Necrotising sinusitis with orbital complication in patient with macrophage activation syndrome (MAS)

Background: Macrophage activation syndrome (MAC) is a potentially fatal clinical-laboratory syndrome of uncontrolled hyperinflammation arising as a result of hereditary or acquired immune-mediated processes of cellular overactivation and nonmalignant proliferation of tissue macrophages/histiocytes, which can cause multiorgan failure.Case report: We present a clinical case of 15-years old child, who was diagnosed with juvenile idiopathic arthritis in 2019. The disease started with macrophage activation syndrome. In the next years the child had multiple hospitalizations in the Pediatrics clinic, but in the course of the disease it developed the picture of severe necrotic pansinuitis with an orbital complication, which required an immediate surgical intervention. Ever since the child had an ongoing necrotizing process in the area of the nasal passages, sinuses, upper jaw and hard palate. Other complications were breakthrough of the hard palate, loss of healthy teeth from the upper dentition and creation of direct communication between the oral cavity and the left maxillary sinus.Conclusions: The diagnosis of MAS is difficult to make, but increased awareness of this disease is an essential for its recognition. The struggle with autoimmune diseases often lasts for years with periods of exacerbation and remission of symptoms. Complications related to them can affect different organs and systems and require interdisciplinary approach

Rola uniwersyteckiego muzeum archeologicznego w procesie edukacyjnym

Музей археологии Оренбургского государственного педагогического университета открылся в 2004 г. Музей играет значительную роль в учебном процессе университета. В экспозиции представлена история Оренбургского края в каменном, бронзовом и раннем железном веках, а также в эпоху средневековья. Посетив музей, можно получить наглядное представление о том, как выглядел древний человек, чем он занимался в разные эпохи. Самые древние экспонаты относятся к VIII тыс. до н. э., а самые поздние – к периоду Золотой Орды (XIV в.). Несомненным украшением музея является кираса сарматского воина. Посетители также знакомятся с современными методами археологических исследований, новыми находками и открытиями. Музей выполняет учебную, хранительскую и научно-исследовательскую функции. Музей археологии посещают студенты, школьники и ученые из разных городов России, ближнего и дальнего зарубежья.Muzeum Archeologiczne Państwowego Uniwersytetu Pedagogicznego w Orenburgu zostało otwarto w 2004 r. Ekspozycja odzwierciedla główne etapy rozwoju laboratorium archeologicznego, prezentując materiały wykopaliskowe z wypraw. Ciekawe znaleziska, rekonstrukcje i fotografie przedstawiono w 13 gablotach. Eksponaty obrazują historię regionu Orenburga w epoce kamienia, brązu i wczesnego żelaza, a także w średniowieczu. Wizualizują one losy człowieka różnych epok dziejów świata. Najstarsze eksponaty pochodzą z 8 tys. p.n.e., a najnowsze – z okresu Złotej Ordy. Niewątpliwą ozdobą muzeum jest kirys sarmackiego wojownika. Zwiedzający zapoznają się również z nowoczesnymi metodami badań archeologicznych, najnowszymi znaleziskami i odkryciami. Co roku Muzeum Archeologiczne odwiedza ponad 800 studentów, uczniów i naukowców z różnych miast Rosji oraz z zagranicy. Muzeum odgrywa znaczącą rolę w procesie edukacyjnym uczelni.The Archeological Museum of Orenburg State Pedagogical University was opened in 2004. The museum plays a significant role in the education process: the exposition traces the history of Orenburg region back to the Stone, Bronze and Early Iron ages and to the Medieval period. The museum provides visual representations of ancient humans and their activities. The most ancient exhibits date back to the 8th century BC and the most recent, to the Golden Horde period (14th century). One of the exhibition’s highlights is the armour of a Sarmatian warrior. The museum also presents a variety of methods of archeological investigation, extraordinary finds and discoveries. Thus, apart from conservation, the museum also performs an educational and research functions. The museum is visited by students, schoolchildren and scholars from Russia and abroad

The possibility of forming expressive speech preschool children in the reading of works of literature and folklore

В статье рассматривается понятие "выразительность речи", раскрываются особенности формирования выразительности речи детей дошкольного возраста, показана возможность формирования данного коммуникативного качества речи в процессе чтения произведений литературы и фольклора, представлен анализ образовательной программы "От рождения до школы" в аспекте изучаемой проблемы.The article discusses the concept of "expressive speech" reveals peculiarities of expressiveness of speech of children of preschool age, the possibility of formation of the communicative qualities of speech in the process of reading works of literature and folklore, presents an analysis of the educational program "From birth to school" in the aspect of the problem being studied

Clinical case opticomielit- associated disease in patient with Sjogren's syndrome

Sjogren's syndrome is an autoimmune disease characterized by lesions of epithelial secretory glands. The main clinical feature is 'dry1 triad (xerostomia, xerophthalmia, immune sialodenopatiya). The disease may involve nervous system, especially the optic nerves and spinal cord. The article describes the clinical case of optikomielit- associated disease in patients with Sj gren's syndrome.Синдром Шегрена (СШ ) - аутоиммунное заболевание, характеризующееся поражением секретирующих эпителиальных желез, клинически проявляющееся «сухой» триадой (ксеростомия, ксерофтальмия, иммунная сиалоаденопатия). При СШ возможно поражение нервной системы с вовлечением зрительных нервов и спинного мозга. В статье приведено описание клинического случая оптикомиелит- ассоциированного заболевания у пациентки с синдромом Шегрена

Аcinetobacter baumannii bv Tryptophandestruens bv nov. isolated from clinical samples

The aim of the study was to determine the taxonomic status of a group consisting of atypical strains of Acinetobacter baumannii, outline relevant characteristics and methods necessary for their identification. There were examined 10 strains of A. baumannii (6 of them primary comprised) bearing similar profile of atypical features isolated from clinical samples (urine, sputum) in 2017–2019 at the Military Medical Academy. Сlinical strains of typical A. baumannii (n = 36), Acinetobacter nosocomialis (n = 14), Acinetobacter pittii (n = 9) and 1 strain of Acinetobacter calcoaceticus isolated from the external environment were used in comparative studies. Atypical strains had the characteristics of A. calcoaceticus — A. baumannii (ACB) complex bacteria and were identified as A. baumannii. The utilization of substrates as the only carbon source was studied on a dense synthetic medium added with 0.2 % substrate during incubation for 72 hours at 37°C. Carbohydrate oxidation coupled to acid formation was detected on the Hugh–Leifson medium by using a micromethod. Aromatic amino acid biotransformation was carried out in liquid and dense nutrient media assessed in chromogenic reaction. The rpoB gene was used for strain genetic characterization. Amplification of two 940 and 1210 base pair (bp)-long fragments from the rpoB gene was performed by the routine polymerase chain reaction using primers with previously described sequences. Amplification products were sequenced by Sanger using Big Dye Terminator v3.1 (Applied Biosystems, USA) and capillary electrophoresis on an automatic sequencer ABI PRISM 3130 (Applied Biosystems, USA), followed by using methods for determining the similarity levels of sequenced fragments with the rpoB gene sequences of the reference strain A. baumannii ATCC 17978 (GenBank accession no. CP053098.1). It was found that all strains belonging to atypical A. baumannii spp. had a specific set of features that distinguish them from typical strains of A. baumannii as well as other types of the ACB complex: detected biotransformation of L-tryptophan (via anthranilate pathway) and anthranilic acid under unambiguous lack of such signs in other bacteria; lack of utilized sodium hippurate and L-arabinose being unambiguously evident in other bacteria; lack of utilized L-tryptophan, putrescine, L-ornithine being utilized in the majority of strains of belonging to other bacterial species. Genetic analysis showed that the control strains of typical A. baumannii displayed 99.20–99.21% similarity within the sequenced fragments of the rpoB gene with those from the rpoB gene of the reference strain. All 10 strains of atypical A. baumannii had similar features (99.20–99.21%). At the same time, parameters of control strains from other bacterial species significantly differed: A. nosocomialis (95.10–95.97%), A. pittii (94.63–94.92%), A. calcoaceticus (93.00%). Hence, the strains of atypical and typical A. baumannii are genetically homogeneous and belong to the same species. The data presented allow us to consider this group of atypical A. baumannii strains as a new biovar. We propose the name for this new biovar — tryptophandestruens (tryptophan-destroying) stemming from the Latin word destruens — destroying. Identification of A. baumannii bv. tryptophandestruens bacteria can be carried out in laboratory of any level by using tests for L-tryptophan biotransformation as well as sodium hippurate utilization

GLAUCOMA PROGRESSION. IMPACT OF RISK FACTORS ON THE DISEASE

The aim of the study is to assess the effect of systemic and local risk factors on the rate of glaucoma progression, the specificity and informative nature of ophthalmological studies for assessment of the rate of glaucoma progression.Material and methods. A retrospective analysis of the medical case histories and outpatient charts of 217 patients (268 eyes) for the period from 2014 to 2017 was conducted. The patients with primary open-angle glaucoma having at least 5 Humphrey field-of-view (24-2) studies and optic coherence tomography of the optic nerve disk and retina with a guided progression analysis (GPA) function (SD-OCT) were included in the study. The patients were divided into 2 groups: with rapid progression (more than 1 dB per year, 144 eyes (103 patients)) and slow progression (less than 1 dB per year, 124 eyes (114 patients)). The data of standard ophthalmological methods of investigation (visometry, ophthalmoscopy, biomicroscopy, measurement of intraocular pressure (IOP) according to Maklakov) were additionally analyzed. Demographic and clinical data were assessed: gender, age, cornea central thickness, refraction, IOP, glucocorticosteroid intake, cardiovascular diseases presence, arterial hypertension, arterial hypotension, local hypotensive therapy. Results and discussion. The analysis revealed the main risk factors in glaucoma progression, which include age, cardiovascular diseases presence, high initial IOP values, pronounced functional changes in thevisual fields (lower mean deviation), pseudoexfoliation syndrome

Epidemiological features of primary progressive multiple sclerosis (literature review)

Primary-progressive multiple sclerosis (PPMS) is characterized by progressive accuimulation of neurological deficit without exacerbations and remissions. Pathomorphological studies indicate the predominance of neurodegenerative processes over the inflammatory. PPRS points to worse prognosis compared with remitting and secondary-progressive MS. Immunomodulatory treatment and courses of corticosteroids are not effective. There are no genetic and immunological markers of PPRS, so the results of epidemiological studies are very important.Первично-прогрессирующий рассеянный склероз (ППРС) характеризуется прогрессирующим нарастанием неврологического дефицита с момента дебюта заболевания, без четких обострений и ремиссий. Патоморфологически нейродегенеративные процессы преобладают над воспалительными. При ППРС отмечается худший прогноз, в сравнении с ремитирующим и вторично-прогрессирующим PC, известные препараты, изменяющие течение рассеянного склероза (ПИТРС) и курсы кортикостероидов не эффективны. До сих пор не существует генетических и иммунологических маркеров ППРС, в связи с чем результаты эпидемиологических исследований имеют важное научное значение

The importance of pathogenicity factors of some Streptococcus spp. and Klebsiella spp. in determining their etiological role in the inflammatory processes of the respiratory tract

Together with the known pathogens of inflammatory processes of the respiratory tract in clinical practice are often found representatives of Streptococcus and Klebsiella, previously considered commensals of the mucous membranes of the upper respiratory tract. The exchange of genetic information facilitates the transfer of virulence factors between strains not only within the species but also within the genus. In such cases, the acquisition of virulence genes by nonpathogenic species from representatives of pathogenic species contributes to the manifestation of previously not typical properties. Therefore, the aim of the research was to study the virulence of opportunistic Streptococcus spp. and Klebsiella spp. in inflammatory processes of the respiratory tract and substantiate their etiological role in the development of the disease. We studied 220 strains of Streptococcus spp. and 97 strains of Klebsiella spp., isolated from patients with inflammatory processes in the respiratory tract and from healthy individuals. Strains of Streptococcus spp. were investigated for the presence of virulence genes: sagA, lmb, fapl, ply, lytA. Strains of Klebsiella spp. were examined for the presence of virulence genes: MrkD, magA, kfu. The phenotypic marker of lmb gene expression in Streptococcus and MrkD gene in Klebsiella was the indicator of adhesion of isolated strains to buccal epithelial cells. Expression of the fapl gene was evaluated in a phenotypic biofilm formation test. In individuals with upper respiratory tract inflammation, the most common types of strepto -cocci were: S. mitis, S. anginosus, and S. oralis. Strains of these species isolated from inflammatory processes in the upper respiratory tract had 2—4 times greater adhesiveness than strains isolated from healthy individuals. Phenotypic determination of the ability to biofilm formation showed that strains of Streptococcus containing the fapl gene formed a dense biofilm in contrast to strains without the fapl gene. K. oxytoca strains isolated from people with sinusitis had mrkd, magA, and kfu virulence genes that are characteristic of K. pneumoniae strains. In phenotypic tests, it was found that the value of the adhesion index in K. oxytoca strains isolated from patients is 4 times higher than in strains of this species isolated from healthy individuals. Thus, to confirm the etiological role of an opportunistic microorganism in the development of the infectious process, it is necessary to be guided by data on the genetic and phenotypic markers of virulence of the isolated strain

Clinical case drug-induced cerebral vasculitis caused by antiretroviral Therapy

Vasculitis is heterogeneity group of diseases, which characterized by inflammation of the vessel wall. Pathological process may involve vessels of central nervous system. One of the rare reason of vasculitis is drug exposure. The article describes the clinical case of drug-induced vasculitis in patient, who takes antiretroviral therapy.Васкулиты - гетерогенная группа заболеваний, основным морфологическим признаком которых является воспаление сосудистой стенки. В патологический процесс могут вовлекаться сосуды центральной нервной системы. Одним из редких этиологических факторов развития васкулитов в настоящее время считается токсическое действие лекарственных препаратов. Представлено клиническое наблюдение пациентки с церебральным, лекарственно обусловленным васкулитом на фоне приема антиретровирусной терапии

Assessing <i>Serratia</i> spp. pathogenic potential from cryogenic habitats

The genus Serratia are opportunistic bacteria widely spread in natural environment. At the same time, this bacterial genus consists of the species associated with outbreaks of nosocomial infections. Serratia species are found in extreme habitats, but pathogenic potential of polyextremophilic strains in this genus remains unexplored. The aim of this study was to compare the genomes of two Serratia strains isolated in polar regions, primarily examining genetic factors of virulence and adaptation to cryogenic environment. During the 56th Russian Antarctic Expedition the Serratia liquefaciens 72 strain was isolated from a guano sample of the Adelie Penguin (Pygoscelis adeliae) colony on Tokarev Island (Haswell Archipelago, East Antarctica). The Serratia fonticola 5l strain was isolated from the frozen carcass of moose (Alces alces) fossils found on the Buor-Khaya Peninsula near the Laptev Sea coast (Yakutia Region, Russia). The whole-genome sequencing of such strains allowed to reveal genetic structures evidencing about their successful adaptation to low temperatures. Thus, it was found that both genomes contain genes encoding the main cold shock proteins, phylogenetically close to the corresponding genes in the hypobarotolerant Serratia liquefaciens strain ATCC 27592. Furthermore, both strains bear a cluster of tc-fABCD genes determining the bacterial adhesion to epithelial tissues, and the genes for RTX toxins — adhesins, crucial factors of biofilm formation in pathogenic Gram-negative bacteria. Experimental studies confirmed the ability of Serratia liquefaciens 72 and Serratia fonticola 5l to actively form biofilms in a wide temperature range (from 6°C to 37°C). The results obtained indicate that the examined genus Serratia strains isolated in Arctica and Antarctica exert overall similar adaptation strategies to polar climate, including the ability to produce pili, show active adhesion, and biofilm formation under low temperatures. Genetic adaptive factors may also act as pathogenicity factors allowing extremotolerant Serratia strains to exert traits of opportunistic and nosocomial pathogens and spread via chilled food-borne transmission. The wide use of food technologies, such as cooling and vacuum sealing, can potentially create a new ecological niche favourable for selection of psychrotolerant and hypobarotolerant pathogens. The data obtained allow to raise a question about necessity of further studies to monitor genetic diversity among psychrophilic hypobarotolerant microbial populations possessing pathogenic and epidemic potential