[Implication of functional platelet activity in pathogenesis of Q-fever].

AIM: To ascertain the role of platelets in pathogenesis of clinical symptoms in patients with Q-fever. MATERIAL AND METHODS: We studied hemostasis with estimation of functional platelet activity in 49 patients with Q-fever. RESULTS: Hemorrhagic syndrome (HS) occurred in 34.4% patients with Q-fever (QF) during seasonal rise of morbidity. HS manifested with petechiae (12%), hematomas (32%), nasal bleeding (17%), stomatorrhagia (9%), melena (12%). Characteristics and duration of such symptoms as weakness (100%), myalgia (72%), arthralgia (52.9%) suggested hemocoagulatory disorders as a cause of the symptoms appearance. At the height of the disease thrombocytopenia was accompanied with inhibition of platelet aggregation activity, but regression of the clinical symptoms was associated with an increase in platelet count and platelet hyperaggregation. Fibrinogen content was elevated during hospitalization in 50% patients. CONCLUSION: Clinical manifestations of HS are typical for Q-fever prevalent in the Astrakhan Region. Hemostatic disorders because of altered functional activity of platelets were registered in all the cases and evidence for pathogenetic unbalance of homeostasis in Q-fever patients.

[Hemostatic disorders and their implication in the pathogenesis of Astrakhan rickettsial fever].

AIM: to define a role of hemostatic disorders in the pathogenesis of Astrakhan rickettsial fever (ARL). SUBJECTS AND METHODS: Platelet functional activity and plasma hemostatic parameters were studied in 89 patients of moderate ARL. RESULTS: The clinical manifestations of hemostatic disorders at the height of ARL were characterized by the appearance of typhoid maculopapular rashes in 91.4% of the patients, solitary elements of which were transformed to petechiae in 20% of cases. At convalescence (on day 10.2 +/- 1.3 of the disease), all eruptions regressed via pigmentation. At the peak of the fever, there were nasal hemorrhages and bleedings from the sites of injections; lowered platelet aggregation was detectable in the presence of thrombocytopenia at the height. Coagulation hemostasis changes were characterized only by elevated fibrinogen levels. Increased platelet functional activity and decreased fibrinogen concentrations were observed at convalescence. CONCLUSION: The basis of the clinical manifestations of ARL is hemostatic disorders due to thrombocytopenia and diminished platelet functional activity. In early convalescence, there was improved platelet aggregatability; however, the increasing trend for the rate of aggregation and the radius of aggregates suggests a risk of thrombogenesis in convalescents, which requires their follow-up with obligatory hemostatic monitoring.

[Ultrastructure of parenchymal leaf cells of different soybean varieties systemically infected with soybean mosaic virus].

A comparative study was made of the ultrastructure of parenchyma leaf cells of different soybean varieties systemically infected with soybean mosaic virus (SMV). It has been shown that virus accumulation and formation of virus-specific cylindrical inclusions (CIs) occur in the infected cells, in addition to intracellular changes showing stimulation of lytic processes, such as activation of smooth endoplasmic reticulum and Golgi apparatus, formation of cytoplasmic vacuoles, cytosegresomes, myelin-like bodies, different disturbances in the structure of cell organelles. Many infected cells demonstrated microbodies with invagination in which cylindrical inclusions were often found showing signs of destruction. It is suggested that such microbodies possess autophagic activity towards CIs. A possible relation of the observed virus-induced ultrastructural cell changes with the degree of SMV affection of investigated varieties is discussed

[Distribution of soybean mosaic virus antigen in the leaves of soybean plants with different reaction to virus infection]. / Raspredelenie antigena virusa mozaiki soi v list'iakh rastenii soi s raznoi reaktsiei na virusnoe porazhenie.

The distribution and accumulation of soybean mosaic virus antigen in the leaves of sensitive plants with well expressed mosaic symptoms and symptomless tolerant soybean plants Glycine max (L.) Merr. were similar. Low concentration of virus antigen was found in extremely resistant soybean plants in mechanically inoculated leaves and those of the 2-4 circles two-three weeks after inoculation but 5 weeks later the virus antigen was detected only in the top leaves.

[Comparative efficacy of various methods of laser therapy in patients with acute viral hepatitis B]. / Sravnitel'naia otsenka éffektivnosti razlichnykh sposobov primeneniia lazeroterapii u bol'nykh virusnym gepatitom B.

AIM: To study response to laser therapy in different modes and effects on hemocoagulation in patients with acute viral hepatitis B (AVHB). MATERIAL AND METHODS: Of 173 patients with AVHB, 87 received only basic therapy, 28 patients received placebo (no laser radiation, only signal of the timer) and 58 patients were exposed to laser radiation (32 of them intravenously and 26 supravenously). A course consisted of 10-12 sessions, laser radiation per 1 procedure 300 and 30 mJ, respectively. In addition to routine examinations, hemocoagulation was studied (platelet aggregation and desaggregation, electrocogulogram). RESULTS: Intoxication, hemorrhagic phenomena, jaundice, infusion therapy, hospital stay were shorter in AVHB patients exposed to laser therapy. Mode of action (intra- or supravenous) was insignificant. CONCLUSION: Laser therapy normalizes hemostasis and platelet function. Clinical effectiveness of laser was the same in both modes.

[Trimetazidine effects on exercise tolerance and left ventricular diastolic function in patients with coronary heart disease]. / Vliianie terapii trimetazidinom na tolerantnost' k fizicheskoi nagruzke i diastolicheskuiu funktsiia levogo zheludochka serdtsa u bol'nykh ishemicheskoi bolezn'iu serdtsa.

AIM: Trial of trimetasidine effects on exercise tolerance (ET) and left ventricular diastolic function (LVDF) in patients with coronary heart disease (CHD). MATERIALS AND METHODS: The study group included 40 CHD patients. Of them 10, 18 and 12 had myocardial infarction, unstable angina pectoris and stable angina, respectively. 38 CHD patients of the control group had these disorders, respectively, in 5, 15 and 18 cases. 2-3-month therapy with nitrates, beta-blockers (BB) and inhibitors of angiotensin-converting enzyme (ACE) was given to both groups with adjuvant trimetasidine (60 mg/d) given to patients of the study group. The effects were judged by the results of cycle exercise tests and echo-CG including the loading one. RESULTS: Adjuvant use of trimetasidine improved exercise tolerance, mean threshold capacity, LVDF. When added to BB treatment, trimetasidine reduced damage to LVDF under dipiridamol test. CONCLUSION: Trimetasidine addition to combined treatment of CHD raises exercise tolerance and improves LVDF.

[Autoantibodies to the thrombocytes and erythrocytes in HIV-infected patients]. / Autoantitela k trombotsitam i éritrotsitam u bol'nykh VICh-infektsiei.

In 48 patients with HIV infection were tested for the presence of autologous and allogenic antibodies to red blood cells with the use of Coombs' direct and indirect tests. 18 HIV-infected patients had IgG antibodies to thrombocytes, circulating in the blood (detected by the method of EIA) and bound to thrombocytes (detected by the method of RIA). In 5 out of 48 patients Coombs' direct test yielded positive results with red blood cells. 6 out of 18 examined patients had an elevated content of thrombocyte-bound antibodies. The presence of cross reactions between gp120 of human immunodeficiency virus and gp3a thrombocytes led to the formation of antithrombocyte antibodies and, consequently, to a decrease in the number of thrombocytes.

[The hemostatic system in patients with viral hepatitis C]. / Sistema gemostaza u bol'nykh virusnym gepatitom C.

Plasmic, platelet and fibrinolytic components of hemostasis were studied in 115 patients with severe viral hepatitis C transmitted fecally and orally. Most informative for determination of the disease severity and prognosis of onset of acute hepatic encephalopathy within 1-2 days were plasmic factor II, V, VII, X. In genesis of hemorrhagic syndrome of importance is procoagulant deficiency as a result of detective synthesis and consumption due to DIC syndrome rather than platelet disorder. In addition to procoagulant disorders there were low levels of plasminogen and its inhibitors changing with the disease severity.

[The effect of immunoglobulin on hemostatic function in patients with HIV infection]. / Vliianie immunoglobulina na sostoianie gemostaza u bol'nykh VICh-infektsiei.

The influence of immunoglobulin for intravenous injection on the state of cell- and plasma-mediated elements of hemostasis in patients with HIV infection, treated with immunoglobulin (Ig) in connection with the presence of secondary diseases of bacterial nature and having thrombocytopenia, was analyzed. After two injections of 50.0 ml of Ig to patients with HIV infection and thrombocytopenia a rise in the count of blood platelets in 80% of cases; this rise reached its maximum on day 7-10 after the beginning of treatment and was retained 1-3 months later in most patients on the level of healthy persons. Under the influence of Ig the aggregation capacity of thrombocytes increased mainly in persons with the initially low function of blood platelets. The introduction of Ig did not perceptibly influence the capacity of thrombocytes for endo-exocytosis, the aggregation activity of red blood cells, as well as the plasma-mediated element of hemostasis.

[The thrombocytic link in hemostasis and the immunity system of patients with HIV infection]. / Sostoianie trombotsitarnogo zvena gemostaza i sistemy immuniteta u bol'nykh VICh-infektsiei.

To find out possible relationships between disturbances in the thrombocytic element of hemostasis and in the immune system (the count of lymphocytes CD4, the concentration of IgG, the content of circulating immune complexes), 18 adult patients with HIV infection were examined, and in 8 of them thrombocytopenia was diagnosed. 10 patients without thrombocytopenia formed the control group. The study revealed that with the development of thrombocytopenia in patients with HIV infection the aggregation capacity of their blood platelets decreased, which correlated (p < 0.01) with a decrease in the count of lymphocytes CD4; this was indicative of the progress of immunodeficiency.

[Hemostatic disorders in severe forms of diphtheria and their correction with dicinon]. / Narusheniia gemostaza pri tiazhelykh formakh difterii i ikh korrektsiia ditsinonom.

The presence of thrombohemorrhagic syndrome (THS) has been established in 28 patients with toxic severe diphtheria of oropharynx. In view of the leading role of platelet affection in progression of hemorrhagic disorders in diphtheria, dicinon treatment may be beneficial. THS implications in unfavourable outcome of the disease and prognostic significance of critical thrombocytopenia are considered.

[Clinico-hemostatic characteristics of serum disease in toxic forms of diphtheria]. / Kliniko-gemosatziologicheskie osobennosti techeniia syvorotochnoi bolezni pri toksicheskikh formakh difterii.

Coagulative changes at the height of serum disease were investigated in 28 patients with severe diphtheria. It was found that on day 10 after first injection of diphtheria antitoxin hemocoagulation underwent activation with prevailing thrombogenesis coinciding in time with acute period of serum disease. The severity of serum complications correlated with the degree of coagulation activity. A relationship exists between the amount of the given antitoxin, duration of hormone therapy and occurrence of serum complications. There were specific for serum disease biochemical alterations indicative of destruction of blood cells and vascular-endothelial structures on the disease day 12-14.

[The hemostatic system of patients with a severe course of viral hepatitis E]. / Sostoianie sistemy gemostaza u bol'nykh s tiazhelym techeniem virusnogo gepatita E.

Coagulation and fibrinolysis were evaluated in 119 patients with viral hepatitis E. Hemorrhagic syndrome was found to correlate with the disease severity and initiated by impaired synthesis of coagulation factors produced in the liver. Most informative hemocoagulation parameters were distinguished definitely characterizing hemostatic affection and appropriate to validate adequate therapy.

[Disorders in the plasma and cellular hemostatic components of patients with HIV infection]. / Narusheniia v plazmennom i kletochnom zvene gemostaza bol'nykh s VICh-infektsiei.

Plasmic and platelet components of hemostasis were investigated in 100 HIV-infected subjects. Its degree depended on the infection stage and associated opportunistic infections. The key factor in pathogenesis of hemocoagulatory disorders is reduced count, abnormal function and morphology of platelets. A direct relationship exists between the number of CD4-lymphocytes, a decline in the number and functional activity of platelets. Intravenous injection of immunoglobulin made in Russia as an adjuvant to combined therapy of HIV-infected subjects contributes to recovery of platelet count and aggregation.

[The dynamics of the liver and myocardial enzymes in different forms of diphtheria in adults]. / Dinamika pechenochnykh i miokardial'nykh fermentov pri razlichnykh formakh difterii u vzroslykh.

The authors studied changes in the levels of hepatic and myocardial enzymes in 89 patients with oropharyngeal diphtheria. The forms of the disease were different: carriage of the bacteria, local oropharyngeal diphtheria, toxic and subtoxic disease. Biochemical tests were also performed in 21 patients with lacunar angina. A correlation has been revealed between the intensity of fermentemia, its standing and the severity of the local lesions. Possible usage of biochemical markers is discussed for characterizing toxic diphtheria severity and prognosis of the disease.

[Hemostatic disorders in patients with HIV infection]. / Narusheniia v sisteme gemostaza u bol'nykh s VICh-infektsiei.

Impaired hemostasis was studied in 50 adult patients with HIV infection. The blood coagulative potential, the number and functional activity of platelets were examined. Platelet aggregation and secretion were shown to change earlier than thrombocytopenia developed and clinical signs of HIV infection appeared. The disturbance in the plasma section of hemostasis are due to concurrent opportunistic diseases and infections.

[The role of thrombocytes in blood coagulation disorders in infectious pathology]. / Rol' trombotsitov v koaguliatsionnykh narusheniiakh pri infektsionnoi patologii.

Platelets play the leading role in circulatory disorders seen in patients with infectious diseases. Endotoxinemia leads to platelet activation which shows up by the transformation of platelet forms from disk-shaped to spheroidal and by changes in aggregation and secretion. The degree of those changes correlates with the disease gravity. Experimental endotoxinemia (in vivo and in vitro experiments) demonstrated the same changes in the morphofunctional properties of platelets together with a possibility of correcting circulatory disorders by blockers of prostaglandin biosynthesis, such as indomethacin++, trental and emoxipine.