Combined therapy of reproductive-age women with urogenital Chlamydia Infection

A comprehensive clinical and immunological and microbiological study of 103 patients of reproductive age with infectious and inflammatory disorders of the urogenital tract chlamydial-opportunistic etiology. It was found that Chlamydia associated with opportunistic pathogens, causing inflammatory diseases of the genitourinary system, which are accompanied by dysbiosis and violations of local and systemic immunity. The use of complex antibacterial therapy immunomodulator polyoxidonium helped to restore the existing imbalance in the system of cellular and humoral immunity, ethiopathogene elimination, resolution of clinical symptoms of the disease and improve the quality of life of patients.Проведено комплексное клинико-иммунологическое и микробиологическое исследование 103 пациенток репродуктивного возраста с инфекционно-воспалительной патологией урогенитального тракта хламидийно-оппортунистической этиологии. Установлено, что хламидии, ассоциированные с условно-патогенными микроорганизмами, вызывают воспалительные заболевания мочеполовой системы, которые сопровождаются дисбиозом и наррениями локального и системного иммунитета. Использование в комплексной антибактериальной терапии иммуномодулятора полиоксидония способствовало восстановлению существующего дисбаланса в системе клеточного и гуморального звеньев иммунитета, элиминации этиопатогена, разрешению клинических симптомов заболевания и улучшению качества жизни пациентов

Phagocytic activity of peripheral blood monocytes under <i>in vivo</i> and <i>in vitro</i> hypoxia conditions in tolerant and susceptible to oxygen deficiency rats

It is known that there are individual differences in resistance to hypoxia, which can determine the predisposition to the development and severity of various diseases, including infectious, inflammatory and tumor. There are no standardized methods for assessing resistance to hypoxia in experimental animals and humans without hypoxic exposure. The search for molecular-biological markers, identifying people with different resistance to oxygen deficiency under normoxic conditions or under moderate hypoxic exposure is undoubtedly efficient. It is possible that the assessment of the basic resistance to hypoxia can help to predict the development and severity of the course of diseases, the mechanisms of which are associated with oxygen deficiency. One of the methods to assess organism resistance to hypoxia without exposure in a decompression chamber or in highland conditions can be modeling hypoxia in vitro. The aim of the study was to characterize the phagocytic activity of peripheral blood monocytes in tolerant and susceptible to hypoxia Wistar rats under normoxic conditions, as well as after hypoxic exposure in vitro and in vivo. The resistance of rats to hypoxia was determined by the gasping time at an altitude of 11.500 m in a decompression chamber. A month after determining the resistance to hypoxia, one group of rats was placed in a decompression chamber at an altitude of 5,000 m for 1 hour to simulate the hypoxic state in vivo. Blood from the tail vein of the other group of rats was placed in 1% oxygen for 1 hour to simulate the hypoxic state in vitro. The phagocytic activity of peripheral blood monocytes was assessed by flow cytometry. It was demonstrated that phagocytic activity of monocytes did not differ in tolerant and susceptible to hypoxia rats under normoxic conditions. The phagocytic activity of monocytes after in vitro and in vivo hypoxic exposure was higher in tolerant to hypoxia animals in comparison to susceptible ones. An increase in the phagocytic activity of monocytes compared to normoxia conditions was observed only in tolerant rats under in vitro conditions of hypoxic exposure. The obtained results indicate that tolerant and susceptible to hypoxia organisms differ in the phagocytic activity of monocytes under conditions of oxygen deficiency, which can determine the course of inflammatory and tumor diseases. The data obtained will be the basis for further experimental investigations organism hypoxia resistance markers

Comparative evaluation of different methods of complex immunomodulating therapy for women of reproductive age

The article presents data on the study of the etiological structure of chronic salpingoophoritis and the development of complex therapy for 120 women of reproductive age (mean age 28, 5 ± 7, 2 years). Chlamydia detected in 45% of the examined women; Mycoplasmas and urea plasmas were isolated from 32 and 23% of patients, respectively. The results of clinical and microbiological studies showed the effectiveness of antibiotic therapy with the inclusion of the polyoxidonium immunomodulatory and Wobenzyme polyenzyme.В статье представлены данные по изучению этиологической структуры хронических сальпингоофоритов и разработки комплексной терапии 120 женщин репродуктивного возраста (средний возраст 28,5 ±7,2 года). У 45% обследованных женщин были обнаружены хламидии; микоплазмы и уреаплазмы были выделены у 32 и 23% пациенток соответственно. результаты проведённых клинических и микробиологических исследований свидетельствовали об эффективности антибактериальной терапии с включением иммуномодулятора полиоксидония и полифермента вобэнзима

Clinical and microbiological characteristics of the course and treatment of associated urogenital infections in obstetric and gynaecologic pathology

The paper presents the research on the effectiveness and safety of combination therapy in pregnant women with burdened obstetric history (a history of spontaneous abortion, developing pregnancy, premature birth, fetal malformations, etc.), taking into account the presence In the urogenital tract and opportunistic pathogens microorganisms. The problem of the use of macrolides in combination with metabolic therapy in the first half of pregnancy, which contributed to reducing the threat of termination of pregnancy and the birth of healthy children.В статье представлены данные исследования эффективности и безопасности комплексной терапии у беременных женщин с отягощенным акушерским анамнезом (в анамнезе самопроизвольные выкидыши, неразвивающаяся беременность, преждевременные роды, пороки развития плода и т.д.), с учетом присутствия в урогенитальном тракте условно-патогенных и патогенных микроорганизмов. Рассмотрена проблема использования макролидов в комплексе с метаболической терапией в первой половине беременности, что способствовало снижению угрозы прерывания беременности и рождению здоровых детей

Ecology of vaginal in urogenital chlamidiosis in women of reproductive age

With vaginal dysbiosis, lactobacilli are eliminated, which is accompanied by strict anaerobic colonization ot the vagina. 110 women of reproductive age with urogenital chlamydia at the age of 18 to 45 years were examined. The diagnosis of the disease was made on the basis of clinical and laboratory data. Given the high risk of reproductive dysfunction and the development of various complications from the urogenital tract, the patients underwent a course of local treatment with Vaginorm-C (1 vaginal tablet once a day for 6 days). The study showed that the use of this drug contributed to the restoration of vaginal microbiocenosis in 85% of the examined women.При вагинальном дисбиозе происходит элиминация лактобацилл, которая сопровождается колонизацией влагалища строгими анаэробами. Обследованы 110 женщин репродуктивного возраста с урогенитальным хламидиозом в возрасте от 18 до 45 лет. Диагноз заболевания был поставлен на основании клинико-лабораторных данных. Учитывая высокий риск возникновения нарушения репродуктивной функции и развития различного рода осложнений со стороны урогенитального тракта, пациенткам проведен курс местного лечения препаратом Вагинорм - С (1 вагинальная таблетка 1 раз в день в течение 6 дней). Проведенное исследование показало, что использование данного препарата способствовало восстановлению вагинального микробиоценоза у 85% обследованных женщин

Clinical case the management of a patient with endometriosis of the diaphragm

Extragenital endometriosis — a rare pathology in which tissue similar morphologically to the endometrium is located outside the reproductive system. One of the main problems in the diagnosis and treatment of EGE is the erased course of different forms, so doctors of different profiles have difficulties with making an accurate diagnosis. The clinical case described in this article is a rare manifestation of EGE. Errors in diagnosis, management tactics, as well as in the treatment of the underlying disease were the reason for the provision of inappropriate specialized medical care.Экстрагенитальный эндометриоз (ЭГЭ) — редкая патология, при которой ткань, сходная морфологически эндометрии, лоцируется за пределами репродуктивной системы. Одной из главных проблем в диагностике и лечении ЭГЭ является стертое течение разных форм, поэтому у врачей разных профилей возникают трудности с постановкой точного диагноза. Описанный клинический случай в данной статье является редким проявлением ЭГЭ. Ошибки в диагностике, тактике ведениях, а также в лечении основного заболевания являлись причиной оказания несоответствующей профильной медицинской помощи

MORPHO-FUNCTIONAL CHANGES OF THYMUS AND CONTENTS OF BLOOD LYMPHOCYTE SUBPOPULATIONS IN FEMALE WISTAR RATS WITH DIFFERENT RESISTANCE TO HYPOXIA IN SYSTEMIC INFLAMMATORY RESPONSE

Hypoxia and immune reactions are closely interrelated at molecular, cellular and organism levels, and the individuals differ in resistance to oxygen deficiency. Animals with high and low resistance to hypoxia have different adaptive capabilities and predisposition to the development of inflammatory diseases. Data on the individual characteristics of hypoxia resistance in female laboratory animals and humans, and its relationship to immune system reactions in both normal conditions and inflammatory diseases are not available in the literature. It is known, however, that acute infectious and inflammatory diseases develop at lesser rates and are less severe in women and female laboratory animals than in males, which can be explained by higher resistance of females to hypoxia. The aim of our study is to reveal the features of morpho-functional thymus changes, and subpopulation of peripheral blood lymphocytes in systemic inflammatory response induced by LPS administration to female Wistar rats with different resistance to hypoxia. Resistance of mature female Wistar rats to hypoxia was determined as a survival period in a ventilated lowpressure chamber simulating high altitude condition (11 500 m). The rats with a lifetime “at high altitude” of &gt; 180 s have been classified as highly resistant to hypoxia, and the animals surviving for &lt; 20 seconds were designated low-resistant. One month after determining the hypoxia resistance, the females were injected intraperitoneally with E. coli O26:B6 lipopolysaccharide (LPS) at a dose of 1.5 mg/kg during the dioestrus phase. The animals were withdrawn from the experiment by i/m Zoletyl injection (15 mg/kg) one day after LPS administration. The relative volume fractions of thymic cortex and medulla were evaluated; the areas of necrosis were determined in the liver, and the number of neutrophils in the interalveolar septa was counted in the lungs. The serum contents of corticosterone, testosterone, TGF-β were determined. A flow cytometry evaluation of the relative and absolute numbers was performed for major subpopulations of lymphocytes in peripheral blood. The number of apoptotically dying cells of the thymus was assessed. For statistical processing of the obtained data, the Statistica 8.0 software was applied, using criteria of multiple comparisons by Kruskal–Wallis and Dann. The differences were considered statistically significant at p &lt; 0.05.In both high- and low-resistant to hypoxia females, the development of a systemic inflammatory -response was accompanied by a moderately severe thymic involution, apoptosis of thymocytes, an increase in the absolute number of NK, and rise of testosterone and corticosterone contents. LPS injection into low-resistant rats, if compared to females highly resistant to hypoxia, led to more severe manifestations of systemic inflammation, i.e., a pronounced inflammatory reaction in the lungs and a more extensive liver necrotic area accompanied by increased absolute numbers of regulatory T lymphocytes and T helper cells, and more pronounced thymic accidental involution with apoptotic death of thymocytes. Systemic manifestations of inflammation were less pronounced in hypoxia-resistant female rats, which was apparently associated with activation of lymphocyte  migration from the thymus and blood to the inflammation focus, and development of more effective immune response.Conclusion: immune reactions in the systemic inflammatory response induced by LPS in female Wistar rats depend on individual resistance to hypoxia. These data should be used to develop approaches to personalized therapy of infectious and inflammatory diseases in women

On the issue of carriage and antibiotic resistance of staphylococci isolated from the clinical material of patients of the miscarriage department of the maternity hospital № 2 of the Ministry of Health of the Republic of Dagestan

The frequency of isolating staphylococci and the dynamics of the development of their resistance to antibiotics, isolated from patients of the miscarriage ward of the maternity hospital No. 2 of the Ministry of Health of the Republic of Dagestan for a 5-year period (2013-2017) are analyzed. 398 staphylococcal strains were studied: 203 Staphylococcus aureus and 195 – Staphylococcus epidermidis. It has been established that in the last 2-3 years there has been an increase in the carrier of gram-positive bacteria. There was a marked increase in the outgrowth of S. aureus (almost 2.0 times), and the ratio between S. aureus and S. epidermidis in 2017 increased 1.3 times. The study of the sensitivity of the isolated strains of staphylococci to microbial preparations showed that the overwhelming majority of them are multi-resistant to antibiotics. Determination of sensitivity to antibacterial drugs revealed that most of the isolated strains are sensitive to fluoroquinolone, a new generation of levofloxacin (tavanic).Проанализирована частота выделения стафилококков и динамика развития их резистентности к антибиотикам, выделенных у пациенток отделения невынашивания беременности родильного дома № 2 М3 РД за 5-летний период (2013-2017г.г.). Были изучены 398 штаммов стафилококков: 203 Staphylococcus aureus и 195 - Staphylococcus epidermidis. Установлено, что в последние 2-3 года отмечается рост носительства грамположительных бактерий. Отмечен выраженный рост высеваемости S. aureus (почти в 2,0 раза), а соотношение между S. aureus и S. epidermidis в 2017 г. выросло в 1,3 раза. Изучение чувствительности выделенных штаммов стафилококков к микробным препаратам показало, что преобладающее большинство из них полирезистентны к антибиотикам. Определение чувствительности к антибактериальным препаратам выявило, что большинство выделенных штаммов чувствительны к фторхинолону нового поколения левофлоксацин (таваник)

The Role of Macrophages in the Pathogenesis of SARS-CoV-2-Associated Acute Respiratory Distress Syndrome

Macrophages are cells that mediate both innate and adaptive immunity reactions, playing a major role in both physiological and pathological processes. Systemic SARS-CoV-2-associated complications include acute respiratory distress syndrome (ARDS), disseminated intravascular coagulation syndrome, edema, and pneumonia. These are predominantly effects of massive macrophage activation that collectively can be defined as macrophage activation syndrome. In this review we focus on the role of macrophages in COVID-19, as pathogenesis of the new coronavirus infection, especially in cases complicated by ARDS, largely depends on macrophage phenotypes and functionalities. We describe participation of monocytes, monocyte-derived and resident lung macrophages in SARS-CoV-2-associated ARDS and discuss possible utility of cell therapies for its treatment, notably the use of reprogrammed macrophages with stable pro- or anti-inflammatory phenotypes. © Copyright © 2021 Kosyreva, Dzhalilova, Lokhonina, Vishnyakova and Fatkhudinov

RISK FACTORS OF CARDIAL COMPLICATIONS OF THE EARLY POSTOPERATION PERIOD IN PATIENTS WITH ABDOMINAL AORTA ANEURYSM

Aim. To find out the risk factors for cardial complications of the early postoperation period (EPP) in patients operated for non-complicated abdominal aorta aneurysm (AAA) of atherosclerosis origin.Material and methods. Totally 95 patients studied, of those 88 (88,4%) males, mean age — 67,6±7,1 y. with non-complicated ААА of the atherosclerotic origin. All patients had cardiovascular comorbidities. At baseline all patients were selected into two groups: 1 group — 52 patients 46 (88,5%) men, mean age — 66,8±7,9 y., taking drugs with negative chronotropic effect (beta-blockers, non-dihydropyridine calcium channel antagonists); 2 group — 43 patients, 38 (88,4%) men, mean age 68,5±6,1 y., not taking these drugs. In the each of the groups were two subgroups according the operation approach: minilaparotomy (MLT) or median laparotomy (LT). As an endpoint, we used myocardial infarction (MI), acute heart failure (ACF), cardiac rhythm and conduction disorders. Patients with MI, ACF and cardiovascular mortality were regarded as combined endpoint. Patients with transient myocardium ischemia, without significant increase of the level of cardiospecific enzymes, were regarded as intermediate point of the study.Results. Of 95 operated patients with EPP in 17 (18%) there was endpoint and in 30 (31,6%) — intermediate point. By the stepped discriminate analysis we set the risk factors for endpoint and intermediate point: left ventricle myocardium remodelling (LV), angina pectoris of III functional class, arterial hypertension of the 3 grade with target organs involvement (LV hypertrophy), heart rate ≥84 bpm in postoperation period.Conclusion. In patients with non-complicated AAA of atherosclerotic origin the assessment of baseline cardial status, postoperation period pharmacotherapy, LV remodelling parameters (by EchoCG) and the use of MLT leads to the decrease of the risk of cardial complications of EPP