Terapevt Arkh
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Altogether 52 children suffering from reactive arthritis were placed under observation. In 45 patients arthritis developed after nasopharyngeal infection and was marked by a favourable course with a rapid positive dynamics. 7 children with a history of intestinal infection manifested Reiter's syndrome; in these children arthritis was characterized by a grave and prolonged course and by a high laboratory activity. HLA A10 (RR = 2.7), B27 (RR = 2.5) and DR2 (RR = 2.19) antigen were detected significantly more frequently in ReA patients who suffered nasopharyngeal infection. In children with Reiter's syndrome, the genetic markers of predisposition to the disease were HLA A10 (RR = 5.93) and B27 (RR = 149.1) antigens.
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The rise of the sepsis incidence at therapeutic hospitals, the emergence of new forms and evolutionally new mechanisms of infection, insufficient efficacy of antibacterial therapy necessitate the search of novel approaches to the treatment of sepsis. The use of plasmapheresis (PP) in 27 sepsis patients allowed a two-fold reduction of the lethality as compared to that in the control group. The main mechanisms by which PP acts may involve deblockade of the system of phagocytosing mononuclears, enhancement of the efficacy of antibacterial therapy, protective action on the system of natural detoxication of the body.