Листериозный менингоэнцефалит как оппортунистическое заболевание при ВИЧ-инфекции

Aim: To identify the signs and reasons why listeriosis can be classified as opportunistic infections in HIV infection, requiring timely diagnosis and treatment to prevent the development of a severe course of the disease and minimize the risks of death.  Materials and methods: 38 hospitalized patients with listeriosis meningitis/ meningoencephalitis were examined. All patients were hospitalized in the boxed departments of neuroinfections (the diagnosis of HIV infection was not known) with a directional diagnosis of meningitis of unclear etiology, where, according to the Meningitis program, a PCR examination for L. monocytogenes was included. The comparison group consisted of patients with other most common bacterial pyogenic meningitis (BPM) – meningococcal, pneumococcal and patients with listeriosis meningitis/meningoencephalitis without HIV infection.  Results: Studies have shown that patients with HIV infection accounted for the majority – 26% (out of 38 hospitalized). Men predominated among the patients – 60 %, the average age was 34.9 ± 2.2 years (29 – 41), which differs from the well–known age status, where the risk group is primarily male patients over 70 years of age.  Conclusion: Polymorphism of clinical manifestations of neuro listeriosis in some cases presents diagnostic difficulties for primary care physicians. CNS listeriosis in patients with HIV infection belongs to the category of opportunistic infections, which clinically and in the study of cerebrospinal fluid presents difficulties for early diagnosis, which directly affects the timing of the initiation of etiotropic therapy and the further outcome of the disease. Цель: выявить признаки и причины, по которым листериоз можно отнести в разряд оппортунистических инфекций при ВИЧ-инфекции, требующих своевременной диагностики и лечения для предотвращения развития тяжелого течения заболевания, и минимизировать риски летального исхода.  Материалы и методы. Обследовано 38 госпитализированных с установленным в стационаре листериозным менингитом/менингоэнцефалитом. Все больные госпитализировались в боксированные отделения нейроинфекций (о диагнозе ВИЧ-инфекция не было известно) с направительным диагнозом «Менингит неясной этиологии», где по программе «Менингиты» в ПЦР включено обследование на L. monocytogenes. Группу сравнения составили больные другими наиболее распространенными бактериальными гнойными менингитами – менингококковым, пневмококковым и больные листериозным менингитом/менингоэнцефалитом без ВИЧ-инфекции.  Результаты. Проведенные исследования показали, что больные ВИЧ-инфекцией составили большинство – 26% (из 38 госпитализированных). Среди больных преобладали мужчины – 60 %, средний возраст 34,9±2,2 лет (29–41), что отличается от общеизвестного возрастного статуса, где группой риска, прежде всего, являются пациенты старше 70 лет мужского пола.  Заключение. Полиморфизм клинических проявлений нейролистериоза в ряде случаев представляет диагностические трудности для врачей первичного звена. Листериоз центральной нервной системы у больных ВИЧ-инфекцией относится к категории оппортунистических инфекций, которая клинически и при исследовании спинномозговой жидкости представляет трудности для ранней диагностики, что напрямую влияет на сроки начала этиотропной терапии и дальнейшего исхода заболевания.

Sex specificities of medical and social parameters in patients with coronary artery disease with different severity of depression

Aim. To determine the sex specificities of medical and social parameters in patients hospitalized due to coronary artery disease (CAD), class II, III, IV angina, aged 35-60 years and assess the significance of their relationship with different levels of depression.Material and methods. The study involved 312 patients aged 35-60 with documented CAD, class II, III, IV angina. Two comparison groups were identified: group I — 138 patients (men, 81; women, 57) with CAD and without depression (mean age, 47,8±4,6 years); group II — 174 patients (men, 60; women, 105) with CAD and depression (mean age, 48,3±5,3 years). Medical and social data, the severity of depression and distress tolerance, psychological status and quality of life was assessed. Statistical analysis was carried out, which are presented as the mean and standard error of the mean (M±m). The odds ratio (OR) and 95% confidence interval (CI) were calculated. Differences were considered significant at p<0,05.Results. The prevalence of depression among patients with CAD was 55,77%, while women were 1,5 times more likely to suffer it than men. Depression was significantly associated with hyperglycemia, hypercholesterolemia, and class III-IV angina, regardless of sex. Class III and IV angina prevailed in women, while class II angina — in men (OR, 2,16; 95% CI, 1,37-3,41, p<0,001)). Women were more prone to degree II-III disability (group II, 26,67%; group I 8,77%; p=0,008), compared with men (group II, 27,54%; group I, 11,11%; p=0,012). Sedentary lifestyle was also associated to a greater extent with the female sex than with the male (OR, 2,89, 95% CI, 1,46-5,70, p=0,003; OR, 2,31, 95% CI, 1,19-4,48; p=0,014, respectively). Both men and women showed a significant association of depression with atherosclerosis (p<0,001), however, sex differences did not reach significance. Indicators such as lack of job and higher education, as well as smoking and arrhythmias were characteristic of both sexes, but had a greater impact on the mental condition of men (p=0,002, p<0,001, p=0,0014 and p=0,01, respectively). For men, the relationship of depression with diabetes (8,7 vs 0%; p=0,008), obesity (42,03 vs 19,75%; p=0,004), subordinate status (82,61 vs 64,2%; p=0,016) and unmarried status (60,87 vs 40,74%; p=0,02).Conclusion. There are significant differences in factors contributing to depression in different sex groups. The association of depression with CAD has an adverse effect on the physical and psychological health of both males and females. At the same time, women are more prone to mental disorders than men. It is necessary to further study the sex characteristics of medical and social parameters in order to personalize treatment methods

Medical and social features of patients with coronary artery disease and depression

The article reflects the relevance of determining medical, social and psychological parameters that determine the quality of life (QOL) and depression risk in cardiovascular patients. It has been established that psychological disorders have a negative effect on patients with coronary artery disease (CAD) and are the predictors of health and QOL decline. That is why the clinical manifestations of CAD should be regarded as a result of the behavioral response of patients with depression. During analysis, it was concluded that depression effects not only on the health, but also on psychophysiological characteristics. In this regard, the main subject of study is the relationship of depression to the specific medical and social characteristics of a person. This justifies the need for timely diagnosis of depression and work with psychosocial factors in order to increase the effectiveness of treatment and prevention measures in CAD patients and improve their QOL

The role of probiotic agents in the prevention of seasonal incidence of ARVI

Acute respiratory viral infection, including influenza, remains one of the most pressing health, social and economic problems of our time. The reason is the significant seasonal prevalence of the diseases in all age groups, and a high risk of serious complications and possible exacerbation of pre-existing chronic conditions. Improving the efficacy of modern respiratory antiviral drugs remains a priority. Prevention of acute respiratory viral infection is still vital

Probiotics in the prevention of ARVI

ARVI is a short-term infection of the upper respiratory tract (including middle ear cavity and paranasal sinuses) which is caused by various respiratory viruses. According to the WHO [1], ARVI affects every third person every year. During epidemic outbreaks, 27.3 to 41.2 million cases are registered in Russia, of which 2 million are located in Moscow [2]. Despite a wide range of antiviral and symptomatic medications, the problem of treatment and prevention of ARVI is far from being finally solved. That's why medicines that strengthen the immunity of a macroorganism are becoming increasingly popular