Multiple sclerosis (MS) is an autoimmune and neurodegenerative disease of unknown etiology. Leukocyte infiltration of brain tissue and the subsequent inflammation, demyelination, axonal damage, and formation of sclerotic plaques is a hallmark of MS. Upregulation of proinflammatory cytokines has been suggested to play an essential role in regulating lymphocyte migration in MS. Here we present data on serum cytokine expression in MS cases. Increased serum levels of IL-17 and IL-23 were observed, suggesting activation of the Th17 population of immune effector cells. Additionally, increased levels of IL-22 were observed in the serum of those with acute phase MS. Unexpectedly, we observed an upregulation of the serum chemokine CCL27 in newly diagnosed and acute MS cases. CCL27 is an inflammatory chemokine associated with homing of memory T cells to sites of inflammation. Therefore, its upregulation in association with MS suggests a potential role in disease pathogenesis. Our data supports previous reports showing IL-17 and -23 upregulation in association with MS and potentially identify a previously unknown involvement for CCL27.

Spondylodiscitis is an inflammatory disease of vertebral structures involving intervertebral discs and adjacent vertebral bodies and joints. The main complaint is back pain that is known to be the most prevalent complaint in the general population. Diagnosis of spondylodiscitis is difficult and is often characterized by delay from the debut of symptoms. It is due to the rarity of the disease and non-specificity of its symptoms. The aim was to determine the basic principles of early diagnosis of pyogenic spondylodiscitis. In the present study performed in Kazan City clinical hospital №7, a retrospective analysis of 7 cases of spondylodiscitis during the period from may 2014 to September 2016 was performed. The diagnosis was maid with the use of neuroimaging. In most cases, the lumbar spine was affected. The most common presentation was pain syndrome, moderate to severe. Delay in making a diagnosis from the beginning of the disease was 86.2 days. After antibiotic therapy all patients noted improvement. The study demonstrated that early diagnosis of spondylodiscitis remains a challenge and at the same time requires timely adequate treatment with antibacterial agents. Magnetic resonance imaging is a method of choice for making a diagnosis.

ТрудносТи и ошибки в диагносТике герпесвирусных нейроинфекцийТаТьяна ВсеВолодоВна МаТВееВа, докт. мед. наук, проф. кафедры неврологии, нейрохирургии, медицинской генетики ГБОУ ВПО «Казанский государственный медицинский университет» Минздрава РФ, Казань, Россия, тел. (843) 237-93-23 Эдуард ЗакирЗяноВич якупоВ, докт. мед. наук, проф., зав. кафедрой неврологии, нейрохирургии, медицинской генетики ГБОУ ВПО «Казанский государственный медицинский университет» Минздрава РФ, Казань, Россия, тел. (843) 272-03-40, e-mail: ed_yakupov@mail Реферат. Источником диагностических ошибок при герпесвирусной инфекции, протекающей с поражением нервной системы, является ее редкость. Имеет значение также недостаточная информированность врачей о клинических формах и вариантах течения герпесвирусной нейроинфекции, методах диагностики, отсрочен-ность или отсутствие нейровизуализационных изменений. В статье проводится анализ трудностей и ошибок, с которыми приходилось сталкиваться при подходе к диагнозу герпесвирусной инфекции. Ключевые слова: герпесвирусная нейроинфекция. Difficulties anD mistakes of Diagnosing in herpetic neuroinfectionTaTyana V. MaTVeeVa, eduard Z. yakupoV, IrIna F. khaFIZoVa, albIna r. khakIMoVa, regIna F. MullayanoVa, leysan a. khalIToVa Abstract. Cause of diagnostic mistakes in herpes virus infection with affection of the nervous system, is its rarity, lack of awareness of physicians about the clinical forms and variants of the herpes virus neuroinfections, methods of diagnosis, delayed or absence of neuroimaging changes. The article analyzes the difficulties and mistakes encountered during the approach to the diagnosis of herpes virus infections.

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Реферат. В статье приведен обзор литературы, касающийся особенностей течения, клинических проявлений и диагностики хронической формы клещевого энцефалита. Подробно изложены версии развития патологического процесса и рассмотрены такие варианты патогенеза, как длительная, немая персистенция вируса в организме вследствие поражения клеток глии; затронуты вопросы сохранения в организме человека вирусного генома и пути его «активации». В статье приведена классификация хронической формы инфекции с обзором вариантов течения заболевания. Изложены особенности клинических проявлений со стороны нервной системы и методы лабораторной диагностики инфекции. Также описаны нейровизуализационные особенности клещевого энцефали-та и приведены рисунки из собственного наблюдения, где томографическая картина имела вид множественного поражения белого вещества головного мозга. Ключевые слова: хроническая форма клещевого энцефалита, патогенез, клиническая картина, лабораторная диагностика, магнитно-резонансная томография. ChroniC tiCk-born enCephalitis: the CliniCal and diagnostiCs features (literature review)IrIna F. KhaFIzova, vIldan Kh. Fazylov, Eduard z. yaKupov, TaTyana v. MaTvEEva, albIna r. KhaKIMova, rEgIna F. MullaIanova Abstract. A review of the literature concerning the characteristics of the course, clinical presentation and diagnosis of chronic forms of tick-borne encephalitis is presented. Detailed version of the pathological process is expounded and reviewed the pathogenesis of a long silent persistence of the virus in the body as a result of the defeat of the glial cells: discussed issues of preservation of the viral genome and the ways of the "activation". The article presents the classification of the chronic form of infection with a review variants of the disease. Presented clinical manifestations of the nervous system disorders and laboratory diagnostic of infection. Also described neuroimaging features of tick-borne encephalitis, and presented our observations, where the tomographic picture revealed multiple white matter lesions in the brain.