No 2 (2012)

The paper states and substantiates a task to elaborate a strategy for disinfectant prevention, action programs to develop adequate disinfection technologies, the means, ways, and methodologies for their effective use in practice, which in turn develops tactics to choose the most effective, hygienically safe, and economically optimal disinfecting agents, devices, and preparations, which are adequate to the epidemic situations, from the commercially available range.

The structural features of the regulatory ptxP gene were analyzed in the B. pertussis strains currently isolated from whooping cough patients in Russia. The materials of the investigation were 117 B. pertussis strains isolated from whooping cough patients in Moscow, the Moscow, Novosibirsk, and Vladimir Regions in 2000-2010 and those isolated in 1948—1999 (from the collection of the G.N. Gabrichevsky Moscow Institute of Epidemiology and Microbiology, Russian Inspectorate for the Protection of Consumer Rights and Human Welfare). The investigation was performed sequencing ptxP gene fragments, followed by the analysis of nucleotide sequences, by applying the genomic and BLAST programs and EMBL/GenBank database (http://www.ncbi.nlm.nih.gov/entrez). The characterized B. pertussis strains were deposited in the collection of the G.N. Gabrichevsky Moscow Institute of Epidemiology and Microbiology, Russian Inspectorate for the Protection of Consumer Rights and Human Welfare. The structural features of the ptxP gene encoding the pertussis toxin promoter region were studied and the time course of its change was traced in the B. pertussis strains isolated from whooping cough patients in different periods of the epidemic process of pertussis infection. The circulating B. pertussis strains were ascertained to have undergone substantial structural changes in this gene. There were strains carrying a novel non-vaccine ptxP3 allele that had contrast mutational changes involving the functional region responsible for the binding to the BvgA dimer, which led to an enhanced bonding strength and, as a consequence, to increased pertussis toxin production. The investigation has indicated that the B. pertussis population shows a predominance of strains with the novel non-vaccine ptxP3 allele and a high degree of virulence. The formation of a B. pertussis population follows as variability being in the genetic structure of B. pertussis strains with the emergence of novel non-vaccine alleles that have substantial mutational changes in the genes encoding both major pathogenicity factors and their regulatory structures that are responsible for the level of their expression.

The Russian Federation’s poorly established epidemic situation of HIV infection and drug addiction results in a reduction in the number of conscripts found unfit for military service due to their poor health and rejected from the draftees. The paper presents the results of a study of the pattern and trends of HIV infection detection in citizens during conscript and military service in the Armed Forces of the Russian Federation. HIV infection was ascertained to be most common in the military men serving in the high HIV-infection incidence area and in those who had a previous experience in using narcotic agents and had been called up for military service from the above regions. To prevent the import and further prevalence of HIV infection in the Armed Forces of the Russian Federation, it is expedient to make a compulsory medical examination of citizens to be called up for military service.

The objective of the investigation was to study the activity of lipid peroxidation processes and the efficiency of antioxidant defense in patients with hepatic cirrhosis. Thirty-eight patients with varying hepatic cirrhosis were examined in different periods of the disease. These patients were found to have significantly elevated serum malonic dialdehyde levels with the concurrent reductions in catalase activity and superoxide dismutase concentration.

The paper presents clinical data and the results of magnetic resonance imaging (MRI) and computed tomography and postmortem and immunohistochemical studies of the brain in a 12-year-old child, the cause of his death is progressive growth of high-grade tumor glioblastoma. There are problems in the differential diagnosis of encephalitis and glioblastoma because of the similarity of their clinical and MRI patterns in infiltrative tumor growth. The specific feature of the case is herpetic infection of the central nervous system in parallel with cancer. The data available in the literature are analyzed. Possible ways to solve the problems of the differential diagnosis of these diseases are given.

The paper describes approaches to developing the informative biomarkers of the cell surface phenotype of innate immunity system cells and their secreted products to identify groups of patients at high risk for life-threatening complications of healthcare-associated bacterial and viral infections (HCAI), such as sepsis and systemic inflammatory response syndrome. The groups of potential biomarkers selected to be studied include the markers of immune system cells (HLA-DR, CD88, CD14, and CD33) that do not belong to the lymphoid series (monocytic and myeloid cells). It is suggested that the quantification of the profile of biomarkers (the so-called immune phenomenon) will assist in identifying patients at the highest risk for severe, life-threatening complications of HCAI. The results of the study may be used as the basis for the substantiation of a personified approach to implementing expensive preventive or early therapeutic measures to reduce deaths from HCAI complications (viral and bacterial infections).

An estimated 350 million people have chronic hepatitis B virus (HBV) infection and most of them live in resource-constrained settings. Up to 25% of those persons will die prematurely of hepatocellular carcinoma (HCC) or cirrhosis. Universal hepatitis B immunization programmes that target infants will have an impact on HBV-related deaths several decades after their introduction. Treatment of HBV infection in those who need it has been shown to reduce the risk of HCC and death. It is estimated that 20-30% of persons with HBV infection will benefit from treatment. There are antiviral drugs active against HBV; however, they are not widely available or utilized in persons infected with HBV. Currently recommended antiviral agents used for treatment of human immunodeficiency virus (HIV) infection do not adequately suppress HBV replication, which is of great concern for 10% of the HIV-infected persons in Africa who are diagnosed as being co-infected with HBV. Progressive liver disease has been found to occur in co-infected persons who take no drugs to suppress HBV. In view of these problems, an informal World Health Organization (WHO) consultation of experts concluded that: chronic HBV is a major public health problem in developing countries; all HIV-infected persons should be screened for HBV infection; HIV/HBV co-infected persons should be treated with therapies that are active against both viruses and that reduce the risk of resistance; standards for the management of chronic HBV infection should be adapted to resource-constrained settings. In addition, a research agendum has been developed mainly to prevent and treat chronic HBV infection in resource-constrained settings. The WHO is developing guidelines for the management of chronic HBV infection in resource-constrained settings. An informal WHO technical consultation was held to have expert data for next steps to solve the serious public health problem related to HBV infection and its associated disease burden. It was attended by the representatives of professional medical associations dealing with the study of liver diseases, who are well familiar with guidelines for their treatment in resource-constrained setting, as well as by clinicians from resource-constrained countries and by the representatives of affiliated organizations. The conclusions and recommendations made by this consultation are not a portrayal of the official policy of the WHO and its official guidelines; however they will be of importance in meeting the demands of million HBV-infected people worldwide.