УДК: 616.831-001-036.1-02:616.831-001.34

На підставі обстеження 277 пацієнтів у віддаленому періоді гострої черепно-мозкової травми встановлено особливості термінів виникнення, клінічних виявів (синдромів) та особливостей перебігу травматичної хвороби головного мозку залежно від важкості перенесеної травми. У більшості обстежених хворих травматична хвороба головного мозку розвивалась у терміни від 1 до 5 років. У структурі потерпілих переважали чоловіки з легкою черепно-мозковою травмою віком до 40 років. Провідними клінічними виявами були цефалгія і когнітивні розлади, дуже рідко спостерігався паркінсонічний синдром. Отримані дані свідчать про необхідність профілактики розвитку травматичної хвороби головного мозку при проведенні лікувальних заходів у гострому і проміжному періоді черепно-мозкової травми.
Ключові слова: черепно-мозкова травма, травматична хвороба головного мозку, клінічні синдроми.

Objective: Introduction: data about influence of intradermal vaccination with native autoleukocytes on activity level of pro-inflammatory cytokine tumor necrosis factor alpha in patients with chronic hepatitis B have been presented in the article. The aim: Based on positive results, obtained from autoleukocyte immunization in patients with psoriasis [14], the aim of our research was to use and study such therapy for reducing the synthesis of pro-inflammatory cytokine TNF-α in patients with chronic hepatitis B (chronic hepatitis B).

Patients and methods: Materials and methods: Patients with chronic hepatitis B with high level of tumor necrosis factor alpha (≥30pg/ml) were vaccinated with native autoleukocytes (23); simultaneously, the same procedure was performed to patients (11) with low level of this cytokine (5pg/ml). Leukocytes were isolated from heparinized peripheral venous blood of a patient with hepatitis B by centrifuging plasma, obtained after blood precipitation for 140-160 minutes at temperature 370 С. The suspension was resuspended in 1-1.5 ml of a patient's blood serum and injected into the skin of the back in the dose 0.1 ml.

Results: Results: in 30 days after immunization, reduction of tumor necrosis factor alpha was observed in all patients with its high level (100%), in 65.25% of individuals - to 5 pg/ml; in some patients, who had low or average level of pro-inflammatory cytokine, the level individually increased (41.67%).

Conclusion: Conclusions: The elaborated method of influence on activity of tumor necrosis factor alpha in patients with chronic hepatitis B is effective and worth implementing into clinical practice.

Keywords: tumor necrosis factor alpha; vaccination with autoleukocytes; chronic hepatitis B.

Methylobacterium mesophilicum - is a gram-negative bacillus, most often isolated in medical establishments. For humans M. mesophilicum is considered to be conditionally pathogenic flora. Cases of infection with this agent in humans occur, as a rule, in immunodeficient individuals. A clinical description of a rare case of infection with Methylobacterium mesophilicum with development of acute meningitis in 26-year-old patient is presented in the article. A considerable decrease in bactericidal activity of neutrophils was detected in the patient. So far cases of meningitis due to Methylobacterium mesophilicum have not been described.

The article describes the case of a septic form of a listeriosis with multiple abscesses of the liver. Given clinical example illustrates the severe course of listeriosis with the development of septicemia and lesions of internal organs. Despite the adequate etiotropic and pathogenetic treatment for listeriosis meningoencephalitis, there was a lethal outcome of the disease. The polymorphism of clinical manifestations and the range of course variants often make it difficult to diagnose listeriosis, which in turn requires a more thorough examination of patients as well as carrying out all relevant bacteriological and serological tests.

ABSTRACT
The aim: Was a trial of intradermal immunization with native autoleukocytes as a curative vaccine.
Materials and methods: Thus, 3-shot series vaccination by means of intradermal injection of autoleukocytes with 30 – 40 days interval was conducted for patients who, in spite of continuous (at least 2 years) therapy with nucleotide analogue, experienced HBV DNA reproduction. For this procedure, 80 – 100 ml of a patient’s heparinized venous blood was being precipitated at the temperature 37о С for 120 – 140 minutes, after blood plasma was being centrifuged at 450g for 8 minutes. The precipitate was resuspended in 1 – 1.5 ml of blood serum and injected intradermally in the region of the back.
Results: Viral load decreased in all patients even after single immunization; it was possible to achieve a negative result by ultrasensitive PCR method in 23.33% of patients in the group of patients who did not respond adequately to antiviral therapy.
Conclusions: In patients with chronic hepatitis B, intradermal immunization with autoleukocytes has a significant impact on intensity of virus replication. It is confirmed by a considerable reduction of DNA HBV amount in patients, in whom antiviral therapy was stopped before immunization
 KEY WORDS: chronic hepatitis B, therapy with nucleotide analogue, autoleukocyte vaccination