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Biomedical subjects

N V Astaf'eva

Publications and source records attributed to N V Astaf'eva.

At least 19 recordsLinked to original sources

[The characteristics of myocarditis in diphtheria in adults based on data from the 1993-1994 epidemic].

In 45% of 212 cases of diphtheria toxica in adults heart complications were observed. The earliest ECG signs are sinus bradycardia, AV dissociation, AV escape rhythms, prolongation of QT interval, high U wave (U > T, T + U wave). In the cases where differential diagnosis of myocarditis and other heart diseases in adults is difficult, the attention must be focused on the sickle-like depression ("sagging") of ST-interval that is a typical sign in diphtheric myocarditis. The most severe forms of diphtheric myocarditis are complicated by AV and intraventricular conduction disturbances and malignant ventricular arrhythmias.

Adult↗

[Diphtheria of the oral mucosa].

High incidence of diphtheria became a pressing problem in recent years. The age structure of patients has changed. A specific feature of diphtheria in adults is a high share of toxic forms and a higher incidence of grave combined forms and rare localizations of the disease focus. The oral cavity proper is one of rare localizations of this infection. The authors examined 12 patients in whom the process was localized in various parts of the buccal mucosa: on the upper and lower lips, on the hard and soft palate, on the cheeks and tongue. Morphologic disturbances presenting as necrosis and inflammatory infiltration were detected in sites involved in the diphtheritic process. Changes whose manifestation was related to the diseases severity were found in zones adjacent to the foci. The authors come to a conclusion on a higher incidence of heretofore rare localizations of diphtheria than previously, this making difficult the diagnosis and treatment of the disease.

Adult↗

[Hemostatic disorders in severe forms of diphtheria and their correction with dicinon].

The presence of thrombohemorrhagic syndrome (THS) has been established in 28 patients with toxic severe diphtheria of oropharynx. In view of the leading role of platelet affection in progression of hemorrhagic disorders in diphtheria, dicinon treatment may be beneficial. THS implications in unfavourable outcome of the disease and prognostic significance of critical thrombocytopenia are considered.

Acute Disease↗

[Clinico-hemostatic characteristics of serum disease in toxic forms of diphtheria].

Coagulative changes at the height of serum disease were investigated in 28 patients with severe diphtheria. It was found that on day 10 after first injection of diphtheria antitoxin hemocoagulation underwent activation with prevailing thrombogenesis coinciding in time with acute period of serum disease. The severity of serum complications correlated with the degree of coagulation activity. A relationship exists between the amount of the given antitoxin, duration of hormone therapy and occurrence of serum complications. There were specific for serum disease biochemical alterations indicative of destruction of blood cells and vascular-endothelial structures on the disease day 12-14.

Acute Disease↗

[The dynamics of the liver and myocardial enzymes in different forms of diphtheria in adults].

The authors studied changes in the levels of hepatic and myocardial enzymes in 89 patients with oropharyngeal diphtheria. The forms of the disease were different: carriage of the bacteria, local oropharyngeal diphtheria, toxic and subtoxic disease. Biochemical tests were also performed in 21 patients with lacunar angina. A correlation has been revealed between the intensity of fermentemia, its standing and the severity of the local lesions. Possible usage of biochemical markers is discussed for characterizing toxic diphtheria severity and prognosis of the disease.

Adolescent↗

[Lymphocyte and neutrophil cytochemistry in the dynamics of different forms of diphtheria in adults].

The cytochemical study of lymphocytes and neutrophils isolated from fractionated blood of diphtheria patients and carriers has revealed that a decrease in the activity of lymphocyte succinic dehydrogenase and myeloperoxidase can be observed at all periods of the disease and in all its forms. A decrease in the activity of lymphocyte nonspecific esterase has been noted only in patients with toxic and subtoxic diphtheria and a decrease in the activity of neutrophil alkaline phosphatase, in carriers. The analysis of correlations between the parameters of five enzymes under study (lymphocyte succinic dehydrogenase, lymphocyte acid phosphatase, lymphocyte non-specific esterase, myeloperoxidase, neutrophil alkaline phosphatase) and enzymatic rosette parameters has been made. The analysis has revealed an essential increase in the number of correlations in comparison with donors, changes in the qualitative nature of these correlations and sometimes the reversion of the correlations. Carriers have shown the greatest number of correlations. By the end of the terms of observations no restoration of normal correlations has been observed.

Acid Phosphatase↗

[The cellular immune response in different forms of diphtheria in adults].

In 109 adult diphtheria patients with different forms of the disease (toxic, subtoxic, localized) and carriers, the latter including 6 persons having had the localized form of diphtheria, 12 different subpopulations of T and B lymphocytes and neutrophils were studied by the methods of rosette formation with sheep, mouse and bovine red blood cells. The study showed that, starting from week 2 of the disease, an increase in the content of the subpopulations under study was registered in all forms of diphtheria; the disease, as well as in patients with the localized form of the disease accompanied by complications and in long-term carriers. In all forms of diphtheria a decrease in the content of neutrophil rosette-forming cells was shown. The marker tests for prognostication of the complicated course of the disease, viz. the elevated content of M-rosette-forming cell and T gamma-rosette-forming cells during the first week of then disease, were established.

Adolescent↗

[Indices of diphtheria (antitoxic) immunity in the dynamics of the disease and its treatment in adults].

A total of 1,034 serum samples from 618 persons, including patients with different forms of diphtheria, carriers of the toxigenic forms of Corynebacterium diphtheriae, and angina patients, were studied. Analysis of the incidence of antibodies to C. diphtheriae toxin and their titers revealed that in more than half of all diphtheria patients no antibodies to C. diphtheriae toxin were detected upon admission to hospital. At the same time in 26% of the patients no antibodies were detected during the whole period of the disease; in such patients the toxic and subtoxic forms of diphtheria were registered twice as often as in seropositive patients. In 31% of the patients seronegative by the moment of hospitalization a rapid increase in the titers of antibodies C. diphtheriae toxin was observed in the course of the disease, which was indicative of the secondary character of immune response in patients who had been immunized earlier.

Adult↗

[Croup in toxic forms of diphtheria in adults].

Toxic patterns of diphtheria of the fauces in adults are characterized by laryngeal lesions which considerably deteriorate the disease prognosis. The clinical manifestations of diphtheric croup may be unpronounced in such cases and be masked by other severe disease symptoms. If patients with toxic diphtheria develop croup, the necessity of surgical treatment arises at earlier times as compared with cases of isolated croup.

Adolescent↗