The review shows the role of the intestinal microflora in the development of atherosclerosis, coronary heart disease, overweight / obesity and diabetes. It is well known that consumption of foods rich in saturated fats and cholesterol (meat, egg yolk and milk products with high fat content) is associated with an increased risk of cardiovascular disease. However, new studies show that the atherogenic properties of these products are also due to the high content of L-carnitine and its structural analog choline, which, after entering the body is metabolized by intestinal bacteria up to trimethylamine (TMA), and then converted in the liver to trimethylamine-N-oxide (TMAO) having direct atherogenic action. It was found that elevated levels of TMAO increases the risk of myocardial infarction, stroke, cardiac failure and death, including the common causes. In the center of international attention is also the question of the role of the intestinal microbiota imbalance in the development of insulin resistance, endothelial dysfunction, increase of the adhesive properties of macrophages, the appearance of dyslipidemia, elevated blood pressure, overweight. Attention of the doctors is focused on the extremely importance of maintaining a normal balance of the intestinal microbiota to prevent cardiometabolic diseases apart from implementation of already well-known and generally accepted preventive measures.

In the paper are discussed the long-term results of the author and his collaborators, as well as literary data. The questions of classification of intrauterine infections (IUI) are discussed and the principles of their laboratory and morphological diagnostics. Original charts of different variants of intrauterine infect are cited. Brief characteristics of well and less known etiological forms of IUI are presented. Special attention is devoted to different clinical outcomes of intrauterine infect: starting with preterm stillbirth till apparently healthy baby with latent infection which can unfavorable influence upon the course of different pathological processes much later. The questions which need further complex study are formulated.

For the purpose of clinical laboratory and virologic characteristics of chronic HCV-infection, depending on the gene polymorphisms of IL-28B were examined 104patients. In 70 patients (50 – with genotype 1 and 20 – with genotypes 2 and 3) treated with pegylated interferon-α2a (PIFN) and ribavirin (RBV), evaluated the frequency of sustained virologic response (SVR). According to the results of the study it was found that the patients with HCV had a sufficiently high frequency of registration of «favorable» prognostic single nucleotide polymorphisms (SNPs) rs12979860 CC (23.1%) and rs8099917 TT gene IL-28B (50,9%). On therapy of PIFN and RBV SVR frequency rate in patients with chronic hepatitis C (genotype 1)
and SNPs CC rs12979860 (82,4%) was significantly higher than the efficiency of treatment in patients without this polymorphism (45,5%). In chronic HCV-infection (genotypes 2 and 3) SVR was observed significantly more frequently in patients who have both IL28B CC polymorphism rs12979860, and TT for rs8099917 (88,8%).

The aim: to study the psycho-vegetative status of the quantitative contents of serotonin in blood platelets in patients after the Ixodes tick-borne borreliosis, to evaluate the clinical efficiency treatment by adamantilfenilamin of postinfection asthenia.

Materials and methods: there was clinical supervision and inspection conducted of 118 convalescents borreliosis after a course of inpatient treatment. All patients were examined using psychovegetative tests. Platelet serotonin concentration levels were measured by enzyme immunoassay. For the treatment of postinfectious asthenia 36 convalescents received adamantilbromfenilamin in a dose of 100 mg for 25 days.

Results: when tested convalescents marked change in indicators of emotional and personality disorders. Quantitative study of blood platelet serotonin content revealed a significant decrease in this indicator relative to control values. Study the correlations between obtained when testing the psycho-emotional parameters and platelet serotonin levels showed a negative correlation between serotonin and an indicator of reactive anxiety (R = -0,81, p <0,05). To correct these violations convalescents with severe asthenia postinfection were treated adamantilfenilamin. Established clinical efficacy contributing to the improvement of the quality of life.

Conclusion: the research of neurotransmitter serotonin in patients during the convalescence period after borreliosis possible to evaluate the extent of potential damage to the nervous tissue in the inflammatory process and its involvement in the formation of anxiety and depressive symptoms. adamantilbromfenilamin can be recommended for rehabilitation patients with residual effects in the form of postinfectious asthenia.

The objective was to develop a model for prediction of trichinellosis severity in the acute period of the disease based on the minimum but sufficient number of the most common and always investigated symptoms and syndromes that do not require a high qualification of medical staff and high-tech instrumental methods of a research. On the basis of a study of 106 case histories of trichinellosis patients a mathematical discriminant model was offered, based on some early clinical and laboratory signs (body temperature, presence of a swollen face, pain when moving a tongue, eosinophilia and signs of myocarditis development), which has a sufficiently high information capacity (86,8%) and is statistically significant (p<0,001) for predicting severity of trichinosis.

Aim: to study of the frequency of isolation and determination of the spectrum of enterovirus serotypes excreted by children living in the North-Western region of Russia and children arriving in this region from unsafe territories.

Materials and methods: we investigated 832 samples of children with acute flaccid paralysis and 1153 samples of healthy children from institutions and migrants’ families. Isolation and identification of enteroviruses were conducted according to WHO recommendations.

Results: enteroviruses of different serotypes were detected in all categories of children. The percentage of detection of enteroviruses in the samples of children from institutions and from migrants’ families was significantly higher than in those of patients with acute flaccid paralysis. In children living in the North-West of Russia we detected enteroviruses ECHO 6, which were not found in children who arrived in the North-Western region of Russia. Enteroviruses ECHO 30 were revealed in resident children more frequently than in children from migrants’ families. Enteroviruses of serotypes which had not circulated earlier in the North-Western region of Russia were revealed in the samples of children from migrants’ families. They were Coxsackieviruses A 13, 17, 24 and enterovirus 99 (species C), enteroviruses 75 and 120 (species B and A).

Conclusion: the difference in the spectrum of enterovirus serotypes excreted by resident children and children who arrived in the North-Western region of Russia from unsafe territories was shown. The obtained data will enlarge the scope of knowledge about enterovirus circulation among various groups of population during different periods of time on different territories.

The objective: to assess clinical features of food-borne diseases in patients with H. pylori infection.

Materials and methods: 98 patients with an acute intestinal infection were examined for the presence of helicobacter pylori infection. Clinical and laboratory parameters were estimated in 82 subjects. Patients were distributed to two groups: 41 H. pylori-infected patients (H. pylori IgG antibodies and DNA in feces) and41 H. pylori-noninfected patients.

Results: in patients with Helicobacter pyloriinfection a higher range of leukocytosis were indicated: 10,7±2,5×109/l vs 8,6±2,6×109/l respectively, р<0,05, and ESR – 16,2±8,7 mm/h vs 11,2±7,8 mm/h respectively, p<0,05. In H. pyloriinfected patients number of bowel movementsand vomitswere indicated more often than those in the control group: (9,4±5,3 vs 6,7±3,6 times/day respectively, р<0,05; and 4,8±3,4 and 1,0±1,4 times/day, р<0,05). Normalization of bowel function was observedearlier in control group compare with H. pylori-infected patients (3,0±0,7 day of disease and 4,4±1,4 day of disease respectively, in р<0,05).

Conclusions: H. pylori-infected patients had clinically and laboratory more severe presentation of acute intestinal infection. Clinical improvementin this patientsoccurredat a later date.

Objective: the aim of our work is to describe a condition of the reactive astrocytes in the white matter in preterm and term infants with infectious diseases.

Materials and methods: postmortem investigation of periventricular white matter performed on material from 56 children, 35 of them were born preterm (24–36 weeks gestation).
Twenty-five children diagnosed with various infectious diseases, other have had clinical signs of hypoxic-ischemic brain injury. Immunohistochemical expression of glial fibrillary acidic protein was used as a marker for reactive astrocyte. We estimated the degree of the astrocytes reactivity, according to the mean percentage of the marker expression in anterior and posterior horns of the lateral ventricles: stage 0 – 0–1,4%, I stage – 1,5–6%, II stage – 6,1–15%, III stage – above 15,1%.

Results: comparison of the morphometric marks of the white matter showed no significant differences between groups with infections and hypoxic pathology. In 54.84% of children born at 24–33 weeks gestation determined weak stage of astroglial reactivity. Whereas due to maturation of astrocytes in children born after 34 weeks of gestation more common moderate and severe stages of astrocytes reactivity (collectively, 69,6%) was detected. Severe stage of the reactive astrocytes accompanied by the development of necrotic lesions in the periventricular white matter in 64,3% of cases, in our opinion, as a result of progressive degenerative process in glial cells. The remaining cases relates to the severe telencephalic leukoencephalopathy, perhaps some of them may contain undiagnosed necrosis outside of the white matter regions estimated in our study.

Conclusion: morphometric study of the periventricular white matter using a marker of astrocytes allows to assess their reactive changes and to perform differential diagnosis of main forms of white matter injury in infants.

The purpose of researchis the determiningthe etiological structure ofintrauterine infections in Saint-Petersburg pediatric patients, pregnant women andinfants born to them using a variety of virological methods.

Methods: serum from 164 children aged from 1 month to 14 years with diagnosis of «intrauterine infection». Serum from 80 pregnant women, collected in each trimester (total – 240 samples, their 42 children (at the age of 1–2 and 4–6  months of life, total – 82 samples). Immunoglobulin Mand G (IgM and IgG)to herpes virus type 1, cytomegalovirus (CMV), Toxoplasma gondii, mycoplasma and chlamydia, rubella, Epstein-Barr virus (EBV) and parvovirus B19, as well as IgG avidity,were determined by ELISA in all these samples. Theimmunoblot (Western blot), using the «Immunoblot2000» with test kits from «Euroimmun AG» (Germany), was applied to confirm cases. Statistical analysis wasperformed with theprograms Microsoft Excel, Statistica6.

Results: cytomegalovirus, herpes virus 1st type and Epstein-Barr virus infections are dominate in the structure of intrauterine ones (45%, 23% and 14%, respectively). Laboratory evidence ofreactivationof cytomegalovirus (35% ofpregnant womenin the 2nd and/or 3rd trimesters) and acuteparvovirus infection (15% of cases) were found. Specific IgM to cytomegalovirus were detected in 6,2% ofchildren in the firstsix months of life.

Conclusions: with the aim of early detection of cytomegalovirus reactivation and acute parvovirus infection it isnecessary to monitor pregnant women with the definition of specific IgM, IgG and avidity IgG. The procedure to using immunoblotting in the diagnosis of intrauterine infections
needs to be further study.

Medical aid improvement in the cases of congenital infections (CI) is one of the most important problems in modern obstetrics and perinatology. The true incidence of congenital infections is not known. One of the reasons for this situation is the lack of common approaches to diagnostics and registration of congenital infections. Use of a standard definition of CI will allow providing the common approaches to diagnostics and registration of congenital infections both in maternity hospitals and hospitals for children.

Diagnostic of active tuberculosis among HIV – infected people is difficult problem, demanding of significant healthcare costs.

The objective: to evaluate the cost-effectiveness of different diagnostic scenarios detecting tuberculosis among HIVinfected.

Material and methods: the evaluation was carried out through modeling, from the health care system perspective, in cohorts with different CD 4+ counts (<200, 200–499, >500). The three scenarios were examined: (1) «Base» – the current TB diagnostic scheme in the Russia; (2) «Addition» – the «Base» scenario augmented by Xpert/Rif; (3) «Replacement » – only one Gene Xpert/Rif.

Results: using «Addition» scenario in CD 4+cohort <200, allows to detect 8 additional TB patients per 1000 HIV-infected people, significantly increases the number of effectively treated patients, including patients with initial rifampicin drug resistant, prevents 5 deaths, reduce opportunity oftransmission TB and further spread TB in population. Additional costs per one additional effectively treated patient, identified in the «Addition» scenario, compared to «Basic», is 1130 thousand rubles, additional costs per one prevented death is 943 thousand rubles. Using the algorithm «Replacement » can lead to significant diagnostic delays, its use has
neither clinical nor economic feasibility.

Conclusions: adding Gene Xpert MBT/Rif to the TB diagnostic
algorithm is economically feasible in patient cohort with CD 4+ <200 cells/ml.