[The prevalence of chronic pathology of ENT organs and oral mucosa in the HIV-infected patients depending on their immune status].

The objective of the present study was to estimate the prevalence of chronic pathology of ENT organs and mucous membrane of the oral cavity in the HIV-infected patients depending on the number of cells containing CD4 markers in 1 mcl of blood plasma. It was shown that the prevalence of chronic pathology of ENT organs and oral mucosa in the HIV-infected patients depends on the number of cells carrying CD4 markers in 1 mcl of blood plasma. This pathology was found in 64.6% of the patients at immunological stage I of infection with human immunodeficiency virus (over 500 CD4 per 1 mcl plasma), in 73.4% of the patients at stage II of HIV infection (200-499 CD4/1 mcl), and in 90.7% of the patients at stage III of HIV infection (less than 200 CD4/1 mcl). The frequency of individual nosological forms of ENT disease at different stages of infection with human immunodeficiency virus is discussed. Certain diseases pathognomonic for HIV-infected adult subjects were identified including adenoid vegetations, cheilitis, oral hairy leukoplakia, and oropharyngeal candidiasis. Combined chronic pathology of ENT organs as well as certain clinical features of the above diseases may suggest diagnosis of immunodeficiency and require the assessment for the HIV status.

Agreement in patient-physician communication in primary care: a study from Central and Eastern Europe.

OBJECTIVE: Efficient patient-physician collaboration is proven to have a direct benefit on health care outcomes through improved compliance, appointment keeping and use of preventive services. The aim of this study was to evaluate the patient-physician agreement on communication during primary care consultations and consider possible discrepancies. METHODS: A cross-sectional survey using self-administered questionnaires was performed in primary care in four European countries (Lithuania, Slovenia, Serbia and Russia). Post-consultation evaluations of doctor-patient communication were made by patients and physicians and were compared with pre-consultation expectations of the patient. Discrepancies in these evaluations were determined for the entire database, and within groups of expectations, using factor analysis. RESULTS: One thousand three hundred and thirty-two sets of questionnaires were collected by the study team. In this sample, in more than 90% of consultations physicians and patients agreed about meeting patient expectations. Discrepancies were more likely to be identified when the patients were consulting the physician for the first time or had not seen that physician for more than 12 months (up to 26.1%). There is a significantly lower correlation between the physician recognising patient's unmet expectations for all factors if the physician had been working in Primary Care for between 6 and 10 years (8.6%). The results demonstrate that physicians working more than 16 years in practice are less likely to recognise that they have failed to meet the expectations of patients who are seeking reassurance (9%). CONCLUSION: Personal continuity of care is associated with a lower discrepancy between the opinions of patients and physicians regarding meeting patient expectations during consultations in primary care. The highest agreement is within first 6 years in practice, which may reflect long-term effects of training. PRACTICE IMPLICATIONS: Primary care physicians should put more emphasis on identifying and addressing patient expectations in primary care consultation, including agreement with patient. Existing discrepancies may be considered to be indicators of potential opportunities to improve physician's performance and overall quality of care.

[Blood biochemical parameters of tilted primates periodically subjected to gravitational stimuli].

Head-down tilting of primates (HOT) is a universal method of studying the hypokinetic syndrome effects on functionality of various body systems. Clinical biochemical blood assay was performed in a 25-day HDT experiment (-5 degrees) with 11 Macaca rhesus. One group of animals was kept tilted all the time through, whereas the other was periodically returned into the orthostatic position for 30 to 120 minutes 4-5 times a week. Dry chemistry was employed in biochemical analysis of blood serum and enzyme immunodetection (EID) in measuring blood hormones. As a rule, the biochemical parameters of primates' serum were within the physiological norm range. Shifts in protein, carbohydrate and mineral metabolism were sought for and enzymic activity in blood serum and hormone concentrations were determined. HDT did not produce noteworthy changes in blood concentrations of somatotropic hormone, thyrotrophic hormone (TTH), triiodothyronine (T3), thyroxine (T4) or cortisol. Animals of both groups showed statistically reliable decrease in blood osteocalcine. The preventive complex did not contribute materially to the control of metabolic homeostasis and endocrine function of the primates adapting to the 25-day HDT.

Levels of some antiviral antibodies in patients with different serum content of total cholesterol.

We measured the content of specific antibodies to some viral antigens (herpes, cytomegalovirus, measles, rubella, mumps) in patients with different levels of total serum cholesterol. The levels of IgG to the most prevalent viral infections (measles, herpes, rubella) were higher in patients with 6-7 mmol/liter total serum cholesterol (mild and moderate hypercholesterolemia). These data confirm the relationship between the status of the lipid transporting system and antiviral immunity and the existence of a cholesterol optimum (mild and moderate hypercholesterolemia) for maximally effective functioning of the immunity system.

[Blood plasma volume dynamics in monkeys during immersion]. / Dinamika ob"ema plazmy u obez'ian v usloviiakh immersii.

Dynamics of blood plasma volume (PV) was studied with indirect methods (hematocrit count, hemoglobin, total protein and high-molecular protein) during 9-d immersion of monkeys Macaca mulatta. The animals were donned in waterproof suits, motor restrained in space seat liners and immersed down to the xiphisternum. Two monkeys were immersed in the bath at one time. The suits were changed every day under ketamine (10 mg/kg of body mass). There were two groups with 12 animals in each. The first group was kept in the bath 3 days and the second--9 days. Prior to the experiment, the animals had been trained to stay in the seat liner put down into the dry bath. It was shown that already two days of exposure to the hydrostatic forces (approximately 15 mm Hg) and absence of negative pressure breathing reduced PV by 18-20% on the average in all animals. Subsequent PV dynamics was individual by character; however, PV deficit persisted during 4 days of immersion in the whole group. In this period, albumin filtration was increased significantly, whereas high-molecular protein filtration was increased to a less degree. During the remaining days in immersion PV regained normal values. Ten days of readaptation (reclined positioning of monkeys brought back into cage) raised VP beyond baseline values. This phenomenon can be attributed to the necessity to provide appropriate venous return and sufficient blood supply of organs and tissues following extension of blood vessels capacity.

Physiological reactions of primates to 9-D immersion and head-down tilt.

Purpose of the investigation was to compare physiological reactions of primates (Macaca mulatta) to microgravity simulated by immersion and head-down tilt (HDT). In immersion experiments, primates in waterproof suits were put into motion-restraining chairs and immersed into water (t=35.4 degrees C) breast-deep for 9 days. In 9-d HDT experiments, prone primates were motor restrained in dedicated tilt beds at -5 degrees. It was found that the CNS functioning was significantly affected, the plasma volume reduced and the marrow erythropoietic function declined. Atrophy developed in leg muscles on a backdrop of iliopectineal spongy osteopenia. Loss in hydration, inhibition of erythropoietic hemopoiesis and iliopectineal spongy osteopenia were more pronounced following immersion than HDT.

Metabolic parameters of Bion 11 monkeys.

Biochemical parameters of protein, carbohydrate, and fluid-electrolyte metabolism were measured in the blood of Bion 11 rhesus monkeys. The 14-day flight induced changes in total protein, BUN, and calcium, which were also seen in humans during long-duration space missions. It was concluded that protein and calcium metabolism changed while carbohydrate metabolism remained unaltered.

Energy metabolism of Macaca mulatta during spaceflight.

The mean daily energy expenditure rates of two rhesus monkeys (Macaca mulatta) were determined during spaceflight on the joint U.S./Russian Bion 11 mission by the doubly labeled water (DLW, 2H218O) method. Control values were obtained from two studies performed under flight-like conditions (n = 4). The mean inflight energy expenditure for the two Bion 11 monkeys was 81.3 kcal/kg/day, which was higher than that seen previously. The average energy expenditure (77.6 +/- 4.4 kcal/kg/day) for the four ground control monkeys was slightly lower than had been measured previously.

Evaluation of bone and collagen metabolism by assessing urinary biomarkers in non-human primates.

The purpose of this investigation was to evaluate mineralized and non-mineralized connective tissue responses of non-human primates to microgravity by non-invasive analysis of urinary biomarkers.

[The enzymatic activity of IgG preparations in viral hepatitis]. / Fermentativnaia aktivnost' preparatov IgG pri virusnykh gepatitakh.

The activity of the enzymatic activity of the preparations of IgG1, IgG2 and IgG4, isolated from the blood of patients with acute virus hepatitis B and chronic viral hepatitis C resulting in cirrhosis, was studied. The blood samples were found to have DNAase activity significantly exceeding that of immunoglobulins isolated from the blood sera of healthy donors, as well as peroxidase, oxidase and esterase activities, whose level did not significantly differ from those of the donor blood sera. The interaction of IgG preparations with the cations of different metals was studied. The study revealed that the addition of CuSO4 solution at the final concentration of 4.7 x 10(-5) M to the blood samples led to a significant increase in activity in comparison with the initial one (on the average, 7.8 +/- 2.97 times) in all 14 samples. The activity thus observed was partially inhibited by the addition of the solution of staphylococcal protein A. As noted in the course of this study, high DNAase and peroxidase activities of Ig were most frequently observed in patients with cirrhosis of the liver. The difference in the levels of IgG activity between patients with cirrhosis of the liver and patients with virus hepatitis, but no signs of cirrhosis, is not significant.

[Viral hepatitis delta in the republic of Belarus]. / Virusnyi gepatit del'ta v Respublike Belarus'.

26,740 blood donors and persons of high risk groups with respect to HBV infection, residing in different regions of Belarus, were examined for the presence of HBsAg in 1983-1997. Of these, 1372 persons (5.1%) were found to have HBsAg, and out of 1081 HBsAg-positive persons anti-HDV antibodies (Ab) were detected in 96 persons (8.9%). In spite of a decrease in acute virus hepatitis B morbidity and in HBsAg carriership, the occurrence of anti-HBV Ab remained stable during the period of 16 years and was equal, on the average, about 4% among asymptomatic HBsAg carriers. Patients having tuberculosis, rheumatoid arthritis, diabetes mellitus, hematological diseases, chronic hepatitides and cirrhosis of the liver were an important reservoir of HBV and HDV infections for regions with the low level of the spread of HBV. A decrease in the detection rate of anti-HDV Ab in patients with cirrhosis of the liver from 47.6% to 15.4% was noted. In 1991-1997 a decrease in the detection rate of anti-HDV Ab in patients with chronic hepatic lesions in comparison with 1983-1990 was observed, and in the age group older than 50 years this decrease was from 33.3% to 8.3%. This difference was particularly pronounces in patients with cirrhosis of the liver: 53.9% and 7.7% respectively.

[The guanine content in specimens of house dust collected in the living quarters of healthy persons and of patients with atopic bronchial asthma]. / Soderzhanie guanina v obraztsakh domashnei pyli, sobrannoi v zhilishchakh zdorovykh i bol'nykh atopicheskoi bronkhial'noi astmoi.

The content of insoluble guanine fractions originating from micromites in specimens of house dust, collected in the dwellings of 15 healthy persons with no signs of allergy and 64 patients with atopic bronchial asthma (ABA), was studied. The content of these fractions in house dust in the dwellings of ABA patients was significantly higher than that in house dust in the dwellings of healthy persons (0.76 +/- 0.119 in comparison 0.31 +/- 0.040, p < 0.05). A high content of guanine was detected in house dust of the dwellings of 74.1% of ABA patients and 33.3% of healthy persons, which was indicative of the importance of mite contamination in the formation of ABA.

Energy expenditure in rhesus monkeys (Macaca mulatta) during spaceflight using doubly labeled water (2H2(18)O).

The mean daily energy expenditure rates of three rhesus monkeys (Macaca mulatta) were determined during spaceflight on the joint US-Russian Cosmos 2044 and 2229 missions by the doubly labeled water (2H2(18)O) method. In-flight values were compared with ground data obtained from seven measurements taken from six chair-adapted control monkeys. The mean energy expenditure for the ground control determinations was 94.5 +/- 6.4 kcal.kg-1.day-1 (n = 6). The mean in-flight energy expenditure, 55.1 +/- 8.0 kcal.kg-1.day-1 (n = 3), was significantly less than the mean ground control value (P < 0.05). These data suggest that energy expenditure in restrained rhesus monkeys is significantly reduced during spaceflight.

[The indices of water-salt metabolism and of the endocrine status in monkeys after flights on the Kosmos biological satellites]. / Pokazateli vodno-solevogo obmena i éndokrinnogo statusa u obez'ian posle poletov na biologicheskikh sputnikakh "Kosmos".

Findings of studying the indices of water-salt metabolism and endocrine status of monkeys after their exposure in the weightless environment onboard the biological satellites of Earth have revealed a change in the blood serum concentrations of electrolytes which is indicative of instability of the system responsible for maintenance of the fluid-mineral homeostasis during readaptation. Results of studying the endocrine status of monkeys infer alteration in calcium metabolism, i.e. decreased levels of parathyroid hormone, calcitonin and the transport form of vitamin D3.

[Hepatitis B and delta infections in patients with tuberculosis]. / Gepatit B i del'ta-infektsii u bol'nykh tuberkulezom.

Clinical variants of the course and outcomes of HBV and delta infections have been studied in pulmonary tuberculosis patients in the general structure of 1465 patients who were treated for hepatitis B. Enzyme immunoassay and radioimmunoassays were used to study the detection rate of contamination markers HBV activity and delta-virus replication in 437 pulmonary tuberculosis patients. Viruses were found to be predisposed to prolonged persistence and wide spread among tuberculosis patients.

[History and future of the scientific activities of the Division of Radiation Pathology of the Central Scientific Research Roentgenoradiology Institute of the USSR Ministry of Public Health]. / Istoriia i perspektivy nauchnoi deiatel'nosti otdeleniia radiatsionnoi patologii Tsentral'nogo nauchno-issledovatel'skogo rentgenoradiologicheskogo instituta Minzdrava SSSR.

One of the main lines of research pursued in the Department is concerned with the assessment of the contribution of small doses of ionizing radiation to the development of some features of a number of somatic and infectious diseases in persons exposed to ionizing radiation. For this purpose, combined clinicolaboratory investigation of this group of patients and some organizational and methodological measures are proposed for the optimization of their follow-up.