Наукові праці. Кафедра інфекційних хвороб

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A lethal case of viral-bacterial pneumonia with relative lymphopenia: retrospective evaluation
(Харківський національний медичний університет, 2019) Gradil, Grigory
The author presents a clinical case of a fatal course of community acquired viral-bacterial pneumonia in a patient without underlying risk factors but with atypical course. Lymphopenia and neutropenia development is considered a prognostic factor for severe course and the probability of a fatal outcome. Morphology demonstrated impairment of vascular endothelial cells, hypoplasia of the lymphoid follicles in the spleen, massive necrosis of the liver parenchyma with hemorrhages. At present such case should be differentiated with pneumonia caused by mycoplasmas, legionella, rickettsias, chlamydia, pneumocystis, as well as, in the presence of epidemiological data, with influenza A (H1N1) California 2009, influenza H5N1, coronaviral infection (MERS-CoV), that is infections complicated with acute respiratory distress syndrome (ARDS). The mechanisms of neutropenia and lymphopenia development in viral lesions of the respiratory system require further inverstigation.
Anaplasmosis: experimental immunodeficient state model
(2019) Bondarenko, Andriy; Pokhil, Sergey; Lytvynenko, Marianna; Bocharova, Tetiana; Gargin, Vitaliy
Introduction: The recently described anaplasmosis infection is widespread but concerns to the insufficiently known group of diseases. The aim of our research is the development of uniform biological model for reproducing of artificial immunodeficient state by experimental anaplasmosis. Materials and methods: Algorithm of experimental anaplasmosis reproducing, consisted of such consecutive stages: 1) artificial forming of the immunodeficient state at nonlinear white mise (Mus musculus L.); 2) preparation of the tested biological material samples; 3) inoculation by prepared samples of the laboratory animals with the artificially formed immunodeficient state; 4) sampling from the dead or slaughtered (by the method of chloroformed anesthesia) experimental animals of sectional material (organs and targets tissues); 5) verification of aetiology by express detection of causative agents by the method of PCR in the selected samples of sectional material. Results: Biological model of experimental anaplasmosis have been created suitable for realization of both diagnostic and epidemiological, epizootic, ecobiological and other researches of different origin biological material samples, including samples of solid and liquid consistency material. Formed model realised in premature death of experimental animals in 17.4 % cases; resulted in an onset of disease clinical signs without death during the term of supervision in 43.8 % cases; coursed in the absence of the expressed symptoms of infection in 31.3 % cases. Conclusions: Developed biological model of experimental anaplasmosis consists in that as laboratory animals with the increased sensitiveness to the infection and accumulation of causative agent are used white nonlinear mice with the artificially formed immunodeficient state.
Application of apri index for noninvasive evalution of liver fibrosis activity in patients with chronic hepatitis C
(2018-04-24) Kozko, Volodymyr; Vinokurova, O.; Baichykova, A.; Pavlova, A.
seventy-nine patients, age from forty to forty-five years old, with chronic hepatitis C were examined in the clinic. All the patients studied determined the stage o f fibrosis and the severity o f the disease with the help o f the GenoFibroTest system, an expert system o f biochemical blood indices. Modern statistical methods were used to determine the dependence between the stages o f fibrosis and APRI. It was found that the APRI value from 0 to 1 corresponds to F0 - F1, more than 1 to F2-F4, respectively.
Assessment of the demyelinating process activity in patients with herpesviral meningitis and meningoencephalitis based on the level of myelin basic protein (MBP) in the cerebrospinal fluid
(Aluna Publishing, 2021-03) Sokhan, Anton; Burma, Yaroslava; Pavlov2, Volodimir; Goidenko, Oleksandr; Markush, Larisa; Spitsyna, Hanna; Kolesnyk, Liudmyla
The aim: To study the peculiarities of demyelination by detection of changes in the levels of myelin basic protein (MBP) in CSF of patients with acute herpesviral meningitis (M) and meningoencephalitis (ME). Materials and methods: A total of 136 CSF samples from 68 patients with herpesviral M and ME were collected. The control group consisted of patients with acute respiratory infection and meningismus. MBP level in CSF was identified at the admission and after 10-12 days of treatment. Analysis of MBP concentrations in CSF was performed using an enzyme immunoassay. Results: Examination of patients on the first day of hospitalization showed the presence of a significant increase of MBP in the CSF in all patients with viral M/ME compared with the indicators of the comparison group (р<0.01). In all groups of patients with ME, the level of MBP in CSF was significantly higher than the indicators of comparison group and M groups of the suitable etiology of the disease (p<0.01). In patients with lethal outcome, the MBP level was significantly higher (p<0.01) than in all meningitis groups, but we did not find a significant difference with the patients with ME (p>0.05). Conclusions: The increase of MBP level identified in patients with acute M/ME confirms the presence of the demyelinating process that occurs in all patients, but it is more pronounced in patients with ME.
Biochemical manifestations of liver affection in patients with infectious mononucleosis
(2014-03) Mohylenets, Olena; Kozko, Volodymyr; Merkulova, Nina; Bondarenko, A.; Solomennik, G.; Iurko, Kateryna; Nikitina, V.; Vinokurova, O.
Biochemical parameters of cerebrospinal fluid in patients with acute viralmeningitis and meningoencephalitis
(2018) Kozko, Volodymyr; Sokhan, A.; Burma, Ya.; Kuznetsova, Anastasiia; Gavrylov, Anatoliy
The aim. Determination of the diagnostic value of lactate, lactate dehydrogenase, cholinesterase, acid phosphatase and cholinesterase in CSF for early diagnosis and prognosis of acute viral meningitis and meningoencephalitis. Materials and methods. 92 patients with a confirmed viral etiology of the disease were examined. Among them – 20 patients with HSV 1,2 neuroinfection, 19 patients with EBV, 15 with VZV, 14 with HHV-6 and 24 patients with enterovirus neuroinfection. Patients were divided into groups depending on the etiology and severity of the disease. In addition to analyzing the clinical course of the disease, we conducted a CSF study to determine the level of lactate, lactate dehydrogenase, creatinine kinase, cholinesterase and acid phosphatase on admission to hospital and after 10-12 days of treatment. Results of the study. The highest mean age was observed in patients with VZV meningitis – 38.27±18.24 years, the youngest were patients with enterovirus infection – 24.05±5.72 (р˂0.001). The number of women and men was the same in almost all groups, but among patients with HSV 1, 2 neuroinfection women were significantly prevalent – 16 (80 %) out of 20 cases. The most severe course was observed in groups of EBV and HHV-6 neuroinfections. Neuroinfections of enterovirus etiology had the most favorable course. The obtained data indicate the dependence of the levels of indicators, which were determined primarily from the severity of the disease. So the level of creatinine kinase and acid phosphatase in patients with moderate severity was significantly higher in comparison with severe patients (p<0.05). The lactate level was higher in patients with severe neuroinfection (p<0.05). The highest levels of lactate were detected in patients with HHV-6 meningoencephalitis (p<0.05). The level of cholinesterase was significantly lower in severe patients. Conclusions. The obtained data confirm the presence of deep metabolic disturbances in the brain tissues in all patients with acute viral neuroinfections both at the onset of the disease and in the dynamics of treatment. Determination of levels of creatinine kinase, acid phosphatase, lactate and cholinesterase in CSF of patients with acute viral neuroinfection has a high diagnostic value, but cannot be used to predict an unfavorable course of the disease
Cerebrospinal fluid levels ofneurospecific markers in adult patients with bacterial meningitis
(Тбилисский государственный медицинский университет, 2017) Sokhan, A.; Zots, Y.; Gavrylov, Anatoliy; Iurko, Kateryna; Solomennik, A.; Kuznetsova, Anastasiia
At present, the great attention is given to the neurospecific markers as their elevated level in the cerebrospinal fluid corresponds to the degree of destruction of relevant CNS cells. Therefore, actual direction of the studies of the pathogenesis and diagnosis of CNS diseases is to determine levels of neurospecific markers in the cerebrospinal fluid (CSF). The purpose of the study was to evaluate the diagnostic and prognostic role of NSE, S-100 protein, GFAP and MBP levels in CSF of patients with acute bacterial meningitis. S-100 protein, NSE, GFAP and MBP levels in CSF of patients with acute pneumococcal and meningococcal meningitis were determined during admission and after 10-12 days of treatment. Patients were divided into groups depending on the etiology and severity of the disease. 60 cases of acute bacterial meningitis, as a study group, and 12 cases with acute respiratory infection and meningism, as a control group, were analyzed. It is shown that CSF levels of NSE, S-100 protein, GFAP and MBP on the first day of admission were significantly increased (P<0,05), depending on the severity of the disease. The highest levels of neurospecific markers have been identified in non-survivors (P<0,001). The concentration changes of CSF neurospecific markers are found to be helpful as a diagnostic and prognostic marker in acute bacterial meningitis.
Chronic hepatitis c: research of topical biochemical aspects in patients
(2020) Yurko, K.; Solomennyk, G.; Vinokurova, O.; Verzunova, V.; Hladka, I.
80 patients with chronic hepatitis C were examined. Non-invasive evaluation of the necro-inflammatory process of the liver was performed using ActiTest. It is revealed that with high necro-inflammatory activity of the liver, the most likely are changes ofsuch biochemical parameters as f-glutamyltranspeptidase, alanine aminotransferase, haptoglobin, apolipoprotein A1, alpha2-macroglobulin.
Clinical and epidemiological aspects of yersinioses in kharkiv region
(2015) Mohylenets, Olena; Могиленець, Олена Іванівна
Clinical and laboratory characteristics of enteroviral meningitis in adults
(Сумський державний університет, 2017) Sokhan, A.
The aim is to detect and characterize clinical symptoms and laboratory abnormalities in adult patients with enteroviral meningitis. Materials and methods. 39 cases of enteroviral meningitis in adults were analyzed. The average age of the patients was 24.05 ± 0.91 years. Among them were 20 men and 19 women. The comparison group consisted of 12 patients without diseases of the central nervous system. We analyzed the clinical symptoms, indicators of complete blood count, clinical analysis of cerebrospinal fluid (CSF), as well as the level of neuron-specific enolase (NSE), lactate, LDG, cortisol, creatine kinase and cholinesterase in the CSF of patients at the time of admission and on 10–12 day of treatment. Results. The disease is characterized by acute onset with fever, headache, photophobia, sore throat, cough, dyspeptic symptoms. Patients hospitalized at 3.33 ± 0.27 day of illness. Noteworthy is the absence or weak expression of meningeal signs in more than 76 % of cases. In the clinical analysis of the CSF we discovered two types of change – in 24 (61.54 %) cases dominated lymphocytes, while in 15 (38.46 %) predominated neutrophils. In the first day after admission CSF levels of creatinine kinase and lactate was significantly higher and levels of cortisol, cholinesterase and lactate dehydrogenase was significantly lower compared with the control group (P ˂ 0.05). Conclusions. Enteroviral meningitis is found mostly in young people. It is characterized by acute onset with typical symptoms of meningeal syndrome, but meningeal signs in most patients are mild (61.54 %) or negative (15.39 %). Clinical analysis of CSF is characterized by typical for aseptic meningitis changes, but in 38.46 % cases neutrophil level was above 50 %. In the acute phase there is a significant increased CSF level of cortisol, lactate, NSE, CK and decrease of LDH and cholinesterase, which can be used in differential diagnosis and evaluation of pathogenic disorders.
Colloidal Silicon Dioxide in Tablet form (Carbowhite) Efficacy in Patients with Acute Diarrhea: Results of Randomized, Double- Blind, Placebo-Controlled, Multi- Center Study
(2020) Tieroshyn, Vadym; Moroz, Larisa; Prishliak, Oleksandra; Shostakovich-Koretska, Lyudmila; Kruglova, Oksana; Gordienko, Lyudmila
The acute diarrhea is a wide-spread disease. The prescription of enterosorbents is appropriate as a primary measure for the treatment of the acute diarrhea for effective prevention of the fluid and electrolyte loss, as well as method for symptom relief of the attack of the disease. Aim of the study - the antidiarrheal efficacy and safety study of high-dispersion silicon dioxide enterosorbent in tablet dosage form in patients with acute diarrhea. This was randomized, double-blind, placebo-controlled, 4-center study. Acute diarrhea was defined as three and more episodes of watery stool per day either during 48 hours or less before study entry in the patients having normal stool recently. It has been postulated that symptoms and signs of acute diarrhea have to be caused by direct infection of the gastrointestinal tract and did not associated with moderate-to-severe systemic states. 144 patients with established acute diarrhea were randomized into treatment group (enterosorbent “Carbowhite”, n = 120) or placebo group. Date collection including severity diarrhea, systemic symptoms was performed at baseline and daily during 7 days. Stool examination and serological assay were performed at baseline. The primary end points were declared as time to complete recovery from acute diarrhea. It has been found that the use of the siliceous enterosorbent (“Carbowhite”) allowed to reduce (p < 0.001) the treatment period averagely for 0.9 days (95% confidence interval 0.5–1.2 days) in comparison with placebo. Data of safety monitoring has revealed that both patient groups had negative stool culture, while initiation of antibiotic treatment was run more frequently in placebo group (8.3%) compared to investigational product group (4.1%, P = 0.044). The siliceous enterosorbent “Carbowhite” was well tolerated and reduced the recovery time of the acute episode of the diarrhea in the clinically significant form.
Diagnosis of familial medeterranian fever masked by symptoms of chronic pancreatitis
(2014-09) Vasylieva, O.; Katsapov, Dmytro
Diagnostic Value of Neurospecific Markers NSE, S-100, GFAP, MBP and BDNF in Cerebrospinal Fluid in Patients with Viral Meningitis
(Тернопільський державний медичний університет, 2018) Kozko, V.; Sokhan, A.; Burma, Ya.
The aim of the work – to determine the diagnostic value of the levels of neurospecific markers NSE, GFAP, S-100, MBP, and BDNF in the CSF of adult patients with viral meningitis. Patients and Methods. 50 cases of acute viral meningitis were analyzed. There were 21 patients with HSV 1,2 infection, 19 patients with EBV infection, 10 patients with enteroviral meningitis. The CSF level of neuro-specific markers was determined in the first and 10–12 days of treatment using the ELISA method. Results. The most significant changes were identified in patients with severe illness. On the first day of treatment, the levels of NSE, S-100, GFAP, MBP, and BDNF in patients with moderate severity of the disease were lower in patients with enteroviral meningitis (P˂0.001). In severe cases NSE, GFAP and BDNF were higher (P˂0.05) in patients with HSV neuroinfection. The neuro-specific markers NSE, S-100, GFAP and MBP on the first day of treatment were in direct strong correlation with the severity of neurological symptoms. The strongest (r=0.712) direct correlation is observed between the severity of neurological symptoms and the level of NSE and GFAP. At the same time, we found a strong reverse correlation (r=-0.727) between the level of BDNF and the duration of neurological symptoms. Conclusions. Increased levels of NSE, S-100, GFAP and MBP indicate presents damages of neurons astroglia and myelin nerves in all cases of viral meningitis. Major changes are observed in patients with severe neuroinfection. In patients with severe herpes viral meningitis/meningoencephalitis, the activity of regenerative processes in the tissues of the central nervous system decreases due to a decrease of CSF BDNF level (P<0.05)
Diagnostic value of neurospecific markers NSE, S-100, GFAP, MBP and BDNF in cerebrospinal fluid in patients with viral meningitis
(2018) Kozko, Volodymyr; Sokhan, A.; Burma, Ya.
The aim of the work - to determine the diagnostic value of the levels of neurospecific markers NSE, GFAP, S-100, MBP, and BDNF in the CSF of adult patients with viral meningitis. Patients and Methods. 50 cases of acute viral meningitis were analyzed. There were 21 patients with HSV 1,2 infection, 19 patients with EBV infection, 10 patients with enteroviral meningitis. The CSF level of neuro-specific markers was determined in the first and 10-12 days of treatment using the ELISA method. Results. The most significant changes were identified in patients with severe illness. On the first day o f treatment, the levels of NSE, S-100, GFAP, MBP, and BDNF in patients with moderate severity of the disease were lower in patients with enteroviral meningitis (P<0.001). In severe cases NSE, GFAP and BDNF were higher (P<0.05) in patients with HSV neuroinfection. The neuro-specific markers NSE, S-100, GFAP and MBP on the first day of treatment were in direct strong correlation with the severity of neurological symptoms. The strongest (r=0.712) direct correlation is observed between the severity of neurological symptoms and the level of NSE and GFAP. At the same time, we found a strong reverse correlation (r=-0.727) between the level of BDNF and the duration of neurological symptoms. Conclusions. Increased levels of NSE, S-100, GFAP and MBP indicate presents damages of neurons astroglia and myelin nerves in all cases of viral meningitis. Major changes are observed in patients with severe neuroinfection. In patients with severe herpes viral meningitis/meningoencephalitis, the activity of regenerative processes in the tissues of the central nervous system decreases due to a decrease of CSF BDNF level (P<0.05).
Diagnostic value of statistic hepatic scintigraphy in definition of chronic hepatitis and viral cirrhosis of the liver
(2015-03-30) Kozko, Volodymyr; Merkulova, Nina; Tkachenko, V.; Gradil, Grigory; Solomennik, A.; Lavrov, P.; Paskevich, O.; Wickman, Y.; Vasiliev, L.
Dialectics of medical and society interaction: development prospects
(2018) Lantukh, A.; Merkulova, Nina; Solomennyk, A.; Mohylenets, Olena
The article reveals that on the basis of modern interaction of medicine and society, the nature of human’s disease is increasingly determined by social causes, so the Hippocratic model has already been worked out and the transition to a self-regulatory and preventive model becomes relevant. However, modern society more and more requires genetic engineering. It is interested in genomic analysis, gene therapy, and hence the issue of genetic safety is becoming even more acute, especially in aspects of identifying the risk factors for genetic pathology and preparing recommendations for their prevention. Therefore, in the depths of self-regulatory and preventive model, predictive medicine emerges as a protection of human life that prevents the risk of disease and the transmission of diseases to subsequent generations. This encourages further transformation of medicine model, namely, the preventive. In comparison with preventive medicine, it has a larger volume, more filled with social content. Preventive medicine must prevent unwanted illnesses; respond instantly to all technical inventions that are directly related to the person, protection and preservation of his health. Therefore, precisely in preventive medicine some efforts of not only physicians can and should be merged, but also of other specialists: physicists, chemists, biologists, philosophers, theologians and other specialists.
Distribution and frequency of Blastocystis sp. by methods of microscopy and cultivation in faeces of residents of Kharkov region
(2022-07) Bodnia, I.; Pokhil, S.; Bodnia, K.; Pavliy, V.; Skoryk, L.
Dynamics analiysis of the measles incindence rate among the population of Ukraine in the period from 2015 to 2021
(2022-06-10) Yurko, Kateryna; Solomennyk, Hanna; Vynokurova, Olha; Chebotenko, O.; Hladchenko, N.
Effectiveness of Intravenous Isoniazid and Ethambutol
(2019-08-31) Butov, Dmytro; Feshchenko, Yurii; Kuzhko, Mykhailo; Gumeniuk, Mykola; Yurko, Kateryna; Grygorova, Alina; Tkachenko, Anton; Nekrasova, Natalia; Tlustova, Tetiana; Kikinchuk, Vasyl; Peshenko, Alexandr; Butova, Tetiana
Background: The aim of this study was to investigate the effectiveness of intravenous isoniazid (H) and ethambutol (E) administered in patients with new sputum positive drug-susceptible pulmonary tuberculosis (TB) with tuberculous meningoencephalitis (TM) and human immunodeficiency virus (HIV) co-infection in the intensive phase of treatment. Methods: Fifty-four patients with TB/TM and HIV co-infection were enrolled for this study. Group 1 comprised of 23 patients treated with E and H intravenously, while rifampicin and pyrazinamide were prescribed orally. Group 2 consisted of 31 patients treated with the first-line anti-TB drugs orally. The concentrations of H and E in blood serum were detected using a chromatographic method. Results: A significant improvement in the clinical symptoms and X-ray signs in patients treated intravenously with H and E was observed and compared to group 2. The sputum Mycobacterium tuberculosis positivity was observed during the second month of the treatment in 25.0% of patients from group 1 and 76.1% of the patients from the control group (p=0.003). In addition, nine patients (39.1%) died up to 6 months when H and E were prescribed intravenously compared with 22 (70.9%) in group 2 (p=0.023). Conclusion: In TB/TM with HIV, the intravenous H and E treatment was more effective than oral H and E treatment at 2 months of intensive treatment in sputum conversion as well as in clinical improvement, accompanied by significantly higher mean serum concentrations. In addition, the mortality rate was lower in intravenous H and E treatment compared to oral treatment.
Effectiveness of the drug phosphogliv in patients with chronic hepatitis C
(2014-03) Kozko, Volodymyr; Solomennik, G.; Bondar, O.; Mohylenets, Olena; Merkulova, Nina; Vinokurova, O.; Iurko, Kateryna; Minakova, S.

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