[The efficacy of anti-viral therapy and serotherapy of tick-borne encephalitis in children]. / Effektivnost' protivovirusnoi terapii i seroterapii kleshchevogo entsefalita u detei.

OBJECTIVE: To evaluate the efficacy of different methods of antivirus therapy of tick-borne encephalitis (TBE) in children in the acute period and during chronic infections. MATERIAL AND METHODS: During 1 year, 130 children, aged 7-17 years, with TBEV received therapy in the acute period (an average in 3.5±1.3 days) in groups 1 (n=84) and 2 (n=20), and in the chronic infection in groups 3 (n=15) and 4 (n=11). Ribavirin orally, recombinant interferon-α2 (IFN-α2) i/m or in suppositories and anaferon orally were prescribed to children of groups 1 and 3. Children of groups 2 and 4 received tick-borne immunoglobulin (IgG)i/m and ribonuclease i/m. At admission, all patients received infusions of cytoflavin in the drip at the rate of 0.6 ml/kg per day. Etiological diagnosis included ELISA (IgM, G, viral antigen), and virus RNA by PCR in the blood and CSF. MRI of the brain and cervical spinal cord using standard programs was performed. All studies were performed prior to and in the course of treatment. RESULTS AND CONCLUSION: In patients of group 1, the period of increase in symptoms was reduced by ~ 4 days, and the duration of impairment of consciousness and pleocytosis in CSF ~ by 5 days, which was accompanied by a faster clearance of the virus in CSF, compared with group 2. In group 1, recovery without neurological deficit was observed in 83.3% (n=70), all patients had no progression of infection. In group 2, 30% of children (n=6) acquired TBEV chronic infection, and in 55% (n=11) there was a neurological deficit without progression. In patients of group 3 with chronic TBEV, the improvement was observed in 86.7% of cases, and complete regression of symptoms occurred in 1 patient, and replication of the virus was arrested in all of them. In group 4, symptoms increased in 72.7%, while virus replication was preserved and atrophic changes in the CNS increased on MRI. Antiviral therapy (ribavirin, IFN-α2 and release of active antibodies to gamma interferon -anaferon children) has the highest efficacy when prescribed for the first 5 days, while IgG and ribonuclease have insufficient efficacy in TBEV.

[Panencephalitis in children in modern conditions: clinical, etiological and mri-aspects]. / Panéntsefality u detei v sovremennykh usloviiakh: kliniko-étiologicheskie i MRT-aspekty.

AIM: To characterize the clinical picture, infectious etiology and MRI results of panencephalitis (PANE) in children, depending on the duration of the disease. MATERIAL AND METHODS: Children (n=32) with PANE at the age from 3 months up to 17 years were examined for a group of actual viral and bacterial infections. The inclusion criterion was a diffuse lesion of white matter hemispheres on MRI. MRI of the brain and spinal cord, CSF study (pleocytosis, oligoclonal IgG, the main myelin protein (MBP) were performed. The follow-up was 5-10 years. The complex therapy included etiotropic (antiviral) and pathogenetic agents, with priority given to cytoflavin as a drug with a multimodal effect. RESULTS: In 84.4% of cases, PANE in children are recorded under the age of 3 years and in 71.9% of cases, are associated with congenital infections with the prevalence of herpes viruses, especially cytomegalovirus (37,8%) and herpes type 6 (21.9%). In 78.3% of cases, PANE have chronic gradual development more often with a delay in the formation of motor and speech/prespeech skills, and manifested with pyramidal, cerebellar and other symptoms in the future. PANE is accompanied by a lesion of the white matter of the hemispheres in 1/2 cases with periventricular localization, less often in infratentorial structures (46.9%) and spinal cord (21.9%). With the duration of symptoms up to 3 months (n=22) PANE are characterized by inflammatory-demyelinating changes, signs of mass effect, contrast+, pleocytosis in CSF and the increase in MBP (average 4.2±0.8 ng/ml), and, with the duration of more than 3 months, by degenerative-sclerosing changes (n=10) and CSF oligoclonal IgG in 90% of cases. CONCLUSION: In almost 2/3 of cases, PANE are associated with congenital infections, accompanied by extensive symmetrical foci of demyelination in the CNS, and their clinical and laboratory parameters and outcomes depend on the start of treatment, with the positive dynamics in 75% of cases.

[Enterovirus infection as a risk factor of acute coronary syndrome and its complications].

Antigens of enteroviruses were detected quantitatively in the modified complement-binding reaction in blood samples from 102 of the 208 (49%) patients with ACS, in coronary artery tissues from 23 of 24 and heart from 51 of 94 (54.3%) patients with MI who died from cardiogenic shock and/or cardiac rupture. The relative level of enterovirus antigen (RLEVA) in the blood of patients with MI complicated and uncomplicated by cardiogenic shock and/or cardiac rupture was 0.42 +/- 0.04 and 0.29 +/- 0.02 arbitrary units respectively (p = 0.032) compared with 0.21 +/- 0.07 in patients with unstable angina (UA) (p = 0.0001). RLEVA in patients with UA was significantly lower than in those with uncomplicated MI (p < 0.011). RLEVA in necrotized myocardial areas after death from cardiogenic shock (0.54 +/- 0.18) and/or cardiac rupture (0.46 +/- 0.15) was higher than outside MI zones (0.30 +/- 0.14 and 0.26 +/- 0.10 respectively) (p < 0.01). RLEVA in coronary vessels feeding the necrotic zones of patients with MI complicated by cardiogenic shock (0.44 +/- 0.18) was higher (p = 0.03) than in the vessel feeding tissues outside the MI zone (0.29 +/- 0.19). It is concluded that enterovirus infection is a factor of ACS; it is directly involved in its pathogenesis and promotes the development of cardiogenic shock and/or cardiac rupture.

[Clinical laboratory characteristics of serous meningitides in Saint Petersburg].

Four hundred and sixty-seven cases of serous meningitides that had occurred in 2007 and 2009, verified by the standard virological techniques: polymerase chain reaction, enzyme immunoassay, and complement-binding reaction, were analyzed. The authors ascertained the following features: the shift of the morbidity peak to autumn and winter months, the preponderance of ECHO enterovirus serotypes 6, 11, and 30 among the pathogens, the onset of meningitis masking various diseases, multiple organ dysfunction with a predominance of central nervous system changes and with the involvement of the cardiovascular system.

[The use of a modified complement fixation reaction for the rapid diagnosis of viral infections in children]. / Ispol'zovanie modifitsrovannoi reaktsii sviazyvaniia komplementa dlia ékspresssnoi diagnostiki virusnykh infektsii u detei.

A system of diagnostic tests (complement enzyme assay) is developed, detecting viral and other antigens, toxins, antibodies, and specific immune complexes in liquid enzyme immunoassay based on the complement fixation test. The system is simple and economic, the results can be transferred into digital data, and the above factors can be detected individually in biological materials from patients. The system is effective, and in many cases (for example, in the diagnosis of enteroviral diseases) is the only method for rapid isolation and typing of the infection agents.

[Variants of immune response in children with acute respiratory viral infections]. / Varianty immunnogo otveta pri ostrykh respiratorno-virusnykh infektsiiakh u detei.

Four patterns of changes in the proliferative activity of T-lymphocytes in the lymphocyte blastogenesis test with phytohemagglutinin (PHA) are distinguished in children with acute respiratory viral infections (ARVI). The differences between these patterns are due to aggravated clinical severity of the infection process and enhancement of the cytokine reaction of macrophage monocytes. Comparison of immunological characteristics of response to ARVI in 4 groups of children showed that high reactivity of T-lymphocytes during the acute phase of disease (first and third variants) correlated with a relatively weak production of immunoglobulins and antiviral antibodies, while the suppression of T-lymphocyte response to PHA (second and fourth variants) is associated with expressed humoral profile of immune response by the level of immunoglobulin and antiviral antibody production. These data permit a hypothesis about the predominant generation of T x 1-like clones in children with the first and third variants of immune response and of T x 2-like clones in children with the second and fourth variants.

[Biological activity of the poly(G).poly(C) complex, modified by divalent platinum compounds]. / Biologicheskaia aktivnost' kompleksa poli(G).poli(C), modifitsirovannogo soedinenimi dvukhvalentnoi platiny.

Modification of poly(G).poly(C) with cys-diaminodichloroplatinum (cys-DDP) at the level of rb = 0.02 increased the in vivo antiviral and interferon-inducing activity of the complex, in contrast to the data reported for complex poly(G).poly(C). Antiinfluenza activity in this case depends on the method of modification and increases more intensively when a ready complex is treated with cys-DDP, as against treatment of poly(G) alone before the formation of a complex with poly(C). If rb is increased, the activity reduces again. Modification with trans-DDP at rb = 0.02 also leads to an increase of antiinfluenza activity of poly(G).poly(C), but mainly after pretreatment of poly(G).

[Pathogenetic and pathomorphological problems of viral-bacterial associations in children dying of meningococcal infection]. / Nekotorye voprosy patogeneza i patomorfologii virusno-bakterial'nykh assotsiatsii u detei, umershikh ot meningokokkovoi infektsii.

The information on 63 children dying from hypertoxic forms of meningococcal infection is presented. Four groups of brain damage by respiratory viruses (RV) are distinguished on the basis of the results of morphological and virological examination: 1) with a recent RV generalization (26 cases); 2) with dissemination of an etiological agent but without clear-cut structural changes (6 cases); 3) with an isolated affection of the brain (13 cases); 4) without clear-cut brain damage. Experimental influenza-meningococcal infection was reproduced in 260 white rats. Enhancement of the animal death rate, multiplication of virus and the degree of brain damage in cases of combined action of both etiological agents is demonstrated. The ability of influenza virus, when inoculated intranasally together with meningococcus, to penetrate and to multiply in the brain provoking meningitis and choroiditis is shown virologically, histologically and electron microscopically.

[Effect of a number of preparations on the function of the immune system in experimental influenza in mice]. / Vliianie riada preparatov na sostoianie immunoi sistemy pri éksperimental'nom grippe u myshei.

(CBA X C57B1) X F1 mice were sensitized intraperitoneally with sheep erythrocytes and infected with influenza A viruses: nonpathogenic Leningrad-77 (H1N1) or pathogenic PR8 (HON1), before or five days after administration into the oesophagus of sodium succinate, levamisole, complexes I (panangin, sodium succinate, sodium glutamate) and 2 (lipoic acid, phosphothyamine, riboflavin, sodium pantothenate). The number of rosette-forming cells (RFC) in the spleen at 7 and 14 days postinfection, antibody titres, interferon level in the blood, the amount of virus in the lungs, spleen and lung morphology were studied. All the preparations used were found to increase the number of RFC in the spleen. Most effective were levamisole before infection, sodium succinate after infection, combination thereof, complex I after infection.

[Isolation of influenza A viruses in 1981 in Leningrad with and antigenic formula (H0N1) related to strain A/PR8/34]. / Vydelenie v 1981. v Leningrade virusov grippa A s antigennoi formuloi (H0N1), rodstvennykh shtammu A/PR8/34.

wo strains of influenza A (H0N1) virus closely related to A/PR8/34 virus were isolated from the cerebrospinal fluid of children suffering from a disease diagnosed as purulent meningitis. Apart from similarities. Marked differences of the new strains from the laboratory A/PR8/34 virus were found which rules out the association of the isolates with contamination with the laboratory strains. Examinations of paired sera from the children, sources of the isolates, revealed no rise in titres of antihemagglutinating antibodies but established a 4-8-fold rise of titres of antineuraminidase antibodies to the A/PR8/34 virus which attests to infection of these children with influenza H0N1 viruses.