Репозиторий Университета

© 2018 Elsevier B.V. Background: Very recently, a novel European hantavirus, Sochi virus, has been discovered which causes severe courses of hantavirus disease with a case fatality rate of about 15 percent. Objectives: We aimed to study to which extent and with which clinical severity children were affected by Sochi virus infection. Study design: Sochi virus infection of patients was confirmed by molecular, serological, and epizoonotic studies. Clinical and laboratory parameters were analyzed for the age group of up to 15 years (n = 6) in comparison to all older patients (n = 56). Results: 9.7 percent of patients with hantavirus disease studied (6/62) were up to 15 years old. The children showed moderate to severe clinical courses similarly to the situation in adults. Conclusions: While children are in general considered to be less affected by hantavirus infections than adults, in case of highly pathogenic hantaviruses, such as Sochi virus, frequency of clinical cases as well as their clinical course are comparable between children and adults. Therefore, hantavirus disease, particularly in regions endemic to highly pathogenic hantaviruses, should be considered in cases of unclear fever and kidney/pulmonary failure in children.

© 2018 Meditsina Publishers. All rights reserved. Results of medico-sociological studying of specifics of social installations of the population concerning HIV-infected citizens are presented in article. The conducted research shows that now the deficiency of objective information on a problem of HIV-infection/AIDS is observed, and negative installations of russians concerning HIV-infected persons still remain widespread social practice. Authors note that despite efforts of the state, medical and public organizations on increase in level of tolerance of the population concerning HIV-infection/AIDS, the fact of establishment of the diagnosis «HIV-infection», besides problems of medical character, causes change of the social status HIV-infected and also attracts extensive social and reputation losses – that, in general, distances the HIV-infection carrier from other population and intensifies social inequality.

© 2018 Meditsina Publishers. All rights reserved. Results of medico-sociological studying of level of readiness of Russians for vaccination against HIV- infection/AIDS are presented in article. The conducted research shows that now HIV- infection is associated at Russians with consumption of drugs and insufficient social responsibility of youth and also with risks at delivery of health care and implementation of cosmetic procedures. Authors note that in spite of the fact that development of vaccine against HIV-infection/AIDS is represented to the interviewed Russians one of possible ways of overcoming epidemic, respondents perceive personal participation in vaccination against HIV- infection/AIDS as a high-risk step.

© 2018 Meditsina Publishers. All rights reserved. Results of the medico-sociological research directed to studying of the ideas of the HIV-infected widespread in modern Russian society are presented in article. The obtained data have allowed to design a modern social portrait of the HIV-infected Russian. Now in representations of Russians the typical HIV-infected - the young childless and single man regardless of sexual orientation who is living in the large city, having an average special educations or being in process of that receiving which level of income we will compare with a living wage. The HIV-infected has been infected as a result of a youth error (the unprotected sexual contact or the intravenous use of drugs) and lives with this diagnosis several years, leads a risk-free life more often, at the same time usually hides the diagnosis and separates from social communications.

© 2018, Dynasty Publishing House. All rights reserved. The objective. To specify the frequency and species composition of vaginal bacterial carriage in pregnant women at the term of gestation 35–37 wks. Patients and methods. We examined 800 pregnant women, who were followed-up on an outpatient basis at terms of gestation 35–37 wks. Cultural examination of the content of the posterior vaginal fornix was performed. Species identification of microorganisms was performed by the method of direct protein profiling with the help of MALDI-TOF mass spectrometry, FLEX series, Bruker Daltonic GmbH, Germany. Results. The growth of flora was obtained in 761 patients (95%). Bacterial vaginosis (n = 71), Candida vulvovaginitis (n = 83) were diagnosed in 154 patients (19%). Lactobacillus spp. were found in 80% (n = 637) of examined women, of them in 161 (20%) in monoculture. Bacterial carriage was diagnosed in 55.8% of cases. The prevalence of Enterococcus faecalis, Escherichia coli, Streptococcus agalactiae, Staphylococcus epidermidis and Staphylococcus haemoliticus was noted. They were much more rarely detected in monoculture: E. faecalis (1%), S. agalactiae (0.1%), S. epidermidis (0.1%), Candida albicans (0.1%). In 39 (5%) patients, no growth of flora was found. In 17 patients we found extended-spectrum B-lactamase-producing bacteria: E. coli (n = 15), Klebsiella pneumoniae (n = 2). Conclusion. Taking into account a high prevalence of vaginal bacterial carriage in pregnant women in the 3rd trimester, it might be expedient to consider inclusion of microbiological examination of vaginal discharge in the basic spectrum of antenatal observation and screening examination of pregnant in the Russian Federation.

© 2018, Dynasty Publishing House. All rights reserved. At present the incidence rates of urogenital chlamydiosis maintain the leading positions among sexually transmitted infections. Special attention to this infection is conditioned by a high risk for development of complications on the part of the reproductive system in both women and men. The ability of Chlamydia to affect various tissues accounts for a broad spectrum of clinical manifestations of urogenital pathologies: urethritis, vulvovaginitis, cervicitis, endometritis, salpingitis, epididymitis, prostatitis, proctitis, and also extragenital forms of disease. Taking into account a possibility of transition of Chlamydia infection into a latent stage with subsequent development of a chronic persisting course, early and adequate management of infection is of considerable importance. Etiotropic therapy of Chlamydia infection employs antibacterial drugs capable of penetrating into cells. Tetracycline antibiotics are the most effective drugs of choice administered as part of complex therapy. Minolexin is a tetracycline antibiotic that demonstrates the best effectiveness in the fight against infectious agents affecting the urogenital tract. The article presents the author’s clinical experience of using minolexin for management of urogenital chlamydiosis in 60 patients.

© 2018, Dynasty Publishing House. All rights reserved. The objective. To study the effectiveness, safety and tolerance of Viferon® (human recombinant interferon alpha-2b with antioxidants vitamins Е and С) as compared with standard therapy in complex treatment of mixed female urogenital infections during pregnancy and the effect of Viferon® on the formation of immunity in ontogenesis and during the early adaptation period of newborns. Patients and methods. The study included 70 women aged 18 to 40 years with mixed urogenital infections. The treatment group included 36 patients, who received etiotropic antimicrobial and antiviral therapy, underwent correction of immune status disorders and restoration of vaginal colonisation resistance. Along with standard therapy, patients of the treatment group received Viferon®, suppositories 500 000 IU, according to the schedule: 1 suppository 2 times/day every day for 10 days, then 1 suppository 2 times/day for 9 days with a 3-day interval. Aftre that, Viferon®, suppositories 150 000 IU 1 suppository 2 times daily every day for 5 days every 4 weeks until delivery. The control group comprised 34 patients who received standard therapy without interferon correction. All patients received standard therapy appropriate for their disease. Results. Among the patients receiving Viferon®, the development of placental insufficiency was recorded by 2 times more rarely. In the treatment group (Viferon®), fetal growth restriction (IUGR) was diagnosed only in 8.3%. In the control group, IUGR was found in 22% (OR + 2.65). In the treatment group, the incidence of fetal CMV infection was reduced by 16 timesd anf of herpesvirus infection type 2 – by 10 times. In the group of patients who did not use Viferon®, the share of newborns with CNS lesions amounted to 18.4%, whereas in the treatment group it approached 6.5% (OR –2.83). Inclusion of Viferon® in complex therapy resulted in a lower incidence of infectious lesions of the skin and mucous membranes of the newborn infants (amniotic fluid infection syndrome) by 5.8 times. Colclusion. The use of Viferon® (human recombinant interferon alpha-2b with antioxidants vitamins Е and С) suppositories in complex therapy in pregnant women with infection promotes a faster elimination of viruses, a significant decrease of the signs of threatened miscarriage, premature labour, risk for developing PI and IUGR, associated with inflammatory process (p < 0.05).

The objective of the research was to elaborate experimental-theoretical and clinic-bacteriological rationale for the application of laser diagnostic for identification of main pathogens of purulent-inflammatory processes in maxillofacial area. For germs identification by giant Raman scattering effect SERS-substrate with nano silver metallic balls, reference strains (Ps. aeruginosa 27853 and S. aureus 25923) and clinical cultures of Staphylococcus, Bacillus and Escherichia coli were used. Using an example of purulent inflammation pathogens we considered that each of bacterial species is characterized by individual spectral lines of Raman scattering, which allows to identify them in short term (1-2 min). Moreover the proposed method is highly sensitive (105-106 CFU/ml). Creation of germs library and device portability makes use of laser diagnostic for express-indication purulent infections possible directly in clinical conditions. Thus, analytical capability, quick result, high sensitivity and peculiarity, economical effectiveness due to lack of necessity to use growth medium and to transport it to microbiological lab gives an opportunity to consider laser diagnostic as a perspective universal express-method of clinical microbiology.

© 2018 Copyright O. Zolnikova et al. We have reviewed the currently published results on a role of the gut microflora in a prevention of acute respiratory infections. The main biological properties of probiotic bacteria are presented in a context of their modulating activity on an inflammatory immune response. Available data on the reduction of a possible risk, duration, and severity of respiratory infection symptoms during a probiotic medication intake were analyzed. Potential antiviral probiotic mechanisms have been reviewed and discussed.

© 2018, Dynasty Publishing House. All rights reserved. Bronchial obstruction, developing in children of preschool age against the background of acute respiratory infection, is characterised by a high prevalence, heterogeneity of clinical signs, difficulties of differential diagnosis, and a tendency to recurrence. Treatment of an acute episode of bronchial obstruction in acute respiratory infection is pathogenetic, since it is aimed at alleviation of bronchial spasm, oedema and mucus hypersecretion, and also at elimination of respiratory failure and hypoxia, if present. Therapy should be started as soon as possible, at the appearance of the first clinical and physical signs of bronchial obstruction. Drugs of choice for stopping bronchial obstruction are short-acting (4–6 h) β2-agonists: fenoterol, salbutamol.

© 2018 Russian Academy of Sciences. Wide circulation of HIV-infection/AIDS is a socially important problem for the majority of the countries of the world now. Against the background of the remaining high rates of infection spread beyond the borders of risk groups, a series of the negative phenomena aggravating an epidemiological situation on HIV-infection and other socially important diseases is observed (tuberculosis, hepatitises, etc.): depression of the general indicators of health of the population, urbanization, complicating of life rhythm, wide circulation of dependences on psychoactive agents, and, above all - serious transformation of institute of family, liberalization of sex behavior, of traditional family values. Now in representations of Russians the typical HIV-positive-a young childless and single man regardless of sexual orientation who is living in the large city, having an average special educations or being in process of its receiving whith level of income comparable to average one. The HIV-positive has been Infected as a result of a youth error (unprotected sexual contact or the intravenous use of drugs) and lives with this diagnosis several years, leads a risk-free life more often, at the same time usually hiding the diagnosis and separated from social communications. Existence of this diagnosis involves social trouble and the social not approved behavior, but if the disease affects the loved one, many Russians are potentially ready to give moral and psychological support (56%), financial support (including in purchase of drugs), the help in search of necessary experts and visit of the medical organizations (6,9%) and also to care for the HIV infected and their children (6%). According to authors, the widespread negative perception of people with "HIV-infection" diagnosis is in many respects caused by insufficient informing the population on HIV-infection/AIDS problems.

The aim of the study was to assess the possibility of penetration of Escherichia coli bacteria into the dentinal tubules of the samples and determine the antimicrobial efficacy after 5 and 20 min exposition of 3% H2O2 (groups I and II) and 1 and 5 min exposition of 3% NaOCl (groups III and IV) for surface disinfection of bovine teeth. The samples were subjected to inoculation with E. coli suspension. The quality of disinfection was assessed with the three methods. The surface disinfection of samples proved to be effective only in groups II and IV. In the cultures of all dissolutions of dentinal chips suspensions in groups I, III and V there was a growth of E. coli in the form of a continuous pitch. In the group II a growth of Escherichia coli was revealed only in the initial dissolution in the quantity 1,8x101 CFU/ml, whereas in the group IV the growth was nil. Quantitative estimation of bacterial penetration using the method of maximum dissolutions revealed similar quantity of bacteria as in the group II as well as in the calculation of CFU. The application of 3% solution of H2O2 with the exposition of 20 minutes secures the qualitative surface disinfection of teeth without destruction of bacteria inside dental tubules and that allows to discover viable bacteria inside dentinal tubules.

© 2018 Media Sphera Publishing Group.All Rights Reserved. In the modern clinic of internal diseases, the specific gravity of the infectious pathology, manifested by various clinical syndromes, is increasing. Infectious pathology is represented by diseases of the respiratory system, heart disease (infective endocarditis, cardioimplant infections, viral myocarditis), infectious arthropathies, extrahepatic manifestations of viral hepatitis, cytopenic syndromes, various manifestations of sepsis and some other conditions.In most cases, the diagnosis and management of such patients is the responsibility of the internist, who must be able to suspect the infection and carry out its verification. In the process of diagnostic search and management of patients, close interaction of the internist with a clinical microbiologist, clinical pharmacologist and other related specialists is necessary.

© The authors team, 2018.All Rights Reserved. Purpose: to evaluate effectiveness of Oscillococcinum in the treatment of acute respiratory viral infections (ARVI) in children of different age groups. We observed 140 children from 1 to 14 years with mild to moderate-severe acute respiratory viral infection. 80 children (Group 1) were treated with Oscillococcinum, 60 children (Group 2) were treated symptomatically. Group 1 was divided into Subgroup 1А (40 children of 1-5 years old) and Subgroup 1B (40 children >5-14 years old). Group 2 was divided into Subgroup 2А (30 children of 1-5 years old) and Subgroup 2B (30 children >5-14 years old). The follow-up period was 7-10 days. Clinical efficacy was assessed by the severity of ARVI symptoms in scores from 0 to 2. All adverse events of the therapy were recorded. Also we evaluated disappearance of ARVI symptoms within 48 hours after the beginning of the therapy. Results: Oscillococcinum reduced the duration of ARVI in children of different age groups. During the first two days the symptoms of acute respiratory viral infection disappeared in 13 (16.3%) children of Group 1 receiving oscilococcinum and in 4 (6.7%) patients from Group 2 (OR = 2.7, 95 % CI 0.8-8.8, p <0.001). Conclusion: Oscillococcinum is an effective and safe drug to treat ARVI in children of different age groups.

© 2018, Dynasty Publishing House. All rights reserved. The objective. To study the effectiveness of two-step treatment of female patients with cervical intraepithelial neoplasia (CIN) associated with papillomavirus infection (PVI). Patients and methods. 126 female patients of reproductive age were examined (mean age – 31.4 ± 2.1 years), in whom CIN was associated with papillomavirus infection (PVI). In all cases, cervical pathologies – low-grade squamous intraepithelial lesions (L-SIL) have been found. In all patients treatment included a surgical step (laser and plasma energy) and medication, which was employed in 101 (80.1%) patients (treatment group). 25 (19.9%) women comprised the control group, since they did not receive post-operative pathogenetic therapy. In the treatment group, patients received an immunostimulating and antiviral drug inosine pranobex (IP) – Isoprinosine. Results. The effectiveness of treatment was assessed after 60 and 120 days from the termination of complex therapy (treatment group), or surgical intervention (control group). After a 60-day period, complete elimination of virus was noted 97 (96%) patients of the treatment group and in 18 (72%) of the control group. After 120 days, PVI relapse was recorded in 3 women of the treatment group (3%) and in 4 (22%) – of the control group among patients with complete elimination of virus. Conclusion. The use of IP as monotherapy is an optimal solution ensuring minimal risks of relapses of pathological PVI. Preparations of pure IFN and their inductors do not always promote complete elimination of PVI owing to interferon resistance of HPV-infected patients.

© Saint Petersburg Pasteur Institute. All rights reserved. The aim of the present systematic literature review is to summarize data on the role of TLRs in maintaining homeostasis of the female genitals, in maintaining the physiological development of pregnancy, provision of anti-infective resistance in pregnant women with intrauterine infection. The review substantiates the importance of TLRs of female genitals as a necessary and determining factor in the reaction to various changes in the environment, and also responsible for changes in metabolic, structural, or energy, in the maintenance of anti-infective resistance and homeostasis. As universal regulators of vital activity of organism TLRs in conjunction with other receptors of innate immunity provide maintaining the general reactivity and anti-infective resistance at the physiological level. In physiologically developing pregnancy in a background of immunosuppression in response to pregnancy TLRs during contact with infectious and non-infectious pathogens stimulate the production of nonspecific adaptive immunity factors (defensins, cathelicidins, histatines, etc.), which together with the non-specific innate factors lysozyme, complement, properdin, etc. support anti-infective resistance of the female genitals at a high level at the beginning of the infectious process. Possible violations of the development of pregnancy may be accompanied by changes in the response of TLRs to infectious and non-infectious factors until hyper-reaction, excessive inflammation or apoptosis, which requires adequate management of pregnancy. Was established the significance of the influence of pathogens of infectious and noninfectious origin in intrauterine infection indirectly through TLRs in the homeostasis of the organism, on the formation of breaches in anti-infective resistance at the organism and community level the identification of new pathophysiological and immunological pathogenetic mechanisms of development of pathological processes. IUI is a penetration of microorganisms into the tissues of fetus and it's infection. The inhibition of the functional activity of TLRs is accompanied by the direct effect of the pathogen on the tissues, and during hyper-reaction of TLRs to pathogens revealed a pronounced inflammatory response in the fetus. The level of expression of TLRs correlates directly with the severity of the process that can be considered as early markers of infection. Depending on the nature of the pathogen an increased expression of one or the other TLRs is observed. Explained the lack of symptoms, the possibility of atypical manifestations, the asymptomatic course of infection.

© 2018 Tomsk National Research Medical Center of the Russian Academy of Sciences. All Rights Reserved. The differential diagnosis of pulmonary diseases is extremely difficult and requires high qualifications of the radiologist and clinician. The differential diagnosis is used to distinguish different lung diseases: nonspecific inflammatory lung diseases (empyema, abscess, pneumonia), tuberculosis, sarcoidosis, benign tumors, lung cancer, lymphogranulomatosis, metastatic changes, and inflammatory changes in lung tissue. We present a clinical case, in which the differential diagnosis between tumor and inflammatory changes in lung tissue allowed the choice of optimal treatment tactics.

© 2018 Russian Electronic Journal of Radiology.All right reserved. Purpose: Complications after hip/knee/other joint arthroplasty develop in approximately 1-1.5% of young people and in 2.5-3% of elderly patients. Despite the meager chance of developing negative consequences, they can affect anyone, especially those who did not follow the rigorous rehabilitation program. Complications after endoprosthetics of hip/knee/other joints results from incorrect postoperative care and physical activity after discharge from the hospital. The second reason is technical approach of the surgeon. And third is an inadequate preoperative examination. The aim of the article is to have a detailed description of short term, midterm and long-term complications after joint replacement surgeries and of the methods (clinical and radiological) to avoid those complications with all the required parameters.

© 2018 Voprosy Sovremennoi Pediatrii - Current Pediatrics. All rights reserved. Background. Infections are the main cause of death for patients with autoimmune rheumatic diseases. In adult patients with rheumatoid arthritis (RA), mortality caused by respiratory infections is 2-5 times higher than in the population. One of the frequent infectious complications in the course of treatment with tocilizumab, the first-choice drug for treating systemic juvenile idiopathic arthritis (sJIA), is pneumonia characterized by a poor clinical picture, normal values of laboratory indices of the disease activity (ESR, C-reactive protein) with pronounced changes in the lungs revealed by computed tomography. In case of acute respiratory infection in children with systemic JIA, immunosuppressants and genetically engineered biological preparations (GEBP) are discontinued. This often leads to an exacerbation of the underlying disease and the progression of a pathological process. At present, vaccination against pneumococcal infection in Russia is not included in the standard for managing patients with rheumatic diseases. Studies of the safety and efficacy of vaccination with 13-valent pneumococcal conjugate vaccine (PCV) in patients with sJIA receiving genetically engineered biological preparations were not conducted. Clinical Case Description. The article shares the experience of vaccination of a girl aged 9 years with a 13-valent PCV that was conducted in the course of a scientific investigation, which studied the efficacy and safety of vaccination of children with systemic JIA prior to prescription of GEBP tocilizumab. Vaccination did not cause a deterioration in the course of the main disease (1 month), led to a reduction in the incidence of acute respiratory infections (from 4 to 1 time within 6 months before and after vaccination), and discontinuation of antibacterial drugs within 6 months after vaccination. Conclusion. The safety of a 13-valent PCV in a child with sJIA and a decrease of the incidence of respiratory diseases after vaccination, their complications, and the use of antibacterial drugs have been shown.