The effect of cytomegalovirus on clinical and paraclinical as well as immune parameters of children with rotavirus infection

The aim is to evaluate the effect of cytomegalovirus on clinical and paraclinical as well as immunological parameters in children with rotavirus infection (RVI). Materials and methods. 50 children aged one to three years, patients with moderate and severe intestinal infections of rotavirus etiology were examined. All children were examined for herpes virus infections types 1, 2, 4, 5, 6. Enzyme-linked immunosorbent assay (ELISA) was used to determine the level of specific Ig G and Ig M for herpes viruses types 1, 2, 4, 5, 6, and in the case of a positive test, polymerase chain reaction (PCR) determined the presence of DNA (qualitatively) of these herpesviruses. Group 1 (mono-RVI), which was taken as a reference, included 33 children in whom no infection with any of these viruses of the herpes group was detected. Group 2 included 17 patients who underwent RVI on the background of CMV infection, the presence of infection with other viruses of the herpes group was excluded. Immune response parameters (CD 3+, CD 4+, CD 8+, CD 16+, CD 22+, Ig A, Ig M, Ig G, IL 1β, 4, TNF-α) in the acute period of the disease and in the period of convalescence were analyzed. Qualitative indicators were given in the form of absolute and relative (%) value. Significance of differences was determined using Pearson’s χ2 test (Pearson’s Chi-squared test). Quantitative indicators were given in the form of median (Me) and values of lower (LQ) and upper (UQ) quartiles. The significance of differences in quantitative indicators in two unrelated groups was determined using the Mann–Whitney U-test. The threshold value of the confidence level was taken as 0.05. Results. The analysis of the obtained data allows to establish that in the acute period of RVI infection in children with CMV leads to lower figures of temperature reaction, lower vomiting rate, prolongation of hospitalization, along with decrease in leukocytes, CD 16+ (%) cells and immunoregulatory index (CD 4+/CD 8+) against the background of increased levels of monocytes, CD 8+ (%) T-lymphocytes, concentrations of IL-4 and TNF-α. During convalescence, the presence of CMV is associated with an increase in the duration of fever and diarrhea, an increase in monocytes, CD 8+ (%) T cells, concentrations of IL-4, TNF-α and lower figures of immunoregulatory index, CD 16+ (%), CD 22+ (%) T cells and Ig M. Conclusions. Latent cytomegalovirus infection in children with rotavirus gastroenteritis significantly affects a number of clinical and paraclinical as well as immune parameters, which leads to a decrease in the intensity of clinical manifestations in the acute period of the disease and the prolongation of some symptoms during convalescence.

The state of cellular immunity of patients with tonsillitis and infected with herpes virus type 6

Currently, the incidence of tonsillitis in children is very common and represents a serious medical and social problem. In young children, viral tonsillitis predominates, while bacterial tonsillitis is more common between the ages of 5–15. The frequency of registration of infection with viruses of the herpes group, including the human herpes virus (HHV) type 6, is increasing. The healing processes in infectious pathology are primarily due to the balanced work of the cellular and humoral links of the body’s immune response, the state of which can be influenced by concomitant infection with herpes viruses. The aim of the work was to study the cellular immune response of children with tonsillitis infected with HHV-6 type. The study of the influence of HHV-6 infection on the state of the cellular component of the immune response in 74 children with tonsillitis in the acute period and in the period of convalescence was carried out. All patients were diagnosed with a moderate form of tonsillitis; the etiological factor was hemolytic streptococcus group A. It was revealed that in children with mono-infection at the onset of the disease, there is a moderate response of cellular immunity (t = 2.76), while the presence of HHV-6 infection leads to more pronounced changes in the parameters of CD lymphocytes (t = 4.06). We found a significant increase in the content of CD16+-lymphocytes in tonsillitis of streptococcal etiology, but the maximum growth was recorded in patients with mono-infection (p < 0.05). By the time of convalescence, complete recovery of T-lymphocytes in infected HHV-6 patients does not occur. The degree of deviation from the standard for the entire complex of CD-lymphocytes during the period of convalescence was more pronounced in patients with co-infection (t = 2.83). The obtained data indicate the suppression of the cellular component of the immune response in patients with tonsillitis against the background of HHV-6 infection, which requires a differentiated approach to treatment and medical supervision of such patients.

INDIVIDUAL CORRECTION OF THE TREATMENT OF PATIENTS WITH HEPATOSPLENOMEGALY SYNDROME, TAKING INTO ACCOUNT THE PARAMETERS OF LIPID AND PROTEIN METABOLISM

Summary. Purpose: to identify the features of lipid metabolism in patients with hepatosplenomegaly syndrome (HSS) of various origins to develop an individualized approach to the treatment of patients with this pathology. Materials and methods: blood serum of 73 patients with HSS on the background of liver cirrhosis complicated by portal hypertension, divided into 3 groups 1) with the etiological factor of hepatitis viruses HCV / HBV, 2) with autoimmune hepatitis with the etiological factor of the herpes group viruses CMV / VEB, 3) against the background of liver hepatosis and fermentopathies. Results and its discussion. In patients with HSS, multidirectional changes in the synthesis of lipid fractions were observed, also associated with impaired protein metabolism, namely: - with HSS against the background of viral hepatitis B and C, hypocholesterolemia and hypobetacholesterolemia were observed due to a decrease in cholesterol synthesis in hepatocytes; a decrease in the concentration of HDL is also associated with a violation of the process of cholesterol esterification due to a deficiency of the enzyme lecithin cholesterol acyltransferase, and an increase in the concentration of LDL is associated with a deficiency of the enzyme lipoprotein lipase in viral damage to hepatocytes. - with HSS against the background of autoimmune hepatitis, no significant changes were observed in the synthesis of lipid fractions; - in hepatosis (fermentopathies), type 5 hyperlipidemia with hypercholesterolemia and hypotriglyceridemia was found, which are a consequence of impaired formation and excretion of lipids from the liver, probably as a result of a decrease in the synthesis of apoproteins and indicate the accumulation of fat in hepatocytes and the formation of hepatosis. Conclusion: Surgical or endovascular treatment of HSS against the background of liver cirrhosis or hepatosis needs to be supplemented with individualized metabolic drug therapy, including lipid-lowering therapy. When detecting hypocholesterolemia and hypobetacholesterolemia in the first group, lipid-lowering therapy is not indicated, whereas if type 5 hyperlipidemia with hypercholesterolemia and hypotriglyceridemia is detected in the group of patients with fatty hepatosis, lipid-lowering therapy is necessary.

Evaluation of the antiherpetic activity of toothpaste with herbal ingredients and rinses in the treatment of chronic generalized periodontitis

Relevance. There is very little literature data on the role of viral infection in the genesis of periodontal diseases, mainly the work of foreign authors. It is believed that the mucous membrane of the oral cavity, including the gums, is the habitat of some viruses of the herpes group (Epstein-Barr, cytomegalovirus, etc.). They can be in a latent state in the salivary glands, epithelial cells of the mucous membrane of the nasopharynx, oral cavity and under adverse conditions, are activated, causing an exacerbation of the process. Currently, methods for detecting viruses using laboratory tests (PCR diagnostics) have been somewhat simplified, which made it possible to evaluate the therapeutic effect of domestic oral care products against viruses. The use of plaque control agents such as prophylactic toothpastes and mouth rinses on a regular basis helps to reduce the risk of developing inflammatory periodontal diseases.Purpose. To study the effect of domestic oral care products on the level of oral cavity contamination with herpes group viruses in patients suffering from chronic generalized periodontitis.Materials and methods. Under clinical supervision were 52 patients (28 men, 24 women) of middle age 31-54 years with chronic generalized periodontitis of moderate severity, divided into groups: group 1 – 26 patients who used «Asepta Sensitive» preventive toothpaste on basis of plant components. They were divided into 2 subgroups of 13 patients: subgroup «a»- only paste, subgroup «b» - paste with the additional use of rinse aid «Asepta ® Active» in the first 8 days with a further transition to rinse «Asepta ® Fresh» from 9 days of the study. Group 2 consisted of 26 patients who used «Asepta ® Active» toothpaste with a similar division into subgroups: subgroup «a» without rinsing agents and subgroup «b» with rinsing agents. The control group of patients without inflammatory diseases of the periodontium and oral mucosa included 15 people who were not treated.Results. It was revealed that the DNA of the herpes simplex virus ½ types (HSV ½) at the beginning of the study was detected in 28.8% of patients with periodontitis, Epstein-Barr virus 42.3% of patients, and cytomegalovirus in 36.5%. When using oral care products containing antiseptics, adult patients suffering from chronic generalized periodontitis, we have achieved good results in the treatment of this disease. The effectiveness of the action of toothpaste and rinses in adults with chronic generalized periodontitis is high – a decrease in performance by an average of 1.2-2 times lower than without rinse aid. This allows, subject to the rules of individual oral hygiene, to quickly stop the main clinical symptoms of chronic generalized periodontitis and reduce the level of oral contamination by herpes viruses.Conclusion. In the treatment of patients with chronic generalized periodontitis, no significant clinical differences were found when using various schemes for the use of oral care products. At the same time, the use of the «Asepta ® Active» rinse agent with chlorhexidine helps to reduce the frequency of detection of herpes group viruses in the oral cavity by 1.5-2.5 times and reduces the signs of periodontal inflammation in patients with chronic generalized periodontitis.

ETHIOPATHOGENETIC BIOMARKERS FOR THE FORMATION OF HEPATOSPLENOMEGAL SYNDROME AND THE CHOICE OF TREATMENT OF PATIENTS WITH ESOPHAGEAL PHLEBECTASIS BLEEDING

Summary. A range of specific biomarkers to evaluate the severity of the condition, the choice of tactics, effectiveness and prognosis of treatment are used. Goal. Evaluation of biomarkers characterizing the etiopathogenetic disorders in hepatosplenomegaly syndrome complicated by recurrent bleeding from esophageal phlebectasis to select individual treatment tactics. Materials and methods. The digestive function of phagocytes is investigated, the concentration of opsonizing, membranotropic cytotoxic factors and the degree of endogenous intoxication in 3 groups of patients with different etiological factors of hepatosplenomegaly, complicated by bleeding are evaluated. Results. The presence of specific trigger factors (viral hepatitis, herpes viruses, hereditary-related disorders of lysosomal enzymes) made it possible to classify patients into three groups. In the first group of patients with viral hepatitis B and C the induction of phagocytic activity of neutrophils, a significant increase in lymphocytotoxicity on the background of disorders of protein and lipid metabolism showed. In the second group of patients with the presence of herpes group viruses and autoimmune component an imbalance of opsonizing factors revealed, in particular proteins of the complement system, which caused impaired clearance of low molecular weight immune complexes and products of their degradation. In the third group of patients with hepatitis a significant decrease in the activity of lysosomal enzymes of phagocytic cells are found. The identified pathogenetic biomarkers indicate the presence in this group of patients with congenital enzymopathy characteristic of accumulation diseases. For patients with a pronounced manifestation of intercellular interactions disorders, as an effective alternative to liver transplantation the use of transfusions of mesenchymal stem cells, which are capable of trans differentiation under the influence of mediator microenvironment factors may be.

FEATURES OF THE CLINICAL COURSE OF ROTAVIRUS INFECTION IN CHILDREN INFECTED WITH HERPES VIRUSES AND THEIR BLOOD INTERLEUKIN REACTIONS

FEATURES OF THE CLINICAL COURSE OF ROTAVIRUS INFECTION IN CHILDREN INFECTED WITH HERPES VIRUSES AND THEIR BLOOD INTERLEUKIN REACTIONS Sliepchenko M.Yu. Background. The widespread prevalence of intestinal infections of rotavirus etiology, the economic damage caused by it and the difficulties of treating patients cause the medical and social significance of this pathology. Along with this, a herpes virus infection and its negative effect on the immune response of the human body is a pressing problem. The purpose of the study is to identify the characteristics of presentation and the course of rotavirus infection in children infected with herpes viruses, and to establish the characteristics of the reaction of interleukins in their blood. Subjects and Methods. 38 children aged one to three years with moderate and severe forms of intestinal infection rotavirus etiology, who received appropriate treatment were examined. The children were divided into two groups: Group 1 included 18 children who did not have a background infection and Group 2 comprised 20 patients with acute rotavirus infection who were infected with herpes viruses. Along with the generally accepted clinical and laboratory examination, the levels of interleukins 1β, 4, TNFα in the blood serum in the time course of the disease were determined by an ELISA method for all children. Results. Assessment of clinical and immunological parameters of rotavirus infection in children showed that infection with viruses of the herpes group contributed to a less severity of symptoms of the disease at the initial stage, but longer persistence, which was probably due to insufficient reaction of proinflammatory interleukins in blood in the acute period at relatively high levels during the course of the disease. Keywords: clinic, children, cytokines, herpes and rotavirus infections. Резюме. ОСОБЛИВОСТІ КЛІНІЧНОГО ПЕРЕБІГУ РОТАВІРУСНОЇ ІНФЕКЦІЇ У ДІТЕЙ, ІНФІКОВАНИХ ГЕРПЕСВІРУСАМИ, І РЕАКЦІЇ ІНТЕРЛЕЙКІНІВ ЇХ КРОВІ Слєпченко М.Ю.Вступ. Широка розповсюдженість кишкових інфекцій ротавірусної етіології, спричинені нею економічні збитки і труднощі терапії хворих обумовлюють медичне і соціальне значення зазначеної патології. Поряд з цим, актуальною проблемою є герпесвірусна інфекція і її негативний вплив на імунну відповідь організму людини. Мета дослідження полягає у виявленні особливостей клінічної картини і перебігу ротавірусної інфекції у дітей, інфікованих герпесвирусами, а також, встановлення особливостей реакції інтерлейкінів їх крові. Суб’єкт та методи. Для реалізації мети нами було обстежено 38 дітей у віці одного - трьох років, хворих на середньотяжкі і тяжкі форми кишкової інфекції ротавірусної етіології, з приводу якої вони отримували відповідне лікування. Діти були розділені на дві групи: перша група - 18 дітей не мали фонового інфікування і друга група- 20 хворих, що переносили РВИ на тлі інфікування їх різними герпесвирусами. Поряд із загальноприйнятим клініко-лабораторним обстеженням усім дітям визначалися рівні інтерлейкінів 1β, 4, ФНО в сироватці крові в динаміці хвороби імуноферментним методом. Результати. При аналізі клініко-імунологічних параметрів ротавірусної інфекції у дітей встановлено, що інфікування вірусами групи герпес сприяє меншій виразності симптомів хвороби на початковому етапі, але більш тривалого їх збереження, що, ймовірно, обумовлено недостатньо вираженою реакцією прозапальних інтерлейкінів крові дітей в гострий період, і збереженням їх на відносно високому рівні протягом хвороби.Ключові слова: діти, герпес- і ротавірусна інфекції, клініка, цитокіни. Резюме. ОСОБЕННОСТИ КЛИНИЧЕСКОГО ТЕЧЕНИЯ РОТАВИРУСНОЙ ИНФЕКЦИИ У ДЕТЕЙ, ИНФИЦИРОВАННЫХ ГЕРПЕСВИРУСАМИ, И РЕАКЦИИ ИНТЕРЛЕЙКИНОВ ИХ КРОВИ. Слепченко М.Ю. Вступление. Широкая распространенность кишечных инфекций ротавирусной этиологии, наносимый ею экономический ущерб и трудности терапии больных обуславливают медицинское и социальное значение указанной патологии. Наряду с этим, актуальной проблемой является герпесвирусная инфекция и ее негативное влияние на имунный ответ организма человека. Цель исследования заключается в выявлении особенностей клинической картины и течения ротавирусной инфекции у детей, инфицированных герпесвирусами, а также, установлении особенностей реакции интерлейкинов их крови. Субъект и методы. Для реализации цели нами было обследовано 38 детей в возрасте одного - трех лет, больных среднетяжелыми и тяжелыми формами кишечной инфекции ротавирусной этиологии, по поводу которой они получали соответствующее лечение. Дети были разделены на две группы: первая группа - 18 детей не имели фонового инфицирования и вторая группа - 20 пациентов, переносили РВИ на фоне инфицирования их различными герпесвирусами. Наряду с общепринятым клинико-лабораторным обследованием всем детям определялись уровни интерлейкинов 1β, 4, ФНОα в сыворотке крови в динамике болезни иммуноферментным методом. Результаты. При анализе клинико-иммунологических параметров ротавирусной инфекции у детей установлено, что инфицирование вирусами группы герпес способствует меньшей выраженности симптомов болезни на начальном этапе, но более длительному их сохранению, что, вероятно, обусловлено недостаточно выраженной реакцией провоспалительных интерлейкинов крови детей в острый период, и сохранением их на относительно высоких цифрах в течении болезни. Ключевые слова: дети, герпес- и ротавирусная инфекции, клиника, цитокины.

CHRONIC PHARYNGITIS: ETIOLOGY, PATHOGENESIS, TREATMENT. NEW APPROACHES TO THE ESTIMATION OF ETIOPATOGENESIS

The work discusses modern issues of etiopathogenesis, treatment of chronic pharyngitis. The results of the application of a modern method for the diagnosis of mass spectrometry of microbial markers (MSMM), which allows to detect the microorganisms in a biofilm, in a “sleeping state” under the protection of mucin are presented. With the help of this express method, it is possible to conduct a determination of the content in a smear from the pharynx 57 biomarkers of microorganisms at the same time 2 hours after delivery to the laboratory. It was found that 100% of the examined patients with a recurring course of HF (n = 62) increased the total content of microorganisms, which indicates the need for antibacterial therapy; 87% of patients have elevated levels of endotoxin, which is a sign of general intoxication; 71% of patients have reduced plasmalogene content and these patients may be at increased risk for lipid metabolic disturbances; in 100% of the examined patients with frequent exacerbations of CP in the pharynx the nasopharyngeal microflora (coccal) is determined, as well as new etiopathogenetically significant microorganisms (not detected by PCR and cultures), among which there are 7 transient microorganisms (normally in the orifice their level = 0), 11 resident (6- found in the throat in the norm in the minimum level and 5 in the high content). Also, with the help of MSMM, a significant or moderate increase in the content of herpes, cytomegalovirus was detected in the majority (75%) of patients, which indicates the important role of the viruses of the herpes group in the etiopathogenesis in the recurrent course of CP; level of Candida spp. elevated in half of patients; the content of normal microflora is increased in 71% of patients, which indicates the preservation of local resistance in patients with chronic HF, examined by the authors. Thus, the use of MSMM for chronic fever allows to identify new etiopathogenetic microorganisms, on this basis to prescribe a more effective therapy. Thus? it is possible to carry out personified, more effective treatment.

New Clinical and Laboratory Findings of SHAPU

Introduction: The cause of Seasonal hyperacute panuveitis (SHAPU) also known as seasonal endophthalmitis is not yet confirmed. So far, bacteria have been isolated from the vitreous of three cases, VZV from the aqueous of one case and anellovirus from the vitreous of 30 cases of SHAPU. Its connection with moth is still assumed but not proven yet.Objective: To study the clinical and microbiological features of SHAPU. To find out indirect evidence of it connection with moths.Method: Prospective longitudinal study of all the cases of SHAPU observed at Tilganga Institute of Ophthalmology in 2009 and 2010. A detailed ocular examination was performed on each case and vitreous fluid was removed from almost all cases for microbiological study.Result: 66 cases of SHAPU were identified. Most were children. Twenty-three percent reported a recent history of white moth contact. Fine brown hairs, were present in 5 eyes. Bacteria were isolated from the vitreous of 9 eyes, PCR testing of the vitreous of all 48 cases showed no evidence of HSV, VZV or CMV DNA. Twenty of 34 cases (58.8%) who presented within 7 days of onset of symptoms had a final visual acuity ≥ 6/60 whereas 4/25 cases (16.0%) who presented after 7 days had final visual acuity ≥ 6/60 (p=0.001).Conclusion: Herpes group of virus is the less likely cause of SHAPU. Bacteria are found in more cases. Early presentation is associated with a better visual outcome. Role of moth in its pathogenesis is still suspected.

Recent developments and new frontiers in childhood arterial ischemic stroke

This review will discuss important developments in childhood arterial ischemic stroke over the past decade, focusing on improved understanding of the causes, consequences, and targets for intervention. Risk factors for childhood arterial ischemic stroke are different to adults. Infections, particularly herpes group viruses, are important precipitants for stroke. Non-atherosclerotic arteriopathies are the most common cause of childhood arterial ischemic stroke and an important predictor of recurrent events. Recent advances include the identification of serum biomarkers for inflammation and endothelial injury, and imaging biomarkers to monitor for vascular progression. Multicenter trials of immunotherapies in focal cerebral arteriopathies are currently in development. Recognition of clinical and radiological phenotypic patterns has facilitated the discovery of multisystem disorders associated with arterial ischemic stroke including ACTA2 arteriopathy and adenosine deaminase 2 deficiency. Identification of these Mendelian disorders provide insights into genetic mechanisms of disease and have implications for medical and surgical management. In contrast to adults, there are long diagnostic delays in childhood arterial ischemic stroke. Refinement of pediatric Code Stroke protocols and clinical decision support tools are essential to improve diagnostic certainty and improve access to reperfusion therapies. Children do not recover better than adults following arterial ischemic stroke, with more than half of survivors having long-term impairments. The physical, cognitive, and behavioral consequences of childhood arterial ischemic stroke are increasingly reported but further research is required to understand their impact on participation, quality of life, psychosocial, and family functioning. Longitudinal studies and the use of advanced imaging techniques, to understand neurobiological correlates of functional reorganization, are essential to developing targeted intervention strategies to facilitate recovery.

Prediction of Layer Chicken Disease using Fuzzy Analytical Hierarcy Process

Chicken disease belong to the herpes group that often attacks poultry like laying hens. Various types of diseases that can attack such as marek, IB chicken, chicken NP, CA, EDS. Therefore it is necessary to be given a special vaccine for poultry that can anticipate the dominant diseases attacking poultry in particular chicken laying. So need a prediction model with the concept of fuzzy analytical hierarchy process. analytical hierarchy process is one of the methods in the decision-making system that uses several variables with a multilevel analysis process using criteria such as decreased egg production, cough, watery eyes, wings hanging down, a gray sprocket, legs paralyzed. From the test results obtained varied values with alternative results obtained: Marek 0.1487, IB chicken 0.3464, CA 0.1769, chicken NP 0.2407, EDS 0.0884. Then fuzzy analytical hierarcy process is good for predicting laying hens disease