Rituximab and Abatacept Are Effective in Differential Treatment of Interstitial Lymphocytic Lung Disease in Children With Primary Immunodeficiencies.

Background: Interstitial lymphocytic lung disease (ILLD), a recently recognized complication of primary immunodeficiencies (PID), is caused by immune dysregulation, abnormal bronchus-associated lymphoid tissue (BALT) hyperplasia, with subsequent progressive loss of pulmonary function. Various modes of standard immunosuppressive therapy for ILLD have been shown as only partially effective. Objectives: To retrospectively evaluate the safety and efficacy of abatacept or rituximab in treatment of ILLD in children with PID. Methods: 29 children (median age 11 years) with various forms of PID received one of the two therapy regimens predominantly based on the lesions' immunohistopathology: children with prevalent B-cell lung infiltration received rituximab (n = 16), and those with predominantly T-cell infiltration received abatacept (n = 17). Clinical and radiological symptoms were assessed using a severity scale developed for the study. Results: The targeted therapy with abatacept (A) or rituximab (R) enabled long-term control of clinical (A 3.4 ± 1.3 vs. 0.6 ± 0.1; R 2.8 ± 1 vs. 0.7 ± 0.05, p < 0.01) and radiological (A 18.4 ± 3.1 vs. 6.0 ± 2.0; R 30 ± 7.1 vs. 10 ± 1.7, p < 0.01) symptoms of ILLD in both groups and significantly improved patients' quality of life, as measured by the total scale (TS) score of 57 ± 2.1 in treatment recipients vs. 31.2 ± 1.9 before therapy (p < 0.01). Conclusions: ILLD histopathology should be considered when selecting treatment. Abatacept and rituximab are effective and safe in differential treatment of ILLD in children.

PECULIARITIES OF EVALUATION OF THE ORAL FLUID ANTIOXIDANT ACTIVITY IN PATIENTS WITH LOCAL OR SYSTEMIC DISEASES.

The aim - in the given research, the difficulties in interpreting the study results of oxidative homeostasis of oral fluid are analyzed. Changes in the total antioxidant activity of blood and saliva can be multidirectional - an increase or decrease in the oral fluid indicator and a reduction in the parameter of blood plasma can be recorded. To resolve the emerging difficulties, there was proposed a parallel assessment of the dynamics of changes in the total antioxidant activity of blood plasma and oral fluid in the patients of 4 groups with nosological forms of fundamentally different in the distribution and localization of the pathological process, which include: phlegmons of the maxillofacial region, partial absence of teeth, type 2 diabetes mellitus and the pelvic inflammatory diseases. As a result of the conducted studies, it was shown that a simultaneous decrease in the total antioxidant activity of blood plasma and oral fluid was attributable to the chronic long-term somatic diseases of a systemic character with a significant metabolic disorder, such as type 2 diabetes mellitus. A decrease in the total antioxidant activity of blood plasma and the unchanged oral fluid index was characteristic of somatic diseases of limited prevalence without affection of the maxillofacial region's tissues. In our case, such an example was a chronic inflammatory disease of the uterus with a combined course of bilateral salpingoophoritis. An increase in the oral fluid's total antioxidant activity on the background of a normal or even slightly reduced level of the antioxidant potential of blood plasma was characteristic of dental diseases. The latter situation was most likely for the dental profile diseases, in which damage to the oral tissues can provoke the leaching of cellular contents, including endogenous antioxidants or other components of regenerative activity in the oral fluid. Herein, changes in the antioxidant activity of blood plasma may reflect the prevalence of a pathological process at the systemic level or its limitation only to the dentoalveolar system's tissues and elements. As an example of such a situation, the patients with phlegmon of the maxillofacial region or patients with partial absence of teeth can be cited.

[Epidemiology and risk factors of inflammatory bowel diseases].

The paper dedicated to comparative gap of epidemiology data in Ukraine, Europe and North America, review of evidence-based researches of value of particular risk factors of Crohn's disease and ulcerative colitis.

[Current state of epidemiologic surveillance of natural foci of plague of North Caucasus]. / Sovremennoe sostoianie épidemiologicheskogo nadzora v prirodnykh ochagakh chumy Severnogo Kavkaza.

Information on the epizootic situation in plague in the natural foci of North Caucasus and on the influence of a number of anthropogenic and natural factors on this situation is presented. The data given in this work indicate that under the conditions of the anthropogenic transformation of landscapes the character of the epizootic manifestations of plague is changed and new factors, capable of aggravating epidemiological situation, appear. In addition, some other factors must be considered, such as the insufficient financing of reliable field surveys at present, the impossibility of making reliable epizootological studies due to causes of the social character (armed conflicts), thus making it impossible to evaluate, with a sufficient degree of reliability, the real epizootic state of a number of territories and, therefore, the risk of human infection. In this connection the necessity to carefully plan prophylactic measures and measures aimed at the localization and liquidation of the probable foci of infection arises.

[Analysis of prevalence and etiopathogenetic factors in patients with gastric and duodenal ulcer]. / Analiz rasprostranennosti i patogeneticheskykh faktorov u bol'nykh iazvennoi bolezn'iu zheludka i dvenadtsatiperstnoi kishki.

The article focuses on the prevalence of most common factors for origination and relapse of ulcer disease. In large contingents of patients with gastric and duodenal ulcer frequency is shown of factors for the development and progress of ulcer disease.

[Outbreak of tularemia in the Republic of Dagestan]. / Vspyshka tuliaremii v Respublike Dagestan.

In Daghestan in the focus of the flood-plain swamp type 64 persons fell ill with tularemia in 1999. During the epizootological survey 8 Francisella tularensis strains were isolated from vectors and carriers and in 7 samples taken from open water reservoirs, as well as in 1 sample obtained from Ixodes ticks, tularemia antigen was detected. Humans were infected mainly by the transmissive route, as found in 71.8% of patients. 28% of patients were infected through contacts. The disease took mainly a mild course, registered in 95.6% of patients. The disease affected those persons who had not been immunized against tularemia.

[Helicobacter pylori prevalence among patients with gastroduodenal diseases in Kiev]. / Rasprostranennost' Helicobacter pylori sredi bol'nykh s zabolevaniiami gastroduodenal'noi zony v Kieve.

It is for the first time in Ukraine that a study has been made on the epidemiology of H. pylori infection among patients with disorders of the stomach and duodenum. The diagnosis of the infection was done with the aid of various invasive and noninvasive tests, 13C-urea breathing test, a unique for Ukraine and countries of the Western Europe method of examination included. Ascertained among the above category of patients was wide prevalence of H. pylori, which fact confirms its leading etiological role in disorders of the stomach and duodenum once again.

[State of pulmonary metabolism during radiotherapy of thoracic neoformations and possibilities of its correction]. / Sostoianie metabolizma legkikh pri luchevoi terapii novoobrazovanii v oblasti grudnoi kletki i vozmozhnosti korrektsii.

AIM: The study pulmonary metabolism by exhalation condensate of expired air (CEA) and ways of its correction in patients exposed to radiotherapy to the chest area. MATERIALS AND METHODS: 25 women aged 20 to 40 years with breast cancer stage I-II were divided into two groups: control group underwent conservative treatment without correction and the study group was given the extract of Ural licorice for 14 days. In CEA, lipid peroxidation enzymes and products of thiobarbituric acid were assayed. Biochemical examination of CEA was done by means of Cobas mira automatic analyzer. RESULTS: Administration of Ural licorice promoted inactivation of lipid peroxidation and maintenance of most of the biochemical parameters on the baseline level. This effect may be due to composition of the Ural licorice which contains antioxidants and stimulators of lung surfactant synthesis. CONCLUSION: Administration of Ural licorice extract seems promising for prevention of radiation complications in the lungs during radiotherapy to the chest area.

[Morphology of recent meningococcal infections in children]. / Morfologiia sovremennoi meningokokkovoi infektsii u detei.

An analysis of 108 cases of children's death which occurred in 1981-1991 from hypertoxic meningococcal infection (MI) in St. Petersburg is presented. Serogroup B meningococcus as a causative agent was found in 44% of the cases. The role in the thanatogenesis of inflammatory and immune reactions, viral-bacterial associations was shown on the basis of detailed study of 47 cases. Hemorrhagic adrenal necrosis was diagnosed in 94.7% of the cases. Two clinicomorphological variants of the disease are distinguished: 1) variant with a moderate hemorrhagic eruption without pronounced kidney lesion, 2) variant with an abundant confluent rash and pronounced kidney lesions and choroid plexus immune lesions.

[Morphologic aspects of hemostasis disturbances in meningococcemia in children]. / Morfologicheskie aspekty narushenii gemostaza pri meningokoktsemii u detei.

21 children who died from meningococcemia were studied. Shock disturbances of the microcirculation and thrombocytic part of hemostasis prevailed within first hours of the disease in the form of adrenal hemorrhages and brain edema as immediate cause of death. With an increase of the disease duration, aggregational thrombocytopenia, generalized microthrombosis, coagulopathy, fibrinolysis activation resulted in massive hemorrhages in a number of organs and tissues and manifested in the syndrome of polyorganic failure. No significant differences were found depending upon treatment.