[HIV/AIDS masks in a therapist's practice].

AIM: To investigate clinical manifestations and diagnostic difficulties in patients with HIV/AIDS in the practice of therapeutic units of a multidisciplinary hospital. SUBJECTS AND METHODS: The investigation included 65 HIV/AIDS patients admitted to the therapy units of a Saratov Regional clinical hospital in 2007 to 2011. The clinical features of HIV/AIDS, immunological status, and viral load were studied. RESULTS: The structure of the clinical manifestation of HIV/AIDS showed a preponderance of lung injury in 45 (69%) patients. There were hematological disorders in 38 (58%) patients and nephropathy in 33 (51 %); 11 (17%) patients were diagnosed with infective endocarditis. Rheumatic symptoms and syndromes mimicking HIV/AIDS were found in 10 (15.4%) patients. The degree of immune disorders was most severe in patients with pulmonary dissemination and rheumatic masks and mutually related to the rate of cutaneous manifestations. The specific features of lung injury, infective endocarditis, pulmonary hypertension, rheumatic symptoms, and kidney injury were discussed in HIV/AIDS patients having different causes for admission to specialized therapy units. CONCLUSION: In connection with the clinical polymorphism of HIV/AIDS, physicians of all specialties should be alert for the possible clinical manifestations of this disease to timely examine patients.

[Diagnostic difficulties in patients with disseminated processes in lungs].

Pulmonary disseminations are frequently encountered in the practical work of a multi-disciplinary hospital and require differential diagnostics by join efforts of specialists in different fields of medicine. The aim of this study was to estimate the frequency and clinical picture of these conditions. We analysed clinical records of 154 patients admitted to the department of pulmonology and intensive therapy. Most patients in need of intensive therapy (n=54) presented with disseminations of infectious origin, such as disseminated tuberculosis (32%), pulmonary problems associated with sepsis and infectious endocarditis (14%), HIV-associated disseminations (23%). Canceromatosis and idiopathic interstitial pneumonia occurred in 18 and 13% of the cases respectively. Patients in the department of pulmonology had pulmonary dissemination syndrome of unclear origin or no overt clinical symptoms (n=100). The leading cause of their disease was sarcoidosis (60%) and idiopathic interstitial pneumonia (20%). 27 patients had this syndrome associated with HIV/AIDS. Clinical examples and difficulties of early diagnostics of pulmonary dissemination syndrome are discussed with reference to underlying diseases (sepsis, infectious endocarditis, HIV/AIDS, Goodpasture's syndrome). Special attention is given to the management of this condition based at a multidisciplinary hospital.

[Iatrogenic lung diseases].

The interest in iatrogenic diseases in general and those of lungs in particular is due to the possibility of elucidating and eliminating their etiological factors for the prevention of progression of pathological changes. However, diagnostics of such conditions is hampered by the lack of their specific clinical and morphological manifestations. The present study considers the relationship between interstitial lung lesions and the use of high doses of melothrexate (30 mg/week) for the treatment of Crohn's disease. The authors emphasize the necessity of regular monitoring the state of the respiratory system in metothrexate-treated patients and vigilance over the risk of alveolitis in such patients. The awareness of the patients of the possible side effects of metothrexate therapy is of primary importance.

Water status and LPO in rat tissues during massive blood loss and irradiation with He-Ne laser.

We revealed a relationship between water balance and LPO in the myocardium, liver, and blood plasma during massive blood loss and irradiation with He-Ne laser. Low-intensity laser irradiation of the plasma inhibits LPO and normalizes water balance in rat tissues during massive blood loss.

[Various forms of water in the rat myocardium and liver during blood loss and the early postresuscitation period]. / Zakonomernosti izmeneniia razlichnykh form vody v miokarde i pecheni krys pri krovopotere i v rannem postreanimatsionnom periode.

Different forms of water content were studied in myocardium and liver of male rats at 2-h hypotension and during the early postreanimation period. The phenomenon of redistribution of free and bound water was found. Comparison of water balance during the postreanimation period in the myocardium and liver revealed that normalization of different forms of water occured in myocardium. In hepatocytes oedema remained over the whole period studied.

Some biochemical characteristics and water exchange in human articular cartilage in osteoarthrosis.

Rearrangement of intra- and intermolecular bonds in collagen molecule, disaggregation of proteoglycans and their elimination from cartilage involved in osteoarthrosis are responsible for water accumulation and its increased mobility in cartilage.

Biochemical characteristics and water exchange in the surface layer of human joint cartilage.

We compared the contents of collagen, glycosaminoglycans, and various forms of water in the surface layer and whole tissue of joint cartilages of different localization. It was found that the surface layer is characterized by reduced content of glycosaminoglycans compared to the whole tissue and higher water-holding capacity due high content of bound water.

[Changes in biochemical characteristics of collagen and the cartilage water in osteoarthritis]. / Izmenenie biokhimicheskikh kharakteristik kollagena i sostoianiia vody khriashcha pri osteoartrite.

The stability of collagen molecules and moisture capacity of human normal and osteoarthrotic (OA) cartilage were studied before and after extraction of glycosaminoglycans (GAG) by 4M guanidinum chloride. The content and nature of water were determined by Fisher titration, DSC and analysis of sorbtion-desorbtion processes of water vapour in cartilage. The stability of collagen molecules was determined by the degree of enzymatic hydrolysis: collagenase, pronase and pepsin. It was found that weakening of bonds between main compounds of the cartilage matrix and decrease of GAG quantities in the OA cartilage were accompanied by structural disorganization of the collagen network, which is manifested by breakdowns of intramolecular bonds in telopeptides and intermolecular bonds in the spiral part of collagen molecules, these changes may contribute to increase of total water in OA cartilage. The correlation of free and bound water fractions in cartilage was increased from 5 to 44 in OA cartilage. These results can be used as a criterion of pathological condition of human articular cartilage.

[Water-exchange processes in hyaline cartilage and its basic components in a normal state and in osteoarthritis]. / Vlagoobmennye protsessy v gialinovom khriashche i ego osnovnykh komponentakh v norme i osteoartroze.

The content of different forms of tissue water was studied in the normal articular cartilage and osteoarthrosis cartilage and its structural components: collagen, potassium hyaluronate, sodium chondroitinsulphate and its complexes. In the components of cartilage matrix a few of fractions of bound water different in the strength of binding are present. At the maximal humidity, all water in collagen binds with the active groups of biopolymers and in the glycosaminoglycans, in addition to bound water, are present, two crystal forms of freezing water (free water) at least. The quantity of free water in the collagen-chondroitin sulphat membrane, is increased with the increase of chondroitin sulphate. In the collagen-hyaluronate complex, fraction of free water is found only at the low concentration of hyaluronate kalium. It was shown that in the hyalin cartilage, in different from the other connective tissue (skin, achilles tendon), the most part of water is free water and its quantity is increased in the osteoarthrosis. It is supposed that the rearrangement of binding and free-water fractions in the osteoarthrosis is the result of deficiency of hyaluronic acid and therefore this may be regarded in the improvement of methods of treatment. This scientific and methodical approach allow to receive information on the forms and binding energy of water in the biological tissues, which is absorbed from fluids and steam phase and determine characters of the pathological changes.