Vol 70, No 1 (2015)

Objective: Our aim was to investigate the glutathione-disulfide system of antioxidant defense in men with different body mass index and infertility. Methods: 60 men with infertility were examined — 30 with normal weight and 30 with overweight. 30 fertile men were included in the control group. Hemolysate made from red blood cells was used as a material for study. The level of reduced (GSH) and oxidized glutathione (GSSG), and glutathione activity was determined by enzyme spectrofluorophotometer SHIMADZU-1501 (Japan). Results: In infertile men with normal body weight decrease of GSH to 15.35% was combined with a decrease in the activity of enzymes — glutathione reductase (GR) to 53.41%, glutathione peroxidase (GPO) to 51.44%, and increased activity of glutathione-S-transferaze (GST) to 31.52% as compared with the control group. In the group of infertile men with overweight a decrease in the activity of GR, 56.77% and 56.22% at the GPO on the background of a stable level of GST was detected in comparison with fertile men. The concentration of GSH in infertile group decreased by 20.08%, and the concentration of GSSG increased by 20.38%. Conclusion: It has been established that imbalance in the glutathione system is the most prominent feature in men with infertility and overweight as compared to infertile men with normal body weight.

Macrophages have recently been shown to play a key role in promoting of recovery after some diseases as well as in aggravation of inflammatory responses, all the functions being resulted from microenvironmental conditions and therefore phenotypes acquired by macrophages in these conditions. In this article some protective functions of macrophages during infectious and oncologic diseases as well as pathogenic roles in a number of inflammatory diseases are reviewed. Much attention is devoted to opportunities of macrophage reprogramming.

Food allergy (FA) in children, especially in infancy, is still a significant public health problem. The severity and prognosis of disease progression associated with FA considerably depends on the correct and early diagnostics of this pathology, as well as on the following management of a child. At the same time delayed elimination diet administration, unreasonable or overlong dietary intervention might have become abuse management of a patient and have a negative impact on the development of a child and reduce the quality of life. The article summarizes the current practical approaches to the diagnosis of FA based on evidence-based medicine and adopted European and Russian national consensus documents, as well as on our own experience of management of patients with this pathology. FA diagnosis in a child usually includes clinical laboratory tests and clarification of clinical and anamnestic data. Unfortunately, it is a fact that preference is given to laboratory methods for diagnosis based on specific IgE determination or skin samples. However, the basis for cause-significant allergen identifying is detecting detailed medical history and clinical picture of a disease which still appears to be the most reliable tool for FA diagnosis.

The rare combination of intestinal lymphangiectasia with malrotation of the duodenum in a child of three months of life is described. Basing on the literature review only 3 similar cases were described in the world practice. The boy with protein-losing enteropathy was examined at Moscow Scientific Centre of Children’s Health. The child had vomiting, diarrhea, loss in body weight, hypoproteinemia, lymphopenia. The infectious nature of the disease was excluded. It had been suggested the Waldman desease (primary intestinal lymphangiectasia). The prognosis for such disease is unfavorable. An examination of the child was continued against the backdrop of ongoing symptomatic therapy. Complete physical examination included monitoring laboratory blood tests, X-ray examination with contrast, CT-scan, gastroduodenoscopy with biopsy of the mucosa of the small intestine. Malrotation duodenum with the recurrent mid-gut volvulus with the development of secondary intestinal lymphangiectasia was diagnosed. Modern methods of examination and multidisciplinary approach made it possible to diagnose the case. Operation to eliminate fixation duodenum resulted in the recovery of the patient. At the present time the child grows and develops according to age and does not require treatment. The prognosis for this disease is regarded as favorable.

Shiga toxin-producing Escherichia coli (STEC) food-borne infections are reported worldwide and represent a serious problem for public healthcare. In the Russian Federation there is little information on epidemiology and etiology of STEC-infections as well as on molecular-genetic peculiarities of STEC pathogens. Objective: Our aim was to describe a food-borne outbreak as hemorrhagic colitis (HC) along with hemolytic uremic syndrome (HUS), enterocolitis, and acute gastroenteritis in children in St.-Petersburg in 2013. Methods: Epidemiological, microbiological, molecular-genetic and bioinformatiс methods were applied. Results: Objects to study were clinical specimens, milk and food samples, as well as STEC strains isolated during the outbreak. The outbreak of food-borne infection was found to be caused by STEC-contaminated raw milk as confirmed by epidemiological analysis, detection of STEC DNA and isolation of relevant pathogens in milk and sick children fecal specimens. The whole-genome sequencing revealed two groups of pathogens, E. coli O157:H7 and E. coli О101:H33 among collected strains. Group I strains were attributed to the previously known sequence type ST24, while group II strains belonged to the previously non-described sequence type ST145. In strain genomes of both groups there were identified nucleotide sequences of VT2-like prophage carrying stx2с gene, plasmid enterohemolysin gene, and gene of the STEC main adhesion factor intimin. Gene of intimin gamma was identified in E. coli O157:H7 strains and intimin iota 2 in E. coli O101:H33 strains. The latter previously was identified only in enteropathogenic E. coli (EPEC) strains.Conclusion: The additional knowledge of epidemiology and biology of STEC pathogens would assist clinicians and epidemiologists in diagnosing, treating and preventing hemorrhagic colitis.

Objective: The aim of the study was to evaluate the diagnostic value of specific and nonspecific scoring systems Tolstoy–Krasnogorov score, Ranson, BISAP, Glasgow, MODS 2, APACHE II and CTSI, which used at urgent pancreatology for estimation the severity of acute pancreatitis and status of patient. Methods: 1550 case reports of patients which had inpatient surgical treatment at Road clinical hospital at the station Krasnoyarsk from 2009 till 2013 were analyzed. Diagnosis of severe acute pancreatitis and its complications were determined based on anamnestic data, physical examination, clinical indexes, ultrasonic examination and computed tomography angiography. Specific and nonspecific scores (scoring system of estimation by Tolstoy–Krasnogorov, Ranson, Glasgow, BISAP, MODS 2, APACHE II, CTSI) were used for estimation the severity of acute pancreatitis and patient’s general condition. Effectiveness of these scoring systems was determined based on some parameters: accuracy (Ас), sensitivity (Se), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV). Results: Most valuables score for estimation of acute pancreatitis’s severity is BISAP (Se — 98,10%), for estimation of organ failure — MODS 2, (Sp — 100%, PPV — 100%) and APACHE II (Sp — 100% PPV — 100%), for detection of pancreatonecrosis sings — CTSI (Sp — 100%, NPV — 100%), for estimation of need for intensive care — MODS 2, (Sp — 100%, PPV — 100%, NPV — 96,29%) and APACHE II (Sp — 100%, PPV — 100%, NPV — 97,21%), for prediction of lethality — MODS 2, (Se — 100% Sp — 98,14%, NPV — 100%) and APACHE II (Se — 95,00%, NPV — 99,86%). Conclusion: Most effective scores for estimation of acute pancreatitis’s severity are Score of estimation by Tolstoy–Krasnogorov, Ranson, Glasgow and BISAP. Scoring systems MODS 2, APACHE II high specificity and positive predictive value allow using it at clinical practice.

Background: A current etiological and pathogenic opinion about human health disturbance thereupon extreme factor effects is shown that this cause is principal mechanism of regulatory system (neuroimmunoendocrine complex) distress. In endocrine link occurs hormonal disbalance in hypothalamus-hypophysis axis, physiological interrelation disturbances in central – peripheral gland system (hypophysis-adrenal, hypophysis-thyroid) and metabolism abnormalities subsequently. Objective: Our aim was to determine the particular content of adrenocorticotropic and thyrothrophin hormone, cortisol, thyroxin and triiodthyronine features at law order staff in dependence from professional loading. Methods: It’s provided two investigation series among law order staff groups — combatants, ordinary policemen and military school students. The investigation period for all people corresponds to combat mission beginning and its finish. In blood serum an adrenocorticotropic (ACTH) and thyrothrophin (TSH) hormone, cortisol, thyroxin (Т₄) and triiodthyronine (Т₃) levels were determined. Results: A higher ACTH and TSH levels detected at combatants in both investigation series. A cortisol, Т₄ and Т₃ at combatants before military mission were least in comparative with other groups, but after mission it indexes were largest. Conclusion: Prolonged changes of endocrine secretory function that lead to hormonal disbalance can result to adaptation derangement. In connection with it in medical providing system for person that undergo extreme negative professional factors it’s necessary create a special endocrine link  with the view of organism resistance and life viability to extreme emergency factors and for prevention of pathological conditions.

Objective: Our aim was to investigate the influence of thymic polypeptides on pain sensitivity and to analyze a possible role of the opioid system in the implementation of the analgesia caused by immobilization stress. Methods: The study was performed on male Wistar rats at the Moscow state University named after M. V. Lomonosov. We studied effects of thymus peptides: thymuline (0.15 mg/kg), fraction 5 thymosin (0.25 microgram/kg) and tactivin (0.5 mg/kg) on pain sensitivity in rats using test «tail flick» without stress, with acute (3 h) and sub acute (12 h) immobilization stress. The comparison groups were animals treated with saline and spleen polypeptides. Results: It is shown that preparations of thymus increase the threshold of pain sensitivity in the intact animals. Immobilization stress duration 3 and 12 h in thymus peptides treated rats caused a less pronounced increase in pain threshold than in the control groups (immobilization stress 3 h: tactivin — р=0.025, thymuline — р=0.022, fraction 5 thymosin — р=0.033; immobilization stress 12 h: tactivin — р=0.034, thymuline — р=0.027, fraction 5 thymosin — р=0.036.). The opioid receptor blocker naloxone (1 mg/kg) did not completely block the stress-induced analgesia, indicating the presence of both opioid and non-opioid components in this state. In thymus peptides treated rats, opioid component was less pronounced than in the control groups (tactivin — р=0.031, thymuline — р=0.026, fraction 5 thymosin — р=0.029). Conclusion: Pre-activation of the opioid system by the thymus polypeptides leads to an increase in the share of non-opioid component of the stress-induced analgesia and prevents the depletion of the opioid system in immobilization stress.