[Immunological parameters of urine in differential diagnosis of chronic recurrent cystitis in women].

INTRODUCTION: Chronic recurrent cystitis (CRC) is a complex multifaceted problem of modern uroinfectology. OBJECTIVE: To study the immunological parameters of urine in patients with chronic recurrent cystitis depending on the etiological factor. MATERIALS AND METHODS: The prospective study included 71 patients aged 20-45 years who had previously been diagnosed with recurrent lower urinary tract infection: chronic recurrent cystitis (CRC) during an exacerbation period. Based on the results of bacteriological and PCR studies of urine, scraping of the urethra and vagina, depending on the dominant etiological factor, the patients were divided into three groups: group 1 (n=30) - with papillomavirus CRC (PVI-CRC), group 2 (n=30) - with bacterial CRC (B - CRC), group 3 (n=11) - with candida CRC (C - CRC). Analysis of the assessment of immunological parameters of urine was carried out using an enzyme-linked immunosorbent assay (ELISA-BEST). RESULTS: Based on the results of an immunological study of urine in the study groups, characteristic specific changes in the level of interleukins and interferons were identified, which made it possible to determine a protocol for the differential diagnosis of CRC. CONCLUSIONS: Our study shows the advisability of testing interleukins in urine (IL-1 beta, IL-6, IL-8); these indicators can serve as scoring criteria in the differential diagnosis of CRC of various origins. CONCLUSIONS: , it is reasonable to study the level of IFN-2b and IFN; when identifying the functional inferiority of the IFN system in women with CRC, correction of the IFN system is necessary.

[Cytological examination of urine in the differential diagnosis of recurrent lower urinary tract infection].

INTRODUCTION: A diagnosis and treatment of recurrent lower urinary tract infection (UTI) in women is still one of the unresolved problems of urology. The proper identification of the etiological factor determines the treatment tactics. Therefore, the most urgent issue of recurrent lower UTI is the differential diagnosis of the causative pathogens. MATERIALS AND METHODS: A cytological study of urine was performed in 151 patients with recurrent lower UTI, who, according to the results of bacteriological and PCR studies of urine, were divided into three groups, depending on the etiological factor. The group 1 (n=70) included women with recurrent lower UTI of bacterial etiology, while in group 2 (n= 70) papillomavirus etiology was found, and in group 3 (n=11) candida species were the causative pathogens. The age of the patients ranged from 20 to 45 years (32.3+/-7.8). RESULTS: In the majority of patients with recurrent lower UTI of bacterial etiology, the cytological features were represented by leukocytes, plasma, epithelial cells and bacteria in combination with actively phagocytic macrophages. In group 3, in addition to a large number of leukocytes (neutrophils) and epithelial cells, Candida mycelium was found. In group 2, signs of bacterial inflammation were minimal, while a predominance of lymphocytes, epithelial cells, and the presence of single neutrophils was seen. With papillomavirus lesions of the bladder, urothelial cell dystrophy with the presence of koilocytes developed. CONCLUSIONS: A cytological examination of urine can confirm the etiology of the recurrent lower UTI and be an evidence-based criterion in the differential diagnosis of bacterial, candidiasis, and papillomavirus infection. Total transformation of the urothelium and vacuolization of urothelial cells, as well as an excess of lymphocytes in the urine in the absence of neutrophils, are the characteristic features of viral recurrent lower UTI.

[Modern aspects of the etiological structure of chronic recurrent cystitis].

The review is devoted to the study of modern aspects of the etiological structure of chronic recurrent cystitis. The search was carried out using the databases Medline, PubMed, EMBASE. The data of the literature search indicate that chronic recurrent cystitis in women is one of the most common and urgent problems in modern urology, which affects all age categories and has a polyetiological structure. Issues of the pathogenesis of chronic recurrent cystitis, as well as methods of diagnosis and treatment, are closely related to the etiological factors of the disease. The success of chronic recurrent cystitis treatment mainly depends on the accurate identification of the pathogen.

[Efficacy of Uronext in chronic recurrent bacterial-viral cystitis with multiple resistance to antibacterial drugs].

Chronic recurrent cystitis (CRC) is one of the most common diseases of the lower urinary tract in the female population. Difficulties in diagnosis and treatment, despite the observance of modern clinical recommendations for CRC, are due to the versatility and polyetiology of the pathogenesis of the disease. The most difficult and discussed section of this problem is the diagnosis and treatment of CRC of papillomavirus (PV) etiology. The article presents its own clinical observation - Diagnosis and treatment of a patient with CRC PV etiology. CRC, in addition to bacterial uropathogens, can be caused by various representatives of a viral infection. Among all viral pathogens, HPV has the widest pathogenic potential. Currently, there is no single etiotropic therapy for PVI of the urinary tract and reproductive organs; there is no systemic treatment of patients with HPV-associated lesions, including the bladder. Nevertheless, an important principle of therapy, which has already become an axiom, is applied - an integrated approach that includes anti-inflammatory,antiadhesive, antiviral and immunoactive therapy.

[Forensic medical diagnostics of acute and chronic alcohol intoxication].

The principal characteristics and results of experimental studies on the problem of acute and chronic alcohol intoxication are presented. The mechanisms of toxic action of ethanol and acetaldehyde are considered with special reference to the comprehensive qualitative estimation of these toxicants and their pathomorphological effects in the target organs. The influence of ethanol-oxidizing enzyme systems in the brain on the development of alcohol tolerance is illustrated. The mechanisms of hormonal regulation via the hypothalamic-pituitary-adrenal axis in the case of exogenous alcoholemia are considered. The dependence of pathological morphological changes in the brain, hypophysis, and adrenal glands on the stage and severity of alcoholic intoxication has been elucidated. Criteria for the morphological and histochemical evaluation of the degree of alcohol-induced lesions and the severity of abstinence syndrome have been developed. The role of alcohol effects in tanatogenesis associated with alcohol-induced diseases is discussed.

[The activity of ethanol- and aldehyde-oxidizing enzymes of the brain in ethanol intoxication]. / Aktivnost' étanol- i al'degidokisliaiushchikh fermetov golovnogo mozga pri otravlenii étilovym spirtom.

The distributed activity of alcohol dehydrogenase (ADG) and aldehyde dehydrogenase (AldDG) was histochemically studied in neurons of locus coeruleus, nuclei of raphe, substantia nigra and in cerebellar cortex in death or intoxication of ethanol (IE). The enzymatic activity was found to be changing depending on whether there was IE or not. Both higher ADG and lower AldDG were registered in the examined brain sections, which differ by mediatory structure of the neuronic centers. The detected regularities can be used within the forensic medical diagnosis of IE.

[Ethanol-oxidizing enzymes of the adrenal glands in acute alcoholic intoxication]. / Etanolokisliaiushchie fermenty nadpochechnikov pri ostroi alkogolnoi intoksikatsii.

Complex morphological-and-histological examinations of the adrenal glands were performed on actual forensic-medical samples in acute alcoholic intoxication (AAI), i.e. 107 death cases of men and women, aged 17 to 60, due to mechanical trauma, lethal ethanol intoxication and somatic complications of chronic alcoholism. A differentiated distribution of ethanol-oxidizing enzymes was defined, i.e. of alcohol-dehydrogenase and acetyl-dehydrogenase in the structural-and-functional zones of the adrenal cortex and medullary substance. A differential activity of enzymes was established that correlated with the level of exogenous alcoholemia. Sets of morphological signs related with examinations of the adrenal glands, which enabled a differential diagnosis of death causes in AAI, were specified.

[Histochemical changes in the hypothalamus, hypophysis, and adrenal glands observed in ethanol poisoning]. / Gistokhimicheskie izmeneniia v gipotalamuse, gipofize i nadpochechnikakh pri otravlenii étilovym spirtom.

A comprehensive morphological-and-histochemical study of neuroendocrinal internals in cases of ethanol poisonings was undertaken. Actual forensic medical materials were used (62 cadavers) to make morphometry examinations of the hypothesis and adrenal glands. Besides, the distribution of alcohol dehydrogenase and acetaldehyde dehydrogenase was investigated in the mediatory differential brain sections, i.e. cerebellum, locus coeruleus, dorsal raphe nucleus, hypothalamus and adrenal glands. A differential distribution of ethanol-oxidizing enzymes as well as their changes in ethanol lethal poisoning were established; additionally, a variety of morphological signs were defined, which enable the differential diagnosis of a death reason in acute alcoholic intoxication.

[Acetaldehyde and some biochemical parameters in alcoholic intoxications]. / Atsetal'degid i nekotorye biokhimicheskie parametry pri alkogol'nykh intoksikatsiiakh.

The need in comprehensive gas chromatography and biochemistry examinations is grounded for cadaver expertise in order to cope with issues related with alcoholic intoxication. Descriptions of 3 examination methods of biological fluids are elucidated, i.e. gas chromatography, electrophoresis and fixing of a degree of endogenous intoxication. The concentration of acetaldehyde in 3 body media (blood, urine and liquor) are analyzed in detail; the isoenzyme spectra of lactate-, alcohol- and aldehyde dehydrogenase as well as the contents of medium molecules in death of alcohol poisonings and due to mechanical trauma are also in the focus of attention.

[Morphologic characteristics of lesions of the small intestinal mucosa in chronic ischemia]. / Morfologicheskaia kharakteristika porazhenii slizistoi obolochki tonkoi kishki pri ee khronicheskoi ishemii.

The results of morphologic examination of the small bowel mucosa of 32 patients with the ischemic disease of the alimentary organs provoked by stenosis of a. iliaca are analyzed. The diagnosis was confirmed angiographically and in the course of operation. Aspiration biopsy of the jejunum was performed by means of Ts. G. Masevich's sound. Chronic intestinal ischemia provokes the development of the atrophic changes in the mucosa with the decrease of its thickness due to the lowering of the height of its villi. The number of the goblet cells is increasing as well as the cell infiltration, the degenerative changes in the epithelium are observed. These alterations correlate with the degree of both the vessel narrowing and collateral circulation.