Обложка журнала

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LEADING ARTICLE

Infectious disease services: achievements and out-look. The 80th anniversary of the department of pediatric infections infectious disease chair of kazan state medical university. V.A. Anokhin P. 5

ORIGINAL ARTICLES

Metabolic enzyme systems activity evaluation in patients with streptococcal tonsillitis and ways of phar-macologic correction with ksimedon. I.E. Kravchenko, V.Kh. Fazylov, R.G. Zaripova P. 8

Enterotoxigenity of strains of S.aureus, isolated from children with intestinal dysbiosis. I.V. Nikolayeva P.13

Clinical and diagnostic features of pneumonia among drug addicts depending on comorbidity. R.F. Khamitov, I.G. Mustafin, O.L. Chernova P. 16

Systemic inflammatory response and progression of hiv-infection. G.R. Khasanova, O.I. Bikkinina, L.B. Akchurina, V.A. Anokhin, I.I. Akhmetov P. 21

CASE REPORT

Differential diagnosis of inflammatory and nonin-flammatory myocarditis of the young athlete (a clinical case). L.A. Balykova, S.A. Ivyansky, N.V. She-kina, A.N. Urzyaеva, I.A. Gorbunova P.28

The case of toxic shock syndrom in a patient with scarlet fever. Kh.S. Khaertynov, V.A. Anokhin, L.M. Abilmazhganova, M.I. Ismaguilova P. 32

HELP FOR PRACTITIONER

Difficulties and mistakes of diagnosing in herpetic neuroinfection. T.V. Matveeva, E.Z. Yakupov, I.F. Khafizova, A.R. KHakimova, R.F. Mullayanova, L.A. Khalitova P.36

REVIEW

Evolution of celiac disease diagnosis and therapy approaches. А.А. Kamalova, М.О. Pirogova P. 40

Probiotics use in neonates and infants (literature review). I.V. Nikolaeva, L.A. Kupchikhina P. 48

Principles of medical therapy of myocarditis in children. D.I. Sadykova P. 54

Drug allergy in antibiotics using. O.V. Skorokhodkina, A.V. Luntsov P. 60

Immune defense mechanisms in newborn infants. Kh.S. Khaertynov, V.A. Anokhin P. 67

Clinical significance of zinc deficiency in the child (literature review). S.V. Khaliullina P. 73

Chronic tick-born encephalitis: the clinical and diagnostics features (literature review). I.F. Khafizova, V.Kh. Fazylov, E.Z. Yakupov, T.V. Matveeva, A.R. Khakimova, R.F. Mullaianova P. 79

CLINICAL LECTURE

Kawasaki syndrome in children (Clinical lecture). S.Ya. Volgina P. 86

CONGRESSES, CONFERENCES

Thesis of Russian scientific practical conference «Infections and somatic pathology» timed for the 80th anniversary of the department of children's infections of Kazan state medical university of Mi-nistry of Health of Russian Federation on 24th—25th of may, 2013, Kazan P. 92

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LEADING ARTICLE

PDF downloadInfectious disease services: achievements and outlook. The 80th anniversary of the department of pediatric infections infectious disease chair of kazan state medical university

Vladimir A. Anokhin

Abstract. The history of foundation of the Pediatric infectious diseases department of Kazan State University is presented. The author evaluates perspectives of the development of the specialty of infectious diseases in Russia. The main trends of changes in the structure of Infectious diseases and principles of work of Infectious disease specialists are described.

Key words: infectious diseases, infectious diseases specialist, department.

 

ORIGINAL ARTICLES

PDF downloadMetabolic enzyme systems activity evaluation in patients with streptococcal tonsillitis and ways of pharmacologic correction with ksimedon.

Irina E. Kravchenko, Vildan Kh. Fazylov, Raysa G. Zaripova

Abstract. Objective. To determinate activity of acetylation and oxidation in patients with streptococcal quinsy and pharmacological correction with xymedon. Material and methods. 85 patients with quinsy caused by S.pyogenes (57 women and 28 men) 17—35 years old were divided into main group (43) and comparison group (42). The control group consisted of 110 healthy subjects aged 18—25 years. Patients from the comparison group received routine treatment (mainly penicillins), patients from main group received xymedon (0,5 g × TID before meals 7 days). Determination of the concentration of the urine isoniazid was used to identify the phenotype of acetylation (AF). To determine the phenotype of oxidation (OF) we used a modified Antipyrine test. Statistical data processing included chi-square distribution, comparison of means by Student t-test and evaluation of the proportion of the significance of differences in two groups. Results. A survey of healthy individuals showed that slow OF corresponds to the type of fast acetylation, rapid OF — Slow AF. For the average OF characterized by equal distribution in the direction of the fast and slow types of acetylation. In the main group, an induction was observed in patients with AF with a slow transformation into a fast phenotype; in patients with slow OF — to middle phenotype. In individuals with the fast oxidation and acetylation phenotype was observed less pronounced induction. Conclusion. Inclusion of xymedon in pathogenetic therapy of quinsy is useful to correct the metabolic processes, considering the acetylation, oxidation phenotypes and the forms of the disease.

Key words: quinsy, streptococcus, acetylation, oxidation, phenotype, xymedon.

 

References

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PDF downloadEnterotoxigenity of strains of S.aureus, isolated from children with intestinal dysbiosis

Irina V. Nikolayeva

Abstract. Objective. To determine the frequency of production of enterotoxin A and B strains of S.aureus isolated from children with various forms of intestinal dysbiosis. Methods. 74 strains of S.aureus, isolated from the feces of young children with intestinal dysbiosis were studied. 16 strains isolated from children aged 1—6 months, 13 strains — from children aged 6—12 months and 42 strains from children aged 1—3 years. 24 (36,5%) children were an asymptomatic carrier of S.aureus (compensated intestinal dysbiosis), 51 (63,5%) children were diagnosed with symptomatic staphylococcal intestinal dysbiosis. Determination of strains of S.aureus to the production of enterotoxin A (SEA) and B (SEB) was performed by IHT. In this work we used staphylococcal erythrocytic diagnostic tools developed in NIIEM them. NF Gamal. As a control enterotoxigenic strains of S.aureus (producer SEA-FRI-722 and producer SEV S 6715 H) and enterotoxins SEA, SEV company «Serva» (Germany) and enterotoxins SEA, SEV, obtained in the laboratory NIIEM them. N.F. Gamal. Results. 74 enterotoxigenic strains of intestinal S.aureus, isolated from young children with intestinal dysbiosis were analyzed. The ability to produce SEA was detected in 5,3% SEB — in 10,7%, SEA+SEB in 1,3% of the cultures studied. Enterotoxigenic strains isolated from children with normal stool were detected in 16,1%, in children with bowel dysfunction — in 18,2% of cases. Conclusion. SEA and SEB does not play essential role in the development of bowel dysfunction in intestinal dysbiosis. Asymptomatic colonization of enterotoxigenic strains of S.aureus young children can exist.

Keywords: children, intestinal dysbiosis, S.aureus, enterotoxins A and B.

 

References

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PDF downloadClinical and diagnostic features of pneumonia among drug addicts depending on comorbidity

Rustem F. Khamitov, Ilshat G. Mustafin, Olga L. Chernova

Abstract. Objective. To reveal clinical and diagnostic features of pneumonia in drug addicts, including, depending on comorbidities: HIV infection and viral hepatitis. Methods. Medical records of 36 patients with drug addicts hospitalized in the pulmonary department with a diagnosis of «community acquired pneumonia» for the period from 2008 to 2010 were analyzed. 27 men aged 26 to 42 years [mean age (34,2±0,8) years] and 9 women from 22 to 33 years [mean age (25,1±0,6) years] were assessed. 6 of them (16,7%) were re-hospitalized due to recurrent disease. For comparison we have chosen a non-drug addicted non-HIV and non viral hepatitis group of patients hospitalized in the same department with pneumonia 36 patients (27 men and 9 women) aged 20 to 45 years (mean age 32±0,8). Results. The results demonstrate the characteristics of pneumonia in these patients: a prolonged and severe, frequent development of pulmonary and extra-pulmonary complications, pronounced findings in laboratory and radiological data. Pneumonia in patients with drug addiction resists to treatment with antibiotics and usually needs a repeatedly change of the antibiotic due to its ineffectiveness. Pathogenetic therapy in the treatment of pneumonia against drug also characterized by its intensity and variety. Conclusion. The presence of drug, viral hepatitis and HIV infection can be considered as risk factors for adverse outcome of pneumonia, including lethal, which determines the need for the timely correction of adequate diagnostic and treatment tactics.

Key words: pneumonia, hepatitis, HIV, drug addiction.

 

References

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PDF downloadSystemic inflammatory response and progression of HIV-infection

Gulshat R. Khasanova, Olesya I. Bikkinina, Lilia B. Akchurina, Vladimir A. Anokhin, Ildus.I. Akhmetov

Abstract. Objective. To assess the role of endotoxin of gram-negative bacteria in the hyperactivation of the immune system and the progression of the disease and the identification of the possible impact of TLR4 gene polymorphisms on the progression of HIV infection. Methods. A clinical study of 232 people diagnosed with «HIV» (48,3% men) was performed. The control group consisted of 26 healthy volunteers aged 23 to 55 years (M±SD = 30,6±11,3). A retrospective cohort study was performed to assess the impact of TLR4 gene polymorphisms on the progression of the disease. The study group included 100 people who were divided into 2 groups: Group 1 consisted of patients who have over 5 years of follow-level CD4 + cells stably held above 350 cells in 1 μL. The second group consisted of patients who have over 5 years of decreased CD4+ cell counts below 350. The control group for the molecular genetic analysis consisted of 100 healthy volunteers. Statistical analysis of the data was performed using Portable Statistica 8 and Epiinfo. Results. In a group of 232 HIV-infected patients, a statistically significant increase in endotoxin sSD14 soluble protein, interleukin-1β, tumor necrosis factor-α, C-reactive protein revealed. Demonstrated a protective effect of the mutant G-allele polymorphism 896 A/G (299Asp>Gly) gene TLR4 against disease progression in women. Conclusion. The rate of disease progression vary in individual patients. Immune hyperactivation plays an role in progression of the immunedeficit.

Key words: HIV-infection, hyperactivation of the immune system, TLR4 polymorphisms.

 

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CASE REPORT

PDF downloadDifferential diagnosis of inflammatory and nonin-flammatory myocarditis of the young athlete (a clinical case)

Larisa A. Balykova, Stanislav A. Ivyansky, Natalia V. Shekina, Anna N. Urzyaеva, Inna A. Gorbunova

Abstract. A case history of myocarditis in young athlete is presented. This case required the differential diagnosis with extreme specific adaptation changes (“athlete’s heart”) and dysadaptation remodeling (“stress-induced cardiomyopathy”). The main signs, indicating myocarditis were complains on fatigue after exercise connected with virus infection, repolarization disorders, myocardium hypertrophy, dilatation, systolic and diastolic dysfunction, high levels of cardiac enzymes and antibodies to Epstein—Barr virus and also myocardial scintigraphy results.

Key words: myocarditis, children athletes, athlete’s heart.

 

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  8. Baughman, K.L. Diagnosis of myocarditis: Death of the Dallas criteria / K.L. Baughman // Circulation. — 2006. — Vol. 113. — P.593—595.
  9. Dennert, R. Acute viral myocarditis / R. Dennert, H.J. Crijns, S. Heymans // Eur. Heart J. — 2008. — Vol. 29. — P.2073—2082.
  10. Friedrich, M.G. For the International Consensus Group on Cardiovascular MR in Myocarditis Cardiovascular magnetic resonance in myocarditis: A JACC White Paper / M.G. Friedrich, U. Sechtem, J. Schulz-Menger [et al.] // J. Am. Coll. Cardiol. — 2009. — Vol. 53, № 17. — P.1475—1487.
  11. Maron, B.J. Sudden Deaths in Young Competitive Athletes Analysis of 1866 Deaths in the United States, 1980—2006 / B.J. Maron, J.J. Doerer, T.S. Haas [et al.] // Circulation. — 2009. — Vol. 119. — P.1085—1092.
  12. Sharma, S. Physiologic limits of left ventricular hypertrophy in junior elite athletes: Relevance to differential diagnosis of athlete’s heart and hypertrophic cardiomyopathy / S. Sharma, B.J. Maron, S. Firoozi, [et al.] // J. Am. Coll. Cardiol. 2002. — Vol. 40, № 8. — P.1431—1436.
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PDF downloadThe case of toxic shock syndrom in a patient with scarlet fever

Khalit S. Khaertynov, Vladimir A. Anokhin, Lilia M. Abilmazhganova, Milausha I. Ismagilova

Abstract. This article describes a clinical case of toxic shock syndrome in 7 years old girl with scarlet fever. Possible causes of toxic shock syndrome and its clinical manifestations assessed.


Key words: streptococcal diseases, scarlet fever, toxic shock syndrome.

 

References

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HELP FOR PRACTITIONER

PDF downloadDifficulties and mistakes of diagnosing in herpetic neuroinfection

Tatyana V. Matveeva, Eduard Z. Yakupov, Irina F. Khafizova, Albina R. Khakimova, Regina F. Mullayanova, Leysan A. Khalitova

Abstract. Cause of diagnostic mistakes in herpes virus infection with affection of the nervous system, is its rarity, lack of awareness of physicians about the clinical forms and variants of the herpes virus neuroinfections, methods of diagnosis, delayed or absence of neuroimaging changes. The article analyzes the difficulties and mistakes encountered during the approach to the diagnosis of herpes virus infections.


Key words: herpesvirus neuroinfection

 

References

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REVIEW

PDF downloadEvolution of celiac disease diagnosis and therapy approaches

Аelita А. Kamalova, Мargarita О. Pirogova

Abstract. The article reviews the history of the celiac disease diagnostic approaches from the first description made by S. Gee till development serological and genetic tests. Transformation of classification and diagnosis is described according to current data. Current guidelines of European Society for Pediatric Gastroenterology, Hepatology, and Nutrition for the diagnosis of coeliac disease (2012) are discussed.


Key words: diagnosis of celiac disease, children, ESPGHAN guidelines.

 

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  46. Laserna-Mendieta, E.J. A proposed reference change value for an IgA anti-tissue transglutaminase immunoassay to improve interpretation of serial results in celiac patients / E.J. Laserna-Mendieta, D. Pineda-Tenor, J. Timуn-Zapata [et al.] // Clin. Chim. Acta. — 2013. — Mar. 4. [Epub ahead of print].
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  48. Nachman, F. Serological tests for celiac disease as indicators of long-term compliance with the gluten-free diet / F. Nachman, E. Sugai, H. Vazquez [et al.] // Eur. J. Gastroenterol. Hepatol. — 2011. — Vol. 23(6). — Р.473—480.
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  50. De Angelis, M. VSL#3 probiotic preparation has the capacity to hidrolyze gliadin polypeptides responsible for Celiac Sprue / M. de Angelis, C.G. Rizzelli, A. Fasano [et al.] // Biochim. Biophys. Acta. — 2006. — Vol. 1762(1). — P.80—93.

 

PDF downloadProbiotics use in neonates and infants (literature review)

Irina V. Nikolaeva, L.A. Kupchikhina

Abstract. The article reviews using probiotics in neonates and infants. The intestinal microflora of infants is the most favorable environment for the probiotic correction, due to the fact that it is in the stage of formation and is unstable microecological system. The paper includes the results of studies on the preventive and therapeutic efficacy of probiotics in infectious and non-infectious diseases in infants, and presents a modern strategy of probiotic’s use in children of this age group.

Key words: probiotics, neonates, infants.

 

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PDF downloadPrinciples of medical therapy of myocarditis in children

Dinara I. Sadykova

Abstract. The article describes the current understanding of the ethiology of myocarditis in children. Discusses the tools of standard therapy, new medications approaches, principles of quality control and cure of disease, as well as advanced therapeutic strategies.

Key words: myocarditis, pharmacotherapy, medications, kids.

 

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PDF downloadDrug allergy in antibiotics using

Olesya V. Skorokhodkina, Akeksey V. Luntsov

Abstract. Clinical characteristics of symptoms of hypersensitivity in antibiotics using and modern approaches to the diagnosis of drug allergy are given in the review.


Key words: antibiotics, hypersensitivity, drug allergy diagnosis.

 

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  25. Allergologiya i immunologiya: nacional’noe rukovodstvo / pod red. R.M. Haitova, N.I. Il’inoi. — M.: Geotar-Media, 2009. — 649 s.

 

PDF downloadImmune defense mechanisms in newborn infants

Khalit S. Khaertynov, Vladimir A. Anokhin

Abstract. The article presents a literature review on the mechanisms of immune defense in children newborn period with a focus on innate immunity. Current development principles and diagnosis of inflammation in infectious diseases are reviewed. The relevance of the study polymorphism of Toll-like receptors in various infectious diseases is demonstrated. Questions of apoptosis in the development of the infectious process are reviewed.

Key words: newborns, immunity, inflammation, apoptosis.

 

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PDF downloadClinical significance of zinc deficiency in the child (literature review)

Svetlana V. Khaliullina

Abstract. Zinc plays an important role in many biochemical processes in a human body. Zinc deficiency has an effect on the functional activity of many organs and systems: gastrointestinal, central and peripheral nervous system, immune, skeletal, reproductive system, etc. The importance of zinc in human metabolism becomes especially noticeable when it is deficient (when it is in short supply). This article highlights the issues related to zinc deficiency among children with medical disorders and infectious diseases.

Key words: zinc-deficient state, diarrhea, children.

 

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  51. Lazzerini, M. Oral zinc for treating diarrhoea in children / M. Lazzerini, L. Ronfani // Cochrane Database Syst. Rev. — 2012. — Jun. 13. — P.6—CD005436.
  52. Вrown, K.H. Zinc fortification of cereal flours: current recommendations and research needs / K.H. Вrown, K.M. Hambidge, P. Ranum // Food Nutr. Bull. — 2010. — Vol. 31. — P.62—74.
  53. Whittaker, P. Iron and zinc interactions in humans / P. Whittaker // Am. J. Clin. Nutr. — 1998. — Vol. 68 (suppl.). — P.442—446.
  54. INCLEN Childnet Zinc Effectiveness for Diarrhea (IC-ZED) Group. Zinc supplementation for children with acute diarrhea is highly acceptable, generally does not affect oral rehydration therapy and is associated with less use of other medications: A randomized trial in five countries // Journal of Pediatric Gastroenterology and Nutrition. — 2006. — Vol. 42. — P.300—305.

 

PDF downloadChronic tick-born encephalitis: the clinical and diagnostics features (literature review)

Irina F. Khafizova, Vildan Kh. Fazylov, Eduard Z. Yakupov, Tatyana V. Matveeva, Albina R. Khakimova, Regina F. Mullaianova

Abstract. A review of the literature concerning the characteristics of the course, clinical presentation and diagnosis of chronic forms of tick-borne encephalitis is presented. Detailed version of the pathological process is expounded and reviewed the pathogenesis of a long silent persistence of the virus in the body as a result of the defeat of the glial cells: discussed issues of preservation of the viral genome and the ways of the “activation”. The article presents the classification of the chronic form of infection with a review variants of the disease. Presented clinical manifestations of the nervous system disorders and laboratory diagnostic of infection. Also described neuroimaging features of tick-borne encephalitis, and presented our observations, where the tomographic picture revealed multiple white matter lesions in the brain.


Key words: chronic tick-born encephalitis, pathogenesis, clinical features, laboratory diagnostics, magnetic resonance imaging.

 

References

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  7. Komandenko, N.I. Klinika i nekotorye voprosy patogeneza progredientnyh form eksperimental’nogo kleschevogo encefalita / N.I. Komandenko, V.I. Il’enko, V.G. Platonov, A.G. Panov // Zhurnal nevropatologii i psihiatrii im. Korsakova. — 1972. — № 7. — S.1000—1007.
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  14. Umanskii, K.G. Struktura progredientnyh form kleschevogo encefalita / K.G. Umanskii, E.P. Dekonenko // Zhurnal nevropatologii i psihiatrii im. Korsakova. — 1983. — № 8. — S.1173—1179.
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  18. Gadolinium Enhancement of Cauda Equina: A New MR Imaging Finding in the Radiculitic Form of Tick-Borne Encephalitis / S. Marjelund, A. Jaaskelainen, T. Tikkakoski [et al.] // Am. J. Neuroradiol. — 2006. — № 27. — P.995—997.
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  20. Magnetic resonance imaging findings and outcome in severe tick– borne encephalitis: report of four cases and review of the literature / S. Marjelund, T. Tikkakoski, S. Tuisku [et al.] // Acta Radiol. — 2004. — № 45. — P.88—94.
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CLINICAL LECTURE

PDF downloadKawasaki syndrome in children (Clinical lecture)

Svetlana Ya. Volgina

Abstract. The lecture addresses issues of the epidemiology, pathogenesis, clinical manifestations, diagnosis and differential diagnosis of the syndrome (disease) Kawasaki in children. Diagnostic algorithm is presented with incomplete Kawasaki syndrome. Recognised treatment of patients, and tactics of patients resistant to therapy.

Key words: Kawasaki syndrome, children.

 

References

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  17. Kanegaye, J.T. Lymph-Node-First Presentation of Kawasaki Disease Compared with Bacterial Cervical Adenitis and Typical Kawasaki Disease / J.T. Kanegaye, E. Van Cott, A.H. Tremoulet [et al.] // J. Pediatr. — 2013 — Vol. 7.
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CONGRESSES, CONFERENCES

PDF downloadThesis of Russian scientific practical conference «Infections and somatic pathology» timed for the 80th anniversary of the department of children's infections of Kazan state medical university of Mi-nistry of Health of Russian Federation on 24th—25th of may, 2013, Kazan P. 92 (Russian only)