[Description of the case of adverse pasteurellosis in a cirrhosis patient. Case report].

The article describes a clinical case of an unfavorable course of pasteurellosis in a patient with liver cirrhosis. Possible variants of the clinical course, clinical and epidemiological data, on the basis of which pasteurellosis can be suspected, modern recommendations for antibiotic therapy are considered.

[The problem of diagnosis and differential diagnosis of botulism in pregnant women. Case report].

The article describes a clinical observation of a severe course of a sporadic case of foodborne botulism in a woman at 32 weeks gestation with a successful resolution of pregnancy by independent childbirth. No adverse effects of botulism on pregnancy, delivery, and fetal development were noted. Anti-botulinum serum was administered to the patient no earlier than 96 hours from the onset of the disease. The paper analyzes the clinical picture of botulism, on the basis of which it is necessary to carry out a differential diagnosis.

[Human babesiosis: clinical cases in the european part of the Russian Federation].

The article describes four clinical observations of patients with babesiosis detected in the European part of the Russian Federation, two of whom were under the direct supervision of the authors. The analysis of epidemiological data, clinical picture, results of laboratory studies in the dynamics of the disease. Differential diagnosis and treatment are discussed.

[Treatment of chronic viral hepatitis C with direct acting antiviral agent: review].

HCV infection treatment regimens are viewed from positions of HCV life cycle and replication, effects of NS3/4A protease inhibitors and NS5A/NS5B inhibitors on HCV strain replication. Evolution of HCV treatment regimens from its discovery to modern DAA agents had led to substantial progress although drug resistance poses a new issue to be addressed.

The problem of diagnosis of generalized and focal forms of salmonellosis.

The article describes the clinical observation with an unfavorable outcome of the generalized form of salmonella infection caused by Salmonella typhimurium group B in a woman of 60 years without immunodeficiency, complicated by the development of multiple abscesses of the lower parts of abdominal cavity, probably of appendicular origin. In a short literary review, the pathogenetic mechanisms that contribute to the formation of generalized and extraintestinal forms of salmonella infection are discussed.

Pets in modern society: hidden threats.

The article discusses the problem of the role of pets as a source of zoonotic infections, representing a hidden threat to modern society. Since the content is now very popular at home, both traditional and exotic animals, it is necessary to develop an interdisciplinary program to control the spread of zoonotic infections and the risks of their infection with people. Since the problem lies in the intersection of several disciplines, joint efforts of doctors, veterinarians, health organizers and laboratory specialists are necessary.

[Difficulties in the diagnosis of diarrhea-associated hemolytic uremic syndrome in adults]. / Trudnosti diagnostiki gemolitiko-uremicheskogo sindroma, assotsiirovannogo s diareei, u vzroslykh.

Hemolytic uremic syndrome (HUS) is a rare, but menacing condition registered mainly in children. The paper gives a detailed description and analysis of a clinical case of HUS with a favorable outcome in an adult woman who developed the syndrome in the presence of bloody diarrhea. It considers an update on the etiology, pathogenesis, and clinical features of HUS associated with diarrheal syndrome and discusses differential diagnostic features, diagnostic problems, and characteristics of management tactics for patients.

[Description of a case of severe Q fever].

The paper considers a rare clinical case of severe Q fever in a young man with no compromised premorbid background. It describes and analyzes clinical manifestations and laboratory findings with consideration for the current data available in the literature. The issues of the differential diagnosis, laboratory diagnosis, and treatment of Q fever are discussed.

[Pathogenetic aspects of intoxication syndrome in the clinical picture of infectious diseases].

Pathogenetic mechanisms of intoxication syndrome in patients with infectious diseases are considered in the context of current general pathologic concepts. All major components of pathogenesis are discussed in terms of the authors' original observations and literature data. Bacterial endo- and exotoxines are believed to be the main inductors of intoxication. Results of original studies suggest an important contribution of Shiga toxins to specific clinical manifestations of infectious diseases. A novel interpretation of the role of intoxication syndrome in the development of infectious diseases is proposed.

[A focal infiltration in the upper lobe of the right lung as a manifestation of the initial stage of secondary syphilis].

Among sexually transmitted diseases, the incidence of primary and secondary syphilis has substantially increased in Russian Federation within the recent years. Modern clinicians, acquainted only with conventional dermatovenerologic symptoms of the disease, are less aware of rare manifestations of syphilis as a generalized infection. A rare case of syphilis with infiltrative pulmonary lesion is discussed in the article; the attention of practitioners is drawn to "unusual" manifestations of syphilis.

[A clinical and pathothysiological study of protein C in patients with generalized meningococcosis]. / Kliniko-patofiziologicheskoe issledovanie proteina C u bol'nykh s generalizovannoi formoi meningokokkovoi infektsii.

The clinical-and-pathogenetic significance of protein C was dynamically investigated within the infection processes in 23 patients (mean age 44 years) with meningococcemia. A reliably lower concentration of protein C in blood plasma (mean 37.8%) was registered versus the normal parameters (N = 70-130%) at exacerbation irrespective of a disease outcome. Leyden mutation was detected in 30.5% of patients. The presence of the above genetic defect denoted a predisposition to a severe disseminated intravascular coagulation (DIC) syndrome in patients of the studied group. A lower concentration of protein C was detected in blood plasma of patients with meningococcemia; it correlated with severity of the infection process and with the development of organic malfunction. The study of the concentration of protein C enabled an evaluation of the functional condition of anticoagulation mechanisms in the DIC development and can be regarded as an important extra criterion for the evaluation of thrombohemorrhagic syndrome in patients with meningococcemia.

[Priming-phenomenon of neutrophils in patients with Flexner infection]. / Praiming-fenomen neitrofilov u bol'nykh shigellezom Fleksnera.

AIM: To study reproducibility of priming phenomenon of neutrophils in patients with acute Flexner's dysentery and its realization manifestation. MATERIAL AND METHODS: A chemiluminescent response of peripheral blood neutrophils was studied in patients with acute mild and moderate dysentery in the presence of luminol. Lipopolysaccharide Salmonella typhimurium at a final concentration of 20 ng/ml served as a priming substance of S-chemotype. Neutrophils were stimulated with phorbol myristate acetate in concentration 10(-6) M and isolated on Histopaque double gradient (Sigma reagents, USA). RESULTS: In reproduction of priming-phenomenon in vitro on neutrophils of patients with acute Flexner's dysentery chemiluminescence amplitude increased 1.29-1.69-fold vs control. CONCLUSION: Priming-phenomenon on neutrophils in acute dysentery is reproducible. This confirms modulating properties of lipopolysaccharides in conditions of systemic nonphysiological endotoxinemia. Priming phenomenon may be involved in both maintenance of homeostasis and pathophysiological processes.

[Changes in the levels of acute phase proteins in viral hepatitis]. / Dinamika urovnia belkov ostroi fazy pri virusnykh porazheniiakh pecheni.

AIM: To investigate changes in the levels of acute phase proteins (APP) in the serum of patients with acute and chronic viral hepatitis of various etiology. MATERIAL AND METHODS: APP (prealbumin, albumin, transferrin, haptoglobin) were measured by automatic kinetic analyzer JCS II TM (Beckman) in 92 patients with acute and 61 patients with chronic viral hepatitis. Synthesis of albumin, prealbumin was depressed, of haptoglobin increased in patients with acute viral hepatitis irrespective of etiology at the height of intoxication. In chronic viral diseases APP content depended on the disease etiology. In chronic hepatitis C, B + C and D albumin, haptoglobin and transferrin were low in clinical exacerbation while in patients with chronic hepatitis B a fall in albumin, prealbumin and transferrin is accompanied with high haptoglobin. CONCLUSION: A complicated multidirectional changes in APP in patients with acute or chronic hepatitis serve, on the one hand, an integral diagnostic indication of hepatic function in conditions of systemic endotoxemia. On the other hand, endotoxemia is caused by lipopolysaccharides of gram-negative bacteria entering blood flow in great amounts in morphofunctional hepatic disorders caused by viral hepatitis of different etiology.

[Functional heterogeneity of polymorphonuclear leukocytes population in peripheral blood of patients with acute dysentery]. / Geterogennost' funktsional'nogo sostoianiia populiatsii polimorfno-iadernykh le'ikotsitov perifericheskoi krovi u bol'nykh ostroi dizenteriei.

AIM: To study chemiluminescence (CL) of polymorphonuclear neutrophils (PMNL) in peripheral blood of patients with acute mild and moderate dysentery caused by Shig. Flexneri in response to Re- and S-chemotype lipopolysaccharide (LPS) Sh. Flexneri and agonists fMLP, PMA and OZ. RESULTS: PMNL population proved functionally heterogeneic, correlating with acute dysentery severity. Subgroups of PMNL varied by CL amplitude, reserve ability to additional stimulation. LPS rather modulated CL of PMNL than stimulated it. CL intensity depended on LPS structure and concentration. Mild acute dysentery was characterized by pool of primed PMNL which had higher functional reserves. CONCLUSION: CL analysis can be used for raising accuracy of dysentery prognosis and severity, assessment of implications of functional state of neutrophil granulocytes for support of antiendotoxin immunity in acute dysentery.