[Clinical and epidemiological aspects of infectious diseases (findings from Saint Petersburg)]. / Kliniko-épidemiologicheskie aspekty infektsionnoi patologii (po materialam Sankt-Peterburga).

The paper analyzes official statistics on infectious diseases, data on the course and outcomes of infections which have been most common in the region in the past 20 years. It shows that the epidemiological situation has deteriorated, the incidence of severe and complicated forms and mortality due to infectious diseases have increased. Great emphasis is laid on the epidemics of dysenteria and diphtheria in the past years. The etiological, clinical and epidemiological features of acute viral hepatitis are discussed. The HIV infection situation is assessed. The paper shows it necessary to improve outpatient diagnosis of infections, to rigorously implement a programme for vaccine prevention, to develop adequate etiotropic and pathogenetic therapeutic techniques for infectious diseases.

[The biochemical aspects of the pathogenesis of viral hepatitides]. / Biokhimicheskie aspekty patogeneza virusnykh gepatitov.

502 patients with acute viral hepatitis B were examined for blood levels of hydrocortisone and insulin, blood proteolytic systems, proteinase inhibitors, acute phase proteins. Most of the biochemical reactions promoted compensation and adaptation processes inhibiting the disease progression. In severe and progressive hepatitides biochemical mechanisms of adaptation are impaired. This entails pathogenetic implications.

[The significance of lipid peroxidation in the pathogenesis of leptospirosis and its complications]. / Znachenie perekisnogo okisleniia lipidov v patogeneze leptospiroza i ego oslozhnenii.

Lipid peroxidation (LPO) and antioxidant plasma activity were evaluated in 39 patients with leptospiral jaundice. At the height of the disease LPO proceeded more actively, being the highest in cases of severe complications. Early in the disease course general antioxidant activity of plasma was inhibited significantly more noticeably in complicated versus uncomplicated leptospirosis. This confirms pathogenetic implication of membrane LPO in leptospirosis. The approaches to prognostication of the disease course and completeness of the response are proposed.

[CLinico-morphologic correlations in Flexner's and Sonne dysentery]. / Kliniko-morfologicheskie sopostavleniia pri dizenterii fleksnera i zonne.

The clinical and morphological data were studied and compared in 84 patients with Flexner's dysentery and 40 with Sonne dysentery. It is established that more pronounced and lingering colitic syndrome typical of Flexner's dysentery is related to more lasting persistence of causative agents in the superficial epithelium and in the m. mucosae of the rectum. Unlike Sonne dysentery, insufficiency of the local defence mechanisms was discovered in patients with Flexner's dysentery, namely inhibition of mucus secretion, low level of elimination of microorganisms with desquamated colonocytes at the disease onset, pathological changes of interepithelial lymphocytes, ineffective phagocytosis of bacteria by macrophages of the m. mucosae during convalescence.

[The importance of the antioxidant protection systems of the blood in adaptation to the infectious process in viral hepatitis B]. / Znachenie sistem antioksidantnoi zashchity krovi v adaptatsii k infektsionnomu protsessu pri virusnom gepatite B.

The components of the blood antioxidant systems (superoxide dismutase, catalase, ceruloplasmin, glutathione system) take a direct part in the molecular mechanisms of the body adaptation under conditions of viral hepatitis infection. The peculiarity of the mechanisms by which lipid peroxidation is regulated in different grades of hepatitis is of a role in the disease pathogenesis and underlies the prediction of the course of hepatitis.

[Clinico-morphological comparisons in different types of dysentery]. / Kliniko-morfologicheskie sopostavleniia pri razlichnom techenii dizenterii.

Clinical evidence and morphological picture of rectal biopsy specimens were analysed for 125 dysentery patients. As compared to a light course, moderately severe and severe dysentery presented enhanced microbial adherence and an elevated level of large lymphocytes in the external epithelium of the rectum, deeper penetration of Shigella into crypts. On day 9-15 of the disease in attenuation of the clinical symptoms in severe and moderately dysentery morphological shifts persisted whereas the light run was associated with a marked decline of microbial invasion and cellular infiltration of the epithelium. In the protracted condition elimination of the microbes with desquamative colonocytes appeared inhibited permitting prognosis of the protraction as early as day 2-4 of the disease.

[Clinico-morphological criteria of diagnosis of dysentery and Salmonella infections]. / Kliniko-morfologicheskie kriterii diagnostiki dizenterii i salmonelleza.

Clinical symptoms and laboratory findings have been evaluated for 108 patients with intestinal infection associated with apparent colitic syndrome. Differential diagnosis between dysentery and salmonellosis was not an easy task even though clinical signs of the diseases appeared different. Dysentery ran with tenesmus, sigmoid pain and spasms. Symptoms of gastritis, intoxication, dehydration, hepatomegaly predominated in salmonellosis. In obscure cases colonic biopsy can be helpful due to high sensitivity of immunofluorescence in histological sections. Morphological diagnostic criteria comprise intensive microbial invasion, pronounced immunomorphological reaction in superficial epithelium of the colon for dysentery and macrophagal affection of the colonic mucosa plate for salmonellosis.

[Protracted forms of viral hepatitis A in adolescents]. / Zatiazhnye formy virusnogo gepatita A u podrostkov.

The results of study of the clinical picture and outcomes of type A viral hepatitis (HA) in 80 male adolescents aged 15-18 years are presented. The diagnosis was confirmed serologically. A greater incidence of the protracted forms of HA has been found in adolescents which in most cases had a favourable outcome. Protracted hepatitis was marked by long-term persistence of anti-HVA IgM. The chronic form of viral hepatitis had a course of a mixed A and B viral infection.

[Quantitative histoenzymological studies in the diagnosis of chronic viral hepatitis]. / Kolichestvennye gistoénzimologicheskie issledovaniia v diagnostike khronicheskogo virusnogo gepatita.

The examination has involved 89 patients with chronic viral hepatitis, aged 14 to 59, 68 male and 21 female ones. Thirty-two (36.0%) patients suffered from chronic viral hepatitis B. Life-time biopsy of the liver was performed in all the cases. Chronic persistent hepatitis (CPH) has been diagnosed in 39 patients, chronic active one (CAH) in 50. Histochemical examinations of the biopsy specimens included measurements of alkaline phosphatase (AP) by the azocompound method, of 5-nucleotidase (5-Nuc) by the Ca-Co method, and of hepatocyte pigments. Stereologic methods were used in morphometric analysis of the area of sinusoids active for AP and 5-Nuc enzymes and of the intracellular pigment level with consideration for their distribution in the hepatic lobe. The findings evidence a significant increase of the area of sinusoids active for AP and 5-Nuc in CAH patients, in contrast to those with CPH, but the latter group has developed much higher levels of hepatocyte pigments. These data may be useful to specify the activity of chronic viral hepatitis in cases with poorly representative biopsy specimens.