No 6 (2015)

Objective. To define all types of monetary costs that are associated with the prevalence of chronic hepatitis C (CHC) and imposed on society. Materials and methods. The epidemiological burden of CHC, which was subsequently transferring into economic burden, was determined during this investigation. The cost-of-illness study was a methodological basis for measuring the economic burden. Results. In 2013, the epidemiological burden of CHC in Russia was determined by the following main indicators. There were 497,300 registered patients with CHC. The duration of a sick leave for virus hepatitides was 4.9 days longer than that for all causes. The able-bodied-aged disabled persons due to CHC and its outcomes were estimated to be 651 people. At this age, there were 5103 deceased cases related to CHC and its outcomes, which was higher than those due to a number of other diseases in this cohort. The economic burden of HCH and its poor outcomes was 29 billion rubles. The pattern of the burden showed a preponderance of indirect costs, the proportion of which constituted slightly more than half. Conclusion. CHC imposes a substantial epidemiological and economic burden on society. Estimation of the economic burden of CHC will provide a well-reasoned basis to decide whether there is a need for the early treatment of this disease.

Objective. To evaluate the efficiency of rehabilitation in frequently ill children (FICs) aged 7-10 years in a sanatorium, by using the dietary supplement Bion ®3 Kid in the package of health promotion measures for the probiotic correction of the microflora. Subjects and methods. Clinical and laboratory data were analyzed in 78 FICs who were in the intermorbid period (beyond the episodes of acute respiratory infections) to be rehabilitated in a children’s sanatorium. In spite of that the children were considered apparently healthy, active complaints of increased fatigability, abdominal pains and headache, dry skin, etc. were revealed through questioning and examination. Results. Normal values in hemogram readings and serum iron, calcium, and zinc levels were detected according to laboratory findings. The microbiota exhibited dysbacteriosis in the oropharynx and intestine (89.7 and 94.9%, respectively), which was mainly caused by the low content of obligate microorganisms and the activation of the transient microflora. All the children were found to have impaired metabolic activity of the enteric microflora as structural imbalance and a preponderance of proteolytic anaerobes. The specific features of metabolic disturbances were identified in relation to the presence of a compromised family history in FICs. Conclusion. Incorporation of Bion ®3 Kid into the package of health promotion measures increases the clinical and laboratory indicators of the efficiency of rehabilitation in FICs and assists in reducing the incidence of recurrent diseases.

The paper gives the results of two large international studies SALING and VIKING-3, on the basis of which dolutegravir (DTG) is recommended as part of second- and subsequent-line antiretroviral therapy (ART) regimens in case of ineffective previous treatment regimens incorporating not only protease or nonnucleoside reverse transcriptase inhibitors, but also first-generation HIV integrase inhibitor (II) [raltegravir (RAL) and elvitegravir (EVG)]. The SALING study has indicated that DTG used in combination with other antiretroviral drugs has a higher virologic efficacy and a higher genetic threshold to the development of resistance than RAL and is also well tolerated by previously treated patients. DTG used as part of an ART regimen using a higher daily dose (50 mg twice daily) (the VIKING-3 study) was effective and safe in patients having rich experience of therapy and HIV resistance to first-generation II (RAL and EVG) and viral multiple resistance to other classes of antiretroviral drugs.

The paper considers the selected issues of the epizootiology of rabies, primarily giving attention to cheiropter reservoirs that are of fundamental importance and relevance in the context of the emergence of new etiological and ecological variants of rabies infection. It gives and discusses the natural and historical signs of the complex ecological and epidemiological pattern of rabies at the present-day stage; data on the real epidemiological importance of rabies in rodents, on its clinical picture and epizootiology in bats, on the role of negrogenicity in the virulence of lyssaviruses, in the reservoirs and geographic distribution of the aerial and terrestrial ecotype of rabies, on cases of bat lyssavirus infection and human morbidity.

The paper briefly reviews the current state-of-the-art of the biofilm-forming capacity of non-fermentative bacteria that are main causative agents of nosocomial infections. The purpose of the paper is to attract the attention of specialists of different profiles to the problems of microorganisms that produce biofilms making bacteria antibiotic and disinfectant resistant. Bacterial biofilm formation stages are shown. The literature dealing with the influence of biotic and abiotic factors on biofilm-forming bacteria is analyzed. Promising areas in the study of bacterial biofilm formation and in the elaboration of measures against the bacteria having this capacity are indicated.

Meningococcemia in children is inherent in the development of infectious and toxic shock with the fulminant disease leading to death. The decline in the incidence of meningococcal infection in recent years has resulted in decreased alertness to this disease and diagnostic errors by physicians. The paper uses clinical examples to analyze the most typical errors made by a physician when diagnosing meningococcal infection.