Лимбический аутоиммунный энцефалит с антителами к глутаматдекарбоксилазе (GAD)

Limbic encephalitis (LE) is a rare neurological syndrome, in most cases has a paraneoplastic nature, but recently there has been a large number of observations of idiopathic autoimmune LE associated with antibodies to neuronal membrane proteins. A clinical case of a disease in a 13-year-old patient with the detection of antibodies to glutamate decarboxylase (GAD) is described. The debut of the disease is marked by a decrease in memory for current events after the first convulsive attack during 2 months.Лимбический энцефалит (ЛЭ) — редкий неврологический синдром, в большинстве случаев имеет паранеопластическую природу, однако в последнее время накоплено большое число наблюдений идиопатического аутоиммунного ЛЭ, ассоциированного с антителами к белкам нейрональной мембраны. Описан клинический случай заболевания у 13-летней пациентки с выявлением антител к глутаматдекарбоксилазе (GAD). Дебют заболевания отмечен снижением памяти на текущие события после первого судорожного приступа в течение 2-х мес

Клинический случай энцефалита с антителами к NMDA-рецепторам

Anti-NMDA receptor encephalitis is an autoimmune disease of the central nervous system caused by autoantibodies to the NR1 and NR2 subunits of the glutamate NMDA receptor, with the possibility of both death and rapid remission. The binding of these antibodies blocks receptors and causes slowly developing psychiatric disorders, motor disorders and seizures.Presented clinical observation in a 9-year-old patient. The disease debuted with prodromal flu-like symptoms, fever, headache and general weakness, after which neuropsychiatric symptoms, impaired memory and speech developed, further progression of the disease, convulsive status, and coma with a fatal outcome were noted. The final diagnosis of autoimmune encephalitis was made after identification of antibodies to the N-methyl-D-aspartate (NMDA) receptor in the blood.Анти-NMDA-рецепторный энцефалит — аутоиммунное заболевание центральной нервной системы, вызываемое аутоантителами к NR1 и NR2-субъединицам глутаматного NMDA-рецептора, с возможностью как летального исхода, так и быстрой ремиссии. Закрепление этих антител блокирует рецепторы и вызывает медленно развивающиеся психиатрические нарушения, двигательные нарушения и приступы.Представлено собственное клиническое наблюдение у 9-летней пациентки. Заболевание дебютировало с продромальных гриппоподобных симптомов, лихорадки, головной боли и общей слабости, после чего развились нейропсихиатрические признаки, нарушение памяти и речи, далее отмечалось прогрессирование заболевания, судорожный статус, кома с летальным исходом. Окончательный диагноз аутоиммунного энцефалита был поставлен после идентификации антител к N-метил-D-аспартат (NMDA) рецептору в крови

Эпидемиологическая ситуация по новой коронавирусной инфекции в Республике Дагестан и меры по ее снижению

The article shows the epidemiological situation of the coronavirus infection COVID-19 (SARS-CoV2) in the Republic of Dagestan for the period 2020-2022, according to the «Republican Center for Infectious Diseases and AIDS» of Makhachkala, Dagestan. Results. The epidemiological situation of the new coronavirus infection in the Republic of Dagestan (RD) remains unfavorable. In 2020, since the beginning of the pandemic, the «Wuhan» strain has been circulating, and since September 2020, the active circulation of the British «alpha» strain has begun. A new wave in 2021 with the highest incidence was recorded from June to September – associated with the inclusion of the Indian «delta» strain SARS-CoV-2 in the epidemic process. Strains of «omicron» that exist today are BA.1 and BA.2 may lead to hospitalization. They are still dangerous for residential people and patients with risk factors. Conclusion. Among the adult population, the largest number of cases of the disease was registered 90.7%. Three main age risk groups have been identified: the adult population from 50 to 64 years; from 65 years and older and from 40 to 49 years. The analysis of mortality by age groups also revealed the main risk groups: persons aged 50-59 years (15.12%); 60-64 years (23%) and over 65 years (55.6%). On 04.07.2022 1,557,661 people were vaccinated with the Gum-COVID-Vac, EpiVacCorona, KoviVak and Sputnik Light vaccine, including 1,377,645 people who completed vaccination.В статье показана эпидемиологическая ситуация по коронавирусной инфекции СОVID-19 (SARS-CoV2) в Республике Дагестан за период 2020-2022 гг., по данным «Республиканского центра инфекционных заболеваний и СПИД» г. Махачкалы, Дагестан. Результаты. Эпидемиологическая ситуация по коронавирусной инфекции в Республике Дагестан (РД) остается неблагополучной. В 2020 году с начала пандемии циркулировал «уханьский» штамм, а с сентября 2020 года началась активная циркуляция британского «альфа» штамма. Новая волна в 2021 году с наиболее высоким уровнем заболеваемости регистрировалась с июня по сентябрь и была связана с включением в эпидпроцесс индийского «дельта» штамма SARS-CoV-2. Штаммы «омикрон», которые есть на сегодняшний день, BA.1 и BA.2 могут приводить к госпитализации. Они по-прежнему опасны для пожилых людей и пациентов с факторами риска. Заключение. Среди взрослого населения зарегистрировано наибольшее количество случаев заболевания 90,7%. Выявлены три основные группы риска среди взрослого населения: 40-49 лет, 50-64 года; 65 лет и старше. Анализ смертности внутри этих групп также позволил выявить наиболее высокую смертность среди лиц в возрасте 50-59 лет (15,12%); 60-64 лет (23%) и старше 65 лет (55,6%). На 04.07.2022 г. привито от коронавирусной инфекции вакцинами «Гам-КОВИД-Вак», «ЭпиВакКорона», «КовиВак» и «Спутник Лайт» 1 557 661 человек, в том числе завершили вакцинацию 1 377 645 человек

Течение новой коронавирусной инфекции у детей: некоторые аспекты мониторинга заболеваемости и анализа летальности

The work objective was to carry out the analysis of the existing in the Russian Federation monitoring of the incidence of new coronavirus infection in children and specific features of death cases caused by COVID-19 in children. Materials and methods. The analysis of the data of operative statistics presented on the sites of the governments of the regions where the incidence among children was considered within the period from April 22, 2020 to June 26, 2020, as well as the data of the Main non-staff experts in infectious diseases in children was performed. The inpatient medical documentation and the data of pathologicoanatomic investigation of children died due to COVID-19 were analyzed. Results. Prevalence of COVID-19 in children from various regions of the Russian Federation was from 1% to 8.6% in the structure of general disease incidence. The asymptomatic and mild forms of the disease which did not require hospitalization, were noted in 55–60% of the cases. 12 death cases associated with COVID-19 were registered for June 22, 2020. The analysis of 8 presented cases showed that 6 patients out of 8 died children were of the first half of the year of life (3 girls and 5 boys). In most cases the children were admitted to the hospital at the 8–12th day of the disease in severe and extremely severe condition due to pulmonary-cardiac insufficiency, six patients had fever up to 38–39°С, four patients had signs of consciousness depression. All children were diagnosed with community-acquired bilateral pneumonia according to the data of roentgenography, ultrasound investigation or computer tomography of the chest organs that did not always coincide with the intensity of respiratory syndrome. The direct cause of death was cardiac or pulmonary-cardiac insufficiency. Conclusion. The analysis of clinical and laboratory manifestations of COVID-19 with an unfavourable outcome in children revealed some difficulties in the interpretation of its role in thanatogenesis. The significance of comorbid pathologies in the development of unfavourable outcomes is doubtless.Цель: провести анализ существующего в РФ мониторинга заболеваемости детей новой коронавирусной инфекцией и особенностей летальных случаев COVID-19 у детей. Материалы и методы: в период с 22.04.2020 г. по 26.06.2020 г. проведен анализ данных оперативной статистики на сайтах правительств регионов, в которых учитывали заболеваемость детей, а также данные главных внештатных специалистов по инфекционным болезням у детей. Проанализированы медицинские карты стационарных больных и данные патолого-анатомического исследования детей, погибших от COVID-19. Результаты. Распространенность COVID-19 у детей в различных регионах РФ составляла от 1% до 8,6% в структуре общей заболеваемости. Бессимптомные и легкие формы болезни, не требовавшие госпитализации, отмечали в 55–60% случаев. На 22.06.2020 г. было зарегистрировано 12 летальных случаев, ассоциированных с COVID-19. Анализ 8 представленных случаев показал, что из 8 погибших детей 6 человек были первого полугодия жизни (3 девочки и 5 мальчиков). В большинстве случаев дети поступали в стационар на 8–12-й дни заболевания в тяжелом и крайне тяжелом состоянии за счет легочносердечной недостаточности, 6 – с лихорадкой до 38–39°С, 4 – с признаками угнетения сознания. У всех детей по данным рентгенографии, ультразвукового исследования или компьютерной томографии органов грудной клетки диагностировали внебольничную двустороннюю пневмонию, что не всегда совпадало с выраженностью респираторного синдрома. Непосредственной причиной смерти явилась сердечная или легочно-сердечная недостаточность. Заключение. Анализ клинических и лабораторных проявлений COVID-19 с неблагоприятным исходом у детей выявил сложности в интерпретации ее роли в танатогенезе. Несомненным является значение коморбидной патологии в развитии неблагоприятных исходов

ТЕЧЕНИЕ ЭПИДЕМИЧЕСКОГО ПАРОТИТА В ПЕРИОД ПОДЪЕМА ЗАБОЛЕВАЕМОСТИ, ПО ДАННЫМ РЕСПУБЛИКАНСКОГО ЦЕНТРА ИНФЕКЦИОННЫХ БОЛЕЗНЕЙ Г. МАХАЧКАЛЫ

The aim of the study was to study the course of epidemic parotitis in patients with a sharp increase in the incidence rate in Dagestan in 2017, and to analyze the coverage of vaccination against this infection.In the Republic of Dagestan, from January to December 2017, there was an increase in the incidence of mumps infection — 2,632 cases, in 2016 —148, in 2015 — 1 case. It turned out that 1492 (56.6%) of 2,632 patients with epidemic parotitis in 2017 were not vaccinated.Clinical and laboratory monitoring of 449 patients with epidemic parotitis hospitalized in the Republican Center for Infectious Diseases was carried out. The greatest number of cases was between the ages of 12 and 35 years. The clinical picture of parotitis infection in adults did not differ from that of children. First parotid glands are affected, then the lesions of other glandular organs are joined — pancreatitis (51.2%), orchitis (32%) and CNS — meningitis (16%). Outcomes of the disease were favorable. Цель исследования: изучить течение эпидемического паротита у больных при резком увеличении заболеваемости в Дагестане в 2017 г. и проанализировать охват вакцинацией против данной инфекции. В республике Дагестан с января по декабрь 2017 г. зарегистрировано повышение заболеваемости паротитной инфекцией — 2632 случая, в 2016 г. —148, в 2015 г. — 1 случай. Оказалось, что 1492 (56,6%) человека из 2632 заболевших в 2017 г. эпидемическим паротитом не были привиты. Проведено клинико-лабораторное наблюдение 449 больных эпидемическим паротитом, госпитализированных в Республиканский центр инфекционных болезней г. Махачкалы. Наибольшее количество заболевших было в возрасте от 12 до 35 лет. Клиническая картина паротитной инфекции у взрослых не отличалась от таковой у детей. Сначала поражаются околоушные слюнные железы, затем присоединяются поражения других железистых органов — панкреатит (51,2%), орхит (32%) и ЦНС — менингит (16%).  Исходы заболевания отмечались благоприятные

Limbic autoimmune encephalitis with antibodies to glutamate decarboxylase (GAD)

Limbic encephalitis (LE) is a rare neurological syndrome, in most cases has a paraneoplastic nature, but recently there has been a large number of observations of idiopathic autoimmune LE associated with antibodies to neuronal membrane proteins. A clinical case of a disease in a 13-year-old patient with the detection of antibodies to glutamate decarboxylase (GAD) is described. The debut of the disease is marked by a decrease in memory for current events after the first convulsive attack during 2 months

The main aspects of the immunoprophylaxis of infectious diseases in the Republic of Dagestan

The analysis of the epidemiological situation of vaccine-preventable infections in the Republic of Dagestan. The introduction of mass vaccine prophylaxis had a positive effect on reducing the incidence of infections such as poliomyelitis, diphtheria, tetanus, rubella, and viral hepatitis B in the Republic of Dagestan. However, despite the ongoing routine immunization of the population for “controlled” infections, the incidence of measles and parotitis infection remains high in 2018, this is due to an increase in the number of people who refuse to receive preventive vaccinations, in most cases, for religious reasons

Clinical case of encephalitis with antibodies to NMDA receptors

Anti-NMDA receptor encephalitis is an autoimmune disease of the central nervous system caused by autoantibodies to the NR1 and NR2 subunits of the glutamate NMDA receptor, with the possibility of both death and rapid remission. The binding of these antibodies blocks receptors and causes slowly developing psychiatric disorders, motor disorders and seizures.Presented clinical observation in a 9-year-old patient. The disease debuted with prodromal flu-like symptoms, fever, headache and general weakness, after which neuropsychiatric symptoms, impaired memory and speech developed, further progression of the disease, convulsive status, and coma with a fatal outcome were noted. The final diagnosis of autoimmune encephalitis was made after identification of antibodies to the N-methyl-D-aspartate (NMDA) receptor in the blood

Course of a new coronavirus infection in children: some aspects of monitoring and analysis of mortality

The work objective was to carry out the analysis of the existing in the Russian Federation monitoring of the incidence of new coronavirus infection in children and specific features of death cases caused by COVID-19 in children. Materials and methods. The analysis of the data of operative statistics presented on the sites of the governments of the regions where the incidence among children was considered within the period from April 22, 2020 to June 26, 2020, as well as the data of the Main non-staff experts in infectious diseases in children was performed. The inpatient medical documentation and the data of pathologicoanatomic investigation of children died due to COVID-19 were analyzed. Results. Prevalence of COVID-19 in children from various regions of the Russian Federation was from 1% to 8.6% in the structure of general disease incidence. The asymptomatic and mild forms of the disease which did not require hospitalization, were noted in 55–60% of the cases. 12 death cases associated with COVID-19 were registered for June 22, 2020. The analysis of 8 presented cases showed that 6 patients out of 8 died children were of the first half of the year of life (3 girls and 5 boys). In most cases the children were admitted to the hospital at the 8–12th day of the disease in severe and extremely severe condition due to pulmonary-cardiac insufficiency, six patients had fever up to 38–39°С, four patients had signs of consciousness depression. All children were diagnosed with community-acquired bilateral pneumonia according to the data of roentgenography, ultrasound investigation or computer tomography of the chest organs that did not always coincide with the intensity of respiratory syndrome. The direct cause of death was cardiac or pulmonary-cardiac insufficiency. Conclusion. The analysis of clinical and laboratory manifestations of COVID-19 with an unfavourable outcome in children revealed some difficulties in the interpretation of its role in thanatogenesis. The significance of comorbid pathologies in the development of unfavourable outcomes is doubtless

THE COURSE OF EPIDEMIC PAROTITIS DURING THE PERIOD OF RISING MORBIDITY, ACCORDING TO THE REPUBLICAN CENTER FOR INFECTIOUS DISEASES IN MAKHACHKALA

The aim of the study was to study the course of epidemic parotitis in patients with a sharp increase in the incidence rate in Dagestan in 2017, and to analyze the coverage of vaccination against this infection.In the Republic of Dagestan, from January to December 2017, there was an increase in the incidence of mumps infection — 2,632 cases, in 2016 —148, in 2015 — 1 case. It turned out that 1492 (56.6%) of 2,632 patients with epidemic parotitis in 2017 were not vaccinated.Clinical and laboratory monitoring of 449 patients with epidemic parotitis hospitalized in the Republican Center for Infectious Diseases was carried out. The greatest number of cases was between the ages of 12 and 35 years. The clinical picture of parotitis infection in adults did not differ from that of children. First parotid glands are affected, then the lesions of other glandular organs are joined — pancreatitis (51.2%), orchitis (32%) and CNS — meningitis (16%). Outcomes of the disease were favorable