Inflammatory bowel diseases is a large group of nosologic forms such as more frequent acute intestinal infection, especially dysentery, chronic inflammatory diseases such as ulcerative colitis and Cron’s disease with lesions of the bowel, antibiotics-associated and ischemic colitis. There are some difficulties in differential diagnostics of inflammatory bowel diseases despite their widespread and tendency to more frequent occurrence. On the one hand, this is largely due to similar clinical picture which is most often presented by diarrhea and abdominal pain of different degree of intensity, and, on the other hand, by the disadvantages of laboratory diagnostics techniques. The article discusses the problem of clinical and morphological aspects of the differential colitis diagnostics with more detailed characteristics of fibrinous colitis of different etiology. The morphological differential diagnostics criteria, as well as a summary table of comparative characteristics of antibiotics-associated pseudomembranous colitis, dysentery, invasive candidiasis of bowel, ulcerative colitis and ischemic colitis have been presented. The importance of an integrated approach to the differential diagnostics of inflammatory bowel diseases, based on the analysis of anamnesis, clinical-laboratory and morphological data is stressed. The algorithm for optimizing of differential diagnostics of inflammatory bowel diseases with recommendations for qualitative morphological examination has been suggested. 

Currently diagnosis of infective endocarditis remains a challenge for physicians. The disease is diagnosed within 1 month after primary visit to a doctor only in 26% of cases, from 1 to 3 month – 40% of patients, and 34% – from 4 months to 1 year. In 10% of cases infective endocarditis was diagnosed at autopsy. Late diagnosis of infective endocarditis is associated with a polymorphism of a clinical picture, due to the development of systemic infection with embolic, thrombohemorrhagic, immune mechanism of damage to organs and tissues. The authors provide information about clinical «masks» of the disease, the most common of which are the mask of pneumonic, rheumatological, renal, cardiac, neurological and hematological diseases. 

The purpose of work – to acquaint specialists with the clinical picture of infectious endocarditis. The multidisciplinary nature of the problem of infective endocarditis requires orientation in her clinical picture primary care physicians and specialists in different fields. 

The article summarized the material on the epidemiology of Ebola virus disease published in foreign literature and epidemiological analysis of the Ebola virus disease on the basis of official statistics in three countries in West Africa (Guinea in comparison with Liberia and Sierra Leone). Features of its development was detected in particular the different of intensity, dynamics of morbidity and mortality in the general population and health workers, caused by the biological characteristics of the pathogen as well as socioeconomic factors. Revealed discrepancies between the levels of morbidity and mortality determine the need for further study of the causes of this phenomenon. 

Modern concepts of the influence of the proteins from viruses-etiological agents of flu – Influenzavirus A, B and C (Orthomyxoviridae) – on the development of different elements of the main disease pathogenesis are analyzed in the review. In particular, the short description of life cycle of Influenza viruses is alleguered with special attention to those its stages which are capable to modulate pathogenetic mechanisms. The interrelation between the structure of hemagglutinin receptor-binding site and virus tropism as well as the influence of the receptor-destroying virus proteins on this phenomenon is described. The mechanism of suppression of interferon production in the infected cell by virus NS1 protein is presented. The induction of apoptosis by nonstructural PB1-F2 protein of Influenza A virusis described. 

the purpose of the study. identify the epidemiological of chronic hepatitis B and C, especially in the general population and in patients with different clinical forms of tuberculosis for the period of 2008–2010, treated in the regional clinical TB dispensary Kirov; correlate these data with the frequency of detection of HBV markers and HCVinfections in donors as conditionally healthy population in the region. 

Materials and methods. A total of 6959 patients Kirov TB dispensaries in the age range 18–70 years. All patients were screened for markers of viral hepatitis C and B (anti-HCV and HBSAg ELISA). Of them, 537 (7,72%) patients with different forms of tuberculosis were diagnosed with chronic hepatitis B, C, or B + C. The diagnosis of chronic hepatitis B or C based on clinical and anamnestic data, the results of EGD, abdominal ultrasonography. The comparison group included 13,222 primary donors of 6 areas of the Kirov region is also examined for the presence of markers of viral hepatitis B and C for the period 2008–2011 Determination of HBsAg, anti-HBs, anti-HBc anti-HCV were determined by solid-phase ELISA; study of the epidemiological situation of chronic hepatitis B and C are carried out on the basis of the Center for Hygiene and Epidemiology in the Russian Federation and the Kirov region for the 1998–2013 biennium. (Form No 2). 

Results and conclusions. The study showed a trend toward stable growth on the incidence of HCV, a slight decrease in the incidence of chronic hepatitis B and a consistently high level of registration of patients with pulmonary tuberculosis, including smear-positive pulmonary forms in the general population of the region. CHC is prevalent among nosology chronic hepatitis in KO (77,2%). CHC also prevailed in the structure of morbidity in patients with tuberculosis as well as in the general population; CHB met in 2–2,8 times less compared to CHC (p <0,05). The tendency to increase the number of TB patients and mixed-hepatitis B + C. The incidence of chronic hepatitis B, C and mixed infection in the total group of patients with various forms of tuberculosis for 3 years was 7,72%, which is 10,2 times higher than in blood donors. 

Aim – to analyze causes of death of HIV infected subjects died in Lomonosov District of the Leningrad Region, Russia, in 1999-2011. 

Materials and Methods. A retrospective analysis of 118 autopsy results of all HIV-infected patients who died in hospitals of Lomonosov district of the Leningrad region, as well as those delivered to the autopsy department from homes or streets in 1999–2011. 

Results. Males were 76%, the middle age – 32,1±4,3 years. The HIV-infection was the cause of death in 53 subjects (49%). Tuberculosis was the major postmortem diagnosis in this group of patients (85%). Due to other diseases or have died a violent death 29 (27%) and 27 (24%) individuals correspondingly. From 62 patients deceased in hospitals 18% subjects died at first day of staying at hospitals, and 42% during first three days.
Antiretroviral treatment was prescribed to 9 patients. All of the were nonadherent to treatment and follow-up. Other study subjects were nonadherent to follow-up or never on follow-up. 

Conclusion. In almost half of subjects the death was due to progression of HIV-disease. All HIV-infected patients had poor adherence to follow-up and/or antiretroviral treatment. The results confirm the critical importance of timely and early detection of HIV-infected persons, regular follow-up and improving adherence to antiretroviral therapy among HIVinfected patients. 

Purpose: to evaluate epidemiologic situation as to meningococcal infection and reveal clinical-epidemiological features of the disease on the territory of Krasnoyarsk сity and Krasnoyarsk Krai at the present stage. 

Data and methods: The research gives the analysis of MI morbidity and mortality rates in children of the region according to official information from the Federal Service for Supervision of Consumer Rights Protection and Human Welfare in Krasnoyarsk Krai for the period 2000–2014. The work studies clinical and epidemiological features of the disease in 53 patients with the generalized form of meningococcal infection (GFMI) who were treated in the infectious disease department of the Regional Interdistrict Children’s Clinical Hospital of Krasnoyarsk for the period 2010–2014. 

Results: The epidemiological situation as to MI in Krasnoyarsk for the period 2000-2013 years is characterized by the signs of interepidemic period with morbidity rises in the winter-spring period. Children from 1 year to 3 years (54,7%) prevail over all MI diseased. The number of children in the first year of life decreased almost two times (from 40% to 20,7%). At the same time the proportion of children older than 4 years increased. The leading serotype among laboratory-confirmed cases of MI in Krasnoyarsk Krai is still the B group meningitis (64,7%). 

Conclusion: On the territory of Krasnoyarsk Krai the MI morbidity is sporadic. The generalized forms of meningococcal infection are characterized by early overt symptoms which make it possible to set a diagnosis. The clinical picture of the generalized forms of the disease almost did not change significantly. 

Graft-versus-host disease is a major complication of allogenic bone marrow transplantation. Beta herpes viruses’ role in pathogenesis and prognosis of graft-versus-host disease is significant. 

Objective: To study beta herpes viruses evidence in skin biopsy specimens in graft-versus-host disease patients. 

Material and methods: Clinical features of 50 patients with cutaneous graft-versus-host disease were examined. Cytomegalovirus and human herpes virus 6 DNA detection in skin biopsy specimens was performed by PCR. 

Results: Correlation between human herpes virus 6 and poor prognosis in graft-versus-host disease patients has been found. 

Conclusion: Beta herpes virus detection after allogenic bone marrow transplantation could be important in prognosis of graft-versus-host disease. 

The purpose of the study: the study of individual psychological characteristics of HIV-infected people. 

Materials and methods: we used the hospital anxiety scale and depression HADS, depression scale Beck and Zung.
The results of the study: According to the scale HADS subclinical forms of anxiety are more common in women (31,5±2,65%) than men (12,5±1,48 %), and, at the age of 20-29 years. Clinically evident anxiety occurs more often in women (19±1,34%) than men (14,5±2,1 %) in the age – men – 20–29 years, while for women 20–24. Subclinical (18±1,34%) and clinical (9±0,68%) forms of depression have also been noted in the female population in the age 3,8±0,32% of men and 14,1±1,21% in women. On a scale of Beck expressed signs of depression found in 34,8±2,4% of men aged 25–29 years and 43±2,83% of women aged 20–24. 

Conclusion: 

1. Our studies showed the presence of depressive and anxiety symptoms in a significant number of the surveyed HIV – infected. 

2. In the analysis of different age and sex groups of HIVinfected patients, found that anxiety and depression more likely in women in the age group 20-29 years. 

3. The obtained results can be used to develop methods of prevention of mental disorders. 

The results of clinical laboratory analysis conducted in 64 children with Epstein-Barr virus mononucleosis during the acute period and in different time follow-up observations are presents. It is shown that EBV-mononucleosis in children is accompanied by distinct changes of hemostasis, the Genesis of which play some role virusinduced autoimmune mechanisms, developing on the background of hyperactively immune system. The revealed correlation of data breaches with the severity of the infectious process. It was found that the criterion prolongation hemostatic changes are persistent viral activity. Interferon therapy in complex treatment of children, the sick EBV-mononucleosis, contributed to a more rapid regression of a number of clinical symptoms of disease and normalization gemostaziologicheskikh of indicators. Recommended expansion of the research program of follow-up of persons with EBV infection. 

Interleukin-6 plays a central role in antiviral immunity. However, the function of this cytokine in the pathogenesis of herpes zoster is unknown. 

The objective of this study was todeterminethe dynamicsof serum interleukin-6 level in HIV-infected patients with herpes zoster. 

55 patients with herpes zoster (30 HIV-positive and 25 HIV-negative) were included. Serum interleukin-6 levels were measured before acyclovir treatment, on the 3rd day of treatment and after healing of skin lesions. The clinical course and dynamics of laboratory data were also evaluated. 

The study showed that elevated serum levels of interleukin-6 were associated with HIV-positive status, severity of rash, fever anddecreaseof CD4-lymphocytes. Levels of interleukin-6 in HIV-infected patients were significantly reduced during herpes zoster treatment and reached the level of HIVnegative cohort.Interleukin-6 levels in complicated course of herpes zoster in HIV-infected patients with low CD4-lymphocyte count (less than 350 cells/ml) were significantly higher compared to levels in uncomplicated course of the disease. 

The purpose of research is analysis of clinical course and treatment results of patients with cholera in the Azov area. 

Materials and methods. During the period from 29.05.2011 to 19.08.2011 33 cases of cholera (32 adults and 1 child) and 25 vibrio carriers (22 adults and 3 children), which were caused by toxigenic strains of Vibrio cholera El Tor serogroup O1 Ogawa. 

Results. Likely factors of disease transmission in Mariupol are sea and river water, and the fish that were caught in the waters of the city. Typical and watery diarrhoea, vomiting, abdominal pain and lack of normal body temperature, dehydration syndrome, characterized clinical cholera for adults in most cases. The mean duration of diarrhoea was 6,6 days. At 46.9% observed atypical symptoms in 10 (31,3%) – abdominal pain (1 patient cramping in 7 cases, localized in the epigastria region, at 2-over stomach). In 5 patients (15,6%) had an increase in body temperature to 37,2–37,7 degrees Celsius. In 15 (46,9%) patients had severe nausea accompanied by vomiting. Easy for cholera was observed in 1 (3.1%), moderate – in 14 (43,8%), heavy – in 17 (53,1%) patients. Dehydration I level is set at 4 (12,5%), II – from 6 (18,7%), III – in 18 (56,3%), IV – 4 (12,5%) patients. Cholera outbreak was characterized by a predominance of severe disease and severe dehydration (III and IV), which was observed in 68.8% of patients. The decisive factor in the treatment of cholera patients was initiated in a timely manner rehydration therapy, in particular the introduction of the solution «Trisol». Against the background of rehydration therapy hyperkalaemia was observed in 9,4% of cases, vascular rehydration at 9,4%, the cell rehydration in 3,1% of patients. Fatal accidents cholera outbreaks have not been observed. 

Conclusion. Clinical diagnosis of cholera and the provision of medical care in the prehospital phase were poor, indicating the need for systematic conducting training seminars among experts of ambulance, as well as doctors of primary medical network. Cholera hospitals (or base hospitals) must be equipped with a mobile diagnostics (ultrasound, X-rays) and modern laboratory equipment. The required list of drug supply cholera hospitals should be expanded in view of possible complications and comorbidities.

Differential diagnosis disseminated diseases provides sarcoidosis and tuberculosis. Frequency of mistakes consists over 40% [Visel AA, 2013]. That’s why including of new diagnosis methods is weary important. Оbjective: to indicat diagnosis value of immunologic methods in differential diagnosis with sarcoidosis and tuberculosis. In the department of phthisiopulmonology were examined 66 patients with lung over 2013 to 2014. Complex of examination included: examination of the respiratory excretion material (sputum) for detection of MBT using laboratory methods, X-ray examination (computed tomography), histological examination after transbronchial biopsy of lung tissue. All of diagnosis were proved by histological and bacteriological methods. After complex of examination patients were divided in two groups: I group (n=32) – pulmonary TB; II group (n=17) – sarcoidosis II study. All of patients were examined with immunologic tests (tuberculin skin test (TST), Diaskintest® (DST) QuantiFERON ®-TB Gold (QFT) and T.-SPOT.TB test (T-SPOT). In the I group this tests was significant different positive results with QFT (78,1%), T-SPOT (71,9%), DST (81,3%) in comparison with negative results of this tests (p˂0,001). Diagnostic value was: TST (DSe – 84,4%, DSp – 40,0%, Dv – 70,2%, PVPR – 75,0%, PVNR – 54,5%); QFT (DSe – 74,2%, DSp – 88,2%, Dv – 79,2%, PVPR – 92,0%, PVNR – 65,2%); TB.SPOT (DSe – 80,6%, DSp – 87,5%, Dv – 83,0%, PVPR – 92,6%, PVNR – 70,0%); DST (DSe – 81,3%, DSp – 94,1%, Dv – 85,7%, PVPR – 96,3%, PVNR – 72,7%); Сonclusion: diagnostic value of immunologic tests QFT, TB.SPOT and DST was more significantly higher in comparison with TST. The use of immunological tests can help in differential diagnosis of tuberculosis and sarcoidosis. 

Efficiency of the telbivudine administration in the third trimestr of pregnancy for the prevention of perinatal transmission of hepatitis B virus

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