Asunto(s)

RESUMEN

Calcified aortic valves were detected in 109 patients studied in hospital by an echocardiographic method (2D- and M-scanning). It was found that, unlike rheumatism, calcification starting in the aortic annulus and semilunar bases might result in formation of degenerative (non-inflammatory) calcific aortic stenosis. The latter differs from rheumatic aortic stenosis in commissural fusions. The authors defined clinical and echocardiographic differentially diagnostic criteria for degenerative (non-inflammatory) and rheumatic (inflammatory) calcific aortic stenosis. They also discussed pathogenetic aspects of aortic valve calcification and problems of terminology.

Asunto(s)

Asunto(s)

RESUMEN

Altogether 26 cases of anaerobic infection (AI) of various etiology were analysed. Local tissue ischemia and operations on gastrointestinal organs in patients with secondary immunodeficit conditions are the factors facilitating the development of AI. The distinction is made between clostridial AI with a rapidly progressing gaseous gangrene and the non-clostridial AI with a slower course of a serous-purulent phlegmoma. Anaerobic myositis is observed in all forms of AI. Depending on the localisation of AI, anaerobic cellulitis and fasciitis are mentioned which occur mainly in non-clostridial AI. The treatment of AI and the mechanisms of death are discussed.

Asunto(s)

RESUMEN

An experimental study in white mice infected with influenza virus A1, staphylococcus, Pseudomonas aeruginosa, Escherichia coli or Proteus, showed toxic vascular, stromal and cardiomyocyte damage in the myocardium within the first 2-3 days (circulation disorders, edema, dystrophic and necrotic changes in cardiomyocytes), which by day 3-5 were replaced by inflammation resulting in the formation of myocarditic cardiosclerosis foci by the 3d-4th week. Certain immune disorders were detected in patients with infectious myocarditis; cardiac antigen was found in the serum of 24%, anticardiac antibodies in 22%, positive blast transformation tests in 7.5%, as well as reduced quantities of T cells. Coons's method at late dates after staphylococcal angina revealed antibodies to myocardial structures in 45.7% of patients, and those to connective tissue in 36.1-31.4%. Myocarditis signs were identified in part of those. A scheme is proposed for the pathogenesis of infectious myocarditis.

Asunto(s)

RESUMEN

Fourteen cases of nonclostridial anaerobic infections of soft tissues caused by peptococci, peptostreptococci, bacteroids or their combinations with E. coli, Proteus, and Staphylococcus aureus were studied. They are characterized by a rapid spread of serous-suppurative inflammation and the causative agents in loose fibrous connective tissue of subcutaneous adipose tissue (cellutitis), surface fascia (fasciitis), or skeletal muscles (myositis). Dissolution of intercellular structures of the connective tissue, extensive necroses, mild leukocyte reaction, and a wide peripheral zone of toxic edema are observed in the focus of inflammation. This is due to a high toxicity and enzymatic activity of the causative agents. Gas formation is observed when anaerobes are combined with E. coli.

Asunto(s)

Asunto(s)

RESUMEN

Pathological examinations of 23 fatalities due to sepsis caused by polymicrobial flora revealed in 7 cases polymicrobial flora in metastatic foci of dissimilar composition in different foci, in 4 cases monomicrobial flora but varying in different foci, in 12 cases monomicrobial flora similar in all examined septic foci despite the presence in the blood of two or more agents. Localization of metastatic septic foci to a certain extent dependent on the nature of the sepsis causative agents comprising the association. Polymicrobial forms of sepsis were found in fatal cases due to leukemia in 50.0%, to burn sepsis in 10.8%, and to other diseases in 2.8% of the cases, indicating the dependence of their development on the degree of reduction of immunological responsiveness of the patients. The effect of antibacterial therapy given to the patients on the etiology of sepsis is discussed.

Asunto(s)

RESUMEN

Sepsis is an uncompensated bacteriemia with metastatic lesions in the form of purulent vasculites and perivascular necroses in septicemia and abscesses arising later at their sites in pyemia. Purulent resorptive fever differs from sepsis by the lack of metastatic lesions. Septic shock is caused by very acute toxicity in sepsis or purulent resorptive fever leading to disorders in microcirculation with increased permeability of vessel walls, secondary dystrophic and necrotic changes in the organs (lungs, kidneys, liver, heart).

Asunto(s)

RESUMEN

After recovery from sepsis, scars of cysts with fibrous walls are formed at the site of metastatic abscesses containing sideroblasts, lymphocytes and plasma cells in the scar tissue. Focal lympho-plasmacytic infiltrates persist for over a month in the stroma of the organs which had metastatic lesions.

Asunto(s)

Asunto(s)

RESUMEN

In the past decade the rate of purulent infectious complications caused by staphylococci and gram-negative bacteria of the genera Pseudomonas and Enterobacteriaceae which are highly resistant to antibiotics has increased. In therapeutic institutions these microbes cause group contageous diseases which are called "hospital infection". They are characterized by the development of fibrinopurulent, purulent, or purulent-necrotic inflammation. The amount of necrotic changes, the depth of extention of the inflammatory process, and the severity of general toxicity in progressive infection depend considerably on the features of toxins, enzymes, and other biologically active substances of the causative agents. Differences in the pathogenesis, clinical and morphological manifestations, and specific antibacterial means for therapy of purulent infections require that individual forms are distinguished among them by etiology.

Asunto(s)

RESUMEN

The clinical course and morphological changes in 33 limb joints in 20 burnt patients with pyocyanic arthritis have been studied. The latter is characterized by a grave clinical course and not infrequently complicated with sepsis which becomes especially hazardous after destruction of articular cartilages. Destructive changes in the joints would develop in different terms: following 25-45 days in large joints, in smaller one 10-15 days after the appearance of the clinical picture of this complication. Surgical therapy (arthrotomy, amputation of the extremity) associated with conservative measures (antibacterial therapy, blood transfusion, etc) should be considered to be the mostly effective treatment for destructive forms of arthritis.

Asunto(s)

RESUMEN

Analysis of prosector's findings and results of pathoanatomical studies of 65 cases who had died from sepsis showed that its incidence increased from 0.92% in 1956--1960 to 4.11% in 1971-1974. Along with the well-known typical manifestations of sepsis, a number of its perculiar features associated with application of modern therapeutic methods are considered: the prevailing form of sepsis is pyemia (81.5%), considerable incidence of sepsis following peritonitis and septic thrombophlebitis developing at sites of prolonged catheterization of veins. The significance of staphylococci and Bacillus pyocyaneus, which are resistant to the majority of the available at present antibiotics, as principle pathogenes of modern sepsis is emphasized. A dependence between the localization and size of metastatic foci and the kind of pathogene and nature of its toxines is noted. Among the conditions contributing to the development of sepsis the authors consider a reduction of the immunological reactivity of the organism morphologically characterized in the dead persons studied by the absence in lymphatic follicles of lymphatic nodes and the spleen, of "light" centres, drastic atrophic changes in the thymus gland in the majority of cases, and by slightly manifested phenomena of phagocytosis of microbes in the foci of inflammation. The role of operative and other traumas, the character of preceding diseases and application of immunodepressive therapy in the reduction of the immunological reactivity of the organism is tressed.

Asunto(s)

Asunto(s)

Asunto(s)

Asunto(s)

Asunto(s)

Asunto(s)

Asunto(s)