Vol 24, No 3 (2019)

Purpose. To develop ways to improve the regional model of providing medical care to infectious patients in the Republic of Tatarstan on the basis of the rational use of available resources and the introduction of modern medical technologies. Results and discussion. Over the analyzed observation period of 13 years (2005-2017), there was a significant reduction in the resource provision of the infectious diseases service of the Republic of Tatarstan, including the material and technical base, human resources (infectious disease doctors) and the cost of medical care infectious patients. During the same period, the primary infectious morbidity (FM) of the population tended to decrease (the rate of decline was 17.0%). The significant impact of the resource provision of the infectious service (CID, beds, infectious disease physicians) on the indicators of the IZ population (p <0.05) has been established. Effective ways to improve the ways of improving of specialized medical care for infectious patients are presented - the creation of the Republican Advisory Center for Infectious Pathology and reception and diagnostic departments based on infectious hospitals. Conclusions. The introduction of new structural and functional models in the work of the infectious service will improve the availability and quality of medical care for infectious patients throughout the territory of the Republic of Tatarstan in the context of existing resource support.

Taking into account the high prevalence of cutaneous leishmaniasis in Uzbekistan, as well as the tendency of increase in the incidence of this disease over the past 5 years, important and necessary is to determine the species composition of leishmania, as well as their vectors and natural reservoirs. According to the results of molecular-biological diagnostics, carried out in present study, in samples taken from ulcers of patients from Jizzakh region, which previously considered endemic for anthraponotic cutaneous leishmaniasis, was detected L.mayor, the causative agent of zoonotic cutaneous leishmaniasis.

The incidence of acute intestinal infections in the Russian Federation remains high and does not tend to decrease. The General susceptibility of the population, the variety of pathogens of infectious diseases accompanied by diarrhea syndrome, necessitates the improvement of clinical diagnosis and differential diagnosis in the treatment of patients with diarrhea at the primary stage of medical care. The article presents the etiological and epidemiological aspects of the most common in the Russian Federation acute intestinal infectious diseases accompanied by diarrhea syndrome: food toxicoinfections, viral gastroenteritis, salmonellosis, shigellosis, campylobacteriosis, pseudomembranous colitis. The sources of infection and pathways of pathogens are characterized. The pathogenesis of the main types of diarrhea caused by various pathogens of intestinal infections is described. It is shown that the action of enterotoxins of pathogens that activate adenylate cyclase contributes to the development of secretory type of diarrhea; the place of localization of the pathological process is the small intestine. Pathogens exhibiting high invasive activity contribute to the development of inflammatory type of diarrhea; the pathological process is localized in the colon. With direct damage to enterocytes of the small intestine by pathogens of viral gastroenteritis, an osmotic type of diarrhea is formed, associated with a violation of the digesting and absorption function of the small intestine. Presented distinctive clinical criteria of three types of diarrhea: color, consistency of the stool, the presence of pathological impurities in it. The differences of abdominal syndrome in the analyzed nosology: the nature and localization of abdominal pain. The presented differential diagnostic signs of diarrhea and abdominal syndrome allow for early diagnosis of infectious disease before laboratory confirmation and contribute to the improvement of the algorithm of medical care in acute intestinal infections accompanied by diarrhea syndrome.