[Masks of subacute infectious endocarditis]. / "Maski" podostrogo infektsionnogo éndokardita.

AIM: Formulation of approaches to differential diagnosis and treatment policy for subacute infectious endocarditis (SIE) when it is masked by another monoorganic or systemic disease. MATERIALS AND METHODS: The course of SIE was analysed in 132 patients of whom 74(56%) had erroneous admittance diagnoses. Rheumocarditis was not confirmed in 34 patients, 24 patients had nonspecific reactions masking SLE (4 cases), glomerulonephritis (7 cases), myocarditis (4 cases), hemorrhagic vasculitis, nodular periarteritis, polymyositis (9 cases). RESULTS: The "masks" made the SIE diagnosis more difficult, resulted in late or invalid treatment--monotherapy with steroid hormones, in particular. This complicated the diagnostic process and aggravated the disease course. CONCLUSION: To detect SIE it is necessary besides analysis of case record and symptoms to performe echocardiography in dynamics, because of possible late development of valvular defect. High-dose antibiotic therapy is justified for diagnosis of ex juvantibus when the diagnosis remains controversial.

[The microflora characteristics of the large intestine in infectious endocarditis]. / Osobennosti mikroflory tolstogo kishechnika pri infektsionnom endokardite.

The state of the microflora of the large intestine in 18 patients with infectious endocarditis (IE) was studied. The study revealed that the existing specific features of the microbial picture of the large intestine were caused by changes in the content of some representatives of the indigenous group of microbes, as well as in the concentration and occurrence of transitory microbial species. Changes in the character of the microbial picture were found to depend on the activity of IE, as well as on the dynamics of the disease. In the course of this study no correlations between changes in the microbial picture of the intestine and the sex of the patients, as well as between the fact of the infection being primary or not and the presence of different clinical symptoms and syndromes of IE, were established. On the basis of the data thus obtained the most informative diagnostic signs reflecting the general character of changes typical of this disease were selected.

[Microecology of non spore-forming anaerobes in health and in disease]. / Mikroékologiia nesporoobrazuiushchikh anaérobov v norme i pri patologii.

The authors studied the species-specific and quantitative composition of the large intestinal microbiocenosis on exposures to various factors of endo- and exogenous etiologies: the presence of a pathological process and its specific features, dietary trace element composition, unfavorable environmental (chemical) factors, as well as the impact of coexistence in the same family and the factors of family variability (the individual genotype of the macro-organism). The microenvironment of non spore-forming anaerobes that colonize the large bowel was found to be influenced by a number of various factors, both exo- and endogenous. The magnitude of these changes is associated with the intensity and specificity of an influencing factor.

[Several mechanisms of immunological adaptation in the etiology of subacute infectious endocarditis]. / O nekotorykh mekhanizmakh immunologicheskoi adaptatsii pri razvitii podostrogo infektsionnogo éndokardita.

The paper deals with the possibility of identifying the persons predisposed to the development of subacute septic endocarditis (SSE), with the prediction of the course of the disease and the clarification of reasons for the inefficiency of antibacterial therapy. The studies performed revealed the impairment of cooperative interaction of the immune system, which prevents it from fulfilling its main task, i.e. to make an immunological surveillance over the maintenance of internal constancy. Imperfection of this function in SSE patients and rheumatic heart diseases is based on the body's sharply limited adaptation which results from the genetically determined low values of the immune functional reserve realizable by the level of intracellular energy processes which are substantially lower in SSE patients, as evidenced by the studies conducted. This is very important for predicting whether it may develop in some patients with rheumatic diseases. The necessity of using large doses of antibiotics decreases the activity of intracellular processes to a greater extent, aggravating primarily phagocytic function, as reflected in the efficiency of antibiotic therapy.

[Microbiocenotic changes in the large intestine of patients with various diseases]. / Izmeneniia mikrobiotsenoza tolstoi kishki u bol'nykh razlichnymi zabolevaniiami.

The specific features of the components of human large bowel microbiocenosis were studied in healthy persons and patients with various pyo-inflammatory and other diseases in relation to the physiological status. The presence of a pathological process was demonstrated to be a powerful factor of intestinal microbiocenotic variations. No specific changes in the large bowel microflora were found in the abnormalities in question.

[Myocarditis in chronic active hepatitis]. / Miokardit pri khronicheskom aktivnom gepatite.

Myocarditis attended chronic active hepatitis in 22 patients (in 13 of them the outcome of hepatitis was liver cirrhosis). Twelve patients recovered, postmyocarditis cardiosclerosis developed in 6 and 4 patients died. Chronic myocarditis in the stage of aggravation was revealed in 3 cases at autopsy and severe postmyocarditis cardiosclerosis with manifested dilatation of the heart cavities in 1 case.

[A rapidly progressing variant of subacute infectious endocarditis]. / Bystroprogressiruiushchii variant podostrogo infektsionnogo éndokardita.

A total of 122 patients with subacute infectious endocarditis (SIE) were examined. Of these, 33 patients demonstrated an extremely severe disease course. In spite of adequate antibacterial treatment, the lethal outcome ensued within the first 2-2.5 years of the disease. A rapidly progressing variant of SIE was characterized by persistent fever, predominance of aortal heart diseases, renal injuries with an early development of renal failure, hemorrhagic vasculitis, relapsing thromboembolism, refractory heart failure, persistent anemia, lymphopenia, and by the presence of large movable vegetations discovered on echocardiography.