[Ascaris lumbricoides-induced pancreatic lesion]. / Porazhenie podzheludochnoi zhelezy Ascaris lumbricoides.

Ascaris lumbricoides is nematode localized in human small bowel in most cases. This nematode is capable for migration. Pancreatitis is one of the most common surgical diseases. One of the causes of this pancreatitis may be migration of Ascaris lumbricoides from small bowel through the major duodenal papilla to the pancreatic ducts. This migration is provided by complex of morphological and functional disorders of digestive system associated with this helminthiasis, as well as certain risk factors. These are previous cholecystectomy, sphincterotomy, living in endemic areas, massive Ascaris lumbricoides invasion, pregnancy. Damage of the pancreas develops due to direct mechanical effect of nematodes and allergic reactions, papillitis and functional disorders of digestive tract. Pancreatitis is usually mild, but severe course of disease is also possible. A typical symptom of pancreatitis caused by Ascaris lumbricoides is helminths in vomit and/or feces.

[The effect of serotonin on the cytotoxic activity of natural killer lymphocytes in patients with the first episode of endogenous psychosis].

Authors studied the level of cytotoxic activity of natural killer lymphocytes (NKCA) and the effect of monocytes, serotonin, rate of serotonin reuptake by lymphocytes and psychotropic therapy on NKCA levels in 59 male patients, aged 18-30 years, with the first episode of attack-like progressive schizophrenia (33 patients) and schizoaffective psychosis (26 patients). All patients were examined at baseline, 4 and 8 weeks after the beginning of treatment with haloperidol and clozapine. Before the treatment, the decrease of NKCA was found in a half of patients compared to controls. In other patients, the NKCA levels were high and did not differ from those in controls. The treatment resistance was estimated as 70,6% in patients with schizophrenia with initially low NKCA levels and 30,8% in patients with schizoaffective psychosis with initially low NKCA levels. During the treatment, the initially high NKCA level decreased while the initially low level increased but remained lower compared to controls. These changes suggest the active reaction from the immune system of the patient to treatment with neuroleptics. The changes of NKCA values during the treatment were reciprocally related to the maximal rate of serotonin reuptake by lymphocytes. Serotonin added to the cell culture in vitro normalized the NKCA level in cultures with- and without monocytes. This effect was revealed in both pathologies only in responders, regardless of the presence or absence monocytes, that may be explained by the presence of active serotonin receptors on the NK cell surface in these patients.

[Determination of the concentration of C-reactive protein, oligopeptides and lactoferrin of blood as a method of early diagnosis of mesenchymal sepsis].

The investigation of results of treatment included the observation of 2250 patients with pyo-necrotic diseases of soft tissues. For the early diagnosis of sepsis the indices of C-reactive protein, oligopeptides and lactoferrin of blood were used. In the presence of one or more symptoms of the systemic inflammatory reaction the level of the indices was increased from 1.1-3.1 up to 4-7 times depending on the degree of the systemic response severity. When the inflammatory process was local the data of the markers remain normal. These markers allow the confirmation of the clinical diagnosis of sepsis, assessment of the degree of the systemic inflammatory reaction and prognosis of the disease.

[Detoxication and anti-inflammatory therapy in the treatment of generalized soft tissue infections].

Treatment results of 276 patients with generalized soft tissue infections are analyzed. Patients were divided in three comparable groups. Clinical effect (oligopeptide and lactoferrin blood concentrations) of intravenous delivered antibiotics and crystalloid solutions with nonsteroid anti-inflammatory drugs (NSAID) was compared with infusions of pent oxyfillin with glucose-potassium solution. Intravenous infusion of 10-12 ml/kg/day crystalloids and glucose-potassium solution showed better detoxication effect then 3-4 ml/kg/day saline with antibiotics combination. The use of pentoxyfillin demonstrated better anti-inflammatory effect then NSAID. Direct correlation between oligopeptide (r=0,89, p<0,05) and lactoferrin (r=0,93, p<0,05) concentrations and time of the systemic inflammatory reaction syndrome reduction was observed, which allowed the use of these substances in treatment efficacy monitoring.

[A new approach to clinical and laboratory diagnosis of systemic and local soft tissue infections].

Dynamic measurements of blood TNF-a, IL-IRA, CRP, oligopeptide, and lactoferrin levels in patients with systemic and local soft tissue infections revealed direct correlation between them which allowed to use these indicators for the diagnosis of systemic infections. Results of clinical and laboratory analyses provided a basis for distinguishing short-term systemic inflammatory response syndrome and sepsis and developing relevant diagnostic criteria. Sepsis combined with systemic inflammatory response syndrome persisting for more than 72 hours after the onset of adequate therapy was characterized by CRP levels > 30 mg/l, oligopeptides > 0.34 U, lactoferrin > 1900 ng/ml, TNF-a > 6 pg/ml, ILL-IRA < 1500 pg/ml Patients with systemic inflammatory response syndrome for less than 72 hours had lower TNF-a, CRP, oligopeptide, and lactoferrin levels with IL-IRA > 1500 pg/ml. This new approach to early diagnosis of systemic infections makes it possible to optimize their treatment and thereby enhance its efficiency.

[The use of plasma lactoferrin in the diagnosis of pyonecrotic infections of soft tissues and sepsis].

Plasma lactoferrin dynamics was investigated in 120 of the 2250 patients with local and generalized soft tissue infections. Systemic symptoms were observed in 15% of the patients with soft tissue infections, syndrome of systemic inflammatory response in 13%, and sepsis in 42%. In 89% of the patients with systemic inflammatory reactions the blood lactoferrin level was 1.1-1.3 times the normal one within 72 hours after the onset of therapy; it dropped to the normal value in 12-15 days. Normalization of blood lactoferrin in patients with mild and moderate systemic inflammatory reactions roughly coincided with the disappearance of symptoms of generalized infection. It occurred 5-6 days after the septic process was resolved in patients with severe inflammatory reactions. Normal blood lactoferrin levels were characteristic of a mild inflammatory reaction and local forms of infection. A rise in blood lactoferrin above 1400 ng/ml combined with the syndrome of systemic inflammatory reaction over 72 hr in duration was regarded as a diagnostic criterion of sepsis. It is suggested that monitoring blood lactoferrin during treatment of systemic inflammatory reactions and sepsis be used for the choice of therapeutic strategy and the assessment of efficiency of its efficiency.

Family business in Russia: the path to middle class?

The paper seeks to explore via a series of interview-based case studies aspects of the emergence of an entrepreneurial middle-class in Russia. The paper notes the origins of those studied in the professional or highly skilled workers in the former Soviet Union. The paper reveals the complexity and fragility of the circumstances of these entrepreneurs and suggests that commentary in both Russia and the West that pins its hopes for social stability on the emergence of a new property owning middle class in Russia are, at best, premature.