Pub Date : 2023-01-01DOI: 10.20953/1729-9225-2023-2-27-34
R. Tlyustangelova, N. Pshenichcnaya, A. Tsikunib, A. S. Zhuravlev
Some patients develop irritable bowel syndrome (IBS) after acute diarrhea of bacterial etiology (ADBE). There are isolated works that present data concerning the parameters of total lipids and phospholipids in intestinal infections. The features of changes in lipid and phospholipid spectra in relation to the prognosis of IBS development in ADBE has not yet been evaluated. Objective. To evaluate serum lipid and phospholipid spectrum in patients with ADBE and to determine its significance in the development of IBS. Materials and methods. The study was performed in a group of patients with ADBE aged 18–65 years (n = 50) who received inpatient treatment in 2021–2022 at the Adygea Republican Infectious Diseases Hospital. For laboratory verification of the diagnosis, a bacteriological method and polymerase chain reaction (PCR) with a reagent kit “AmpliSens® AII screen-FL” were used. Blood sampling for lipid spectrum estimation was done on day 2–3 of the disease. The levels of triglycerides (TG), total cholesterol, high-density lipoproteins (HDL) and low-density lipoproteins (LDL), apolipoprotein A1 (APO-A1) and apolipoprotein-B (APO-B) were determined by enzymatic colorimetric method. Serum phospholipids were also isolated and fractionated into lysophosphatidylcholine, sphingomyelin, phosphatidylcholine, phosphatidylethanolamine by a unified thin-layer chromatography using Sorbfil TLC plates and Sorbfil TLC densitometer. SPSS Statistics 26.0 program was used to process the obtained results. ROC analysis was used to estimate the probability of IBS development. Results. The study of total lipid spectrum in patients in the acute period of the disease revealed hypertriglyceridemia of 2.2 mmol/L (95% CI: 1.9–2.5), which was observed in 62% of patients. An increase in the level of phosphatidylcholine was observed in 90% of patients, lysophosphatidylcholine – in 56%, a decrease in the level of phosphatidylethanolamine – in 72%, and sphingomyelin – in 24%. Subsequently, within a month after convalescence, 16 (32%) patients developed IBS. For the parameters that were altered in most patients with IBS (cholesterol, TG, phosphatidylcholine, phosphatidylethanolamine), ROC analysis was performed to assess the risk of developing post-infectious IBS. At a cholesterol level of 3.75 mmol/L and higher (AUC = 0.716 ± 0.086; p = 0.019), blood triglycerides 2.115 mmol/L and higher (AUC = 0.889 ± 0.051; p < 0.001), phosphatidylcholine 63.8% and higher (AUC = 0.827 ± 0.058; p < 0.001), phosphatidylethanolamine 14.3% and lower (AUC = 0.853 ± 0.055; p < 0.001), a high risk of developing IBS was predicted. Conclusion. Based on the increase in the level of cholesterol, triglycerides, phosphatidylcholine above or decrease in the level of phosphatidylethanolamine below the threshold values obtained by ROC analysis, it is possible to predict a high or low risk of IBS development in ADBE patients and to determine indications for timely preventive therapy of this pathology. Key words
{"title":"Changes in lipid and phospholipid spectrum of blood serum in bacterial intestinal infections as predictors of irritable bowel syndrome development","authors":"R. Tlyustangelova, N. Pshenichcnaya, A. Tsikunib, A. S. Zhuravlev","doi":"10.20953/1729-9225-2023-2-27-34","DOIUrl":"https://doi.org/10.20953/1729-9225-2023-2-27-34","url":null,"abstract":"Some patients develop irritable bowel syndrome (IBS) after acute diarrhea of bacterial etiology (ADBE). There are isolated works that present data concerning the parameters of total lipids and phospholipids in intestinal infections. The features of changes in lipid and phospholipid spectra in relation to the prognosis of IBS development in ADBE has not yet been evaluated. Objective. To evaluate serum lipid and phospholipid spectrum in patients with ADBE and to determine its significance in the development of IBS. Materials and methods. The study was performed in a group of patients with ADBE aged 18–65 years (n = 50) who received inpatient treatment in 2021–2022 at the Adygea Republican Infectious Diseases Hospital. For laboratory verification of the diagnosis, a bacteriological method and polymerase chain reaction (PCR) with a reagent kit “AmpliSens® AII screen-FL” were used. Blood sampling for lipid spectrum estimation was done on day 2–3 of the disease. The levels of triglycerides (TG), total cholesterol, high-density lipoproteins (HDL) and low-density lipoproteins (LDL), apolipoprotein A1 (APO-A1) and apolipoprotein-B (APO-B) were determined by enzymatic colorimetric method. Serum phospholipids were also isolated and fractionated into lysophosphatidylcholine, sphingomyelin, phosphatidylcholine, phosphatidylethanolamine by a unified thin-layer chromatography using Sorbfil TLC plates and Sorbfil TLC densitometer. SPSS Statistics 26.0 program was used to process the obtained results. ROC analysis was used to estimate the probability of IBS development. Results. The study of total lipid spectrum in patients in the acute period of the disease revealed hypertriglyceridemia of 2.2 mmol/L (95% CI: 1.9–2.5), which was observed in 62% of patients. An increase in the level of phosphatidylcholine was observed in 90% of patients, lysophosphatidylcholine – in 56%, a decrease in the level of phosphatidylethanolamine – in 72%, and sphingomyelin – in 24%. Subsequently, within a month after convalescence, 16 (32%) patients developed IBS. For the parameters that were altered in most patients with IBS (cholesterol, TG, phosphatidylcholine, phosphatidylethanolamine), ROC analysis was performed to assess the risk of developing post-infectious IBS. At a cholesterol level of 3.75 mmol/L and higher (AUC = 0.716 ± 0.086; p = 0.019), blood triglycerides 2.115 mmol/L and higher (AUC = 0.889 ± 0.051; p < 0.001), phosphatidylcholine 63.8% and higher (AUC = 0.827 ± 0.058; p < 0.001), phosphatidylethanolamine 14.3% and lower (AUC = 0.853 ± 0.055; p < 0.001), a high risk of developing IBS was predicted. Conclusion. Based on the increase in the level of cholesterol, triglycerides, phosphatidylcholine above or decrease in the level of phosphatidylethanolamine below the threshold values obtained by ROC analysis, it is possible to predict a high or low risk of IBS development in ADBE patients and to determine indications for timely preventive therapy of this pathology. Key words","PeriodicalId":37794,"journal":{"name":"Infektsionnye Bolezni","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67729376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.20953/1729-9225-2023-2-82-94
A. G. Lyutov, V. Aleshkin, L. Novikova, S. Bochkareva, O. M. Kostrova, A. Aleshkin, M. M. Zueva
Airborne infections constitute an extensive group of human diseases. The first barrier to the penetration of infectious agents is the oropharyngeal mucosa, where the autonomic immune system plays a special role. Therefore, maintaining the active function of mucosal immunity and its correction in situ, in the focus of inflammation, is an important way to stop respiratory infections. The coronavirus pandemic has spurred the search for effective means of preventing and treating viral diseases. Various nasal formulations have been proposed with barrier, virucidal, anti-inflammatory and antibacterial properties. An important place belongs to antibodies directed against a specific pathogen, for which it is proposed to use monoclonal antibodies, antibodies isolated from eggs of immunized chickens, nano-antibodies of representatives of the Camelid family, or colostrum antibodies of vaccinated cows. In our opinion, it is more attractive to use antibodies isolated from human blood plasma, which have a wide spectrum of activity, therefore, in the case of mixed infection or difficult diagnosis, they can have a preventive or therapeutic effect against many pathogens. Nasal drops or spray containing human immunoglobulin can be an effective treatment for many bacterial and viral infections, including COVID-19. Key words: аirborne infections, COVID-19, prevention, nasal drugs, antibodies, human immunoglobulin
{"title":"Review of nasal drugs for prevention and treatment of airborne infections","authors":"A. G. Lyutov, V. Aleshkin, L. Novikova, S. Bochkareva, O. M. Kostrova, A. Aleshkin, M. M. Zueva","doi":"10.20953/1729-9225-2023-2-82-94","DOIUrl":"https://doi.org/10.20953/1729-9225-2023-2-82-94","url":null,"abstract":"Airborne infections constitute an extensive group of human diseases. The first barrier to the penetration of infectious agents is the oropharyngeal mucosa, where the autonomic immune system plays a special role. Therefore, maintaining the active function of mucosal immunity and its correction in situ, in the focus of inflammation, is an important way to stop respiratory infections. The coronavirus pandemic has spurred the search for effective means of preventing and treating viral diseases. Various nasal formulations have been proposed with barrier, virucidal, anti-inflammatory and antibacterial properties. An important place belongs to antibodies directed against a specific pathogen, for which it is proposed to use monoclonal antibodies, antibodies isolated from eggs of immunized chickens, nano-antibodies of representatives of the Camelid family, or colostrum antibodies of vaccinated cows. In our opinion, it is more attractive to use antibodies isolated from human blood plasma, which have a wide spectrum of activity, therefore, in the case of mixed infection or difficult diagnosis, they can have a preventive or therapeutic effect against many pathogens. Nasal drops or spray containing human immunoglobulin can be an effective treatment for many bacterial and viral infections, including COVID-19. Key words: аirborne infections, COVID-19, prevention, nasal drugs, antibodies, human immunoglobulin","PeriodicalId":37794,"journal":{"name":"Infektsionnye Bolezni","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67729449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.20953/1729-9225-2023-2-23-26
A. R. Marzhokhova, Z. Kharaeva, Z. Ponezheva, L. Balagova, M. Ivanova, M. Marzhokhova
Objective. Compare the features of the duration of ARVI, influenza and COVID-19 at the modern stage. Materials and methods. 552 histories of patients d with acute respiratory viral infections, 29 with influenza and 1805 with coronavirus infection with community-acquired bilateral polysegmental pneumonia and respiratory failure (RF) of 0-3 stages who received treatment in hospitals in Nalchik were studied. Arithmetic averages and percentages in relation to the total values of the studied parameters were calculated. Results. In the group of patients with COVID-19, the severe duration of the disease was observed more often, 74 patients died, which accounted for 4% of all patients with coronavirus infection. The most common cause of death in patients with COVID-19 was pulmonary embolism. There were no deaths among patients with acute respiratory viral infections and influenza. In addition to similar symptoms, such as fever, cough, sore throat, the symptoms were identified , which are more often for ARVI influenza and COVID-19. For ARVI, this is sneezing, short-term fever, conjunctivitis, runny nose, for influenza – pain when moving the eye, pain in the eyebrow arches, granularity and petechiae on the hard palate, longer fever, for COVID-19 – anosmia, loss of taste, severe and persistent fatigue, shortness of breath, severe sweating, prolonged fever. Key words: influenza, acute respiratory viral infections, distinctive features, COVID-19
{"title":"Comparative characteristics of acute respiratory viral infections, influenza and COVID-19 according to the data of infectious diseases hospital in Nalchik","authors":"A. R. Marzhokhova, Z. Kharaeva, Z. Ponezheva, L. Balagova, M. Ivanova, M. Marzhokhova","doi":"10.20953/1729-9225-2023-2-23-26","DOIUrl":"https://doi.org/10.20953/1729-9225-2023-2-23-26","url":null,"abstract":"Objective. Compare the features of the duration of ARVI, influenza and COVID-19 at the modern stage. Materials and methods. 552 histories of patients d with acute respiratory viral infections, 29 with influenza and 1805 with coronavirus infection with community-acquired bilateral polysegmental pneumonia and respiratory failure (RF) of 0-3 stages who received treatment in hospitals in Nalchik were studied. Arithmetic averages and percentages in relation to the total values of the studied parameters were calculated. Results. In the group of patients with COVID-19, the severe duration of the disease was observed more often, 74 patients died, which accounted for 4% of all patients with coronavirus infection. The most common cause of death in patients with COVID-19 was pulmonary embolism. There were no deaths among patients with acute respiratory viral infections and influenza. In addition to similar symptoms, such as fever, cough, sore throat, the symptoms were identified , which are more often for ARVI influenza and COVID-19. For ARVI, this is sneezing, short-term fever, conjunctivitis, runny nose, for influenza – pain when moving the eye, pain in the eyebrow arches, granularity and petechiae on the hard palate, longer fever, for COVID-19 – anosmia, loss of taste, severe and persistent fatigue, shortness of breath, severe sweating, prolonged fever. Key words: influenza, acute respiratory viral infections, distinctive features, COVID-19","PeriodicalId":37794,"journal":{"name":"Infektsionnye Bolezni","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67729321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.20953/1729-9225-2023-2-15-20
S. A. Magomedova, E. A. Arbulieva, D. Abdurakhmanov, I. O. Alieva
Objective. To evaluate the possibility of using bulevirtide, the HBV and HDV entry inhibitor, in patients with chronic hepatitis D (CHD) at the stage of decompensated cirrhosis. Patients and methods. The results of the use of bulevirtide 2 mg in 14 patients with CHD at the stage of cirrhosis with impaired liver function – class B (13 patients) and C (1 patient) according to Child–Pugh were analyzed; 12 patients received monotherapy with bulevirtide, 2 patients received combination therapy with bulevirtide and peginterferon. Results. The use of bulevirtide for 48 weeks demonstrated a reduction in HDV RNA levels from 6.1 log10 to 3.6 log10 (p = 0.006); the achievement of a virological response in 70% of patients, a decrease in the level of alanine aminotransferase (ALT) from 52 to 29 U/L (р = 0,04), an increase in the frequency of detection of normal ALT levels compared with the baseline (from 43 to 82%), a decrease in liver stiffness from 20.8 kPa to 18.6 kPa (p = 0.016) (with a median decrease of 10.1 kPa); safety and good tolerability (no serious adverse events (AEs), severe or moderate AEs, cases of discontinuation of treatment). Positive dynamics of liver function parameters was observed: a decrease in the severity of liver disease to the level of compensated cirrhosis (decline in Child–Pugh score by 2 points), the frequency of hepatic encephalopathy (from 86 to 9%), ascites (from 64 to 18%), bilirubin levels, increased levels of albumin, prothrombin. The dynamics of the number of leukocytes and platelets during treatment did not require treatment correction. Conclusion. The analysis of the first experience in Russia of antiviral therapy for CHD and decompensated cirrhosis allows us to recommend the use of bulevirtide in this category of patients. Further studies are needed to clarify the optimal treatment regimens, the impact of treatment on clinical outcomes, the risk of hepatic complications (decompensation, HCC, death from liver failure or transplantation) and patient survival. Key words: bulevirtide, chronic hepatitis D, decompensated cirrhosis, chronic liver failure
{"title":"Antiviral therapy experience in patients with chronic hepatitis D and decompensated cirrhosis","authors":"S. A. Magomedova, E. A. Arbulieva, D. Abdurakhmanov, I. O. Alieva","doi":"10.20953/1729-9225-2023-2-15-20","DOIUrl":"https://doi.org/10.20953/1729-9225-2023-2-15-20","url":null,"abstract":"Objective. To evaluate the possibility of using bulevirtide, the HBV and HDV entry inhibitor, in patients with chronic hepatitis D (CHD) at the stage of decompensated cirrhosis. Patients and methods. The results of the use of bulevirtide 2 mg in 14 patients with CHD at the stage of cirrhosis with impaired liver function – class B (13 patients) and C (1 patient) according to Child–Pugh were analyzed; 12 patients received monotherapy with bulevirtide, 2 patients received combination therapy with bulevirtide and peginterferon. Results. The use of bulevirtide for 48 weeks demonstrated a reduction in HDV RNA levels from 6.1 log10 to 3.6 log10 (p = 0.006); the achievement of a virological response in 70% of patients, a decrease in the level of alanine aminotransferase (ALT) from 52 to 29 U/L (р = 0,04), an increase in the frequency of detection of normal ALT levels compared with the baseline (from 43 to 82%), a decrease in liver stiffness from 20.8 kPa to 18.6 kPa (p = 0.016) (with a median decrease of 10.1 kPa); safety and good tolerability (no serious adverse events (AEs), severe or moderate AEs, cases of discontinuation of treatment). Positive dynamics of liver function parameters was observed: a decrease in the severity of liver disease to the level of compensated cirrhosis (decline in Child–Pugh score by 2 points), the frequency of hepatic encephalopathy (from 86 to 9%), ascites (from 64 to 18%), bilirubin levels, increased levels of albumin, prothrombin. The dynamics of the number of leukocytes and platelets during treatment did not require treatment correction. Conclusion. The analysis of the first experience in Russia of antiviral therapy for CHD and decompensated cirrhosis allows us to recommend the use of bulevirtide in this category of patients. Further studies are needed to clarify the optimal treatment regimens, the impact of treatment on clinical outcomes, the risk of hepatic complications (decompensation, HCC, death from liver failure or transplantation) and patient survival. Key words: bulevirtide, chronic hepatitis D, decompensated cirrhosis, chronic liver failure","PeriodicalId":37794,"journal":{"name":"Infektsionnye Bolezni","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67729267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.20953/1729-9225-2023-2-47-56
M. Tahani, Shiva Rakhshani Nasab, I. Shahramian, M. Afshari, H. Mirzaei, F. Parooie, M. Salarzaei
Gamma-glutamyl transferase (GGT) is an enzyme found in many body organs, and its highest concentration is found in the liver. The level of GGT is increased following liver damage in different diseases. This systematic review and meta-analysis was performed to evaluate GGT levels in COVID-19 patients and determine its predictive role in diagnosing the severity of the disease. The methods used in this systematic review were performed by the PRISMA checklist instructions. Two independent researchers searched international databases (PubMed, Web of Science, Scopus, and Google Scholar) to find related studies published in English from the time of the COVID-19 pandemic to October 2021. Stata software version 11 (StataCorp, College Station, TX, USA) was used for statistical analysis. Serum GGT level in ICU patients was 18.19 units higher than in other patients. This difference was statistically significant. Also, ALT and AST levels among ICU patients were higher than patients in other wards, which showed a statistically significant difference. GGT seems to be a good predictor for the severity of COVID-19. Laboratory data in hospitalized patients with COVID-19, including serum levels of GGT, ALT, and AST, play an essential part in predicting poor outcomes, especially among ICU patients. Key words: Gamma glutamyl transferase, COVID-19, biomarker, systematic review, meta-analysis
γ -谷氨酰转移酶(GGT)是一种存在于许多身体器官中的酶，其浓度最高的是肝脏。不同疾病肝损伤后GGT水平升高。本系统综述和荟萃分析旨在评估COVID-19患者的GGT水平，并确定其在诊断疾病严重程度中的预测作用。本系统评价中使用的方法按照PRISMA检查表说明执行。两名独立研究人员检索了国际数据库(PubMed、Web of Science、Scopus和谷歌Scholar)，以查找从COVID-19大流行期间到2021年10月期间发表的相关英文研究。采用Stata软件11 (StataCorp, College Station, TX, USA)进行统计分析。ICU患者血清GGT水平较其他患者高18.19个单位。这一差异具有统计学意义。ICU患者ALT、AST水平高于其他病区，差异有统计学意义。GGT似乎是COVID-19严重程度的一个很好的预测指标。COVID-19住院患者的实验室数据，包括血清GGT、ALT和AST水平，在预测预后不良方面发挥着重要作用，特别是在ICU患者中。关键词:谷氨酰转移酶，COVID-19，生物标志物，系统评价，meta分析
{"title":"GGT Level as a New Biomarker of COVID-19 Infection; a Systematic Review and Meta‑Analysis Comparing Intensive Care Unit (ICU) Patients with Non-ICU Cases","authors":"M. Tahani, Shiva Rakhshani Nasab, I. Shahramian, M. Afshari, H. Mirzaei, F. Parooie, M. Salarzaei","doi":"10.20953/1729-9225-2023-2-47-56","DOIUrl":"https://doi.org/10.20953/1729-9225-2023-2-47-56","url":null,"abstract":"Gamma-glutamyl transferase (GGT) is an enzyme found in many body organs, and its highest concentration is found in the liver. The level of GGT is increased following liver damage in different diseases. This systematic review and meta-analysis was performed to evaluate GGT levels in COVID-19 patients and determine its predictive role in diagnosing the severity of the disease. The methods used in this systematic review were performed by the PRISMA checklist instructions. Two independent researchers searched international databases (PubMed, Web of Science, Scopus, and Google Scholar) to find related studies published in English from the time of the COVID-19 pandemic to October 2021. Stata software version 11 (StataCorp, College Station, TX, USA) was used for statistical analysis. Serum GGT level in ICU patients was 18.19 units higher than in other patients. This difference was statistically significant. Also, ALT and AST levels among ICU patients were higher than patients in other wards, which showed a statistically significant difference. GGT seems to be a good predictor for the severity of COVID-19. Laboratory data in hospitalized patients with COVID-19, including serum levels of GGT, ALT, and AST, play an essential part in predicting poor outcomes, especially among ICU patients. Key words: Gamma glutamyl transferase, COVID-19, biomarker, systematic review, meta-analysis","PeriodicalId":37794,"journal":{"name":"Infektsionnye Bolezni","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67729693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.20953/1729-9225-2023-2-111-118
K. Markova, E. Skripchenko, N. Skripchenko, L. A. Alekseeva, T. V. Bessonova, G. F. Zheleznikova, E. Vishnevetskaya, Y. Nesterova, G. Ivanova
In recent decades, there has been an increase in the number of oncological cases in children. Most common diseases are hemoblastoses, which are characterized by clinical polymorphism in the disease onset, so differential diagnosis should be made. This article presents a clinical case of serous meningitis in a child with increasing dynamics of lymphocytic pleocytosis. The clinical diagnosis of lymphocytic choriomeningitis was based on clinical and anamnestic data (accommodation in the private sector, moderate severity of the general infectious syndrome in combination with severe cerebral and meningeal symptoms), laboratory data (increasing lymphocytic pleocytosis and cell-protein dissociation in the cerebrospinal fluid). The therapy correction included antiviral therapy, which helped to achieve normalization of the cerebrospinal fluid and clinical recovery of the child from an acute neuroinfectious disease in a short time. This clinical case is unique in that 2.5 months after the disease onset, the patient developed convergent strabismus and was hospitalized. Routine blood analysis revealed 25% of blast forms. Further, the diagnosis of acute lymphoblastic leukemia was confirmed, and specific therapy was initiated. It is generally recognized that a prolonged infectious process can be a trigger for both autoimmune and paraneoplastic processes, so long-time patient observation should be provided by a group of specialists (pediatrician, neurologist, infectionist, etc.), and control laboratory examination should be done. Key words: herpesviruses, children, leukemia, lymphocytic choriomeningitis, meningitis, cytoflavin
{"title":"Viral infections as a cause or a trigger for the development of hemoblastosis?","authors":"K. Markova, E. Skripchenko, N. Skripchenko, L. A. Alekseeva, T. V. Bessonova, G. F. Zheleznikova, E. Vishnevetskaya, Y. Nesterova, G. Ivanova","doi":"10.20953/1729-9225-2023-2-111-118","DOIUrl":"https://doi.org/10.20953/1729-9225-2023-2-111-118","url":null,"abstract":"In recent decades, there has been an increase in the number of oncological cases in children. Most common diseases are hemoblastoses, which are characterized by clinical polymorphism in the disease onset, so differential diagnosis should be made. This article presents a clinical case of serous meningitis in a child with increasing dynamics of lymphocytic pleocytosis. The clinical diagnosis of lymphocytic choriomeningitis was based on clinical and anamnestic data (accommodation in the private sector, moderate severity of the general infectious syndrome in combination with severe cerebral and meningeal symptoms), laboratory data (increasing lymphocytic pleocytosis and cell-protein dissociation in the cerebrospinal fluid). The therapy correction included antiviral therapy, which helped to achieve normalization of the cerebrospinal fluid and clinical recovery of the child from an acute neuroinfectious disease in a short time. This clinical case is unique in that 2.5 months after the disease onset, the patient developed convergent strabismus and was hospitalized. Routine blood analysis revealed 25% of blast forms. Further, the diagnosis of acute lymphoblastic leukemia was confirmed, and specific therapy was initiated. It is generally recognized that a prolonged infectious process can be a trigger for both autoimmune and paraneoplastic processes, so long-time patient observation should be provided by a group of specialists (pediatrician, neurologist, infectionist, etc.), and control laboratory examination should be done. Key words: herpesviruses, children, leukemia, lymphocytic choriomeningitis, meningitis, cytoflavin","PeriodicalId":37794,"journal":{"name":"Infektsionnye Bolezni","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67729151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.20953/1729-9225-2023-2-41-46
S. Krasilnikova, K. Gorbunova, T. Eliseeva, M.T. Maigadzhieva, D. Ovsyannikov, E. V. Krasilnikova, O. Khaletskaya
Objective. A longitudinal cohort study was conducted to assess the effect of intranasal recombinant interferon α-2b-based medicine (Grippferon) on clinical, functional and immunological parameters in patients with concomitant bronchial asthma (BA) and allergic rhinitis (AR). Patients and methods. Twelve children aged between 10 and 17 years were examined. Clinical symptoms and nasal respiratory function, the content of VEGF, interleukins IL-1, -2, -4, -6, eosinophilic cationic protein (ECP) and total IgE in nasal secretions were assessed on days 1 and 31. Results. The study results showed a statistically significant increase in nasal respiratory flow (p = 0.001), a decrease in the severity of nasal (p = 0.002) and sinonasal symptoms (p = 0.0015), a reduction in VEGF concentration in nasal secretions (p = 0.014) and a downward trend in ECP (p = 0.09) and IL-4 (p = 0.10) levels. No statistically significant changes in IL-1, IL-6, and IgE content were found. Conclusion. The intranasal use of recombinant interferon α-2b-based medicine (Grippferon) for prevention of acute respiratory viral infections is well-tolerated by patients with AR and BA with shown notable improvement in nasal respiratory function, decrease in the severity of nasal and sinonasal symptoms and downward trends in the content of several T2 inflammation biomarkers in nasal secretions. Key words: interferon α-2b, cytokines, allergic rhinitis, bronchial asthma, acute respiratory viral infections, prevention, Grippferon
{"title":"Effect of the intranasal interferon-alpha-2b medicine on the dynamics of clinical, functional and immunological parameters in patients with concomitant allergic rhinitis and bronchial asthma","authors":"S. Krasilnikova, K. Gorbunova, T. Eliseeva, M.T. Maigadzhieva, D. Ovsyannikov, E. V. Krasilnikova, O. Khaletskaya","doi":"10.20953/1729-9225-2023-2-41-46","DOIUrl":"https://doi.org/10.20953/1729-9225-2023-2-41-46","url":null,"abstract":"Objective. A longitudinal cohort study was conducted to assess the effect of intranasal recombinant interferon α-2b-based medicine (Grippferon) on clinical, functional and immunological parameters in patients with concomitant bronchial asthma (BA) and allergic rhinitis (AR). Patients and methods. Twelve children aged between 10 and 17 years were examined. Clinical symptoms and nasal respiratory function, the content of VEGF, interleukins IL-1, -2, -4, -6, eosinophilic cationic protein (ECP) and total IgE in nasal secretions were assessed on days 1 and 31. Results. The study results showed a statistically significant increase in nasal respiratory flow (p = 0.001), a decrease in the severity of nasal (p = 0.002) and sinonasal symptoms (p = 0.0015), a reduction in VEGF concentration in nasal secretions (p = 0.014) and a downward trend in ECP (p = 0.09) and IL-4 (p = 0.10) levels. No statistically significant changes in IL-1, IL-6, and IgE content were found. Conclusion. The intranasal use of recombinant interferon α-2b-based medicine (Grippferon) for prevention of acute respiratory viral infections is well-tolerated by patients with AR and BA with shown notable improvement in nasal respiratory function, decrease in the severity of nasal and sinonasal symptoms and downward trends in the content of several T2 inflammation biomarkers in nasal secretions. Key words: interferon α-2b, cytokines, allergic rhinitis, bronchial asthma, acute respiratory viral infections, prevention, Grippferon","PeriodicalId":37794,"journal":{"name":"Infektsionnye Bolezni","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67729469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.20953/1729-9225-2023-2-104-110
N. Tkhakushinova, T. Baum, O. Pervishko, L. Ledenko, I.D. Kuanova
Atypical hemolytic uremic syndrome is rare condition. Orphan or rare diseases are chronic life-threatening and require specific means for their treatment (orphan drugs). In many cases the early diagnosis and treatment of orphan disease helps to avoid serious complications and lethal outcome. Clinical case. The patient, 6 years old,presented to the clinic with complaints of fever, vomiting, diarrhea up to 10 times a day. He was treated in outpatient department for 5 days, received symptomatic therapy, was not observed by pediatrician. In connection with the deterioration of condition patient was presented to inpatient infectious department of Children's Infectious City Hospital. The child had severe condition and changes in laboratory parameters (thrombocytopenia, increased levels of urea and creatinine) and was referred to intensive care department. Against the background of treatment, the patient had a persistent thrombotic microangiopathy, plasma resistance, kidney failure , and therefore it was diagnosed hemolytic uremic syndrome. Before starting of plasma therapy, we studied of ADAMTS-13 activity was for verify the diagnosis. The activity of ADAMTS-13 metalloproteinase in the blood plasma was 47% of the level of ADAMTS-13 activity in the control plasma, which was confirmation of the presence of a rare genetic disease in this child. The child received treatment with eculizumab. Conclusion. The presented clinical case shows the difficulties of diagnosis and treatment of orphan diseases. The early diagnosis and correct therapy are necessary for the successful management of children with hemolytic uremic syndrome. Key words: thrombotic microangiopathy, atypical hemolytic uremic syndrome, complement system, children
{"title":"Atypical hemolytic uremic syndrome in a six-year-old child","authors":"N. Tkhakushinova, T. Baum, O. Pervishko, L. Ledenko, I.D. Kuanova","doi":"10.20953/1729-9225-2023-2-104-110","DOIUrl":"https://doi.org/10.20953/1729-9225-2023-2-104-110","url":null,"abstract":"Atypical hemolytic uremic syndrome is rare condition. Orphan or rare diseases are chronic life-threatening and require specific means for their treatment (orphan drugs). In many cases the early diagnosis and treatment of orphan disease helps to avoid serious complications and lethal outcome. Clinical case. The patient, 6 years old,presented to the clinic with complaints of fever, vomiting, diarrhea up to 10 times a day. He was treated in outpatient department for 5 days, received symptomatic therapy, was not observed by pediatrician. In connection with the deterioration of condition patient was presented to inpatient infectious department of Children's Infectious City Hospital. The child had severe condition and changes in laboratory parameters (thrombocytopenia, increased levels of urea and creatinine) and was referred to intensive care department. Against the background of treatment, the patient had a persistent thrombotic microangiopathy, plasma resistance, kidney failure , and therefore it was diagnosed hemolytic uremic syndrome. Before starting of plasma therapy, we studied of ADAMTS-13 activity was for verify the diagnosis. The activity of ADAMTS-13 metalloproteinase in the blood plasma was 47% of the level of ADAMTS-13 activity in the control plasma, which was confirmation of the presence of a rare genetic disease in this child. The child received treatment with eculizumab. Conclusion. The presented clinical case shows the difficulties of diagnosis and treatment of orphan diseases. The early diagnosis and correct therapy are necessary for the successful management of children with hemolytic uremic syndrome. Key words: thrombotic microangiopathy, atypical hemolytic uremic syndrome, complement system, children","PeriodicalId":37794,"journal":{"name":"Infektsionnye Bolezni","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67729040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.20953/1729-9225-2023-2-5-14
P. Bogomolov, A. O. Bueverov, N. Barsukova, E. A. Isaeva, I. Maev, S. V. Koblov, N.A. Shub, M.V. Arapova, M. Kalashnikov
Objective. This study aims to analyze the results of using bulevirtide, an HBV and HDV entry inhibitor, in real-world practice in patients with chronic hepatitis D in the Moscow region. The analysis focuses on the effectiveness and safety of bulvertide treatment, both as monotherapy and in combination with peginterferon, during the compensated and decompensated stages of liver cirrhosis. Patients and methods. The study evaluated the efficacy and safety of bulevirtide treatment in two patient groups. The first group consisted of 61 patients with compensated disease, including 27 individuals with Child–Pugh class A liver cirrhosis. The second group included 8 patients with Child–Pugh class B cirrhosis. Results. Among patients with compensated disease, a 48-week treatment with bulevirtide resulted in a significant decrease in HDV RNA levels from 6.9 log10 to undetectable (p < 0.001). Furthermore, alanine aminotransferase (ALT) levels decreased from 64.0 to 37.0 U/l (p < 0.001). The median reduction in HDV RNA levels from baseline was -5.1 log10 (monotherapy: -4.2 log10, dual therapy: -5.7 log10). The virological response rate was 94% (monotherapy: 88%, dual therapy: 96%) with «full virological response» (aviremia) observed in 66% of patients and normal ALT levels in 59% of patients (compared to 22% at baseline). Virological efficacy improved over the course of treatment. Similar virological response dynamics were observed in patients with compensated cirrhosis compared to the overall group. In patients with decompensated cirrhosis, a virological response was observed in 6 out of 8 patients during treatment, and a biochemical response (a decrease in ALT levels from 60.0 U/I to 45.0 U/l) in 5 out of 8 patients. After 48 weeks of treatment, all 5 patients who reached this point achieved a virological response (decrease in HDV RNA levels from 5.1 log10 to 3.0 log10, median decrease of -2.5 log10 from baseline). One patient on monotherapy achieved «full virological response» (aviremia). Improvement of liver function was observed, including a reduction in liver damage severity based on Child–Pugh score to the compensated cirrhosis level (6 points), down-staging from Child–Pugh class B to A in 3 patients, and clinical resolution of ascites in 7 out of 8 patients and hepatic encephalopathy in 3 out of 5 patients. Bilirubin, albumin, INR, prothrombin time remained stable. The treatment was well tolerated, no serious adverse events, cases of treatment withdrawal were registered. The reduction in leukocyte and platelet counts, related to interferon, did not necessitate treatment adjustment. Conclusion. The analysis of bulevirtide use in patients with CHD in real-world practice demonstrated high treatment efficacy, safety and good tolerability, even in cases of compensated and decompensated liver cirrhosis. This study also presents the first experience of antiviral therapy for decompensated liver cirrhosis in Russia, supporting the recommendation of bulevirtide
{"title":"Treatment of patients with chronic HDV infection: routine clinical practice in the Moscow region","authors":"P. Bogomolov, A. O. Bueverov, N. Barsukova, E. A. Isaeva, I. Maev, S. V. Koblov, N.A. Shub, M.V. Arapova, M. Kalashnikov","doi":"10.20953/1729-9225-2023-2-5-14","DOIUrl":"https://doi.org/10.20953/1729-9225-2023-2-5-14","url":null,"abstract":"Objective. This study aims to analyze the results of using bulevirtide, an HBV and HDV entry inhibitor, in real-world practice in patients with chronic hepatitis D in the Moscow region. The analysis focuses on the effectiveness and safety of bulvertide treatment, both as monotherapy and in combination with peginterferon, during the compensated and decompensated stages of liver cirrhosis. Patients and methods. The study evaluated the efficacy and safety of bulevirtide treatment in two patient groups. The first group consisted of 61 patients with compensated disease, including 27 individuals with Child–Pugh class A liver cirrhosis. The second group included 8 patients with Child–Pugh class B cirrhosis. Results. Among patients with compensated disease, a 48-week treatment with bulevirtide resulted in a significant decrease in HDV RNA levels from 6.9 log10 to undetectable (p < 0.001). Furthermore, alanine aminotransferase (ALT) levels decreased from 64.0 to 37.0 U/l (p < 0.001). The median reduction in HDV RNA levels from baseline was -5.1 log10 (monotherapy: -4.2 log10, dual therapy: -5.7 log10). The virological response rate was 94% (monotherapy: 88%, dual therapy: 96%) with «full virological response» (aviremia) observed in 66% of patients and normal ALT levels in 59% of patients (compared to 22% at baseline). Virological efficacy improved over the course of treatment. Similar virological response dynamics were observed in patients with compensated cirrhosis compared to the overall group. In patients with decompensated cirrhosis, a virological response was observed in 6 out of 8 patients during treatment, and a biochemical response (a decrease in ALT levels from 60.0 U/I to 45.0 U/l) in 5 out of 8 patients. After 48 weeks of treatment, all 5 patients who reached this point achieved a virological response (decrease in HDV RNA levels from 5.1 log10 to 3.0 log10, median decrease of -2.5 log10 from baseline). One patient on monotherapy achieved «full virological response» (aviremia). Improvement of liver function was observed, including a reduction in liver damage severity based on Child–Pugh score to the compensated cirrhosis level (6 points), down-staging from Child–Pugh class B to A in 3 patients, and clinical resolution of ascites in 7 out of 8 patients and hepatic encephalopathy in 3 out of 5 patients. Bilirubin, albumin, INR, prothrombin time remained stable. The treatment was well tolerated, no serious adverse events, cases of treatment withdrawal were registered. The reduction in leukocyte and platelet counts, related to interferon, did not necessitate treatment adjustment. Conclusion. The analysis of bulevirtide use in patients with CHD in real-world practice demonstrated high treatment efficacy, safety and good tolerability, even in cases of compensated and decompensated liver cirrhosis. This study also presents the first experience of antiviral therapy for decompensated liver cirrhosis in Russia, supporting the recommendation of bulevirtide","PeriodicalId":37794,"journal":{"name":"Infektsionnye Bolezni","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67729300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.20953/1729-9225-2023-1-95-103
D. Isakov
During lifetime the human body is constantly in contact with various microorganisms, which can be either harmless and/or beneficial, or can cause various infectious diseases. Acute respiratory viral infections (ARVI) are the most common among them: according to the official report “The 2020 Status of Sanitary and Epidemiological Population Well-being in the Russian Federation” the economic cost of ARVI of multiple and unspecified localization was quite substantial, amounting to 606,505,442.0 roubles. The main causative agents of ARVI are influenza viruses type A and B, respiratory syncytial virus, parainfluenza viruses, rhinoviruses, adenoviruses, human metapneumoviruses and seasonal coronaviruses. Several viruses, such as influenza virus, measles virus and coronaviruses MERS-CoV and SARS-CoV-2 (causative agent of the novel coronavirus infection COVID-19) can cause severe pneumonia, which clinical picture can partially resemble seasonal ARVI. In addition to the well-known respiratory pathogens, special attention should be given to human herpesviruses with lifelong persistence that can cause chronic infections as well as reveal impaired immune surveillance. They are also detected in reactivation state in human lung (and other) tissues during asymptomatic course (HSV-1, EBV, CMV, HHV-6B, HHV-7). In this regard, it is essential to analyse the latest data on herpesviruses reactivation, especially during the ongoing COVID-19 pandemic. Key words: latent herpesviruses, genome editing, memory T-cell, recombinant interferon alpha-2b, Ophthalmoferon, Herpferon, Grippferon, COVID-19
{"title":"Innovative approaches to treatment of human herpesvirus infections during the COVID-19 pandemic","authors":"D. Isakov","doi":"10.20953/1729-9225-2023-1-95-103","DOIUrl":"https://doi.org/10.20953/1729-9225-2023-1-95-103","url":null,"abstract":"During lifetime the human body is constantly in contact with various microorganisms, which can be either harmless and/or beneficial, or can cause various infectious diseases. Acute respiratory viral infections (ARVI) are the most common among them: according to the official report “The 2020 Status of Sanitary and Epidemiological Population Well-being in the Russian Federation” the economic cost of ARVI of multiple and unspecified localization was quite substantial, amounting to 606,505,442.0 roubles. The main causative agents of ARVI are influenza viruses type A and B, respiratory syncytial virus, parainfluenza viruses, rhinoviruses, adenoviruses, human metapneumoviruses and seasonal coronaviruses. Several viruses, such as influenza virus, measles virus and coronaviruses MERS-CoV and SARS-CoV-2 (causative agent of the novel coronavirus infection COVID-19) can cause severe pneumonia, which clinical picture can partially resemble seasonal ARVI. In addition to the well-known respiratory pathogens, special attention should be given to human herpesviruses with lifelong persistence that can cause chronic infections as well as reveal impaired immune surveillance. They are also detected in reactivation state in human lung (and other) tissues during asymptomatic course (HSV-1, EBV, CMV, HHV-6B, HHV-7). In this regard, it is essential to analyse the latest data on herpesviruses reactivation, especially during the ongoing COVID-19 pandemic. Key words: latent herpesviruses, genome editing, memory T-cell, recombinant interferon alpha-2b, Ophthalmoferon, Herpferon, Grippferon, COVID-19","PeriodicalId":37794,"journal":{"name":"Infektsionnye Bolezni","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67729022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：