['Masks' of acute neuroinfections and markers of differencial diagnosis]. / 'Maski' ostrykh neiroinfektsii i markery differentsial'noi diagnostiki.

AIM: To compare thе medical history, clinical features, composition of cerebrospinal fluid (CSF), results of laboratory and instrumental examinations of patients with acute neuroinfections and differentiable diseases including a pseudoinflammatory variant of the acute stage of uncomplicated subarachnoid hemorrhage (SAH), consequences of traumatic brain injury (traumatic SAH, SAN combination with secondary purulent meningitis, posttraumatic nasal liquorrhea, intracerebral hematomas), abscesses and tumors of the brain, lymphoma with proven CNS. These diagnoses were mistakenly made to patients admitted to an infectious department. MATERIAL AND METHODS: Forty-six patients, aged from 18 to 83 years, hospitalized in the Department of neuroinfections and intensive care in 2010-2016 were examined. Conventional clinical neurological, laboratory, instrumental (including MRI) examinations of patients, comprehensive examination of CSF samples, the study of markers of inflammation (C - reactive protein, CSF lactate), immunophenotyping of CSF cells were performed. RESULTS AND CONCLUSION: The misdiagnosis can be explained by the overestimation of such symptoms as the acute (in most cases) onset of the disease with increased body temperature to febrile levels, presence of meningeal syndrome, disorders of consciousness and focal symptoms of varying severity. The authors showed the errors and difficulties in the diagnosis, the role and importance of an integrated, interdisciplinary approach taking into account history, clinical data, results of CSF study, conventional and special methods of laboratory and instrumental examination of patients.

[Cerebrospinal fluid in clinical aspects of tuberculosis of the central nervous system].

OBJECTIVE: To identify clinical features of tuberculosis of the meninges and central nervous system (TM) with detailed characterization of changes in the composition of cerebrospinal fluid (CSF) in the initial period of the disease. MATERIAL AND METHODS: We analyzed the results of the examination of 42 patients, aged from 17 to 49 years, who were hospitalized in 2005-2014. RESULTS AND CONCLUSION: Most of the patients were admitted in the hospital in early acute disease onset. Along with the description of inflectional and cerebral symptoms, meningeal signs, disorders of consciousness and focal symptoms, we presented cell count values, protein and glucose concentrations at initial examination of CSF as well as the results of additional examination and specific therapy issues. The importance of combining treatment standards and individualization of therapy of TM patients is emphasized.

[THE PATHOGENIC POTENTIAL OF MORAXELLA CATARRHALIS AND STAPHYLOCOCCUS EPIDERMIDIS UNDER INFLAMMATORY PROCESSES OF UPPER RESPIRATORY TRACTS].

The frequent isolation from biological material of Moraxella catarrhalis under bronchitis and pneumonia and Staphilococcus epidermidis under rhinitis and sinusitis requires profound investigation offactors ofpathogenicity ofthe mentioned microorganisms. The genetic and phenotypic markers of virulence of strains M. catarrhalis and S. epidermidis are examined. Their etiologic role in development of infection processes of respiratory tract and middle ear is determined The most of M catarrhalis strains isolated under bronchitis and pneumonia have gene mcaP responsiblefor production ofprotein McaP that provides adhesion to epithelium cell of host and lipolitic activity of bacteria. The strains isolated from patients with pneumonia had the most adhesive activity. The cluster of genes ICA with leading role of gene icaA is responsible for for availability offactors of intercellular adhesion in Staphilococci strains. In the clinical samples from patients with sinusitis this gene is detected 5 times more frequently than from healthy individuals. In phenotypic tests, expression of gene icaA in S. epidermidis isolated from patients is three times higher than in strains isolated from healthy individuals. To establish etiologic role of M. catarrhalis and S. epidermidis and to develop tactic of therapy of patients with bronchitis, pneumonia and sinusitis complex approach is needed, including detection of genetic and phenotypic markers of virulence in isolated microorganisms.

[Rare forms of segmental exanthema in patients with Herpes zoster].

OBJECTIVE: To describe rare clinical cases of Herpes zoster with a rash appeared simultaneously in different segmental zones (zoster duplex unilateralis and zoster duplex bilateralis). MATERIAL AND METHODS: Brief details of medical histories of 3 patients are presented. RESULTS AND CONCLUSION: A very rare possibility of the complete fusion of bilateral exanthema on the same topographic level with the development of an entire zoster that confirm a historical name of the disease has been demonstrated. A mistaken translation of disease name into Russian as "lishai" is emphasized. Recommendations on the complex, stage-by-stage treatment of patients, including psychotherapeutic treatment of the pain syndrome, are presented.

[Exogenous allergic alveolitis in workers engaged in the manufacture of pepsin]. / Ekzogennyi allergicheskii al'veolit u rabochikh proizvodstva pepsina.

A case is reported of an affliction in a worker engaged in the production of enzyme powder-like drugs who in the course of his work over 30 years had been exposed to aerosols containing pepsin and hydrochloric acid. The lung X-ray disclosed pneumothorax, with the cardiovascular shadow and trachea displaced to the right. There were signs of myocardial hypoxia and pulmonary hypertension on the electrocardiogram. The described case suggests to us its occupational causation and permits classifying the form of affection of the bronchopulmonary system as an occupational health problem.

[Trypsin-like proteinase from Actinomyces fradiae 119]. / Tripsinopodobnaia proteinaza Actinomyces fradiae 119.

Using electrophoresis and ultracentrifugation, a homogeneous proteinase was isolated from protofradine, a protease Act. fradiae 119 preparation. The purification procedure included filtration on DEAE-cellulose, gel filtration through Arcylex P-10, CM-chromatography and desalting on Sephadex G-15. The proteinase under study is an endopeptidase which hydrolyzes low molecular weight synthetic trypsin substrates as well as casein and denaturated collagen. Diisopropylfluorophosphate and soya bean trypsin inhibitor completely inhibit the proteinase activity, whereas pCMB and EDTA have no such effect. The stability maximum is observed at pH of 2.5-3.5, the action maximum at pH 8.7-9.5. The amino acid composition of the enzyme is similar to that of trypsin from Str. griseus. The molecular weights of the proteinase as determined by gel filtration and sedimentation equilibrium method are equal to 25400 and 26500, respectively. The isoelectric point lies at 5.3. The data obtained suggest that the proteinase can be attributed to the family of trypsin proteinases.

[Immunoepidemiological study of the meningococcal carrier state in groups of children and adolescents]. / Immunoépidemiologicheskoe izuchenie meningokokkovogo nositel'stva v kollektivakh detei i podrostkov.

Immunoepidemiological study in groups of children of different ages was carried out. The study comprised the monthly bacteriological examination of the members of these groups and selective determination of the presence of specific meningococcal A- and C-antibodies, IgA, IgM and IgG in the blood serum, as well as the lysozyme activity of the saliva. The results thus obtained indicated that during the whole year two rises in the level of meningococcal carriership, in autumn and in spring, were registered, while the cases of meningococcal diseases were absent. The first rise was due to the influence of the conditions under which the groups had been formed, as well as to some decrease in specific immunity characteristics and nonspecific protective factors; the second rise occurred simultaneously with a considerable decrease in the content of specific meningococcal A- and O-antibodies.