Corneal Ulcers (Infectious Keratitis)

Microbial keratitis is an infectious process that occurs due to the proliferation of microorganisms (bacteria, fungi, viruses, and parasites) and associated inflammation and tissue destruction. Smears and cultures are indicated for the isolation of microorganisms and for making the correct diagnosis and immediate initiation of antimicrobial therapy, especially in cases where corneal infiltrate is chronic, large, deep, or atypical. Microbial keratitis is considered a vision-threatening ocular emergency. Therefore, this chapter, which consists of almost all cases studied before and after treatment, highlights the importance of early recognition, isolation of specific microorganisms, and sensitivity-based therapy. Also, the evaluation of these cases helps to show the appearance of the eye after the therapeutic treatment and demonstrates the emergency of immediate surgery to save the eyeball in cases where medical treatment is ineffective. The authors have summarized the treatment options they have used for bacterial, fungal, acanthamoeba, and herpetic keratitis cases.

Peculiarities of interaction of high and low virulent strains of tick-borne Encephalitis virus of the Far Eastern subtype with human blood leukocytes

In this work, it was necessary to show the first stage of the interaction of the tick-borne encephalitis virus with blood cells, during which the selection of virus strains capable of successful assembly of virions occurs.The aim of the work: to show ex vivo the features of interaction of strains TBEV with different molecular genetic structure and virulence with human blood leukocytes.Materials and methods. The donor’s venous blood was infected ex vivo with the TBEV using the highly virulent strain Dal’negorsk and the low-virulent strain Primorye-437. Virus accumulation in experimental blood samples was observed after 15 min, 30 min, 1 h, and 24 h of exposition. The indication of the virus, shown by different methods of laboratory diagnostics (ELISA, PCR, IFA, titer of the infectious virus), made it possible to identify the characteristic features of the initial stage of the infectious process caused by these strains TBEV.Conclusion. The highly pathogenic strain Dal‘ has demonstrated the ability to quickly penetrate into leukocytes in 15 minutes, and, therefore, at the initial stage of the infectious process, to implement the mechanisms of its “escape” from immune supervision. The low-virulent strain P-437, on the contrary, showed the ability to stay on the surface of leukocytes for a long time, penetrating into them only after 24 hours of exposure, immediately influencing the cells of the immune system, which can lead to rapid elimination of the virus from the body.

Bone and Joint Infections: The Role of Imaging in Tailoring Diagnosis to Improve Patients’ Care

Imaging is needed for the diagnosis of bone and joint infections, determining the severity and extent of disease, planning biopsy, and monitoring the response to treatment. Some radiological features are pathognomonic of bone and joint infections for each modality used. However, imaging diagnosis of these infections is challenging because of several overlaps with non-infectious etiologies. Interventional radiology is generally needed to verify the diagnosis and to identify the microorganism involved in the infectious process through imaging-guided biopsy. This narrative review aims to summarize the radiological features of the commonest orthopedic infections, the indications and the limits of different modalities in the diagnostic strategy as well as to outline recent findings that may facilitate diagnosis.

ASSESSMENT OF ANTITOXIC AND ANTI-INFECTIOUS ACTIONS OF THE EXPERIMENTAL PREPARATION

In the course of the research, the antitoxic and anti-infectious effects of the developed drug were determined on white mice and white rats. To assess the antitoxic effect in the experiment on white rats, cadmium damage was modeled, followed by taking into account the antidote activity. An increase in the survival rate of animals receiving the drug was found – 60 % versus 40 % in the control, higher hematological indicators: the content of hemoglobin, erythrocytes and leukocytes in the blood of experimental animals was higher than similar control values, respectively, by 3.8, 15.3 and 16,4 %. The anti-infectious effect of the feed additive was determined during the experiment on infecting white mice with the causative agent of Escherichiosis – E. coli (strain "KB-1"). It was found that the introduction of the study drug into the diet of infected animals smoothed the clinical picture of the infectious process, had a hemoprotective effect: the content of erythrocytes, leukocytes, neutrophils, lymphocytes, neutrophils in the blood of experimental animals exceeded the control values, respectively, by 2.5, 13.6, 16, 7, 14.3, 28.6 %. The results of the investigated subject showed that the investigational drug has a well-pronounced antitoxic and anti-infectious effect.

A controversial role of neutrophils in tuberculosis infection pathogenesis

Tuberculosis (TB) continues to be an important and unresolved medical problem. About a quarter of mankind is infected with Mycobacterium tuberculosis, and about 5–10% of these people eventually develop TB. Macrophages and CD4+ T cells are considered the key cells providing defense against TB infection. The role of neutrophils in TB is less well defined. Neutrophils are short-lived granulocytes among first migrate into the infectious lung tissue and phagocy tose mycobacteria. On the one hand, there is evidence for protective role of neutrophils in TB released via anti-microbial peptides inhibiting mycobacterial growth, up-regulation of CD4+ T-cell activation, and dendritic cell migration in the lymph nodes. On the other hand, infection of genetically TB susceptible animals leads to an overwhelming lung neutrophil inflammation, development of necrotic granulomata, and a rapid death. Neutrophils act directly or indirectly on mycobacteria by different oxidative or other reactions including neutrophil extracellular traps (NETs) formation. Phagocytosis of mycobacteria by neutrophils is accompanied by the production of pro-inflammatory factors, thus making neutrophils active participants of inflammation in all stages of the infectious process. Finally, neutrophils die by apoptosis or necrosis. Necrosis of neutrophils, which is activated by reactive oxygen species, also prolongs the inflammation. In this way, there is strong evidence that neutrophils are the cells involved in the transition of infection to the terminal stage, participating in lung tissue destruction. Although neutrophils evolutionary developed many ways to resist pathogens, it is likely, that neutrophils do not possess sufficient anti-mycobactericidal capacities due to the development of many adaptations allowing mycobacteria to survive inside the neutrophils. Neutrophils effectively phagocytose but poorly kill mycobacteria, thus hiding bacilli from more efficient killers, macrophages, and playing the role of the “Trojan Horse”. In this review, we summarize the data on the involvement of neutrophils in TB inflammation. We discuss their ambiguous role in pathogenesis which depends upon mycobacterial virulence, host genetics, dynamics of migration to inflammatory foci, and persistence during initial and chronic stages of the infectious process.

Pediatric Sciatic Neuropathy Secondary to Subacute Ischial Osteomyelitis: A Case Report

Sciatic neuropathy (SN) is rarely encountered in the pediatric population. The causes of this mononeuropathy are either infectious, immune mediated, toxic, or infiltrative (tumoral). In this article, we presented the case of a 7.5-year-old male child who presented to the emergency department with a painful right lower limb. Magnetic resonance imaging confirmed the diagnosis of subacute osteomyelitis of the ischium, which extended toward the external hip rotators and infiltrated the tissues around the sciatic nerve. Treatment with intravenous antibiotics (flucloxacillin 50 mg/kg/d and gentamicin 10 mg/kg/d) rapidly improved the child's condition and relieved neurological symptoms within a few days. Traumatic and iatrogenic injuries are the most common causes for SN. To our knowledge, this presented case is the first to describe SN due to an infectious process following subacute osteomyelitis.

ANXIETY DISORDERS IN SOMATIC HOSPITAL PATIENTS "BEFORE" AND "AFTER"

В статье анализируются тревожные расстройства, возникающие на фоне вирусной пневмонии, вызванной коронавирусом SARS-CoV-19. Прослежены частота проявлений, формы нарушений, особенности тревоги во время инфекционного процесса у пациентов с тяжелыми соматическими заболеваниями. Отмечены изменения тревожных нарушений в процессе затягивания пандемии, свидетельствующие о снижении адаптационных способностей у людей с комбинированными соматическими нарушениями. The article analyzes anxiety disorders that occur against the background of viral pneumonia caused by the SARS-CoV-19 coronavirus. The frequency of manifestations, forms of disorders, features of anxiety during the infectious process in patients with severe somatic diseases were traced. Changes in anxiety disorders in the process of delaying the pandemic were noted, indicating a decrease in adaptive abilities in people with combined somatic disorders.

Disorders of the Immune System and Susceptibility to Various Diseases in Children with Diabetes Mellitus

The article examines the features of emerging disorders of the immune system in children suffering from diabetes mellitus, as well as the susceptibility of such children to various diseases. The authors note that children with diabetes have some disorders of the immune system, which, combined with high glycemia, increase the risk of infections and their severity, and they should be immediately detected and treated. Infections, even typical childhood diseases, significantly interfere with glycemic control. As a result of the infectious process, the level of counter-regulating hormones, cortisol, adrenaline and growth hormone increases, which leads to increased neoglycogenesis, glycogenesis and increased insulin resistance. This increase in insulin resistance requires adjustment of the patient's usual insulin dose, both basal and bolus. There are usually several hours or days before such a need arises, and it may take time to increase the dose, which can lead to hyperglycemia during this period. The presence of an infectious condition, in turn, increases blood glucose levels and increases the risk of decompensation, so pediatricians should be warned against the need to strengthen monitoring and insulin therapy. Patients with diabetes are often not fully vaccinated against various diseases. Vaccines are vital for these patients, significantly reducing the risk of infections and exacerbating the development of the underlying ailment.

Study of Riamilovir Activity Against SARS-CoV-2 Infection In Syrian Hamsters

The activity of the antimetabolic drug Riamilovir (Triazavirin®) was studied on a model of SARS-CoV-2 infection on Syrian hamsters. Infectious process was caused by the intranasal administration of the virus accumulated in the Vero-B culture with a concentration of 4.25×104 TCID50, in a volume of 26 µl/hamster. The effects of the drug at a dose of 20 mg/kg intraperitoneally daily in the midst of the infectious process were traced to accelerate the clearance of the virus in the lungs, prevent body weight loss and the severity of pulmonary edema, as well as preserve the mass of the spleen. The protective effects of Riamilovir on the structure of the lungs and brain are shown, it is suggested that the drug has the ability to penetrate the blood-brain barrier. It was concluded that Riamilovir has antiviral activity against SARS-CoV-2.

Assessing risks of developing and persistence of infectious process in knee joint replacement

Despite of intensive work on improving endoprosthetic replacement constructions, using minimally invasive techniques, developing methods of prevention for and treatment of periprosthetic joint infection, relapse of infection process can reach up to 52 % after treatment.The aim of the study: to show the importance of identifying the risks of development and recurrence of periprosthetic infection after implantation of a knee joint endoprosthesis. A clinical case of the development of a deep periprosthetic infection in a patient after primary knee replacement and successful treatment of the resulting complication was demonstrated. The analysis of this case of an infectious complication using the proposed prognosis for the development of periprosthetic infection showed that before surgical treatment of the patient, the risk of an infectious process was not assessed, and appropriate preventive and therapeutic measures were not carried out.Materials and methods. In the treatment of developed periprosthetic infection of the knee joint, the author’s algorithm for choosing surgical tactics was used, which allowed to determine the high risk of recurrence of periprosthetic infection, evaluate additional criteria and choose the optimal type of surgical intervention – two-stage revision endoprosthetic, which allowed to stop the infectious process.New was the use of the proposed prognosis for the development of periprosthetic infection and the algorithm for choosing surgical tactics for periprosthetic infection, which make it possible to determine the necessary preventive measures to reduce the risk of an infectious complication and to apply the optimal type of surgical intervention to relieve periprosthetic knee infection.