Presents a clinical case, demonstrating the complexity of differential diagnosis of botulism of a child on the first year of life. The tactic of laboratory research, the therapy and the clinical result of the treatment was described.

The goal is to study the effects of pro-inflammatory agents on the expression of NLRP3 and the structural integrity of cerebral microvessel endothelial cells in vitro.Materials and methods. The study was conducted on a culture of cerebral endothelial cells. The cells were isolated from Wistar rat brains. Polyinosinic-polycytidylic acid (RolyI: C) – 20 µg / ml was added to cerebral microvessel endothelial cells. In another series of experiments, cells incubated with cerebrospinal fluid (CSF) obtained from patients with enteroviral meningitis (100 µl) were used as a comparison group. CSF was standardized for protein concentration by the Lowry method. The protein concentration was 1 µg / ml. As a control group, cerebral endothelial cells have been cultured in a standard medium. We used the culture insert for 12-well plates. After 24 and 72 h of culturing, we measured transendothelial electrical resistance (TEER) in the endothelial layer. Expression of NLRP3 inflammasomes was assessed with immunocytochemistry 24 hrs from the beginning of cell culture. We used double indirect immunoenzymatic staining method according to the manufacturer’s protocol. Primary antibodies to NLRP3 (Abcam, USA, ab51952) in 1: 100 dilution, secondary antibodies labeled with Alexa Fluor 488 (Abcam, USA, ab150117) in dilution 1: 200 have been applied. Visualization was performed by confocal laser microscopy microscope Olympus FV10i (Olympus, Japan).Results. TEER decreased in PolyI:C and CSF-treated cells after 24 hr from the beginning of incubation. After 72 hours, TEER was significantly lower in these groups compare to the control one. NLRP3 expression was maximal in the cells treated with CSF. After incubation of the cells with PolyI:C, NLRP3 expression in cerebral endothelial cells was elevated compare to the control group, but did not reached the level seen in CSF-treated cells.Conclusion. PolyI:C and CSF obtained from the patients with viral meningitis induce disruption of cerebral microvessels endothelial layer integrity with the corresponding rise in NLRP3 expression in the cells, thereby suggesting mechanism of blood-brain barrier impairment in neuroinfection.

The infectious diseases of the central nervous system in children continue to retain the status of a current clinical and scientific problem. The leading place in the structure of the central nervous system nosology of infectious lesions occupies bacterial purulent meningitis (BPMs), characterised by severe, high mortality rate and the risk of the formation of neurological deficiency in the residual period of the disease. BPMs occupy the tenth place in the structure of mortality rate from infectious diseases. The aim To investigate the clinical and epidemiological features of bacterial purulent meningitis in children registered in the Krasnoyarsk Territory. We have analysed the etiologic and age structure, the degree of the severity, the course and outcome of the disease in 142 children aged 0 to 14 years old who were hospitalised in the infectious hospital of Krasnoyarsk in the period 2011–2016. We used the methods of laboratory diagnostics (PCR, reaction of latex agglutination, bacterial inoculation of cerebrospinal fluid and blood for aetiology evaluation) that allowed deciphering the aetiology in 59.8% of patients observed. Based on the laboratory tests results, 38% (54 patients) were diagnosed with meningococcal meningitis (MM), while in 57.4% of cases the disease was associated with meningococcemia. In 12.9% (11 patients) the pneumococcal aetiology of meningitis and in 9.4% (8 patients) the hemophilic aetiology of meningitis was confirmed. The babies of the first month of life (18.58%) had demonstrated the BPME clinical picture; in 33.3% of cases Streptococcus group B was a leading causative factor. The aetiology of BPMs has not been established in 40.2% (57 patients). The largest part of the patients with BPMs was represented by the children aged from 0 to 3 years – 79.6% (113 patients). BPMs usually developed in children with altered premorbid background: hypoxic-ischaemic injury of the central nervous system (55.8%), frequent SARS in anamnesis (10.6%), and congenital malformations (4.2%). It is known that the BPM can be both primary and secondary due to the generalisation of the primary site of infection. Thus, the analysis of the cases revealed that in 37.6% (53 patients) the development of meningitis was preceded by acute inflammatory diseases of the upper respiratory tract, otitis, and sinusitis. Post-traumatic injury of the CNS occurred in 5.6% of cases (8 patients). Depending on the severity of general infections, general cerebral and meningeal symptoms, the character of the CSF and peripheral blood changes, severe BPMs developed in 71.2% of the patients, while 28.8% had demonstrated moderate BPMs. The attention is drawn to a large percentage of complications that developed in the acute period of BPMs, with prevailing septic shock (27.5%) with the development of Waterhouse-Friderichsen syndrome (3.5%), oedema of the brain (37.3%), and impaired consciousness (23.9%). The lethal outcome occurred in 9.8% of cases (14 patients). In 31% of patients, severe residual effects occurred: hypertensive hydrocephalus syndrome (21%), paresis and paralysis (4.7%),- convulsions (1.56%), and strabismus (14%). Thus, the analysis shows that BMPs are characterised by a predominance of severe, complicated forms of the disease, a possible development of lethal outcome, which in turn requires searching for new highly sensitive markers of severity assessment and prognosis.

The objective of the research was to study clinical and epidemiological features and outcomes of generalized forms of meningococcal infection in children from Krasnoyarsk and Krasnoyarsk Territory during the period from 2012 to 2016. Materials and methods. A retrospective analysis of 57 medical records of hospital patients with generalized forms of meningococcal infection was carried out in the infectious and resuscitative departments of the Krasnoyarsk Clinical Hospital No. 1 from 2012 to 2016, including 12 protocols of pathologoanatomical studies of the deceased patients and 45 medical cards of ambulatory patients – convalescents of the disease from 2012 to 2016. Results. The epidemic situation for meningococcal infection in Krasnoyarsk Territory from 2012 to 2016 is characterized by signs of inter-epidemic period. Children of the first 3 years of life are in the group of high risk for the development of GFMI, which accounts for 74% of the total number of cases of children aged 14. There are signs of meningococcal infection «aging» – in the age structure the number of children in the first year of life decreased, while the proportion of children aged 4–7 and 7–14 increased compared to previous decades. There is a tendency to a decrease in the proportion of the combined forms with an increase in the frequency of «pure» meningococcemia. In recent years there has been an «atypical» course of generalized forms of the disease, when classical hemorrhagic necrotic rashes appear only on the 3rd – 4th day of the disease. In convalescents who underwent a combined form of MI and «pure» meningitis severe residual effects leading patients to disability are possible to develop. Conclusion. The use of polyvalent conjugated vaccines in potential risk groups will allow us to reduce the morbidity and mortality from generalized forms of meningococcal infection, including younger children.

Current experimental models of the blood-brain barrier (BBB)in vitro used for studying mechanisms of permeability and intercellularcommunication are discussed in this review. At present,monolayer, multilayer and computer models are in use for theabove-mentioned purposes. Primary isolated cells that make upthe models in vitro may have brain and non-brain origin. Inaddition, transplantable cell lines and co-cultured cells could beused for modeling BBB in vitro.

The objective of the research was to study clinical and epidemiological features and outcomes of generalized forms of meningococcal infection in children from Krasnoyarsk and Krasnoyarsk Territory during the period from 2012 to 2016. Materials and methods. A retrospective analysis of 57 medical records of hospital patients with generalized forms of meningococcal infection was carried out in the infectious and resuscitative departments of the Krasnoyarsk Clinical Hospital No. 1 from 2012 to 2016, including 12 protocols of pathologoanatomical studies of the deceased patients and 45 medical cards of ambulatory patients – convalescents of the disease from 2012 to 2016. Results. The epidemic situation for meningococcal infection in Krasnoyarsk Territory from 2012 to 2016 is characterized by signs of inter-epidemic period. Children of the first 3 years of life are in the group of high risk for the development of GFMI, which accounts for 74% of the total number of cases of children aged 14. There are signs of meningococcal infection « aging » – in the age structure the number of children in the first year of life decreased, while the proportion of children aged 4 – 7 and 7 – 14 increased compared to previous decades. There is a tendency to a decrease in the proportion of the combined forms with an increase in the frequency of « pure » meningococcemia. In recent years there has been an « atypical » course of generalized forms of the disease, when classical hemorrhagic necrotic rashes appear only on the 3rd – 4th day of the disease. In convalescents who underwent a combined form of MI and « pure » meningitis severe residual effects leading patients to disability are possible to develop. Conclusion. The use of polyvalent conjugated vaccines in potential risk groups will allow us to reduce the morbidity and mortality from generalized forms of meningococcal infection, including younger children.

The article presents the current clinical and epidemiological features of enterovirus infection in children of Krasnoyarsk Territory. A retrospective analysis of the incidence of enterovirus infection and enterovirus meningitis in the period 2014—2015 according to the forms of state statistical reporting №2 «Information on infectious and parasitic diseases». Clinical and epidemiological analysis of enterovirus infection in 454 children who were treated at MBUZ «City Children's Infectious Hospital №1» in the period of seasonal rise of morbidity in 2014 revealed a prevalence of etiological structure of enteroviruses Coxsackie B, Coxsackie B5, Coxsackie B3, Coxsackie B4. The region recorded the different clinical forms of enterovirus infection (rash, myalgia, diarrhea, gerpangina), the structure of which is still, aseptic meningitis prevails.

Meningococcal infection (MI) for many years has occupied one of the most important places in the structure of acute neuroinfections in children. Some decline in MI morbidity in recent years has reduced the alertness of doctors to early detection of the disease that in some cases becomes the cause of late hospitalization, development of decompensated shock and ineffective resuscitation. The purpose of the given research is to identify the causes of deaths from generalized forms of MI and the prospects of mortality reduction. The paper gives the expert analysis of 22 medical histories of children who died of generalized forms of MI during the period from 2005 to 2014 in Krasnoyarsk. The work describes the features of the clinical picture of MI generalized forms in children at the present stage, reveals the causes of deaths during the period of sporadic morbidity in the Krasnoyarsk Territory and determines the adverse prognostic features that indicate the particular severity and the development of fulminant course of the disease.

Purpose: to evaluate epidemiologic situation as to meningococcal infection and reveal clinical-epidemiological features of the disease on the territory of Krasnoyarsk сity and Krasnoyarsk Krai at the present stage. Data and methods: The research gives the analysis of MI morbidity and mortality rates in children of the region according to official information from the Federal Service for Supervision of Consumer Rights Protection and Human Welfare in Krasnoyarsk Krai for the period 2000–2014. The work studies clinical and epidemiological features of the disease in 53 patients with the generalized form of meningococcal infection (GFMI) who were treated in the infectious disease department of the Regional Interdistrict Children’s Clinical Hospital of Krasnoyarsk for the period 2010–2014. Results: The epidemiological situation as to MI in Krasnoyarsk for the period 2000-2013 years is characterized by the signs of interepidemic period with morbidity rises in the winter-spring period. Children from 1 year to 3 years (54,7%) prevail over all MI diseased. The number of children in the first year of life decreased almost two times (from 40% to 20,7%). At the same time the proportion of children older than 4 years increased. The leading serotype among laboratory-confirmed cases of MI in Krasnoyarsk Krai is still the B group meningitis (64,7%). Conclusion: On the territory of Krasnoyarsk Krai the MI morbidity is sporadic. The generalized forms of meningococcal infection are characterized by early overt symptoms which make it possible to set a diagnosis. The clinical picture of the generalized forms of the disease almost did not change significantly.

Meningococcal infection (MI) for many years has occupied one of the most important places in the structure of acute neuroinfections in children. Some decline in MI morbidity in recent years has reduced the alertness of doctors to early detection of the disease that in some cases becomes the cause of late hospitalization, development of decompensated shock and ineffective resuscitation. The purpose of the given research is to identify the causes of deaths from generalized forms of MI and the prospects of mortality reduction. The paper gives the expert analysis of 22 medical histories of children who died of generalized forms of MI during the period from 2005 to 2014 in Krasnoyarsk. The work describes the features of the clinical picture of MI generalized forms in children at the present stage, reveals the causes of deaths during the period of sporadic morbidity in the Krasnoyarsk Territory and determines the adverse prognostic features that indicate the particular severity and the development of fulminant course of the disease.

The paper presents the results of the research on effectiveness of combined antiviral therapy conducted with pegylated interferon alpha 2b of prolonged action (Peginterferon alpha 2b at a dose of 60 mcg/m2 per week) and Rebetol (Ribavirin at a dose of 15 mg/kg per day) in 26 children with chronic viral hepatitis C aged from 3 to 17, who underwent regular medical check-ups in City Clinical Hospital № 20 named after I.S. Berzon in Krasnoyarsk. Evaluation of effectiveness of combined antiviral therapy revealed that patients with genotype 1 had an immediate virologic response in 78,5% of cases, 83,3% of patients with genotype 2, 3 had a stable virologic response.

The results of studies of the safety and clinical efficacy of interferon inducer in influenza and other acute respiratory viral infections in children aged 7–14 years are presented. It is shown that the antiviral immunostimulating agent reduces main symptoms of the disease, prevents the development of complications and can be recommended for use in pediatric patients for the treatment of influenza and other acute respiratory viral infections.

Authors discuss etiology of bacterial purulent meningitis in 190 examined children (Krasnoyarsk, 2005–2009). Etiology of meningitis was detected in 68.5% of cases. 57.7% of 130 cases are generalized forms of meningococcal infection, 16.9% –meningitis caused by Haemophilus influenzae, 11.5% – pneumococcal, and 8.4% – streptococcal one. Pneumococcal meningitis differed not only by lesion of tunics but lesion of brain, by severity of disease, prolonged clinical course with development of complications which were life-threatening and in some cases leading to development of disability. Key words: children, bacterial purulent meningitis, pneumococcal meningitis, clinical symptoms, clinical course, outcomes. ( Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(4): 110-113 )

Authors discuss etiology of bacterial purulent meningitis in 190 examined children (Krasnoyarsk, 2005–2009). Etiology of meningitis was detected in 68.5% of cases. 57.7% of 130 cases are generalized forms of meningococcal infection, 16.9% –meningitis caused by Haemophilus influenzae, 11.5% – pneumococcal, and 8.4% – streptococcal one. Pneumococcal meningitis differed not only by lesion of tunics but lesion of brain, by severity of disease, prolonged clinical course with development of complications which were life-threatening and in some cases leading to development of disability.Key words: children, bacterial purulent meningitis, pneumococcal meningitis, clinical symptoms, clinical course, outcomes.(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(4):110-113)