Mononucleosis is generally considered a benign, self-limited disease. However, though uncommon, fatal complications are sometimes encountered. Deaths from liver failure, splenic rupture, respiratory obstruction, neurological complications, secondary infections and bleeding complications have been described. In the forensic setting, there are a few reports of sudden and unexplained deaths from splenic rupture and upper airway obstruction. We report here the first case of sudden and unexplained death from acute hepatitis in infectious mononucleosis presenting as a suspicious death.
A total of 73 patients with acute pneumonia received two-stage treatment: etiotropic treatment based on early etiological diagnosis (at hospital) and subsequent early rehabilitation at sanatorium with the use of peloid therapy. It made it possible to attain the best short-term results in the treatment of pneumonias (as compared with control group patients), to shorten 2-4-fold the times of the patients' stay at hospital and to raise bed capacity, to reduce the total doses and duration of antibacterial therapy, to decrease the possibility of the allergic reactions and side effects, and to reduce 2-fold the cost of antibacterial therapy.
The effect of a selective 5-HT(1A) antagonist, 4-(2'-methoxy-)phenyl-1-[2'-(N-2"-pyridinyl)-p-iodobenzamino-]ethyl-piperazine (p-MPPI), on acute ethanol-induced hypothermia, sleep and suppression of acoustic startle reflex in C3H/He mice and Wistar rats was studied. Administration of p-MPPI at the doses of 0.4, 0.7 and 1.0 mg/kg reduced in a dose-dependent manner the ethanol-induced hypothermia and the sleep time and attenuated the ethanol-induced decrease of acoustic startle reflex magnitude in mice. Similar p-MPPI (0.4 mg/kg) effects on ethanol-induced sleep and hypothermia were obtained in rats. It was concluded that 5-HT(1A) receptors were involved in the mechanisms of the ethanol-induced hypothermia and sleep, and that 5-HT(1A) antagonist increased acute ethanol tolerance.
Great experience with treatment and a comprehensive investigation of the severe combined trauma allowed the authors to choose six basic principles to be followed in diagnosing and treatment of this surgical pathology whose peculiarity is the phenomenon of mutual aggravation of the injuries. Following these principles, especially at surgical hospitals, promotes complete diagnosing, choice of the rational treatment policy in order to avoid medical errors and severe posttraumatic and postshock complications and to improve the outcomes. The authors prove expediency of organization of the multifield specialized centers for treatment of patients with the severe combined traumas.
Changes in the incidence of myocardial infarction, and associated mortality and lethality rates are reviewed over a 8-year period in an Novosibirsk district. Data on late postinfarction outcomes, obtained in a WHO-sponsored study, "Acute myocardial infarction register", are also presented. The incidence, mortality and lethality rates are showing a stabilization trend at present; in late outcomes, the greatest mortality and lethality rates fall to the first postinfarction year.
The article summarizes 15 years of experience of the use of moxifloxacin (Avelox) in Russia in patients with acute bacterial rhinosinusitis. Emphasize its high bactericidal activity against a broad spectrum of microorganisms- from basic agents to the atypical and anaerobic microflora. The results of these studies suggest the continued effectiveness of the dosage of 400 mg a short course (7 days) over 15 years of practical use of the drug, which in its clinical efficacy is superior to amoxicillin/clavulanate, cefuroxime axetil and levofloxacin. The safety profile of moxifloxacin, studied at the population level is not associated with an increased risk of adverse effects in compliance with the dosing regimen, taking into account the indications and contraindications.
The aim of the study was to investigate present and past morbidity in drug addicts, 25 years after hospitalisation for acute hepatitis B or hepatitis nonA-nonB. The hospital records for 214 consecutively admitted patients were analysed, and a follow-up study on 66 of the 144 patients still alive was performed. At follow-up, 1 of 54 (1.8%) hepatitis B patients was still HBsAg positive. Twelve patients originally diagnosed as hepatitis nonA-nonB were all among 54 found to be anti-hepatitis C virus (anti-HCV) positive, and the total anti-HCV prevalence was 81.8%. Twelve (22.2%) of the HCV cases were unknown before the follow-up examination. Four (6.1%) participants were anti-human immunodeficiency virus positive, only 1 was on antiretroviral therapy, and none had developed AIDS. Other chronic somatic diseases were a minor problem, whereas drug users reported skin infections as a frequent complication. Forty-three patients (65%) had abandoned addictive drugs since the hospital stay. Serious mental disorders were reported by 19 patients (28.8%), and 17 (25.8%) regarded themselves as present (9) and former (8) compulsive alcohol drinkers. A large proportion of the participants were granted disability pension (39%), a majority because of psychiatric disorders, drug and alcohol abuse.