Human bocaviruses (HBoVs) 1–4 belong to the Parvoviridae family, and they infect the respiratory or gastrointestinal tracts in children. We investigated the prevalence of HBoV1–4 DNAs in the blood and stool samples, and of HBoV1–4 IgG and IgM in the plasma samples, of children presenting with acute gastroenteritis (AGE). In addition, we identified HBoV co-infections with the five most frequent gastrointestinal pathogens. A total of 83 paired blood and stool samples were collected from children aged five years or less. Infection markers of HBoV1, 2, or 3 (viral DNA in blood and/or stool and/or antibodies) were detected in 61 out of 83 (73.5%) patients. HBoV1, 2, or 3 DNA as a monoinfection was revealed in 18.1%, 2.4%, and 1.2%, respectively, and 21.7% in total. In 56.1% of the HBoV DNA-positive patients, the presence in stool of another virus—most frequently norovirus or rotavirus—was observed. In conclusion, this study, for the first time, illustrates the prevalence and genetic diversity of HBoVs in Latvian children with gastroenteritis, and shows a widespread distribution of these viruses in the community. HBoV1 and 2 are commonly found as single infectious agents in children with AGE, suggesting that the viruses can be as pathogenic by themselves as other enteric agents are.

SummaryIntroduction.For acute appendicitis - the most frequent condition to perform an urgent abdominal operation in pediatric surgery - surgical appendectomy still remains the gold standard regarding treatment, nevertheless nonsurgical management has become more and more recognized as a treatment method for uncomplicated acute appendicitis (UAA). However there are still many unanswered questions regarding possible factors that could predict the treatment outcome as well as appropriate antimicrobial drug regimens.Aim of the Study.The aim was to investigate if there is a possible association between factors such as C-reactive protein (CRP) level, presence of appendicolith, the diameter of the appendix and treatment outcome; as well as to identify most successfully used antimicrobial drug combinations.Material and methods.A retrospective analysis of hospital cases, admitted to a single reference center during the time period from 2013 to 2015. Patients with clinical signs of acute appendicitis, elevated inflammatory markers and radiological findings suggestive for acute appendicitis were included in the study. Nonsurgical treated patients were divided in two groups based on the treatment outcome - successful or unsuccessful. Analysis of the three factors (CRP level, presence of appendicolith and the diameter of the appendix) and most commonly used antimicrobial drug regimen association with treatment outcome was performed.Results.Overall 384 children medical records with acute appendicitis were registered and non-surgical treatment was initiated in 147/384 (38 %) cases. Successful treatment outcome of nonsurgical management was identified in 114/147 (78 %) cases. Analyzing prognostic adverse factors results presents no statistically significant difference in association with CRP level >25 mg/l (p=0,479), presence of appendicolith (p=0,183) and the diameter of appendix >1 cm (p=0,183) with successful or unsuccessful treatment outcome. The two most commonly used antimicrobial drug combinations were - Ampicillin/Metronidazole for 49 patients and Ampicillin/Gentamicin for 44 patients. No relevance with treatment outcome and used antimicrobial agents was detected (p=0,597).The overall recurrence rate after initial presentation is 15 % (17/114). In 3 cases (3 %) recurrent appendicitis developed one month after discharge and in 14 cases (12 %) up to one year after discharge.Conclusions.Prognostic adverse factors - CRP, presence of appendicolith and diameter of appendix - were not statistically reliable in association with initial non-surgical treatment outcome. The success rate of conservative treatment with narrow spectrum antibiotics was 78 %, which is just as high as in cases treated conservatively with broad-spectrum antibiotics from previous studies. Therefore the question of which factors and antimicrobial drug combinations influence the course of treatment still remains unanswered and further studies are required.

The first successful corneal transplantation is known since 1905, performed by Eduard Zirm (2). It has been implemented in order to restore vision in a variety of corneal diseases and after ocular traumas. The traditional technique for corneal transplantation, penetrating keratoplasty (PKP), refers to the full-thickness replacement of corneal tissue with a healthy donor graft (1). Authors report a well-documented case about successfully transplanted cornea after penetrating ocular trauma to improve visual outcome.

 ðàáîòå ïðåäñòàâëåíû ïðåäâàðèòåëüíûå ðåçóëüòàòû ìíîãîöåíòðîâîãî ðàíäîìèçè-ðîâàííîãî êëèíè÷åñêîãî èññëåäîâàíèÿ, öåëü êîòîðîãî -îïðåäåëåíèå îïòèìàëüíîé äëèòåëüíîñòè ðàçíûõ âèäîâ ýíåðãîêîððèãèðóþùåé òåðàïèè. Îáðàáîòàíî 99 ðåãèñòðà-öèîííûõ êàðò áîëüíûõ ñ öåðåáðàëüíûì èíôàðêòîì, ðàíäîìèçèðîâàííûõ ìåòîäîì êîí-âåðòîâ íà 3 ãðóïïû. Ïàöèåíòû 1-é ãðóïïû (ñðàâíåíèÿ), 32 ÷åëîâåêà, â ñîñòàâå êîìï-ëåêñíîé òåðàïèè ïîëó÷àëè àñêîðáèíîâóþ êèñëîòó (5 % ðàñòâîð 2 ðàçà â ñóòêè â ðåêî-ìåíäîâàííîé äîçå 20 ìë/ñóò íà ïðîòÿaeåíèè 20 äíåé); 2-é ãðóïïû (37 ÷åëîâåê) -öèòî-ôëàâèí ïî 10 ìë âíóòðèâåííî êàïåëüíî 2 ðàçà â äåíü â òå÷åíèå 10 ñóò; 3-é ãðóïïû (30 ÷åëîâåê) -öèòîôëàâèí íà ïðîòÿaeåíèè 20 ñóò (1 -10 äíè ïî 20 ìë â ñóòêè, 11 -20 äíè ïî 10 ìë â ñóòêè). Ñðåäíèé áàëë ïî øêàëå NIH ïðè ãîñïèòàëèçàöèè ñîñòàâèë 14,8 ± 2,6. Öèòîôëàâèí âûçûâàë óìåíüøåíèå îáúåìà î÷àãà öåðåáðàëüíîé èøåìèè â ñðåäíåì â 1,7 -1,8 ðàçà (ð < 0,05) ïðè 10-è 20-äíåâíîì êóðñå, â òî âðåìÿ êàê â ãðóïïå àñêîðáèíîâîé êèñëîòû çíà÷èìûõ ìîðôîëîãè÷åñêèõ èçìåíåíèé çàðåãèñòðèðîâàíî íå áûëî. Ýòî êîððåëèðîâàëî ñ ëó÷øåé äèíàìèêîé è èñõîäîì íåâðîëîãè÷åñêîãî è ôóíêöè-îíàëüíîãî ñòàòóñîâ ïàöèåíòîâ, ïîëó÷àâøèõ öèòîôëàâèí. Äîñòîâåðíûõ îáùèõ ðàçëè-÷èé êëèíèêî-ìîðôîëîãè÷åñêèõ äàííûõ 2-é è 3-é ãðóïïû íà íàñòîÿùåì ýòàïå âûÿâèòü íå óäàëîñü, îäíàêî ó ôîíîâî òÿaeåëûõ áîëüíûõ â ãðóïïå ñ öèòîôëàâèíîì (20 äíåé), èìåâøèõ â ìîìåíò ïîñòóïëåíèÿ 18 -20 áàëëîâ ïî øêàëå NIH, ïðîñëåaeèâàëàñü òåí-äåíöèÿ ê óëó÷øåíèþ ïàðàìåòðîâ íåâðîëîãè÷åñêîãî ñòàòóñà, ïî ñðàâíåíèþ ñ ïàöèåíòà-ìè ãðóïï ñðàâíåíèÿ.Êëþ÷åâûå ñëîâà: èíñóëüò; èíôàðêò ìîçãà; îáúåì î÷àãà èøåìèè; àíòèîêñèäàíòû; ýíåðãîêîððåêöèÿ; öèòîôëàâèí. ÂÂÅÄÅÍÈÅÏî äàííûì Íàöèîíàëüíîé Àññîöèàöèè ïî áîðüáå ñ èíñóëüòîì (ÍÀÁÈ), îñòðûé öåðåáðàëüíûé èíñóëüò (ÖÈ) îñòàåòñÿ â íà÷àëå 21-ãî âåêà îäíîé èç âåäóùèõ ôîðì ñîñóäèñòîé ïàòîëîãèè. Îí äåëèò ñ îñòðûì êîðî-íàðíûì ñèíäðîìîì ïåðâîå ìåñòî â ñòðóêòóðå ñìåðòíî-ñòè íàñåëåíèÿ, ÿâëÿÿñü ëèäèðóþùåé ïðè÷èíîé òÿaeå-ëîé è ÷àñòî íåîáðàòèìîé èíâàëèäèçàöèè.  Ðîññèè ðîñò çàáîëåâàåìîñòè ÖÈ çà ïîñëåäíèå 10 ëåò ïðåâû-ñèë 34 %, à ÷àñòîòà ïîñòèíñóëüòíîé èíâàëèäèçàöèè ñîñòàâëÿåò îò 76 äî 82 %, â òî âðåìÿ êàê â Åâðîïå îíà íå ïðåâûøàåò 45 % [4,5,11].  ñâÿçè ñ ýòèì â íàøåé ñòðàíå ðåàëèçîâàíà Ïðîãðàììà ëå÷åíèÿ áîëüíûõ ñ ÖÈ, ñîçäàíû è îñíàùåíû ðåãèîíàëüíûå ñîñóäèñòûå öåíòðû è ïåðâè÷íûå ñîñóäèñòûå îòäåëåíèÿ. Ñîãëàñíî óñòàíîâëåííûì ðåãëàìåíòàì âñå áîëüíûå ñ ÖÈ ïîñòó-ïàþò â áëîêè ðåàíèìàöèè, à ïîñëå ñòàáèëèçàöèè ñî-ñòîÿíèÿ ïåðåâîäÿòñÿ â îòäåëåíèÿ ðàííåé ðåàáèëèòà-öèè, ãäå êóðñ ëå÷åíèÿ, â ñîîòâåòñòâèè ñ ìåäèêî-ýêîíî-ìè÷åñêèìè ñòàíäàðòàìè, ïðîäîëaeàåòñÿ äî 21 ñóò [11].Îäíàêî ïðèõîäèòñÿ êîíñòàòèðîâàòü -íà ñåãîäíÿø-íèé äåíü íåäîñòàòî÷íî ðàçðàáîòàíû íåêîòîðûå âîïðî-ñû òåðàïèè ÖÈ, â ÷àñòíîñòè, ïðîäîëaeèòåëüíîñòü èí-ôóçèîííûõ êóðñîâ òåõ èëè èíûõ ñîñóäèñòûõ è/èëè íåéðîïðîòåêòîðíûõ ïðåïàðàòîâ.  ëèòåðàòóðå ïðàêòè-÷åñêè íåò èññëåäîâàíèé, ïîñâÿùåííûõ ñðàâíèòåëüíî-ìó àíàëèçó ýôôåêòèâíîñòè êóðñîâ êîìïëåêñíîé öèòî-ïðîòåêòèâíîé òåðàïèè ðàçíîé äëèòåëüíîñòè. Êîì-ïëåêñíàÿ öèòîïðîòåêöèÿ äîëaeíà îáåñïå÷èâàòü ïîääåð-aeàíèå îïòèìàëüíîé îêñèãåíàöèè êðîâè (SpO 2 97 -98 %), àäå...