Introduction: To compare the features of the immune status in patients with chronic and complicated pyoderma in the course of complex pharmacotherapy using immunomodulators based on transfer factors and glucosaminylmuramyldipeptide. Materials and methods: A clinical examination of 107 patients with pyoderma, divided into three groups, was carried out. All individuals underwent immunological examination before and after etiopathogenetic treatment. The patients of the first group were additionally treated with a drug containing signaling immunoactive molecules (transfer factor) as an immunomodulator; the patients of the second group received glucosaminylmuramyldipeptide; and the patients of the third group received standard antibacterial therapy. Results and discussion: Prior to the beginning of pathogenetic therapy, the patients were found to lack non-specific mechanisms of antimicrobial protection; there was a decrease in the activity and intensity of phagocytosis: phagocytic index and phagocytic number of neutrophils by 1.2 and 1.3 times; the production of proinflammatory cytokines IL-6 increased by 2.3 times, IL-8 –by 2.1 times, and TNFa – by 2.4 times. The study of immunological parameters after the inclusion of immunomodulators into the therapy revealed an increase in the phagocytic activity of neutrophils, and the indicators of the NST test were close to the control ones. The production of proinflammatory cytokines in the blood serum was restored to the level of the healthy individuals. Normalization of the number of CD4+-, CD8+-, CD19+-cells was observed in 86.0 ± 3% of the patients. At the same time, against the background of the use of glucosaminylmuramyldipeptide, a more intensive recovery of all links of anti-infectious immunity was recorded in comparison with the group where transfer factor molecules were used. Conclusion: A drug based on glucosaminylmuramyldipeptide can be recommended as the drug of choice in non-specific immunocorrection for complex pharmacotherapy of pyoderma accompanied by secondary immune insufficiency, in comparison with a drug containing transfer factors.
The article describes a rare case of a manifest late neurosyphilis with a fatal outcome. Literature data on the features of the clinical course of neurosyphilis and its pathomorphological pattern are given. The results of a laboratory examination, including a histological examination, confirming the syphilitic lesion of the nervous system in this clinical observation are presented.
The determination of blood parameters allowed us to establish that anemia develops in a number of infectious diseases, which is called "anemia of inflammation" or anemia of chronic diseases. The article presents a rare clinical case of the development of anemia of the inflammatory response, accompanied by a marked decrease in the content of hemoglobin (less than 110 g/l), hematocrit (less than 30%) and red blood cells (less than 3,0 х 1012/l), in a child with early congenital syphilis with symptoms of: specific rhinitis, papular infiltration, pemphigus, hepatosplenomegaly and damage to the nervous system. As a result of specific treatment with water-soluble benzylpenicillin salt at the rate of 100 U/kg of body weight for 28 days, and transfusion of erythrocyte mass of 15 ml/kg of child weight, there was a parallel regression of clinical manifestations of syphilis with positive dynamics of serological reactions and restoration of the number of red blood cells and the concentration of hemoglobin in the blood.
Introduction: Given a wide range of pathogenesis of the inflammatory process in pyoderma, which involves a variety of links in the immune response, work is underway to find ways to optimize immunocorrection in this pathology. The aim of the study was to evaluate the clinical and economic effectiveness of immunocorrection in severe and chronic forms of pyoderma with drugs from different pharmacological groups. Materials and methods: The data sources were prospective randomized comparative studies of therapy of 107 pyoderma patients aged 18 to 60 years, divided into groups. The patients of the first group additionally used a biologically active additive containing immunoactive molecules and transfer factors (TF) as an immunomodulator; the patients of the second group used glucosaminylmuramildipeptide (GMDP). The clinical effectiveness of regression of inflammatory symptoms on day 10 of treatment was analyzed. Based on the obtained data, the following types of pharmacoeconomical analysis were performed: calculation of the course price, the cost/effectiveness ratio, and the availability coefficient. Results and discussion: The results of the study showed that the number of cured patients was 91.4% in the first group and 97.2% in the second group of patients. The treatment cost when using the drug is by 970 rubles smaller; the cost/effectiveness ratio (CER) per patient was 1.8 higher for a drug containing transfer factors and amounted to 25.9. The calculation of the availability coefficient (AC) revealed a difference in glucosaminylmuramyldipeptide which was 2.1 times smaller. Conclusion: It was found that a drug based on glucosaminylmuramildipeptide is a more effective and cost-effective means of immunocorrection in severe forms of pyoderma. This confirms a faster regression of clinical manifestations of the disease and lower cost/effectiveness ratio and availability coefficient.
Цель исследования-дать клиническое обоснование применения природных иммуномодуляторов для лечения больных с инфекциями кожи и мягких тканей. Материал и методы. Пациенты были разделены на три группы: в 1-й группе (n=35) была назначена антибактериальная терапия в сочетании с пептидом, содержащим сигнальные иммуноактивные молекулы; во 2-й группе (n=36) применяли комбинацию с иммуномодулятором, являющимся аналогом мурамилдипептидапептидогликана клеточной стенки бактерий; пациенты 3-й группы (n=36) получали только антимикробную терапию. Результаты. Терапия с применением иммунных препаратов показала высокую клиническую эффективность. Использование иммунных препаратов сопровождалось значительным подавлением роста патогенной микрофлоры, уменьшением КОЕ/мл в 5 раз. Заключение. Глюкозаминилмурамилдипептид является наиболее эффективным средством иммунокоррекции в комплексной терапии хронических и осложненных форм пиодермий.
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