[The efficiency of modernmethods of laboratory diagnosis in the evaluation of various forms of hemorrhagic fever with renal syndrome caused by the Puumala hantavirus (PUUV).]

We've conducted the analysis of both traditional and new methods of laboratory diagnosis to estimate the severity and damage of target organs during Hemorrhagic Fever with Renal Syndrome (HFRS). It was shown that thrombocytopenia corresponds to the severity of the disease and correlates with the severity of renal failure. The level of C-reactive protein reflects the activity of the inflammatory process and correlates with the characteristic laboratory criteria of the disease. Blood serum levels of alveomucine in patients with HFRS more than 45.0 U/ml indicates lung damage. HFRS on the territory of the Bashkortostan Republic is caused by the serotype of Puumala hantavirus; dependence of the form of the disease on the content of antiviral antibodies is not revealed.

[Clinical and morphological parallels in lung lesions associated with hemorrhagic fever with renal syndrome].

The authors report the results of clinical examination of the respiratory, organs of 97 patients with hemorrhagic fever and renal syndrome (HFRS) with confirmed Puumala serotype. Retrospective analysis of 16 fatal cases is presented. It is shown that patients with moderately severe and severe forms of the disease exhibit early clinical and X-ray signs of pulmonary lesions and respiratory insufficiency Some of them suffer acute respiratory distress syndrome confirmed by morphological findings at autopsy.

[Cardiopulmonary syndrome in hantavirus infection (an overview)].

The article provides an overview of domestic and foreign literature on modern aspects of hantavirus infection. Hemorrhagic fever with renal syndrome and hantavirus cardiopulmonary syndrome have a high epidemiological significance for Russia's Armed Forces and the armies of many foreign countries. Current knowledge of the various manifestations of the disease contribute to the improvement of diagnosis and timely delivery of medical and preventive measures.

[The diagnostic significance of alveomucin in patients with hemorrhagic fever with renal syndrome].

The article considers the results of analysis of serum alveomucin levels in 97 patients with hemorrhagic fever with renal syndrome depending on the form and period of disease. It is demonstrated that in patients with hemorrhagic fever with renal syndrome and clinical radiologic symptoms of lung affection already in initial period of disease the level of serum alveomucin is reliably higher than in the control group and the group of patients with hemorrhagic fever with renal syndrome and without lung affection. The correlation analysis revealed the reverse dependence between the level of alveomucin and arterial blood saturation with oxygen in patients with hemorrhagic fever with renal syndrome and disease form of medium severity.

[The diagnostic value of serum alveomucin test in diseases with lungs affection].

The study was organized to determine the diagnostic value of concentration of blood serum alveo-mucin as a marker of lesion of lung tissue in patients with community-acquired pneumonia and hemorrhagic fever with renal syndrome. The sampling included 86 patients with community-acquired pneumonia and 97 patients with hemorrhagic fever with renal syndrome. The patients with community-acquired pneumonia were divided in three groups according severity of disease course: slight form, medium-severe form and severe form of disease. The group of patients with medium-severe form of hemorrhagic fever with renal syndrome was divided on two groups depending on clinical roentgenologic pattern: with and without pathology of lungs. The high concentration of alveomucin at the day of hospitalization is typical for patients both with community-acquired pneumonia and with roentgenologically approved lungs affection in case of hemorrhagic fever with renal syndrome in comparison with patients with hemorrhagic fever with renal syndrome without affection of lung tissue (p=0.046). The concentration of alveomucin higher than 47.2 U/ml is established in 86% of patients with community-acquired pneumonia and affection of lung in case of hemorrhagic fever with renal syndrome and in 12% of patients with hemorrhagic fever with renal syndrome without affection of lungs (chi2=0.58 with Yeats equalization, p=0.44).

[State of antiendotoxin defense during community-acquired pneumonia].

AIM: To assess the effect of systemic endotoxinemia and LPS-induced immune response on severity of community-acquired pneumonia (CAP). MATERIALS AND METHODS: Clinico-immunological follow-up of 60 patients with CAP of different severity was conducted. LPS was quantitatively measured by ENDOSAFE ENDOCHROME (0.015-0.12 EU/ml), LBP--by Hbt Human LBP ELISA (min 1 ng/ml), IgG to core region of LPS--by Hbt EndoCAb ELISA (min 0.125 MU/ml) ("HyCult biotechnology", Netherlands). RESULTS: Level of LPS in blood was not increased, whereas there was increase of antiendotoxin proteins in patients with more severe CAP with Gram-negative or mixed bacterial flora identified. Correlation between levels of LBP, IgG to core-region of LPS, IL-6, TNF-alpha, IL-4 and immune response abnormalities during severe forms of disease was demonstrated. CONCLUSION: State of antiendotoxin immunity is an etiologic marker of CAP and its severity.

[Clinical and diagnostic value of the determination of alveomucin in patients with community-acquired pneumonia].

The study was undertaken to define the clinical and diagnostic value of the determination of the serum levels of alveomucin in patients with community-acquired pneumonia and the correlation of this index with the etiological factors of the disease and its severity. The investigators used general clinical, laboratory, and instrumental studies and specific serodiagnostic assays of the pathogen and measured alveomucin levels on the principle of a double-site enzyme immunoassay. Examining the serum level of alveomucin in the examinees indicated that on admission day this index was 34% higher in the patients with community-acquired pneumonia than in the healthy individuals (52.59 +/- 2.8 and 39.22 +/- 2.8 U/ml, respectively). The mean value of this index was reduced to 49.88 +/- 2.29 U/ml) in the course of the disease. A certain association was found between the study index and the clinical characteristics of the disease: a direct correlation was established between the extent of lung injury and the level of mucin antigen. An assay of serum alveomucin depending on the severity of community-associated pneumonia revealed that on the first days of admission its values did not differ significantly from that in patients with different forms of the disease. However, there were statistically significant differences in this index according to the severity of the disease in its course. Analysis of serum alveomucin values in relation to the etiology of the disease also revealed certain regularities.

[Clinico-diagnostic evaluation of changes in ATPase activity, lipid peroxidation and stability of red cell membranes in patients suffering from hemorrhagic fever with renal syndrome]. / Kliniko-diagnosticheskaia otsenka izmenenii adenozintrifosfataznoi aktivnosti, sostoianiia perekisnogo okisleniia lipidov i stabil'nosti membran éritrotsitov u bol'nykh gemorragicheskoi likhoradkoi s pochechnym sindromom.

AIM: To examine morphofunctional and metabolic features of erythrocytes affecting blood rheology in patients with hemorrhagic fever with renal syndrome (HFRS) for assessment of the disease severity. MATERIAL AND METHODS: 130 HFRS patients were examined using clinical, laboratory, serological tests and fluorescent antibody test. Activity of transport ATPase and content of lipid peroxidation (LPO) products in erythrocyte membranes were measured. These membranes stability was assessed by osmotic and acid resistance in different disease periods. RESULTS: Inhibition of Na+, K+, Ca+ active ATPase of erythrocyte membrane occurred in all the examinees, LPO products rose. The membrane stability was more disturbed in moderate and severe HFRS, especially in polyuretic period. CONCLUSION: Depression of ATPase activity, growth of LPO content in erythrocytes, their relationships can be used as indicators of red cell metabolic disorders, abnormal blood rheology, and eventually, in the disease prognosis. Early membrane defects detected by osmotic and acid resistance can improve the disease diagnosis and provide data on the condition's severity.