[Autoimmune encephalitis].

The authors consider the issues related to pathogenesis, clinical features, diagnosis and treatment of autoimmune encephalitis. It has been demonstrated that the development of autoimmune encephalitis can be associated with the oncologic process or be of idiopathic character. The pathogenesis of autoimmune encephalitis is caused by the production of antibodies that directly or indirectly (via T-cell mechanism) damage exo-and/or endocellular structures of the nerve cells. The presence of antobodies to endocellular structures of neurons in the cerebrospinal fluid of patients with autoimmune encephalitis in the vast majority of cases (> 95%) indicates the concomitant oncologic process, the presence of antibodies to membranes or neuronal synapses can be not associated with the oncologic process. Along with complex examination, including neuroimaging, EEG, cerebrospinal fluid and antibodies, the diagnostic algorithm in autoimmune encephalitis should include the search for the nidus of cancer. The treatment algorithm in autoimmune encephalitis included the combined immunosupressive therapy, plasmapheresis, immunoglobulines, cytostatics as well as treatment of the oncologic process.

[Palivizumab: four seasons in Russia].

In 2010, the Russian Federation (RF) registered palivizumab--innovative drug, based on monoclonal antibodies for passive immunization of seasonal respiratory syncytial virus (RSV) infection in children of disease severe progress risk group, which include primarily premature infants, children with bronchopulmonary dysplasia and hemodynamically significant congenital heart disease. Currently, palivizumab is included in the list of recommended medicines and medical care standards of different countries, including Russia. In the review the results of Russian research on the progress of RSV infection, its epidemiology and immunization experience gained over the 2010-2014 period are summarized in relation to the foreign data. During the four epidemic seasons palivizumab immunization covered more than 3,200 children of severe RSV infection risk group with a progressive annual increase in the number of patients who received the drug. Geography of palivizumab immunization is also greatly expanded in our country during this time. If during the first two seasons measures of immunization were taken mainly in Moscow and St. Petersburg, at the present time, thirty one territorial entities of the Russian Federation have the experience in the drug application. Analysis of the results of RSV infection immunization (made in several regions) confirms the high clinical efficacy and palivizumab safety already demonstrated in international studies. In addition, the analysis presents the potential to improve the efficiency of the integrated RSV infection immunization programs, realizing in the establishment of high-risk child group register, adequate counseling for parents, as well as the development of the routing of patients and coordination of interaction between different health institutions during the immunization.

[Peculiarities of physical growth and body composition of preterm infants, received different types of feeding, at the discharge from hospital].

BACKGROUND: This article is devoted to a research and practice problem--optimization of feeding preterm infants. PATIENTS AND METHODS: 80 preterm infants of different GA with perinatal pathology were included in the study group. Anthropometric figures of weight and length z-scores and also BMI of preterm infants, received different types of feedings, at the discharge are presented. All patients' body composition (Fat free mass and Fat mass) was estimated by air plethysmography. RESULTS: Less mass and length at the discharge in preterm infants, received breast feeding (including fortified milk), in comparison with the infants, received mixed and formula feeding, were found out. At the same time, preterm infants received breast feeding had more optimal body composition (less fat mass), than the infants received formula feeding. CONCLUSION: Personalised approach to human milk fortifiers prescription is explained. Important practical value of methodology for estimating body composition by air plethysmography is established.

[Evaluation of premature infants nutritional status by air plethysmography: first Russian prospective study].

In this article results of first Russian study on premature infants body composition in association with trend of their physical development within the first month and according to way of feeding. 30 preterm newborns without signs of intrauterine hypotrophy at birth with gestational age less than 35 month were examined by air body plethysmography. The infants were examined reaching term corrected age. Less levels of fat-free mass and increased percentage of fat were found in premature infants. The negative association between gestational age and the specific content of fat was found. This increases the risk of long-term metabolic diseases in preterm infants. It is found that preterm infants fed by fortified human milk have a more optimal body composition (less body fat levels) than infants fed by formula. The found consistent patterns confirm the necessity of supplying preterm infants with human milk for more adequate formation of plastic processes.

[Infra-red spectrometry in oral liquid study for diagnostic purposes].

Infra-red (IR) spectrometry of the saliva was done by means of specially developed hardware-software complex. It was established, that in 9 wide ranges of the IR-spectrum there were diverse fluctuations of transmittance that characterize intermolecular interactions of various molecules associated with water and metabolites of biological systems. The found fluctuations were characterized quantitatively by dispersion of transmittance coefficients. It gave chance on 9 values of the given values by means of multidimensional analysis (Mahalanobis distance and Bartlett's criteria) defined on various frequencies of spectrum in comparison with the standard, quantitatively characterize the state of biological liquid that can be used 4 diagnostic purposes.

[The novel method of assessment of individual total cardiovascular risk for the population of Russia].

Novel innovative technology of assessment of level of total cardiovascular risk with consideration of a broad list of parameters of the state of individual health and its determining factors is described. The proposed model of risk is based on results of 20-year prospective observation of large contingents of population of Russia. For the first time the model of risk was constructed taking into account in addition to traditional risk factors and clinical characteristics peculiarities of population of Russia, in particular level of education. It was found in prospective studies that level of education in this country appeared to be an independent marker of risk and that traditional risk factors (behavioral, biochemical etc) had different prognostic value at different levels of education. Novel scale of risk and elaborated on its basis computer program of risk assessment allow to widen indications to its application, elevate accuracy of estimation of risk of development of fatal cardiovascular diseases for population of Russia, to obtain for a concrete patient parameters of absolute as well as relative risk (in % of excess or lowering of risk relative to its average statistical value for population with same age, sex, and level of education). The elaborated technology of estimation of total individual risk was tested on various contingents of patients with verified diagnoses of cardiovascular diseases as well as in groups of relatively healthy volunteers. Medical technology of risk assessment by novel scale is designed for application during primary screening of various population groups and can be fulfilled by both physicians and intermediate medical personnel. At present the computer program for assessment of cardiovascular risk based on this novel method is being prepared for clinical testing and subsequent implementation.

[Comparative clinico-immuno-chemical analysis of remittent and secondary-progressive course of multiple sclerosis]. / Sravnitel'nyi kliniko-immunokhimicheskii analiz remittiruiushchego i vtorichno-progressiruiushchego techeniia rasseiannogo skleroza.

Immunochemical monitoring of remittent and secondary-progressive course of multiple sclerosis (MS) was performed. Examination of 61 patients was performed during 3 years. Inflammatory cytokines: (IL-1, IL-2, IL-6, TNF-alpha), were measured in supernatants of the peripheral blood mononuclear cells while some neurospecific proteins (GFAP and alpha 2-GP), vesicular-cellular molecules of the adhesion (sVCAM-1) were estimated in blood serum. 50 healthy donors entered the control group. The results demonstrated a remaining functional tension of cell immunity and a decrease of the resistance of hematoencephalic barrier (HEB) at all MS stages. However, in secondary-progressive MS concentration of the sVCAM-1 in blood serum was elevated as compared with the control group, patients with remittent course and in clinical improvement. It is suggested that some functional alteration of HEB endothelium, manifest in constant pathologic expression of sVCAM-1 molecule, is one of the pathochemical mechanisms promoting progression of MS process.

[The possibility of the use of several clinical, genetic and MRI characteristics for the prognosis of effects of beta-interferon-1beta treatment in multiple sclerosis]. / Vozmozhnost' ispol'zovaniia klinicheskikh, geneticheskikh pokazatelei i dannykh magnitno-rezonansnoi tomografii dlia prognozirovaniia éffektov lecheniia beta-interferonom-1-beta rasseiannogo skleroza.

Recently, beta-interferons have become the first line medicine of pathogenic treatment of multiple sclerosis (MS). 75 MS patients from Moscow received the treatment with beta-interferon-1b (betaferon). Clinical, genetic and MRI data on 48 of them were included in detailed statistical analyses. High basic frequency of relapses, absence of atrophy of the brain at the first MRI scans and the presence of HLA-DRB1*15 (less significant DRB1*0301 and DRB1*04) were associated with better clinical effects of one year Betaferon course--decrease of relapses frequency and delay in EDSS progression.

[Clinical and immunochemical characteristics of remittent multiple sclerosis]. / Kliniko-immunologicheskaia kharakteristika remittiruiushchego techeniia rasseiannogo skleroza.

Immunochemical monitoring was used to examine 37 patients with remittent multiple sclerosis (MS) for 3 years. There were changes in the blood concentrations of the supernatants IL-1 beta, IL-2, IL-6, alpha-TNF, in the serum levels of the adhesion molecule sVCAM, the neurospecific proteins GFAP and alpha 2GP. Only does active MS show a simultaneous increase in the serum concentrations of SVCAM and GFAP and alpha 2GP, which may be used as a test for the objectification of MS aggravation, the efficiency of therapy. The revealed higher secretion of antiinflammatory of cytokines at all disease stages, no recovery of blood-brain barrier responsiveness and at remission provide evidence for the likelihood of a permanent immunopathological process in MS with prevailing inflammatory and destructive changes during a clinical exacerbation and of the induction of active astrogliosis at its remission.

[Resistance of the hemato-encephalic barrier in tick-borne neural infection (Lyme disease and tick-borne encephalitis)]. / Rezistentnost' gematoéntsefalicheskogo bar'era pri kleshchevoi neiroinfektsii (bolezn' Laima, kleshchevoi éntsefalit).

The dynamic state of hematoencephalic barrier (HEB) was estimated in Russian tick-borne encephalitic (RTBE) and in meningeal syndrome (Lyme's disease, LD). The enzyme immunoassays of neurospecific proteins in blood serum such as alpha 1-BG and enolase (NSE) were performed in the course of disease. The break of HEB at blood-brain direction was proved in patients with RTBE and LD for the proteins mentioned above. The blood serum NSE levels as well as their dynamics confirmed the functional alteration of brain neurons' permeability in LD and pronounced destruction of such neurons in RTBE. The acute increase of blood NSE concentration was observed within some days before the development of clinical signs of paresis. The authors suppose that the enzyme immunoassays of neurospecific proteins which are of rather high value for HEB permeability and neuronal destruction control may be successfully applied in monitoring of both therapy's efficacy and individualization of pharmacotherapy.