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Biomedical subjects

V V Maleev

Publications and source records attributed to V V Maleev.

At least 19 recordsLinked to original sources
PubMed1999

[Prognosis in meningococcal disease: methodology and practice].

78 patients with systemic meningococcal disease admitted to the Intensive Care Unit of the 2nd Moscow Hospital for Infectious Diseases were studied and the composite prognostic score was developed to estimate the risk of lethal outcome. The stepwise variable selection procedure for the multiple logistic regression was applied to 30 potential clinical and laboratory risk factors and markers. Five factors were selected for the score, namely the platelet count (< 150 x 10(6)/ml), the presence of hemorrhages into the eye or mucosal tissue, the interval from the last urination before admission (> 4 h), the respiration rate (> 170% of age-adjusted normal value) and age (< 2 or > 65 years) with regression coefficients 0.3, 0.2, 0.2 and 0.1, respectively. Both for the source clinical group and for the additional test group (64 patients), the scale was able to classify correctly 95% of cases using the data collected at admission. Ten prognostic scores proposed previously by foreign investigators were tested in the same patients and the best four scores were selected (GMSPS, Gedde-Dahl, Niklasson, Kahn); the scores classified correctly 85-90% of cases. This study is an example of methodological approaches to prognostic score construction in medicine.

Adolescent↗
PubMed1999

[The interconnection between the severity of meningococcal infection and the endotoxicity levels and patient's blood complement].

Seventy-eight patients with severe systemic meningococcal disease admitted to the Intensive Care Unit of the Second Moscow Hospital for Infectious Diseases were divided into four groups by complications of their disease: patients with refractory septic shock (RSS)--group 1; patients with early septic shock (ESS)--group 2; patients without shock but with severe mental disorders--group 3; patients without any of these complications--group 4. The LPS concentration in plasma was assessed by chromogenic method. Initial LPS levels in plasma of group 3 or group 4 patients (170 ng/l, median value and 360 ng/l, respectively) were greater than those of healthy donors (LPS < 15 ng/l). LPS concentration was significantly greater in group 2 (920 ng/l) or group 1 (12,400 ng/l). LPS levels declined exponentially in all the patients. The half-life was calculated to be 1.4 (+) -0.3 h. In group 2 and 1, respectively, the classical pathway complement activity in patients' serum was 50 and 10% of normal control values. To estimate significant prognostic factors for fatality in our patients, specificity and factor fatality difference of various clinical and laboratory factors were calculated. The cut-off LPS value for development of ESS was 600 ng/l and that for development of RSS and death was 8000 ng/l. For the prediction of fatality using the former cut-off value of LPS, sensitivity was 84% and specificity 100%. Using plasma complement activity (cut-off--15% of normal value) for prediction, sensitivity was 75% and specificity was 100%. Other factors (platelet and WBC count, blood pH, BP, etc.) had lower predictive power. Thus to date plasma endotoxin level and complement activity are the best prognostic factors in meningococcal disease.

Adolescent↗
PubMed1996

[Complications of food poisoning and salmonellosis].

During the follow-up of 32,448 patients with food poisoning and salmonellosis complications occurred in 665 (2.01%). Among them were general circulation disorders (shock), myocardial infarction, acute cerebral vascular accidents, mesenterial thromboembolism, pneumonia, acute renal failure (0.09, 0.4, 0.4, 0.1, 0.5 and 0.6% of patients, respectively). Complications of food poisoning and salmonellosis caused lethal outcomes in 0.03% of cases. For the last 15 years acute adrenal insufficiency in patients with food poisoning and salmonellosis has not been reported.

Foodborne Diseases↗
PubMed1995

[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↗
PubMed1995

[A case of an unusual course in measles].

An adult woman with catarrhal measles developed idiopathic ketosis. The contributing factors were: diet noncompliance (taking meat rich in fat), emotional stress and fatigue, acute infection (measles).

Acute Disease↗
PubMed1995

[Acute intestinal infections and chronic alcoholism].

153 chronic alcoholics were given treatment against food poisoning. 55 of them developed withdrawal syndrome, 98 had alcoholic psychosis including 88 with delirium tremens. The acute intestinal infection in these alcoholics was managed with rehydration using polyionic crystalloid solutions under controlled diuresis. Previous relief of central excitation contributed much to a positive treatment outcome.

Acute Disease↗
PubMed1995

[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↗
PubMed1994

[Disorders in the plasma and cellular hemostatic components of patients with HIV infection].

Plasmic and platelet components of hemostasis were investigated in 100 HIV-infected subjects. Its degree depended on the infection stage and associated opportunistic infections. The key factor in pathogenesis of hemocoagulatory disorders is reduced count, abnormal function and morphology of platelets. A direct relationship exists between the number of CD4-lymphocytes, a decline in the number and functional activity of platelets. Intravenous injection of immunoglobulin made in Russia as an adjuvant to combined therapy of HIV-infected subjects contributes to recovery of platelet count and aggregation.

Antigen-Antibody Complex↗
PubMed1993

[Acute kidney failure as a complication of food poisonings].

Literature data and original experience are reviewed on the treatment of alimentary toxoinfections complicated with acute renal failure (ARF). Out of 192 patients prerenal ARF was recorded in 74.5%, renal in 25.5% of the cases. ARF resulted from hemodynamic disturbances, salt and water loss, intoxication. ARF clinical symptoms were poor, the patients developed decompensated metabolic acidosis and hyperazotemia. Pathological and histological evidence is available for 17 patients with "shock kidney". They died of infective toxic shock. The treatment of ARF complicating acute alimentary toxoinfections in 98.9% made a success if implied polyion crystalloid solutions. Hemodialysis was demanded in 1.1% of the cases.

Acute Kidney Injury↗