[Meningococcal disease: early clinical diagnosis and emergency care].

Late diagnosis of meningococcal disease leads to high mortality. Early diagnosis of its generalized forms plays a crucial role in the pre-hospital phase and mainly based on the clinical picture of the disease. In most cases, pre-hospital typical mistake is late diagnosis of meningococcal disease: We propose an algorithm of early diagnosis of generalized forms of the disease in order to reduce the number of diagnostic errors. Proper and timely diagnosis will enable the physician pre-hospital fully implement measures to provide emergency and urgent care in generalized meningococcal infection, leading to. a more.favourable course and a significant improvement in the outcomes of the disease in the course of further hospital treatment.

[The condition of the stomach, duodenum and bile ducts in patients with chronic hepatitis C].

AIM: To study the status of the stomach, duodenum and biliary tracts in young patients with chronic hepatitis C. MATERIAL AND METHODS: We studied associated pathology of the gastroduodenal zone and biliary tract in 140 patients with CHC aged 16 to 35 years (mean age 25 +/- 0.8 years). We used USI and MRT of the abdominal organs, fibroesophagogastroduodenoscopy with biopsy of gastric mucosa for H. pylori, fractional duodenal tubing. 30 healthy males were controls. RESULTS: Asymtomatic gastroduodenal and biliary defects were found (75.5%). Endoscopic signs of gastroduodenal lesions were frequent (76.3%) in CHC patients, the majority of them were associated with H. Pylori and were not significantly different from those in the controls. Biliary tracts pathology, as shown by USI and MRT, occurred in 50.8%, were primarily functional (74.5%) and combined with high occurrence of bile mixed microflora with predominance of B. Fragilis (81%). Correlation of pathological changes of the gastroduodenal zone and biliary tract was established in CHC patients. How ever, they do not correlate with clinicolaboratory and histological signs of HCV infection. CONCLUSION. Young patients with CHC demonstrated no correlation between pathological changes of the gastroduodenal zone, biliary tracts and clinicolaboratory, histological signs of HCV infection. Therefore, it is recommended not to eradicate HP-infection and not to suppress opportunistic bile microflora in CHC young patients in the absence of clinical symptoms of gastrointestinal changes.

[Comorbid gastric and duodenal changes in chronic hepatitis C in young patients]. / Soputstvuiushchie izmeneniia v zheludke i dvenadtsatiperstnoi kishke pri khronicheskom gepatite C u lits molodogo vozrasta.

Characteristics of the gastroduodenal zone, frequency of gastric mucosa contamination with Helicobacter pylori (HP) were studied in young patients with chronic hepatitis C (CHC). Affections of the stomach and the duodenum were encountered in 76.3% of CHC patients. They run, as a rule, latently and in most cases (80%) are associated with HP. Concurrent diseases of the upper gastroduodenal tract seem to have only a minor impact on the course of HCV infection. Therefore, it is better to avoid eradication of HP in young patients with CHC.