[Clinical and Immunological Features of Infectious Complications in Patients with Multiple Myeloma].

BACKGROUND: Infectious complications--the leading cause of mortality in patients with multiple myeloma (MM), their appearance is regarded as an adverse prognostic factor in the course of the disease. OBJECTIVE: The aim of our study was to evaluate the clinical and immunological features of infectious complications in patients with G-immunochemical MM to find the most informative indicators in their forecasting. METHODS: A randomized controlled trial was made. All patients were divided into 3 groupsfor comparison: Group 1 (n = 47)--MM patients, G-immunochemical variant with infection, Group 2 (n = 54)--MM patients, G-immunochemical option no infectious complications, and Group 3 (n = 125)--healthy volunteers. Research material was deoxygenated blood taken on admission of a patient to the hematology department before the pathogenetic treatment. Identification of G-variant was carried by immunofixation and electrophoresis. The immune status was assessed by indirect immunofluorescence. The concentration of IgA, M, E and G, and the levels of IL 2, IL 4, IL 8, TNFα, IFNγ in serum was determined by enzyme immunoassay. The activity of neutrophil granulocytes (NG) was studied by chemiluminescent analysis of spontaneous and induced production of reactive oxygen species. Statistical analysis was performed using the software STATISTICA v. 8.0 (USA), RESULTS: We analyzed data from 101 patients with MM and 125 healthy volunteers. The average age of MM patients was 60.53 ± 6.78 years. The group of healthy volunteers was similar in sex and age to groups of patients with MM. In patients with MM in the presence of infectious complications the researchers detected combined secondary development of T and B cell immunodeficiency, changes in non-specific immunity depended on the stage of the disease, unidirectional irregularities in spontaneous and induced chemiluminescence activity NG in II stage disease and multidirectional irregularities in stage III (p = 0.045). Prevalence of the content of proinflammatory cytokines on inflammatory (p < 0.001) and the deviation of the immune response to Th1-type were detected. CONCLUSION: the set of 6 informative indicators (the content of IL 4, IL 2, TNF α, IgG, the absolute number of CD4+ and CD19+ cells) enables the development of prediction method of infectious complications in patients with MM.

[The role of cell-mediated immunity in progression of myeloma disease].

The aim of the work was to study the role of cellular and humoral immunity in progression of myeloma disease (MD). The study included 97 patients and 125 age and sex-matched healthy volunteers. The state of cell-mediated and humoral immunity was evaluated at admission, before the pathogenetic treatment, by indirect immunofluorescence technique using anti-CD3, CD4+, CD8+, CD16+, CD19+, HLA-DR+ monoclonal antibodies. Serum IgA, IgM, IgE, IgG were measured by immunoenzymatic assay. The results were analysed using Statistica 7.0 (StatSoft, USA) program. The quantitative values are expressed as the median (Me) and interquartile range (C25-C75). Qualitative variables are presented as absolute values and percentage. The critical statistical significance level was taken as 0.05. The patients with MD developed combined secondary T, B-cell immunodeficiency. The disbalance between CD4+ cells and cytotoxic lymphocytes as well as signs of B-lymphocyte deficit increased with the progress of the disease. The number of NK-cells decreased at all stages of the disease. A rise in the serum level of LgC at all stages compared with control is an identifying sign confirming diagnosis of G-variant of myeloma disease.

[Chlamydial infection in chronic adenoiditis children].

The examination of 169 children aged 3-15 years admitted to ENT department for exacerbation of chronic adenoiditis has shown high chlamydial contamination of the pharyngeal mucosa. Identification of chlamydial structures and specific antibodies was performed with application of direct (polymerase chain reaction, immunofluorescence) and indirect (EIA) methods. Specific structure of the verified pathogens as well as clinical manifestations of adenoiditis associated with chlamydial infection and characteristics of immune response of the child to chlamydia are described.

[Regularities of physical development of Chukotka children aged 8-12 years].

School children in Chukotka aged 8-12 years were examined to study the characteristics of their physical development and its association with age, sex, and ethnicity. The study demonstrated that the migrants had higher values of body length and body mass, with a step-wise pattern of their increase, higher body fat component content as compared with the aborigines. The migrants showed higher circumferential dimensions, while the growth rate of these parameters was higher in aborigines. Maximal growth rates of extremity diameters were different in specific ethnic groups, while the skeletal mass was greater in migrants. In aborigine boys more active thorax growth was found, while aborigine girls had higher pelvic growth rate. Migrants were shown to have higher muscular and bone mass, than aborigines.

Ethnic and environmental factors in health formation in the Siberian population.

Today, the Russian North and Siberia has become a region with a great number of ecological and social problems with negative influences on the health state of their population, especially of the children. We made the evaluation of the health state of children aged less than three years using the cell-molecular parameters of the erythrocytes membrane. We revealed the peculiarities of the structural and functional characteristics of the cell membrane, especially in membranous structural phospholipids. We estimated the resistance of the membrane structure to damaging influences and revealed that regulator systems on the level of cell membrane had become in 65% of children--with Northerners less stable against loading states. We studied iododeficiency diseases in the Basin of the Enysei River and found a region of heavy iododeficiency in the Tuva Republic. We revealed the most distinctive signs of metabolic reactions in the blood of non-indigenous children. We studied ethnic peculiarities of disease development. In total, we revealed that the pathology formed in Native and strange populations, in children and adults, depended on ecological conditions and ethnicity.

[The medical social status of adolescents of the Republic of Tuva].

The characteristics of the social status of the adolescents of indigenous population of the Republic of Tuva are presented. The questionnaire was proposed to 206 eleventh grade students of general education schools (128 respondents from rural area and 78 respondents from urban area). The development of the personality of adolescents occurs in the unfavorable conditions and under the negative impact of the factors of nearest environment. The hierarchy of the adolescents' vital values is analyzed. The adolescents give preference to school studies, personal health caring, sports and friendship. Such values as family establishment, sex and feasting revelry are rejected by the respondents. The study results are recommended to be applied in the planning of psychological medical and educational activities in the field of the development of the healthy life-style among the students of general education schools.

[Microbiocenosis of nasal mucous membrane during allergic rhinosinusitis].

Overall quantity of microorganisms and their relative prevalence on nasal mucous membrane in patients with allergic rhinosinusitis are determined. Microbial flora in studied group was characterized qualitatively and quantitatively. Obtained results showed that there were changes of microbiocenosis of nasal mucous membrane during allergic rhinosinusitis and in characteristics of species in Staphylococcus genus.

[The influence of severe iodine insufficiency on the character of intellectual deficit].

To study mental deficit in 60 children living in the areas with marked insufficiency of iodine in the soil, water and air, pupils of 3-4 grades of secondary schools in the western regions of Tyva Republic, where researchers of the State Medical Research Institute, Siberian Department of Russian Academy of Sciences, had discovered the hotbed of severe iodine insufficiency in 1997, were examined. Authors also studied 175 children who lived in the same social and economic conditions in the areas with light and moderate degree of iodine insufficiency. Impairments of memory, mental ability, intellectual function and visual motor coordination were found in the structure of mental deficit caused by the severe iodine insufficiency. In children from areas with light and moderate iodine insufficiency these disturbances were more subtle. Disturbances of analytical synthetic function and logical thinking were determined in the intellectual sphere. Processes suggesting between sensory integration disturbances were found in the perceptual sphere.

[The activity of NAD(P)-dependent dehydrogenases in blood lymphocytes in children and adolescents with different duration of insulin-dependent diabetes mellitus]. / Aktivnost' NAD(P)-zavisimykh degidrogenaz v limfotsitakh krovi u detei i podrostkov s raznoi prodolzhitel'nost'iu insulinozavisimogo diabeta.

The levels of blood lymphocyte NAD(P)-dependent dehydrogenases were investigated in children and teenagers with different duration of insulin-dependent diabetes mellitus (IDDM). The level of some NAD(P)-dependent dehydrogenases changed proportionally in dependence of IDDM duration and insulin therapy did not restore their activities to the normal level. It is suggested that these changes may reflect decrease of energy metabolism and plastic processes in blood lymphocytes from diabetic children and teenagers reflecting. These changes correspond to altered functional reactivity of immunocompetent cells and represent metabolic basis of immunopathogenic complications of IDDM.

[The mechanism of normolipidemia among the Northern area ethnic groups]. / Mekhanizm normolipidemii u severnykh narodnostei

Biochemical composition of the bile and blood serum was investigated in Evenkia and Yakutia residents and immigrants. Blood lipids in the immigrants were much higher while bile lipids lower than in the natives. It is suggested that normolipidemia in the residents may be determined by intensive synthesis of biliary acids and other lipids in the liver and their secretion into the bile. Later, high content of primary cholates (17%) was found in the bile of residents which was not confirmed in the immigrants.

[Data from an expedition to study a Siberian vegan settlement]. / Materialy ékspeditsionnogo issledovaniia sibirskogo poseleniia veganov.

Health status, the way of life and nourishment of 84 vegans in Siberian village (Krasnoyarsk region) were studied and compared with those of 26 meat-eaters. The investigation included work with a questionnaire, clinico-diagnostic and laboratory research. It was shown that a vegetarian diet improves the serum lipid spectrum (cholesterol, LPLD, cholesterol of LPNP, atherogenic coefficient), normalizes weight and cardiovascular system. The vegans had normal levels of vitamin B12 and serum Fe but the calcium level in this group was lowered as compared with the control group. The pathology of internals (nephroptosis, lithic diathesis, tendency to lithogenesis) was observed. Apparently, the high serum Zn levels found in both groups aren't directly caused by the diet but by climate and geographic factors.

[Ecological influences on the health status of small-size populations of the North]. / Ekologicheskaia obuslovlennost' sostoianiia zdorov'ia malochislennykh narodnostei Severa.

The paper gives the results of examining the ecological impact on the health of the native populations of the North, shows the influence of drastic changes in the traditional lifestyle of the natives on the prevalence and specific features of the course of major diseases in the North. The ecological situation rapidly changing in the areas of large-scale economical development has influences on human regulatory systems in the North.