the association of herpes simplex viruses I and II type - triggers of infectious process deterioration, determining the prognosis and outcome of the development of the UGI in preg-nant.

© 2018 Meditsina Publishers. All rights reserved. The spread of a latent tuberculosis infection - 2.3 billion people - is of emergency importance for the global task of mankind - to eliminate tuberculosis as a common disease by 2035. For children, due to the limited use of the radiological diagnosis methods, the main methods today are the immunological tests for the detection of tuberculous infection. The most common used method is the tuberculin skin test (Mantoux test) due to its lack of specificity has significant drawbacks, especially in countries using mass BCG vaccination. Relatively new methods using specific recombinant MTB proteins, both in vitro tests and in new skin tests, allow to determine tuberculosis infection in latent or active form much more specifically, however, they are somewhat less sensitive, in comparison with the Mantoux test, which requires development of these methods with the introduction of new additional specific antigens. It is obvious that crucial task is the development of new methods for distinguishing active and latent tuberculosis infection or being able to predict progression from latent to active TB diseases both in children and in adult population. The article shows new diagnostic techniques of blood cells and plasma samples based on the use of flow cytometry with the detection of antigen-specific T-cells producing interferongamma and tumor necrosis factor alpha, T-cells specific markers, as well as using combinations of the identification of various protein factors that have the prospect to determining active tuberculosis infection signs. However, these methods are still time-consuming and expensive. Currently, some new promising approaches based on the using of new genetically engineered products are being developed to determine specific antibodies in the blood serum. With the development of accelerated methods for the analysis of the expression of specific genes in blood cells, this direction also has the prospect of introducing into healthcare practice.

© 2018 Techno-Press, Ltd. In order to prevent the phenomena of "microbiological genocide", unjustified and unfavorable violations in microecological systems, and, first of all, human microbiota during the implementation of the disinfection prevention of diseases, the necessity for the scientific justification and practical provision of sufficient antimicrobial selectivity of disinfecting effects, is substantiated in the article. It is necessary to decode and take into account the susceptibility of different microbe pathogens to various disinfectants in comparison with saprophyte, and even more so, useful microflora.

© 2018 Dynasty Publishing House. All rights reserved. The objective: To optimize a tactics of examination and treatment of patients with a benign cervical pathology associated with papillomavirus infection (PVI) in female patients of reproductive age. Patients and methods: 124 patients aged 22 to 35 years underwent complex examination and treatment. Two groups were singled out: the first (main) group included 72 patients, who in the postoperative period received treatment with an antiviral immunostimulating drug isoprinosine, the second group comprised 52 patients, who did not receive the antiviral medication (control group). Inosine pranobex (isoprinosine) was administered 3 g/day (2 tablets 3 times daily) for 28 days. A carbon dioxide (CO2) laser and argon plasma were used to destroy the affected uterine cervical epithelium. Results: The Pap test found various pathological changes in 112 (90.3%) patients. ASCUS smear results had similar incidence rates in the groups 16 and 18% (p > 0.05). The incidence of LSIL in the groups was 31.9 and 32.6%, respectively (p > 0.05). In the basic group, 60 days afterwards complete elimination of virus was noted in 95.8% of cases; in the control group in 78.8%. The frequency of HPV infection recurrence among patients with complete virus elimination was 2.9% in the basic group, in the control group - 14.6%. Conclusion: The employment of the surgical stage permits to destroy pathological tissue, deactivate virus at the local level and prepare conditions for deactivation of virus in the body. Postoperative antiviral and immunostimulating therapy not only ensures practically complete elimination of virus but also reduces recurrences of PVI.

© 2018 Dynasty Publishing House. All rights reserved. A systematic review substantiates the significance of mutual influence and interaction between infection pathogens, humoral and cell-mediated innate immunity that condition triggering or termination of infectious process, its prodromal period, severity of clinical manifestations and outcomes of urogenital infections in pregnant women. The determining factor is the result of TLRs response to microbial patterns taking into account the preparedness and state of innate immune receptors. The latter might ensure a higher anti-infection resistance to the pathogen up to termination of disease, or to promote the development of infectious process with marked inflammatory reaction, or to make the infectious process chronic up to damaging the tissue cells of the macroorganism. The understanding of the mechanisms of natural anti-infectious resistance and enhanced sensitivity and susceptibility to infectious agents has been objectified. TLRs act as molecular genetic markers of anti-infection resistance of the body and its state of health.

© 2018 Vitebsk State Medical University. All rights reserved. This clinical case demonstrates the development of severe streptococcal (Streptococcus pyogenes) necrotizing soft tissue infection as a result of perforation of the sigmoid neoplasm. The rapidly progressive necrotic process in the soft tissues of the lumbar and gluteal region as well as necrotic process in the left thigh (with the predominant lesion of the superficial fascia, subcutaneous fat and skin) led to the formation of an extensive postnecrectomic wound defect with an area of more than 1000 square centimeters. In addition to the severity of illness, the patient's belated treatment and the underestimation of the clinical situation by surgeons who provided emergency care contributed to such an extensive spread of the pathological process. The development of sepsis was accompanied by severe multiple organ failure. Because of the severity of the patient's condition, the surgical removal of the sigmoid neoplasm extended in the abdomen wall became possible only after its stabilization as a result of surgical focal sanation and complex intensive therapy in the conditions of the ICU. The most important point of the stage-by-stage surgical treatment was the choice of methods for the plastic closure of an extensive postnecrectomic wound that involved the entire left gluteal region, part of the lumbar and antero-inner surface of the left thigh. Taking into account the size and localization of the defect, the plastic reserves of the surrounding skin, the wound was closed in three stages with the help of combined plastic surgery techniques: with local tissues by the method of tissue expansion and a split-thickness skin graft.

© КОЛЛЕКТИВ АВТОРОВ, 2018 The most abundant protozoan Blastocystis spp. from human and animal intestines is one of the poor-studied pathogens causing the occurrence of a protozoal infection of the human gastrointestinal tract. In Russia, no Blastocyst invasion is recorded and neither included in the forms of state statistical reporting. The manifestations of the epidemic process of blastocyst can be judged based on a small number of studies. Analysis of clinical observations and literature data indicates a variety of forms, localization, and nature of the infection manifestation. This article is devoted to substantiating the need to detect blastocysts in environmental objects (water, soil, surfaces) as potential risk factors for the occurrence of a protozoal infection. At the same time, the studies both of the survival duration in the external environment and influence of various factors the Blastocystis survival have both the theoretical and practical importance. This information can be used in problems of epidemiology and epizootiology, for developing new methods for Blastocystis elimination, and identifying ways of spreading these parasites. Infection risk factors are sanitary and hygienic problems of environmental objects (geographical, environmental and social factors), profession features, contact with animals, use of contaminated water and food, immigration and travel to tropical countries, as well as people with weakened immune status.

© 2018, Dynasty Publishing House. All rights reserved. The article presents non-pharmaceutical methods of rehabilitation of children with acute respiratory infections (ARI) used at a hospital, polyclinic (rehabilitation centre), medical resort. Specificities of administering medical exercise therapy, massage, inhalation therapy, balneo-halotherapy and other methods at different stages of rehabilitation are discussed. The authors analyse the results of research works that are demonstrative of the necessity of including in rehabilitation programmes for children with ARI of the drug levocarnitine that enhances their effectiveness. Administration of levocarnitine in doses of 50 to 100 mg/kg/day 2 times daily, as 1–1.5-month courses, prevents the development of repeat episodes of acute respiratory viral infections in children and reduces their duration, restoring the activity of immune cells. Also, recommendations are given to physicians about the use of Elcar® in children who fall ill frequently and for prevention of respiratory infections. physicians about the use of Elcar in children who fall ill frequently and for prevention of respiratory infections.

© 2018, Bionika Media Ltd.. All rights reserved. Urinary disorders in women with recurrent urinary tract infections (UTI) are a serious problem that has not yet been solved despite that there are a large number of papers on this topic. Pregnant women who have experienced acute urinary tract infection and those who have been treated for asymptomatic bacteriuria should be followed up until delivery, by examining their urine to prove the efficiency of antibacterial therapy that can threaten their pregnancy. It is necessary to emphasize the importance of prevention, timely detection of signs of UTI in pregnant women and the correct choice of antibiotic therapy in the developed UTI.

© 2018 Media Sphera Publishing Group.All Rights Reserved. In the article we present three clinical observations demonstrating that HCV infection in patients with remission of Wilson disease causes an recrudescence of the disease, in one of the observations - decompensation of liver cirrhosis. In this study we first describe on the successful treatment of HCV infection with direct antiviral drugs in patients with Wilson disease. Establishment of all factors of liver damage and successful treatment (elimination of the virus, adequate lifelong medical treatment) allow to expect a favorable prognosis in patients with a combination of Wilson disease and HCV infection.

© 2018 Media Sphera Publishing Group.All Rights Reserved. The aim of the study was to evaluate the clinical and interferon-modulating efficacy of a combination of rectal and topical dosage forms of IFN-α2b with antioxidants in the treatment of acute respiratory infections (ARIs) in comparison with other variants of antiviral therapy. Materials and methods. A total of 90 servicemen aged 19.2±0.9 years with uncomplicated forms of ARI were hospitalized not later than 48 hours after the onset of the disease. Patients were randomized into 3 groups of 30 people each. In the first group, patients received rectal suppositories containing IFN-α2b (1 million IU) and antioxidants (alpha-tocopherol acetate and ascorbic acid) twice a day for 5 days. In the second group, patients received intranasally a gel formulation containing IFN-α2b (36 000 IU/1 g) and antioxidants 3 times a day in addition to the above suppositories. In the third group, patients were prescribed umifenovir (reference drug) at dose of 200 mg 4 times a day for 5 days. The dynamics of regression of clinical manifestations of ARI in different groups, changes in concentrations of IFN-α and IFN-γ in blood plasma, as well as spontaneous and induced production of these cytokines by blood cells ex vivo were evaluated. After that, the patients were observed for another 3 months to register repeated cases of hospitalization for ARI. Results. Marked tendency to accelerate the regression of symptoms of intoxication and fever was observed when intranasal dosage form of IFN-α2b was administered to patients receiving the rectal form of this cytokine. The combination of rectal and topical dosage forms of IFN-α2b with antioxidants was more effective than monotherapy with the rectal suppositories in preventing repeated hospitalization for ARI. The above combination caused the most complete correction of induced production of IFN-α by blood cells ex vivo at its initial deviation from the norm. Conclusion. The obtained data indicate the expediency of using the combination of rectal and topical dosage forms of IFN-α2b with antioxidants for treatment of ARI.

© Bionika Media Ltd. Objective. To investigate the clinical efficacy of Elgyna in the medical treatment of human papillomavirus (HPV)- associated cervical intraepithelial neoplasias (CIN). Subject and methods. The results of antibacterial therapy prior to destructive treatment were comparatively analyzed in 53 patients with severe dysbiosis in HPV-associated CIN. A study group included 27 patients who took the combined drug Elgyna as one vaginal tablet twice daily (6 administrations); a comparison group of 27 patients received the combined drug Tergynan as one vaginal tablet twice daily (6 administrations). A control group comprised 20 women with the visually unchanged cervix. All the women underwent standard examinations and vaginal microbiocenosis estimation by RT-PCR assay using the Femoflor test. Results. The use of the combined drug Elgyna during medical treatment before destruction was found to normalize molecular biological parameters at the local level and contributes to a significant reduction in the time of epithelialization and a decline in the number of recurrences. Conclusion. HPV-associated cervical neoplasias are accompanied by the development of pronounced dysbiotic processes in the vagina with the predominant involvement of obligate anaerobes. Taking into account the properties of the combined drug Elgyna that provides a normalizing effect on the parameters of biocenosis in accelerating healing and in preventing a recurrence of the process, it is appropriate to prescribe the drug before destructive treatments.

© 2018 Dynasty Publishing House. All rights reserved. The systematic review provides a justification for the value of innate immunity as an initial, necessary and determinant stage in the development of adaptive immunity. The participation of TLRs as a leading component of PRRs-system in maintaining natural congenital anti-infection resistance and homeostasis of the organism, in launching and dynamics of development of adaptive immunity to pathogens of infectious and non-infectious genesis was studied in detail. The importance of the influence of these pathogens on the homeostasis of the organism, on the formation of disturbances in anti-infective resistance at the organism and local levels, revealing new pathophysiological and immunological pathogenetic mechanisms of the development of these pathological processes is established. The colossal gap between fundamental studies of the biology and morphology of microorganisms and clinical studies of the diseases they cause is shortening. In an accessible form, explanations are provided for the absence of symptoms, the possibility of atypical manifestations, and the asymptomatic course of infection. There are new wide opportunities to improve and enhance the information content and personalization methods of diagnosis, treatment and prevention, as well as the creation of pharmaceuticals that act detrimental to all forms of cycle of development of pathogens, and new immunomodulatory drugs for the most effective treatment and prevention of diseases.

© 2018, Dynasty Publishing House. All rights reserved.  Objective: to evaluate the possibility of creating a human model of acute Helicobacter pylori infection in healthy volunteers after infecting them with a mutant rifampicin-resistant strain of H. pylori KM-11 (Rif R ), to obtain evidence of H. pylori survival and invasion into the gastric mucosa, describe the symptoms, and assess the efficacy of H. pylori eradication therapy with Stimbifid plus. Materials and methods. In our experiments, we used conventional white mice of both genders weighing 18–20 g. The concentration of bifidobacteria, lactobacilli, and Escherichia (CFU) in animal faeces was determined by inoculating tenfold dilutions of biomaterial onto solid media and further counting of bacterial colonies grown after the incubation period. Microorganisms were cultivated in an anaerobic incubator and then identified by morphological evaluation and using biochemical identification kits. We created a murine model of H. pylori infection by oral administration of H. pylori KM-11 (Rif R ) suspensions to immunocompromised mice that had earlier undergone intramuscular administration of dexamethasone. For a human model of H. pylori infection, we selected healthy male volunteers. They took suspensions of H. pylori KM-11 (Rif R ) isolates in isotonic sodium chloride solution. Fecal specimens were collected from volunteers on daily basis during the entire follow-up period and then 2 weeks and 1 month after treatment completion. Fecal suspensions in isotonic sodium chloride solution were inoculated onto the selective hemin-containing solid media with rifampicin at a concentration of 160 µg·mL –1 . The results of this experiment (H. pylori colony count) were used to evaluate the efficacy of H. pylori eradication therapy with Stimbifid plus. Results. Both in vitro experiments and murine models demonstrated high anti-H. pylori activity of Stimbifid plus and its ingredients, restoration of the gastric microbiota, restoration of gastric colonization resistance, and eradication of H. pylori KM-11 (Rif R ). Self-infection with H. pylori KM-11 (RifR) caused acute infection in volunteers. The disease manifested with mild ailment, epigastric discomfort, belching, increased stool frequency, and changes in the color of stool. The detection of H. pylori KM-11 (Rif R ) in the faeces of volunteers and isolation of pure cultures prior to treatment initiation indicated bacterial adhesion to gastric mucosa and survival of microorganisms. Treatment with Stimbifid plus caused gradual decrease in the number of bacteria isolated from feces and their complete elimination by day 11 of therapy. All fecal specimens collected 2 weeks and 1 month after therapy completion from volunteers were negative for H. pylori KM-11 (Rif R ). None of the study participants required in-patient treatment. Conclusion. The results of our experiments obtained in both murine and human models of H. pylori infection will be used for more detailed assessment of this pathological process, clinical manifestations, impact of H. pylori virulence factors on the host, choosing new methods for the prevention and treatment of chronic gastritis caused by H. pylori, and monitoring the efficacy of eradication therapy.

© 2018, Bionika Media Ltd. All rights reserved. Aim. To investigate the clinical features of the course and outcomes of pregnancy and placental morphology in HIV-infected pregnant women. Material and methods. This study is a retrospective analysis of 29 pregnant women. The study group comprised 14 pregnant women with antenatal human immunodeficiency virus infection. Fifteen women with a physiological course of pregnancy made up a control group. The mean age of patients in the study and control group was 28.0 ± 2.6 and 21.1±2.3 years, respectively. The analysis included gynecological history, the course of pregnancy and childbirth, and perinatal outcomes of newborns. The morphological study of placenta included macroscopic and histological examinations, and immunohistochemical studies using antibodies targeting CCR5 receptors. Results. Pregnant women in the study group had a gynecological history of sexually transmitted infections. The most frequent complications of the second and third trimesters of pregnancy were anemia (78.6%), the threatened preterm birth (35.7%), and preeclampsia (28.6%). Complications of labor were premature rupture of membranes (35.7%) and uncoordinated uterine activity (14.3%). Placental morphology showed signs of inflammation and hypoxia. Immunohistochemical studies identified a higher expression of CCR5 in chorionic villi. Conclusion. The findings indicate increased levels of CCR5 expression and the development of chronic placental insufficiency in HIV-infected pregnant women, which indicates the need for dynamic monitoring of this group of patients.

© 2018. Modern medicine, relying on a verified strategy and consistent approach, has proved that to date, HIV infection, thanks to effective antiretroviral therapy, has evolved from a category of incurable and deadly diseases into a nosology potentially controlled by medical and diagnostic measures. Moreover, as shown by numerous studies, not only clinical, but also the population effect has been achieved. The life expectancy of HIV-infected people has increased, its quality has significantly improved, and the number of potential sources of infection has decreased. The concept of «treatment as prevention» at the present stage becomes an integral part of the complex of measures to combat HIV infection, since the early onset of ART can significantly reduce the risk of transmission of the pathogen, as well as the level of AIDS-associated morbidity and mortality. In addition to ART, the principles of comprehensive prevention remain unshakable, taking into account the modern epidemiological features of HIV infection.