Vol 11, No 2 (2021)

Objective. To analyze the incidence of acute respiratory infections (ARI) in the f irst half of 2020 versus the same period of2016-2019 in the regions of the Russian Federation according to the population size, geographical location, and average annual air temperature. Materials and methods. The investigators retrospectively analyzed the incidence of COVID-19, acute respiratory viral infections (ARVI), influenza, and community-acquired pneumonia (CAP) in Russia. The Kolmogorov-Smirnov test and Spearman’s regression and correlation analysis were used to determine the possible association of morbidity with climatogeographic and social characteristics. Results. The incidence of ARI (including COVID-19) in the first half of2020 exceeded the average incidence of ARI in the same period of 2016-2019 in 32 regions of the Russian Federation. The maximum excess was observed in the regions located in the immediate vicinity of the People’s Republic of China, the countries of the Middle East and the European Union. These were the Republics of Buryatia (33.78%), Tyva (51.34%), Ingushetia (79.76%), Altai (693.77%), Dagestan (1445.00%), the Trans-Baikal Territory (44.01%), and the Kaliningrad Region (651.98%). The incidence increase was less pronounced (0.01-22.28%) in 25 regions of the Russian Federation, whereas its decrease by 0.55-37.29% was noted in 53 regions. There was a statistically significant relationship between the incidence of ARI and the population size. Conclusion. In the first half of 2020, the maximum increase in incidence of ARI versus that in other regions was recorded in the border regions. There was a weak significant relationship between the population size and the increased incidence of ARI. There was no association between the incidence increase and the average annual air temperature.

Objective. To assess the epidemic situation over a long time and the clinical course of non-poliomyelitic enterovirus infections (NEVI) in the Krasnodar Territory. Subjects and methods. The manifestations of the epidemic process were retrospectively analyzed; the paper gives the results of virological monitoring and the characteristics of the clinical manifestations of NEVI in 170 adult patients hospitalized in the Krasnodar Territory from 2002 to 2019. Results. The epidemiological features of enterovirus infection in the territory are mainly sporadic childhood morbidity, summer-autumn seasonality, and contact transmission. The climatic and geographical features of the region determine the risks of complicating the epidemic situation associated with the possibility of importing new strains of enteroviruses due to the influx of tourists to the Black Sea coast in the summer months. NEVI was characterized by a benign clinical course and a tendency to the prevalence of its mild forms among outpatients and to that of serous meningitis among inpatients. Conclusion. The epidemic process of NEVI in the Krasnodar Territory is sustained and tends to increase in intensity due to the constant circulation of various enterovirus serotypes and to changes in the pathogenic landscape. It is advisable to take further measures for the epidemiological surveillance of NEVI, by developing prognostic technologies, as well as to train physicians of various specialties in diagnosing the disease.

Objective. To comparatively analyze the incidence of COVID-19 among the population of Moscow and in the organized groups of dormitories during the pandemic period March to June 2020, by taking into account the stages of constraint release. Materials and methods. A selective longitudinal prospective analytical study was conducted in the period April 12 to June 23, 2020 in 350 COVID-19 foci formed in the Moscow dormitories with a total number of3,228 cases compared to the dynamics of a daily increase/decrease in COVID-19 cases among the population of Moscow, as shown by official statistics. Results. There was a direct relationship of the change in the number of COVID-19 cases among the residents of dormitories to the intensity of a daily increase in new cases of diseases in Moscow (r = 0.81; p = 0.0001) in the period April 12 to June 23, 2020. Over the same period, the changes in the number of foci in the dormitories were strongly correlated with the daily increase in new COVID-19 cases (r = 0.72; p = 0.0001). The similar results were observed when studying the trend in the incidence of COVID-19 in the dormitories of the city, which had a significant correlation with the trend in the incidence of this disease in the population of Moscow (r = 0.6; p = 0.00000002). Conclusion. The study has demonstrated the effectiveness of timely and comprehensive antiepidemic measures in the foci of COVID-19 in the dormitories at the metropolitan level. The introduced restrictive measures are fundamental in the formation of a change in the trend in the incidence of this disease in the population in both the megalopolis itself and organized groups.

Objective. To investigate the dynamics of self-assessments for the emotional state in HIV-infected patients and to assess behavioral strategies aimed at reducing the stress load. Subjects and methods. The investigation was conducted using the questionnaire method. Group 1 included 79 HIVinfected patients who were interviewed on May 21 to June 15, 2020; Group 2 consisted of 81 respondents who were interviewed on October 16 to November 27, 2020. The authors studied the dynamics of self-assessments of a risk for coronavirus infection and the emotional state of the respondents, changes in behavioral strategies aimed at reducing the level of stress due to coronavirus infection (COVID-19). The findings were assessed using the content analysis method. Results. The respondents most often rated their risk for COVID-19 as the same as for most people (72.4 and 76.5% in Groups 1 and 2, respectively). The proportion of respondents denying the risk of infection decreased (18.9 and 12.3%, respectively), while that of respondents rating it as high increased (5 and 7.4%). The denial of anxiety due to COVID-19 decreased from 51.9% to 44.4% over time, with an increase in the proportion of respondents who reported frequent feelings of anxiety (3.8 and 6.2%). The answer «I feel anxiety almost all the time» was recorded for the f irst time in Group 2 (2.5%). The median scores of the Emotions Self-Assessment Scale were 9.0 [5.0; 8.0] in Group 1 and 7.0[5.0; 10.0] in Group 2 (p = 0.02). The self-rating of 5scores and the lower scores on the visual analogue scale were recorded in 25.52 and 30% of cases in Groups 1 and 2, respectively. The cumulative content of anxiety reduction techniques by the groups was 66 and 99 units, respectively. Individual ways of maintaining the mental ecology prevailed. Group 2 showed a statistically significant decrease in the role of religion and religious rites in reducing the anxiety of respondents, as well as the importance of limiting unreliable information about the coronavirus, the use of only reliable information sources were noted for the first time; there were also descriptions of maladaptive behaviors (excessive eating, drinking, smoking), but their share was low (4.9%). Sleep and rest as ways to reduce anxiety and stress were relevant only in Group 2. Conclusion. The HIV-infected respondents exhibited an increasing level of COVID-19 epidemic-induced emotional distress (negative emotional coloring of the situation, lack of adaptive methods for reducing anxiety/stress), which should be taken into account when consulting during the pandemic and future vaccination campaigns for people living with HIV.

Objective. To investigate the clinical and epidemiological characteristics of patients with potentially HPV-related head and neck cancers on the basis of the results of a sampling study. Subjects and methods. The investigators retrospectively studied data from 295patients with head and neck cancers who had sought medical care at University Clinical Hospital One, Sechenov University, in 2018 to 2020. The information was obtained applying the inpatient medical records (Form 003/y) and the questionnaire method. Analytical and statistical methods were used to analyze and process the material. Results. HPV16 was most frequently detected in 75.7% (56.7-89.1%) of patients with oral and pharyngeal cancers and in 25% (4.7-63.2%) of those with laryngeal cancer. There was a significant preponderance of patients with Stages III and IV. Among the deceased, the proportion of people with HPV-positive head and neck cancers accounted for 10.0% (2.8-24.8%). The proportion of low-grade squamous cell carcinoma was 41.2% (33.9-48.7%). Conclusion. The identified clinical and epidemiological characteristics of patients with potentially HPV-related head and neck cancers should contribute to the further improvement of the existing prevention programs for this condition and to the development of new ones.

Objective. To substantiate the need to develop a system for the epidemiological safety of ultrasound diagnosis. Material and methods: A psychological verbal communication method was used. The survey was conducted by the Russian Association of Ultrasound Diagnosticians in Medicine (RAUDM) among 7,000 diagnostic ultrasound practitioners. A questionnaire was designed by the experts of the G.N. Gabrichevsky Moscow Research Institute of Epidemiology and Microbiology and approved by the RAUDM Executive Committee. The investigators analyzed the results of the questionnaire survey by 869 (12.4%) ultrasound diagnosticians representing 77 administrative territories of the Russian Federation. Results. Percutaneous and intracavitary sensors between patient uses were not disinfected in 38.7% and 16.8% of respondents, respectively. Only 50.0% of respondents were disinfected at the final stage of processing the sensors used for intraoperative studies. Non-sterile coatings for intracavitary sensors were used in 34.3% of respondents; sterile disposable coatings for sensors during intraoperative examinations were irregularly applied to 9.3% of respondents. Conclusion. The investigators have revealed the potential risks of infection in patients during ultrasound examinations, which are associated with ultrasound diagnosticians’ lack of awareness of infection prevention and control. It is necessary to develop a system for the epidemiological safety of ultrasound examinations with the standardization of requirements for its components.

Objective. To design the optimal composition of protective media for lyophilization of the reference Yersinia pestis EV NIIEG strain and its genetically engineered variants Y. pestis EVA and Y. pestis EV76R16, with chromosomal and plasmid resistance to antibiotics, respectively. Materials and methods. The quantitative ratios of the components of the protective media based on the standard sucrose-gelatin with thiourea (SGT) medium were optimized using the mathematical experiment planning methods (PFE 23) and (PFE 2*). The Monte Carlo method was used for calculations according to the licensed random number generation program. The results of experimental studies conducted on the proposed matrix were used to construct mathematical models for the processes of optimizing protection environments. The obtained models constructed for each of the Yersinia pestis EV NIIEG, Y. pestis EVA, and Y. pestis EV76R16 strains taken in the experiment, without performing natural experiments, were used to estimate virtually the optimal quantitative ratios of the components of the protective media. The effectiveness of the designed environments was tested experimentally. Results. The protective properties of the obtained protective media using a balanced quantitative approach were increased for the reference strain by 2 times, for the EV76R16 strain by 1.5 times, and for Y. pestis EVA by 3 times as compared to the control SGT medium. Conclusion. The use of the mathematical experiment planning methods could adjust the quantitative composition of protective media for each of the 3 strains taken in the experiment, by reducing the time of the experiment and the material costs for the depreciation of the equipment used.

The outcomes of treatment for multidrug-resistant tuberculosis (MDR-TB) are significantly inferior to those in the absence of M. tuberculosis resistance. The presence of HIV infection further worsens the prognosis in these patients, including due to an increase in the frequency of adverse events (AEs) of therapy. Objective. To analyze the structure of AEs in the simultaneous treatment of MDR-TB and HIV infection and to study their possible relationship to antiretroviral drugs. Subjects and methods. Design: a retrospective cohort study. The investigators studied the medical records of patients over the age of 18 who had been registered for the Fourth TB chemotherapy regimen in Vladimir and the Vladimir Region in 2014-2016 and received antiretroviral therapy (ART) at the first stage of treatment. Results. AEs of varying severity were observed in 63.3% of patients. The most often recorded cases were gastrointestinal AES (18.1%); the little less often cases were hepatotoxic and myelotoxic AEs (11.1% each). Among the patients receiving antiretroviral therapy based on protease inhibitors; AEs were significantly more common than those in the group of individuals taking non-nucleoside reverse transcriptase inhibitors. Conclusion. AES during combination therapy for MDR-TB and HIV infection were found with high frequency. Further investigations are advisable to improve the algorithms for their monitoring and prevention.