[Assessment of the phenotypic composition of lymphocytes, immunoglobulins and their relationships in patients with chronic rinosinusitis]. / Otsenka fenotipicheskogo sostava limfotsitov, immunoglobulinov i ikh vzaimootnoshenii u patsientov s khronicheskim rinosinusitom.

OBJECTIVE: The study of the population and subpopulation content of lymphocytes and immunoglobulins and their associations in IgE-mediated CRS relative to other CRS and the control group. MATERIAL AND METHODS: 23 patients with IgE-mediated chronic rhinusinusitis and 67 patients with normal IgE blood levels were examined. For analysis, flow cytometry (Cytomics FC500, Beckman Coulter, USA), using monoclonal antibodies CD3+, CD4+, CD8+, CD16+, CD19+ and enzyme immunoassay (Thermo Scientific Multiskan FC, Thermo Fisher Scientific, USA), using IgA, IgM, IgE and IgG in serum, statistical processing was performed using Statistica 7.0. RESULTS: In patients with CRS and IgE-mediated CRS, hyperactivation was revealed in both T- and B-cell immunity, manifested by an increase in the level of T-lymphocytes, NK-lymphocytes and B-lymphocytes. More pronounced disorders in the immune status are detected in patients with IgE - mediated CRS, there is a more pronounced activation of the T-cell immune link due to an increase in T-helper cells, T-killer/suppressor cells, an imbalance in their number is accompanied by a decrease in their ratio in the immunoregulatory index. Activation of the immune system in patients with CRS is also associated with an increase in the content of mature B-lymphocytes (CD19+), while only in patients with IgE-mediated CRS, hypergammaglobulinemia of classes A and M was detected. CONCLUSION: Changes in the immune status indicate a violation of immune regulation, confirmed by the revealed correlations between the subpopulations of lymphocytes and immunoglobulins that implement the immune response in this condition. The greatest number of violations in the regulation is associated with mature T-lymphocytes in both CRS and IgE-mediated CRS, while only IgA fully retains its function.

[Health risk factors in the family-members of chlamydiosis patients]. / Faktory riska dlia zdorov'ia chlenov semei s ochagom khlamidiinoi infektsii.

AIM: To study the characteristics of health state in family-members of ENT-patients with identified Chlamydia infection. METHODS: We have examined 245 members of 87 families of otorhinolaryngological patients with verified (44 families) and without (44 families) Chlamydia infection. Laboratory methods of the research included the identification of the following types: Chlamydia trachomatis and Chlamydophila pneumoniae. Chlamydia diagnostics involved both direct immune fluorescence and immune enzyme analyses as well as polymerase chain reaction. Health state in ENT-patient family-members has been evaluated by the complex method based on the special questionnaire for every family-member aimed at determining the health category, the calculation of health average coefficient for each family member followed by the determination of family identity with some definite health category. RESULTS: in the families of otorhinolaryngological patients with verified Chlamydia infection there have been revealed considerably more family-members with acute and chronic pathology of different organs and systems associated with functional disorders. The health status of family members of ENT patients with respiratory Chlamydia was significantly worse than in families of patients with negative laboratory results for Chlamydia, which was manifested by a much smaller number of healthy family members and a large number of people with risk factors for health.

[Clinico-anamnestic diagnostics of chronic maxillary sinusitis associated with chlamydial infection]. / Kliniko-anamnesticheskaya diagnostika khronicheskogo verkhnechelyustnogo sinusita, assotsiirovannogo s khlamidiinym infitsirovaniem.

The present study included 201 adult patients presenting with exacerbation of chronic maxillary sinusitis. The presence of Chlamydia trachomatis and Chl. pneumoniae was verified by the direct immunofluorescencetechnique and polymerase chain reaction. The study material consisted of swipes und swabs from the mucous membrane of the middle nasal passage. The information from the patients was collected with the use of a questionnaire specially elaborated for the purpose of this study. The correlation relationships were established by means of gamma-statistics. The method is based on the calculation of the integral index characterizing the risk of development of chlamydial infection using the scoring scale for the evaluation of the clinical and anamnestic characteristics of the patients. The assessment of the risk of chlamydial colonization by the anamnestic method makes it possible to enhance the effectiveness of clinical diagnostics of chlamydial infection and thereby provides a basis for the prescription of the adequate anti-chlamydial treatment facilitating reduction of the frequency of complications and preventing dissemination of the causative factor of the disease. Moreover, this approach creates the conditions for the targeted selection of the patients to be referred to the laboratory verification of Chlamydia. Highoperating performance and effectiveness characteristics of the clinic-anamnestic diagnostics make it a method of choice for the wide application in the clinical practice.

[MEDICAL AND SOCIAL STATE OF HEALTH IN FAMILIES WITH THE FOCUS OF RESPIRATORY CHLAMYDIA].

Medical and social state of health in family persons was assessed on the basis of a questionnaire. Developed by the author's questionnaire included two sections, reflecting the state of health, health risk factors and social characteristics of the family members of ENT patients. In the article there is presented an analysis of the medical and social state of 44 families of patients with diseases of the upper respiratory tract associated with chlamydial infection. The comparison was performed with 43 families of ENT patients with unconfirmed respiratory chlamydia. Diagnosis of Chlamydia infection complex was carried out with the use of laboratory methods (direct immunofluorescence and enzyme-linked immunosorbent assays, polymerase chain reaction). The health and social status of families with hearth respiratory chlamydia were shown to be significantly worse compared with families with the lack of the latter

[The algorithm for laboratory diagnostics of chlamydial infection in the patients presenting with chronic sinusitis]. / Algoritm laboratornoĭ diagnostiki khlamidiĭnoĭ infektsii u bol'nykh khronicheskim sinusitom.

The objective of the present study was to develop a system of laboratory diagnostics ofchlamydial infection in the mucous membrane of the nose and paranasal sinuses in the patients presenting with chronic sinusitis. A total of 168 subjects at the age varying from 18 to 65 years were available for the examination based at the Department of Otorhinolaryngologyduring the period of exacerbation of chronic sinusitis. Chlamydia were identified by simultaneously using two direct (polymerase chain reaction and direct immunofluorescence) and one indirect (immunoenzymatic assay) methods. The study has demonstrated the high degree of probability of the detection of chlamydial infection based on the above complex of the laboratory methods. It is concluded that the use of the proposed algorithm in practical medicine makes it possible to improve the quality of laboratory verification of chlamydial infection and thereby to choose the adequate diagnostic strategy for the patients suspected of having chlamydial infection and to evaluate the effectiveness of the therapeutic measures being taken.

[The frequency of chlamydial infection in the children attending pre-school institutions].

The objective of the present study was to estimate the prevalence and specific features of chlamydial infection within an organized group of children of pre-school age. The data concerning the frequency of chlamydial infection of the upper respiratory tract in the children attending pre-school facilities are reported. The species composition of identified Chlamydia depending on the sex of the children is described. It is shown that acute and chronic ENT pathology in the patients presenting with chlamydial infection occurs much more frequently than in the unaffected children. These results were obtained during the examination of 121 children. Chlamydia was identified by means of the direct immunofluorescence technique.

[Optimization of medical care provided to the patients suffering respiratory chlamydiosis].

The objective of the present study was to elaborate the complex of measures intended to optimize medical care for the patients suffering respiratory chlamydiosis. The adequate organizational measures concerning the prophylactic and therapeutic treatment of inflammatory pathology of the upper respiratory tract associated with Chlamydia infection have not been proposed up to the present time and need to be urgently developed. The importance of this issue has been confirmed in a study involving 245 subjects that demonstrated the imperfection of the structure of the currently operating system of outpatient and hospital-based service provided to the patients with respiratory chlamydiosis. The authors propose the program that defines priority activities in the field under discussion and outline possible ways to reduce morbidity and the number of cases.

[Medical and social characteristics of the families having patients with ENT pathology and verified Chlamydia infection].

The objective of the present study was to evaluate the medico-social status of 44 families having patients with ENT pathology; special attention was given to the patients with this condition and concomitant verified Chlamydia infection in the upper respiratory tract. The results of their examination were compared with those obtained in the control group of 43 families including the patients with ENT pathology and unconfirmed respiratory chlamydiasis. Chlamydia infection was diagnosed by combining standard laboratory techniques such as direct immunofluorescent and immunoenzymatic assays alomg with polymerase chain reaction. The results of the present study indicate that the medical and social status of the families having a member with respiratory chlamydiasis is inferior to that of the families unaffected by this infection.

[Specific distribution patterns and manifestations of respiratory chlamydiosis of the upper respiratory tract in different population groups].

The objective of this study was to elucidate specific distribution patterns and manifestations of respiratory chlamydiosis affecting the upper respiratory tract in different groups of the patients (both children and adults) presenting with otorhinolaryngological problems. Chlamydia were detected with the use of a combination of laboratory methods including PCR, direct immunofluorescent and imunoenzymatic assays. The study included 1329 patients. The data obtained suggest the high prevalence of chlamydial infection of the upper respiratory tract in different groups of the population. The species composition of the identified bacteria was shown to depend on the age and sex of the affected subjects.

[Peculiar manifestations of familial chlamydiasis of the upper respiratory tract].

The aim of the present study was to elucidate the frequency of chlamydial infection in the members of the families having the confirmed disease and concomitant ENT pathologies. Another objective was the comparative analysis of otorhinolaryngological morbidity in the families with and without the carriers of respiratory chlamydiasis. A total of 87 families were involved in the study. Chlamydial infection was diagnosed by a set of laboratory methods including direct immunofluoresent and immunoenzyme analysis as well as polymerase chain reaction (PVR). It was shown that the presence of a patient suffering from respiratory chlamydiasis in the family creates the risk of infection for its remaining members. Moreover the frequency of ENT morbidity increases in the families that serve as a hotbed of chlamydiasis of the upper respiratory tract.

[Improvement of health care for patients with upper respiratory tract diseases associated with chlamydia infection].

At present the issues in regard to Chlamydia infection are not only limited by urogenital system. By the way optimal organization and non-urogenital chlamydiosis treatment strategy (with respiratory tract involvement in particular) have not been worked out yet and require immediate solutions. Due to new knowledge on respiratory chlamidiosis the authors discuss scientific background for future development of complex measures and main directions of health care support strategy for patients with upper respiratory associated with Chlamydia infection.

[Immunity features in patients with upper respiratory tract disease caused by Chlamydia].

Comparative analysis of results of clinical and laboratory evaluation of patients with chronic nasal or nasal sinuses' diseases (chronic rhinitis or maxillary sinusitis) associated or not associated with Chlamydia infection was performed. It was shown that in patients infected with Chlamydia, along with unidirectional changes typical for all patients irrespective from presence or absence of Chlamydia, the features of immune response against these infectious agents take place.