[Analysis of fatal outcomes of meningococcal infection in adults].

Clinical characteristics and pathomorphological manifestations in 69 patients aged 18 to 86 years with a fatal outcome of the disease were examined in order to analyze the causes of severe course and high mortality of generalized forms meningococcal infection. It was found that the main clinical form was meningococcemia (90%), in the majority in combination with meningitis (52%). The fulminant course in 77% of patients with meningococcal sepsis manifested itself as a sudden onset, rapid development of typical symptoms. Hemorrhagic exanthema was detected on the first day of meningococcemia. The leading complications and critical conditions were infectious-toxic shock, disseminated intravascular coagulation and acute adrenal insufficiency (Waterhouse-Friederiksen syndrome). The severe course of meningitis (in 10%) led to the development of cerebral coma, the morphological substrate of which was edema - swelling of the brain.

[Dynamics of vowel acoustic space indicators in patients with long-term hearing loss]. / Dinamika pokazatelei akusticheskikh treugol'nikov glasnykh zvukov u patsientov, stradayushchikh dlitel'nym narusheniem slukha.

New procedure of vowel acoustic space (VAS) (of vowel acoustic triangles) transformation for the purpose of characterization of vowel production in individuals with long-term hearing loss (HL) was developed. OBJECTIVE: To characterize VAS of adult Russian speakers with long-term HL using newly developed acoustic indicators. MATERIAL AND METHODS: Recordings of sustained Russian cardinal vowels /a/, /i/, /u/ of 10 women and 10 men with long-term HL were acoustically analyzed. For each participant, two first formants of each vowel were measured and log-transformed (logF1, logF2). VAS was transformed into right triangles, their /u/ corners were moved to the origin, and their legs were aligned with axes. VAS was almost symmetrical, equal and have a maximum size in the control group consisted of subjects without hearing impairment while these of long-term HL group VAS size tended to have reduced and VAS stretched along one axis. RESULTS: Our study showed that a new VAS normalization approach can distinguish at least three groups of people with long-term HL. CONCLUSION: There are those with vowel triangles stretched along logF1-axis, with vowel triangles stretched along logF2-axis, and with symmetrical vowel triangles. Causes of the VAS differences require further investigation.

Study of the Role of Hearing Aid on the Area of the Acoustic Field of Vowels.

The method of transformation of acoustic vowel triangles (AVT) /a/, /i/, /u/ was used for an objective assessment of the acoustic features of vowels in the speech production of 20 persons with long-term hearing impairment (LHI). The logarithm of the values ​​of the first two formants of each vowel (logF1, logF2) was determined for each subject. AVTs were transformed into the right-angled triangles, the vertices of the sound /u/ of which were moved to the origin of coordinates and the legs were aligned with the coordinate axes. In patients with LHI, the size of the triangles usually decreased, and they were stretched along one of the axes, which probably depends not only on the hearing loss severity but also on the duration of hearing aid use. The presented approach to the normalization of AVTs makes it possible to distinguish at least three groups of persons with LHI: in the first group, vowel triangles are stretched along the logF1 axis; in the second group, vowel triangles are stretched along the logF2 axis; and in the third group, AVT are symmetric.

[Tropical malaria with a fatal outcome]. / Tropicheskaya malyariya s letal'nym iskhodom.

Tropical malaria is an acute infectious disease from a group of parasitic diseases transmitted by the vector-borne route. Russia registers deaths due to imported malaria. The paper gives brief information on the epidemiology, etiology, and clinical manifestations of the disease and describes the fatal outcome of cerebral tropical malaria, as well as morphological changes in organs and tissues. The K76T mutation associated with drug resistance in parasites was identified in the structure of the plasmodium gene.

[Additive technologies for complete recovery of joint function in revision endoprosthesis surgery (experimental trial)]. / Additivnaia tekhnologiia v polnom vosstanovlenii funktsii sustava pri éndoprotezirovanii (éksperimental'noe issledovanie).

AIM: Experimental analysis of the strength properties of integration of muscle tissue, tendons and ligaments, bone tissue into titanium highly porous materials prepared by using of additive technologies. MATERIAL AND METHODS: The study included 9 mature rabbits of the Chinchilla breed. Both posterior paws and latissimus dorsi muscles (36 specimens) were used. Titanium models (Ti-6-Al-4-V, 'Rematitan', Germany) were made by additive technologies with preliminary prototyping, the prototypes had a highly porous mesh structure. RESULTS: It was developed experimental model of functional bone defect involving points of attachment of the muscle and ligaments. Strength of attachment of muscles to highly porous implants was 145 H vs. 31 H for standard models. Tensile strength for fixation to bone tissue was 84 H vs. 152 H in the main group. CONCLUSION: It was found integration of soft tissues and bones into highly porous titanium implants prepared with additive technologies. Fixation strength significantly exceeds that for standard models.

[Complexity of the therapy of P. falciparum - malaria in the Russian Federation].

The article presents a clinical case of malaria in a 29-year - old man without immunodeficiency, complicated by the development of infectious - toxic shock, anemia, kidney damage. The brief literature review discusses the complexity of etiotropic therapy, the problem of pathogen resistance to antimalarial drugs, pathogenetic mechanisms that contribute to the formation of shock, anemia and kidney damage in tropical malaria.

[ZIKA FEVER: CLINICAL, EPIDEMIOLOGICAL, LABORATORY, AND DIAGNOSTIC ASPECTS].

The authors overview data on the prevalence of Zika fever with reference to biological properties of the causative agent, epidemiological process, pathogenesis, and clinical symptoms of the disease. Special attention is given to the identification of the virus in pregnant women, microcephaly in the babies born by Zika-infected women, algorithm of laboratory diagnostics, and measures needed to prevent and control mosquitoes that spread viruses.

[Zika virus infection: clinical and diagnostic aspects and organization of preventive measures].

The article presents modem data about Zika virus outbreak, the biological characteristics of the pathogen, vectors, the nature of the epidemic process, pathogenesis and diagnosis of infection. This infection has a high potential for epidemic spread because vectors are widely represented in the fauna of many climatic and geographic zones. It presents information on the main clinical manifestations of the disease. Particular attention is paid to the problem of congenital maiformations of the nervous system (microcephaly and others) detected in infants born to women infected with Zika virus. The basis of therapy in this disease constitute a pathogenic agent. The'package of, measures for the prevention of disease caused by Zika virus, including early identification and treatment of patients, as well as measures for the destruction of the virus vectors.

POSSIBILITIES OF MODERN TECHNOLOGIES OF VISUALIZATION AND MODELING IN ORTHOPEDICS AND THEIR ROLE IN DEVELOPMENT OF INDIVIDUAL CONSTRUCTIONS IN HIP ARTHROPLASTY.

The article presents the authors' experience. Medical visualization is applied in orthopedics on all stages such as diagnostics, treatment planning and control of the results. Modern approaches in instrumental diagnostics and specialized application-dependent software allowed a new qualitative level of orthopedics and medical care in different areas of medicine. Modern technologies gave a lot of opportunities to doctors in order to improve diagnostics at higher level, make an individual planning of operations and built individual implants, when it wasn't possible to use standard constructions.

[EBOLA HEMORRHAGIC FEVER; ETIOLOGY, EPIDEMIOLOGY, PATHOGENESIS, AND CLINICAL SYMPTOMS].

The data on the prevalence of disease caused by Ebola virus, biological features of its pathogen, character of the epidemiological process, pathogenesis and clinical symptoms are presented. The disease is characterized by suppression of protective immunological mechanisms and systemic inflammatory reaction accounting for the lesions of vascular endothelium, hemostatic and immune systems. It eventually leads to polyorgan insufficiency and severe shock. Lethality amounts to 50%.

[EBOLA HEMORRHAGIC FEVER: DIAGNOSTICS, ETIOTROPIC AND PATHOGENETIC THERAPY, PREVENTION].

The data on diagnostics, etiotropic and pathogenetic therapy, prevention of Ebola hemorrhagic fever are presented including diagnostic algorithms for different clinical situations. Fundamentals of pathogenetic therapy are described. Various groups of medications used for antiviral therapy of conditions caused by Ebola virus are characterized. Experimental drugs at different stages of clinical studies are considered along with candidate vaccines being developed for the prevention of the disease.

[Treatment of Ebola virus disease].

Treatment of Ebola virus disease. The article presents data on the etiology, pathogenesis, clinical presentation, diagnosis and modern approaches to the treatment of Ebola haemorrhagic fever. This serious infectious disease with a high fatality rate is characterized by intoxication, severe haemorrhages, disseminated intravascular coagulation, and multiple organ failure with the development of severe shock. It is emphasized that the treatment of patients with Ebola should be conducted under strict anti-epidemic regime. Since there is currently no effective drugs against Ebola virus, the basis of modern treatment of this disease are pathogenic and symptomatic treatments. The main activities should be aimed at correcting violations homeostasis, blood volume deficiency, disorders of water and electrolyte balance, acid-base status osmolar and oncotic pressure shortfall of clotting factors and blood components. The treatment program should be drawn up taking into account the stage of the disease, the severity of the course and comorbidity.

[Ebola virus disease: clinical and diagnostic aspects and organization of treatment-and-prophylactic measures].

The article presents data about world spread of Ebola virus disease, biological characteristics of the pathogen, the laws of the epidemic process in this disease, its pathogenesis, clinical manifestations and diagnosis. Pointed out that the current anti-viral agents, effective for the Ebola virus, have not been developed. Timely performed pathogenetic therapy improves the prognosis of the disease. The basis of this therapy is infusion-detoxification activities and replenishment of losses, of electrolytes, as well as anti-inflammatory and anti-emetic drugs. The Armed Forces of the Russian Federation received the guidelines for preventive measure that can reduce Ebola virus disease transmission. Recommendations for emergency anti-epidemic commission consisted of representatives of the command, specialists and medical services and logistics, are given. Fundamentally important condition for the effective anti-epidemic measures is not only the constant readiness of medical personnel in the detection of disease EVD, but also the appropriate level of equipment of medical institutions of medical supplies and equipment.

[Delivery of healthcare to patients with infectious diseases during the pre-hospital stage].

In the field infectious military hospital work with double-triple overcharge. It leads to reduction of health care to patients, requires the additional hospital departments or evacuation of contagious patients to other hospitals. That is why the pre-hospital care is of prime importance. According to modem concept the number of interim stages is minimal--1 stage--on site of definition of contagious patients (isolator of medical station of military unit) and 2 stage--infectious military hospital. Main measures of health care to contagious patients during the pre-hospital stage are early active detection of patients or suspected of having infection, early clinical diagnosis, medical sorting, delivery of emergency care, treatment in isolators in case of delay of evacuation and evacuation in infectious military hospital.

[Features of clinic, diagnostics and treatment of typhoid fever in young patients].

Typhoid fever is a dangerous infection. The article analyzes the clinical aspects, diagnostic possibilities and casual treatment of the young men in organized group with typhoid. It's shown that despite early hospitalization (at average of 5.5 days) the main manifestations peculiar to the "classical" infection retained. The majority (61.5%) had disease of moderate severity, mild form were at 37,4% of patients. Complications occurred in 5.0% of the patients: pneumonia (2.8%), myocarditis (2.2%) and pancreatits (2.2%). Pathogen isolated from patients with typhoid fever had reduced susceptibility to fluoroquinolones. Antimicrobial therapy showed the advantage of the 3 generation cephalosporin (ceftriaxone) compared with ciprofloxacin or a combination of the latter with cefotaxime.

[Hemodynamic correlation between the reaction of circulatory system on physical activity and exogenic adrenaline in liquidators of Chernobyl accident with neurocirculatory dystonia syndrome].

The article presents a correlation analysis between hemodynamic changes occurred after performing submaximum physical activity using bicycle ergometer (physical stress) and intravenous injection of adrenalin (pharmacological stress) in 30 liquidators of Chernobyl accident and who have a neurocirculatory dystonia syndrome. It enables to establish interrelations for a number of maximal values of parameters of hemodynamics which is determined by the same shifts in circulatory system with sympathoadrenal direction during these two kinds of stress influence.

[Clinical-morphological treatment of the rupture of the cavernous formations in the spleen as a rare complication of typhoid fever].

Typhoid fever--usually is a hard disease, often is accompanied by specific epiphenomenons. Whipping of lien--arare,eventually mortiferous epiphenomenon. The article presents a clinical surveillance of the lien whipping by patient with typhoid fever. Pathomorphological examination showed, that cavernous appearance of lien are two secondary cyst of non-traumatic origin with a capsule of more, then a year. Whipping of lien is not typical for typhoid fever, but in condition of inborn dysplasiaof lien vas, this epiphenomenon is well-formed.

[Analysis of fatal outcomes issues of typhus fever].

The nature and frequency of complications in patients with typhus fever are of importance for its outcome. The causes of death were studied in 126 patients who had died from this disease. The immediate causes of death were as follows: infectious-toxic shock (31.7%), pneumonia (28.6%), and perforative peritonitis (26.2%). The pathomorphism of Payer's patches does not allow the stages of the disease to be identified. An immunohistochemical study established a drastic preponderance of granulomatous macrophages without proliferation markers with a simultaneous reduction in the count of T and B lymphocytes and dendritic cells.