Pub Date : 2021-01-01DOI: 10.20953/1729-9225-2021-1-71-82
N. Skripchenko, E. Egorova, A. Vilnits, E. Skripchenko, L. A. Alekseeva
Purulent meningitis in children is a severe disease characterized by high mortality, particularly in case of pneumococcal infection. Cerebrovascular lesions in purulent meningitis are one of the most important pathogenic factors that determine the course of the disease. The severity of vascular lesions (including those to cerebral vessels) in bacterial infection depends on patient’s age and disease severity, which is associated with its etiology. Objective. To characterize cerebrovascular disorders in children with purulent meningitis and assess their association with the disease etiology and severity. Patients and methods. This study included 80 children aged 1 month to 17 years and 11 months with purulent meningitis caused by different pathogens and confirmed cerebrovascular lesions. In addition to clinical monitoring, all patients have undergone blood clotting tests (including platelet count, prothrombin, fibrinogen, activated partial thromboplastin time, and thrombin time), and assessment of D-dimer and level of circulating endothelial cells during the disease. Results. We observed various lesions to vessels in children with purulent meningitis, which is attributed to both structural and functional impairments in the vessel wall, as well as to an impaired vasomotor function of the endothelium. Conclusion. We found that cytoflavin, a drug with a multimodal action (including endothelium protection), was effective for the treatment of purulent meningitis. Key words: children, purulent meningitis, cerebrovascular disorders, vasculitis, D-dimer, circulating endothelial cells, cytoflavin
{"title":"Cerebrovascular lesions in children with purulent meningitis","authors":"N. Skripchenko, E. Egorova, A. Vilnits, E. Skripchenko, L. A. Alekseeva","doi":"10.20953/1729-9225-2021-1-71-82","DOIUrl":"https://doi.org/10.20953/1729-9225-2021-1-71-82","url":null,"abstract":"Purulent meningitis in children is a severe disease characterized by high mortality, particularly in case of pneumococcal infection. Cerebrovascular lesions in purulent meningitis are one of the most important pathogenic factors that determine the course of the disease. The severity of vascular lesions (including those to cerebral vessels) in bacterial infection depends on patient’s age and disease severity, which is associated with its etiology. Objective. To characterize cerebrovascular disorders in children with purulent meningitis and assess their association with the disease etiology and severity. Patients and methods. This study included 80 children aged 1 month to 17 years and 11 months with purulent meningitis caused by different pathogens and confirmed cerebrovascular lesions. In addition to clinical monitoring, all patients have undergone blood clotting tests (including platelet count, prothrombin, fibrinogen, activated partial thromboplastin time, and thrombin time), and assessment of D-dimer and level of circulating endothelial cells during the disease. Results. We observed various lesions to vessels in children with purulent meningitis, which is attributed to both structural and functional impairments in the vessel wall, as well as to an impaired vasomotor function of the endothelium. Conclusion. We found that cytoflavin, a drug with a multimodal action (including endothelium protection), was effective for the treatment of purulent meningitis. Key words: children, purulent meningitis, cerebrovascular disorders, vasculitis, D-dimer, circulating endothelial cells, cytoflavin","PeriodicalId":37794,"journal":{"name":"Infektsionnye Bolezni","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67724362","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 : 2021-01-01DOI: 10.20953/1729-9225-2021-1-58-63
J.-C. Khakizimana, V. N. Timchenko, V. Novikova, O. Gurina, T. Chernova, A. E. Blinov, O. Varlamova, O. V. Bulina, M. A. Shakmaeva
Objective. To analyze clinical and laboratory parameters, as well as the dynamics of cytokine production in children of different ages with acute infectious mononucleosis caused by Epstein-Barr virus (EBV mononucleosis). Patients and methods. We examined two groups of patients: group I included 20 children aged 1 to 7 years, whereas group II included 29 children aged 8 to 17 years. All study participants were tested in the acute phase of the disease and in early convalescence. We evaluated serum levels of interleukin-6 (IL-6), interleukin-10 (IL-10), tumor necrosis factor-α (TNF-α), and interferon-α (IFN-α) using enzyme-linked immunosorbent assay (ELISA) (standard Vektor-Best kits, Russia). Data analysis was performed using Microsoft Excel 2019 for Windows and IBM SPSS statistics; we applied the methods of non-parametric statistics. Differences were considered significant at p < 0.05. Results. The majority of children had fever, intoxication, acute tonsillitis, and enlarged cervical lymph nodes. Laboratory makers, such as lymphocytosis, neutropenia, and thrombocytopenia were more pronounced in children from group II. In both groups, the level of cytokines in the acute period of the disease was higher than the discriminatory one. In early convalescence, patients from group I demonstrated more significant reduction in the cytokine level than patients from group II (р < 0.05). In children over 7 years of age, the levels of IL-10 and TNF-α positively correlated with the disease duration (p < 0.01 and p < 0.05, respectively) Conclusion. The level of cytokine production in acute EBV mononucleosis depends on patients’ age. Concentrations of IL-10 and TNF-α can serve as markers reflecting the severity of EBV mononucleosis and can be used for disease prognosis. Key words: EBV mononucleosis, children, cytokines, IL-6, IL-10, TNF-α, IFN-α
{"title":"Cytokine production and clinical and laboratory aspects of EBV-associated acute infectious mononucleosis in children","authors":"J.-C. Khakizimana, V. N. Timchenko, V. Novikova, O. Gurina, T. Chernova, A. E. Blinov, O. Varlamova, O. V. Bulina, M. A. Shakmaeva","doi":"10.20953/1729-9225-2021-1-58-63","DOIUrl":"https://doi.org/10.20953/1729-9225-2021-1-58-63","url":null,"abstract":"Objective. To analyze clinical and laboratory parameters, as well as the dynamics of cytokine production in children of different ages with acute infectious mononucleosis caused by Epstein-Barr virus (EBV mononucleosis). Patients and methods. We examined two groups of patients: group I included 20 children aged 1 to 7 years, whereas group II included 29 children aged 8 to 17 years. All study participants were tested in the acute phase of the disease and in early convalescence. We evaluated serum levels of interleukin-6 (IL-6), interleukin-10 (IL-10), tumor necrosis factor-α (TNF-α), and interferon-α (IFN-α) using enzyme-linked immunosorbent assay (ELISA) (standard Vektor-Best kits, Russia). Data analysis was performed using Microsoft Excel 2019 for Windows and IBM SPSS statistics; we applied the methods of non-parametric statistics. Differences were considered significant at p < 0.05. Results. The majority of children had fever, intoxication, acute tonsillitis, and enlarged cervical lymph nodes. Laboratory makers, such as lymphocytosis, neutropenia, and thrombocytopenia were more pronounced in children from group II. In both groups, the level of cytokines in the acute period of the disease was higher than the discriminatory one. In early convalescence, patients from group I demonstrated more significant reduction in the cytokine level than patients from group II (р < 0.05). In children over 7 years of age, the levels of IL-10 and TNF-α positively correlated with the disease duration (p < 0.01 and p < 0.05, respectively) Conclusion. The level of cytokine production in acute EBV mononucleosis depends on patients’ age. Concentrations of IL-10 and TNF-α can serve as markers reflecting the severity of EBV mononucleosis and can be used for disease prognosis. Key words: EBV mononucleosis, children, cytokines, IL-6, IL-10, TNF-α, IFN-α","PeriodicalId":37794,"journal":{"name":"Infektsionnye Bolezni","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67724615","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 : 2021-01-01DOI: 10.20953/1729-9225-2021-3-116-122
A. Zaplatnikov, E. Kondyurina
In this article, we discuss the problem of improving vaccination efficacy in children using an antiviral drug with an immunomodulatory effect Anaferon for children produced in Russia. We analyzed the results of randomized clinical trials (RCTs) evaluating the efficacy and safety of Anaferon for children during vaccination against influenza and pneumococcal infection, including that in children with frequent respiratory infections. According to RCT, Anaferon for children used for the prevention of acute respiratory viral infections (ARVI) in combination with specific immunoprophylaxis of influenza and pneumococcal infection, increased the vaccination coverage by reducing the frequency of ARVI episodes before vaccination period and facilitating the development of an adequate immune response after vaccination. Anaferon for children also demonstrated a good safety profile. We described the schemes of ARVI/influenza prevention: 1 tablet a day for 2–4 weeks before vaccination with possible continuation after vaccination for up to 3 months, depending on the clinical situation during the development of active immunity. The results of RCTs and many years of experience allow us to recommend Anaferon for children combination with specific immunoprophylaxis to optimize the vaccination campaign, especially in children with low resistance to infections. It is particularly important during the pandemic of new coronavirus infection. Key words: vaccination, Anaferon for children, prevention, acute respiratory viral infections
{"title":"Problems of vaccination and ways to optimize it: a review of randomized clinical trials evaluating Anaferon for children","authors":"A. Zaplatnikov, E. Kondyurina","doi":"10.20953/1729-9225-2021-3-116-122","DOIUrl":"https://doi.org/10.20953/1729-9225-2021-3-116-122","url":null,"abstract":"In this article, we discuss the problem of improving vaccination efficacy in children using an antiviral drug with an immunomodulatory effect Anaferon for children produced in Russia. We analyzed the results of randomized clinical trials (RCTs) evaluating the efficacy and safety of Anaferon for children during vaccination against influenza and pneumococcal infection, including that in children with frequent respiratory infections. According to RCT, Anaferon for children used for the prevention of acute respiratory viral infections (ARVI) in combination with specific immunoprophylaxis of influenza and pneumococcal infection, increased the vaccination coverage by reducing the frequency of ARVI episodes before vaccination period and facilitating the development of an adequate immune response after vaccination. Anaferon for children also demonstrated a good safety profile. We described the schemes of ARVI/influenza prevention: 1 tablet a day for 2–4 weeks before vaccination with possible continuation after vaccination for up to 3 months, depending on the clinical situation during the development of active immunity. The results of RCTs and many years of experience allow us to recommend Anaferon for children combination with specific immunoprophylaxis to optimize the vaccination campaign, especially in children with low resistance to infections. It is particularly important during the pandemic of new coronavirus infection. Key words: vaccination, Anaferon for children, prevention, acute respiratory viral infections","PeriodicalId":37794,"journal":{"name":"Infektsionnye Bolezni","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67725287","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 : 2021-01-01DOI: 10.20953/1729-9225-2021-3-24-29
V. Krasnov, A. A. Katirkina, P. G. Zubarov, A. Levina, G. S. Bragina, E. N. Vyzhlova
Objective. To evaluate the efficacy and safety of VIFERON® (recombinant interferon α-2b) rectal suppositories and gel for external and local use in the complex therapy of COVID-19 in adult patients. Patients and methods. 140 patients with COVID-19 were included in a prospective comparative controlled research study. The main group consisted of 71 patients who received standard therapy for coronavirus infection in combination with VIFERON® (rectal suppositories 3.000.000 IU for 1 supp. 3 times a day and gel 36.000 IU/g 5 times a day on the surface of nasal mucosa and palatine tonsils for 14 days); the comparison group – 69 patients who received standard therapy. Results. Patients who received VIFERON® complex therapy demonstrated more rapid clinical improvement by reducing the duration of symptoms of weakness and intoxication compared to the patients who received only standard therapy. The high activity of VIFERON® in elimination rate of SARS-CoV-2 RNA in nasopharyngeal samples was shown. The use of VIFERON® made it possible to achieve a stable concentration of IL-6 in the blood serum during the entire follow-up period. There were no adverse events associated with the administration of VIFERON®. Conclusion. The results obtained indicate the superiority of therapy with the inclusion of VIFERON® over standard therapy. Given the favorable safety profile, the studied regimen can be recommended for the treatment of adult patients, especially from risk groups, where the possibilities of conventional etiotropic therapy are limited due to possible toxicological effects. Key words: VIFERON®, human recombinant interferon α-2b, COVID-19 coronavirus infection
{"title":"Efficacy of recombinant interferon α-2b in the complex therapy of COVID-19","authors":"V. Krasnov, A. A. Katirkina, P. G. Zubarov, A. Levina, G. S. Bragina, E. N. Vyzhlova","doi":"10.20953/1729-9225-2021-3-24-29","DOIUrl":"https://doi.org/10.20953/1729-9225-2021-3-24-29","url":null,"abstract":"Objective. To evaluate the efficacy and safety of VIFERON® (recombinant interferon α-2b) rectal suppositories and gel for external and local use in the complex therapy of COVID-19 in adult patients. Patients and methods. 140 patients with COVID-19 were included in a prospective comparative controlled research study. The main group consisted of 71 patients who received standard therapy for coronavirus infection in combination with VIFERON® (rectal suppositories 3.000.000 IU for 1 supp. 3 times a day and gel 36.000 IU/g 5 times a day on the surface of nasal mucosa and palatine tonsils for 14 days); the comparison group – 69 patients who received standard therapy. Results. Patients who received VIFERON® complex therapy demonstrated more rapid clinical improvement by reducing the duration of symptoms of weakness and intoxication compared to the patients who received only standard therapy. The high activity of VIFERON® in elimination rate of SARS-CoV-2 RNA in nasopharyngeal samples was shown. The use of VIFERON® made it possible to achieve a stable concentration of IL-6 in the blood serum during the entire follow-up period. There were no adverse events associated with the administration of VIFERON®. Conclusion. The results obtained indicate the superiority of therapy with the inclusion of VIFERON® over standard therapy. Given the favorable safety profile, the studied regimen can be recommended for the treatment of adult patients, especially from risk groups, where the possibilities of conventional etiotropic therapy are limited due to possible toxicological effects. Key words: VIFERON®, human recombinant interferon α-2b, COVID-19 coronavirus infection","PeriodicalId":37794,"journal":{"name":"Infektsionnye Bolezni","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67726137","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 : 2021-01-01DOI: 10.20953/1729-9225-2021-3-43-57
E. Nurmukhametova, N. Blokhina, N.Yu. Tikhonova
Direct-acting antivirals (DAAs) have significantly changed the treatment of chronic hepatitis C (CHC) and the prognosis for patients since their introduction into clinical practice in 2014–2015. Objective. Study of the evolution and efficacy of antiviral therapy (AVT) for CHC based on the results of providing medical care to patients in Moscow in 2002–2020. Patients and methods. The study was conducted in the Center for the Treatment of Chronic Viral Hepatitis “Infectious Clinical Hospital No 1 of the Moscow City Health Department”. For quantitative variables, the mean and standard deviation were used, while for categorical variables, frequency and proportion were counted (%). Results. 69,745 patients were diagnosed with CHC among all the patients who were examined in the Center. The pooled SVR rate of various therapy regimens was as follows in the HCV genotype 1 (GT1) cohort: IFN + ribavirin – 41.7%; DAAs + PegIFN + ribavirin – 77.4%; IFN-free regimens – 94.0%. Age older than 40 years, diabetes mellitus (DM), history of AVT failure (retreatment), and liver cirrhosis (LC) adversely affected the achievement of SVR. In the patients with HCV GT2 and GT3, the IFN + ribavirin combination allowed SVR achievement in 68.5% of patients, while IFN-free regimens were effective in 95.2% of patients. The predictive factors for achieving SVR were similar to those in the GT1 subgroup, except that the effect of age and DM did not reach statistical significance. Conclusions. The efficacy of DAAs in real clinical practice significantly exceeds the efficacy of IFN-based regimens in patients with various HCV infection genotypes. Achievement of SVR as a result of AVT reduces the likelihood of LC and HCC development. Key words: viral hepatitis, chronic hepatitis, antiviral therapy, peginterferon, interferon-free, dual therapy, triple therapy
{"title":"Antiviral therapy for chronic hepatitis C: many years of real clinical experience","authors":"E. Nurmukhametova, N. Blokhina, N.Yu. Tikhonova","doi":"10.20953/1729-9225-2021-3-43-57","DOIUrl":"https://doi.org/10.20953/1729-9225-2021-3-43-57","url":null,"abstract":"Direct-acting antivirals (DAAs) have significantly changed the treatment of chronic hepatitis C (CHC) and the prognosis for patients since their introduction into clinical practice in 2014–2015. Objective. Study of the evolution and efficacy of antiviral therapy (AVT) for CHC based on the results of providing medical care to patients in Moscow in 2002–2020. Patients and methods. The study was conducted in the Center for the Treatment of Chronic Viral Hepatitis “Infectious Clinical Hospital No 1 of the Moscow City Health Department”. For quantitative variables, the mean and standard deviation were used, while for categorical variables, frequency and proportion were counted (%). Results. 69,745 patients were diagnosed with CHC among all the patients who were examined in the Center. The pooled SVR rate of various therapy regimens was as follows in the HCV genotype 1 (GT1) cohort: IFN + ribavirin – 41.7%; DAAs + PegIFN + ribavirin – 77.4%; IFN-free regimens – 94.0%. Age older than 40 years, diabetes mellitus (DM), history of AVT failure (retreatment), and liver cirrhosis (LC) adversely affected the achievement of SVR. In the patients with HCV GT2 and GT3, the IFN + ribavirin combination allowed SVR achievement in 68.5% of patients, while IFN-free regimens were effective in 95.2% of patients. The predictive factors for achieving SVR were similar to those in the GT1 subgroup, except that the effect of age and DM did not reach statistical significance. Conclusions. The efficacy of DAAs in real clinical practice significantly exceeds the efficacy of IFN-based regimens in patients with various HCV infection genotypes. Achievement of SVR as a result of AVT reduces the likelihood of LC and HCC development. Key words: viral hepatitis, chronic hepatitis, antiviral therapy, peginterferon, interferon-free, dual therapy, triple therapy","PeriodicalId":37794,"journal":{"name":"Infektsionnye Bolezni","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67726206","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 : 2021-01-01DOI: 10.20953/1729-9225-2021-3-104-108
S. Engashev, V. Kukes, A. Poddubikov, N. G. Sidorov, O. K. Parfenova, A. Leonova, O. Dorogova
The second fraction of antiseptic Dorogov's stimulator (ASD-2F) is a derivative of raw biological materials, namely a mixture of products of thermal protein degradation. ‘ASD-2B drops’ is dietary supplement containing ASD-2F. Each component of ‘ASD-2B drops’ plays a role in some processes of a living organism. ASD-2F affects the functional activity of many organs and systems of the body and increases the resistance to negative factors, such as microorganisms causing various infectious diseases. The development of multidrug resistance by many microorganisms necessitates the search for new antimicrobial agents. In this study, we examined antimicrobial properties of ‘ASD-2B drops.’ We found that this substance affected the growth of the majority of microorganisms used in our experiments. The therapeutic dose recommended by the manufacturer demonstrated the most pronounced antimicrobial effect, which indicates the effectiveness of ‘ASD 2B drops’ in this dose. Our findings suggest that ASD-2F might have a high clinical significance. Key words: ‘ASD-2B drops,’ second fraction of antiseptic Dorogov's stimulator, antimicrobial activity
{"title":"Antimicrobial activity of the ASD-2F","authors":"S. Engashev, V. Kukes, A. Poddubikov, N. G. Sidorov, O. K. Parfenova, A. Leonova, O. Dorogova","doi":"10.20953/1729-9225-2021-3-104-108","DOIUrl":"https://doi.org/10.20953/1729-9225-2021-3-104-108","url":null,"abstract":"The second fraction of antiseptic Dorogov's stimulator (ASD-2F) is a derivative of raw biological materials, namely a mixture of products of thermal protein degradation. ‘ASD-2B drops’ is dietary supplement containing ASD-2F. Each component of ‘ASD-2B drops’ plays a role in some processes of a living organism. ASD-2F affects the functional activity of many organs and systems of the body and increases the resistance to negative factors, such as microorganisms causing various infectious diseases. The development of multidrug resistance by many microorganisms necessitates the search for new antimicrobial agents. In this study, we examined antimicrobial properties of ‘ASD-2B drops.’ We found that this substance affected the growth of the majority of microorganisms used in our experiments. The therapeutic dose recommended by the manufacturer demonstrated the most pronounced antimicrobial effect, which indicates the effectiveness of ‘ASD 2B drops’ in this dose. Our findings suggest that ASD-2F might have a high clinical significance. Key words: ‘ASD-2B drops,’ second fraction of antiseptic Dorogov's stimulator, antimicrobial activity","PeriodicalId":37794,"journal":{"name":"Infektsionnye Bolezni","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67725464","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 : 2021-01-01DOI: 10.20953/1729-9225-2021-4-29-36
E. Grebenkina, D. Usenko, O. Chugunova
In recent years, significant breakthroughs have been made in the study of etiology, pathogenesis, and the development of accessible diagnostic methods, as well as in the treatment of acute intestinal infections, resulting in a significantly lower frequency of their severe course and adverse outcomes and in reducing the frequency and duration of hospitalization. At the same time, the emergence of modern biochemical markers of injury of different organs and systems makes it possible to investigate new pathological conditions that were previously detected in the stage of clinical manifestations. These include the problem of early diagnosis of acute kidney injury in children, the frequency and timing of which have not yet been studied. Objective. Comparative evaluation of the diagnostic value of glomerular filtration rate and serum cystatin C levels for early diagnosis of kidney failure in children with acute intestinal infections (AII). Patients and methods. This study included 80 children with acute intestinal infection who were hospitalized in G.N.Speransky Children’s Clinical Hospital No 9. In all cases the course of disease was moderate-to-severe without developing hemolyticuremic syndrome. To assess kidney function in the acute period of intestinal infection, we studied glomerular filtration rate (GFR) by the “bedside” Schwartz equation, as well as serum cystatin C levels. Results. In the acute period of AII in children under 3 years of age, GFR was 98.56 ± 2.84 mL/min/1.73 m2 according to the “bedside” Schwartz equation of 2009. In the group of children over 3–7 years of age, these values were 108.85 ± 3.84 mL/min/1.73 m2, differences are statistically significant (p < 0.001). High (>950 ng/mL) serum cystatin C levels were found in 22% of patients. In other patients, cystatin C levels remained within or below the normal range. The analysis showed that 10% of children in the age group of 1–3 years and 2.5% of children in the age group of 3–7 years were at risk of developing acute kidney injury in AII, according to the GFR estimation based on the Schwartz “bedside” equation and cystatin C-based equation. When assessing the risk of developing acute kidney injury according to the GFR estimation using the cystatin C-based equation, the proportion of such patients in the age group of 1–3 years was 20% and in the age group of 3–7 years – 22%, and when assessing GFR according to the Schwartz “bedside” equation only, the proportion of children was 7.5% and 7.5%, respectively. Conclusion. Determination of cystatin C levels in children in the early period of acute intestinal infections of moderate severity is an earlier and more accurate marker of acute kidney injury, regardless of age and sex of patients, in comparison with the evaluation of glomerular filtration rate. Inclusion of cystatin C in laboratory test plan allows timely identification of patients who are in the risk group of developing acute kidney injury. Key words: children, kidney failure,
{"title":"Early diagnosis of kidney failure in children with acute intestinal infections","authors":"E. Grebenkina, D. Usenko, O. Chugunova","doi":"10.20953/1729-9225-2021-4-29-36","DOIUrl":"https://doi.org/10.20953/1729-9225-2021-4-29-36","url":null,"abstract":"In recent years, significant breakthroughs have been made in the study of etiology, pathogenesis, and the development of accessible diagnostic methods, as well as in the treatment of acute intestinal infections, resulting in a significantly lower frequency of their severe course and adverse outcomes and in reducing the frequency and duration of hospitalization. At the same time, the emergence of modern biochemical markers of injury of different organs and systems makes it possible to investigate new pathological conditions that were previously detected in the stage of clinical manifestations. These include the problem of early diagnosis of acute kidney injury in children, the frequency and timing of which have not yet been studied. Objective. Comparative evaluation of the diagnostic value of glomerular filtration rate and serum cystatin C levels for early diagnosis of kidney failure in children with acute intestinal infections (AII). Patients and methods. This study included 80 children with acute intestinal infection who were hospitalized in G.N.Speransky Children’s Clinical Hospital No 9. In all cases the course of disease was moderate-to-severe without developing hemolyticuremic syndrome. To assess kidney function in the acute period of intestinal infection, we studied glomerular filtration rate (GFR) by the “bedside” Schwartz equation, as well as serum cystatin C levels. Results. In the acute period of AII in children under 3 years of age, GFR was 98.56 ± 2.84 mL/min/1.73 m2 according to the “bedside” Schwartz equation of 2009. In the group of children over 3–7 years of age, these values were 108.85 ± 3.84 mL/min/1.73 m2, differences are statistically significant (p < 0.001). High (>950 ng/mL) serum cystatin C levels were found in 22% of patients. In other patients, cystatin C levels remained within or below the normal range. The analysis showed that 10% of children in the age group of 1–3 years and 2.5% of children in the age group of 3–7 years were at risk of developing acute kidney injury in AII, according to the GFR estimation based on the Schwartz “bedside” equation and cystatin C-based equation. When assessing the risk of developing acute kidney injury according to the GFR estimation using the cystatin C-based equation, the proportion of such patients in the age group of 1–3 years was 20% and in the age group of 3–7 years – 22%, and when assessing GFR according to the Schwartz “bedside” equation only, the proportion of children was 7.5% and 7.5%, respectively. Conclusion. Determination of cystatin C levels in children in the early period of acute intestinal infections of moderate severity is an earlier and more accurate marker of acute kidney injury, regardless of age and sex of patients, in comparison with the evaluation of glomerular filtration rate. Inclusion of cystatin C in laboratory test plan allows timely identification of patients who are in the risk group of developing acute kidney injury. Key words: children, kidney failure, ","PeriodicalId":37794,"journal":{"name":"Infektsionnye Bolezni","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67726363","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 : 2021-01-01DOI: 10.20953/1729-9225-2021-4-121-122
{"title":"Resolution of the Council of Experts. New possibilities of etiotropic therapy for coronavirus infection","authors":"","doi":"10.20953/1729-9225-2021-4-121-122","DOIUrl":"https://doi.org/10.20953/1729-9225-2021-4-121-122","url":null,"abstract":"","PeriodicalId":37794,"journal":{"name":"Infektsionnye Bolezni","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67726562","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 : 2021-01-01DOI: 10.20953/1729-9225-2021-1-159-164
E. Shavarova, E. R. Cazahmedov, M. Alekseeva, L. Ezhova, Z. Kobalava
The coronavirus disease COVID-19 is characterized by high mortality and the lack of effective etiotropic therapy. Activation of oxidative stress may be one of the links in the pathogenesis of organ damage of this infection. Objective. To assess the ability of Mexidol® to influence the rate of clinical improvement in pneumonia caused by the SARSCoV-2 virus in hospitalized patients with the novel coronavirus disease COVID-19 and concomitant discirculatory encephalopathy. 62 patients over the age of 18 years with confirmed new coronavirus disease COVID-19 according to computed tomography (CT) of the lungs (stages CT1, CT2, CT3) and PCR of a swab from the nasopharynx and oropharynx for SARS-CoV-2 virus RNA were included. After randomization patients of group 1 received an infusion of Mexidol® at a dose of 1000 mg/day, patients of group 2 – an infusion of isotonic sodium chloride solution for 7 days. Compared with the control group, the patients receiving Mexidol® therapy showed a significantly more pronounced decrease in body temperature, a tendency towards a decrease in the severity of shortness of breath. In the Mexidol® group, the concentration of superoxidedismutase did not change, while in the control group there was a tendency to its decrease, C-reactive protein decreased 2.2 times more than in the control group (p = 0.09). There was a tendency for a more rapid decrease in ferritin in the active intervention group. Mexidol® therapy can have a positive effect on the clinical manifestations and severity of laboratory-inflammatory syndrome in patients with the new coronavirus disease COVID-19. Key words: coronavirus disease COVID-19, oxidative stress, Mexidol
{"title":"Role of antioxidant therapy in patients with moderate and severe COVID-19","authors":"E. Shavarova, E. R. Cazahmedov, M. Alekseeva, L. Ezhova, Z. Kobalava","doi":"10.20953/1729-9225-2021-1-159-164","DOIUrl":"https://doi.org/10.20953/1729-9225-2021-1-159-164","url":null,"abstract":"The coronavirus disease COVID-19 is characterized by high mortality and the lack of effective etiotropic therapy. Activation of oxidative stress may be one of the links in the pathogenesis of organ damage of this infection. Objective. To assess the ability of Mexidol® to influence the rate of clinical improvement in pneumonia caused by the SARSCoV-2 virus in hospitalized patients with the novel coronavirus disease COVID-19 and concomitant discirculatory encephalopathy. 62 patients over the age of 18 years with confirmed new coronavirus disease COVID-19 according to computed tomography (CT) of the lungs (stages CT1, CT2, CT3) and PCR of a swab from the nasopharynx and oropharynx for SARS-CoV-2 virus RNA were included. After randomization patients of group 1 received an infusion of Mexidol® at a dose of 1000 mg/day, patients of group 2 – an infusion of isotonic sodium chloride solution for 7 days. Compared with the control group, the patients receiving Mexidol® therapy showed a significantly more pronounced decrease in body temperature, a tendency towards a decrease in the severity of shortness of breath. In the Mexidol® group, the concentration of superoxidedismutase did not change, while in the control group there was a tendency to its decrease, C-reactive protein decreased 2.2 times more than in the control group (p = 0.09). There was a tendency for a more rapid decrease in ferritin in the active intervention group. Mexidol® therapy can have a positive effect on the clinical manifestations and severity of laboratory-inflammatory syndrome in patients with the new coronavirus disease COVID-19. Key words: coronavirus disease COVID-19, oxidative stress, Mexidol","PeriodicalId":37794,"journal":{"name":"Infektsionnye Bolezni","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67724218","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 : 2021-01-01DOI: 10.20953/1729-9225-2021-1-91-96
V. Novikova, A. Khavkin, A. V. Polunina, A. Gorelov
This review summarizes relevant scientific literature analyzing the lung-gut axis and its association with coronavirus infection (COVID-19), lesions to the gastrointestinal tract caused by this infection, and state of the microbiome. Approximately 20%–50% of COVID-19 patients have such symptoms as nausea, vomiting, and diarrhea, as well as SARS-CoV-2 RNA detected in their feces. Therefore, investigation of the virus effect on the gastrointestinal tract and its commensal flora is important not only for research purposes, but for clinical practice, since patients with COVID-19 demonstrate both qualitative and quantitative changes in their microbiome. The latter may serve as a basis for the development of additional probiotic therapy for gastrointestinal lesions in COVID-19 patients. Despite the existing evidence, it is still necessary to clarify the effect of the intestinal microbiome on the pathogenesis of coronavirus infection and the disease course. Key words: COVID-19, coronavirus infection, microbiome, intestinal microbiota, SARS-CoV-2, probiotics, probiotic therapy
{"title":"The lung-gut axis and COVID-19","authors":"V. Novikova, A. Khavkin, A. V. Polunina, A. Gorelov","doi":"10.20953/1729-9225-2021-1-91-96","DOIUrl":"https://doi.org/10.20953/1729-9225-2021-1-91-96","url":null,"abstract":"This review summarizes relevant scientific literature analyzing the lung-gut axis and its association with coronavirus infection (COVID-19), lesions to the gastrointestinal tract caused by this infection, and state of the microbiome. Approximately 20%–50% of COVID-19 patients have such symptoms as nausea, vomiting, and diarrhea, as well as SARS-CoV-2 RNA detected in their feces. Therefore, investigation of the virus effect on the gastrointestinal tract and its commensal flora is important not only for research purposes, but for clinical practice, since patients with COVID-19 demonstrate both qualitative and quantitative changes in their microbiome. The latter may serve as a basis for the development of additional probiotic therapy for gastrointestinal lesions in COVID-19 patients. Despite the existing evidence, it is still necessary to clarify the effect of the intestinal microbiome on the pathogenesis of coronavirus infection and the disease course. Key words: COVID-19, coronavirus infection, microbiome, intestinal microbiota, SARS-CoV-2, probiotics, probiotic therapy","PeriodicalId":37794,"journal":{"name":"Infektsionnye Bolezni","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67724486","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：