Huseinov E. Clinical and epidemiological characteristics, diagnosis, treatment and prognosis of acute brucellosis

The dissertation is devoted to increase of efficiency of diagnostics and treatment of acute brucellosis by comparison of epidemiological and clinical features of the disease with markers of inflammation, polymorphism of IL-4 (-6), TLR-2 (-4) genes and development of complications. Scientific data on the epidemiological aspects of the prevalence of acute brucellosis and clinical course of the disease, taking into account the gender, age, occupational and seasonal features of the infectious process are supplemented. It is established that among clinical manifestations of acute brucellosis on the background of general intoxication symptoms hepatolyenial syndrome develops with the development of acute hepatitis in 35,83 ± 4,37% cases with a prevalence of 2.5 times of these symptoms in men and sacroileitis and peripheral arthitis in female is 15.8 and 12 times prevalence, respectively.The research and the data on the defeat of the cardiovascular and hepatobiliary systems in acute brucellosis are studied in detail. In 77.50 ± 3.81% of persons, there were signs of heart damage, both directly in the myocardium, as evidenced by impaired repolarization and a decrease in the myocardial ejection fraction below 50-60%, and the cardiac system. It was found that the ALT level in serum was 1.9 times higher in the main group of patients with acute brucellosis than in the control group of almost healthy persons, and the level of AST in the serum was almost 2.5 times, respectively.Data on the efficacy of various treatment regimens for acute brucellosis and the dynamics of pro- and anti-inflammatory interleukins, as well as TLR-2 (-4) before and after therapy are complited. For the first time, using multivariate covariance analysis (MANCOVA), it was found that Arg/Gln and Arg/Arg polymorphisms of TLR-2 gene compared to Gln/Gln contributed to the accelerated normalization of ESR, CRP, ALT, IL-6, TLR-2, TLR-4 levels in the serum.