[Sporadic and group imported cases of hepatitis E in St. Petersburg].

AIM: Carry out retrospective clinical-epidemiological analysis of sporadic and group cases of acute HE morbidity in St. Petersburg (2000 - 2012). MATERIALS AND METHODS; Medical histories of 11 patients with sporadic morbidity (9 males and 2 females, average age 36 +/- 18) and 13 patients involved in group HE morbidity were analyzed. Acute hepatitis E diagnosis was established based on common clinical-epidemiological criteria confirmed by results of biochemical study and data of objective examination. Hepatitis E etiological membership was confirmed by detection in patient blood sera of specific marker of infection--anti-HEV G and M classes with laboratory exclusion of hepatitis A, B and C. RESULTS: Study of epidemiological anamnesis of patients showed that 8 of them were migrants from countries with tropical and subtropical climate. 3 patients were residents of St. Petersburg. In the end of December 2011 and in January 2012 a group HE morbidity was registered among those who had arrived to study in St. Petersburg from India (Mumbai) in a group exceeding 200 individuals. Clinical characteristic of acute HE during sporadic and group morbidity is given. CONCLUSION: The presence of sporadic and group HE morbidity in St. Petersburg indicates the necessity to register these situation in organization of protection of the territory of Russia from endogenous HE.

[Chronic viral hepatitis in St.Petersburg].

Morbidity data on chronic viral hepatitis including cirrhotic stages of disease and lethality indexes in St. Petersburg are provided. The necessity of isolation in ICD- 10 and statistical accounting of chronic viral hepatitis diagnosis with outcome into cirrhosis (cirrhotic stage) is shown. During use of viral etiology liver cirrhosis diagnosis the disease is registered in the structure of liver diseases which does not allow to have data on unfavorable outcomes of chronic viral hepatitis and for complete morbidity accounting.

[Clinical and economic expedience of ertapenem therapy of complicated urinary tract infection].

Clinical and economic investigation of various antibiotics use in the treatment of complicated urinary tract infection (CUTI) was performed under the Russian economic environment. The drugs of comparison were ertapenem, ceftriaxone and levofloxacin. Direct costs and their structure were shown, and the cost efficiency was calculated. Alternative analysis and one-side susceptibility analysis were performed. In complicated urinary tract infections when the major pathogens were Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis it was clinically and economically reasonable to start the treatment with ceftriaxone or ertapenem, while levofloxacin could be an alternative strategy. When the effects of the acquired resistance on the treatment effectiveness were evaluated (SIS model) it was shown that the pathogens susceptibility to ertapenem was preserved for a significantly longer time than that to ceftriaxone or levofloxacin (60 months). Such a parameter may serve as an additional evidence of the reasonable use of ertapenem as the starting treatment of CUTI.

[Evaluation of antiepileptic effects of cortexin in a model of convulsions].

We studied antiepileptic effects of cortexin administered in doses 0,015, 0,15 and 1,0 mg/kg intraperitoneally in solution or intranasally in the complex with nanoparticles in a model of acute and chronic convulsions in rats induced by pentylenetetrazole. In the model of epileptic status, the long-term preliminary administration of cortexin had no effect on convulsions while in the model of chronic convulsions (temporal epilepsy), cortexin had a marked dose-dependent antiepileptic effect. The influence of cortexin on neuroplasticity and its clinical potential are discussed.

[Brain natriuretic peptide detection in patients with chronic heart failure of elderly and senile age].

This article describes the diagnostic possibilities of research of NT-BNP level in blood of the patients of elderly and senile age with congestive heart failure. Statistically significant correlation between BNP concentration and a functional class of heart insufficiency is revealed. Definition of BNP level enables to diagnose differentially the difficult forms of congestive heart failure.

[The topical problems of morphological diagnosis and the pathomorphism of HIV infection].

The paper analyzes the frequency of admissions to the S. P. Botkin Clinical Infectious Hospital and the City AIDS Center among patients with HIV infection and the structure of fatal outcomes. It is concluded that there is a considerable increase in mortality and the number of patients needing hospitalization. The dead HIV-infected patients autopsied at the Unit of Morbid Anatomy, S. P. Botkin Hospital, in the past years are characterized in detail. The topical problems of HIV infection the solution of which require the participation of pathomorphologists are discussed.

[Predictive value of variability of the laboratory indices in the development of premature aging].

Diagnostics of those or other pathological processes is connected with an estimation of deviations of corresponding laboratory indexes from their reference values. Results of the research enable to use the indexes of individual variability of laboratory tests as a criterion of individual resistance, which has a prognosis value in studying of age pathology. It also essentially expands ideas about activation of the peroxide oxidation of the lipids as the basic trigger factor of the accelerated aging.

[Hepatoprotective activity of remaxol in patients with chronic hepatic disorders].

This milticentre randomized clinical study of the efficiency of remaxol infusion solution (hepatoprotective medicine for chronic liver dysfunction) included 494 patients with chronic hepatitis B and C. 294 of them staying in 7 clinics were given remaxol and 200 ones received placebo. Randomization was achieved by the envelope method. A detailed description of clinical and laboratory characteristics of the diseases is presented. Effects of remaxol vs placebo on the functional activity of affected liver are discussed. Results of laboratory and clinical analysis indicate that mechanism of remaxol action is based on hepatoprotective, antioxidative, and anticholestatic activities of the drug.

[Akatinol memantine in patients with vascular cognitive disorders].

Treatment of cognitive disorders developed in cerebrovascular pathology is an actual medical problem. Of great importance is the timed diagnosis of these changes in the earlier phases of the development of cognitive deficit as well as adequate therapy that can delay and prevent the development of such complication as dementia. Pathogenetic mechanisms of cognitive disorders are associated with brain vascular and neurodegenerative changes that determine using drugs with vasoactive, metabolic and/or neuromediator effects. Memantine (the active component of akatinol memantine) is a drug that exerts an effect on the glutamatergic system, a non competitive antagonist of NMDA-receptors. The results of studies on the efficacy of this drug in moderate cognitive disorders are inconsistent and the amount of research is small. The present study aimed at the evaluation of changes of neuropsychological parameters in patients with moderate cognitive impairment caused by cerebrovascular pathology who were treated with memantine compared to the control group. Results of randomized open study suggested a significant clinical efficacy of akatinol memantine in the treatment of patients with vascular cognitive disorders. The treatment with akatinol memantine in dose 20 mg/day (10 mg twice a day) during six months significantly reduced cognitive deficit. The most distinct dynamics was related with ideation praxis, visual-spatial and speech functions, word selection, storage of instructions, increasing of volume of audio-speech and visual memory.

[Anxiety level during morphine abstinence correlates with the status of nitrergic system in the rat hippocampus].

Opiate addiction is accompanied by long-term structural and functional changes in brain regions persisting during abstinence, this status being an experimental model of the aberrant neuroplasticity. Nitric oxide is known to be involved in mechanisms of psychopathological events during opiate abstinence. In this study, indices of a nitregic system (nitric synthase activity--NOS, nitrites and nitrates concentration--NOx-) were measured in the rat brain region during morphine abstinence. Prior to this, the rats were tested for anxiety in an elevated plus maze. NOS activity increased in hippocampus 3 days after morphine withdrawal, while NOx--6 days after withdrawal. No changes of the nitrergic system could be revealed in other brain regions under study. Six days (but not 3 days) after morphine withdrawal, rats visited the open arms of the plus maze more frequently and spent more time in these arms as compared with respective controls. The data suggest that nitrergic system changes in the hippocampus may be involved in molecular mechanisms of behavioural alteration during morphine abstinence in rats.

[Nitric oxide synthase activity and nitrates/nitrites level in brain regions during the spontaneous morphine withdrawal in rats].

Nitric oxide synthase (NOS) activity and nitrate/nitrites (NO(x)-) concentrations were measured in brain regions of rats during the spontaneous morphine withdrawal. Male Wistar rats were injected intraperotoneally with morphine hydrochloride at increasing doses (10-100 mg/kg) during 6 days twice a day. Thirty six hours after the last injection the severity of the spontaneous morphine withdrawal syndrome was determined by specific autonomic and locomotor indices. Both NOS activity and NO(x)- levels increased in the midbrain and the hippocampus, decreased in the striatum and the hypothalamus, and did not change in the cerebral cortex and the brain stem. NO(x)- concentrations in the cerebellum did not change, while NOS activity decreased. Both NOS activities and NO(x)- concentrations in the cerebral cortex, striatum, midbrain, and cerebellum correlated with withdrawal syndrome severity on the whole, and with the specific signs of abstinence.

[Effects of intracerebroventricular administration of a caspase-3 inhibitor Z-DEVD-FMK on behavior of rats].

Rats received intracerebroventricular injections of z-DEVD-FMK (caspase-3 inhibitor) or z-FA-FMK (control peptide) in a dose of 3 nmol. Administration of z-DEVD-FMK significantly decreased the number of avoidance reactions in some blocks of trials in active avoidance (shuttle box) learning. However, only slight effect of the caspase inhibitor across the session was found. Z-DEVD-FMK impaired development of some essential components of the two-way active avoidance performance, such as escape reaction, conditioned fear reaction, and inter-trial crossings. Z-DEVD-FMK did not impair working memory in the spontaneous alternation behavior paradigm. Z-DEVD-FMK affected neither emotionality nor locomotor activity in the open-field test. It also did not influence behavior in the light-dark chamber. Measurement of caspase-3 activity in rat brain regions involved in active avoidance learning revealed z-DEVD-FMK-related inhibition of the enzyme activity most pronounced (about 30%) in the fronto-parietal cortex; a similar effect was close to significant in the hippocampus. The results suggest the involvement of brain caspase-3 in selected forms of learning.

[Statistical indices in medicine and epidemiology and their classification].

Mathematical statistics deals with abstract notions, while medicine solves complicated and many-sided problems. For this reason medical statistics faces some moot points in the interpretation of a number of notions and the classification of statistical indices. In the present article the definition of variables and statistical indices is formulated and their characterization is given. An attempt is made to provide the systematization and natural classification of the latter. Statistical indices are defined as the characteristics of statistical totalities. To classify statistical indices, the most essential signs are used: the character of a variable (external relations), the trend of study (internal content), the form of expression (calculation), derived indices and characteristics (comparison and the results of analysis).

[Using thioGlo-1 for the determination of thiols in brain tissue]. / Opredelenie tiolovykh grupp v tkani mozga pri pomoshchi Thioglo-1.

A technique for the fluorometric determination of protein and non-protein thiols in brain tissue with the maleimide reagent ThioGlo-1is has been described. Comparison with the most popular spectrophotometric Ellman method has been performed. The ThioGlo-1-based method is highly sensitive and may be used for thiol determination both in homogenates and supernatants of brain tissue.

[Electroconvulsive shock causes neuronal death in the mouse hippocampus: correlation of neurodegeneration and convulsive activity]. / Elektrokonvul'sivnyi shok vyzyvaet gibel' neironov v gippokampe myshei: korreliatsiia neirodegeneratsii s sudorozhnoi aktivnost'iu.

Relations between seizures induced by repeated electroshock (ES) and structural changes in the hippocampus were investigated in Balb/C mice. Brain sections of the animals 2 or 7 days after the last ES were stained for Nissl or TUNEL (apoptotic nuclei). Direct measurement of caspase-3 activity (a key enzyme of apoptosis) in brain regions was performed immediately after the last ES. Statistically significant, albeit moderate cell loss was demonstrated in the CA1 field and dentate gyrus, but not in the CA3 field of the hippocampus. The number of neurons in these fields inversely correlated with seizure severity. No apoptotic nuclei could be revealed either in hippocampus or in other brain regions. Caspase-3 in the hippocampus decreased after ES. The data obtained support the results from other groups showing prominent functional changes in neurons induced by repeated ES and extend this concept directly testifying for a moderate (within 10%), albeit statistically significant neuronal death in selected hippocampal fields. The inverse correlation of cell number with severity of seizures suggest that these are seizures inducing neuronal death.

[Effects of morphine withdrawal on the indices of free radical homeostasis and nitric oxide system in rat liver and thymus]. / Vliianie sindroma otmeny morfina na pokazateli svobodnoradikal'nogo gomeostaza i sistemu oksida azota v pecheni i timuse krys.

Indices of oxidative stress, nitric oxide (NO) metabolism as well as the activity of caspase-3, an important enzyme of apoptotic cell death, were measured during the morphine withdrawal syndrome in liver and thymus of rats. Male Wistar rats were administered with morphine hydrochloride (i.p., at increasing doses from 10 to 100 mg/kg, twice a day, for 6 days). Thirty-six hours after the last administration the withdrawal syndrome was monitored using the specific autonomic and locomotor indices. During this period, weights of body and thymus significantly decreased. Oxidative stress in liver was accompanied by an increase in aspartate aminotransferase and gamma-glutamyl transferase in blood serum. No signs of oxidative stress could be demonstrated in thymus. The activity of the Ca(2+)-dependent isoform of nitric oxide synthase (NOS) in liver increased, while, the activity of the Ca(2+)-independent NOS diminished, the total activity of NOS in liver and thymus remained unchanged. The concentration of nitrates/nitrites in blood was decreased, in thymus increased, and in liver unchanged. Caspase-3 activity changed neither in liver, nor in thymus. The results are discussed from the perspective of possible antioxidant and antiapoptotic role of NO during morphine withdrawal syndrome.

[Caspase-3 inhibition blocks long-term potentiation in hippocampal slices]. / Ingibirovanie kaspazy-3 blokiruet dlitel'nuiu potentsiatsiiu v srezakh gippokampa.

Incubation of hippocampal slices with Z-DEVD-FMK, a specific inhibitor of caspase-3, elicits a time dependent decrease in long-term potentiation (LTP). After 4 hours or later after the incubation with Z-DEVD-FMK the tetanization fails to induce LTP. However, Z-DEVD-FMK does not affect basal indices of synaptic plasticity and short-term plasticity (population spike amplitudes and paired pulse facilitation). The results are the first evidence for the involvement of caspase-3-mediated mechanisms in long-term potentiation phenomenon.

[Morbidity: terminology, mechanisms of formation and classification]. / Zabolevaemost': terminologiia, mekhanizmy formirovaniia i klassifikatsiia.

In the 70-ies of the last century the evolution of the epidemic process doctrine resulted in developing population approach to morbidity analysis, in addition to the traditional focal approach. On the one hand, this led to the discussion on the possibility of applying such notion to non-infectious diseases and, on the other hand, to the discussion on the mechanisms of the development and formation of different manifestations in infectious diseases. In both cases the discussion was centered on the phenomenon of morbidity. The present article deals with the nature of morbidity as a phenomenon and the acceptability of general scientific approaches in the interpretation of seasonal and cyclic character of morbidity from the viewpoint of the wave process in an open system. On the basis of the data presented in this work the terms used in epidemiology in considering manifestations of the epidemic process are discussed. The improved classification of morbidity by qualitative and quantitative signs for infectious diseases is proposed.