No 1 (2017)

Objective. To carry out an epidemiological analysis of the incidence of pyoseptic infections (PSIs) in the hospitals of Nizhny Novgorod and its region. Materials and methods. The data available in the 2014-2015 governmental reports «On the sanitary and epidemic wellbeing of the population in the Nizhny Novgorod Region» were analyzed. Results. Nosocomial infections (NIs) were registered in 308 cases in the maternity hospitals of the Nizhny Novgorod Region; in 179 cases (including 95 neonatal PSI cases) in the children’s hospitals and departments, and in 413 cases in surgical hospitals and departments. The incidence rate of neonatal PSIs was 7.5 per 1,000 live births in the maternity hospitals and 5.0 per 1,000 live births in the obstetric departments. That of NIs was 12.0 per 1,000 live births. The proportion of bacteriologically confirmed neonatal PSIs was 95.5%. Conclusion. This study allows one to formulate some risk factors for hospital epidemic ill-being and, as a result, the emergence of PSI cases.

The analysis of the incidence of influenza in the Russian Federation over the last 20 years have shown that influenza immunization leads to substantially reduced morbidity rates, the prevention of complications, and lower death rates. The paper gives the results of monitoring the epidemiological situation of influenza in the 2015-2016 epidemic season and analyzes the efficiency of immunization with Russian vaccines against influenza in the population of the Russian Federation within the National Immunization Calendar in the 2015-2016 epidemic season. There was a low incidence rate (2.7% of cases) and the severe course of the disease was absent in the people vaccinated against influenza. Influenza-related deaths were mainly due to delayed care-seeking and concomitant chronic diseases in the victims. The Russian influenza vaccines «Grippol®», «Grippol®plus», «Savigripp®», and «Ultrix®» were found to be highly effective and safe.

Objective. To analyze the involvement of different social groups (by gender, age, and place of registration) in the spread of syphilis and gonorrhea at different stages of the epidemic. Materials and methods. Based on the statistical data available in the Irkutsk Region over 1988-2013, the investigators conducted a retrospective epidemiological study of the incidence of syphilis and gonorrhea in various social groups. The average incidence rates were compared at different stages of the epidemic cycle. Results. The incidence rates of syphilis and gonorrhea in the general population amounted to 232 and 292 per 100,000 population during in the epidemic rise (1993-1997), 125 and 155 in the decline phase (2005-2009), and 66 and 78 in 2013, respectively. Both infections were more often registered among women and the rural population in the rise phase. The highest incidence rates of syphilis and gonorrhea were recorded in the age group of 18-19 years in the rise phase and in the group of 20-29 years in the decline phase. Conclusion. The same generation born in the late 1970s to early 1980s participated most actively in the formation of risk groups at the beginning of the epidemic and during the period of declining incidence.

Based on the data available in the Russian and foreign literature over the last 10 years, the authors consider the role of herpesvirus infection as trigger and/or pathogenetic factors leading to the development of autoimmune processes, juvenile arthritis (JA) in particular. Herpesviruses are pantropic and widely distributed in the human population. The spectrum of the clinical manifestations of herpesvirus infection is very diverse in children: it depends on the localization of the pathological process, its extent, the patient’s immune system, and the antigenic type of the virus. According to the present-day concepts, JA is a heterogeneous group of chronic joint diseases with different etiopathogenesis and immunogenetic origin, nosology, and controversial prognosis. JA includes juvenile rheumatoid arthritis (juvenile idiopathic arthritis) and juvenile spondyloarthritis. The prevalence of JA in different countries ranges from 0.05 to 0.6% and its incidence does from 2 to 19 cases per 100,000 children under 16 years of age. The review discusses the influence of different endogenous and environmental factors on the development and progression of rheumatoid arthritis and the role of the genetically determined and secondary defects in immunoregulatory mechanisms, which lead to rapid transformation of an acute physiological inflammatory response to chronic progressive inflammation. It describes the current theories explaining the development of pathological autoimmune processes, such as the theory of genetic predisposition, the theory of immune dysregulation, the theory of network regulation, and the infection theory (including the relationship to the course of herpesvirus infection). The types of viral and bacterial infections and their impact on the development of severe clinical forms of JA are considered. The paper presents the modern concepts of pharmacotherapy for arthritis, juvenile idiopathic arthritis in particular. It describes the possible effects of biological agents on the reactivation of latent viral infections. Whether antiviral drugs can be used in children and should be administered in different stages and clinical types of JA is discussed.

The paper presents the results of a clinical trial comparing two first-line antiretroviral therapy (ART) regimens including combined drugs containing lamivudine and zidovudine. Objective. To compare the efficacy and safety of the brand-name drug combivir (AZT/3TC) and the generic drug dizaverox (AZT/3TC), by using the conventional comparison criteria. Subjects and methods. The investigation enrolled 61 patients: Group 1 included 32 patients receiving dizaverox (AZT/3TC); Group 2 consisted of 29 patients taking combivir (AZT/3TC). The groups were matched for age, sex, and clinical characteristics of HIV infection. All the patients had not previously received ART, had indications for therapy initiation; after the use of antiretroviral drugs they were followed up during 24 weeks. In this period, the investigators evaluated the clinical and immunological efficacy of the drugs and the severity of adverse events during their development. All the patients underwent a standard examination within the scheduled time and, if necessary, an additional in-depth examination. Results. With the comparable immunological efficacy of the drugs, the rate and amount of an increment in the number of CD4 lymphocytes were significantly higher in Group 1 than in Group 2 (230 and 144.5 cells/pl, respectively). At 24 weeks, the proportion of patients with suppressed HIV activity was also significantly higher in Groupl than in Group 2 (86.4% and 75%, respectively). In both groups, adverse events were recorded in 85% of the patients; anemia and hypercholesterolemia were most common; cytopenia, various gastrointestinal disorders, and hyperglycemia were encountered. The therapy was discontinued because of adverse reactions in 5 (15.6%) and 8 (27.6%) patients in Groups 1 and 2, respectively. Conclusion. The results of the study showed that the combined drugs taken for 24 weeks by HIV-infected patients who have not previously received ART have comparable clinical, immunological, and virological effects. At the same time, immunological and virological improvements occurred significantly faster and more substantially and adverse events developed less frequently in Group 1 patients.

In Russia, scientific medicine appeared and developed rapidly in the 18th century. Among the physicians who contributed to the development of Russian medicine, the disciples of Russian hospital schools, who vigorously fought the epidemics of plague, smallpox, and other epidemic diseases, played a great role. It was during this historical period when in Russia the teaching of contagionists came into contention in the struggle against the miasma theory. The study of their works written in the footsteps of controlling epidemic diseases gives every reason to believe that scientific epidemiology as an integral part of Russian scientific medicine began to take shape in the second half of the 18th century. As a historical argument in favor of the latter statement, the authors give an analysis of the events occurred 245 years ago during the 1770-1772 plague epidemic in Moscow.