Vol 17, No 6 (2012)

The epidemiological features and social factors of HIV-infection were studied. The clinical picture of disease was estimated. The laboratory researches included detection of contents CD4-lymphocytes and blood lipid structure. The patients with HIV-infection in the 3rd stage were divided into 2 groups according to duration of a course of the stage. The number of females involved in a HIV-infection as a result of the sharp increase of heterosexual way of transmittion was enlarged considerably. Pronounced changes of lipid metabolism in patients with HIV-infection in a 3rd stage were observed. As lisophospholipids indices in HIV patients with duration of the 3rd stage more than 5 years were several times lower, than in the HIV patients with the smaller experience, it is possible to use these parameters for prognosing the course of the disease.

The aim of this work was the study of red blood indices in patients with acute viral hepatitises (AVH) and the effect of omeprazole treatment and comorbidities of pancreas and thyroid. Red blood indices were studied in the course of the disease in 167 AVH patients, including 35 cases with AVH "A", 43 cases with AVH "B", and 89 cases – with AVH "C". Patients were divided into follows: control group (112 patients) treated with standard therapy and studied group (55 patients), received the therapy with omeprazole due to preexisting pancreatitis. Studies were performed with the use of Sysmex Hematology Analyzer KX-21n. Red blood cells, hemoglobin, MCV, MCH, MCHC, RDWc were determined. In acute AVH certain changes in erythrocyte hemogram were found, namely anisocytosis in 39-74% of cases, increase of MCH in 15-23% of cases and MCHC lowering in 28-42% of cases. These changes are more specific for hepatitis "B" and "C", and are less common and less severe in hepatitis "A". Diserythropoiesis remains till the period of reconvalescence in 38-46% of cases in the form of macroanisocytosis and deceased hemoglobin formation (13-38% of cases), and in 19-33% of cases in the form of hyperchromic erythrocytes. Pathological changes in erythrocyte hemogram were exacerbated by concomitant thyroid disease in acute hepatitis "C" and the pathology of the pancreas in acute hepatitis "A". No association between omeprazole treatment and development of anisocytosis in AVH patients was found. Typical changes in the morphofunctional state of red blood cells in AVH are: the decrease in the average hemoglobin concentration (MCHC), and increase in the erythrocyte anisocytosis (RDWc). Anisocytosis, disturbance in hemoglobin formation and in some cases - hyperchromia of erythrocytes remain during the recovery period. Development of anisocytosis is mostly determined with the viral exposure than with comorbidity or omeprazole treatment and can be considered an independent sign of viral infection of the liver.

Among children of early age still severe forms of a disease which can lead to lethal outcomes are registered still most often. Untimely diagnostics and the wrong assessment of the severity of pertussis cause mistakes in treatment and are significantly impact on a disease outcome. The analysis of features of a course of pertussis in children of early age is based on supervision over 670 children hospitalized in Moscow Infectious Clinical Hospital No. 1. Studying of clinic picure of pertussis in comparative evolutionary aspect allowed to establish the main reasons for an adverse course of pertussis a lethality at the present stage. The main factors promoting development of severe forms of a Bordetella pertussis infection in children of early age are the anatomical and physiological features, the burdened premorbid background, accompanying infectious diseases and biological properties of circulating strains of a Bordetella pertussis microbe. Pertussis in children of early age has own the clinical features, being characterized first of all by severity of the disease course. The most significant options of a mixtinfection are a combination of pertussis with CMV infection, the RS-infection.

The dynamics of verified cases of dengue fever in Russian tourists for the period 2009-2011 is presented in the paper. A detailed description of the clinical symptoms, common clinical and biochemical indices is given. Two cases of disease in pregnant women are considered. The possibility of mixtinfection of dengue fever with other diseases, as well as difficulties in the diagnosis and differential diagnosis of dengue fever have been shown. However, the authors present the epidemiological, clinical and laboratory criteria and proposed diagnostic algorithm based on mentioned indices.

Coxiellosis (Q-fever) is a systemic natural focal zooanthroponosis disease, which has a very wide geographical area. A variety of clinical manifestations and the absence of pathognomonic signs of illness forces to use for making a definite diagnosis complex of techniques including epizootological, epidemiological data, clinical manifestations, and certainly the results of several serological tests designed to detect antibodies to Coxiella burnetii. There is presented a description of an acute case of Q - fever in a child in the subject, characterized as trouble-free of Coxiellosis from 70-ies of the last century.