scholarly journals Clinical picture in a child who often gets sick (a new look at the origin, diagnosis and treatment). Report 1. Origin and clinical picture

2021 ◽  
Vol 9 (4) ◽  
pp. 23-38
Author(s):  
I.S. Markov ◽  
A.I. Markov
Keyword(s):  
Infectious Diseases ◽  
Clinical Picture ◽  
Inflammatory Diseases ◽  
Clinical Manifestations ◽  
Diagnostic System ◽  
Enzyme Linked Immunosorbent Assay ◽  
Low Grade ◽  
Bacteriological Examination ◽  
Selective Iga Deficiency ◽  
Group I

Objective: to determine the clinical picture in children who often get sick, taking into account the currently available data from the medical literature and authors’ observations accumulated over the past 25 years of clinical practice. Materials and methods. The design of the study was clinical and diagnostic and included the search for ways to diagnose and treat pathological conditions that compose the current clinical picture of children who often get sick. The studies were prospective and retrospective, longitudinal, with long-term follow-up of a certain part of the same patients for 1–10 years after diagnosis of “frequently ill child” and appropriate treatment. In terms of the effectiveness of the results, the resear­ches were direct, because it undoubtedly contributed to the reco­very of the child with the improvement/normalization of his general state and quality of life. The studies were multicenter, conducted in an outpatient setting at the premises of two clinics specialized in the field of chronic infectious diseases, with full laboratory researches and the department of pediatric infectious diseases of the medical university. The participants were children from infancy to 14 years of age, whose parents in 2009–2020 consulted with complaints about frequent illnesses of their children. Results. In 2010–2020, the authors supervised 3,547 children, who often get sick (6–12 epi­sodes a year and even more: 1–2 disea­ses a month), and the period of each episode of their illness lasted more than 5–7 days. There were 862/3,547 (24.3 %) children under 3 years of age, 1,295/3,547 (36.5 %) from 3 to 7 years of age, and 1,390/3,547 (39.2 %) from 7 to 14 years of age. Given the clinically dominant symptoms, which are often intertwined into one holistic picture of these common diseases, children were divided into two large groups of observations. Group I, which was conventionally called “Clinical picture of frequently ill children with purulent-inflammatory diseases”, included 1,595/3,547 patients (45 %). Another 1,952/3,547 (55 %) individuals were included in group II with a conditional name “Clinical picture of frequently ill children with dominant toxic manifestations”. The second group of patients who often get sick also includes patients with fever not associated with acute purulent-inflammatory conditions or their recurren­ces. This group under supervision consisted of 1,952/3,547 (55 %) children — from infancy to 14 years with thermoregulatory disorders, including persistent low-grade fever — 1,206/1,952 (61.8 %), febrile seizures — 721/1952 (36.9 %) and 25/1,952 (1.3 %) children of mostly school age with fever at the level of 38–40 °C and above for several months to 4 years and other symptoms of chronic bacterial intoxication syndrome. All children were examined bacteriologically (nasopharyngeal, oral swab culture, etc., as well as warm urine tests three times, three days in a row), toxicologically using Toxicon diagnostic system; they also underwent gene­ral clinical examinations, enzyme-linked immunosorbent assay and polymerase chain reaction, determination of immunological status, according to indicators — instrumental examination. Two foci of chronic bacterial infection were found to be present in all frequently ill children: in the nasopharynx, which in 3,467/3,547, or 97.7 % of cases, was associated with S.aureus, and in the kidneys (nephrodysbacteriosis), which was dominated by enterococci and Escherichia coli accounted for almost 2/3 (3,312/5,313, or 63 %) of all isolated urinary strains and detected in the urine of a total of 3,312/3,547 (93.4 %) children. Based on toxicological examination of the blood, severe toxemia was found in the vast majority of children (77/96, or 80.2 %), 16/96 (16.7 %) had moderate and only 3/96 (3.1 %) — mild form. The form of intoxication was mainly compensated in 87/96 (90.6 %) patients, another 9/96 (9.4 %) had generalization stage. When determining the immune status studied in 2,160/3,547 (60.1 %) of frequently ill children from infancy to 14 years of age in both observation groups, it was found that cellular and humoral immunity was usually either within normal limits or often even higher than normal. Only in 67/2,160 (3.1 %) cases, mild cellular immunodeficiency was detected, and in 7/2,160 (0.3 %) children — selective IgA deficiency. Treatment of all 3,547 frequently ill children of both observation groups was performed using bacterial autovaccines made from strains isolated during bacteriological examination. The number of children who underwent treatment the consequences of which can be considered established and not associated with concomitant use of antibacterial drugs was 3,159/3,547, or 89.1 %. In total, 3,093/3159, or 97.9 % of frequently ill children, recovered completely within 6–24 months after starting antibiotic-free bacterial autovaccine treatment. Conclusions. The clinical picture of a child who often gets sick is currently collective and consists of symptoms of recurrent respiratory diseases or recurrent acute respiratory viral infections, recurrent purulent-inflammatory diseases of the nose, pharynx, mouth, ears, eyes and bronchopulmonary system, as well as clinical manifestations of chronic bacterial intoxication syndrome developed on the background of nephrodysbacteriosis. The etiological and pathogenetic diagnosis is confirmed by the results of bacteriological and toxicological examinations. Standard treatment of frequently ill children using antibiotics is not effective. A positive clinical effect can be achieved in 97.9 % of children with complete recovery after the use of bacterial autovaccines made from strains isolated during bacteriological examination.

scholarly journals Clinical picture in a child who often gets sick (a new look at the origin, diagnosis and treatment). Report 2. Diagnosis and treatment

2021 ◽  
Vol 9 (5-6) ◽  
pp. 6-20
Author(s):  
I.S. Markov ◽  
A.I. Markov
Keyword(s):  
Infectious Diseases ◽  
Clinical Picture ◽  
Inflammatory Diseases ◽  
Clinical Manifestations ◽  
Diagnosis And Treatment ◽  
Enzyme Linked Immunosorbent Assay ◽  
Low Grade ◽  
Bacteriological Examination ◽  
Selective Iga Deficiency ◽  
Group I

Objective: to determine the clinical picture in children who often get sick, taking into account the currently available data from the medical literature and authors’ observations accumulated over the past 25 years of clinical practice. Materials and methods. The design of the study was clinical and diagnostic and included the search for ways to diagnose and treat pathological conditions that compose the current clinical picture of children who often get sick. The studies were prospective and retrospective, longitudinal, with long-term follow-up of a certain part of the same patients for 1–10 years after diagnosis of “frequently ill child” and appropriate treatment. In terms of the effectiveness of the results, the researches were direct, because it undoubtedly contributed to the recovery of the child with the improvement/normalization of his general state and quality of life. The studies were multicenter, conducted in an outpatient setting at the premises of two clinics specialized in the field of chronic infectious diseases, with full laboratory researches and the department of pediatric infectious diseases of the medical university. The participants were children from infancy to 14 years of age, whose parents in 2009–2020 consulted with complaints about frequent illnesses of their children. Results. In 2010–2020, the authors supervised 3,547 children, who often get sick (6–12 episodes a year and even more: 1–2 diseases a month), and the period of each episode of their illness lasted more than 5–7 days. There were 862/3,547 (24.3 %) children under 3 years of age, 1,295/3,547 (36.5 %) from 3 to 7 years of age, and 1,390/3,547 (39.2 %) from 7 to 14 years of age. Given the clinically dominant symptoms, which are often intertwined into one holistic picture of these common diseases, children were divided into two large groups of observations. Group I, which was conventionally called “Clinical picture of frequently ill children with purulent-inflammatory diseases”, included 1,595/3,547 patients (45 %). Another 1,952/3,547 (55 %) individuals were included in group II with a conditional name “Clinical picture of frequently ill children with dominant toxic manifestations”. The second group of patients who often get sick also includes patients with fever not associated with acute purulent-inflammatory conditions or their recurrences. This group under supervision consisted of 1,952/3,547 (55 %) children — from infancy to 14 years with thermoregulatory disorders, including persistent low-grade fever — 1,206/1,952 (61.8 %), febrile seizures — 721/1952 (36.9 %) and 25/1,952 (1.3 %) children of mostly school age with fever at the level of 38–40 ºC and above for several months to 4 years and other symptoms of chronic bacterial intoxication syndrome. All children were examined bacteriologically (nasopharyngeal, oral swab culture, etc., as well as warm urine tests three times, three days in a row), toxicologically using Toxicon diagnostic system; they also underwent general clinical exa­minations, enzyme-linked immunosorbent assay and polymerase chain reaction, determination of immunological status, according to indicators — instrumental examination. Two foci of chronic bacterial infection were found to be present in all frequently ill children: in the nasopharynx, which in 3,467/3,547, or 97.7 % of cases, was associated with S.aureus, and in the kidneys (nephrodysbacteriosis), which was dominated by enterococci and Escherichia coli accounted for almost 2/3 (3,312/5,313, or 63 %) of all isolated urinary strains and detected in the urine of a total of 3,312/3,547 (93.4 %) children. Based on toxicological examination of the blood, severe toxemia was found in the vast majority of children (77/96, or 80.2 %), 16/96 (16.7 %) had moderate and only 3/96 (3.1 %) — mild form. The form of intoxication was mainly compensated in 87/96 (90.6 %) patients, another 9/96 (9.4 %) had generalization stage. When determining the immune status studied in 2,160/3,547 (60.1 %) of frequently ill children from infancy to 14 years of age in both observation groups, it was found that cellular and humoral immunity was usually either within normal limits or often even higher than normal. Only in 67/2,160 (3.1 %) cases, mild cellular immunodeficiency was detected, and in 7/2,160 (0.3 %) children — selective IgA deficiency. Treatment of all 3,547 frequently ill children of both observation groups was performed using bacterial autovaccines made from strains isolated during bacteriological examination. The number of children who underwent treatment the consequences of which can be considered established and not associated with concomitant use of antibacterial drugs was 3,159/3,547, or 89.1 %. In total, 3,093/3159, or 97.9 % of frequently ill children, recovered completely within 6–24 months after starting antibiotic-free bacterial autovaccine treatment. Conclusions. The clinical picture of a child who often gets sick is currently collective and consists of symptoms of recurrent respiratory diseases or recurrent acute respiratory viral infections, recurrent purulent-inflammatory diseases of the nose, pharynx, mouth, ears, eyes and bronchopulmonary system, as well as clinical manifestations of chronic bacterial intoxication syndrome developed on the background of nephrodysbacteriosis. The etiological and pathogenetic diagnosis is confirmed by the results of bacteriological and toxicological examinations. Standard treatment of frequently ill children using antibiotics is not effective. A positive clinical effect can be achieved in 97.9 % of children with complete recovery after the use of bacterial autovaccines made from strains isolated during bacteriological examination.

Serum phospholipases A2 in inflammatory diseases

1993 ◽  
Vol 39 (12) ◽  
pp. 2453-2459 ◽  
Author(s):  
T J Nevalainen
Keyword(s):  
Acute Pancreatitis ◽  
Catalytic Activity ◽  
Seminal Fluid ◽  
Inflammatory Diseases ◽  
Pancreatic Acinar Cell ◽  
Enzyme Linked Immunosorbent Assay ◽  
Serum Samples ◽  
Gland Cells ◽  
Group I ◽  
Cellular Source

Abstract Phospholipase A2 (EC 3.1.1.4; PLA2) is detected in serum by determination of either the catalytic activity of the enzyme or the concentration of the enzyme protein by immunoassays. The most sensitive methods for determining PLA2 catalytic activity are radiometric assays, with a substrate of synthetic phospholipid (e.g., phosphatidylcholine or phosphatidylethanolamine) containing a 14C- or 3H-labeled fatty acid at the sn-2-position. Membranes of autoclaved Escherichia coli grown in the presence of radioactive oleic acid may also be used as a substrate. The released fatty acids are separated from the unreacted substrate and quantified by liquid scintillation counting. PLA2 catalytic activities are increased in serum in sepsis, acute pancreatitis, peritonitis, multiple injuries, rheumatoid arthritis, and other arthropathies. Immunoassays--radioimmunoassay, enzyme-linked immunosorbent assay, or time-resolved fluoroimmunoassay--are based on the use of either polyclonal or monoclonal antibodies to purified PLA2s. Specific assays have been developed for both pancreatic group I PLA2 (PLA2-I) and nonpancreatic group II PLA2 (PLA2-II). The cellular source of PLA2-I in serum is the pancreatic acinar cell. Increased serum PLA2-I values have been reported in acute pancreatitis, pancreatic cancer, and abdominal trauma. Increased PLA2-II values are found in conditions involving inflammation, e.g., sepsis, infections, acute pancreatitis, various forms of arthritis, cancer, complications of pregnancy, and postoperative states. Good correlations have been found in serum samples between the catalytic activity of PLA2 and the concentration of PLA2-II but not PLA2-I. PLA2-II may represent an acute-phase protein. The cellular source of the PLA2-II in serum is unknown; it is present in large amounts in cartilage and Paneth cells, prostatic gland cells, seminal fluid, lacrimal gland cells, and tears, but cannot be demonstrated by immunohistochemical or immunochemical methods in inflammatory cells.

scholarly journals Prolonged subfebrile condition, pyretic fever and febrile attacks of unknown genesis: new approach to diagnosis and treatment. Part 1. Clinical picture

2021 ◽  
Vol 9 (4) ◽  
pp. 6-14
Author(s):  
I.S. Markov ◽  
A.I. Markov
Keyword(s):  
Bacterial Infection ◽  
Temperature Regime ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Unknown Origin ◽  
Chronic Pyelonephritis ◽  
Low Grade ◽  
Bacteriological Examination ◽  
Short Term ◽  
Pathological Conditions

Background. The study was aimed to establish the true etiological cause of such pathological conditions as prolonged low-grade fever, fever of unknown genesis, and cases of rapid short-term febrile increase of temperature of unknown origin. Materials and methods. The design of the study was clinical-diagnostic and included the search for ways to diagnose and treat such pathological conditions as prolonged subfebrile fever, fever of unknown genesis, and cases of rapid short-term febrile increase of temperature of unknown origin. The studies were prospective-retrospective and were longitudinal with long-term periodic follow-up of a certain part of the same patients during 1–10 years after diagnosis of CBIS (chronic bacterial intoxication syndrome) and appropriate treatment. According to the effectiveness of the obtained results, the study was direct, because it undoubtedly led to the recovery of the patient with the improvement of his/her state and life. All patients (infants and adults aged till 80 years) who went to the hospital during 2009–2020 with complaints about violation of the temperature regime (subfebrile or febrile increase). Results. During 2009–2020, 3999 patients (adults — 2047/3999, 51.2 %, children — 1952/3999, 48.8 %) with a fever of unknown origin, namely 1578/2047 (77.1 %) adults and 1206/1952 (61.8 %) children with prolonged subfebrile fever, 70/2047 (3.4 %) and 25/1952 (1.3 %), respectively — with febrile fever and 399/2047 (19.5 %) and 721/1952 (36.9 %) — with febrile attacks (FA), were observed by the authors. In all 3999 (100 %) patients, there was detected a focus of chronic bacterial infection in the kidneys. Herewith in more than 2/3 cases (2780/3999 patients, 69.5 %), there was diagnosed the locally asymptomatic nephrodysbacteriosis without clinical, general laboratory (inclu­ding almost normal general analysis of urine) and instrumental signs of the inflammatory process in the kidneys. In 960/3999 (24.0 %) ca­ses, there was first established the latent form of delayed clinically asymptomatic chronic pyelonephritis. 259/3999 (6.5 %) patients were diagnosed with chronic pyelonephritis at the stage of clinical exacerbation. As a consequence of the formation of a focus of chronic bacterial infection in the kidneys, the patients developed monosymptomatic (only with temperature increase) or full-symptom CBIS, namely: 2024/2784 (72.7 %) children and adults with prolonged subfebrile fever there presented with typical clinical manifestations of CBIS in various combinations, but in 760/2784 (27.3 %) cases, the subfebrile temperature was monosymptoma­tic without other complaints and clinical symptoms. The diagnosis was confirmed by bacteriological examination of warm urine (three times, for three days running) and toxicological blood examination using the diagnostic system Toxicon. Urine cultures of various bacteria were isolated from urine in all 3999 (100 %) patients. Herewith in 2205/3999 (55.1 %) cases, there were isolated one culture of bacteria in each case, in 1608/3999 (40.2 %) patients — simultaneously two cultures of different bacteria, i.e. another 3216 strains, in 186/3999 (4,7 %) — three cultures (558 strains). That is, in general, there were isolated 5979 strains of different bacteria, which were considered as diagnostic confirmation of the presence of a focus of chronic bacterial infection in the kidneys in all 3999 patients with prolonged subfebrile fever, fever of unknown genesis, or febrile attacks. The main factors of the occurrence of temperature regime disorders on the background of CBIS were Enterococci (2471/3999 strains from 61.8 % of patients), Escherichia coli — 1495/3999 strains (from 37.4 % of patients) and Staphylococci (Staphylococcus aureus and Staphylococcus haemolyticus) and Streptococci (Streptococcus pyogenes): a total of 696/3999 strains (from 17.4 % of patients). In 818 (100 %) patients who were examined using the Toxi­con system, all, without exception, the indicators of cytolytic activity of toxic proteomes, which were tested, significantly exceeded the norm (p < 0.001). In the vast majority of patients (in 664/818 or 81.17 % of cases), there was detected severe toxemia, in 140/818 (17.11 %) — moderate and only in 14 (1.71 %) — mild. All 3999 patients with prolonged subfebrile fever, fever of unknown genesis, and FA were treated with bacterial autovaccines made from strains, isolated during the bacteriological examination. One cycle consisted of 2–3 courses of immunization with bacterial vaccines. One course included 10 or 12 subcutaneous injections in increasing dosage during 19–21 days. Between courses, there was maintained an interval of 3 to 4 weeks. The treatment cycle generally lasted from 70 to 110 days, depending on the number of courses. Intervals between treatment cycles were usually maintained for 3 months. The effectiveness of such treatment was 71.2 % after the first cycle, 92.8 % — after the second, and 99.2 % — after the third with full recovery of the ability to work, lost during the illness, and the emotional level of personal life. Conclusions. It has been established that the etiological cause of the occurrence of prolonged subfebrile fever, febrile fevers of unknown genesis, and febrile attacks is such a clinically and nosologically separate disease as chronic bacterial intoxication syndrome, which develops on the background of a chronic bacterial focus, usually locally asymptomatic infection in the kidneys, called nephrodysbacteriosis, and is usually associated with severe bacterial endotoxicosis that was confirmed by appropriate toxicological examination of the blood. The use of bacterial autovaccines was proved to be an effective method of treatment (up to 99.2 %) of patients with increased temperature of bacterial-toxic origin.

scholarly journals A mini review of electrochemical genosensor based biosensor diagnostic system for infectious diseases

2021 ◽  
Vol 1 (1) ◽  
pp. 14-17
Author(s):  
Nor Azizah Parmin ◽  
Uda Hashim ◽  
Subash C.B. Gopinath ◽  
Farrah Aini Dahalan ◽  
C.H. Voon ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Pathogenic Bacteria ◽  
Diagnostic System ◽  
Alternative Methods ◽  
Enzyme Linked Immunosorbent Assay ◽  
Chain Reaction ◽  
Food Protection ◽  
Detection Systems ◽  
Polymerase Chain ◽  
Electrochemical Genosensor

The quest for alternative methods is driven by the need to provide expertise in real time in biological fields such as medicine, pathogenic bacteria and viruses identification, food protection, and quality control. Polymerase Chain Reaction (PCR) and Enzyme Linked Immunosorbent Assay (ELISA) are examples of traditional methods that have some limitations and lengthy procedures. Biosensors are the most appealing option because they provide easy, dependable, fast, and selective detection systems compared to conventional methods. This review provides an overview of electrochemical genosensor based biosensor diagnostic system for infectious diseases detection as well as their applications, demonstrating their utility as a fast and responsive tool for detecting pathogenic bacteria, viruses, GMOs, and human diseases.

scholarly journals Complications of Urogenital Chlamydial Infection in Women

2019 ◽  
Vol 26 (1) ◽  
Author(s):  
Oksana Kukhta ◽  
Oleksandr Aleksandruk
Keyword(s):  
Ectopic Pregnancy ◽  
Chlamydial Infection ◽  
Inflammatory Diseases ◽  
Wide Spectrum ◽  
Morphological Structure ◽  
Enzyme Linked Immunosorbent Assay ◽  
Direct Immunofluorescence ◽  
Common Disease ◽  
Group I ◽  
Urogenital Chlamydial Infection

The objective of the research was to identify the spectrum of complications in women with chronic urogenital chlamydial infection. Materials and methods. There were examined 128 women with chronic inflammatory diseases of genital organs at the age of 16-40 years who were diagnosed with urogenital chlamydial infection and 25 apparently healthy women. In both women with chlamydial infection and healthy ones, urogenital chlamydial infection was diagnosed based on the data of clinical examination and the results of laboratory tests (the identification of chlamydial morphological structure on the pathologic specimens stained according to the Romanowsky-Giemsa method; the identification of chlamydial antigens using the direct immunofluorescence technique; the study of Chlamydia trachomatis antibody titers using the enzyme-linked immunosorbent assay). Results. According to the results of our study, chlamydiae were the most common causes of inflammatory lesions of the urogenital organs in women of different ages leading to different reproductive complications and affecting females mostly at the age of 21-30 years. In women of Group I and Group II, chronic chlamydial disease was detected; disease duration ranged from 6 months to more than 2 years. Miscarriages, infertility (primary, secondary), ectopic pregnancy (tubal, ovarian) were the severest and the most numerous reproductive complications in the examined patients. Conclusion. Chronic chlamydial infection is the most common disease of the female urinogenital organs leading to a wide spectrum of complications including infertility (primary, secondary), miscarriages, ectopic pregnancy (tubal, ovarian), chronic abdominal pain, sexual dysfunction (low libido, hypo/anorgasmia, painful intercourse, neurotic symptoms).

scholarly journals Prolonged subfebrile condition, pyretic fever and febrile attacks of unknown genesis: new approach to diagnosis and treatment. Part 2. Diagnostics and treatment

2021 ◽  
Vol 9 (5-6) ◽  
pp. 42-52
Author(s):  
I.S. Markov ◽  
A.I. Markov
Keyword(s):  
Bacterial Infection ◽  
Temperature Regime ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Unknown Origin ◽  
Chronic Pyelonephritis ◽  
Low Grade ◽  
Bacteriological Examination ◽  
Short Term ◽  
Pathological Conditions

Background. The study was aimed to establish the true etiological cause of such pathological conditions as prolonged low-grade fever, fever of unknown genesis, and cases of rapid short-term febrile increase of temperature of unknown origin. Materials and methods. The design of the study was clinical-diagnostic and included the search for ways to diagnose and treat such pathological conditions as prolonged subfebrile fever, fever of unknown genesis, and cases of rapid short-term febrile increase of temperature of unknown origin. The studies were prospective-retrospective and were longitudinal with long-term periodic follow-up of a certain part of the same patients during 1–10 years after diagnosis of CBIS (chronic bacterial intoxication syndrome) and appropriate treatment. According to the effectiveness of the obtained results, the study was direct, because it undoubtedly led to the recovery of the patient with the improvement of his/her state and life. All patients (infants and adults aged till 80 years) who went to the hospital during 2009–2020 with complaints about violation of the temperature regime (subfebrile or febrile increase). Results. During 2009–2020, 3999 patients (adults — 2047/3999, 51.2 %, children — 1952/3999, 48.8 %) with a fever of unknown origin, namely 1578/2047 (77.1 %) adults and 1206/1952 (61.8 %) children with prolonged subfebrile fever, 70/2047 (3.4 %) and 25/1952 (1.3 %), respectively — with febrile fever and 399/2047 (19.5 %) and 721/1952 (36.9 %) — with febrile attacks (FA), were observed by the authors. In all 3999 (100 %) patients, there was detected a focus of chronic bacterial infection in the kidneys. Herewith in more than 2/3 cases (2780/3999 patients, 69.5 %), there was diagnosed the locally asymptomatic nephrodysbacteriosis without clinical, general laboratory (inclu­ding almost normal general analysis of urine) and instrumental signs of the inflammatory process in the kidneys. In 960/3999 (24.0 %) ca­ses, there was first established the latent form of delayed clinically asymptomatic chronic pyelonephritis. 259/3999 (6.5 %) patients were diagnosed with chronic pyelonephritis at the stage of clinical exacerbation. As a consequence of the formation of a focus of chronic bacterial infection in the kidneys, the patients developed monosymptomatic (only with temperature increase) or full-symptom CBIS, namely: 2024/2784 (72.7 %) children and adults with prolonged subfebrile fever there presented with typical clinical manifestations of CBIS in various combinations, but in 760/2784 (27.3 %) cases, the subfebrile temperature was monosymptoma­tic without other complaints and clinical symptoms. The diagnosis was confirmed by bacteriological examination of warm urine (three times, for three days running) and toxicological blood examination using the diagnostic system Toxicon. Urine cultures of various bacteria were isolated from urine in all 3999 (100 %) patients. Herewith in 2205/3999 (55.1 %) cases, there were isolated one culture of bacteria in each case, in 1608/3999 (40.2 %) patients — simultaneously two cultures of different bacteria, i.e. another 3216 strains, in 186/3999 (4,7 %) — three cultures (558 strains). That is, in general, there were isolated 5979 strains of different bacteria, which were considered as diagnostic confirmation of the presence of a focus of chronic bacterial infection in the kidneys in all 3999 patients with prolonged subfebrile fever, fever of unknown genesis, or febrile attacks. The main factors of the occurrence of temperature regime disorders on the background of CBIS were Enterococci (2471/3999 strains from 61.8 % of patients), Escherichia coli — 1495/3999 strains (from 37.4 % of patients) and Staphylococci (Staphylococcus aureus and Staphylococcus haemolyticus) and Streptococci (Streptococcus pyogenes): a total of 696/3999 strains (from 17.4 % of patients). In 818 (100 %) patients who were examined using the Toxi­con system, all, without exception, the indicators of cytolytic activity of toxic proteomes, which were tested, significantly exceeded the norm (p < 0.001). In the vast majority of patients (in 664/818 or 81.17 % of cases), there was detected severe toxemia, in 140/818 (17.11 %) — moderate and only in 14 (1.71 %) — mild. All 3999 patients with prolonged subfebrile fever, fever of unknown genesis, and FA were treated with bacterial autovaccines made from strains, isolated during the bacteriological examination. One cycle consisted of 2–3 courses of immunization with bacterial vaccines. One course included 10 or 12 subcutaneous injections in increasing dosage during 19–21 days. Between courses, there was maintained an interval of 3 to 4 weeks. The treatment cycle generally lasted from 70 to 110 days, depending on the number of courses. Intervals between treatment cycles were usually maintained for 3 months. The effectiveness of such treatment was 71.2 % after the first cycle, 92.8 % — after the second, and 99.2 % — after the third with full recovery of the ability to work, lost during the illness, and the emotional level of personal life. Conclusions. It has been established that the etiological cause of the occurrence of prolonged subfebrile fever, febrile fevers of unknown genesis, and febrile attacks is such a clinically and nosologically separate disease as chronic bacterial intoxication syndrome, which develops on the background of a chronic bacterial focus, usually locally asymptomatic infection in the kidneys, called nephrodysbacteriosis, and is usually associated with severe bacterial endotoxicosis that was confirmed by appropriate toxicological examination of the blood. The use of bacterial autovaccines was proved to be an effective method of treatment (up to 99.2 %) of patients with increased temperature of bacterial-toxic origin.

scholarly journals Possibilities of topical treatment of inflammatory diseases of vulva and vagina in girls

2017 ◽  
Vol 8 (3) ◽  
pp. 88-93 ◽  
Author(s):  
Anna V Mironova ◽  
Ivan I Chernichenko
Keyword(s):  
Clinical Picture ◽  
Inflammatory Process ◽  
Inflammatory Diseases ◽  
Local Treatment ◽  
Clinical Manifestations ◽  
Ease Of Use ◽  
Diagnostic Methods ◽  
Minimal Risk ◽  
Childhood Infections ◽  
Frequent Reason

Vulvitis and vaginitis in girls are the most frequent reason for contacting a pediatric gynecologist. The article considers options for local treatment with various forms of inflammation of the vulva and vagina. In recent years, there has been an increase in this pathology. The maximum number of appeals is observed at 1 year of age and at the age of 3-7 years. The formation of the inflammatory process in the vagina is caused by the state of the endocrine and immune systems, as well as a number of anatomical and physiological features of the structure of the external sexual organs. An important role in the development of vulvovaginitis and vulvitis is played by extragenital pathology. The development of the secondary inflammatory process in the vagina provokes such diseases as urinary tract infection, dysbacteriosis, atopic dermatitis, noopharyngeal diseases, frequent colds, transient immunodeficiency states, childhood infections. The clinical manifestations of vulva-guinitis and vulvitis are similar and depend on the severity of the process, the type of exciter. In acute nonspecific vulvovaginitis, a vivid clinical picture is typical. This discharge from the genital tract, hyperemia and swelling of the vulva, discomfort, burning with urination. The diagnosis of the disease is based on the details of complaints, clinical picture, laboratory and instrumental diagnostic methods. In the treatment of non-specific vulvovaginitis, girls rarely resort to the use of systemic antibacterial drugs. Preference is given to topical preparations. The advantage of local treatment is a minimal risk of adverse reactions, simplicity and ease of use, in the absence of contraindications (except for individual intolerance of the drug), as well as in the possibility of use in extragenital pathology.

Optimization of diagnostic system of hand diseases in employees working under combined effects of vibration and physical overloads

2019 ◽  
pp. 950-955
Author(s):  
M. M. Poroshina ◽  
E. M. Vlasova ◽  
A. Ya. Perevalov
Keyword(s):  
Working Conditions ◽  
Comparison Group ◽  
Clinical Manifestations ◽  
Diagnostic System ◽  
Pain Syndrome ◽  
Observation Group ◽  
Combined Effects ◽  
X Rays ◽  
Industrial Enterprises ◽  
Special Assessment

The results of research carried out by theFederalScientificCenterfor Medical and Preventive Technologies of Public Health Risk Management Technologies for the period 2013–2018 showed that diseases associated with the combined effects of vibration and physical overload, employees of hazardous industries develop with experience of 15 years or more. The risk group is women older than 35 years and men older than 40 years. Pathology at the stage of detailed clinical manifestations is characterized by persistent pain syndrome, and, as a consequence, a decrease in the ability to work of workers.The aim of the study was to optimize the system of diagnosis of hand diseases in workers of industrial enterprises engaged in labor activities under the combined effects of vibration and physical overload, for the development of primary prevention programs.The observation group consisted of 32 employees aged 39.3±4.3 years, with an experience of 17.4±4.3 years; the comparison group consisted of 30 employees whose working conditions are not related to the studied factors; the average age was 40.6±3.4 years, experience was 19.1±3.1 years. The examination included analysis of the results of a special assessment of working conditions; assessment of neurological status; functional tests; laboratory studies (assessment of inflammation), hand dynamometry, stimulation electroneuromyography; x-rays of the hands and wrist joints, ultrasound examination of the hands.More than half of the surveyed persons of the observation group and 3/4 of the workers of the comparison group did not make complaints. Indicators of dynamometry of workers in both groups corresponded to physiological norm (p>0.05). Analysis of the results of dynamometer with data from previous years of PMO showed a decrease in strength of muscles of the hand leading hands on 2je,0–16. 7% and from 83.3% of the employees of the monitoring group and in 44.4% of the comparison group (p<0.05), in 50 % of the cases there was a decrease in the percentage of changes in the hand force variation (HFV) in the observation group, and in 38.9% of the cases the indicators remained unchanged. According to ultrasound of the hands, signs of tendinopathy were established in 85% of the employees of the observation group in the absence of persons with similar changes in the comparison group.In order to optimize the diagnosis of diseases of the hand in industrial workers who carry out their work under the combined effects of vibration and physical overload, in the case of a decrease in the rate of carpal dynamometry by 5% or more during the year, it is recommended to conduct ultrasound of the tendon-ligamentous apparatus of the hand, which will allow timely identification of early signs of tendinopathy.

Clinical manifestations, diagnosis and treatment of HIV infection of stage 4 (severely symptomatic stage) in the practice of a health professional

2020 ◽  
pp. 27-34
Author(s):  
A. Nikitina ◽  
A. Rusanova ◽  
A. Zhilenkova
Keyword(s):  
Hiv Infection ◽  
Health Professional ◽  
Clinical Picture ◽  
Clinical Manifestations ◽  
Significant Problem ◽  
Diagnosis And Treatment ◽  
Modern World ◽  
Infected People ◽  
Stage 4 ◽  
Future Practice

HIV infection is a significant problem in the modern world, because there are more and more infected people every year. This article will consider: the clinical picture, diagnosis and treatment of this disease in different countries. Based on these data, the following conclusions will be made to help doctors in their future practice correctly approach the diagnosis and treatment of patients with this disease.

scholarly journals Obstructive Sleep Apnea and Inflammation: Proof of Concept Based on Two Illustrative Cytokines

2019 ◽  
Vol 20 (3) ◽  
pp. 459 ◽  
Author(s):  
Leila Kheirandish-Gozal ◽  
David Gozal
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Inflammatory Diseases ◽  
Sleep Apnea Syndrome ◽  
Special Focus ◽  
Normal Body Mass Index ◽  
Low Grade ◽  
Obstructive Sleep ◽  
Inflammatory Processes ◽  
Factor Α

Obstructive sleep apnea syndrome (OSAS) is a markedly prevalent condition across the lifespan, particularly in overweight and obese individuals, which has been associated with an independent risk for neurocognitive, behavioral, and mood problems as well as cardiovascular and metabolic morbidities, ultimately fostering increases in overall mortality rates. In adult patients, excessive daytime sleepiness (EDS) is the most frequent symptom leading to clinical referral for evaluation and treatment, but classic EDS features are less likely to be reported in children, particularly among those with normal body-mass index. The cumulative evidence collected over the last two decades supports a conceptual framework, whereby sleep-disordered breathing in general and more particularly OSAS should be viewed as low-grade chronic inflammatory diseases. Accordingly, it is assumed that a proportion of the morbid phenotypic signature in OSAS is causally explained by underlying inflammatory processes inducing end-organ dysfunction. Here, the published links between OSAS and systemic inflammation will be critically reviewed, with special focus on the pro-inflammatory cytokines tumor necrosis factor α (TNF-α) and interleukin 6 (IL-6), since these constitute classical prototypes of the large spectrum of inflammatory molecules that have been explored in OSAS patients.

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